How to Prepare for Your First Therapy Session
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Everyone (who ever has therapy, anyway) has a first therapy session. So, how to make best use of that, and get things going most effectively? Dr. Tori Olds has advice:
Things to prepare
Questions that you should consider, and prepare answers to beforehand, include:
- Why are you here? Not in any deep philosophical sense, but, what brought you to therapy?
- What would you like to focus on? Chances are, you are paying a hefty hourly rate—so having considered this will allow you to get your money’s worth.
- How will you know when you’ve met your goal? Note that this is really two questions in one, because first you need to identify your goal, and then you need to expand on it. If you woke up tomorrow and all your psychological problems were solved, how would you know? What would be different? What does it look like?
If you have a little time between now and your first session, journaling can help a lot.
Remember also that a first therapy session can also be like a mutual interview, to decide whether it’s a good match. Not every therapist is good at their job, and not every therapist will be good for you specifically. Sometimes, a therapist may be a mismatch through no fault of their own. Considering what those reasons might be can also be a good thing to think about in advance, to help find the best therapist for you in fewer tries!
For most on these ideas, enjoy:
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You might also like to read:
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All In Your Head (Which Is Where It’s Supposed To Be)
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Today’s news is all about things above the neck, and mostly in the brain. From beating depression to beating cognitive decline, from mindfulness against pain to dentistry nightmares to avoid:
Transcranial ultrasound stimulation
Transcranial magnetic stimulation is one of those treatments that sounds like it’s out of a 1950s sci-fi novel, and yet, it actually works (it’s very well-evidenced against treatment-resistant depression, amongst other things). However, a weakness of it is that it’s difficult to target precisely, making modulation of most neurological disorders impossible. Using ultrasound instead of a magnetic field allows for much more finesse, with very promising initial results across a range of neurological disorders
Read in full: Transcranial ultrasound stimulation: a new frontier in non-invasive brain therapy
Related: Antidepressants: Personalization Is Key!
This may cause more pain and damage, but at least it’s more expensive too…
While socialized healthcare systems sometimes run into the problem of not wanting to spend money where it actually is needed, private healthcare systems have the opposite problem: there’s a profit incentive to upsell to more expensive treatments. Here’s how that’s played out in dentistry:
Read in full: Dentists are pulling healthy and treatable teeth to profit from implants, experts warn
Related: Tooth Remineralization: How To Heal Your Teeth Naturally
Mindfulness vs placebo, for pain
It can be difficult with some “alternative therapies” to test against placebo, for example “and control group B will merely believe that they are being pierced with needles”, etc. However, in this case, mindfulness meditation was tested as an analgesic vs sham meditation (just deep breathing) and also vs placebo analgesic cream, vs distraction (listening to an audiobook). Mindfulness meditation beat all of the other things:
Read in full: Mindfulness meditation outperforms placebo in reducing pain
Related: No-Frills, Evidence-Based Mindfulness
Getting personal with AI doctors
One of the common reasons that people reject AI doctors is the “lack of a human touch”. However, human and AI doctors may be meeting in the middle nowadays, as humans are pressed to see more patients in less time, and AI is trained to be more personal—not just a friendlier affect, but also, such things as remembering the patient’s previous encounters (again, something with which overworked human doctors sometimes struggle). This makes a big difference to patient satisfaction:
Read in full: Personalization key to patient satisfaction with AI doctors
Related: AI: The Doctor That Never Tires?
Combination brain therapy against cognitive decline
This study found that out of various combinations trialled, the best intervention against cognitive decline was a combination of 1) cognitive remediation (therapeutic interventions designed to improve cognitive functioning, like puzzles and logic problems), and 2) transcranial direct current stimulation (tDCS), a form of non-invasive direct brain stimulation, similar to the magnetic or ultrasound methods we mentioned earlier today. Here’s how it worked:
Read in full: Study reveals effective combination therapy to slow cognitive decline in older adults
Related: How To Reduce Your Alzheimer’s Risk
Take care!
