Loss, Trauma, and Resilience – by Dr. Pauline Boss

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Most books about bereavement are focused on grieving healthily and then moving on healthily. And, while it may be said “everyone’s grief is on their own timescale”… society’s expectation is often quite fixed:

“Time will heal”, they say.

But what if it doesn’t? What happens when that’s not possible?

Ambiguous loss occurs when someone is on the one hand “gone”, but on the other hand, not necessarily.

This can be:

  • Someone was lost in a way that didn’t leave a body to 100% confirm it
    • (e.g. disaster, terrorism, war, murder, missing persons)
  • Someone remains physically present but in some ways already “gone”
    • (e.g. Alzheimer’s disease or other dementia, brain injury, coma)

These things stop us continuing as normal, and/but also stop us from moving on as normal.

When either kind of moving forward is made impossible, everything gets frozen in place. How does one deal with that?

Dr. Boss wrote this book for therapists, but its content is equally useful for anyone struggling with ambiguous loss—or who has a loved one who is, in turn, struggling with that.

The book looks at the impact of ambiguous loss on continuing life, and how to navigate that:

  • How to be resilient, in the sense of when life tries to break you, to have ways to bend instead.
  • How to live with the cognitive dissonance of a loved one who is a sort of “Schrödinger’s person”.
  • How, and this is sometimes the biggest one, to manage ambiguous loss in a society that often pushes toward: “it’s been x period of time, come on, get over it now, back to normal”

Will this book heal your heart and resolve your grief? No, it won’t. But what it can do is give a roadmap for nonetheless thriving in life, while gently holding onto whatever we need to along the way.

Click here to check out “Ambiguous loss, Trauma, and Resilience” on Amazon—it can really help

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    Delve into the CBT Workbook for Mental Health for effective, practical solutions to stress, anxiety, and more—your go-to for high-impact self-improvement tactics.

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  • Is Cutting Calories The Key To Healthy Long Life?

    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.

    Caloric Restriction with Optimal Nutrition

    Yesterday, we asked you “What is your opinion of caloric restriction as a health practice?” and got the above-depicted, below-described spread of responses:

    • 48% said “It is a robust, scientifically proven way to live longer and healthier”
    • 23% said “It may help us to live longer, but at the cost of enjoying it fully”
    • 17% said “It’s a dangerous fad that makes people weak, tired, sick, and unhealthy”
    • 12% said “Counting calories is irrelevant to good health; the body compensates”

    So… What does the science say?

    A note on terms, first

    “Caloric restriction” (henceforth: CR), as a term, sees scientific use to mean anything from a 25% reduction to a 50% reduction, compared to metabolic base rate.

    This can also be expressed the other way around, “dropping to 60% of the metabolic base rate” (i.e., a 40% reduction).

    Here we don’t have the space to go into much depth, so our policy will be: if research papers consider it CR, then so will we.

    A quick spoiler, first

    The above statements about CR are all to at least some degree True in one way or another.

    However, there are very important distinctions, so let’s press on…

    CR is a robust, scientifically proven way to live longer and healthier: True or False?

    True! This has been well-studied and well-documented. There’s more science for this than we could possibly list here, but here’s a good starting point:

    ❝Calorie restriction (CR), a nutritional intervention of reduced energy intake but with adequate nutrition, has been shown to extend healthspan and lifespan in rodent and primate models.

    Accumulating data from observational and randomized clinical trials indicate that CR in humans results in some of the same metabolic and molecular adaptations that have been shown to improve health and retard the accumulation of molecular damage in animal models of longevity.

    In particular, moderate CR in humans ameliorates multiple metabolic and hormonal factors that are implicated in the pathogenesis of type 2 diabetes, cardiovascular diseases, and cancer, the leading causes of morbidity, disability and mortality❞

    Source: Ageing Research Reviews | Calorie restriction in humans: an update

    See also: Caloric restriction in humans reveals immunometabolic regulators of health span

    We could devote a whole article (or a whole book, really) to this, but the super-short version is that it lowers the metabolic “tax” on the body and allows the body to function better for longer.

    CR may help us to live longer, but at the cost of enjoying it fully: True or False?

    True or False, contingently, depending on what’s important to you. And that depends on psychology as much as physiology, but it’s worth noting that there is often a selection bias in the research papers; people ill-suited to CR drop out of the studies and are not counted in the final data.

    Also, relevant for a lot of our readers, most (human-based) studies recruit people over 18 and under 60. So while it is reasonable to assume the same benefits will be carried over that age, there is not nearly as much data for it.

