Healthy Living Magazine - Summer 2010 by Judd Zekas

healthyliving Issue 7 | Summer 2010-11

Overcoming MS new research into lifestyle benefits

Gratitude for life meditation as celebration

Healthy eating

ÂŠFar Flung Gallery 2010 ÂŠRonnie

for the festive season

The Gawler Foundation magazine An integrated approach to health

healing and wellbeing

Annual Conference

Integrative Medicine: The emerging mainstream

Our Annual Profound Healing - Sustainable Wellbeing Conference was held on November 13 and 14 at the Hilton on the Park, Melbourne. This event brings together leading thinkers in the fields of integrative health care, cancer treatment and wellness and is insightful, informative and empowering for all those who attend. Moderated by our CEO Karin Knoester, the two day conference featured 12 keynote presentations, 12 interactive workshops and a lively panel discussion. Participants also enjoyed a wholefoods plant-based lunch each day, Qi Gong and Laughter workshops, Michael Johnson's harp music during breaks and the opportunity to meet friends, old and new. Prof Ian Olver, CEO Cancer Council Australia was the first of a highly regarded list of speakers including Prof Avni Sali, Prof Kerryn Phelps, Prof Margaret O’Connor, Dr David Morawetz, Dr Craig Hassed, Dr Carole Hungerford, Dr Elizabeth Brophy and Dr Lesley Braun to name a few. Professor Phelps said “Integrative medicine is the emerging mainstream and a philosophy of living that seeks the optimal environment for health. And it is a consumer lead revolution.” With 70% of Australians consulting a CAM (complementary and alternative medicine practitioner), the future and role of Integrative Medicine is the topic of the moment. There were many conference highlights, including a stimulating panel discussion. Some of the key areas discussed on the panel included: • Current changes in training (integrative) doctors for the future.

• Call to enhance the registration and regulation of CAM practitioners across different modalities so that training, treatment and efficacy can be relied on to be systematic and consistent. • Call for the allocation of research dollars for CAM (presently zero) and insight into the difficulties associated with using western research methods to critically evaluate CAM. • Calls for participants to support the lobby for Medicare changes and allocated research funding by contacting local members of government. Clinicians across all modalities (CAMs and western medicine practitioners) were encouraged to grow skills and experience across a more holistic range of health services. This is an exciting time for health consumers as we move towards a time of greater collaboration and cooperation in health care that is underscored by a fundamental philosophical shift towards lifestyle based health care, or Integrated Medicine. In the future, the question 'what is best for this patient at this time?' will require every practitioner to review a broad range of western and complementary therapies that work in harmony with the patient. In the meantime, as health consumers we need to explore our alternatives and reach our own conclusion as to the best possible combination for us. As Prof Phelps said, 'conventional wisdom is often neither' and every person has the right to ask questions and expect support in their own health and healing endeavours.

Profound Healing - Sustainable Wellbeing

From the CEO Hello everyone...I can't quite believe I'm writing the final magazine piece for the year. Where on earth does the time go? I often sit and wonder how I spent my time in a year, has it been fulfilling, or have I missed opportunities? For the most part, we here at the Foundation find the time we spend very fulfilling. Throughout the year, we get to meet so many wonderful people who come and attend the programs and workshops, visit Hawthorn, or just simply drop us a line with information about what they are doing. It's been a big year for us with the opening of the Hawthorn Centre and the appointment of a new Therapeutic Director. We have had some changes at the staff and Board levels and of course there are the usual struggles of ensuring our income exceeds our expenses. Nice segue into my invitation to support our Christmas Appeal this year! Isabelle Henry has very kindly let us share her story of how she is living with cancer, and we hope it inspires others facing the disease to approach life in a similar way. I also hope that it inspires you to help support people who attend our programs, particularly our ‘Living Well’ program which we provide to people with financial challenges at the rate of $60 for the 12 week program. That is just $5 per week! If you are able to, we would appreciate your support. Our Conference this year was fantastic. Professor Kerryn Phelps moderated a discussion panel made up of Professor Ian Olver, Professor Avni Sali, Dr Elizabeth Brophy, Dr Craig Hassed and Dr Lesley Braun on the topic of Integrative Medicine and challenges for the future - and a highlight was the audience participation and hearing individual stories. I know that attendees valued the opportunity to interact with such an eminent panel. For those of you who have not attended a conference before, make a note for next year - it really is a not-to-be-missed event and a wonderful way to spend a weekend. As the year draws to a close it's perhaps a good time to think about how you will spend your time next year. In January 2011, Siegfried Gutbrod (our Therapeutic Director) is facilitating a new program called ‘Set your Compass’, a retreat that will help you discover the meaning and purpose of your life and identify what is really important to you. The retreat will feature meditation, contemplations, artistic activities, individual and group work and walking the labyrinth. A great way to start the journey of a new year with your compass set in the right direction. I wish you a Christmas season filled with deep peace and great joy. I hope you get to spend it with those you love, and may you receive love in abundance. Karin Knoester is The Gawler Foundation’s Chief Executive. She can be contacted by email: karin@gawler.org

The Gawler Foundation Inc. is a not for profit organisation committed to an integrated approach to health, healing and wellbeing that includes the body, emotions, mind and spirit. Our mission is to work within an integrative medical framework to provide access to the best possible instruction and support for the implementation of self-help techniques for people experiencing cancer, Multiple Sclerosis or other serious illness.

Directors of the Board Irene Goonan, President Ray Cummings, Treasurer Professor Avni Sali Janne Palthe Shelley Oldham Dr Mark Nethercote Karin Knoester, CEO The Gawler Foundation Yarra Valley Living Centre Hawthorn Centre 55 Rayner Court 565 Burwood Rd Yarra Junction 3797 Hawthorn 3122 PO Box 77 Yarra Junction VIC 3797 Phone 03 5967 1730 Fax 03 5967 1715 Email info@gawler.org www.gawler.org

Editorial Editor and Designer, Lindy Schneider media@gawler.org

Editorial Committee: Karin Knoester, CEO Siegfried Gutbrod, Therapeutic Director Paul Bedson, Therapist Greg Rumbold, Research Officer Christine Johnson, Community Relations

Membership and Subscriptions Contact: sue@gawler.org © The Gawler Foundation 2010

ABN 79 160 595 251

The contents of this magazine do not necessarily reflect the opinions of The Gawler Foundation and should not be construed as medical advice. The Gawler Foundation accepts no responsibility for the accuracy of any of the opinions, advice, representations or information contained in this publication. The Gawler Foundation encourages readers to be discerning with information presented and when making treatment, dietary and lifestyle choices. Printed on 100% post consumer waste recycled paper using vegetable oil based inks.

Integrated cancer care A different paradigm by Siegfried Gutbrod

After spending five years overseas, I came back to Australia and rejoined The Gawler Foundation in April this year in the role of Therapeutic Director. I quickly noticed that the overall landscape for the provision of cancer services had changed in Australia in the time I was away. One of the new phenomena was the newly established integrated cancer services offered by the Victorian and other state governments, as well as the building of new integrated cancer wellness centres such as the Olivia Newton-John Wellness Centre, part of the Austin Hospital in Melbourne. I explored, in more detail, the services being offered by these new centres and I was very pleased to recognise that many of the services/therapies offered in these centres fall into the integrated healthcare model.

Opening the door to new possibilities

The services/options include: • Personal and family support • Massage • Meditation/relaxation/Tai Chi • Exercise • Nutrition • Peer support groups

The underlying paradigms for the integrated cancer services/centres as I understand them are:

• The expertise and therapies of conventional medical care represent the primary tools for dealing with the illness of "Hope is not the cancer e.g. surgery, chemotherapy conviction that and radiotherapy.

something will turn out well, but the certainty that something makes sense regardless of how it turns out."

• Emotional/psychological and spiritual support

At first glance many of the integrated cancer services/ centres offer a range of options for people with cancer and their families/carers that is similar to The Gawler Foundation. All seem to fit well into the model of Integrative Medicine to which The Gawler Foundation is fully committed. This model incorporates evidence-based and safe therapies from conventional medical care, complementary therapies and lifestyle interventions applied in a holistic way and including the physical, mental, emotional, spiritual and social dimensions. However, there are significant paradigmatic differences between the approach of The Gawler Foundation and that of integrated cancer centres. It is the main healthyliving - The Gawler Foundation magazine

• The belief that the application of these tools by representatives of conventional medical care alone can determine the outcome of the treatment in terms of ‘quantity of life’/ survival time.

