Complementary Health...

 

Yoga as a Complementary Therapy for Clinical Depression Complementary Health Practice Review, 12/17/10

Mehta P et al. – A total of 18 studies met the criteria. Some of the designs utilized by the interventions were pretest posttest, quasi–experimental and randomized controlled trials. It was found that majority of the interventions (17) were able to significantly reduce depressive symptoms in the patients under study. However, several methodological limitations were identified in the conduct of the intervention trials, which future interventions must consider.

 

 

 

 

 

Electroconvulsive therapy for treating schizophrenia: a chart review of patients from two catchment areas European Archives of Psychiatry and Clinical Neuroscience, 12/13/10

Kristensen D et al. – To examine disease and treatment characteristics of patients with schizophrenia treated with electroconvulsive therapy (ECT). ECT proved to be effective in a population of patients that were severely ill with treatment–refractory schizophrenia. This does not imply that the patients were cured from schizophrenia. Rather, it reflects the degree of relief from psychosis and disruptive behaviour, as described in the patient charts. The treatment was often offered to patients after considerable disease durations.

 

 

 

 

Efficacy of antidepressants and benzodiazepines in minor depression: systematic review and meta-analysis British Journal of Psychiatry, 01/06/11

Barbui C et al. – There is evidence showing there is unlikely to be a clinically important advantage for antidepressants over placebo in individuals with minor depression. For benzodiazepines, no evidence is available, and thus it is not possible to determine their potential therapeutic role in this condition.

 

 

Clozapine versus...

 

Clozapine versus other atypical antipsychotics for schizophrenia (>> click to go to the journal's website) Cochrane Reviews, 12/01/10

Asenjo Lobos C et al. – Clozapine was somewhat more efficacious than zotepine. Also, inefficacy of treatment led more frequently to leaving the studies early in the risperidone group suggesting a certain higher efficacy of clozapine. The principal drawback of clozapine were its adverse effects which lead to significantly higher numbers of participants leaving the studies early compared to olanzapine and risperidone. Clozapine was associated with more sedation and hypersalivation than olanzapine, quetiapine and risperidone and with more seizures than olanzapine and risperidone. There was a higher incidence of white blood cell decrease in clozapine groups than olanzapine and more weight gain than in risperidone groups. On the other hand clozapine produced fewer movement disorder than risperidone and less prolactin increase than olanzapine, quetiapine and zotepine.

 

 

 

 

Presynaptic Dopamine in Schizophrenia (>> click to go to the journal's website) CNS Neuroscience & Therapeutics, 01/10/11

Miyake N et al. – Excessive striatal presynaptic dopamine is linked to the emergence of acute psychotic symptoms and to their response to treatment in schizophrenia. Understanding the etiology of this dysregulation and its consequences on the rest of the circuitry is important for future drug development.

 

 

 

 

 

 

The Role of Beta-Blockers as First-Line Therapy in Hypertension (>> click to go to the journal's website) Current Atherosclerosis Reports, 01/07/11

De Caterina AR et al. – Thee available evidence does not support the use of beta–blockers (BBs) as first–line drugs in the treatment of uncomplicated hypertension. It remains to be determined whether newer BBs, such as nebivolol and carvedilol, will be more effective than older compounds in improving cardiovascular prognosis.

 

 

 

 

 

Examination of the Utility of Psychotherapy for Patients with Treatment Resistant Depression: A Systematic Review (>> click to go to the journal's website) Journal of General Internal Medicine, 01/10/11

Trivedi RB et al. – Review demonstrates the utility of psychotherapy in managing treatment resistant depression. However, evidence is sparse and results are mixed. Given that quality trials are lacking, rigorous clinical trials are recommended to guide practice. In the interim, primary care providers should consider psychotherapy when treating patients with treatment resistant depression.

 

 

 

 

 

Beta-Blockers in Hypertension (>> click to go to the journal's website) The American Journal of Cardiology, 12/13/10

Ram CVS – Much of the unfavorable data revealed in the recent meta–analyses were gleaned from studies involving nonvasodilating, traditional (beta) blockers, such as atenolol. However, findings with traditional (beta) blockers may not be extrapolated to other members of the class, particularly those agents with vasodilatory activity. Vasodilatory (beta) blockers (i.e., carvedilol and nebivolol) reduce blood pressure in large part through reducing systemic vascular resistance rather than by decreasing cardiac output, as is observed with traditional (beta) blockers. It is time for a reexamination of the clinical evidence for the use of (beta) blockers in hypertension, recognizing that there are patients for whom (beta) blockers, particularly those with vasodilatory actions, are an appropriate treatment option.

 

 

 

 

 

The effect of low-dose spironolactone on resistant hypertension (>> click to go to the journal's website) Journal of the American Society of Hypertension, 12/23/10

Engbaek M et al. – The objective was to estimate the effect of addition of low–dose spironolactone to previous antihypertensive therapy in patients with resistant hypertension. Patients had 25 to 50 mg of spironolactone once daily added to the treatment of hypertension that was uncontrolled despite previous treatment with three classes of antihypertensive drugs. The effect on blood pressure was estimated by office measurements together with serum potassium and adverse effects. Low–dose spironolactone is highly effective when added to previous treatment of patients with resistant hypertension.

 

 

 

 

 

The Role of Benzodiazepines in the Treatment of Anxiety Disorders (>> click to go to the journal's website) Psychiatric Annals, 12/16/10

Macaluso M et al. – Since the patent of chlordiazepoxide nearly 50 years ago, benzodiazepines are one of the most widely prescribed psychotropic medications worldwide. As a class, benzodiazepines share the following properties: anxiolytic, hypnotic, sedative, anticonvulsant, amnestic, and muscle relaxant. These effects are mediated through agonist activity at GABA–A receptors, where endogenous GABA binding has inhibitory effects.

