Complex PTSD – by Pete Walker

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We’ve written before about Complex PTSD, but there’s a lot more to be said than we can fit into an article or two.

Pete Walker, a licensed marriage and family therapist, does an excellent job and pulls no punches, starting from the book’s dedication and carrying the hard-hitting seriousness all the way through to the Appendices.

To this end, it absolutely may not be an easy book to read at times (emotionally speaking), especially if you have C-PTSD. On the other hand, you may also find it a very validating 300-odd pages of “Yes, he is telling my life story in words, now this makes sense!”

That said, it’s mostly not an anecdotes-based book and nor is it just a feelsy ride; it’s also a textbook and a how-to manual. It’s a textbook of how and why things come about the way they do, and a manual of how to effectively manage C-PTSD, and find peace. There’s no silver bullet here, but there is a very comprehensive guide, and chapters full of tools to use (and no, not the same CBT things you’ve probably read a hundred times, this is C-PTSD-specific stuff).

Bottom line: this is the C-PTSD book; if you buy only one book on the topic, make it this one.

Click here to check out Complex PTSD: From Surviving To Thriving, and indeed thrive!

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  • What’s Your Personal Life Expectancy?
    This test predicts your life expectancy based on global statistics. It generates a clock to show your life-seconds ticking away. Curious under-45s mostly use this service.

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  • Yoga Safety: Simple Guidelines

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I was wondering whether there were very simple, clear bullet points or instructions on things to be wary of in Yoga.❞

    That’s quite a large topic, and not one that lends itself well to being conveyed in bullet points, but first we’ll share the article you sent us when sending this question:

    Tips for Avoiding Yoga Injuries

    …and next we’ll recommend the YouTube channel @livinleggings, whose videos we feature here from time to time. She (Liv) has a lot of good videos on problems/mistakes/injuries to avoid.

    Here’s a great one to get you started:

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  • Hate salad or veggies? Just keep eating them. Here’s how our tastebuds adapt to what we eat

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    Do you hate salad? It’s OK if you do, there are plenty of foods in the world, and lots of different ways to prepare them.

    But given almost all of us don’t eat enough vegetables, even though most of us (81%) know eating more vegetables is a simple way to improve our health, you might want to try.

    If this idea makes you miserable, fear not, with time and a little effort you can make friends with salad.

    Why don’t I like salads?

    It’s an unfortunate quirk of evolution that vegetables are so good for us but they aren’t all immediately tasty to all of us. We have evolved to enjoy the sweet or umami (savoury) taste of higher energy foods, because starvation is a more immediate risk than long-term health.

    Vegetables aren’t particularly high energy but they are jam-packed with dietary fibre, vitamins and minerals, and health-promoting compounds called bioactives.

    Those bioactives are part of the reason vegetables taste bitter. Plant bioactives, also called phytonutrients, are made by plants to protect themselves against environmental stress and predators. The very things that make plant foods bitter, are the things that make them good for us.

    Unfortunately, bitter taste evolved to protect us from poisons, and possibly from over-eating one single plant food. So in a way, plant foods can taste like poison.

    For some of us, this bitter sensing is particularly acute, and for others it isn’t so bad. This is partly due to our genes. Humans have at least 25 different receptors that detect bitterness, and we each have our own genetic combinations. So some people really, really taste some bitter compounds while others can barely detect them.

    This means we don’t all have the same starting point when it comes to interacting with salads and veggies. So be patient with yourself. But the steps toward learning to like salads and veggies are the same regardless of your starting point.

    It takes time

    We can train our tastes because our genes and our receptors aren’t the end of the story. Repeat exposures to bitter foods can help us adapt over time. Repeat exposures help our brain learn that bitter vegetables aren’t posions.

    And as we change what we eat, the enzymes and other proteins in our saliva change too. This changes how different compounds in food are broken down and detected by our taste buds. How exactly this works isn’t clear, but it’s similar to other behavioural cognitive training.

    Add masking ingredients

    The good news is we can use lots of great strategies to mask the bitterness of vegetables, and this positively reinforces our taste training.

    Salt and fat can reduce the perception of bitterness, so adding seasoning and dressing can help make salads taste better instantly. You are probably thinking, “but don’t we need to reduce our salt and fat intake?” – yes, but you will get more nutritional bang-for-buck by reducing those in discretionary foods like cakes, biscuits, chips and desserts, not by trying to avoid them with your vegetables.

    Adding heat with chillies or pepper can also help by acting as a decoy to the bitterness. Adding fruits to salads adds sweetness and juiciness, this can help improve the overall flavour and texture balance, increasing enjoyment.

    Pairing foods you are learning to like with foods you already like can also help.

    The options for salads are almost endless, if you don’t like the standard garden salad you were raised on, that’s OK, keep experimenting.