Václav Havel

Wonderful! It seemed that many of the services The Gawler Foundation has been promoting so vigorously over the last 25 years have finally found their way into mainstream medical cancer care. A dream of Ian Gawler’s coming true? After looking more deeply into the reality of 2010, it became clear that the hoped-for miracle has not quite happened yet.

purpose of this article to start naming these differences as they have a profound impact on the ‘consumer’ of these services; the people dealing with cancer, their families and carers.

• The application of a ‘curative approach’ to cancer focuses squarely on the diagnosis and elimination of the pathology of cancer through specific cancer-destructive therapies. • The conventional medical expert knows what is best for the patient and acts accordingly, with a high level of authority. • The patient is expected to be relatively passive. This has the potential to leave the patient in a disempowered position and when the patient asks what he/she can directly contribute to the healing process, the answer is very often ‘nothing’ except trusting the medical profession and to follow advice. • The abovementioned complementary therapies and lifestyle options are seen by conventional medicine under the heading of ‘Supportive Care’. This is seen as beneficial to the adjustment and quality of life of the person receiving the treatment for cancer but has a minimal role in healing and survival time. • Following on from this, the concept of ‘hope’ for survival or increase in survival time is greatly discouraged by ‘Supportive Care’. There is a fear of ‘creating false hope’ with all the legal and other implications that can go with it, creating a passive

"Integrated cancer care has been the cornerstone of The Gawler Foundation's programs for twenty five years. So, how are recently established 'Integrated cancer centres' similar and different to the approach taken by the Foundation and what does that mean for those seeking cancer support?" culture of hopelessness. The underlying paradigm for The Gawler Foundation approach is: • The person with the illness needs to be encouraged and supported to take charge of his/ her own healing process, to be in an empowered position, in the driver's seat of the healing journey.

into inner peace using the lifestyle tool of meditation and good therapeutic help. There is no guarantee for achieving the healing goals. Death is an inevitable outcome of life in general. When people can transform the fear of their own mortality, irrespective of whether they are diagnosed with a serious illness, they have a better chance to enjoy life to the fullest and to have a ‘better death’ whenever that may occur.

• Empowerment requires that the person with the illness be informed of what lifestyle options and The Gawler Foundation’s approach does not appeal complementary therapies are available (in addition to everybody diagnosed with cancer. Actually, it only to the conventional medical interventions) at the appeals to a minority as it requires a very active role of beginning of the healing process. The person with the taking responsibility and usually involves committed, illness needs to be able to make an dedicated work related to lifestyle informed choice of what interventions interventions such as using food "Ideally people he/she consciously chooses to therapeutically and alleviating stress diagnosed with achieve the healing goal. The on a deep level. decision will take into account both cancer would be told quantitative and qualitative measures. Many people diagnosed with a at the early stage serious illness are very happy to stay • Hope is real and critical and often of all the options in a passive role and hope that the is the starting point that leads to medical experts will do the right thing in the model of remarkable, unexpected outcomes. to ‘fix the problem’. I respect that There is plenty of evidence of people ‘Integrative Medicine’. choice without judgment. However, who, against all odds, have survived Unfortunately this is we see many people who reach the cancer long term or found a way to coend of the medical road and are not happening." exist with cancer for long timeframes told that there is nothing more that or simply exceeded their statisticalconventional medicine can do except based prognosis. Hope is not just to provide palliative care. Only then the search begins wishful thinking. Hope, in order to be effective, needs in earnest for other options outside of mainstream three components. Firstly, it needs to be directed towards medicine. Ideally people diagnosed with cancer would achieving a healing goal. Secondly, it needs to include be told at the early stage of all the options in the model a commitment to a set of specific interventions which of ‘Integrative Medicine’. Unfortunately this is not have the potential to alter the outcome. Thirdly, it needs happening. to be backed up by the willpower to implement these interventions. There is growing statistical As indicated above, at first glance there seems to be evidence that this form of hope increases survival time. a narrowing of the difference in paradigms between conventional medical care for cancer patients and the • There are many intervention options that directly approach of The Gawler Foundation. However, below impact the key outcome measure of survival time. the surface there remain significant paradigmatic The interventions applied by conventional medicine differences which are not easy to bridge and are (surgery, chemo, radiotherapy) are important options, important to acknowledge. Nevertheless, I very much however, there is clear and increasing statistical welcome the growing significance of ‘Supportive Care’ evidence that lifestyle interventions also impact in the field of integrative cancer services/centres survival time (meditation, nutrition, emotional and as this directly benefits the people who have been spiritual aspects, physical exercise etc). diagnosed with cancer, their family and carers. • The ‘healing approach’ focuses on the whole Siegfried Gutbrod, Therapeutic Director at the person by embracing the physical, emotional, mental, Foundation, is a counsellor, group facilitator and spiritual social and spiritual dimensions of the ill person. care consultant for dying people. He holds a Masters degree in Counselling and a Diploma in Psychophonetics • Better decisions can be made by the person in the Counselling. driver's seat from a state of inner peace. Stress and healthyliving - The Gawler Foundation magazine 5 fear can be transformed by the person with the illness

A meditation for

Gratitude

From intention springs the deed, from the deed springs the habit.

From the habit grows the character, from the character develops destiny. Old Chinese saying by Paul Bedson Just as resentment can blind us to love, the ‘more syndrome’—or, as it is commonly called, greed—can blind us to all the gifts and blessings we already have in our lives. Gratitude is an acknowledgement of all that sustains us, nourishes us, inspires us and touches our heart. Gratitude gives thanks for all our blessings, great and small, and gives appreciation for all those people and things that support and carry us through each day. The habit of the 'more syndrome' can keep us constantly hoping for and running towards some imagined future happiness…always wanting more: to do more, to have more, to get more and to be more. In the process of constantly 'running', we can easily ignore or take for granted the many blessings that we already have in our lives. The 'more syndrome' can keep us believing that the glass is always only half full. Cultivating gratitude helps to heal this habit by reminding us of the good in life, the good in ourselves and in other people. Through sensationalist media reporting we receive enough exposure to the bad in life. It is easy to forget about the good. There are so many good people in the world and in our lives, and there is so much good inside each individual. In the simple words of Walt Whitman: “I am larger and better than I thought. I did not think I held so much goodness”. Admittedly, at times our perception of our own worth may be clouded by ignorance, pain, fear or anger. But still, the good exists. Cultivating gratitude is not about putting on rosecoloured glasses and a false smile. Paradoxically, as we accept and acknowledge our pain, vulnerability and suffering and feel compassion for ourselves and others, we can naturally begin to sense the sweetness and goodness in life. The seeds of gratitude can appear effortlessly from the practice of Mindfulness-Based Stillness

healthyliving - The Gawler Foundation magazine

Meditation (MBSM). When we stop struggling with ourselves and others, we give ourselves more space. By letting go of expectations and judgements, we also give ourselves more space. Out of that spaciousness, gratitude can begin to emerge quite naturally. Intentional meditation on the quality of gratitude can enhance this emergence. Like the quality of forgiveness, gratitude cannot be forced but it can be developed by choosing to practise and cultivate it. MBSM can prepare the way. Once gratitude starts to touch your heart and mind, you may well find it arising spontaneously at any time or place. Just by momentarily pausing the forward momentum of the utilitarian mind, a space for gratitude can open up. Mindfulness can create the space. I recall sitting on a bench in the Mount Tomah Botanical Gardens in the Blue Mountains. I was sitting quietly admiring the view when a small bird landed on a branch just above my head. The bird began to sing the sweetest song. It seemed to be singing just to me. Some part of my mind whimsically asked the question, “What did I do to deserve that?”. My inner knowing replied, “You did nothing to deserve it. It was a gift, a blessing!” My heart and my whole body filled with such a deep sense of gratitude, that it brought tears of joy to my eyes. When gratitude appears, it humbles the mind, gladdens the heart and leads to joy. We do not have to earn or fight for everything life brings to support and inspire us. We receive so many blessings that are not earned but are freely given by life. It behoves us to give thanks.

