Nesrin Abu Ata, MD

As the new year starts, and as you think of what intentions you want to set for this new year, how do you approach it? Do you make a list of goals you want to accomplish? Do you use a vision board? Do you find yourself sometimes feeling like you may not have all the needed resources, be it physical, material, emotional or spiritual? Do you end up feeling overwhelmed or start judging yourself for the past goals that you had and didn’t quite accomplish the way you planned? Have you ever wondered if  there is one crucial ingredient or a secret weapon that can help you on your journey to bring you fulfillment of your intentions? And if such a thing existed, how far would you be willing to travel to obtain it?

The crucial ingredient to inspire you, support you, uplift you and sustain you on your journey to pursue your intentions for this year is YOU-nique. It is YOU. Some people refer to it as TRUE SELF, and I like it call YOUR WISE HEART. Your wise heart has depth, evenness, acceptance and wisdom that only YOU would know and that only would apply to you, nobody else.

How do you access YOUR WISE HEART? Because once you access YOUR WISE HEART, you will know it. And, then, there is no stopping you from your fulfilling your life trajectory.

There are eight qualities that are doorways to your wise heart. By distancing yourself from your common behaviors, patterns and thoughts, you tap into these eight quality and experience your wise heart. So, as you set change in motion in your thoughts, behaviors and patterns, start listening to the following qualities show up in your life.

1. Curiosity: This is the first step to making any change. This is where you start to be able to turn towards yourself and inquire within yourself to see what you are actually doing before you can make any changes. Do you find yourself judgmental, closed off and so stay stuck and negative? What happen if you let go of that judgement and become curious about getting to know yourself?
2. Clarity: This comes from curiosity. If you are open to looking inward and learning about your patterns, then you begin to understand why you do the things you do. You become an observer of yourself. The observer self sees the big picture and offers a bigger perspective beyond a narrow viewpoint. Making decisions and setting boundaries become easier as a result.
3. Compassion: This happens naturally after taking an inventory inwards and gaining clarity of why you did what you did. Compassion is hard to practice, both for yourself and for everyone else. But, with perspective and seeing the picture, you understand that you are not the only one struggling and that others are struggling also. And, you apply the same compassion you would give to a friend to yourself. You notice that you become kinder and less defensive and feeling isolated.
4. Calm: This comes with clarity, and you can see and trust the bigger picture. You are no longer seeing things through the lens of fear and intention emotions. You are no longer holding on too tight, and getting upset over the smallest things that may not be relevant to your path in the long run.
5. Confidence: This comes with finding calm and clarity. Inner trust comes more naturally and with trust, you are able to bounce back more easily, even when things don’t go as you expected.
6. Courage: This comes with confidence, and the ability to act on decisions. It is taking the right action and is the anecdote to fear. You will find yourself pursing experience you were previously afraid to do.
7. Creativity: With courage and confidence, you may feel yourself lighter, more creative and expressing yourself more. You will feel your connection to your intuition and be inspired.
8. Connectedness: This comes with self compassion and being able to feel seen and accepted. You will start to feel more at peace and safe. And as result, you will find yourself spending more time with people and be in nature.

So, what are you waiting for?

What you have been waiting for is YOU.

Will you take the first step to be with yourself, and look within yourself with curiosity, and compassion?

Are you ready to be inspired and transformed by experiencing YOUR AMAZING WISE HEART?

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References: Internal Family Systems. Richard Schwartz, PhD.

The Vision. The Dream. The Intention.
Once Upon A Time, many many moons ago, people from around the world were in tune with cycles, rhythms, seasons, so much so that a lunar calendar was born. The lunar calendar remains, and so does the moon with its cycles.

While the path of the moon continues round and round, many of us have gotten of cycle, and in states of dis-ease, spun off by foreign rhythms, spinning us out of control. Rituals, setting intentions, taking the time to pause and listen to our inner guidance and wisdom within a community bring us back into rhythm, harmony and a state of ease.

It is between the inhalation and exhalation that we can take a pause and reset our nervous system. On the night of a new moon, of this simple pause that nature gives, please come and join me in community, to set your own intentions and come into rhythm, and right relationship with yourself, your life and your loved ones. Please share this with others to attend.

Come as you far, no more and no less.