 

 

 

 

 

Treatment of trigeminal neuralgia: role of radiofrequency ablation (>> click to go to the journal's website) Journal of Pain Research, 01/03/11

Emril DR et al. – Trigeminal neuralgia (TN) is a neuropathic pain condition affecting the face. It has a significant impact on the quality of life and physical function of patients. Evidence suggests that the likely etiology is vascular compression of the trigeminal nerve leading to focal demyelination and aberrant neural discharge. Secondary causes such as multiple sclerosis or brain tumors can also produce symptomatic TN. Treatment must be individualized to each patient. Carbamazepine remains the drug of choice in the first–line treatment of TN.

 

 

 

 

 

Antipsychotic Occupancy of Dopamine Receptors in Schizophrenia (>> click to go to the journal's website) CNS Neuroscience & Therapeutics, 01/03/11

Nord M et al. – The positron emission tomography (PET)–defined interval for optimal antipsychotic drug treatment has been implemented in the evolvement of dose recommendations for classical as well as more recently developed drugs. Another consistent finding is lower D2–occupancy during treatment with the prototype atypical antipsychotic clozapine. The mechanism of action(MoA) of clozapine remains to be fully understood and may include nondopaminergic mechanisms. A general limitation is that currently available PET–radioligands are not selective for any of the five dopamine receptor subtypes. Current attempts at developing such ligands may provide the tools required to refine further the MoA of antipsychotic drugs.

Antidepressant Therapy with...

* escitalopram

January 18, 2010 — Antidepressant therapy with the selective serotonin reuptake inhibitor escitalopram significantly reduced menopausal hot flash frequency and severity compared with placebo, according to the results of a new study published in the January 19 issue of the Journal of the American Medical Association.

* Un nou antidepresiv

 

• Formulary Coverage
• Patient Financial Support
• Patient Education

In 8-week clinical studies of PRISTIQ, the 50 mg dose showed:

• Discontinuation rate due to adverse events comparable to placebo¹
• Nausea generally mild to moderate, decreased to placebo-like levels within 1 week²
• No significant mean weight gain in 3 clinical studies^1,2
  • No statistical difference in mean weight change over 6 months with PRISTIQ vs. placebo at 4-8 times the recommended 50 mg dose¹
• Low incidence of spontaneously reported sexual function disorders in men and women^1,2

Discontinuation rate due to adverse events with PRISTIQ 50 mg comparable to placebo in 8-week clinical studies¹

Pooled data from 5 double-blind, randomized, placebo-controlled, fixed-dose 8-week trials of 50, 100, 200, and 400 mg q.d. of PRISTIQ in adults aged 18 years or older with MDD (N=2,001). Data from 50-mg (n=317) and placebo (n=636) arms shown²

Most commonly observed adverse reactions

Adverse reaction rates observed in clinical studies may not reflect rates observed in practice.

The most commonly observed adverse reactions in patients taking PRISTIQ vs placebo for MDD in short-term fixed-dose premarketing studies (incidence ≥5% and at least twice the rate of placebo in the 50-mg dose group) were:¹

Pooled data from 5 double-blind, randomized, placebo-controlled, fixed-dose, 8-week trials of 50, 100, 200, and 400 mg q.d. of PRISTIQ in adults aged 18 or older with MDD (N=2,001). Data from 50-mg (n=317) and placebo (n=636) arms shown.^1,2

Nausea was generally mild to moderate and decreased to placebo-like levels within 1 week²

• In two 8-week clinical studies, the overall incidence of nausea at 50 mg was 22%
• 1% of patients discontinued due to nausea at the recommended therapeutic dose of 50 mg²

Pooled data from 5 double-blind, randomized, placebo-controlled, fixed-dose 8-week trials of 50, 100, 200, and 400 mg q.d. of PRISTIQ in adults 18 or older with MDD (N=2,001), two of which included the 50-mg dose.  Data from 50-mg (n=317) and placebo (n=636) arms shown.²

No significant mean weight gain in two 8-week studies with PRISTIQ 50 mg vs placebo^1,2

*Pooled data from 2 double-blind, randomized, placebo-controlled, fixed-dose, 8-week studies of PRISTIQ 50 mg/day.^1,2

No significant mean weight change in one long-term study with PRISTIQ¹

Sexual function disorders: Adverse reactions (≥2% in men^‡ or women^†) during the on-therapy period

* Pooled data from 2 double-blind, randomized, placebo-controlled, fixed-dose 8-week studies of
PRISTIQ 50 mg/day.
†Sample size, women: placebo, n=397; PRISTIQ 50 mg, n=209.
‡Sample size, men: placebo, n=239; PRISTIQ 50 mg, n=108.

• Self-reported sexual adverse reaction rates observed in clinical studies may not reflect rates observed in practice.
• Physicians should routinely inquire about possible sexual side effects.

Next: Safety Profile

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PRISTIQ is indicated for the treatment of major depressive disorder in adults.

Important Safety Information for PRISTIQ

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of Major Depressive Disorder (MDD) and other psychiatric disorders. Anyone considering the use of PRISTIQ or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. PRISTIQ is not approved for use in pediatric patients.

Contraindications

• PRISTIQ is contraindicated in patients with a known hypersensitivity to PRISTIQ or venlafaxine.
• PRISTIQ must not be used concomitantly with an MAOI or within 14 days of stopping an MAOI.  Allow 7 days after stopping PRISTIQ before starting an MAOI.