Paul Bedson is a therapist at The Gawler Foundation where he facilitates key Foundation programs.

Prepare yourself for this meditation by practising Mindfulness-based Stillness Meditation for five minutes or simply sit and relax for a few minutes. Bring to mind all of the material things in your life that sustain and comfort you . . . the food you eat, the clothes you wear, your home . . . Bring to mind the material things that entertain and inspire you . . . your books, garden, television, furnishings, artworks . . . In your mind, begin to recall and name all those material things. As you dwell on these things, say to yourself: Thank you. Thank you for all these things that support and comfort me, that amuse and inspire me. Thank you very much. Breathe consciously . . . Direct the breath towards your heart . . . As you breathe out, let your heart be touched with the feeling of gratitude. Now allow to come to mind all of your teachers . . . all those who have encouraged, inspired or otherwise helped you to grow . . . Some of your teachers may have been kind, some more ruthless . . . In your mind, begin to recall, picture and name all of your teachers. Then say to yourself: Thank you. Thank you to all of my teachers. Thank you for the lessons you have given me. Thank you very much. Breathe consciously . . . Direct the breath towards your heart . . . As you breathe out, let your heart be touched with the feeling of gratitude. Now allow to come to mind all of your friends . . . all of the people who have shared fun, challenges and love with you . . . all of the people who have supported you . . . It may be a small select group or a larger group . . . In your mind, begin to recall, picture and name all of your friends. Then say to yourself: Thank you. Thank you to all of my friends. Thank you for your love and support. Thank you very much. Breathe consciously . . . Direct the breath towards your heart . . . As you breathe out, let your heart be touched with the feeling of gratitude. Now allow to come to mind all of your family members . . . your parents, grandparents and ancestors who stand behind you . . . your brothers and sisters who stand beside you . . . perhaps your children

who stand in front of you . . . All of your family members . . . In your mind, begin to recall, picture and bring to mind all of your family members. Then say to yourself: Thank you. Thank you to all of my family members. Thank you for all the fun, challenges and love that we have shared. Thank you for your love and support. Thank you very much. Breathe consciously . . . Direct the breath towards your heart . . . As you breathe out, let your heart be touched with the feeling of gratitude. Now allow to come to mind the people with whom you have shared intimate love . . . your lovers, partners, spouse . . . all of the people who have touched your heart as you have touched theirs . . . It may be a small select group or just one person . . . In your mind, begin to recall, picture and name your beloved ones. Then say to yourself: Thank you. Thank you to my loved ones. Thank you for the love that we have shared. Thank you very much. Breathe consciously . . . Direct the breath towards your heart . . . As you breathe out, let your heart be touched with the feeling of gratitude. Now bring to mind your own unique and precious self . . . In your mind, begin to recall times in your life, see your face at various ages, and say your own name. Then say to yourself: Thank you. Thank you to my own true self. Thank you for this precious life. Thank you very much. Breathe consciously . . . Direct the breath towards your heart . . . As you breathe out, let your heart be touched with the feeling of gratitude. Let the feeling of gratitude spread to every part of your body. Let every cell of your body say: Thank you. Thank you very much. Thank you for this life. If it feels appropriate, place your palms together in front of your chest in a prayer position. You may even like to bow your head a little as you continue to say to yourself and to all of Life: Thank you. Thank you very much.

giving thanks for life

healthyliving - The Gawler Foundation magazine 7

Research Evidence Summary

MS research indicates positive by Prof George Jelinek

Overcoming MS The December issue of the international journal Quality in Primary Care contains the paper published by Professor George Jelinek, Dr Ian Gawler and their colleagues reporting the results of the ongoing longitudinal cohort study on people attending the multiple sclerosis (MS) residential retreats at the Foundation since 2002.

Lifestyle and therapy recommendations Diet and supplements A plant-based wholefood diet plus fish, with no saturated fat, as far as practical Omega-3 fatty acid supplements: 20g (20mls or 20 capsules) a day (of flaxseed oil or fish oil, or the equivalent amount in fish)

Most people with MS are treated with long-term drug therapy including the interferons, glatiramer, and more recently natalizumab. However the effectiveness of these drugs in slowing disease progression is questionable, as is their costeffectiveness. Studies on therapies such as a low saturated fat diet, vitamin D supplementation, exercise and stress management have suggested a benefit, and there has been a call for these modalities to be considered in the management of people with MS. Professor Jelinek has written a book entitled Overcoming Multiple Sclerosis: an Evidence-Based Guide to Recovery published by Allen and Unwin, and runs a website www.overcomingmultiplesclerosis. org, outlining these approaches.

Optional B group vitamins or B12 supplement if needed

The table (at right) shows the recommendations provided in the retreats. Briefly, our study aimed to evaluate the effect of these residential retreats promoting lifestyle modification on the health related quality of life (HRQOL) of people with MS. The study, approved by the Ethics Committee of the University of Melbourne, started with the first retreat in April 2002, and has been enrolling people attending retreats since. The paper presents the results of the first analysis of data to 2008. Participants attending the retreats were asked to complete the MSQOL-54 questionnaire, a validated measure of quality of life for people with MS, just prior to, and at 1 year and 2.5 years post-retreat.

30 minutes around 5 times a week preferably outdoors

Professor George Jelinek facilitates the Overcoming MS retreat at The Gawler Foundation. Diagnosed with MS himself in 1999, he is both a doctor and a patient and has gone 11 years without relapse.

REFERENCES - Given the extent of references supporting this article there is insufficient space to list them all.The full list of references for the research studies summarised in this evidence summary is available on our website.

8 healthyliving

- The Gawler Foundation magazine

Vitamin D Sunlight 15 minutes daily 3-5 times a week as close to all over as practical Vitamin D3 supplement of 5000 IU daily in winter or if no sun exposure Aim to keep blood level of vitamin D around 150nmol/L

Meditation 30 minutes daily

Exercise Medication One of the disease-modifying drugs, beginning as early in the illness as possible, if required Steroids for any acute relapse that is distressing One of the more potent drugs, such as mitoxantrone, if the disease is rapidly progressive

outcomes ABC TV '7.30 Report' interview

See George interviewed about his MS work here at The Gawler Foundation. Check local program guides for details. The results were quite stunning. Of 188 retreat participants, 109 (58%) completed questionnaires. The group showed a significant improvement in health related quality of life (HRQOL) at 1 year and 2.5 years follow-up. After 1 year, overall QOL improved 11.3% from 73.4 to 81.7 (p<0.001), physical health 15.4% from 66.2 to 76.4 (p=0.001) and mental health 13.3% from 73.7 to 83.6 (p<0.001). After 2.5 years, overall QOL improved 4.8% from baseline going from 68.4 to 71.7 (P=0.03), physical health improved 17.3% from 59.7 to 70.0 (P=0.01), and mental health improved 14.5% from 66.9 to 76.6 (P<0.01). None of the domains revealed any deterioration at either timepoint. It is interesting to note that the biggest long term improvement was in physical health. Results are presented graphically in Figures 1 and 2 for the 1 year and 2.5 year follow ups.

Our Approach The Gawler Foundation

The initial findings of this ongoing research study are positive and encouraging. The results show that the people who have attended the Overcoming Multiple Sclerosis retreats at The Gawler Foundation experience an improvement in health related quality of life over the subsequent 2.5 year period. This is one of the few research studies to have examined the potential benefits of these lifestyle and health promotion strategies for people living with multiple sclerosis. The improvement in quality of life observed in this study is an exciting finding and provides evidence of the value and effectiveness of this Gawler Foundation program. Quality of life is a patient outcome measure that extends beyond traditional measures of disease status to include dimensions such as psychological state, social relationships, health perception and functional status. The use of this measure in research studies allows researchers to assess the impact of a disease or illness on health and wellbeing in a comprehensive manner. This ongoing longitudinal study provides the opportunity to continue to monitor the quality of life for these participants over subsequent years.