Logistics
We will do the meetings via zoom for now with the hopes that we will do it in person in the near future.
This is a free offering.
7:00pm-8:30pm CST.
Zoom ID will be sent once you RSVP.
Space is limited to 10 people.
You can let me know if you are attending through facebook message, instagram or email drnesrin@nesrinabuatamd.com

What to Bring
– Something you hold as sacred, or what makes you feel comforted or safe. It may be a stone, or a blanket, or a picture of a loved one.
– Something you hold as beautiful or brings you joy. It may be flowers, or vegetables from your garden, or your pet.
– A hot cup of tea, or maybe some incense

May you be well.
May you be at ease.
May you be at peace.

See you at our circle among other fellow sojourners.

Because there is nobody else like you in the world, your self-care is your unique imprint that only you intimately know and build over time. Anything  worth doing takes time to practice and cultivate, and self-care is no different.  So take a deep breath, maybe get a warm drink and sit in your cozy lounge chair to take measure of YOUR self-care. What we take measure of, we can appreciate and grow.  You may want to get a pen and paper to reflect on the questions below. As you reflect on your self-care journey, I will share with you my evolving journey to self-care practices in the hopes to support and inspire you.

Why do you value self-care practices?

I value my self-care practices because I inherently matter. I matter because I am the only person who can be me. Who I am, my gifts, desires, dreams and visions all matter because I matter. I learned over time to differentiate between self-worth and self-esteem, the latter is based on what I do or what others think of me, all of which is externally driven. I practice self-care because I feel energized, rested, healthy and connected to myself afterwards.

What do your self-care practices look like?              

My self-care practices involve physical, mental, emotional and social routines. Physically, I pay attention to the amount of sleep I get, having regular healthy meals and being physically active. Mentally, I maintain a mindfulness-self compassion meditation practice and a gratitude journal. Emotionally, I practice good boundary setting, saying no, asking for help when I need it, staying true to my values and spending time doing things I enjoy. Socially, distanced of course, I spend time with people whose company and friendship I value.  

What messages from others have you gotten about self-care practices?

I used to think that self-care is selfish and self-indulgent. I also used to think that it was a temporary thing to do rather than a practice to maintain and cultivate. I used to think that there was a right way to do it, and so wouldn’t practice self-care “because I didn’t give it the right amount of time.” I also used to approach self-care practice as something “I deserved if I worked hard enough for it.” I used to think that self-care practices were set in stone and were not dynamic.  

How has your self-care practice evolved over time?

I have learned over time to give myself permission to let my self-care practices adapt, change and grow. I have noticed that my needs vary depending on the season of the year, how my physical health is and the daily demands of life, work and relationships. Each life experience has shaped who I am becoming. I have learned to honor my growth and so reassess what I need from my self-care practices and what I want them to look like. I have certainly had to adapt them during this challenging time for all of us.

When are you least likely to practice self-care?

I noticed that I forgo my self-care practices when I am taking care of others’ needs, and when I have external demands on my time from others and from work. I also noticed that I don’t maintain my self-care practices when I place demands and expectations of myself, when I let myself believe my negative beliefs of myself and when I set poor boundaries.  

When do you know that you need to practice self-care? Do you notice physical or emotional changes without doing self-care?

I notice that I haven’t been practicing self-care enough, or need to adjust it, when I feel easily overwhelmed, become emotionally reactive and don’t have the bandwidth to handle curve balls that life throws at me. I also notice it when I start to be harder on myself and blame myself and show less compassion towards myself and others. I tend to lose my sense of curiosity and adventure and overall feel that I have less physical energy.

Do you keep a certain schedule or rituals for self-care? If not, why not?

I learned that I need to maintain an adaptable routine. The keywords being consistency, flexibility and gentleness towards myself with less self-judgement. There are times, when I have more time to do more self-care. There are other times where I recognize that I need to do more self-care practices depending on life-circumstances. I used to be rigid about my self-care, and that created more stress and self-judgement. It is an evolving dance.

Who or what inspires you to practice self-care? Why?

My patients inspire me to maintain my self-care practices. When I witness how they are able to cultivate over time their self-care practices and how well they feel and grow, it reminds me to listen to myself and my needs. Also, my friends, who are my source of accountability, remind me to return to my self-care practices.

What do you like most about your self-care practices?

I like how I feel, think and connect to myself and others when practicing them.  I also notice that I am able to be and live as a better version of myself. I notice that I am able to pause before reacting to people, places and situations, and act in a way more consistent with my goals, values and visions. I also tend to have less of a need to consume in general, whether it be food, media or buying things.  

What are some of your challenges around self-care practices?

I notice that comparing my self-care practices to what others do for their self-care practices discourages me. Self-judgement about if I am practicing enough or practicing the right way diminish the joy I receive from practicing self-care. When I perceive that I have less time, then I practice less self-care. When I lose sight and connection to my values, I also value less my self-care.