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What Happens To Your Body When You Stop Drinking Alcohol
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Immediately after we stop drinking is rarely when we feel our best. But how long is it before we can expect to see benefits, instead of just suffering?
Timeline
After stopping drinking alcohol for…
- Seconds: the liver starts making progress filtering out toxins and sugars; ethanol starts to leave the system
- 1 hour: fatigue sets in as the body uses a lot of energy to metabolize and eliminate alcohol. However, sleep quality (if one goes to sleep now) is low because alcohol disrupts the brain patterns required for restful sleep
- 6–12 hours: the immune system starts recovering from the suppression caused by alcohol
- 24 hours: immune system is back to normal; withdrawal symptoms may occur in the case of heavy drinkers
- 3–5 days: resting blood pressure begins to drop, as stress levels decrease (alcohol may seem anxiolytic, but it is actually anxiogenic; it just masks its own effect in this regard). Also, because of insulin responses improving, appetite reduces. The liver, once it has finished dealing your last drinking session (if you used to drink all the time, it probably had a backlog to clear), can now begin to make repairs on itself.
- 1 week: skin will start looking better, as antidiuretic hormone levels neutralize, leading to a healthier maintenance of hydration
- 2 weeks: cognitive abilities improve as the brain begins to make progress in repairing itself. At the same time, kidneys start to heal.
- 3–4 weeks: the liver begins to regenerate in earnest. You may wonder what took it so long given the liver’s famous regenerative abilities, but in this case, the liver was also the organ that took the most damage from drinking, so its regeneration gets off to a slow start (in contrast, if the liver had “merely” suffered physical trauma, such as being shot, stabbed,
or eaten by eagles,it’d start regenerating vigorously as soon as the immediate wound-response had been tended to). Once it is able to pick up the pace though, overall health improves, as the liver can focus on breaking down other toxins. - 1–2 months: the heart is able to repair itself, and start to become stronger again (dependent on other lifestyle factors, of course).
- 3 months and more: bodily repairs continue (for example, the damage to the liver is often so severe that it can take quite a bit longer to recover completely, and repairs in the brain are always slow, for reasons beyond the scope of this article). Looking at the big picture, at this point we also see other benefits, such as reduced cancer risks.
In short… It’s never too soon to stop, but it’s also never too late, unless you are going to die in the next few days. So long as you’ll be in the land of the living for a few days yet, there’s time to enjoy the benefits of stopping.
Most importantly: the timeline for the most important repairs is not as long as many people might think, and that itself can be very motivating.
For more detail on much of the above, enjoy:
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Want to learn more?
You might also like to read:
- Can We Drink To Good Health?
- How To Reduce Or Quit Alcohol
- Addiction Myths That Are Hard To Quit
- How To Unfatty A Fatty Liver
Take care!
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The Sucralose News: Scaremongering Or Serious?
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What’s the news on sucralose?
These past days the press has been abuzz with frightening tales:
- This Common Artificial Sweetener Can Break Down DNA, Scientists Warn
- Sucralose Damages DNA, Linked to Leaky Gut
- Chemical found in common sweetener damages DNA
- Chemical found in widely used sweetener breaks up DNA
- Chemical from Splenda breaks up DNA
How true and/or serious is this?
Firstly, let’s manage expectations. Pineapple juice also breaks down DNA, but is not generally considered a health risk. So let’s keep that in mind, while we look into the science.
Is sucralose as scary as pineapple juice, or is it something actually dangerous?
The new study (that sparked off these headlines)
The much-referenced study is publicly available to read in full—here it is:
You may notice that this doesn’t have quite the snappy punchiness of some of the headlines, but let’s break this down, if you’ll pardon the turn of phrase:
- Toxicological: pertaining to whether or not it has toxic qualities
- Pharmacokinetic: the science of asking, of chemicals in bodies, “where did it come from; where did it go; what could it do there; what can we know?”