We concluded that, while HRQOL usually deteriorates over time in people with MS, this was not the case for people attending the Foundationâ&#x20AC;&#x2122;s MS retreats. Indeed, attendance at a residential retreat promoting lifestyle modification appears to have a significant positive effect on QOL for people with MS, lasting at least 2.5 years. It is very gratifying to see such dramatic health improvements in this group of people for whom there has been little realistic hope in the past. The results show the value of the programs offered by the Gawler Foundation, and reflect very positively on the efforts of all the staff involved in their delivery and behind the scenes. Health practitioners caring for people with MS should strongly consider the potential benefits of this approach when they care for people with MS.

Dr Greg Rumbold is a Research Officer at The Gawler Foundation. He has worked in health research for over 20 years in areas including public health, alcohol and drug research, and evidence based medicine.

Request for volunteers We are looking for volunteers who have research experience and training to assist us with our research projects. Send an email to greg@gawler.org to express your interest. healthyliving - The Gawler Foundation magazine 9

What works in Profound Healing - Sustainable Wellbeing Conference Speaker

Grief Counselling?

by Dr David Morawetz This article is a summary of a journal article that appeared in Grief Matters: The Australian Journal of Grief & Bereavement, Summer 2007, pp 56-59. The key findings of counselling effectiveness research, drawn from 40 years of outcome research in counselling and psychotherapy, identify significant success elements which are also applicable to grief counselling. The overall effectiveness of psychotherapy or counselling has been well established (Asay and Lambert, 1999). The data indicates that psychological intervention is superior to both placebo and no-treatment control groups. Indeed, in most quantitative studies, the average treated person has been found to be better off than 80% of those who do not have the benefit of counselling (Lambert and Bergin, 1994). Asay and Lambert (1999) conclude that effective psychotherapy results from the operation of four common factors. The most important of these is client factors, estimated to account for about 40% of the variance of outcome. Relationship factors account for about 30%, while hope and expectation factors account for about 15%, and model and technique factors account for the remaining 15% of outcome variance.

A further insight into client factors can be gained using a metaphor from Gestalt Therapy. It is as if we all have a jar of feelings inside us, and when we experience some unpleasant feelings, like after the death of someone close, it is easy to stuff the unpleasant feelings down into the jar, put the lid on the jar, and no longer feel the unpleasant feelings. But the problem is that the happy feelings and the feelings we need to make good decisions are often trapped underneath the unpleasant feelings, so we don’t have access to these either. What is needed, then, is to take the lid off the jar, experience the unpleasant feelings one more time, and let them go–at which point we can access once again the happy feelings.

The relationship between client and counsellor

More than half a century ago, Carl Rogers (1951) found in path-breaking empirical studies that there are three conditions for effective counselling: unconditional positive regard, accurate empathy and congruence. The most recent literature strongly supports the importance of these factors, even if slightly different words are used such as warmth, caring, acceptance, genuineness and encouragement. Client factors Interestingly, it is the client’s perception of the relationship that is crucial (not the counsellor’s), Client factors include things like the client’s personal strengths and weaknesses, motivation, especially the client’s perception of empathy, talents, values, skills, experiences, perseverance, acceptance and warmth from the counsellor. If resources, beliefs, attitude towards the value of the client is not satisfied with the relationship, it counselling, social supports, willingness to take is most unlikely that any useful grief counselling (or any other useful counselling) will happen. a risk, and potential for change. The severity of the client’s disturbance is important in affecting outcome. So too is the client’s capacity to relate, ego strength, psychological mindedness, and ability to identify a focal problem. Some client variables, such as motivation, can change rapidly in counselling, while others, such as a personality disorder, may be less amenable to change.

healthyliving - The Gawler Foundation magazine

Hope and Expectation The third factor, hope and expectation, consists primarily of the client’s expectations and hope regarding the possibility of change and improvement. Hope and expectation are empowered when counsellors convey an attitude of hope and possibility without minimising the problem or the pain that accompanies it, and

"What determines the effectiveness of grief or general counselling? An effective counsellor tries to find the best approach or technique for this particular client, at this particular time." when counsellors encourage clients to focus on present and future possibilities, instead of focussing only on past problems. It is a very human characteristic to assume that whatever is happening now is what is going to happen forever. That is why, when people are feeling despairing, depressed, defeated and hopeless, the generation of realistic hope can be so important. People who are grieving often ask: ‘Will I ever feel any better?’ One concept that can be helpful to clients in this situation is the difference between ‘getting over it’ and ‘learning to live with it’. With some types of grief after major loss, you may never ‘get over it’ – but you may well be able to ‘learn to live with it’. Being able to talk about clients who have felt the same despair, and have eventually ‘learned to live with the loss’ can be helpful, provided it is not done too soon, or in too cavalier a fashion. (‘She’ll be right, mate’ is definitely not helpful).

Model or Technique The fourth factor is the model or technique used by the counsellor. The grief counselling model needs to fit the client. Counselling is likely to be more successful if a technique is chosen that capitalises on client strengths, is considered empathic, respectful and genuine by the client, fits with the client’s goals for treatment and ideas about the change process, and increases hope, expectancy and sense of personal control. One of the most useful techniques in grief counselling is the concept of the Normal Grief Storm, which was developed by the Australian Graham Fulton (1989). This metaphorical way of understanding the grief process says that it is as if the person who is grieving is trying to survive in a small boat in the middle of a violent storm in a huge ocean. The grieving person is buffeted by: (a) The Waves of Emotion: shock, numbness, disbelief, denial, fear, guilt, pain, devastation, sadness, anger, rage, anxiety, yearning, powerlessness, helplessness, loneliness, despair, isolation, feeling ‘I’m going crazy’, ‘it’s not fair’, ‘why? why? why?’ – then at last relief and acceptance – and then it starts again: denial, pain, anger, sadness, yearning, unsureness, ‘should I be feeling this?’, and so

forth. (b) The Winds of Disturbed Behaviour: listlessness, inability to concentrate, appetite disturbance, sleep disturbance, absent mindedness, restless activity, agitation, distraction, sighing, crying, dreaming, withdrawing into the self, restlessness, searching. (c) The Fog of Disturbed Thought Processes: disoriented, preoccupied, hallucinating, confused, disorganised thinking, out of control, forgetful, questioning, unclear, disbelieving, vague, difficulty concentrating, preoccupied, confused, clear at last – and then it starts again. In my experience, most clients who are grieving find that this concept of the Normal Grief Storm describes accurately what they are going through – and it gives them great relief, because they become aware that they are going through a normal grief process, and they are not ‘going crazy’. Other models or techniques that I believe are very important in grief counselling include: • Active listening – trying to understand what the grieving person is going through: ‘tell me about it, tell me about it’. • Being able to sit with the person in their pain, and in their tears, without trying to make it better. • Asking the client to do some writing, often in the form of a letter to the person who has died. As one client said: ‘When I talk, it comes from my mouth. When I write, it comes from my heart.’ • Understanding that everyone grieves differently. Don’t assume a client will want what others would want in their situation. • Being able to sit with silence. • Understanding that men and women experience grief similarly, but frequently express it differently. • Checking for other earlier unresolved losses in the client’s life. • Helping clients deal with other people’s well-

>continued page 19

Dr Morawetz B.A. (Hons), M.Sc. (Econ), Ph.D., M.Ed. (Counselling), M.Psych. Clinical and Counselling Psychologist in private practice in Canterbury, Melbourne. Dr Morawetz is the author of Sleep Better Without Drugs an Australian self-help program that helps people suffering from insomnia. He is widely acknowledged as one of Australia’s foremost experts on helping people to sleep better without medication. He teaches postgraduate classes on sleep at Monash University, La Trobe University, Swinburne University and to GPs (family doctors) and psychologists. healthyliving - The Gawler Foundation magazine 11

2011 Gawler Foundation Programs Residential Programs - Yarra Junction Residential Programs for Cancer, Multiple Sclerosis and other Illness

Residential Programs Promoting Health and Wellbeing ► Set your Compass for 2011. New!

► Life and Living A ten day transformative program to meet and help overcome the challenges of cancer.

Weekend retreat facilitated by Siegfried Gutbrod which guides purposeful life planning for the next 12 months. Venue: Yarra Valley Living Centre

Venue: Yarra Valley Living Centre

• Friday 21 Jan - Sunday 23 Jan 2011

• Monday 6 Dec - Thursday 16 Dec 2010

► Weekend Meditation Retreat

• Monday 31 Jan - Thursday 10 Feb • Monday 28 Feb - Thursday 10 Mar

Weekend retreat to de-stress, relax and recharge your batteries. An excellent interlude in busy life.