How would you like to grow your self-care practices?                                                                                         

I would like to build more of my self-practices within a community, as it is easy to believe that I am alone and isolated, especially during this challenging time. I look forward to the personal growth in the face of current challenges to adapt my self-care practices. Curiosity and a sense of adventure are key ingredients to the process.  

I don’t know about you, but with COVID and social distancing, I notice that I have been spending a lot more time outside in nature, and that is how I discovered forest bathing. The practice of forest bathing, also called forest therapy, involves no bathing and is not led by a therapist. It originates in Japan since the 1980s, and is known as shinrin-yoku which means “taking in the forest.” It is the practice of moving slowly in nature using all the five senses. It feels like and looks a lot like standing around so to speak. While it may seem easy to do, it turns to be harder to do in practice as you start to notice your thoughts the more you slow down.

When I started moving slowly in nature, I started to notice my own thoughts: am I moving too slowly? What will people think who pass me on the trail? Am I doing this right? However, the more I slowed down, and stopped to notice different plants and animals, the more I became aware of the smells and sounds around me, and the more I was able to appreciate the present moment and my own breath. Doing forest bathing has helped me move from doing more, to more being, which has been enjoyable.

Some of the benefits of forest bathing include relaxation, less stress, connections with nature,  insights to take home, improved mood, improved vigor, reduced fatigue and feelings of awe. Research is showing that being in a natural setting is good for mind-body health. It can lower blood pressure, lower cortisol levels and improve concentration and memory. A chemical released by plants and teers, called phytoncides, boosts the immune system.

How to Go Forest Bathing

• You can choose anywhere in nature, it can be a park, a forest
• Make sure you have left your phone behind
• Relax all your muscles
• Walk aimlessly and slowly
• Let your body be your guide, letting it lead you where it wants to take you
• Follow your nose
• Take your time
• Savor smells, sounds sights of nature, let the forest in
• Slow down, stop often. This is not a hike

So, what are you waiting for? Start your forest bathing therapy today and find out what it is like for you!

“I have a chemical imbalance and that’s why I am seeing you to find the right medication to get chemicals balanced in my brain.”

I often hear the above statement from patients who seek consultation with me for their mental health. In 1960s, psychiatry researchers developed the catecholamine or biogenic amino hypothesis of mood disorder, which led to the concept that an imbalance in neurotransmitters resulted in abnormal moods. This has become how media portrays mental health and treatment. While there is still a role for neurotransmitters, their role is to be understood in the context of the entire brain metabolism. The microbiome and inflammation (among other things like oxidative stress and  mitochrondrial function) all relate to understanding the brain metabolism mechanics. 

Our bodies are a highly complex ecosystem including 39 trillion bacteria, mostly good, inside and on our bodies’ surface. The majority of the bacteria within our bodies (known as the microbiome) work in complex ways to promote and maintain our health by interacting with cells and organs in various ways. Some gut bacteria have endocrine functions and make oxytocin, serotonin and dopamine. These chemicals activate certain signals in the brain and thus affect our mood (G. Clarke et al). Another example is the Lactobacillus plantarum that produces metabolites that stimulate an anti-inflammatory response by intestinal stem cells which would help with healing (A. F. Athiyyah et al.) . 

The microbiome starts at birth after passing through the birth canal, and is shaped  by breast milk first and then diet, environment and human contact throughout our lives. This is why I often ask my patients if they were delivered by cesarean section  and if they were breastfed or bottle fed. This is why it is also important to know if a patient had a gastric bypass as their microbiome has been changed following the surgery. 

A majority of the immune system is located in the gut. The immune  system decides which bacteria and foods are “safe and good”, and which ones need to be defended against by producing certain chemicals that cause inflammatory signals. These signals travel to the brain which can eventually lead to depression and other mental health problems.

Chronic inflammation does not give the body time to heal which results in continued damage to the internal lining of  the intestines. As a result, inflammatory signals and bacteria move to other parts of the body and negatively impact it. All this disturbs the microbiome (also known as gut dysbiosis) which in turn impacts the brain. This is why I ask patients what kind of food they eat, how they find they feel after eating certain foods and whether they tried to eliminate certain foods from their diet. 

Other causes for gut dysbiosis are broad spectrum antibiotic use, chronic stress, a poor diet and the modern environment being too clean. 

So, I tell my patients there is an increase amount of evidence that what we eat affects how we feel, and that every choice we make relative to our diet matters. Keeping a diet journal is a good start to gut and brain health recovery.