Warnings and Precautions

• All patients treated with antidepressants should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the first few months of treatment and when changing the dose. Consider changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse or includes symptoms of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, mania, or suicidality that are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Families and caregivers of patients being treated with antidepressants should be alerted about the need to monitor patients. 
• Development of a potentially life-threatening serotonin syndrome or Neuroleptic Malignant Syndrome-like reactions have been reported with SNRIs and SSRIs alone, including PRISTIQ treatment, but particularly with concomitant use of serotonergic drugs, including triptans, with drugs that impair the metabolism of serotonin (including MAOIs), or with antipsychotics or other dopamine antagonists. If concomitant use with a triptan is clinically warranted, careful observation of the patient is advised, particularly during treatment initiation and dose increases. Concomitant use of PRISTIQ with serotonin precursors is not recommended.
• Patients receiving PRISTIQ should have regular monitoring of blood pressure since increases in blood pressure were observed in clinical studies. Pre-existing hypertension should be controlled before starting PRISTIQ. Caution should be exercised in treating patients with pre-existing hypertension or other underlying conditions that might be compromised by increases in blood pressure. Cases of elevated blood pressure requiring immediate treatment have been reported. For patients who experience a sustained increase in blood pressure, either dose reduction or discontinuation should be considered.
• SSRIs and SNRIs, including PRISTIQ, may increase the risk of bleeding events. Concomitant use of aspirin, NSAIDs, warfarin, and other anticoagulants may add to this risk.
• Mydriasis has been reported in association with PRISTIQ; therefore, patients with raised intraocular pressure or those at risk of acute narrow-angle glaucoma (angle-closure glaucoma) should be monitored.
• PRISTIQ is not approved for use in bipolar depression. Prior to initiating treatment with an antidepressant, patients should be adequately screened to determine the risk of bipolar disorder.
• As with all antidepressants, PRISTIQ should be used cautiously in patients with a history or family history of mania or hypomania, or with a history of seizure disorder.
• Caution is advised in administering PRISTIQ to patients with cardiovascular, cerebrovascular, or lipid metabolism disorders. Increases in blood pressure and small increases in heart rate were observed in clinical studies with PRISTIQ. PRISTIQ has not been evaluated systematically in patients with a recent history of myocardial infarction, unstable heart disease, uncontrolled hypertension, or cerebrovascular disease.
• Dose-related elevations in fasting serum total cholesterol, LDL (low density lipoprotein) cholesterol, and triglycerides were observed in clinical studies. Measurement of serum lipids should be considered during PRISTIQ treatment.
• On discontinuation, adverse events, some of which may be serious, have been reported with PRISTIQ and other SSRIs and SNRIs. Abrupt discontinuation of PRISTIQ has been associated with the appearance of new symptoms. Patients should be monitored for symptoms when discontinuing treatment. A gradual reduction in dose rather than abrupt cessation is recommended whenever possible.
• The recommended dose in patients with severe renal impairment or end-stage renal disease (ESRD) is 50 mg every other day. The dose should not be escalated in patients with moderate or severe renal impairment or ESRD.
• Products containing desvenlafaxine and products containing venlafaxine should not be used concomitantly with PRISTIQ.
• Hyponatremia may occur as a result of treatment with SSRIs and SNRIs, including PRISTIQ. Discontinuation of PRISTIQ should be considered in patients with symptomatic hyponatremia.
• Interstitial lung disease and eosinophilic pneumonia associated with venlafaxine (the parent drug of PRISTIQ) therapy have been rarely reported.

Adverse Reactions

The most commonly observed adverse reactions in patients taking PRISTIQ vs placebo for MDD in short-term fixed-dose premarketing studies (incidence ≥5% and at least twice the rate of placebo in the 50-mg dose group) were nausea (22% vs 10%), dizziness (13% vs 5%), hyperhidrosis (10% vs 4%), constipation (9% vs 4%), and decreased appetite (5% vs 2% ).

Medscape UpToDate

 

The Year in Psychosis and Bipolar Disorder
Medscape Psychiatry & Mental Health, 2011-01-07

Famous Quotes From Orient

 

* The deeper a sand-well is dug the freer is its flow of water. Even so, the deeper a man's learning the greater is his wisdom.

- Tirukkural 40:396

 

 

 

 

 

 

*Teaching nowadays can hardly be compared with the wise ones of old; there is the name without the reality. Who among latter-day students knows they are turning away from awakening and getting mixed up in objects?

- P'u-an

 

 

 

 

 

*Since the old days, it is said that "anger is the fire in one's mind that burns away all of one's virtuous deeds." Anger should be absolutely surrendered.

- Jae Woong Kim, "Polishing the Diamond"

 