- Sucralose-6-acetate: an impurity that can be found in sucralose. For perspective, the study found that the sucralose in Splenda contained “up to” 0.67% sucralose-6-acetate.
- Sucralose: a modified form of sucrose, that makes it hundreds of times sweeter, and non-caloric because the body cannot break it down so it’s treated as a dietary fiber and just passes through
- In vitro: things are happening in petri dishes, not in animals (human or otherwise), which would be called “in vivo”
- Screening assays: “we set up a very closed-parameters chemical test, to see what happens when we add this to this” ⇽ oversimplification, but this is the basic format of a screening assay
Great, now we understand the title, but what about the study?
Researchers looked primarily at the effects of sucralose-6-acetate and sucralose (together and separately) on epithelial cells (these are very simple cells that are easy to study; conveniently, they are also most of what makes up our intestinal walls). For this, they used a fancy way of replicating human intestinal walls, that’s actually quite fascinating but beyond the scope of today’s newsletter. Suffice it to say: it’s quite good, and/but has its limitations too. They also looked at some in vivo rat studies.
What they found was…
Based on samples from the rat feces (somehow this didn’t make it into the headlines), it appears that sucralose may be acetylated in the intestines. What that means is that we, if we are like the rats (definitely not a given, but a reasonable hypothesis), might convert up to 10% of sucralose into sucralose-6-acetate inside us. Iff we do, the next part of the findings become more serious.
Based on the in vitro simulations, both sucralose and sucralose-6-acetate reduced intestinal barrier integrity at least a little, but sucralose-6-acetate was the kicker when it came to most of the effects—at least, so we (reasonably!) suppose.
Basically, there’s a lot of supposition going on here but the suppositions are reasonable. That’s how science works; there’s usually little we can know for sure from a single study; it’s when more studies roll in that we start to get a more complete picture.
What was sucralose-6-acetate found to do? It increased the expression of genes associated with inflammation, oxidative stress, and cancer (granted those three things generally go together). So that’s a “this probably has this end result” supposition.
More concretely, and which most of the headlines latched onto, it was found (in vitro) to induce cytogenic damage, specifically, of the clastogenic variety (produces DNA strand breaks—so this is different than pineapple’s bromelain and DNA-helicase’s relatively harmless unzipping of genes).
The dose makes the poison
So, how much is too much and is that 0.67% something to worry about?
- Remembering the rat study, it may be more like 10% once our intestines have done their thing. Iff we’re like rats.
- But, even if it’s only 0.67%, this will still be above the “threshold of toxicological concern for genotoxicity”, of 0.15µg/person/day.
- On the other hand, the fact that these were in vitro studies is a serious limitation.
- Sometimes something is very dangerous in vitro, because it’s being put directly onto cells, whereas in vivo we may have mechanisms for dealing with that.
We won’t know for sure until we get in vivo studies in human subjects, and that may not happen any time soon, if ever, depending on the technical limitations and ethical considerations that sometimes preclude doing certain studies in humans.
Bottom line:
- The headlines are written to be scary, but aren’t wrong; their claims are fundamentally true
- What that means for us as actual humans may not be the same, however; we don’t know yet
- For now, it is probably reasonable to avoid sucralose just in case
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The Blood Sugar Solution – by Dr. Mark Hyman
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The main purpose of this book is combating metabolic disease, the amalgam of what’s often prediabetes (sometimes fully-fledged diabetes) and cardiovascular disease (sometimes fully-fledged heart disease).
To achieve this (after an introductory section explaining what the sociomedical problems are and why the sociomedical problems are happening), he offers a seven-step program; we’ll not keep those steps a mystery; they are:
- Boost your nutrition
- Regulate your hormones
- Reduce inflammation
- Improve your digestion
- Maximize detoxification
- Enhance energy metabolism
- Soothe your mind
Thereafter, it’s all about leading the reader by the hand through the steps; he also offers a six-week action plan, and a six-week meal plan with recipes.
