PTSD, But, Well…. Complex.

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PTSD is typically associated with military veterans, for example, or sexual assault survivors. There was a clear, indisputable, Bad Thing™ that was experienced, and it left a psychological scar. When something happens to remind us of that—say, there are fireworks, or somebody touches us a certain way—it’ll trigger an immediate strong response of some kind.

These days the word “triggered” has been popularly misappropriated to mean any adverse emotional reaction, often to something trivial.

But, not all trauma is so clear. If PTSD refers to the result of that one time you were smashed with a sledgehammer, C-PTSD (Complex PTSD) refers to the result of having been hit with a rolled-up newspaper every few days for fifteen years, say.

This might have been…

  • childhood emotional neglect
  • a parent with a hair-trigger temper
  • bullying at school
  • extended financial hardship as a young adult
  • “just” being told or shown all too often that your best was never good enough
  • the persistent threat (real or imagined) of doom of some kind
  • the often-reinforced idea that you might lose everything at any moment

If you’re reading this list and thinking “that’s just life though”, you might be in the estimated 1 in 5 people with (often undiagnosed) C-PTSD.

How About You? Take The (5mins) Test Here

Now, we at 10almonds are not doctors or therapists and even if we were, we certainly wouldn’t try to diagnose from afar. But, even if there’s only a partial match, sometimes the same advice can help.

So what are the symptoms of C-PTSD?

  • A feeling that nothing is safe; we might suddenly lose what we have gained
  • The body keeps the score… And it shows. We may have trouble relaxing, an aversion to exercise for reasons that don’t really add up, or an aversion to being touched.
  • Trouble sleeping, born of nagging sense that to sleep is to be vulnerable to attack, and/or lazy, and/or negligent of our duties
  • Poor self-image, about our body and/or about ourself as a person.
  • We’re often drawn to highly unavailable people—or we are the highly unavailable person to which our complementary C-PTSD sufferers are attracted.
  • We are prone to feelings of rage. Whether we keep a calm lid on it or lose our temper, we know it’s there. We’re angry at the world and at ourselves.
  • We are not quick to trust—we may go through the motions of showing trust, but we’re already half-expecting that trust to have been misplaced.
  • “Hell is other people” has become such a rule of life that we may tend to cloister ourselves away from company.
  • We may try to order our environment around us as a matter of safety, and be easily perturbed by sudden changes being imposed on us, even if ostensibly quite minor or harmless.
  • In a bid to try to find safety, we may throw ourselves into work—whatever that is for us. It could be literally our job, or passion projects, or our family, or community, and in and of itself that’s great! But the motivation is more of an attempt to distract ourselves from The Horrors™.

“Alright, I scored more of those than I care to admit. What now?”

A lot of the answer lies in first acknowledging to yourself what happened, to make you feel the way you do now. If you, for example, have an abject hatred of Christmas, what were your childhood Christmases like? If you fear losing money that you’ve accumulated, what underpins that fear? It could be something that directly happened to you, but it also could just be repeated messages you received from your parents, for example.

It could even be that you had superficially an idyllic perfect childhood. Health, wealth, security, a loving family… and simply a chemical imbalance in your brain made it a special kind of Hell for you that nobody understood, and perhaps you didn’t either.

Unfortunately, a difficult task now lies ahead: giving love, understanding, compassion, and reassurance to the person for whom you may have the most contempt in the world: yourself.

If you’d like some help with that, here are some resources:

ComplexTrauma.org (a lot of very good free resources, with no need for interaction)

CPTSD Foundation (mostly paid courses and the like)

Some final words about healing…

  • You are in fact amazing,
  • You can do it, and
  • You deserve it.

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Recommended

  • Self-Compassion In A Relationship (Positives & Pitfalls)
  • Metabolical – by Dr. Robert Lustig
    Peeling back the layers of diet myths, this book serves as a detailed roadmap to healthier living, focusing on nurturing your liver and gut for disease prevention.

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  • The Inflammation Spectrum – by Dr. Will Cole

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    We’ve previously reviewed Dr. Cole’s other book “Gut Feelings”, and now he’s back, this time to tackle inflammation.