Zen Story

Constancy      Shunryu  Suzuki                                           “People who know the state of emptiness will always be able to dissolve their problems with constancy.”   The message for us today is “Cultivate your own spirit.”  It means not to go seeking for something outside yourself.  This is a very important point, and it is the only way to practice Zen.  Of course, studying scriptures or reciting the sutras or sitting is Zen; each of these activities should be Zen.  But if your effort or practice does not have the right orientation, it will not work at all.  Not only will it not work, but it may spoil your pure nature.  Then the more you know about Zen, the more you will become spoiled.  Your mind will be filled with rubbish; your mind will be stained.   It is quite usual for us to gather pieces of information form various sources, thinking in this way to increase our knowledge.  Actually, following this way we wind up not knowing anything at all.  Our understanding of Buddhism should not be just gathering many pieces of information, seeking to gain knowledge.  Instead of gathering knowledge, you should clear your mind.   If your mind is clear, true knowledge is already yours.  When you listen to the teaching with a pure, clear mind, you can accept it as if you were hearing something which you already knew.  This is called emptiness, or omnipotent self, or knowing everything.  When you know everything, you are like a dark sky.  Sometimes a flashing will come through the dark sky. The sky is never surprised when all of a sudden a thunderbolt breaks through.  And when the lightning does flash, a wonderful sight may be seen.  When we have emptiness we are always prepared for watching the flashing.   In China, Rozan is famous for its misty scenery.  I have not been to China yet, but there must be beautiful mountains there. And to see the white clouds or mist come and go through the mountains must be a very wonderful sight.  Although it is wonderful, a Chinese poem says,   “Rozan is famous for its misty, rainy days, And the great river Sekko for its tide, Coming and going. That is all.”   That is all, but it is splendid.  This is how we appreciate things.   So you should accept knowledge as if you're hearing something you already knew.  But this does not mean to receive various pieces of information merely as an echo of your own opinions.  It means that you should not be surprised at whatever you see or hear.  If you receive things just as an echo of yourself, you do not really see them, you do not fully accept them as they are. So when we say, “Rozan is famous for its misty, rain days,” it doesn’t mean to appreciate this sight by recollecting some scenery we have seen before:  “It is not so wonderful. I have seen that sight before.”  Or “I have painted much more beautiful paintings! Rozan is nothing!”  This is not our way.  If you are ready to accept things as they are, you will receive them as old friends, even though you appreciate them with new feeling.   And we should not hoard knowledge; we should be free from our knowledge.  If you collect various pieces of knowledge, as a collection it may be very good, but this is not our way.  We should not try to surprise people by our wonderful treasures.  We should not be interested in something special. If you want to appreciate something fully, you should forget yourself.  You should accept it like lightning flashing in the utter darkness of the sky.   Sometimes we think it is impossible for us to understand something unfamiliar, but actually there is nothing that is unfamiliar to us.  Some people say, “It is almost impossible to understand Buddhism because our cultural background is so different.  How can we understand Oriental thought?”   Of course Buddhism cannot be separated from its cultural background; this is true.  But if a Japanese Buddhist comes to the United States, he is no longer a  Japanese.  I am living in your cultural background.  I am eating nearly the same food as you eat, and I am communicating with you in your language. Even though you do not understand me completely, I want to understand you.  There is always the possibility of understanding as long as we exist in the utter darkness of the sky, as long as we live in emptiness.   I have always said that you must be very patient if you want to understand Buddhism, but I have been seeking for a better word than patience.  The usual translation of the Japanese word nin is “patience,” but perhaps “constancy” is a better word.  You must force yourself to be patient, but in constancy there is no particular effort involved—there is only the unchanging ability to accept things as they are.   For people who have no idea of emptiness, this ability may appear to be patience, but patience can actually be non-acceptance.  People who know, even if only intuitively, the state of emptiness always have open the possibility of accepting things as they are.  They can appreciate everything.  In everything they do, even though it may be very difficult, they will always be able to dissolve their problems by constancy.   Nin is the way we cultivate our own spirit.  Nin is our way of continuous practice.  We should always live in the dark empty sky.  The sky is always the sky.  Even though clouds and lightning come, the sky is not disturbed.  Even if the flashing of enlightenment comes, our practice forgets all about it.  Then it is ready for another enlightenment. It is necessary for us to have enlightenments one after another, if possible, moment after moment.  This is what is called enlightenment before you attain it and after you attain it.     Shunryu Suzuki (1904-1971)

DailyOM

A New Level Of Mastery
Coming Full Circle The reappearance of a pattern is often a sign that we have come full circle and we are close to a new level of mastery.

Life is a circular journey through our issues and processes, and this is why things that are technically new often seem very familiar. It is also why, whenever we work to release a habit, change a pattern, or overcome a fear, we often encounter that issue one last time, even after we thought we had conquered it. Often, when this happens, we feel defeated or frustrated that after all our hard work we are still dealing with the same problem. However, the reappearance of a pattern, habit, or fear, is often a sign that we have come full circle, and that if we can maintain our resolve through one last test, we will achieve a new level of mastery in our lives.

When we come full circle, there is often the feeling that we have arrived in a familiar place, but that we ourselves are somehow different. We know that we can handle challenges that seemed insurmountable when we began our journey, and there is the feeling that we might be ready to take on a new problem, or some new aspect of the old problem. We feel empowered and courageous to have taken on the challenge of stopping a pattern, releasing a habit, or overcoming a fear, and to have succeeded. At times like these, we deserve a moment of rest and self-congratulation before we move on to the next challenge.

Coming full circle is like stepping into a clearing where, for a moment, we can see where we came from and where we are standing at the same time. Remembering that we will be tested again is important, but it's also important to pause and take a look at the ground we've covered, honoring our courage, our persistence, and our achievement. Then we can begin the next leg of our circular journey with a fuller understanding of where we are coming from.                               Temporarily Out Of Balance
Going Through A Phase In the process of becoming, we can become out of balance temporarily, but know it is only a phase and will pass.

We are all almost always in the process of learning something new, developing an underused ability or talent, or toning down an overused one. Some of us are involved in learning how to speak up for ourselves, while others are learning how to be more considerate. In the process of becoming, we are always developing and fine tuning one or the other of our many qualities, and it is a natural part of this process that things tend to get out of balance. This may be upsetting to us, or the people around us, but we can trust that it's a normal part of the work of self-development.

For example, we may go through a phase of needing to learn how to say no, as part of learning to set boundaries and take care of ourselves. During this time, we might say no to just about everything, as a way of practicing and exploring this ability. Like a child who learns a new word, we want to try out this new avenue of expression and empowerment as much as we can because it is new and exciting for us and we want to explore it fully. In this way, we are mastering a new skill, and eventually, as we integrate it into our overall identity, it will resume its position as one part of our balanced life.

In this process, we are overcompensating for a quality that was suppressed in our life, and the swinging of the pendulum from under-use to overuse serves to bring that quality into balance. Understanding what's happening is a useful tool that helps us to be patient with the process. In the end, the pendulum settles comfortably in the center, restoring balance inside and out.                           Full Release
Water Meditation Meditating with water can be a powerful way of aligning ourselves with an element that sustains us.

Our bodies are over fifty percent water, so it makes sense that human beings have always considered water to be a sacred source of life and healing. It is literally half of who we are, and well over half of the earth's surface is water. Water cleanses and hydrates, contains and produces nourishment, and when we enter it, holds us in an embrace that leaves no part of us untouched. Meditating with water can be a powerful way of aligning ourselves more fully with this support system that makes life both possible and pleasurable on so many levels.

