The Hemp Connection:
psychology

As with all professions, there’s a diversity of spiritual belief among psychotherapists, ranging from the atheists to devout Christians, Jews, Buddhists, Hindus, and Muslims. There are those who call themselves “spiritual but not religious,” and those who would say they’re agnostic, always questioning. Some outright label themselves as “Buddhist Psychologists” or “Christian Therapists.” Except in the latter case, it’s generally presumed that psychotherapy and spirituality are separate disciplines, and never the twain shall meet.

I have often wondered though, how a truly great therapist can be utterly godless. Surely it is helpful to have some construct in one’s mind that god, the universe, or some other greater sense of structure, belonging, and control might exist. Not only are we constantly exposed to the complex mysteries of the human brain, mind, heart, and soul, but we are also constantly exposed to the trauma, torture, disease, anger, loneliness, and sadness that brings people to our offices. All of these things are often inflicted by one human being upon another human being (child abuse, spousal abuse, introduction to addictive substances, etc.). There is a powerful depth of sadness present in the fabric and content of my work. It is especially present in issues of grief and loss, chronic illness, or terminal illness.

I always ask my clients about their spiritual background, beliefs, and practices. While I’m not qualified to be a spiritual counselor of any sort, this information gives me a context for a life, and helps to complete the description of a person. For some people, god is an explanation, a support, and a source of strength. For others, god is an excuse, or a punishing figure. Whether god is important to us personally, or in the moment, questions of god often lurk in the background. So for me, god may not be the main course, but s/he is surely present in many ways.

For example, if I have a client who lost her virginity as a result of rape, and she is a staunch Catholic, I know it’s likely that feelings of guilt and shame will be even more prominent for her. If someone had a punishing experience in parochial school and rejects organized religion, I know this is a deep wound, and the person’s sense of belonging and support has been taken away, along with their faith. When a client is suicidal, it is often faith in god, or a belief that god wouldn’t approve of suicide, that keeps the person from attempting suicide. Whether I believe in his or her form of god or not, I’ll take whatever help I can get!

In dealing with issues of chronic illness, and in particular PCOS, there’s often a lot of questioning: “Why me?” “Why did god do this to me?” “Isn’t god supposed to heal me, not make me sick?” These are important issues and needs to explore in therapy. Spirituality often relates to:

• feeling a sense of belonging;
• having faith that there is a reason, even if it’s unclear, for suffering;
• sense of powerlessness;
• ability to control;
• anger;
• need to assign blame;
• development of hopefulness;
• sources of shame, especially as related to sexuality; and
• need for explanations.

Of course it’s not just spirituality or god that provides the answers to these big questions. But in the therapist’s toolbox, addressing spirituality and how it presents in your life is part of the process of developing greater internal strength. God may be part of that. Allowing me to know you in this way is an important part of knowing how you think, what you believe in, where you feel strong, and where you feel weak, so that I can help you to repair the gaps. The ability to access my intuition and connection to a spiritual source helps me to context suffering, illness, trauma, and grief in a way that allows me to remain focused on what you need. It may also be a resource I can draw your attention back to when the going gets tough. In a nutshell, that’s what god’s got to do with it.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.

In my role as a health psychologist who specializes in PCOS and other endocrine disorders, I read a lot of material on PCOS, insulin resistance, infertility, diabetes, and other hormonal matters. The more I read, the more I’m aware of the biases in the various camps, by which I mean, these types of messages that populate the media, presented here with my interpretation of the subtext:

• Natural is the only way to go – you’ll destroy your body with birth control pills and metformin (they’re all toxic chemicals!);
• Supplements are the way to go — forget the pharmaceuticals (it’s only 90 capsules a day, but you’ll manage);
• If you would just practice positive thinking, and say enough mantras, you could improve your fertility and have a cute baby just like this (it’s really your fault);
• We should accept our “flaws” as part of our beauty (and damn the women who take advantage of electrolysis, body sculpting, and hair dye);
• If you don’t follow this medical protocol quite strictly for the rest of your life, you’ll end up in terrible condition, with a host of dreadful side effects that will ultimately make your life miserable and then kill you (I’m the doctor, and I hold all the answers, and I’m going to scare you into compliance);
• Low carbohydrate diets are the only solution (chronic deprivation is the way to go);
• PCOS women shouldn’t exercise too much, or they’ll get all bulky and look like men (this is not actually physiologically possible, but it’s a great excuse);
• Exercise is the only thing that really works, and here’s how to do it (never mind that I don’t have PCOS myself, and know nothing about PCOS).