• Monday 4 April - Thursday 14 April

Venue: Yarra Valley Living Centre

• Monday 2 May - Thursday 12 May

• Friday 28 Jan - Sunday 30 Jan

• Monday 13 June - Thursday 23 June

• Friday 1 July - Sunday 3 July

• Monday 18 July - Thursday 28 July • Monday 22 Aug - Thursday 1 Sept • Mnday 19 Sept - Thursday 29 Sept • Monday 17 Oct - Thursday 27 Oct • Monday 5 Dec - Thursday 15 Dec

► Life and Living - The Next Step A five day follow-up program for people who have completed 'Life and Living' or 'Living Well'. (Formerly known as Health Healing and Beyond)

Venue: Yarra Valley Living Centre • Monday 28 Mar - Friday 1 April • Monday 3 Oct - Friday 7 Oct

► Healing Meditation Retreat Three day retreat that facilitates the healing process for people dealing with an illness. Venue: Yarra Valley Living Centre • Monday 21 Feb - Wednesday 23 Feb • Wednesday 6 July - Friday 8 July • Wednesday 2 Nov - Friday 4 Nov

► Overcoming Multiple Sclerosis

• Friday 25 Nov - Sunday 27 Nov

► Living in Balance Five day retreat to connect with the essence of life, your inner wisdom and strength. Develop healthy strategies and let go of old habits. Venue: Yarra Valley Living Centre • Monday 21 Mar - Friday 25 Mar • Monday 7 Nov - Friday 11 Nov

► Moving to your Rhythm Womens Retreat Weekend retreat to nurture and invigorate your womanhood. A break to recharge, connect and rest. Venue: Yarra Valley Living Centre • Friday 15 Apr - Sunday 17 Apr • Friday 2 Sept - Sunday 4 Sept

► Mindful Movement and Stillness Weekend retreat to explore moving between these three states in daily life. Develop a balanced mindful routine in your life.

Five day practical and inspirational program facilitated by Professor George Jelinek.

Venue: Yarra Valley Living Centre

► Pathways to Intimacy

• Monday 14 Feb - Friday 18 Feb

Weekend retreat for couples and individuals to invite more intimacy in life and enhance all relationships. Venue: Yarra Valley Living Centre

• Monday 10 Oct - Friday 14 Oct • Monday 30 May - Friday 3 June (Follow up)

healthyliving - The Gawler Foundation magazine

• Friday 11 Mar - Sunday 13 Mar

• Friday 27 May - Sunday 29 May

2011 Gawler Foundation Programs

Non-Residential - Hawthorn, Springvale, Footscray

► Living in the Now Five day experiential retreat to enhance the celebration of life and heal resistance to living in the present moment. Venue: Yarra Valley Living Centre ● Monday 16 May - Friday 20 May

Non Residential Programs

Ongoing Meditation and Cancer Support Groups ► Living Well - Cancer, Healing and Wellbeing

Twelve weekly sessions to meet and help overcome the challenges of cancer.

► Ongoing Cancer Support Group The format for this program focuses on sharing new ideas and experiences with others and reinforcing the principles of self-help, group meditation and mutual support. All programs run from 2.30pm - 4.30pm. Venue: The Gawler Foundation at Hawthorn ● Tuesday (weekly) ongoing, commencing 25 Jan Venue: The Bluestone Church, Footscray ● Monday (fortnightly) ongoing, commencing 24 Jan

Death, Fear and Inner Peace. New! One day workshop facilitated by Siegfried Gutbrod which explores mortality, death and dying and living a joyful life. From 9.30am - 4.30pm. Venue: The Gawler Foundation at Hawthorn

Venue: The Gawler Foundation at Hawthorn

2011 TBA - Please register your interest

• Tuesday 25 Jan - Tuesday 12 Apr

Mindfulness-based Stillness Meditation

• Tuesday 10 May - Tuesday 26 July • Tuesday 23 Aug - Tuesday 15 Nov Venue: Springvale Council Offices

► Eight Week Non-Residential Program

• Wednesday 11 May - Wednesday 27 July

The eight week meditation course is an excellent opportunity to learn or deepen your meditation and relaxation skills.

• Thursday 25 Aug - Thursday 10 Nov

Venue: The Gawler Foundation at Hawthorn

Venue: The Bluestone Church, Footscray

Monday 7 Feb - Monday 4 Apr (6.00pm to 7.30pm)

• Monday 24 Jan - Monday 18 Apr

Monday 2 May - Monday 27 Jun (12.30pm to 2.00pm)

• Monday 9 May - Monday 1 Aug

Monday 18 Jul - Monday 5 Sept (12.30pm to 2.00pm)

• Monday 22 Aug - Monday 7 Nov

Monday 10 Oct - Monday 5 Dec (time TBA)

• Wednesday 19 Jan - Wednesday 13 Apr

► Integration Program An eight week program for those who have completed 'Life and Living' or 'Living Well'. Develop, deepen and share healing methods and experiences through an interactive support group program. Programs run from 9.30pm - 12.30pm. Venue: The Gawler Foundation at Hawthorn • Thursday 5 May - Thursday 23 June • Thursday 13 Oct - Thursday 1 Dec

► Meditation Group

Weekly Meditation group provides an opportunity to share your experiences with others and maintain your momentum and commitment to regular practice. Program runs from 1.30pm - 2.30pm. Venue: The Gawler Foundation at Hawthorn ● Tuesday (weekly) ongoing, commencing 25 Jan

Contact and Venue details Bookings: email info@gawler.org or call 03 5967 1730 The Gawler Foundation at Hawthorn 565 Burwood Road, Hawthorn Vic Springvale Council Offices 397-405 Springvale Road, Springvale Vic The Bluestone Church 8A Hyde Street, Footscray Vic The Yarra Valley Living Centre 55 Rayner Court, Yarra Junction Vic healthyliving - The Gawler Foundation magazine 13

From the stillness of meditation, discover the power within to live your life to its full potential.

inspire, inform, amuse, Christmas Thoughts from Leunig Share your story We welcome your contributions to the magazine and would love to hear your feedback and article ideas. If you have a story about the time you have spent in one of our programs and would like to share it, please send to Lindy at media@gawler.org, or post to Healthy Living Magazine PO Box 77 Yarra Junction VIC 3797. Poems, letters, images and inspirations are also welcome.

Dear God, it is timely that we give thanks for the lives of all prophets, teachers, healers and revolutionaries, living and dead, acclaimed or obscure, who have rebelled, worked and suffered for the cause of love and joy. We also celebrate that part of us, that part within ourselves, which has rebelled, worked and suffered for the cause of love and joy. We give thanks and celebrate.

Subscribe Subscribe to this magazine on our website and have it delivered four times a year to your door for $29.95. A great gift idea.

Our new website We are currently updating and improving our website to make it easier to find information and resources.