We may wish to conduct our meditation while in physical contact with a body of water, whether in the intimacy of our bathtub or the vast container of an ocean. We might float on our backs in a swimming pool or sit with just our feet submerged in a pond or creek. On the other hand, we may simply close our eyes and choose a location based on our imagination. Whatever we choose, we can begin by closing our eyes and listening to our breathing. At the same time, we tune in to the particular music of the water we have chosen—the loud rushing of a river or waterfall, or the surreal silence of the world beneath the surface of the ocean. We might consider how the type of water we choose reflects what we seek—the peace beneath the hectic surface of life, the cleansing power of a river racing through a canyon, or the mood lifting, melodic bubbling of a lively creek.

As we move between awareness of our breath and awareness of the water in which we find ourselves, we can begin to release the things we no longer need into the rushing river, or release ourselves completely into the water's embrace as we float, in our minds, in the watery womb of an ocean or a lake. When you feel you are ready to return to more solid ground, ease your body back onto earth, in your mind or in reality, and lie flat on your back, allowing the water to bead and roll off your skin, soaking the earth and evaporating into the air, leaving you cleansed, healed, and renewed.                         Finding Our Own Paths
Entering Awareness We all enter the arena of awareness differently, it doesn't matter how we get there or how long it takes.

Entering into our own spirituality is a private journey. Each of us will be drawn to a different gateway to begin on our personal path to awakening to a greater experience of ourselves. Even though we may be taught certain philosophies or beliefs as children, we still need to find our own way of understanding and applying them in our lives. For those who are raised without a spiritual framework, they may not even know their process as a form of spirituality. But at some stage in their lives, whether in youth or adulthood, they are likely to recognize the resonance of their beliefs, the ring of truth in their philosophy, and their dedication to their chosen purpose.

Our inner guidance will lead us, so that we will be drawn to the right doorway for us--a doorway that only we can recognize by the way it makes us feel inside. It could be a picture of an angel or the gift of a crystal. We may meet someone special who shares their experiences with us in a way that we find intriguing. While visiting the home of an admired friend, we may notice a book or statue of a diety, and ask why they chose those tools. Or a word or phrase may catch our attention in a song, or a lecture. For some they may find their way by walking through the experience of illness before they begin the search for what will help them to truly heal, while others may seek physical improvement and stumble across yoga or meditation--only to find that it leads them to an unexpected place beyond the body.

As we awaken to ourselves and to life, we will become more attuned to what is right for us. The universe speaks to all of us through infinite channels, but we each have our own frequency. Others may share what worked for them, but only we can decide what truly makes us feel inspired, awakened, connected, fully conscious, aware and alive. Whatever our path, it is perfect and is meant especially for us.                         Feeling Our Life
Finding Our Life's Work The way we know we are doing our life's work is by how we feel when we are doing it.

Sometimes it takes us the better part of a lifetime to discover our life's work, even though we may have been doing it our whole lives without necessarily realizing it. Our life's work is not always what we do to make money, although we often think it should be, and sometimes this way of thinking prevents us from seeing clearly what it is. It may be the work of having children, caring for them, and running a household. The way we know our life's work is by how we feel when we are doing it.

When we are doing our life's work, we feel an uncanny sense of ease and alignment. This doesn't mean that the work is always easy, and it doesn't mean that it' the only work we have to do; it just means that there is a conviction deep inside us that tells us we are in tune with our innermost self. When we are engaged in our life's work, our bodies feel more alive, because our energy is devoted to a cause that, in turn, feeds us. We may be tired after engaging in our life's work, but we are almost never depleted. We feel grounded in the world, knowing that we belong here and have something important to offer.

When we are deeply unhappy, depressed, or subject to one illness after another, this may be due to a sense of disconnection from our life's work. At times like these, finding the work we are meant to do is an essential act of healing. Most of us remember a time when we felt fully engaged in some act of work, service or creativity, and it is here that we may rediscover the work we are meant to do now. On the other hand, it may be time to explore what inspires us through volunteering, taking a class, going back to school, or just doing whatever it is we long to try. We all have callings, and when we find them, we owe it to ourselves to nurture and protect them, because while they may or may not be our livelihood, they are the keys to our wellbeing.                          Making The Decision
Saying Yes To The Universe By acknowledging the existence of what's not working for us, we can begin the process of change.

The hardest thing about saying yes to the universe is that it means accepting everything life puts in front of us. Most of us have a habit of going through our days saying no to the things we don't like and yes to the things we do, and yet, everything we encounter is our life. We may be afraid that if we say yes to the things we don't like, we will be stuck with them forever, but really, it is only through acknowledging the existence of what's not working for us that we can begin the process of change. So saying yes doesn't mean indiscriminately accepting things that don't work for us. It means conversing with the universe, and starting the conversation with a very powerful word — yes.

When we say yes to the universe, we enter into a state of trust that whatever our situation is, we can work with it. We express confidence in ourselves, and the universe, and we also express a willingness to learn from whatever comes our way, rather than running and hiding when we don't like what we see. The question we might ask ourselves is what it will take for us to get to the point of saying yes. For some of us, it takes coming up against something we can't ignore, escape, or deny, and so we are left no choice but to say yes. For others, it just seems a natural progression of events that leads us to making the decision to say yes to life.

The first step to saying yes is realizing that in the end it is so much easier than the alternative. Once we understand this, we can begin examining the moments when we resist what is happening, and experiment with occasionally saying yes instead. It might be scary at first, and even painful at times, but if we continue to say yes to every moment through the process, we will discover the joy of being in a positive conversation with a force much bigger than ourselves.                           Graceful Guidance
Working With Angels Angels are symbols of grace and gentle encouragement; they can offer us comfort as they enfold us in their wings.

At some point in our lives, we are likely to find ourselves asking for help, perhaps from no one in particular, and without knowing where help could possibly come from. We may have raised our eyes skyward or whispered our need under our breath only to find that somehow we were heard, and the help we needed arrived. It might have come in the form of a person who appeared at the right time, or perhaps it came in the form of luck, chance, or divine intervention. However assistance appears, these are times when we can be sure that there are angels watching over us.