    The focus here is on understanding what things trigger inflammation in your body—personally yours, not someone else’s—by something close to the usual elimination process yes, but he offers a way of sliding into it gently instead of simply quitting all the things and gradually adding everything back in.

    The next step he takes the reader through is eating not just to avoid triggering inflammation, but to actively combat it. From there, it should be possible for the reader to build an anti-inflammatory cookbook, that’s not only one’s own personal repertoire of cooking, but also specifically tailored to one’s own personal responses to different ingredients.

    The style of this book is very pop-science, helpful, walking-the-reader-by-the-hand through the processes involved. Dr. Cole wants to make everything as easy as possible.

    Bottom line: if your diet could use an anti-inflammatory revamp, this is a top-tier guidebook for doing just that.

    Click here to check out The Inflammation Spectrum, find your food triggers and reset your system!

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  • Gut Health 2.0

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    Gene Expression & Gut Health

    Dr. Tim Spector, a renowned expert in Gut Health 2.0, offers valuable insights and expertise on the latest advancements in improving gut health and overall well-being. With years of research and

    This is Dr. Tim Spector. After training in medicine and becoming a consultant rheumatologist, he’s turned his attention to medical research, and is these days a specialist in twin studies, genetics, epigenetics, microbiome, and diet.

    What does he want us to know?

    For one thing: epigenetics are for more than just getting your grandparents’ trauma.

    More usefully: there are things we can do to improve epigenetic factors in our body

    DNA is often seen as the script by which our body does whatever it’s going to do, but it’s only part of the story. Thinking of DNA as some kind of “magical immutable law of reality” overlooks (to labor the metaphor) script revisions, notes made in the margins, directorial choices, and ad-lib improvizations, as well as the quality of the audience’s hearing and comprehension.

    Hence the premise of one of Dr. Spector’s older books, “Identically Different: Why We Can Change Our Genes

    (*in fact, it was his first, from all the way back in 2013, when he’d only been a doctor for 34 years)

    Gene expression will trump genes every time, and gene expression is something that can often be changed without getting in there with CRISPR / a big pair of scissors and some craft glue.

    How this happens on the micro level is beyond the scope of today’s article; part of it has to do with enzymes that get involved in the DNA transcription process, and those enzymes in turn are despatched or not depending on hormonal messaging—in the broadest sense of “hormonal”; all the body’s hormonal chemical messengers, not just the ones people think of as hormones.

    However, hormonal messaging (of many kinds) is strongly influenced by something we can control relatively easily with a little good (science-based) knowledge: the gut.

    The gut, the SAD, and the easy

    In broad strokes: we know what is good for the gut. We’ve written about it before at 10almonds:

    Making Friends With Your Gut (You Can Thank Us Later)

    This is very much in contrast with what in scientific literature is often abbreviated “SAD”, the Standard American Diet, which is very bad for the gut.

    However, Dr. Spector (while fully encouraging everyone to enjoy an evidence-based gut-healthy diet) wanted to do one better than just a sweeping one-size-fits-all advice, so he set up a big study with 15,000 identical twins; you can read about it here: TwinsUK

    The information that came out of that was about a lot more than just gene expression and gut health, but it did provide the foundation for Dr. Spector’s next project, ZOE.

    ZOE crowdsources huge amounts of data including individual metabolic responses to standardized meals in order to predict personalized food responses based on individual biology and unique microbiome profile.

    In other words, it takes the guesswork out of a) knowing what your genes mean for your food responses b) tailoring your food choices with your genetic expression in mind, and c) ultimately creating a positive feedback loop to much better health on all levels.

    Now, this is not an ad for ZOE, but if you so wish, you can…

    Want to know more?

    Dr. Spector has a bunch of books out, including some that we’ve reviewed previously:

    You can also check out our own previous main feature, which wasn’t about Dr. Spector’s work but was very adjacent:

    The Brain-Gut Highway: A Two-Way Street

    Enjoy!

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  • Long-acting contraceptives seem to be as safe as the pill when it comes to cancer risk

    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.

