The Gym For Your Mental Health
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Getting The Most Out Of Therapy
If you’ve never had therapy, what image do you have of it? Perhaps you imagine a bearded and bespectacled man in a suit, impassively making notes on a clipboard. Perhaps you imagine an empathetic woman, with tissues and camomile tea on standby.
The reality is: the experience of therapy can vary, a lot.
In its results, too! Sometimes we may try therapy and think “well that was a waste of time and money”. Sometimes we may try therapy and it’ll change our life.
So… Is there any way to make it less of a lottery?
First: knowledge is power
And while the therapist-client relationship certainly shouldn’t be a power struggle, you do want to be empowered.
So, read about different styles of therapy, and also, read some how-to guides for self-therapy. We’ve recommended some before in previous editions of 10almonds; you can check those books out here:
- How to Be Your Own Therapist: Boost your mood and reduce your anxiety in 10 minutes a day – by Owen O’Kane
- You Are the One You’ve Been Waiting For: Applying Internal Family Systems to Intimate Relationships – by Dr. Richard Schwartz
- DBT Made Simple: A Step-by-Step Guide to Dialectical Behavior Therapy – by Sheri van Dijk
- How to Do the Work: Recognize Your Patterns, Heal from Your Past, and Create Your Self – by Dr. Nicole LaPera
This will serve two purposes:
- You’ll know what to expect out of a therapist
- You can more efficiently “get to work” in therapy
It also, of course, could help you already, without even going to therapy!
Second: begin with the end in mind
A person who does not know what they want to get out of therapy, will likely not get much out of therapy. Or rather, their first task will be to figure that out. So, figure it out in advance, if you can.
Maybe you have a problem that has a specific name, for example poor self-esteem, anxiety, stress, depression, trauma, neuroticism, phobia, etc.
This isn’t Alcoholics Anonymous, and in this case you don’t want a lifetime of “Hello, my name is ______ and I have ______”, if you can help it.
So, what do you want?
- Maybe you want to be able to go to social events without feeling anxious
- Maybe you want your relationship(s) to be more secure and fulfilling
- Maybe you want to no longer have nightmares about that traumatic thing
- Maybe you want to be able to greet each day’s tasks with confidence and without overwhelm
…etc.
A good therapist will help you to set such goals (if you haven’t already), and attain them.
If you’re going the self-therapy route, then this is your job now!
It will probably start with the question: imagine that everything currently troubling you is now healed.
What would that look like, to you?
Third: get a good match for you
Unless you are going entirely the self-therapy route (which can work for some), you will want a therapist who’s a good match for you.
It may take a degree of “suck it and see” trial runs before you find the right one, but that takes time and money, so you’ll want to streamline the process as much as you can. If you do this well, you may be able to find a good therapist for you first time.
For this, personal recommendations (such as from friends) may help more than exmaining academic and institutional affiliations.
Yes, you want a well-qualified therapist who is a member in good standing of a respectable regulated body… but whether your therapist is easy for you to “get on with” will matter at least as much as whether their approach is psychodynamic, or 4th wave CBT, or IFS, or whatever seems popular in your time and place.
Bear in mind:
- Some therapists are specialized in helping with some kinds of things and not others. It will obviously help if the therapist you choose is specialized in the thing you are seeking help for.
- Some therapists may be able to relate to you better (or not), based on simple factors of who they are. To this end, while your therapist certainly doesn’t have to be a mirror image of you, factors like age, gender, race, etc can be relevant and may be worth considering, depending on what you are seeking help with, and what factors impact that thing.
Prefer keeping things to yourself?
Therapy isn’t for everyone, but having a good relationship with oneself definitely is. You might want to invest in one of the books whose reviews we linked above, and you might also get value from previous Psychology Sunday articles, which you can find in our archive (every seventh edition here has a Psychology Sunday main feature):
Click Here To Check Out The 10almonds Archive
To borrow the catchphrase of Dr. Kirk Honda (a therapist and therapy educator with decades of experience):
❝Take care of yourself, because you deserve it; you really, really do.❞
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Debate over tongue tie procedures in babies continues. Here’s why it can be beneficial for some infants
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There is increasing media interest about surgical procedures on new babies for tongue tie. Some hail it as a miracle cure, others view it as barbaric treatment, though adverse outcomes are rare.