We may find ourselves asking for their help with simple things—like finding a parking spot or to watch over loved ones—but then we forgot to call on them when we found ourselves alone or in pain. We don't need to be aware of them to receive their assistance, but there is comfort in the knowledge that they are there for us when we need them. And when we remain open to their presence, we can call on them whenever we need them to connect and be nurtured by their ethereal and heavenly energy.

As symbols of grace and gentle encouragement, they can offer us comfort as they enfold us in their wings or lift our spirit as they take flight. We may be warmed by their glow, guided by their gentle nudges or inspired by their whispers in our ears. We may hear the name of our angel and feel a personal connection, but it isn't necessary. All they need is to be heard, to see us benefit from their guidance and perhaps to hear a word of thanks sent their way every now and then. Whether they appear in the guise of a helpful stranger, or as a thought that suddenly occurs to us, angels are our loving guides from the spiritual realm, who with a brush of their angelic wings help us to make the most of our human experience by balancing it with the spiritual awareness that all things are possible and that we are not alone.                            Creating A Harmonious Home
A Home Of Love  Our homes can become chaotic; it is at these times that we have the power to decide to bring more love into our homes.

At their best, our homes act as our sanctuaries. They are the nests we return to for rest and nurturing nourishment before we venture out once again to spread our wings and fly. But there are times that we may feel quite differently about our homes—times when we feel surrounded by turmoil rather than harmony, or mired in chaos rather than immersed in peace. It is at these times that we have the power to decide to bring more love into our homes.

When we choose love, we are choosing to begin within. With a deep breath, we close our eyes and ask that when we open them again, we will see where we can make shifts to create greater harmony. These may be inner shifts, such as accepting others' personality traits and working with them rather than against them. Or they may be changes we can make with items around the house--removing the ones that cause frustration and displaying things that make us feel good. Then, we reach out to the people with whom we share our homes--whether they are family members or another combination of people who share our space. We can help to shift their perceptions toward the positive by asking each person to think about their ideal living situation. After allowing some time for reflection, gathering to discuss each person's ideas may lead to the discovery that there are conflicting concepts about what your shared home should provide. Once this information is out in the open, we have a roadmap f! or creating balance and harmony from seemingly disparate desires. Together, agreements can be made to enable all to take the steps needed to create a unified vision.

When we have consciously chosen to make our home a place of harmony, then love's energy can expand throughout the lives of all who live there. Each person will be nurtured, allowing them to take that peace and serenity with them into the world, sharing it with whomever they may encounter; and making every space they enter a warmer and more loving place for everyone.                             Remembering To Pause
Beyond Reacting Our initial response to situations may not always be best, learning the art of pausing before reacting can be helpful.

We have all had the experience of reacting in a way that was less than ideal upon hearing bad news, or being unfairly criticized, or being told something we did not want to hear. This makes sense because when our emotions are triggered, they tend to take center stage, inhibiting our ability to pause before we speak. We may feel compelled to release the tension by expressing ourselves in some way, whether it's yelling back at the person yelling at us, or rushing to deliver words of comfort to a friend in trouble. However, there is much to be said for teaching ourselves to remember to pause and take a deep breath before we respond to the shocks and insults that can come our way in life.

For one thing, our initial response is not always what's best for us, or for the other people involved. Reacting to childish rage with childish rage will only escalate the negativity in a situation, further ensnaring us in an undesirable dynamic. Similarly, when we react defensively, or simply thoughtlessly, we often end up feeling regret over our words or actions. In the end, we save ourselves a lot of pain when we take a deep breath and really tune in to ourselves, and the other person, before we respond. This doesn't necessarily mean we don't say anything, although in some cases, that may be the best option.

Some situations require a fairly immediate response, but even just a moment of grounding ourselves before we do so can help enormously. The next time you find yourself wanting to react, try to pause, and in that pause, take a deep breath. Feel your feet on the floor, the air on your skin, and listen for a response to arise within you, rather than just going with the first thing that pops into your head. You may find that in that moment, there is the potential to move beyond reaction and into the more subtle and creative realm of response, where something new can happen.                        Beyond Behavior
Defense Mechanisms Defense mechanism behaviors that have worked for you in the past may not fit you anymore and need to change.

We all have defense mechanisms that we've developed over time, often without being aware of it. In times of trouble, the behaviors that have worked to get us past challenges with the least amount of pain are the ones that we repeat; even when part of us knows they no longer work. Such behavior is a natural response from our mental and physical aspects. But because we are spiritual beings as well, we have the ability to rise above habits and patterns to see the truth that lay beyond. And from that moment on, we can make choices that allow us to work directly from that place of truth within us.

Most of our defense mechanisms were developed in childhood; from the moment that we realized crying would get us the attention we craved. Passive aggressive ways of communicating may have allowed us to get what we needed without being scolded, punished or laughed at, so we learned to avoid being direct and honest. Some of us may have taken refuge in the lives of others, discovering ways to direct attention away from ourselves entirely. Throwing ourselves into projects or rescuing others from themselves can be effective ways to avoid dealing with our own issues. And when people are truly helped by our actions, we get the added bonus of feeling heroic. But while defenses can keep away the things we fear, they can also work to keep our good from us.

When we can be honest with ourselves about what we truly desire, then we can connect our desires to the creative power of the spirit within us. Knowing that we are one with the energy of the universe allows us release any need for defense. Trusting that power, we know that we are exactly where we are meant to be, and that challenges bring gifts of growth and experience. When we can put down arms raised in defense, then we are free to use our hands, minds, hearts and spirits to mold and shape our abundant energy to create and live our lives.

 

 

 

 

 

 

                                                   Repressing The Inner Voice
                                                                       Giving Away Power

Giving away our power is something we have been taught since childhood by unaware adults in our lives.