    Studies into CR and Health-Related Quality of Life (HRQoL) have been promising, and/but have caveats:

    ❝In non-obese adults, CR had some positive effects and no negative effects on HRQoL.❞

    Source: Effect of Calorie Restriction on Mood, Quality of Life, Sleep, and Sexual Function in Healthy Non-obese Adults

    ❝We do not know what degree of CR is needed to achieve improvements in HRQoL, but we do know it requires an extraordinary amount of support.

    Therefore, the incentive to offer this intervention to a low-risk, normal or overweight individual is lacking and likely not sustainable in practice.❞

    Source: Caloric restriction improves health-related quality of life in healthy normal weight and overweight individuals

    CR a dangerous fad that makes people weak, tired, sick, and unhealthy: True or False?

    True if it is undertaken improperly, and/or without sufficient support. Many people will try CR and forget that the idea is to reduce metabolic load while still getting good nutrition, and focus solely on the calorie-counting.

    So for example, if a person “saves” their calories for the day to have a night out in a bar where they drink their calories as alcohol, then this is going to be abysmal for their health.

    That’s an extreme example, but lesser versions are seen a lot. If you save your calories for a pizza instead of a night of alcoholic drinks, then it’s not quite so woeful, but for example the nutrition-to-calorie ratio of pizza is typically not great. Multiply that by doing it as often as not, and yes, someone’s health is going to be in ruins quite soon.

    Counting calories is irrelevant to good health; the body compensates: True or False?

    True if by “good health” you mean weight loss—which is rarely, if ever, what we mean by “good health” here at 10almonds (unless we clarify such), but it’s a very common association and indeed, for some people it’s a health goal. You cannot sustainably and healthily lose weight by CR alone, especially if you’re not getting optimal nutrition.

    Your body will notice that you are starving, and try to save you by storing as much fat as it can, amongst other measures that will similarly backfire (cortisol running high, energy running low, etc).

    For short term weight loss though, yes, it’ll work. At a cost. That we don’t recommend.

    ❝By itself, decreasing calorie intake will have a limited short-term influence.❞

    Source: Reducing Calorie Intake May Not Help You Lose Body Weight

    See also…

    ❝Caloric restriction is a commonly recommended weight-loss method, yet it may result in short-term weight loss and subsequent weight regain, known as “weight cycling”, which has recently been shown to be associated with both poor sleep and worse cardiovascular health❞

    Source: Dieting Behavior Characterized by Caloric Restriction

    In summary…

    Caloric restriction is a well-studied area of health science. We know:

    • Practised well, it can extend not only lifespan, but also healthspan
    • Practised well, it can improve mood, energy, sexual function, and the other things people fear losing
    • Practised badly, it can be ruinous to the health—it is critical to practise caloric restriction with optimal nutrition.
    • Practised badly, it can lead to unhealthy weight loss and weight regain

    One final note…

    If you’ve tried CR and hated it, and you practised it well (e.g., with optimal nutrition), then we recommend just not doing it.

    You could also try intermittent fasting instead, for similar potential benefits. If that doesn’t work out either, then don’t do that either!

    Sometimes, we’re just weird. It can often be because of a genetic or epigenetic quirk. There are usually workarounds, and/but not everything that’s right for most people will be right for all of us.

    Take care!

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  • How To Escape From A Despairing Mood

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    When we are in a despairing mood, that’s when it can feel hardest to actually implement anything we know about getting out of one. That’s why sometimes, the simplest solutions are the best:

    Imagination Is Key

    Despairing moods occur when it’s hard to envision a better life. Imagination is the power to envision alternatives, such as new jobs, relationships, or lifestyle, but sadness can cloud our ability to imagine solutions like changing careers, moving house, or starting fresh. With enough imagination, most problems can be worked around—and new opportunities can always be found.

    Importantly: we are not bound by our past or present circumstances; we have the freedom and flexibility to choose new paths. That doesn’t mean it’ll always be a walk in the park, but “this too shall pass”.

    You may be thinking: “sometimes the hardship does pass, but can last many years”, and that is true. All the more reason to check if there’s a freer lane you can slip into to speed ahead. Even if there isn’t, the mere act of imagining such lanes is already respite from the hardships—and having envisioned such will make it much easier for you to recognise when opportunities for change do come along.

    To foster imagination, we are advised to expose ourselves to different narratives, preparing ourselves for alternative ways of living. Thus, we can reframe life’s challenges as intellectual puzzles, urging us to rebuild creatively and find new solutions!

    For more on all this, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Behavioral Activation Against Depression & Anxiety

    Take care!

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  • How to Eat to Change How You Drink – by Dr. Brooke Scheller

    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.