Tongue tie occurs when the tissue under the tongue is attached to the lower gum or floor of the mouth in a way that can restrict the movement or range of the tongue. This can impact early breastfeeding in babies. It affects an estimated 8% of children under one year of age.
While there has been an increase in tongue tie releases (also called division or frenotomy), it’s important to keep this in perspective relative to the increase in breastfeeding rates.
The World Health Organization recommends exclusive breastfeeding for the first six months of life, with breastfeeding recommended into the second year of life and beyond for the health of mother and baby as well as optimal growth. Global rates of breastfeeding infants for the first six months have increased from 38% to 48% over the past decade. So, it is not surprising there is also an increase in the number of babies being referred globally with breastfeeding challenges and potential tongue tie.
An Australian study published in 2023 showed that despite a 25% increase in referrals for tongue tie division between 2014 and 2018, there was no increase in the number of tongue tie divisions performed. Tongue tie surgery rates increased in Australia in the decade from 2006 to 2016 (from 1.22 per 1,000 population to 6.35) for 0 to 4 year olds. There is no data on surgery rates in Australia over the last eight years.
Tongue tie division isn’t always appropriate but it can make a big difference to the babies who need it. More referrals doesn’t necessarily mean more procedures are performed.
chomplearn/Shutterstock How tongue tie can affect babies
When tongue tie (ankyloglossia) restricts the movement of the tongue, it can make it more difficult for a baby to latch onto the mother’s breast and painlessly breastfeed.
Earlier this month, the International Consortium of oral Ankylofrenula Professionals released a tongue tie position statement and practice guideline. Written by a range of health professionals, the guidelines define tongue tie as a functional diagnosis that can impact breastfeeding, eating, drinking and speech. The guidelines provide health professionals and families with information on the assessment and management of tongue tie.
Tongue tie release has been shown to improve latch during breastfeeding, reduce nipple pain and improve breast and bottle feeding. Early assessment and treatment are important to help mothers breastfeed for longer and address any potential functional problems.
The frenulum is a band of tissue under the tongue that is attached to the gumline base of the mouth. Akkalak Aiempradit/Shutterstock Where to get advice
If feeding isn’t going well, it may cause pain for the mother or there may be signs the baby isn’t attaching properly to the breast or not getting enough milk. Parents can seek skilled help and assessment from a certified lactation consultant or International Board-Certified Lactation Consultant who can be found via online registry.
Alternatively, a health professional with training and skills in tongue tie assessment and division can assist families. This may include a doctor, midwife, speech pathologist or dentist with extended skills, training and experience in treating babies with tongue tie.
When access to advice or treatment is delayed, it can lead to unnecessary supplementation with bottle feeds, early weaning from breastfeeding and increased parental anxiety.
Getting a tongue tie assessment
During assessment, a qualified health professional will collect a thorough case history, including pregnancy and birth details, do a structural and functional assessment, and conduct a comprehensive breastfeeding or feeding assessment.
They will view and thoroughly examine the mouth, including the tongue’s movement and lift. The appearance of where the tissue attaches to the underside of the tongue, the ability of the tongue to move and how the baby can suck also needs to be properly assessed.
Treatment decisions should focus on the concerns of the mother and baby and the impact of current feeding issues. Tongue tie division as a baby is not recommended for the sole purpose of avoiding speech problems in later life if there are no feeding concerns for the baby.
A properly qualified lactation consultant can help with positioning and attachment. HarryKiiM Stock/Shutterstock Treatment options
The Australian Dental Association’s 2020 guidelines provide a management pathway for babies diagnosed with tongue tie.
Once feeding issues are identified and if a tongue tie is diagnosed, non-surgical management to optimise positioning, latch and education for parents should be the first-line approach.
If feeding issues persist during follow-up assessment after non-surgical management, a tongue tie division may be considered. Tongue tie release may be one option to address functional challenges associated with breastfeeding problems in babies.
There are risks associated with any procedure, including tongue tie release, such as bleeding. These risks should be discussed with the treating practitioner before conducting any laser, scissor or scalpel tongue tie procedure.