    Many women worry hormonal contraceptives have dangerous side-effects including increased cancer risk. But this perception is often out of proportion with the actual risks.

    So, what does the research actually say about cancer risk for contraceptive users?

    And is your cancer risk different if, instead of the pill, you use long-acting reversible contraceptives? These include intrauterine devices or IUDs (such as Mirena), implants under the skin (such as Implanon), and injections (such as Depo Provera).

    Our new study, conducted by the University of Queensland and QIMR Berghofer Medical Research Institute and published by the Journal of the National Cancer Institute, looked at this question.

    We found long-acting contraceptives seem to be as safe as the pill when it comes to cancer risk (which is good news) but not necessarily any safer than the pill.

    Peakstock/Shutterstock
    A woman gets a hormonal birth control product implant
    Some hormonal contraceptives take the form of implants under the skin. WiP-Studio/Shutterstock

    How does the contraceptive pill affect cancer risk?

    The International Agency for Research on Cancer, which compiles evidence on cancer causes, has concluded that oral contraceptives have mixed effects on cancer risk.

    Using the oral contraceptive pill:

    • slightly increases your risk of breast and cervical cancer in the short term, but
    • substantially reduces your risk of cancers of the uterus and ovaries in the longer term.

    Our earlier work showed the pill was responsible for preventing far more cancers overall than it contributed to.

    In previous research we estimated that in 2010, oral contraceptive pill use prevented over 1,300 cases of endometrial and ovarian cancers in Australian women.

    It also prevented almost 500 deaths from these cancers in 2013. This is a reduction of around 25% in the deaths that could have occurred that year if women hadn’t taken the pill.

    In contrast, we calculated the pill may have contributed to around 15 deaths from breast cancer in 2013, which is less than 0.5% of all breast cancer deaths in that year.

    A woman pops contraceptive pills from a pill pack.
    Previous work showed the pill was responsible for preventing far more cancers overall than it contributed to. Image Point Fr

    What about long-acting reversible contraceptives and cancer risk?

    Long-acting reversible contraceptives – which include intrauterine devices or IUDs, implants under the skin, and injections – release progesterone-like hormones.

    These are very effective contraceptives that can last from a few months (injections) up to seven years (intrauterine devices).

    Notably, they don’t contain the hormone oestrogen, which may be responsible for some of the side-effects of the pill (including perhaps contributing to a higher risk of breast cancer).

    Use of these long-acting contraceptives has doubled over the past decade, while the use of the pill has declined. So it’s important to know whether this change could affect cancer risk for Australian women.

    Our new study of more than 1 million Australian women investigated whether long-acting, reversible contraceptives affect risk of invasive cancers. We compared the results to the oral contraceptive pill.

    We used de-identified health records for Australian women aged 55 and under in 2002.

    Among this group, about 176,000 were diagnosed with cancer between 2004 and 2013 when the oldest women were aged 67. We compared hormonal contraceptive use among these women who got cancer to women without cancer.

    We found that long-term users of all types of hormonal contraception had around a 70% lower risk of developing endometrial cancer in the years after use. In other words, the risk of developing endometrial cancer is substantially lower among women who took hormonal contraception compared to those who didn’t.

    For ovarian cancer, we saw a 50% reduced risk (compared to those who took no hormonal contraception) for women who were long-term users of the hormone-containing IUD.

    The risk reduction was not as marked for the implants or injections, however few long-term users of these products developed these cancers in our study.

    As the risk of endometrial and ovarian cancers increases with age, it will be important to look at cancer risk in these women as they get older.

    What about breast cancer risk?

    Our findings suggest that the risk of breast cancer for current users of long-acting contraceptives is similar to users of the pill.

    However, the contraceptive injection was only associated with an increase in breast cancer risk after five years of use and there was no longer a higher risk once women stopped using them.

    Our results suggested that the risk of breast cancer also reduces after stopping use of the contraceptive implants.

    We will need to follow-up the women for longer to determine whether this is also the case for the IUD.

    It is worth emphasising that the breast cancer risk associated with all hormonal contraceptives is very small.