    Whether you want to stop drinking or just cut down, this book can help. But what makes it different from the other reduce/stop drinking books we’ve reviewed?

    Mostly, it’s about nutrition. This book focuses on the way that alcohol changes our relationship to food, our gut, our blood sugars, and more. The author also explains how reducing/stopping drinking, without bearing these things in mind, can be unnecessarily extra hard.

    The remedy? To bear them in mind, of course, but that requires knowing them. So what she does is explain the physiology of what’s going on in terms of each of the above things (and more), and how to adjust your diet to make up for what alcohol has been doing to you, so that you can reduce/quit without feeling constantly terrible.

    The style is very pop-science, light in tone, readable. She makes reference to a lot of hard science, but doesn’t discuss it in more depth than is necessary to convey the useful information. So, this is a practical book, aimed at all people who want to reduce/quit drinking.

    Bottom line: if you feel like it’s hard to drink less because it feels like something is missing, it’s probably because indeed something is missing, and this book can help you bridge that gap!

    Click here to check out How To Eat To Change How You Drink, and do just that!

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Related Posts

  • Mocktails – by Moira Clark
  • Move – by Caroline Williams

    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.

    • Get 150 minutes of moderate exercise per week, says the American Heart Association
    • There are over 10,000 minutes per week, says the pocket calculator

    Is 150/10,000 really the goal here? Really?

    For Caroline Williams, the answer is no.

    In this book that’s practically a manifesto, she outlines the case that:

    • Humans evolved to move
    • Industrialization and capitalism scuppered that
    • We now spend far too long each day without movement

    Furthermore, for Williams this isn’t just an anthropological observation, it’s a problem to be solved, because:

    • Our lack of movement is crippling us—literally
    • Our stagnation affects not just our bodies, but also our minds
      • (again literally—there’s a direct correlation with mental health)
    • We urgently need to fix this

    So, what now, do we need to move in to the gym and become full-time athletes to clock up enough hours of movement? No.

    Williams convincingly argues the case (using data from supercentenarian “blue zones” around the world) that even non-exertive movement is sufficient. In other words, you don’t have to be running; walking is great. You don’t have to be lifting weights; doing the housework or gardening will suffice.

    From that foundational axiom, she calls on us to find ways to build our life around movement… rather than production-efficiency and/or convenience. She gives plenty of tips for such too!

    Bottom line: some books are “I couldn’t put it down!” books. This one’s more of a “I got the urge to get up and get moving!” book.

    Get your get-up-and-go up and going with “Move”—order yours from Amazon today!

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  • What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon

    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.

    There are books aplenty to encourage and help you to lose weight. This isn’t one of those.

    There are also books aplenty to encourage and help you to accept yourself and your body at the weight you are, and forge self-esteem. This isn’t one of those, either—in fact, it starts by assuming you already have that.

    There are fair arguments for body neutrality, and fat acceptance. Very worthy also is the constant fight for bodily sovereignty.

    These are worthy causes, but they’re for the most-part not what our author concerns herself with here. Instead, she cares for a different and very practical goal: fat justice.

    In a world where you may be turned away from medical treatment if you are over a certain size, told to lose half your bodyweight before you can have something you need, she demands better. The battle extends further than healthcare though, and indeed to all areas of life.

    Ultimately, she argues, any society that will disregard the needs of the few because they’re a marginal demographic, is a society that will absolutely fail you if you ever differ from the norm in some way.

    All in all, an important (and for many, perhaps eye-opening) book to read if you are fat, care about fat people, are a person of any size, or care about people in general.

    Pick Up Your Copy of “What We Don’t Talk About When We Talk About Fat”, on Amazon Today!

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  • Can you drink your fruit and vegetables? How does juice compare to the whole food?

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    Do you struggle to eat your fruits and vegetables? You are not alone. Less than 5% of Australians eat the recommended serves of fresh produce each day (with 44% eating enough fruit but only 6% eating the recommended vegetables).

    Adults should aim to eat at least five serves of vegetables (or roughly 375 grams) and two serves of fruit (about 300 grams) each day. Fruits and vegetables help keep us healthy because they have lots of nutrients (vitamins, minerals and fibre) and health-promoting bioactive compounds (substances not technically essential but which have health benefits) without having many calories.

    So, if you are having trouble eating the rainbow, you might be wondering – is it OK to drink your fruits and vegetables instead in a juice or smoothie? Like everything in nutrition, the answer is all about context.