Post-release support by a certified lactation consultant or feeding specialist is necessary after a tongue tie division. A post-release treatment plan should be developed by a team of health professionals including advice and support for breastfeeding to address both the mother and baby’s individual needs.
We would like to acknowledge the contribution of Raymond J. Tseng, DDS, PhD, (Paediatric Dentist) to the writing of this article.
Sharon Smart, Lecturer and Researcher (Speech Pathology) – School of Allied Health, Curtin University; David Todd, Associate Professor, Neonatology, ANU Medical School, Australian National University, and Monica J. Hogan, PhD student, ANU School of Medicine and Psychology, Australian National University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Unchaste Berry
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A Chasteberry, By Any Other Name…
Vitex agnus castus, literally “chaste lamb vine”, hence its modern common English name “chasteberry”, gets its name from its traditional use as an anaphrodisiac for monks (indeed, it’s also called “monk’s pepper”), which traditional use is not in the slightest backed up by modern science.
Nor is its second most popular traditional use (the increase in production of milk) well-supported by science either:
❝Its traditional use as a galactagogue (i.e., a substance that enhances breast milk production) is not well supported in the literature and should be discouraged. There are no clinical data to support the use of chasteberry for reducing sexual desire, which has been a traditional application❞
Source: American Family Physician | Chasteberry
Both of those supposed effects of the chasteberry go against the fact that it has a prolactin-lowering effect:
❝It appears that [chasteberry] may represent a potentially useful and safe phytotherapic option for the management of selected patients with mild hyperprolactinaemia who wish to be treated with phytotherapy.❞
Source: Vitex agnus castus effects on hyperprolactinaemia
Prolactin, by the way, is the hormone that (as the name suggests) stimulates milk production, and also reduces sexual desire (and motivation in general)
- In most women, it spikes during breastfeeding
- In most men, it spikes after orgasm
- In both, it can promote anhedonic depression, as it antagonizes dopamine
In other words, the actual pharmacological effect of chasteberry, when it comes to prolactin, is the opposite of what we would expect from its traditional use.
Ok, so it’s an unchaste berry after all…. Does it have any other claims to examine?
Yes! It genuinely does help relieve PMS, for those who have it, and reduce menopause symptoms, for those who have those, for example:
❝Dry extract of agnus castus fruit is an effective and well tolerated treatment for the relief of symptoms of the premenstrual syndrome.❞
❝That [Vitex agnus castus] trial indicated strong symptomatic relief of common menopausal symptoms❞
Source: Vitex agnus castus essential oil and menopausal balance: a research update
Is it safe?
Generally speaking, yes. It has been described as “well-tolerated” in the studies we mentioned above, which means it has a good safety profile.
However, it may interfere with some antipsychotic medications, certain kinds of hormone replacement therapy, or hormonal birth control.
As ever, speak with your doctor/pharmacist if unsure!
Where can I get some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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The Food Additive You Do Want
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Q: When Is A Fiber Not A Fiber?
A: when it’s a resistant starch. What’s it resistant to? Digestion. So, it functions as though a fiber, and by some systems, may get classified as such.
It’s a little like how sucralose is technically a sugar, but the body processes it like a fiber (but beware, because the sweetness of this disaccharide alone can trigger an insulin response anyway—dose dependent)
There may be other problems too:
But today’s not about sucralose, it’s about…
Guar gum’s surprising dietary role
You may have noticed “guar gum” on the list of ingredients of all kinds of things from baked goods to dairy products to condiments to confectionary and more.
It’s also used in cosmetics and explosives, but let’s not focus on that.
It’s used in food products as…
- a bulking agent
- a thickener
- a stabilizer
Our attention was caught by a new study, that found:
Resistant starch intake facilitates weight loss in humans by reshaping the gut microbiota
Often people think of “fiber helps weight loss” as “well yes, if you are bulking out your food with sawdust, you will eat less”, but it’s not that.
There’s an actual physiological process going on here!