    Experimenting with texture (for example chopping vegetables smaller or chunkier) can also help in finding your salad loves.

    Challenge your biases

    Challenging your biases can also help the salad situation. A phenomenon called the “unhealthy-tasty intuition” makes us assume tasty foods aren’t good for us, and that healthy foods will taste bad. Shaking that assumption off can help you enjoy your vegetables more.

    When researchers labelled vegetables with taste-focused labels, priming subjects for an enjoyable taste, they were more likely to enjoy them compared to when they were told how healthy they were.

    The bottom line

    Vegetables are good for us, but we need to be patient and kind with ourselves when we start trying to eat more.

    Try working with biology and brain, and not against them.

    And hold back from judging yourself or other people if they don’t like the salads you do. We are all on a different point of our taste-training journey.The Conversation

    Emma Beckett, Senior Lecturer (Food Science and Human Nutrition), School of Environmental and Life Sciences, University of Newcastle

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Knitting helps Tom Daley switch off. Its mental health benefits are not just for Olympians

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    Olympian Tom Daley is the most decorated diver in Britain’s history. He is also an avid knitter. At the Paris 2024 Olympics Daley added a fifth medal to his collection – and caught the world’s attention knitting a bright blue “Paris 24” jumper while travelling to the games and in the stands.

    At the Tokyo Olympics, where Daley was first spotted knitting, he explained its positive impact on his mental health.

    It just turned into my mindfulness, my meditation, my calm and my way to escape the stresses of everyday life and, in particular, going to an Olympics.

    The mental health benefits of knitting are well established. So why is someone famous like Daley knitting in public still so surprising?

    Africa Voice/Shutterstock

    Knitting is gendered

    Knitting is usually associated with women – especially older women – as a hobby done at home. In a large international survey of knitting, 99% of respondents identified as female.

    But the history of yarn crafts and gender is more tangled. In Europe in the middle ages, knitting guilds were exclusive and reserved for men. They were part of a respected Europe-wide trade addressing a demand for knitted products that could not be satisfied by domestic workers alone.

    The industrial revolution made the production of clothed goods cheaper and faster than hand-knitting. Knitting and other needle crafts became a leisure activity for women, done in the private sphere of the home.

    World Wars I and II turned the spotlight back on knitting as a “patriotic duty”, but it was still largely taken up by women.

    During COVID lockdowns, knitting saw another resurgence. But knitting still most often makes headlines when men – especially famous men like Daley or actor Ryan Gosling – do it.

    Men who knit are often seen as subverting the stereotype it’s an activity for older women.

    Knitting the stress away

    Knitting can produce a sense of pride and accomplishment. But for an elite sportsperson like Daley – whose accomplishments already include four gold medals and one silver – its benefits lie elsewhere.

    Olympics-level sport relies on perfect scores and world records. When it comes to knitting, many of the mental health benefits are associated with the process, rather than the end result.

    Daley says knitting is the “one thing” that allows him to switch off completely, describing it as “my therapy”. https://www.youtube.com/embed/6wwXGOki–c?wmode=transparent&start=0

    The Olympian says he could

    knit for hours on end, honestly. There’s something that’s so satisfying to me about just having that rhythm and that little “click-clack” of the knitting needles. There is not a day that goes by where I don’t knit.

    Knitting can create a “flow” state through rhythmic, repetitive movements of the yarn and needle. Flow offers us a balance between challenge, accessibility and a sense of control.

    It’s been shown to have benefits relieving stress in high-pressure jobs beyond elite sport. Among surgeons, knitting has been found to improve wellbeing as well as manual dexterity, crucial to their role.

    For other health professionals – including oncology nurses and mental health workers – knitting has helped to reduce “compassion fatigue” and burnout. Participants described the soothing noise of their knitting needles. They developed and strengthened team bonds through collective knitting practices. https://www.youtube.com/embed/dTTJjD_q2Ik?wmode=transparent&start=0 A Swiss psychiatrist says for those with trauma, knitting yarn can be like “knitting the two halves” of the brain “back together”.

    Another study showed knitting in primary school may boost children’s executive function. That includes the ability to pay attention, remember relevant details and block out distractions.

    As a regular creative practice, it has also been used in the treatment of grief, depression and subduing intrusive thoughts, as well countering chronic pain and cognitive decline.

    Knitting is a community

    The evidence for the benefits of knitting is often based on self-reporting. These studies tend to produce consistent results and involve large population samples.

    This may point to another benefit of knitting: its social aspect.

    Knitting and other yarn crafts can be done alone, and usually require simple materials. But they also provide a chance to socialise by bringing people together around a common interest, which can help reduce loneliness.

    The free needle craft database and social network Ravelry contains more than one million patterns, contributed by users. “Yarn bombing” projects aim to engage the community and beautify public places by covering objects such as benches and stop signs with wool.