In many ways, we are taught from the time we are children to give away our power to others. When we were told to kiss and hug relatives or friends of the family when we didn't want to, for example, we were learning to override our inner sense of knowing and our right to determine for ourselves what we want to do. This repression continued, most likely, in many experiences at school and in situations at work. At this point, we may not even know how to hold on to our power, because giving it away is so automatic and ingrained.

To some degree, giving our energy to other people is simply part of the social contract, and we feel that we have to do it in order to survive. It is possible to exchange energy in a way that preserves our inner integrity and stability. This begins in a small way: by listening to the voice that continues to let us know what we want, no matter how many times we override its messages.

Other examples of how we give away our power are buying into trends, letting other people always make decisions for us, not voting, and not voicing an opinion when an inappropriate joke is made. But with not giving our power away we must also be aware of the opposite side, which is standing in our power but being aggressive. Being aggressive is a form of fear, and the remedy is to let our inner balance come back into play.

As we build a relationship with our power, and follow it, we begin to see that we don't always have to do what we're being asked to do by others, and we don't have to jump on every trend. All we have to do is have the confidence to listen to our own voice and let it guide us as we make our own decisions in life and remember the necessity for balance.

 

 

 

 

 

                                                    The Direction Of Happiness
                                                                   Leaving A Relationship

When attempts at working out issues in a relationship aren't working, it may be time to examine moving on.

One of the hardest decisions we ever make in life is leaving a long-term relationship that just isn't working. When attempts at repairing and working out issues aren't working, it may be time to examine moving on. We are emotional creatures, and when our heartstrings are tied to those of another, separating from that person can feel like an act of courage. It is not something most of us will take lightly, and many of us will struggle with our desire to stay in a relationship that is unfulfilling simply in order to avoid that pain. We may question whether the happiness we seek even exists, and we may wonder if we might be wiser to simply settle where we are, making the best of what we have.

On the one hand, we almost relish the idea that true happiness is not out there so that we can avoid the pain of change. On the other hand, we feel within ourselves a yearning to fulfill our desire for relationships that are vital and healing. Ultimately, most of us will follow this call, because deep within ourselves we know that we deserve to be happy. We all deserve to be happy, no matter where we find ourselves in this moment, and we are all justified in moving, like plants toward the light, in the direction that leads to our greatest fulfillment. First, though, we may need to summon the courage to move on from the relationship that appears to be holding us back.

Taking the first steps will be hard, but the happiness we find when we have freed ourselves from a situation that is draining our energy will outshine any hardship we undergo to get there. Keeping our eyes trained on the horizon, we begin the work of disentangling ourselves from the relationship that no longer fits. Every step brings us closer to a relationship that will work, and the freedom we need to find the happiness we deserve.

 

Deepak Chopra

 
*Changing Your Reality - Deepak Chopra

The direction of life is from duality to unity: Today I want to belong. I want to feel safe and at home. I want to be aware of what it's like simply to be, without defenses or desires. I will appreciate the flow of life for what it is–my own true self.

I will notice those moments of intimacy with myself, when I feel that "I am" is enough to sustain me forever. I will lie on the grass looking at the sky, feeling myself at one with nature, expanding until my being fades into the infinite.

The fragmented mind cannot get me to unity, but I have to use it along the way: What does unity really mean to me? What experiences of oneness can I look back upon?

Today I will remember the difference between being at one with myself and being scattered. I will find my center, my peace, my ability to go with the flow. The thoughts and desires that drive me are not the ultimate reality. They are just a way to get myself back to oneness.

I will remember that thoughts come and go like leaves in the wind, but the core of consciousness is forever. My goal is to live from that core.

I am living in many dimensions at once; the appearance of being trapped in time and space is an illusion: Today I will experience myself beyond limitations.

In the same way I will experience love as a light that begins in my heart and spreads out as far as my awareness can reach; as images arise in my mind, I will send love and light in their direction.

Adapted from The Book of Secrets, by Deepak Chopra (Harmony Books, 2004).

 

 

 

 

 

 

 

*What Is My Life Challenge?

posted by Deepak Chopra Jan 20, 2011 5:01 am

Nothing would seem easier than to be yourself, but people complain endlessly about how hard it is. When you are little your parents won't let you be yourself. Later on teachers keep you from being yourself. Then teenage peer pressure takes over, and finally, once society has imposed its demands, freedom is more restricted still.

Alone on a desert island you might be able to be yourself, only guilt and shame would pursue you even there. The inheritance of repression is inescapable.

The whole problem is one of boundaries and resistance. Someone imposes a limit on you, and you resist it in order to break free. Thus "being yourself" becomes a relative thing. Unless someone tells me what I can't do, I have nothing to push against. By implication, my life would be shapeless. I would follow one whim after another, which itself is a kind of prison.

To be in unity, you cannot have limitations. You are wholeness; that is what fills your perception. Choice A and B are equal in your eyes. When this is true, desire can flow where it will. I am not my desires. Being myself no longer has the slightest outside reference.

Doesn't this deprive me of choice? Both yes and no. A person will want to dress and talk in a certain way; there may even be decided likes and dislikes. Yet these are karmic holdovers from the past.

My real existence is simply to be. How would I be able to tell that such a state is real? The skeptic would claim that unity is just a form of self-deception. The problem of self-deception seems trickier still when you realize that the ego, in its need to continue as the center of all activity, has no trouble pretending to gain enlightenment.

Adapted from How To Know God, by Deepak Chopra (Harmony Books, 2000).

 

 

 

 

 

 

*Stop Defending Your Self-Image

posted by Deepak Chopra Jan 10, 2011 5:02 am

Over the years you have built an idealized self-image that you defend as "me." In this image are packed all the things you want to see as true about yourself; banished from it are all the shameful, guilty, and fear-provoking aspects that would threaten your self-confidence.

But the very aspects you try to push away return as the most insistent, demanding voices in your head. The act of banishment creates the chaos of your internal dialogue, and thus your ideal erodes even while you are doing everything to look good and feel good about yourself.