We can’t digest it, but our gut microbiota can and will ferment it. See also:
Fiber against pounds: Resistant starch found to support weight loss
Beyond weight loss
Not everyone wants to lose weight, and even where weight loss is a goal, it’s usually not the only goal. As it turns out, adding guar gum into our diet does more things too:
Resistant starch supplement found to reduce liver triglycerides in people with fatty liver disease
(specifically, this was about NAFLD, non-alcoholic fatty liver disease)
Digging a little, it seems the benefits don’t stop there either:
Diet high in guar gum fiber limits inflammation and delays multiple sclerosis symptoms
(this one was a rodent study, but still, it’s promising and it’s consistent with what one would expect based on what else we know about its function in diet)
Should we just eat foods with guar gum in as an additive?
That depends on what they are, but watch out for the other additives if you do!
You can just buy guar gum by itself, by the way (here’s an example product on Amazon).
It’s doubtlessly no fun to take as a supplement (we haven’t tried this one), but it can be baked into bread, if baking’s your thing, or just used as a thickener in recipes where ordinarily you might use cornstarch or something else.
Can I get similar benefits from other foods?
The relevant quality is also present in resistant starches in general, so you might want to check out these foods, for example:
9 Foods That Are High in Resistant Starch
You can also check out ways to increase your fiber intake in general:
Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
Enjoy!
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Chromium Picolinate For Blood Sugar Control & Weight Loss
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First, a quick disambiguation:
- chromium found in food, trivalent chromium of various kinds, is safe (in the quantities usually consumed) and is sometimes considered an essential mineral, sometimes considered unnecessary but beneficial. It’s hard to know for sure, since it’s in a lot of foods (naturally, like many trace elements)
- chromium found in pollution, hexavalent chromium (so: twice as many cationic bonds, if this writer’s chemistry serves her correctly) is poisonous.
We’re going to be writing about the food kind, which is also possible to take as a supplement.
In this case, supplementing vs getting from food is quite a big difference, by the way, since (unlike for a lot of things, which are often the other way around) the bioavailability of chromium from food is very low (around 2.5%), whereas chromium picolinate, one of the most commonly-used supplement forms, boasts higher bioavailability.
Does it work for blood sugars?
Yes, it does! At least, it does in the case of people with type 2 diabetes. Rather than bombard you with many individual studies, here’s a systematic review and meta-analysis of 22 criteria-meeting randomized clinical trials that found:
❝The available evidence suggests favourable effects of chromium supplementation on glycaemic control in patients with diabetes.
Chromium monosupplement may additionally improve triglycerides and HDL-C levels.❞
Type 1 diabetes does not have anything like the same weight of evidence, and indeed,
we couldn’t find a single human study. It was beneficial for mice with artificially-induced T1D, thoughwait no, we have an update! We found literally a single human study:Chromium picolinate supplementation for diabetes mellitus
Literally, as in: it’s a case study of one person, and the results were a modest reduction in Hb A1c levels after 3 months of 600μg daily; the researchers concluded that ❝chromium picolinate continues to fall squarely within the scope of “alternative medicine,” with both unproven benefits and unknown risks❞.
As for people without diabetes, it may reduce the risk of diabetes:
Risk of Type 2 Diabetes Is Lower in US Adults Taking Chromium-Containing Supplements
However! This was an observational study, and correlation ≠ causation.
Furthermore, they said:
❝Over one-half the adult US population consumes nutritional supplements, and over one-quarter consumes supplemental chromium. The odds of having T2D were lower in those who, in the previous 30 d, had consumed supplements containing chromium❞
That “over one-quarter consumes supplemental chromium” brought our attention to the fact that this is not talking about specifically chromium “monosupplements” (definitely not quarter of the adult population take those), but rather, “multivitamin and mineral” supplements that also contain a tiny amount (often under 50μg) of chromium.
In other words, this ruins the data and honestly the benefit could have been from anything in the “multivitamin and mineral” supplement, or indeed, could just be “the kind of person who takes supplements is the kind of person who lives a lifestyle that is less conducive to becoming diabetic”.
Does it work for weight loss?
We’re running out of space here, so we’ll be brief:
No.
There are many papers that have concluded this, but here are two:
Chromium picolinate supplementation for overweight or obese adults
and
Is it safe?
Science’s current best answer is “we don’t know; it hasn’t been tested enough; we haven’t even established the tolerable upper limit, which is usually step 1 of establishing safety”.