Welcome Shelley We are happy to welcome our new Fundraising and Development Manager, Shelley Calopa. She brings a broad range of marketing and fundraising experience in the not for profit sector having worked with the Royal District Nursing Service and Zoos Victoria. You can email Shelley at shelley@ gawler.org

Siegfried brings a smile to the Prostate Cancer Foundation Conference The Victorian/Tasmanian Chapter of the Prostate Cancer Foundation of Australia held its Annual Conference in Geelong from 22-24 October, 2010. Thanks to the lobbying of four Geelong participants of a recent Gawler Foundation 12 week program at Hawthorn, as well as some other past Gawler program participants, the program organisers for the first time invited a guest speaker from The Gawler Foundation. Our Therapeutic Director Siegfried Gutbrod presented a session on ‘Laughter as the best medicine’ as the dinner speaker on Saturday night in front of 150 conference participants. On Sunday morning, he also presented on the topic of ‘Wellness and Meditation’. The presentations were very well received and put TGF formally on the ‘prostate’ map. Valuable contacts with key people of the Prostate Cancer Foundation were established and we are optimistic we will be involved in next year’s conference. Another of our therapists Robyn Jones followed up with a session on ‘Meditation and Healing’ to the Geelong Prostate Cancer Group in late October. Pictured with Siegfried (at centre) are Roger Northam (left), Member Victorian/Tasmanian Chapter Prostate Cancer Foundation from Geelong who did the 12 week course recently, and John Preston (right), Chairman of the Victoria/Tasmania Chapter of the Prostate Cancer Foundation of Australia.

healthyliving - The Gawler Foundation magazine

news and views

Join us on Facebook.

www.rometosantiagoproject.com.au

John Bettens - Walking the Pilgrim's Path

John Bettens, a past program participant, will embark on an inspiring fundraiser for The Gawler Foundation in April 2011. He will walk 'The Camino', a spiritual pilgram's walk of 3000 kilometres. His journey will take him from St Peter's Basilica in Rome, Italy, to Saint James Cathedral in Santiago de Compostela, Spain, at least four months of walking 25 kilometres per day. John, who is in his early 60s and is a lawyer, is living with two types of cancer - prostate cancer (diagnosed 2003) and follicular lymphoma (diagnosed 2007). He is embarking on this amazing journey as a quest for personal healing and to raise money for the Foundation's ongoing work. You can find out more about John's journey on his website www.rometosantiagoproject.com.au The website also provides which is an initiative of The Gawler visitors with the opportunity Foundation. John will post regular to make a donaton as a sign of updates and photos of his progress support. All donations made are and share a story or two from 'the tax deductable and will benefit path'. future program participants. John aims to raise one million dollars, so every donation made is a 'step' closer to his goal. Please join us in wishing John a wonderful journey and support his dedication by making a donation via our secure website. “Sometimes we get the opportunity to do something a bit out of the ordinary which can do some good in this world. I feel the Rome to Santiago project is one of those ‘somethings’.” John Bettens

Heather Wright, a program participant in October, took this photo in our gardens. She says 'it was a lovely ending to a meditation.' What a wonderful sign of Spring's essence of hope and renewal.

The Way of the Natural Therapist is a compilation of personal stories by a range of complementary therapists. With a chapter written by Siegfried, and a foreword from our CEO Karin, a 10% donation from book sales will be made to The Gawler Foundation. Available from our Resource Centre.

Ian's Blog Out on a Limb

Ian Gawler's new blog 'Out on a limb' can be found at www. gawlerblog.com. He will be posting weekly articles and matters of interest regarding health and wellbeing.

For information: Call The Gawler Foundation on 03 5967 1730 or visit www.gawler.org

healthyliving - The Gawler Foundation magazine 15

In the bookstore POSITIVITY

Barbara L Fredrickson PhD

Reviews by Robin Jones

$21.95

You cannot simply will yourself to feel a positive emotion, but there are certain levers that, if you choose to operate them, will help to tip your mood toward positive feeling. So willpower is not enough, you have to actually do something. This is good news. You have much more control over your positivity than you may have thought. World-renowned researcher Barbara Fredrickson gives you the lab-tested tools to create a healthier, more vibrant and flourishing life through a process she calls 'the upward spiral'. One of the principles of The Gawler Foundation’s programs is to maintain a positive outlook. This entails so much more than pretending to feel positive in order to reassure others. In this new book, you will find techniques, research and stories of people who have successfully used the techniques. Cultivating positivity can make an enormous difference in your life. This book unpacks that difference to reveal how and why positivity carries such potency.

THE LANGUAGE OF PAIN

David Biro, MD

$32.95

Pain regularly accompanies illness, as David Biro knows only too well. Faced with a bone marrow transplant, he was determined to study his pain but found himself unable to articulate its depths, even to his doctors and wife. He has now discovered a way to break through the silent wall of suffering – physical and psychological. He expertly weaves together compelling stories and artwork from patients, along with insights from some of our greatest thinkers, artists and writers. Language can alleviate the loneliness of pain and improve the chances that other people will empathise and respond most effectively.

DON’T GET MAD, GET WISE

Mike George

$23.95

We all know anger. We all seek peace. And many of us find forgiveness difficult, especially when the source of our hurt is up close and personal! Anger destroys, peace restores and forgiveness heals – this is the journey we can all learn to make. But first we have to understand the true cause of our anger, the true source of our peace and the enlightened way of forgiveness. Going beyond the common psychological concepts and quick fix techniques, Mike George reveals the depth of the ‘spiritual perspective’ of anger as the ‘incendiary emotion’, and then shows us the ultimate antidote. Includes: why noone ever makes you angry; ways to dissolve anger and other emotions; why peace is the most profound, powerful and practical state you can ever know; how to find your inner peace and use it wherever you are; and why forgiveness is so hard, absolutely essential and yet ultimately irrelevant. Financial Members receive a ten percent discount on books and audio and five percent discount on the Champion Juicer. Please quote your membership number when ordering. Robin Jones is the manager of The Gawler Foundation’s Resource Centre.

healthyliving - The Gawler Foundation magazine

How to order: Go to the shopping cart at www.gawler.org or contact the Resource Centre on: 03 5967 1730; Fax 03 5967 1715 or email resources@gawler.org. SHIPPING RATES: Available through the shopping cart on our website or contact us.

Fundraising News 2010 Christmas Appeal "This Christmas I want the gift of time; to live my life, to enjoy my friends, to walk through nature and to see the moon reflected in the sea." Isabelle Henry, The Gawler Foundation program participant 2009 Isabelle Henry has an adventurous spirit. At 20, while training as a nurse, she trekked solo across the Serengeti desert, and in the years that followed she developed a love for yachting that would take her on voyages across Australasia. But recently, Isabelle has been on the biggest adventure of her life; navigating her way through cancer and arriving at an unexpected destination–peace. "Being diagnosed with cancer was really scary. I knew I wanted to try everything I could to get rid of it, but I was in a fog and just didn't know where to start. I was just numb. When I made contact with the Foundation that was my turning point." In 2009, Isabelle enrolled in the 12 week program in Footscray while continuing with traditional cancer treatments. Under her doctor's care she received radiation and chemo; at The Gawler Foundation she received counselling, nutritional advice and meditation instruction. At her medical appointments, she was asked to fill out surveys, while at her Gawler Foundation sessions she was asked how she felt and how she was coping. Isabelle is currently feeling 'remarkably well'. She juices daily and meditates regularly. Her checkups have moved from three monthly to five monthly and her scans are all clear. This year she overcame a fear of travelling with cancer and celebrated her 60th birthday with a trip to the USA. She now works in a nursing related field and is going to get back into sailing and bushwalking.

We are now planning what we can offer in 2011 and need your support. Please give generously to our Appeal this Christmas so that we can continue to support people like Isabelle who need our help and a little hope in life. Your donation will make an immediate impact on the lives of people with cancer and their families. Your gift will ensure that financial hardship is never a barrier to attending one of our life-changing programs. This Christmas there is no better present than the gift of hope. Donations can be made via our secure website or by calling us direct on 03 5967 1730.

Thank you CD Giveaway! We have 20 copies of Ian Gawler 's Gratitude meditation CD to give away. Simply be one of the first 20 members to complete and return the 2010 membership survey to win. If you haven’t received your survey, please call us on 03 5967 1730.

Shelley

2010 Christmas Appeal

But more than anything, she longs to make a difference. "For me the most important legacy of The Gawler Foundation's program is that I embrace life. None of us knows how long we have on this earth, and I want to do something useful with the time I have. Now I say yes to everything; to life."