I could go on and on, but you get the idea. There’s a problem with all of these messages, and the problem is, they’re all wrong. There is no one solution that applies universally to all of us. We are each a unique composition of chemistries, ethnicities, weights, ages, and personal points of view. We have access to different specialists and reading materials. We have different beliefs about what works and what doesn’t. We have varying abilities to assess the correctness of scientific or medical data. We have limited finances and time to try every possible potential solution. And we are, quite possibly, exhausted from trying.

Additionally, consider the source. Quite a lot of these messages (picked up directly from my reading, but not attributed, in order to protect the innocent and the not-so-innocent) are presented to us with the intention of selling something – supplements, coaching services, dietary plans, books, CDs, or workshops. There’s nothing wrong with any of those things, by the way, but if the message consistently points in one direction, and it always results in you buying something, it may not be a message you want to heed. This blog tries to present useful information in a way that allows you to make reasonable choices, utilizing commonly available resources, and without pushing you towards any one philosophy, guru, product, or way of thinking. I think that’s a sensible approach.

That being said, we need to respect the choices that our fellow travelers in this PCOS journey are making. If a woman wants to try metformin, or birth control pills, or Spironolactone, or a low carbohydrate diet, and there’s no medical contraindication, let’s support her the best way we can. Don’t present your personal experience as the absolute truth. Offer it as a way of being there for support, or simply to share your experience so she has other “evidence” to consider.

Consider the impact of emphatic statements that “the only” way to produce a baby, or weight loss, or better fasting glucose numbers, is by following your plan. The woman on the other end may not have the time, education, or finances to implement your well-meaning suggestions, and the result on the other end may be a real emotional slam for a woman who’s already feeling fragile and desperate (this is especially true in the fertility/infertility arena).

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.

If you’re a new reader of this blog, or you’ve got a new diagnosis, you are probably starting to realize that there are some changes you need to make if you’re going to be healthy while living with PCOS. Or perhaps you already knew that, or have had the diagnosis for a while, but you’ve been lurking here, just thinking about the idea of change, and not actually committing to change. That’s even an earlier stage in making change that is called pre-contemplation, where you haven’t begun to think about change (but typically, someone else, like your therapist, knows you need to change).

Change conjures up all sorts of feelings. For some, there’s a feeling of excitement and hopefulness. For others, there is sadness about leaving behind a lifestyle, a set of choices, some favorite foods, or a particular relationship or way of functioning. There may be fear about facing the unknown, lacking the knowledge to proceed in a healthy or effective way, or about how your life will rearrange as a result of the conscious changes that you’re making.

When it comes to the areas of exercise and dietary management, all of these issues and more may arise. If your situation is further complicated by depression, anxiety, or an eating disorder, it’s even more complicated. Depression may leave you lethargic and unmotivated; with your brain craving a rebalancing of serotonin, you may be consuming excess carbohydrates to try to fix the balance. Anxiety can escalate to such a place that any idea of change leads to fear and freezing; there seems to be safety in staying in one place, even if it’s an uncomfortable place. And of course, if you’ve got a history of eating disordered behavior, and it’s “working” for you, to keep your weight contained, then the trepidation factor may be enormous.

Here are some things about change that it may be helpful to think about, whether you’re in pre-contemplation, contemplation, or the actual process of creating the change:

• It’s your body, and your decisions. You own them; no one else does.
• You can change your mind at any time. If you’ve started down a certain path, and you really hate it, or it doesn’t appear to be producing results, it’s generally not a lifetime commitment (exceptions come to mind, like having a hysterectomy, or getting a tattoo).
• Medical, dietary, and psychological theory is continuously evolving, and you should be re-evaluating on an ongoing basis anyway.
• There’s no shame in trying. The shame comes from not loving yourself enough to never start trying.
• It really does take practice to produce change. Do some research on how to create that continuity. You may need to schedule exercise into your calendar at a certain time every day (when I was diagnosed with early onset Type II diabetes in 1998, I wasn’t exercising much at all, and I would literally schedule myself to walk for TEN MINUTES a day; every other week, I added five minutes to that time, until I reached 75 minutes a day, and had lost 72 pounds), join a group that meditates (they’ll teach and support you, and keep you accountable), or keep a food log (more accountability!) in order to adhere to whatever program of positive change you’ve devised for yourself.
• There are many people who will support you in creating the change you desire, and a number of them are found right here, at the inCYST community. Seek their help. You’ll be surprised how much support you can find online.
• If you’re trapped in a paralyzing fear, or find yourself repeating negative patterns, or quitting quickly time after time, there may be a deeper psychological issue at play. It’s worth a consultation with a health psychologist or other therapist to assess your behavioral patterns and choice-making skills.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.