To really feel good about yourself, renounce your self-image. Immediately you will find yourself being more open, undefended, and relaxed.

Much time is spent in self-help trying to turn a bad self-image into a good one. As reasonable as that sounds, all self-images have the same pitfall: They keep reminding you of who you were, not who you are. The whole idea of I, me, and mine was erected on memories, and these memories are not really you. If you release yourself from your self-image, you will be free to choose as if for the first time.

Self-image keeps reality away, particularly at the emotional level. Many people don't want to admit what they are actually feeling. Their self-image dictates that being angry, for example, or showing anxiety is not permissible. Such feelings don't accord with the "kind of person I want to be."

Certain emotions feel too dangerous to be part of your ideal image of yourself, so you adopt a disguise that excludes those feelings. Deep-seated rage and fear belong in this category, but sadly so does immense joy, ecstasy, or freewheeling spontaneity.

You stop being ruled by self-image when: You feel what you feel, you are no longer offended by things, you stop appraising how a situation makes you look, you don't exclude people you feel superior or inferior to, you quit worrying about what others think about you, you no longer obsess over money, status, and possessions, and you no longer feel the urge to defend your opinions.

Adapted from The Book of Secrets, by Deepak Chopra (Harmony Books, 2004).

 

 

 

*Quantum Discoveries

posted by Deepak Chopra Jan 6, 2011 5:01 am

We need Nature to free up our nature. We are surrounded by the best of all healing influences–fresh air, sunlight, and beauty. In India, the Hippocrates of Ayurveda, a great physician and sage named Charaka, prescribed some sunlight for all diseases, along with a walk in the early morning, and his advice will never grow stale.

If I find a green meadow splashed with daisies and sit down beside a clear-running brook, I have found medicine. It soothes my hurts as well as when I sat in my mother's lap in infancy, because the Earth really is my mother, and the green meadow is her lap. You and I are strangers, but the internal rhythm of our bodies listens to the same ocean tides that cradled us in a time beyond memory.

Nature is man's healer, because Nature is man. When Ayurveda says that the sun is our right eye and the moon our left eye, we mustn't sneer. By bathing us in the moon, the sun, and the sea, Nature fashioned the bodies we inhabit. These were the ingredients that provided us each with our piece of Nature–a shelter, life-support system, intimate companion, and home for seven decades or more.

The discovery of the quantum realm opened a way to follow the influence of the sun, moon, and sea down deeper into ourselves. I am taking you there only in the hope that there is even more healing to be found there. We already know that a human fetus develops by remembering and imitation the shapes of fish, amphibians, and early mammals. Quantum discoveries enable us to go into our very atoms and remember the early universe itself.

Adapted from Quantum Healing: Exploring the Frontiers of Mind/Body Medicine, by Deepak Chopra (Bantam Books, 1990).

 

 

 

 

 

*From This Lifetime to the Next

posted by Deepak Chopra Jan 5, 2011 5:00 am

People who are disconnected from themselves will be as baffled by the afterlife as they are by the present. For them, cause and effect aren't clear. Feelings of being alienated, alone, victimized, tossed around by fate, out of control, or abused by authority clash with one another. In this fog of confusion they cannot take responsibility for their own motivations and desires, and the afterlife may frighten or baffle them.

Being disconnected is an illusion from the soul's perspective. And however long it may take, understanding, symbolized by light, begins to dawn. In clarity you realize that "I am" is your basis, not the things you did. You no longer identify with being a certain person; you now identify with being conscious, and what fills your mind is fresh possibilities.

The karma you brought into the last lifetime has been exhausted, and fresh seeds of karma are ready to sprout. Being reborn enters your mind gradually. For a long period (speaking objectively) you experience bliss; you have gained pure being, which brings its own fulfillment regardless of any karma, good or bad.

You find yourself in the same gap as the one between two thoughts, only this time you are aware of uncountable possibilities from which to choose. You will witness as the dream of a new identity begins to clothe you, and you will fall into your next life in complete surrender to past actions that you still know almost nothing about.

But all of us can take a more active role in how we reincarnate. The elaborate rituals in the Tibetan Book of the Dead are designed to make freedom of choice real, to bring the person fully aware into the gap so that karma can be shaped, controlled, or even fully resolved.

Adapted from Life After Death: The Burden of Proof, by Deepak Chopra (Harmony Books, 2006)

 

 

*What is Your Belief System about Trauma?
posted by Deepak Chopra Jan 4, 2011 5:00 am

 

If someone randomly commits violence against you, the facts seem to scream that life is unfair, you are innocent, random human cruelty took away your sense of self-control. But despite all that, what's really happening is that you have shifted into relating to the world through a trauma.

It isn't the trauma itself that caused the shift. There had to be readiness inside. In truth life is neither fair nor unfair. The world is a reflection of who we are inside. If you can stop relating to the world through your trauma, there is hope that you can begin to relate through your soul. Here is how the process needs to go.

Victims hang on to their status because they feel innocent. The specific idea I am innocent is a blind, a mask. Yes, you are innocent. But only a stronger sense of self is going to rescue you. Your mind will never resolve why you, of all people, got hurt. Its struggles are futile from the outset.

I've met people who spend years in an attempt to figure out whether their misfortunes are due to bad karma. This becomes the magical word for a twisted logic that says, "I didn't think I deserved to be hurt, but if you look at a deeper, more mystical layer, I did."

This isn't really the answer. First of all, it doesn't heal the wound. Secondly, it exists as a mental construct and does little to salve the emotions, which are the chief fuel for ongoing victimization. You feel victimized, regardless of what your mind says.

The whole package–the event itself, the wound, the feelings that erupt, and the mind's scramble to find an explanation–is so interwoven that it cannot be untangled. If you can face this fact, you have come a long way to understanding how life works.

Adapted from: Peace Is the Way, by Deepak Chopra (Harmony Books, 2005)