Hosted by integrative palliative medicine physician, Dr. Delia Chiaramonte, The Integrative Palliative Podcast helps physicians and clinicians guide families facing serious illness to physical and emotional wellbeing. Listeners will find insights, skills and knowledge in evidence-supported integrative symptom management, as well as attention to their own self-care, because you can't pour from an empty cup! Everyone who cares for seriously ill people will find something for themselves and the ...
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Three Words That Help Reduce Distress in Difficult Times
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10:56When someone you love is is ill or had died, life feels hard. Yet sometimes we add to our distress by judging how we are feeling or behaving. We feel sad and then we feel critical that we're still sad. We feel angry and then feel guilty that we feel angry. It is the "shoulds" that cause us distress - it doesn't have to be that way. This week I'll s…
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Fragments and Light: An Exploration of Traumatic Grief
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23:16In this deeply personal and powerful episode, Dr. Delia Chiaramonte shares her experience of traumatic loss of both her father and her father-in-law. Traumatic grief is not just about missing someone—it’s about having your sense of the world torn apart. It can show up in surprising ways: emotional numbness, panic, guilt, dissociation, and even phys…
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A Call for Medical Aid in Dying: A Tale of Autonomy and Desperation
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17:57Not having access to Medical Aid in Dying can drastically increase suffering for dying people and their families. This week I'll share a deeply personal and painful story about a dying man who wanted to have control over his death and what why he had to face it alone. Helping healers heal others and themselves. Delia Delia Chiaramonte, MD www.integ…
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Bearing Witness to Grief: A Powerful Way to Support Someone Who is Grieving
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9:51It's been an interesting experience for me to experience the loss of my dad and both feel my own grief and also observe it with the lens of a palliative care physician. I have noticed how healing it has been for me when others bear witness to my pain and also when they bear witness to my dad as a person. This is how we can best support people who a…
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Anticipatory Grief: A View From the Inside
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19:10Grief isn't only an issue after a person dies. Anticipatory grief shows up long before a person has passed away. Families facing dementia, ALS, cancer, renal failure, and other serious illnesses can experience anticipatory grief long before the very end of life. This week we take a look at anticipatory grief from the inside because my family is fac…
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Advance Directive Dos and Don'ts: Key Advice for Your Patients, Your Family and Yourself
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21:21Everyone should have an advanced directive. Full stop. You, your parents, your partner, your adult kids - everyone. Most people know that having an advance directive is important but they feel awkward or anxious about actually making it happen. I've seen patients with stroke have a terrible outcome from a poorly done advance directive. And I've see…
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What is Holding You Back? Five Steps for Finally Doing What You've Been Avoiding
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19:07What have you been avoiding? Is there a courageous conversation you should be having? A boundary you should be setting? A household task that needs to be completed? I wrote Coping Courageously: A Heart-Centered Guide for Navigating a Loved One’s Illness Without Losing Yourself about a year ago and I never recorded the audio book! I meant to. I want…
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Palliative Care Updates with Dr. Janet Abrahm
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44:53Dr. Janet Abrahm is a Fellow of the American Academy of Physicians, Fellow of the American Academy of Hospice and Palliative Medicine, and a Fellow of the American Society of Clinical Oncology. She is a Professor of Medicine at Harvard Medical School, a former practicing oncologist, and an internationally recognized expert in supportive and palliat…
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The Physician Entrepreneur: An Inspiring Interview with Dr. Una
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52:01Physicians are expert learners, yet many have the feeling that they can't be entrepreneurs. This week, Nneka Unachukwu, MD (affectionately known as "Dr. Una") will convince you that you can learn the skills to become a physician entrepreneur or a physician "intrapreneur" and create the life that you want. If you have a tiny voice inside that dreams…
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How to Start the Conversation: 5 Tips for Initiating Talks About End-of-Life Wishes
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14:24Talking about advance directives, goals of care, and end-or-life wishes can be scary. Even if the conversation doesn't scare you, finding the right time and the right way to bring it up can be a challenge. This week I share my own recent experience of having a goals of care conversation with a loved one, and give practical guidance for how to get s…
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From Cold Showers to Going Flat: Katie Duke's Empowering View of Breast Cancer From the Inside
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38:24In this episode, Katie Joy Duke (@katiejoyduke) shares her wisdom as a woman and life coach who experienced treatment for stage IV breast cancer. She shares the tough parts and the growth parts, including her decision to pursue an aesthetic flat closure rather than breast reconstruction. She is open and engaging and wise. I know you'll love learnin…
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We create much of our own suffering, and I suggest that we all cut that out! Life sends us enough stress and challenge - why would we add to our suffering for now good reason? Expectations can add to our suffering. Learning to modulate your expectations allows you to stay in the moment and enjoy your experiences, your people, and your moments. Holi…