We had a great chat with Dr. Gretchen this morning! We covered everything from how she does her work, what counseling can do for a woman with PCOS, to her love for her local farmer's market.

If you have ever thought about getting counseling to deal with the stress that your diagnosis has placed on your daily plate, please check in and listen to what Dr. Gretchen has to say!

Gretchen's practice is located in West Los Angeles. You can learn more about her at http://www.drhousemd.com/. She can be contacted directly at 310.625.6083, or gkubacky@yahoo.com.

You’ve no doubt noticed the onslaught of pharmaceutical company sponsored advertising flooding television commercials and magazine inserts. You can hardly glance at the media without hearing about side effects such as 36-hour erections (okay, we don't have to worry about that one!), loose, oily stools, nausea, cramping, bouts of mania, and unexplained bleeding. These same ads proclaim the medication’s benefits even more loudly – freedom from migraine headaches, depression, obesity, and erectile dysfunction. The message seems to be that there’s a pill to fix anything that ails you. Sometimes it seems like every kid you meet is on ADHD medication, and half your friends are on some form of anti-depressant – and it’s true that these medications are prescribed with far too much ease and far too little deep consideration. Yet on the other side, there’s a backlash from those who claim that the body is a self-regulating mechanism; that diet, supplements, and yoga can cure anything up to and including cancer; and that all drugs (prescription medications) are poisons that disrupt the system.

As a psychologist treating primarily patients who are dealing with a chronic or acute illness or medical condition, particularly PCOS and other endocrine disorders, my interest in pharmaceuticals relates to both the psychotropics (medications used to treat mental conditions) as well as the medications prescribed by my patient’s physicians to address the physical symptoms of their conditions. Very few of us actually want to be on medication, but there’s a special stigma still associated with the medications we use to treat our brains. People report feeling weak, broken, damaged, crazy, and worse when it’s suggested that psychotropic medication might be helpful in addressing their depression, anxiety, bipolar disorder, or other condition. Consequently, they often refuse to try the very medication that provides them with the support they need so that they can really achieve something meaningful in their psychotherapy.

The truth is that the mind and body are inseparable, and many mental disorders have a biological base – there is literally a chemical imbalance in the brain, and it can be helped with medication. Just like insulin helps the diabetic, or synthetic thyroid replaces thyroid hormone for someone with hypothyroidism, medications that enhance neurotransmitter functioning can fill in the gaps in brain functioning. Non-pharmaceutical approaches such as nutrition, supplements, and mindfulness meditation practices can be useful, but are often not inadequate, or work too slowly. They require dedication and persistence to work, and many patients suffering from a period of depression or facing significant stressors may not have enough time to implement these methods. Sometimes the"medication" you need to consider is something non-pharmaceutical — Chinese herbs, Sam-E, or St. John's Wort, for example.

My perspective is that medication can serve as a support for the brain while you’re learning better coping skills, allowing the brain to rebalance, and getting relief from your worst symptoms. Yet we continue to demonize Big Pharma as money-grubbing, disrespectful of natural processes, and potentially harmful when it is true that even natural substances can be harmful or fatal – to the patient who is allergic to peanuts, a taste of peanut butter may be far more harmful than a large dose of a medication, and in fact, it’s medication that may save that person’s life. For me personally, medication is always a last resort (unless I've got a serious infection, or acute pain, in which case, I say"bring on the meds — and pronto!"). If my clients are stable enough, I also support their trying other things first. But I feel like Big Pharma's part of my tool box — there when you need it, and I'm quite grateful for it when it lifts someone out of a long-term depression, alleviates suicidality, or decreases life-disrupting levels of anxiety.

Similarly, with pain, the old way of thinking is that you should suck it up, suffer, power through – anything but take painkillers. As it turns out, your body heals faster, your anxiety is lower, and there’s a lower incidence of depression when patients take painkillers as prescribed. For a limited time and a specific use, doesn’t it seem reasonable to use every tool at your disposal? I want my patients to feel better sooner rather than later, so we often have discussions about their ideas about taking medication, whether it’s for a medical or psychological condition. If you automatically reject the idea of medication, especially the psychotropic medications, I invite you to examine your attitudes to see if they’re outdated, impractical, self-destructive, or just flat-out wrong. As always, I advocate taking a proactive stance as a patient, whether that’s in your doctor’s office or the psychotherapist’s consultation room. Perhaps you’ll find that the enemy of wellness lies more within your own mind than in the face of Big Pharma.