The style is very sensationalist (too sensationalist for this reviewer’s personal taste) but nevertheless backed up with hard science when it comes to hard claims. So, if you don’t mind wading through (or skipping) some early chapters that are a bit “used car salesman” in feel, there’s actually a lot of good information, especially in the middle of the book, and useful practical guides in the middle and end.
Bottom line: if you want a good comprehensive science-based practical guide to addressing the risk of metabolic disease, this is that.
Click here to check out The Blood Sugar Solution, and look after yours!
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Half Of Americans Over 50 Have Hemorrhoids, But They Can Be Prevented!
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝Hello. I was hoping you could give some useful tips about how to avoid a painful ailment that has affected Ernest Hemingway, Karl Marx, David Livingstone, Napoleon, Marilyn Monroe, King Alfred, and Martin Luther, and, I confess, me from time to time … namely, hemorrhoids. Help!❞
Firstly: that list could be a lot longer! We don’t have global stats, but in the US for example, half of adults over 50 have hemorrhoids.
So, you’re certainly not alone. People just don’t talk about it.
But, there are preventative things you can do:
Fiber, fiber, fiber. See also:
Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
Hydrate, hydrate, hydrate.
This one’s simple enough. If you are dehydrated, constipation is more likely, and with it, hemorrhoids.
Watch your meds…
Some medications can cause constipation—painkillers containing codeine are a common culprit, for example.
When you go, go!
Not only can prolonged straining promote hemorrhoids, but also (if you’ll pardon the phrasing—there’s only so delicately we can say this) simply sitting with things partway “open” down there is not good for its health; things can quickly become irritated, and that can lead to hemorrhoids.
So: when you go, go. Leave your phone in another room!
Wash—but carefully.
Beyond your normal showering/bathing routine, a bidet is a great option for keeping things happy down there, if you have that option available to you.
However, if you have hemorrhoids, don’t use soap, as this can cause irritation and make it worse.
Warm water is fine, as is a salt bath, and pat dry and/or use gentle wet-wipes rather than rougher paper.
You can follow up with a hemorrhoid cream of your choice (or hydrocortisone, unless that’s contraindicated by another condition you have)
Know when to seek help
Hemorrhoids will usually go away by themselves if not exacerbated. But if it’s getting unduly difficult, and/or you’re bleeding down there, it’s time to see a doctor.
Note on bleeding: even if you’re 100% sure you have hemorrhoids, there are still other reasons you could be bleeding, and so it needs checking out.
Hemorrhoid treatment, if needed, will vary depending on severity. Beyond creams and lotions, there are other options that are less fun but sometimes necessary, including injections, electrotherapy, banding, or surgery.
Take care!
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The Philosophy Gym – by Dr. Stephen Law
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If you’d like to give those “little gray cells” an extra workout, this book is a great starting place.
Dr. Stephen Law is Director of Philosophy at the Department of Continuing Education, University of Oxford. As such, he’s no stranger to providing education that’s both attainable and yet challenging. Here, he lays out important philosophical questions, and challenges the reader to get to grips with them in a systematic fashion.
Each of the 25 questions/problems has a chapter devoted to it, and is ranked:
- Warm-up
- Moderate
- More Challenging
But, he doesn’t leave us to our own devices, nor does he do like a caricature of a philosopher and ask us endless rhetorical questions. Instead, he looks at various approaches taken by other philosophers over time, and invites the reader to try out those methods.
The real gain of this book is not the mere enjoyment of reading, but rather in taking those thinking skills and applying them in life… because most if not all of them do have real-world applications and/or implications too.
The book’s strongest point? That it doesn’t assume prior knowledge (and yet also doesn’t patronize the reader). Philosophy can be difficult to dip one’s toes into without a guide, because philosophers writing about philosophy can at first be like finding yourself at a party where you know nobody, but they all know each other.
In contrast, Law excels at giving quick, to-the-point ground-up summaries of key ideas and their progenitors.
In short: a wonderful way to get your brain doing things it might not have tried before!
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