    About 30 in every 100,000 women aged 20 to 39 years develop breast cancer each year, and any hormonal contraceptive use would only increase this to around 36 cases per 100,000.

    What about other cancers?

    Our study did not show any consistent relationships between contraceptive use and other cancers types. However, we only at looked at invasive cancers (meaning those that start at a primary site but have the potential to spread to other parts of the body).

    A recent French study found that prolonged use of the contraceptive injection increased the risk of meningioma (a type of benign brain tumour).

    However, meningiomas are rare, especially in young women. There are around two cases in every 100,000 in women aged 20–39, so the extra number of cases linked to contraceptive injection use was small.

    The French study found the hormonal IUD did not increase meningioma risk (and they did not investigate contraceptive implants).

    Benefits and side-effects

    There are benefits and side-effects for all medicines, including contraceptives, but it is important to know most very serious side-effects are rare.

    A conversation with your doctor about the balance of benefits and side-effects for you is always a good place to start.

    Susan Jordan, Professor of Epidemiology, The University of Queensland; Karen Tuesley, Postdoctoral Research Fellow, School of Public Health, The University of Queensland, and Penny Webb, Distinguished Scientist, Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute

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

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Related Posts

  • Self-Compassion In A Relationship (Positives & Pitfalls)
  • Is TikTok right? Can adding a teaspoon of cinnamon to your coffee help you burn fat?

    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.

    Cinnamon has been long used around the world in both sweet and savoury dishes and drinks.

    But a new TikTok trend claims adding a teaspoon of cinnamon to your daily coffee (and some cocoa to make it more palatable) for one week can help you burn fat. Is there any truth to this?

    Evannovostro/Shutterstock

    Not all cinnamon is the same

    There are two types of cinnamon, both of which come from grinding the bark of the cinnamomum tree and may include several naturally occurring active ingredients.

    Cassia cinnamon is the most common type available in grocery stores. It has a bitter taste and contains higher levels of one of the active ingredient cinnamaldehyde, a compound that gives cinnamon its flavour and odour. About 95% of cassia cinnamon is cinnamaldehyde.

    The other is Ceylon cinnamon, which tastes sweeter. It contains about 50-60% cinnamaldehyde.

    Does cinnamon burn fat? What does the research say?

    A review of 35 studies examined whether consuming cinnamon could affect waist circumference, which is linked to increased body fat levels. It found cinnamon doses below 1.5 grams per day (around half a teaspoon) decreased waist circumference by 1.68cm. However, consuming more than 1.5g/day did not have a significant effect.

    A meta-analysis of 21 clinical trials with 1,480 total participants found cinnamon also reduced body mass index (BMI) by 0.40kg/m² and body weight by 0.92kg. But it did not change the participants’ composition of fat or lean mass.

    Another umbrella review, which included all the meta-analyses, found a small effect of cinnamon on weight loss. Participants lost an average of 0.67kg and reduced their BMI by 0.45kg/m².

    Spoon of cinnamon
    The effect appears small. Radu Sebastian/Shutterstock

    So overall, the weight loss we see from these high-quality studies is very small, ranging anywhere from two to six months and mostly with no change in body composition.

    The studies included people with different diseases, and most were from the Middle East and/or the Indian subcontinent. So we can’t be certain we would see this effect in people with other health profiles and in other countries. They were also conducted over different lengths of time from two to six months.

    The supplements were different, depending on the study. Some had the active ingredient extracted from cinnamon, others used cinnamon powder. Doses varied from 0.36g to 10g per day.

    They also used the two different types of cinnamon – but none of the studies used cinnamon from the grocery store.

    How could cinnamon result in small amounts of weight loss?

    There are several possible mechanisms.

    It appears to allow blood glucose (sugar) to enter the body’s cells more quickly. This lowers blood glucose levels and can make insulin work more effectively.

    It also seems to improve the way we break down fat when we need it for energy.

    Finally, it may make us feel fuller for longer by slowing down how quickly the food is released from our stomach into the small intestine.

    What are the risks?

    Cinnamon is generally regarded as safe when used as a spice in cooking and food.

    However, in recent months the United States and Australia have issued health alerts about the level of lead and other heavy metals in some cinnamon preparations.