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In the serious illness space, regret is rampant. Caregivers often regret what they did or didn't do when caring for their loved one with cancer, dementia, or other life-limiting illness. Physicians and other clinicians may regret the goals of care conversations that we meant to have but didn't get around to. Regret is terrible and its negative impa…
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Advance Directives & Emergency Medicine: Wisdom From the Front Lines with Dr. Dan Morhaim
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46:34Emergency Medicine physicians face life and death situations as part of their normal work day. They train for that! But what about when an ailing person with a very advanced cancer comes to the ED without an advanced directive? What if half the family wants aggressive care and half the family wants to let the patient die peacefully at home? This we…
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Managing the Holidays When Someone Important is Missing
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20:04Holidays can be joyful times that bring you together with the people that you love. But what if someone is missing? Maybe your loved one has died, or maybe someone important to you can't join you for the holidays this year. How do you balance grief with expectations of holiday joy? This week I discuss how to cope with the holidays when someone you …
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Coping When Faced with Deeply Upsetting Circumstances
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11:34We've just had a big election and many people have strong feelings about the result. Some people are happy about the outcome, and others are feeling deeply distressed. In palliative care we are experts at helping people cope with highly unwanted outcomes. We can use some of our palliative care skills to help people cope with their feelings right no…
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The Basics of Gender Affirming Care: A Primer for Physicians and Clinicians
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29:26Can you define cisgender? Transgender? Intersex? Gender non-conforming? Do you know the difference between sex and gender? Have you heard of a 'dead name?' Do you know why using "Sir" and "Ma'am" can cause you to be inadvertently hurtful to your patients? Providing gender affirming care is important but you may not have learned this in school. Join…
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Supporting Blind Patients: From 'Pity Party' to 'Propel Party' with Sarah Freeman Smith
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40:59Sarah Freeman Smith is a blind inspirational speaker and author, former HR/recruiting leader and disability advocate. She went blind in midlife and in this week's episode of The Integrative Palliative Podcast she shares her journey, the tech that she uses to increase her independence, and guidance for physicians and clinicians to help their visuall…
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Eco-Friendly End-of-Life Options: Green Burials and Beyond
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19:36Many patients are embalmed or cremated after death, but this isn't the only option. Embalming and cremation have a negative impact on the environment, and other, more eco-friendly, options are becoming popular. Options such as green burials, human composting, and reef balls give people options for how to handle their loved one's body after death. D…
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White Coat Crossroads: An Interview with Physician Career Coach Heather Fork, MD
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42:26Many physicians, and other clinicians, are wiped out and burned out. They may wonder if they should stay in medicine, or if there is another path that would make them happier. Yet running away from unhappiness isn't a great strategy because sometimes the unhappiness follows you to your next destination. Dr. Heather Fork is a dermatologist and physi…
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Handling Angry Patients Without Losing Your Cool
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19:40Sometimes patients or family members express their stress with anger. And when the anger is directed your way you may get defensive or annoyed and it can put a pall on your day. Listen to this week's episode for clear guidance about what to do when your patient gets angry so that both of you leave the visit feeling calm. Coping Courageously: A Hear…
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Emotional Needs of the Dying: Four Key Concepts to Discuss with Your Patients
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14:31Don't be afraid to talk about dying. We don't learn to talk about dying and so many people are afraid because they don't know what to say. Here are four key topics to bring up with people who have advanced illness such as progressive metastatic cancer. In patients with Alzheimer's disease or other kinds of dementia, it is important to have these co…
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Mental Status Change in Hospice Patients: What to Do and Not to Do
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12:24Mental status changes in hospice patients are extremely common. Yet are they always due to disease progression? If a patient suddenly gets confused or sleeps all day, what should you do? Should you counsel the family that this is normal? Order testing? Assess the medication list? Family members sometimes worry that sending their loved one with adva…
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When Patients with Cancer Pain Won't Take Opioids: 30 Reasons Why and What to Do About It
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32:42Your patient is in terrible pain from cancer and you have the tools to relieve it. Yet they won't take the oxycontin or morphine that you prescribed. You can see that they are suffering yet you feel powerless to help. This is a common scenario and it can lead to discord between you and your patients. You may feel like saying, "Well fine then. I can…
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Ketamine: What It Is, Who Should Use It, And How the Palliative Population is Different
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11:37Ketamine is in the news right now because Matthew Perry died from improper use of ketamine and his physicians just got arrested for making that possible. It is always a bit shocking when physicians get arrested for prescribing medication. It does seem like his physicians were not acting in accordance with their hippocratic oath - if that's true, sh…
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Dealing with Uncertainty in Health and Life: 4 Dos and 4 Don'ts