Nor is there an estimated average requirement (if indeed there even is a requirement, which question is also not as yet answered conclusively by science), and science falls back to “here’s an average of what people consume in their diet, so that’s probably safe, we guess”.
(that average was reckoned as 25μg/day for young women and 25μg/day for young men, by the way; older ages not as yet reckoned)
You can read about this sorry state of affairs here.
Want to try some?
Notwithstanding the above lack of data for safety, it does have benefits for blood sugars, so if that’s a gamble you’re willing to make, then here’s an example product on Amazon.
Note: the dosage per capsule there (800μg) is half of the low end of the dose that was implicated in the serious kidney condition caused in this case study (1200–2400μg), so if you are going to try it, we strongly recommend not taking more than one per day.
Take care!
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Mediterranean Diet… In A Pill?
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Does It Come In A Pill?
For any as yet unfamiliar with the Mediterranean diet, you may be wondering what it involves, beyond a general expectation that it’s a diet popularly enjoyed in the Mediterranean. What image comes to mind?
We’re willing to bet that tomatoes feature (great source of lycopene, by the way, and if you’re not getting lycopene, you’re missing out), but what else?
- Salads, perhaps? Vegetables, olives? Olive oil, yea or nay?
- Bread? Pasta? Prosciutto, salami? Cheese?
- Pizza but only if it’s Romana style, not Chicago?
- Pan-seared liver, with some fava beans and a nice Chianti?
In fact, the Mediterranean diet is quite clear on all these questions, so to read about these and more (including a “this yes, that no” list), see:
What Is The Mediterranean Diet, And What Is It Good For?
So, how do we get that in a pill?
A plucky band of researchers, Dr. Chiara de Lucia et al. (quite a lot of “et al.”; nine listed authors on the study), wondered to what extent the benefits of the Mediterranean diet come from the fact that the Mediterranean diet is very rich in polyphenols, and set about testing that, by putting the same polyphenols in capsule form, and running a randomized, double-blind, placebo-controlled, crossover clinical intervention trial.
Now, polyphenols are not the only reason the Mediterranean diet is great; there are also other considerations, such as:
- a great macronutrient balance with lots of fiber, healthy fats, moderate carbs, and protein from select sources
- the absence or at least very low presence of a lot of harmful substances such as refined seed oils, added sugars, refined carbohydrates, and the like (“but pasta” yes pasta; in moderation and wholegrain and served with extra sources of fiber and healthy fats, all of which slow down the absorption of the carbs)
…but polyphenols are admittedly very important too; we wrote about some common aspects of them here:
Tasty Polyphenols: Enjoy Bitter Foods For Your Heart & Brain
As for what Dr. de Lucia et al. put into the capsule, behold…
The ingredients:
- Apple Extract 10.0%
- Pomegranate Extract 10.0%
- Tomato Powder 2.5%
- Beet, Spray Dried 2.5%
- Olive Extract 7.5%
- Rosemary Extract 7.5%
- Green Coffee Bean Extract (CA) 7.5%
- Kale, Freeze Dried 2.5%
- Onion Extract 10.0%
- Ginger Extract 10.0%
- Grapefruit Extract 2.5%
- Carrot, Air Dried 2.5%
- Grape Skin Extract 17.5%
- Blueberry Extract 2.5%
- Currant, Freeze Dried 2.5%
- Elderberry, Freeze Dried 2.5%
And the relevant phytochemicals they contain:
- Quercetin
- Luteolin
- Catechins
- Punicalagins
- Phloretin
- Ellagic Acid
- Naringin
- Apigenin
- Isorhamnetin
- Chlorogenic Acids
- Rosmarinic Acid
- Anthocyanins
- Kaempferol
- Proanthocyanidins
- Myricetin
- Betanin
And what, you may wonder, did they find? Well, first let’s briefly summarise the setup of the study:
They took volunteers (n=30), average age 67, BMI >25, without serious health complaints, not taking other supplements, not vegetarian or vegan, not consuming >5 cups of coffee per day, and various other stipulations like that, to create a fairly homogenous study group who were expected to respond well to the intervention. In contrast, someone who takes antioxidant supplements, already eats many different color plants per day, and drinks 10 cups of coffee, probably already has a lot of antioxidant activity going on, and someone with a lower BMI will generally have lower resting levels of inflammatory markers, so it’s harder to see a change, proportionally.