    Lead enters as a contaminant during growth (from the environment) and in harvesting. In some cases, it has been suggested there may have been intentional contamination.

    Some people can have side effects from cinnamon, including gastrointestinal pain and allergic reactions.

    One of the active ingredients, coumarin, can be toxic for some people’s livers. This has prompted the European Food Authority to set a limit of 0.1mg/kg of body weight.

    Cassia cinnamon contains up to 1% of coumarin, and the Ceylon variety contains much less, 0.004%. So for people weighing above 60kg, 2 teaspoons (6g) of cassia cinnamon would bring them over the safe limit.

    What about the coffee and cocoa?

    Many people may think coffee can also help us lose weight. However there isn’t good evidence to support this yet.

    An observational study found drinking one cup of regular coffee was linked to a reduction in weight that is gained over four years, but by a very small amount: an average of 0.12kg.

    Good-quality cocoa and dark chocolate have also been shown to reduce weight. But again, the weight loss was small (between 0.2 and 0.4kg) and only after consuming it for four to eight weeks.

    So what does this all mean?

    Using cinnamon may have a very small effect on weight, but it’s unlikely to deliver meaningful weight loss without other lifestyle adjustments.

    We also need to remember these trials used products that differ from the cinnamon we buy in the shops. How we store and how long we keep cinnamon might also impact or degrade the active ingredients.

    And consuming more isn’t going to provide additional benefit. In fact, it could increase your risk of side effects.

    So if you enjoy the taste of cinnamon in your coffee, continue to add it, but given its strong taste, you’re likely to only want to add a little.

    And no matter how much we’d like this to be true, we certainly won’t gain any fat-loss benefits by consuming cinnamon on doughnuts or in buns, due to their high kilojoule count.

    If you want to lose weight, there are evidence-backed approaches that won’t spoil your morning coffee.

    Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

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

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  • Vaginal Probiotics: What Does The Science Say?

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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 😎

    ❝Is there any merit to vaginal probiotics?❞

    What a fun question! First let’s break it down, as this could mean two different things:

    1. Probiotics, which you consume, using your mouth, which are marketed as benefiting vaginal health
    2. Probiotics taken as a vaginal pessary/suppository, to act directly there

    The former has limited evidence for it, but generally speaking, improving one’s gut health improves all other areas of health, so it’s not surprising if it helps this too.

    See for example:

    Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis

    Some notes:

    • candidal vaginitis means a yeast infection causing vaginal inflammation
    • bacterial vaginosis means a vaginal bacterial imbalance (generally also featuring vaginal inflammation, though it can be asymptomatic)

    In the latter case, the “imbalance” in question is usually a shortage of Lactobacillus sp. (that is to say, the diverse species of the Lactobacillus genus) resulting in an overgrowth of other kinds of bacteria, which in turn results in changing the vaginal microbiome to make it warmer and more acidic than it should be.

    While a healthy vagina shouldn’t smell of roses, it shouldn’t smell fishy either; if it does, that’s a sign of bacterial vaginosis.

    What it’s supposed to be like: slightly bitter, slightly salty, distinctly umami, along with a cocktail of personal pheromones (and if menstruating or otherwise* vaginally bleeding, then of course add: iron/”metallic”). The pheromones will also reflect any hormonal changes, but should never make anything smell bad, just different.

    *e.g. due to PCOS, fibroids, etc. Note that in the case of PCOS, it may also smell a little different (if it does, then usually: a little more musky), due to often different hormone levels. Again: it still shouldn’t smell bad, though, just different.

    In the above-linked study, taking more live Lactobacillus acidophilus (in yogurt, eating it, with their mouths) improved levels of L. acidophilus in the vagina. While the study authors concluded “this ingestion of yogurt may have reduced episodes of bacterial vaginosis”, which is rather a weak claim, it can be argued that it merely improving the levels of L. acidophilus in the vagina was already a win.

    That was a small (n=42, and only 7 followed through to completion) and old (1996) study, and it bears mentioning that most of the studies into this seem to be small and old, but conclude similarly with weakly positive statements.