    The interest in Daley’s knitting online videos have formed a community of their own.

    In them he shows the process of making the jumper, not just the finished product. That includes where he “went wrong” and had to unwind his work.

    His pride in the finished product – a little bit wonky, but “made with love” – can be a refreshing antidote to the flawless achievements often on display at the Olympics.

    Michelle O’Shea, Senior Lecturer, School of Business, Western Sydney University and Gabrielle Weidemann, Associate Professor in Psychological Science, Western Sydney University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • What happens to your vagina as you age?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The vagina is an internal organ with a complex ecosystem, influenced by circulating hormone levels which change during the menstrual cycle, pregnancy, breastfeeding and menopause.

    Around and after menopause, there are normal changes in the growth and function of vaginal cells, as well as the vagina’s microbiome (groups of bacteria living in the vagina). Many women won’t notice these changes. They don’t usually cause symptoms or concern, but if they do, symptoms can usually be managed.

    Here’s what happens to your vagina as you age, whether you notice or not.

    Let’s clear up the terminology

    We’re focusing on the vagina, the muscular tube that goes from the external genitalia (the vulva), past the cervix, to the womb (uterus). Sometimes the word “vagina” is used to include the external genitalia. However, these are different organs and play different roles in women’s health.

    What happens to the vagina as you age?

    Like many other organs in the body, the vagina is sensitive to female sex steroid hormones (hormones) that change around puberty, pregnancy and menopause.

    Menopause is associated with a drop in circulating oestrogen concentrations and the hormone progesterone is no longer produced. The changes in hormones affect the vagina and its ecosystem. Effects may include:

    • less vaginal secretions, potentially leading to dryness
    • less growth of vagina surface cells resulting in a thinned lining
    • alteration to the support structure (connective tissue) around the vagina leading to less elasticity and more narrowing
    • fewer blood vessels around the vagina, which may explain less blood flow after menopause
    • a shift in the type and balance of bacteria, which can change vaginal acidity, from more acidic to more alkaline.

    What symptoms can I expect?

    Many women do not notice any bothersome vaginal changes as they age. There’s also little evidence many of these changes cause vaginal symptoms. For example, there is no direct evidence these changes cause vaginal infection or bleeding in menopausal women.

    Some women notice vaginal dryness after menopause, which may be linked to less vaginal secretions. This may lead to pain and discomfort during sex. But it’s not clear how much of this dryness is due to menopause, as younger women also commonly report it. In one study, 47% of sexually active postmenopausal women reported vaginal dryness, as did around 20% of premenopausal women.

    Other organs close to the vagina, such as the bladder and urethra, are also affected by the change in hormone levels after menopause. Some women experience recurrent urinary tract infections, which may cause pain (including pain to the side of the body) and irritation. So their symptoms are in fact not coming from the vagina itself but relate to changes in the urinary tract.

    Not everyone has the same experience

    Women vary in whether they notice vaginal changes and whether they are bothered by these to the same extent. For example, women with vaginal dryness who are not sexually active may not notice the change in vaginal secretions after menopause. However, some women notice severe dryness that affects their daily function and activities.

    In fact, researchers globally are taking more notice of women’s experiences of menopause to inform future research. This includes prioritising symptoms that matter to women the most, such as vaginal dryness, discomfort, irritation and pain during sex.

    If symptoms bother you

    Symptoms such as dryness, irritation, or pain during sex can usually be effectively managed. Lubricants may reduce pain during sex. Vaginal moisturisers may reduce dryness. Both are available over-the-counter at your local pharmacy.

    While there are many small clinical trials of individual products, these studies lack the power to demonstrate if they are really effective in improving vaginal symptoms.

    In contrast, there is robust evidence that vaginal oestrogen is effective in treating vaginal dryness and reducing pain during sex. It also reduces your chance of recurrent urinary tract infections. You can talk to your doctor about a prescription.

    Vaginal oestrogen is usually inserted using an applicator, two to three times a week. Very little is absorbed into the blood stream, it is generally safe but longer-term trials are required to confirm safety in long-term use beyond a year.

    Women with a history of breast cancer should see their oncologist to discuss using oestrogen as it may not be suitable for them.

    Are there other treatments?

    New treatments for vaginal dryness are under investigation. One avenue relates to our growing understanding of how the vaginal microbiome adapts and modifies around changes in circulating and local concentrations of hormones.

    For example, a small number of reports show that combining vaginal probiotics with low-dose vaginal oestrogen can improve vaginal symptoms. But more evidence is needed before this is recommended.

    Where to from here?

    The normal ageing process, as well as menopause, both affect the vagina as we age.

    Most women do not have troublesome vaginal symptoms during and after menopause, but for some, these may cause discomfort or distress.