Gretchen Kubacky, Psy.D. is a Health Psychologist in West Los Angeles, a member of the inCYST Network, and a frequent speaker and author on issues related to health psychology, women's health, PCOS, and other endocrine disorders. If you have questions for Dr. Gretchen, have a topic you'd like to suggest, or would like to learn more about her practice, please visit her website at www.drhousemd.com.

Everyone’s telling you to “just relax and you’ll get pregnant,” or “take a vacation and it’ll happen.” Isn’t that a huge pressure, besides the basic fact that getting pregnant hasn’t proven to be so easy for you? Getting pregnant can be so frustrating when it involves medical procedures, carefully timed intercourse, self-tests and monitoring, medication, and the like. With PCOS, it’s even more complicated. The good news is, even when it seems like your body just won’t mind your wishes, there are relatively simple and inexpensive things you can do on your own to support yourself in your fertility journey.

If you’ve been dealing with infertility for a while, you’ve likely tried or at least considered some alternative medicine or holistic health practices that you hope will help you conceive. Here’s why you should consider some of the more common approaches to decreasing stress and improving overall health, which include:

Acupuncture is an ancient healing art, part of the system of Traditional Oriental Medicine. It has been used successfully for thousands of years to enhance fertility; you may even find that your physician is able to offer you a referral. Acupuncture is nearly painless – in spite of the needles – and works in conjunction with your traditional treatments. Many acupuncturists also offer nutritional support. Most larger communities have at least one acupuncture school, and their student clinics offer carefully supervised sessions for as little as $20/treatment.

Nutrition – Decreasing or eliminating caffeine, refined sugar, and refined flour will give your body a rest, reduce stress on your digestive system, enhance your immunity, and make your body an optimally healthy place for both you and a baby. If you’re saying “yeah, yeah, yeah, I know all that – and it’s too overwhelming” – start today with a small change, like switching out regular coffee for decaf, or trading in a soda for some iced herbal tea. Your nerves will thank you too.

Yoga is another traditional dating back thousands of years. Yoga is said to massage and stimulate or “tonify” the internal organs, thereby leading to increased health. The slower-paced forms of yoga, such as hatha yoga, or yin yoga, are relaxing practices. But in my opinion, the best thing about yoga is that it helps you love and accept your body, precisely where it is today – not where you hope it will be. If you’re daunted by those fancy yoga studios, head on over to your nearest YMCA or other gym for some great introductory classes. Many yoga studios offer community days, or donation classes, where you pay what you can afford for the class.

Meditation can be as simple as closing your eyes and focusing on the sound and rhythm of your own breath for just five minutes. If you can’t handle five minutes, try three minutes. It can also be a complex and evolving process, if you choose to expand your practice. Regulating your breathing, clearing your mind, and giving yourself time for introspection are all benefits of meditation. If you want more information, do a search for the terms “meditation” or “the relaxation response.”

Positive Thinking/Mindfulness/Visualization – although these are all distinct techniques, the overlap is that they are conscious ways of re-orienting yourself towards remaining in the present, focusing on what is, and using the power of your mind to create the future – or at least improve your experience of the future. As with meditation, the internet is full of information on these techniques, or you may wish to consult with a mental health clinician who utilizes such techniques in her practice.

Optimizing fertility is an activity in which you, the patient, play a very active role. You are already learning how to become proactive in managing your PCOS; this is just an extension of that. Of course your doctor will want to know what other things you’re doing to support your fertility, but you can start right now to take steps to improve your overall physical health and state of mind, thereby reducing the stress actively, instead of just hoping that it will happen “somehow.”

Dr. Gretchen Kubacky is a Health Psychologist in private practice in West Los Angeles. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders. If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.

We've got a great new resource for you!

Gretchen Kubacky, Psy.D, is a psychologist practicing in Los Angeles who specializes in helping people diagnosed with endocrine disorders.

She's dedicated to helping women like you, and we're so excited to have such an awesome member on our team!

PCOS may be about hormones, but hormones are what create emotions. If you don't recognize both parts of the disorder, it's going to be hard to get better.