    However, it does make a difference what kind of Lactobacillus is used, for example in this next study…

    • L. fermentum RC-14 worked well (90% success rate)
    • L. rhamnosus GR-1 worked somewhat (40% success rate)
    • L. rhamnosus GG did not work (0% success rate)

    So, diversity is key, and getting a wide range of Lactobacillus sp. seems to be a safe bet.

    Short version: enjoying probiotics as part of your diet probably improves vaginal health, just like it improves pretty much everything else.

    See also: Make Friends With Your Gut (You Can Thank Us Later)

    You would think that this would mean that taking probiotics as a vaginal pessary/suppository would be even better, but the results are weaker, as in this study, which produced temporary improvements in about half the study group, with only 3 out of 28 being free of bacterial vaginosis the next month:

    Treatment of bacterial vaginosis with lactobacilli

    This study got better results, with a 61% success rate:

    Effectiveness of Lactobacillus-containing vaginal tablets in the treatment of symptomatic bacterial vaginosis

    Important note

    Do note that this last category, involving topical treatments (i.e., manually introducing Lactobacillus sp. to the vagina) were all in cases of pre-existing bacterial vaginosis, not as a prophylactic and/or general health-improving thing.

    If your vagina seems happy right now, then do not mess with its happy bacterial balance!

    And at all times (regardless of whether it seems happy right now or not): do not douche (it does not need it and will not benefit from it; the vagina is self-cleaning*) as this will wash out many of your Lactobacilli and will do absolutely nothing against any Candida there (C. albicans being a rooted fungus, whereas Lactobacillus is a sausage-shaped bacterium with many tiny appendages but no actual ability to stay put), so Candida will flourish in the Lactobacillus’s absence.

    *by the vagina, we are referring to the vaginal canal. The vulva—the outside part consisting of the two pairs of labia, the glans clitoris, and clitoral hood—are not self-cleaning, and should just be washed gently per your normal bath/shower routine; that’s perfectly fine and good.

    And definitely don’t put any “cleansing” toiletries inside the vagina (or any toiletries at all, for that matter), even if they are sold and marketed for that purpose; they will not help and they will harm.

    Also, due to their neighborliness, messing up the microbiome inside the vagina is a common way to also get Candida inside the urethra:

    How To Avoid Urinary Tract Infections (UTIs)

    One other option

    Finally, unless you have a “very good friend” you have a pressing urge to swap germs with, you might want to leave this one to the scientists, but we share this paper just for interest:

    The effectiveness of vaginal microbiota transplantation for vaginal dysbiosis and bacterial vaginosis: a scoping review

    Lastly…

    Going back to oral supplementation, if you’d like to try that then check out this for further notes on what, why, how, etc:

    How Much Difference Do Probiotic Supplements Make To Health?

    Take care!

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  • Life Is in the Transitions – by Bruce Feiler

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    Change happens. Sometimes, because we choose it. More often, we don’t get a choice.

    Our bodies change; with time, with illness, with accident or incident, or even, sometimes, with effort. People in our lives change; they come, they go, they get sick, they die. Our working lives change; we get a job, we lose a job, we change jobs, our jobs change, we retire.

    Whether we’re undergoing cancer treatment or a religious conversion, whether our families are growing or down to the last few standing, change is inescapable.

    Our author makes the case that on average, we each undergo at least 5 major “lifequakes”; changes that shake our lives to the core. Sometimes one will come along when we’ve barely got back on our feet from the previous—if we have at all.

    What, then, to do about this? We can’t stop change from occurring, and some changes aren’t easy to “roll with”. Feiler isn’t prescriptive about this, but rather, descriptive:

    By looking at the stories of hundreds of people he interviewed for this book, he looks at how people pivoted on the spot (or picked up the pieces!) and made the best of their situation—or didn’t.

    Bottom line: zooming out like this, looking at many people’s lives, can remind us that while we don’t get to choose what winds we get swept by, we at least get to choose how we set the sails. The examples of others, as this book gives, can help us make better decisions.

    Click here to check out Life Is In The Transitions, and get conscious about how you handle yours!

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