About those inflammatory markers: that’s what they were testing, to see whether the intervention “worked”; essentially, did the levels of inflammatory markers go up or down (up is bad; down is good).
For more on inflammation, by the way, see:
How to Prevent (or Reduce) Inflammation
…which also explains what it actually is, and some important nuances about it.
Back to the study…
They gave half the participants the supplement for a week and the other half placebo; had a week’s gap as a “washout”, then repeated it, switching the groups, taking blood samples before and after each stage.
What they found:
The group taking the supplement had lower inflammatory markers after a week of taking it, while the group taking the placebo had relatively higher inflammatory markers after a week of taking it; this trend was preserved across both groups (i.e., when they switched roles for the second half).
The results were very significant (p=0.01 or thereabouts), and yet at the same time, quite modest (i.e. the supplement made a very reliable, very small difference), probably because of the small dose (150mg) and small intervention period (1 week).
What the researchers concluded from this
The researchers concluded that this was a success; the study had been primarily to provide proof of principle, not to rock the world. Now they want the experiment to be repeated with larger sample sizes, greater heterogeneity, larger doses, and longer intervention periods.
This is all very reasonable and good science.
What we conclude from this
That ingredients list makes for a good shopping list!
Well, not the extracts they listed, necessarily, but rather those actual fruits, vegetables, etc.
If nine top scientists (anti-aging specialists, neurobiologists, pharmacologists, and at least one professor of applied statistics) came to the conclusion that to get the absolute most bang-for-buck possible, those are the plants to get the phytochemicals from, then we’re not going to ignore that.
So, take another list above and ask yourself: how many of those 16 foods do you eat regularly, and could you work the others in?
Want to make your Mediterranean diet even better?
While the Mediterranean diet is a top-tier catch-all, it can be tweaked for specific areas of health, for example giving it an extra focus on heart health, or brain health, or being anti-inflammatory, or being especially gut healthy:
Four Ways To Upgrade The Mediterranean
Enjoy!
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Dyslexia Test
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(and it’s mostly not about reading/writing!)
More than just shuffled letters
This video provides a self-test based on the Bangor Dyslexia Test (BDT). The BDT is 94% accurate in identifying dyslexia, and it includes 9 parts, with a mix of questions and tasks. Answering “yes” or struggling with tasks indicates possible dyslexia. Collecting 4+ indicators suggests dyslexia, but of course is not a replacement for official diagnosis.
It’s best to watch the video if you can, but here’s what to expect:
- Left-Right confusion: point your left hand to your right/left shoulder.
- Family history: any family members with dyslexia or struggles with reading/writing?
- Repeating numbers (order): repeat a given sequence of numbers in order.
- Letter confusion (e.g. b/d): do you confuse letters like “b” and “d” beyond age 8?
- Times tables: recite the 6, 7, and 8 times tables.
- Word manipulation: replace the letters in a word to create a new word, e.g. change “slide” (s ⇾ g) to “glide.”
- Repeating numbers (reversed): repeat a given sequence of numbers in reverse order.
- Months in reverse: recite the months of the year in reverse order.
- Subtraction: do you struggle with subtraction, e.g. 44-9 or 55-12?
Writer’s anecdote: I am not dyslexic, and/but I have an impressive level of dyscalculia (the purely numerical equivalent), to the point I’ll sometimes use a calculator to do single-digit calculations, and I am so bad at calculating ages or other differences between dates (I will have to count on my fingers or else run the severe risk of out-by-one errors). I have also been known to make mistakes counting down from 10, which really ruins dramatic tension.
In contrast, the left-right thing is interesting, because when I was first learning Arabic, I had no trouble reading/writing right-to-left, but I initially struggled so much to remember which way the “backspace” key would take me (in Arabic the backspace key backspaces to the right, despite still pointing to the left).
Anyway, for the test itself, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Reading, Better (Reading As A Cognitive Exercise)
Take care!
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