Gretchen, we're so glad you are here and we look forward to your contributions!

www.drhousemd.com
http://www.twitter.com/askdrgretchen
http://askdrgretchen.blogspot.com

One of the most frustrating things about PCOS, from my perspective, is that, although we share a common constellation of symptoms (or else we wouldn’t have the diagnosis), every woman’s body is unique. So the dietary treatment of this condition is constantly evolving. I spend a lot of time studying the impacts of food on mood and brain health, and of course, in the great scientific tradition of self-experimentation, I’m always trying out new theories on myself. I wonder, watch, consume, and observe various foods, quantities, and combinations, and then see what happens. I also make observations based on my client’s self-reports, and my interpretation of what happens to their mood and overall sense of well-being, as affected by what they consume. My findings from this moderately unscientific study: • There are no absolutes • The rules change all the time • People believe an astonishing variety of things about food, many of them bearing absolutely no basis in science or reality • Science is probably way behind where it needs to be to support our health • M.D.s are highly unlikely to offer sound advice about food – far better to seek out the services of a dietician • The only thing the food police can agree on is that we should all be eating plenty of organic dark leafy greens • The body is fine with certain foods on some days, and not so fine on others • PMS induces chocolate consumption, wild carb cravings, and a desire for rare, salty beef • Almost everyone with PCOS gets out of control when they over-consume refined carbs • If you’re gluten-sensitive, you will get brain fog if you abuse gluten • It is true that weighing yourself daily, or multiple times a day, contributes to anxiety, and may well be a symptom of an eating disorder • Everything you ban is that much likelier to become the object of your obsession, unless you take steps to balance out your body and your brain chemistry • Details matter • Consistency matters • Treats are really good for staying on track, if they’re chosen wisely • Weight loss is rarely easy; maintenance is even harder • Depressed women with PCOS almost always overeat, not undereat • The less you sleep, the more you eat • Caffeine can be devilishly addictive, or of little consequence • Dairy is the subject of much debate, and a great deal of angst, given its popularity as a self-soothing food category • Carbs are not evil – they’re necessary for healthy brain function – but the belief that they are is remarkably fixed. My point here is that we must consider the challenges of modern dietetics, medical science, and brain treatment (from either a pharmacological or psychological/therapeutic perspective) as a process of constant evolution. If you’re doing something that isn’t working, change it up. If what you’re doing is working, but not working well enough, change it up. If you have a gut sense that something’s bogus, listen to yourself. And if you’re feeling burned out, disgusted, and hopeless about trying to figure this out, give yourself a break, retreat, do the best you can, and come back at it with renewed vigor, a calmer mind, and a more balanced perspective. Seek consultation with experts. Read up a bit. It’s all just information – no judgment. The ability to thrive depends upon your ability to adapt. Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses. If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.

Over the last couple of months, I’ve written extensively about the grief process, and how it applies to PCOS. There is so much to grieve – loss of health, femininity, children, old unhealthy lifestyle choices, even perhaps one’s obesity or body shape. If you missed any of the posts about the grief process, discussing the DABDA model (denial, anger, bargaining, depression, and acceptance), you can find them archived on the inCYST.com site.

Here are my thoughts on what comes after the grief. When you have a death in your life, there’s typically a funeral, or sometimes a life celebration. This celebration occurs while you’re in the depths of your grief, not when you’ve finished grieving. Grieving can be a lengthy and recurrent process, depending upon the circumstances of your life. Events like a new diagnosis, a miscarriage, or simply the arrival of your period if you’re trying to conceive might all feel like losses. Interspersed with the grief, there are still moments of happiness, humor, and even full-blown joy.

If you’ve started to grieve the losses associated with PCOS, I encourage you to also start your own private life celebration, in concurrence with your grieving. Capitalizing on the bright moments is part of an overall strategy of improving your mood by focusing on the positive. Life celebrations usually include music, food, and the company of people that you love. My life celebration is a constantly evolving practice that focuses on the things I’m grateful for, that support my health and give me deep pleasure. For example, today is my day of rest. I got to sleep in, have a cup of chai with my honey, enjoy some lap time with my cat, practice yoga under my favorite tree, enjoy a delicious, healthy and satisfying breakfast of homemade huevos rancheros and mixed berries, and even get in a short walk at the beach. To cap off the decadence, I’m going for a mani/pedi, and will indulge in my one pointless and naughty hour of serious television watching this evening. Swwwwweeeeeeeet! I feel GOOD, and even though I still have some minor pain due to an ankle injury, I’m celebrating my life. It’s rich and satisfying in many ways. Making this list makes me appreciate it even more.

When I focus on the fabulousness of this list, I’m not focusing on the fact that every day can’t be Sunday, that I need to get up to an alarm clock tomorrow, or that I have to make some unpleasant calls to an insurance company, plus go straighten out something at the bank. I’m just focused on enjoying and celebrating my life – my life with PCOS!

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses. If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.