    While hormonal treatments such as vaginal oestrogen are available, there is a pressing need for more non-hormonal treatments.

    Dr Sianan Healy, from Women’s Health Victoria, contributed to this article.

    Louie Ye, Clinical Fellow, Department of Obstetrics and Gynecology, The University of Melbourne and Martha Hickey, Professor of Obstetrics and Gynaecology, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    The Conversation

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  • When A Period Is Very Late (Post-Menopause)

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    Knowledge Is Power Safety, Post-Menopause Too

    Note: this article will be most relevant for a subset of our subscribership, but it’s a very large subset, so we’re going to go ahead and address the reader as “you”.

    If, for example, you are a man and this doesn’t apply to you, we hope it will interest you anyway (we imagine there are women in your life).

    PS: the appendicitis check near the end, works for anyone with an appendix

    We’ve talked before about things that come with (and continue after) menopause:

    But what’s going on if certain menstrual symptoms reappear post-menopause (e.g. after more than a year with no menstruation)?

    Bleeding

    You should not, of course, be experiencing vaginal bleeding post-menopause. You may have seen “PSA” style posts floating around social media warning that this is a sign of cancer. And, it can be!

    But it’s probably not.

    Endometrial cancer (the kind that causes such bleeding) affects 2–3% of women, and of those reporting post-menopausal bleeding, the cause is endometrial cancer only 9% of those times.

    So in other words, it’s not to be ignored, but for 9 people out of 10 it won’t be cancer:

    Read more: Harvard Health | Postmenopausal bleeding: Don’t worry—but do call your doctor

    Other more likely causes are uterine fibroids or polyps. These are unpleasant but benign, and can be corrected with surgery if necessary.

    The most common cause, however is endometrial and/or vaginal atrophy resulting in tears and bleeding.

    Tip: Menopausal HRT will often correct this.

    Read more: The significance of “atrophic endometrium” in women with postmenopausal bleeding

    (“atrophic endometrium” and “endometrial atrophy” are the same thing)

    In summary: no need to panic, but do get it checked out at your earliest convenience. This is not one where we should go “oh that’s weird” and ignore.

    Cramps

    If you are on menopausal HRT, there is a good chance that these are just period cramps. They may feel different than they did before, because you didn’t ovulate and thus you’re not shedding a uterine lining now, but your body is going to do its best to follow the instructions given by the hormones anyway (hormones are just chemical messengers, after all).

    If it is just this, then they will probably settle down to a monthly cycle and become quite predictable.

    Tip: if it’s the above, then normal advice for period cramps will go here. We recommend ginger! It’s been found to be as effective as Novafen (a combination drug of acetaminophen (Tylenol), caffeine, and ibuprofen), in the task of relieving menstrual pain:

    See: Effect of Ginger and Novafen on menstrual pain: A cross-over trial

    It could also be endometriosis. Normally this affects those of childbearing age, but once again, exogenous hormones (as in menopausal HRT) can fool the body into doing it.

    If you are not on menopausal HRT (or sometimes even if you are), uterine fibroids (as discussed previously) are once again a fair candidate, and endometriosis is also still possible, though less likely.

    Special last note

    Important self-check: if you are experiencing a sharp pain in that general area and are worrying if it is appendicitis (also a possibility), then pressing on the appropriately named McBurney’s point is a first-line test for appendicitis. If, after pressing, it hurts a lot more upon removal of pressure (rather than upon application of pressure), this is considered a likely sign of appendicitis. Get thee to a hospital, quickly.

    And if it doesn’t? Still get it checked out at your earliest convenience, of course (better safe than sorry), but you might make an appointment instead of calling an ambulance.

    Take care!

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  • The No-Nonsense Meditation Book – by Dr. Steven Laureys

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    We’ve reviewed books about meditation before, and when we review books, we try to pick ones that have something that make them stand out from the others. So, what stands out in this case?

    The author is a medical doctor and neurologist, with decades of experience focusing on neuronal plasticity and multimodel neural imaging. So, a little beyond “think happy thoughts”-style woo.

    The style of the book is pop-science in tone, but with a lot of hard clinical science underpinning it and referenced throughout, as one would expect of a scientist of Dr. Laurey’s stature (with hundreds of peer-reviewed papers in top-level journals).

    You may be wondering: is this a “how-to” book or a “why-to” book or a “what-happens” book? It’s all three.

    The “how-to” is also, as the title suggests, no-nonsense. We are talking maximum results for minimum mystery here.

    Bottom line: if you’d like to be able to take up a meditative practice and know exactly what it’s doing to your brain (quietening these parts, stimulating and physically growing those parts, etc) then this is the book for you.

    Click here to check out The No-Nonsense Meditation Book, and re-light the less glowy bits of your brain!

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