Shelley Calopa is the Foundation’s Fundraising and Development Manager.

healthyliving - The Gawler Foundation magazine 17

DailyMotion

Have you done a poo today? by Dr Ruth Gawler MB BS FACPsyMed MGP Psych

uring a recent four days in hospital recovering from a successful operation on my lower back for a herniated disc and nerve root compression, it was brought to my attention that we have a society, and a medical culture, which is still somewhat slow to realise the importance of good and regular bowel movements. Often we seem to think this issue is not very significant and treat the subject with humour or avoidance. You can tell culturally that we still have a problem with talking around defecating - in spite of the permissive modern era - because it is only in a medical situation that anyone would be asked 'when did you last open your bowels?' and not 'when did you last do a poo?' In my experience 'open your bowels' is an expression which most Australians are somewhat bewildered by. To understand it, they often require a 'charadeslike accompaniment'. Also, conversation on 'the poo topic' routinely gets heaps of laughs when we bring it up in our programs. The reality is that many people do have problems with constipation. In my experience, many people consider it OK to have a poo only every few days. Ian Gawler recommends that with a healthy bowel and a sound high fibre diet, it is common to poo three times daily; commonly once after

4 ways

...

to promote good bowel action • Keep hydrated - indicated by a moist tongue and regular urination • Eat more fibre in your diet • Exercise regularly • Stop / review medications that slow the bowel 18

healthyliving - The Gawler Foundation magazine

each meal. In hospitals, routine medications for pain - the opiates - are offered with good intention to alleviate suffering but often without due regard for the level of constipation they frequently cause, and what that means for the rest of the person’s body and even their mind. In hospital, I received wonderful care from conscientious, caring nurses and a first-class surgeon, and the food was pretty good. However, when I was 'blocked up' after the surgery, which included a one hour general anaesthetic and 10mgs of morphine for post-op pain, constipation was not considered an issue because it had only been present for one day. One day! Being a meditator I was acutely aware of my abdomen feeling like it was full and uncomfortable. On request, I was given Senokot - privately purchased, and Movicol - with no result. It required repeated requests before I was given a Durolax suppository - and 36 hours later this had the desired effect! And what a wonderful difference it made to my feelings of wellbeing and physical ease. When it comes to children, paediatricians recognise the need to treat chronic constipation vigorously, and the importance of giving the bowel recovery time by helping it to empty daily so that the bowel can regain the workings of its muscular tube over several weeks. They understand that the bowel needs to be fit to function well. But with adults we seem to have a mental block - some would say mental constipation - and often do not use the same principles or understanding. In my view, the principles are very similar, however, many adults recovering from surgery are not offered laxatives unless they have had no action for a few days! And suppositories rather reluctantly. Unfortunately this only adds to the pain issues the patient is dealing with and increases the toxicity in the body from all the material that ends up lying around in the large intestine for too long. All of this delays healing and increases the chances of infection and deep vein thrombosis.

Natural supports for bowel health

Insoluble Fibre - Moves bulk through intestines and helps control the pH (acidity) in the bowel Food Sources - Vegetables like green beans and dark green leafy vegetables - Fruit skins and root vegetable skins - Whole wheat/corn/rice product - Wheat bran I encourage everyone, especially those looking at surgery and time in hospital, to remember it is important to keep yourself pooing daily - at least. In hospitals, the nurses may be too busy to take a big interest in your bowels - they may be more preoccupied with other matters including complications and pain relief. So, it is wise to be your own 'poo monitor' and to regard regular movements as a major factor in your recovery, warranting relaxed vigilance! Obviously, if you have had bowel surgery or you do become severely constipated, that needs more specific and individualised medical advice. However, in general, whether at home or in hospital, eating high fibre foods - like we recommend in general - is the starting point for maintaining frequency. Using a bulking agent, like bran or Granucol may be useful. If you need more help, start with a natural laxative like Senekot. Natural herbs like ginger root and tumeric are not usually strong enough after heavy anaesthetics and opiates to be very effective. At all times, keep your fluids up so you keep everything moist and mobile. Pear juice is a natural laxative, as are prunes and prune juice, flaxseed and olive oil (one to two tablespoons per day). However, do not be afraid of asking for and using a suppository which you may need daily for days or weeks if the constipation has been chronic or severe, or if you are using opiate pain management. For me, following these guidelines for just two days after the surgery, then following on with our normal diet, led to a spectacularly quick recovery. And finally: Question: What is an Italian suppository called? Answer: An innuendo

Ruth

>cont. from page 11

What works in Grief Counselling? meaning but unhelpful reactions: eg. ‘Time heals all, there are plenty of other people worse off’. Helping the client to understand that what these people are often saying is: ‘I don’t know what to say, I don’t know what to do, I can’t handle your grief, I feel uncomfortable, I don’t want to be reminded of my own grief’. • Sharing with clients the difference between ‘getting over it’ and ‘learning to live with it’. What distinguishes more effective counsellors from less effective counsellors is their ability to use the common factors: their ability to empower clients, their ability to develop warm and trusting relationships with clients, their ability to engender realistic hope and their ability to find what seems to be the appropriate model or technique for this particular person at this particular time. Hence, one of the key jobs of the grief counsellor is to provide warm, empathic support so that the client can access his or her client factors as strongly and effectively as possible, thereby making the counselling more productive and more self-sustaining. References Asay, T.P., and Lambert, M.J. (1999). The empirical case for the common factors in therapy: quantitative findings. In Hubble, Duncan and Miller (1999). Fulton, Graham (1989). The normal grief storm: a model for understanding grief and loss. In National Association for Loss and Grief (ed.), Proceedings of the Sixth National Conference, National Association for Loss and Grief, Melbourne, 49-57. Hubble, M.A., Duncan, B.L., and Miller, S.D. (1999). The Heart and Soul of Change: What Works in Therapy. Washington D.C.: American Psychological Association. Lambert, M.J., and Bergin, A.E. (1994). The effectiveness of psychotherapy. In A.E. Bergin and S.L.Garfield (Eds.), Handbook of Psychotherapy and Behaviour Change (4th ed., pp.143-189). New York: Wiley. Morawetz, D. (2002). What works in therapy: what Australian clients say. Psychotherapy in Australia, 9, 1, Nov, 66-70. (A longer version of this paper, with many more Australian case studies, is available on request from the author: morawetz@bigpond.com). Morawetz, D. (2003). Insomnia and Depression: Which Comes First? Sleep Research Online 5(2): 77-81, 2003. www.sro.org/2003/ Morawetz/77/. Rogers, C.R. (1951). Client-Centred Therapy. Boston: Houghton Mifflin. For a full version of this article and extended reference list see www.gawler.org.

MB BS MGP Psych FACPsyMed Dr Ruth Gawler is a GP with a specialist interest in Mind-Body Medicine. She is a program facilitator, GP and therapist at The Gawler Foundation.

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Food for festivities

The festive season is just around the corner and it is time to start thinking about entertaining, dinner parties, picnics and cooking for family and friends to celebrate life. So, what can you cook from the Gawler Wellness diet I hear you ask (that does not contain carrots – we seem to use a lot of those). I have given this some thought and have come up with some great suggestions for PARTY food:

P Parsnip pate A Avocado mousse R Raspberry shake T Tofu cheesecake YYummy Almond and Date Balls Yes, I know there is a lot of sweet things but it is party time – and it’s food to share!

Parsnip Pate 2 cups sliced parsnips 1 cup almonds 1 cup cooked millet 1 cup mashed tofu 1 tablespoon minced onions 1 teaspoon fresh basil 1 tablespoon chopped parsley ½ cup chopped celery 1 tablespoon tamari 1 tablespoon flax oil

Avocado mousse

2 ripe avocados ¼ cup lime or lemon juice ¼ cup honey Method: Blend avocados in food processor until smooth. Add honey and lemon juice and blend together. Adjust to taste and serve with veggie sticks.

Method: Cook the parsnips until tender. Drain and mash. Grind up the almonds. Place celery, tamari, oil and a little water (1 tablespoon) into a blender. Blend to a pulp. Mix in all the remaining ingredients. Mould into shape and chill in the fridge for two hours. Plate up and serve.

Raspberry smoothie ½ cup raspberries 1 banana (optional) 1 teaspoon honey 1 cup soy milk

Method: Blend together well in a vitamiser or with a stick blender. Pour into long glasses and serve.

Gail Lazenbury is The Gawler Foundation’s Catering Manager.

healthyliving - The Gawler Foundation magazine

Tofu Cheesecake Filling: 300 grams tofu ¼ cup agar flakes 1 ½ cups soy milk ¼ teaspoon vanilla essence 2 tablespoons honey ½ teaspoon grated lemon rind 1 ½ cups blueberries (to top)

Crust: 2 cups rolled oats ½ cup apple juice concentrate (enough to hold the oats together) Method: Filling: Blend all the ingredients (except berries) in a food processor until creamy. Place in saucepan and just bring to boil stirring constantly. Take off heat and leave to cool while making crust. Crust: Put oats and apple juice concentrate in food processor and blend until mixture holds together. Press mixture into a lightly oiled pie plate. Bake for 15 minutes at 180C. When cool, pour cheesecake mix onto the crust. Refrigerate for 10 minutes before adding berries to the top of the cheesecake. Refrigerate until needed.