    Darina Belonogova/Pexels

    It might help overcome barriers

    Common reasons for not eating enough fruits and vegetables are preferences, habits, perishability, cost, availability, time and poor cooking skills. Drinking your fruits and vegetables in juices or smoothies can help overcome some of these barriers.

    Juicing or blending can help disguise tastes you don’t like, like bitterness in vegetables. And it can blitz imperfections such as bruises or soft spots. Preparation doesn’t take much skill or time, particularly if you just have to pour store-bought juice from the bottle. Treating for food safety and shipping time does change the make up of juices slightly, but unsweetened juices still remain significant sources of nutrients and beneficial bioactives.

    Juicing can extend shelf life and reduce the cost of nutrients. In fact, when researchers looked at the density of nutrients relative to the costs of common foods, fruit juice was the top performer.

    So, drinking my fruits and veggies counts as a serve, right?

    How juice is positioned in healthy eating recommendations is a bit confusing. The Australian Dietary Guidelines include 100% fruit juice with fruit but vegetable juice isn’t mentioned. This is likely because vegetable juices weren’t as common in 2013 when the guidelines were last revised.

    The guidelines also warn against having juice too often or in too high amounts. This appears to be based on the logic that juice is similar, but not quite as good as, whole fruit. Juice has lower levels of fibre compared to fruits, with fibre important for gut health, heart health and promoting feelings of fullness. Juice and smoothies also release the sugar from the fruit’s other structures, making them “free”. The World Health Organization recommends we limit free sugars for good health.

    But fruit and vegetables are more than just the sum of their parts. When we take a “reductionist” approach to nutrition, foods and drinks are judged based on assumptions made about limited features such as sugar content or specific vitamins.

    But these features might not have the impact we logically assume because of the complexity of foods and people. When humans eat varied and complex diets, we don’t necessarily need to be concerned that some foods are lower in fibre than others. Juice can retain the nutrients and bioactive compounds of fruit and vegetables and even add more because parts of the fruit we don’t normally eat, like the skin, can be included.

    blender and glass of orange juice
    Juicing or blending might mean you eat different parts of the fruit or vegetable. flyingv3/Shutterstock

    So, it is healthy then?

    A recent umbrella review of meta-analyses (a type of research that combines data from multiple studies of multiple outcomes into one paper looked at the relationship between 100% juice and a range of health outcomes.

    Most of the evidence showed juice had a neutral impact on health (meaning no impact) or a positive one. Pure 100% juice was linked to improved heart health and inflammatory markers and wasn’t clearly linked to weight gain, multiple cancer types or metabolic markers (such as blood sugar levels).

    Some health risks linked to drinking juice were reported: death from heart disease, prostate cancer and diabetes risk. But the risks were all reported in observational studies, where researchers look at data from groups of people collected over time. These are not controlled and do not record consumption in the moment. So other drinks people think of as 100% fruit juice (such as sugar-sweetened juices or cordials) might accidentally be counted as 100% fruit juice. These types of studies are not good at showing the direct causes of illness or death.

    What about my teeth?

    The common belief juice damages teeth might not stack up. Studies that show juice damages teeth often lump 100% juice in with sweetened drinks. Or they use model systems like fake mouths that don’t match how people drinks juice in real life. Some use extreme scenarios like sipping on large volumes of drink frequently over long periods of time.

    Juice is acidic and does contain sugars, but it is possible proper oral hygiene, including rinsing, cleaning and using straws can mitigate these risks.

    Again, reducing juice to its acid level misses the rest of the story, including the nutrients and bioactives contained in juice that are beneficial to oral health.

    groups of women outside drinking orange juice in cups
    Juice might be more convenient and could replace less healthy drinks. PintoArt/Shutterstock

    So, what should I do?

    Comparing whole fruit (a food) to juice (a drink) can be problematic. They serve different culinary purposes, so aren’t really interchangeable.

    The Australian Guide to Healthy Eating recommends water as the preferred beverage but this assumes you are getting all your essential nutrients from eating.

    Where juice fits in your diet depends on what you are eating and what other drinks it is replacing. Juice might replace water in the context of a “perfect” diet. Or juice might replace alcohol or sugary soft drinks and make the relative benefits look very different.

    On balance

    Whether you want to eat your fruits and vegetables or drink them comes down to what works for you, how it fits into the context of your diet and your life.

    Smoothies and juices aren’t a silver bullet, and there is no evidence they work as a “cleanse” or detox. But, with society’s low levels of fruit and vegetable eating, having the option to access nutrients and bioactives in a cheap, easy and tasty way shouldn’t be discouraged either.

    Emma Beckett, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation – School of Health Sciences, UNSW Sydney

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

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