Yummy Almond and Date Balls

Staying on track during the celebration season. Some tips from Maia Bedson

Some people find it easy to stay on track with their healing focus or healthy lifestyle choices over the Festive Season but if you are doubtful that such people do exist, it may help to have a few suggestions on how you might do this yourself! • Accept the invitations that are important to you - with the people that matter most. Be discerning. • If practical, let the hosts know that you are paying particular attention to your health so that they can support you. • Consider bringing your own tasty and nutritious snacks to share at Christmas parties.

1 ¾ cups whole almonds (with the skin on) 2 cups pitted dates 1 teaspoon pure vanilla essence

• If this isn’t possible, eat a healthy meal beforehand so that hunger pangs don’t overtake your resolve.

Method: Using a food processor place ¾ cup of whole almonds and whizz till you have a fine almond meal. Remove from food processor and set aside.

• If the gathering is at a restaurant or function centre, call the chef or manager ahead of time and advise them of what you can eat.

Return to the food processor and add 1 cup of whole almonds with the skin on and 2 cups of pitted dates that have been roughly chopped.

• Bring an alternative to alcohol to every gathering so that you can still feel part of the toasting. For example, pomegranate juice or concentrate or bio-dynamic grape juice mixed with mineral water. You can even use a wine glass or champagne flute.

Add 1 teaspoon of pure vanilla essence and process till you have achieved a mixture that is well combined. Then, using a heaped teaspoon of this mixture, mould the paste into balls and roll in the reserved almond meal. Repeat this until you have used up all the mixture. Balls should be kept small as this mixture is very rich.

Social occasions can be challenging so managing your stress levels is important in staying on track. Keep up or renew your meditation practice, allow time for gentle exercise and remember to communicate your needs or concerns to those around you.

Balls can be stored for up to four days in the refrigerator. Note: To avoid overworking your food processor divide the mixture into several batches.

healthyliving - The Gawler Foundation magazine 21

"Having cancer has taught me a great deal" I live with my husband Warren and enjoy long walks in the very hilly area around our home on the outskirts of Albury NSW. Early in 2009, recurring pain in my left hip caused me to make many visits to an osteopath. On one visit she was concerned and gave me a referral for an ultrasound.

A story of discovery by Kaye Ellis

The CT scan which followed showed unmistakable evidence of a growth consuming my left adrenal gland about 10cm long and 5 cm wide. I was told that it was probably an adrenal adenoma, a benign growth. I would, however, need to have it removed by virtue of the space it was taking up in my body and the pain that it was causing. We began referring to the adenoma as 'Adeline'. A biopsy to determine Adeline’s exact nature revealed the devastating news that I had an extremely rare type of carcinoma. Two weeks later, I was admitted to the Albury Base Hospital to have my left adrenal gland, my spleen and possibly my left kidney removed. My family, my friends and my work colleagues prayed for me and I felt an unforgettable peace as they all sent me a pink blanket of love. I felt shrouded in God’s love and the love of everyone praying for me, even those I did not know. The operation was a success and I emerged minus one adrenal gland, my spleen and no Adeline. My kidney remains. I left hospital armed with the opinion of one of the attending surgeons that this rare type of cancer was like spot fires and could spring up anywhere. During the weeks that followed I had lots of support and my treasured friend, Ansje, stayed with me to help with the physical and emotional post operation challenges. It was during this time that I began my meditation practice following the suggestions in Peace of Mind and You Can Conquer Cancer. I tried to watch my thoughts and to let them go but my efforts met with varying degrees of success. This was a time of great reflection for me about my life, my part in the family and my purpose. God was present in every day as my guide and counsellor. I decided to travel to Melbourne each Thursday to attend the Gawler Foundation’s 12 week 'Living Well' program being held in Footscray. Spending time in Melbourne with my adult children each week was a definite drawcard so the course itself, and the knowledge that I would absorb, was only one part of the motivation to take part. 'The Bluestone Church' sounded great as a venue and from the outside was appealing. Inside however there was an austerity about the place not typical of the atmosphere one would initially choose for a wellbeing experience. Funnily enough, however, I felt quite accepting, almost as if it was meant to be like that to fulfil some higher purpose. There was that element of there being just enough - toilets and wash basins with second hand soap, hot drinks available in the break but that is all.

The following week my scheduled scan fulfilled the predictions of the surgeon. Another unusual growth had appeared in the area where my adrenal gland had been. My oncologist was very pessimistic about my future as he didn’t know of any appropriate treatment. I told him about the course I had begun and though he was mildly interested, his advice was to go home and eat what I felt like as it would make no difference! There were more trips to the Alfred hospital for a PET scan and a red blood cell count so that for the next few months I rode a roller coaster of emotion from elation to the depths of despair. The love of my family and friends and the support of the people Kaye and Ansje at the Bluestone Church each Thursday, sustained me so that my confidence and strength gradually returned. I began to feel more and more in control of my destiny. I have made major changes in the way I eat and am now vegetarian. Once a week, however, I eat Atlantic salmon poached in lemon and orange juice. I keep my diet as alkaline as possible and start each day with lemon juice in water. I have purchased a juicer and daily juice carrots, beetroot, ginger and as many green leafy vegetables as possible. Where possible we eat organic and now grow a lot of our own vegies. I also use chickpeas and lentils and find the recipes on the Gawler site a really great resource. The other major changes are that I have eliminated dairy products and I don’t eat any sugar. Meditation has become a regular part of my life every morning and evening and I love it. I look forward to my meditation sessions often led by Ian Gawler on one of my many meditation CDs. Warren sometimes meditates with me too and I am blessed by a few friends who put time aside to join me to explore meditation together and to talk about the deeper issues of life. After my scan back in January, the good news was that Adeline’s baby had shrunk by 5mm and then again last week, I was told that she has shrunk by another 4mm. There is only 11mm remaining of her now, so I believe she is on her way out. My oncologist said that he didn’t know what I was doing but to keep doing it! Having cancer has taught me a great deal. I choose to live my life mindfully. I think about what I put in my mouth and make decisions that will honour my body. I am thankful each day for my strong legs that take me up our hill. I am thankful for the love of my family and friends and I rejoice in the lessons that this journey of discovery is teaching me. Thank you. Kaye.

The Gawler Foundation gratefully acknowledges all our conference sponsors and supporters

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29/8/08 11:16:38 AM

Conference papers

Feedback from conference attendees 'Loved the interactive workshops with practical applications – most valuable.' 'What a wonderful event. I found the speakers inspirational and certainly came away greatly stimulated and determined to take advantage of the Foundation’s programs and, of course, the conference next year.'

Attendees have requested copies of speakers' presentations. Many are not available due to intellectual property considerations; however, abridged versions from some speakers will be available on our website soon.

'Highly qualified and motivated professionals with very structured and informative presentations – all had take-away messages useful in my clinical work.' 'The panel discussion was forthright, thought provoking and respectful.' 'It’s amazing the work that’s been done and the effort that has been put into this conference. Very informative, an eyeopener on a new era of medical practices.' 'A great balance between lectures, workshops and discussions! More of the same…WOW!'

Thank you A very sincere thank you to everyone involved with this special event including speakers, sponsors, supporters, volunteers and staff for their outstanding efforts. Their contribution of resources, knowledge, time and energy ensured the success of our Annual 'Profound Healing - Sustainable Wellbeing' conference.

2011 DIARY DATE: ‘Profound Healing - Sustainable’ Wellbeing Conference Sat 19 & Sun 20 November 2011 at Hilton on the Park, Melbourne.

Blessings for the Season from everyone at

The Gawler Foundation

Christmas gift suggestions:

To your enemy, forgiveness. To an opponent, tolerance. ÂŠKurt Tutschek 2010

To a friend, your heart. To a customer, service. To all, charity. To every child, a good example. To yourself, respect.

by Oren Arnold