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13:43We live in a soup of uncertainty and so do our patients and clients. Caring for patients with serious illnesses such as cancer or Alzheimers dementia can be extremely stressful because the experience is filled with uncertainty. Having a clear approach to dealing with uncertainty reduces stress and increases joy. This week we discuss 4 Dos and 4 Don…
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LovingKindness Meditation: An Experiential Episode to Feed Your Soul
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10:58The LovingKindness, or Metta, meditation (not a typo - that's how it is spelled) is one of my favorite meditations. It offers kindness and healing to you, the people in your life and the world. This week I offer you a LovingKindness meditation for your own wellbeing. You'll notice that there is no intro or ending because I'd like you to hang on to …
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Leave Your Heirs the Gift of Organization: How Adam Zuckerman's "Buried in Work" Simplifies Estate & End-of Life Planning
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42:05Leave your heirs the gift of organization. Estate planning is crucial but many people put it off because they aren't sure how to proceed. Adam Zuckerman is an attorney and entrepreneur who created a company, Buried in Work, after losing his father to cancer. Adam is passionate about making estate planning and end of life preparations as easy as pos…
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Dealing with Challenging Patients: The Power of Empathy Plus Boundaries
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19:20We've all had challenging patient or client interactions. It can be hard to know how to handle them and it can make us feel lousy or even derail our day. You want to be an empathetic physician, nurse, therapist, PA or other clinician but how do you balance empathy with boundaries when a patient or family is angry or mean? This week join me to refle…
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The Less Stress Doc: An Interview with Dr. Gary Sprouse
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37:57Dr. Gary Sprouse is the Less Stress Doc. He is a family physician with expertise in stress management and he's the author of Highway to Your Happy Place: A Roadmap to Less Stress. This week Dr. Sprouse shares tools and insights to help you manage stress, banish guilt and regret, and live a happier life. You can find more information about Dr. Sprou…
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Caring for a Challenging Loved One: 3 Questions and 3 Truths
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11:21Caring for a loved one who is aging or ill is hard. It is especially hard if you've had a challenging relationship with them. If you had a difficult childhood and now find yourself caring for a parent with cancer, a stroke, or Alzheimer's dementia, you may be experiencing extreme stress and overwhelm. Ask yourself these 3 questions and ponder these…
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A Rational Approach to Chiropractic Care: Guidance from Brian Morrison, DC
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49:15Chiropractic care is widely misunderstood by the medical community. In this interesting interview, chiropractor Brian Morrison clues us in to how we got here and the ways in which chiropractic education and clinical care have changed for the better in recent years. Dr. Morrison discusses who benefits most from chiropractic care, and which patients …
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Your Internal Judge Makes Practicing Medicine (and Everything Else) Harder
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16:07Our internal judge has us judging ourselves, other people, and our circumstances. This makes practicing palliative care (and any patient care) harder and generates stress for us that we certainly don't need. This week you'll learn strategies for noticing your own judge and practical techniques for calming it, so you can enjoy your practice more, ha…
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The Power of Mind-Body Medicine: An Interview with James Gordon MD, Founder of the Center for Mind-Body Medicine
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46:11Dr Gordon is a world-recognized authority and pioneer in mind-body medicine, and he is the founder and executive director of The Center for Mind-Body Medicine in Washington, DC. He is a Harvard educated psychiatrist and a clinical professor at Georgetown Medical School. He was chair of the White House Commission on Complementary and Alternative Med…
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Moral Distress, Moral Injury, and Humanity in Healthcare
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18:53Moral distress and moral injury are common in healthcare, yet few physicians, nurses or other clinicians talk about it on a regular basis. Stuffing the shame, guilt, anger and other powerful emotions that can accompany moral injury can lead to clinician burnout, compassion fatigue, depression or even suicide. And it can also result in excellent, em…
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Don't Blame The Victim: 4 Myths of Clinician Self-Care
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13:47The term self-care has a bad rap lately. It can seem like healthcare organizations use terms like "self-care" and "resilience" to make their doctors, nurses, and other healthcare practitioners work harder and harder. They offer free yoga, while piling on more and more work! There is truth to this scenario, yet pushing away the concepts of self-care…
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How to Handle it When Your Patient is Crying
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12:12Many clinicians, especially physicians, don't learn in school what to do when a patient is crying. When we don't know what to do we feel uncomfortable, and no one likes to feel uncomfortable. I've seen many physicians sit in the presence of a crying patient, continue to work on their computer, or awkwardly shift in their seat. This gives the patien…
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Is Joyful Palliative Care possible? Palliative care clinicians are often kind and highly empathetic people, but uncontrolled caring can lead to compassion fatigue or even burnout. Yet approaching the care of seriously ill people with an intentional approach can indeed make palliative care joyful. Here are the steps: 1. More tools to relieve your pa…
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2024 International Congress on Integrative Medicine and Health: 8 Key Takeaways
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15:07The 2024 Integrative Congress on Integrative Medicine and Health was held recently in Cleveland and there were so many wonderful sessions. I attended and have picked out 8 key learnings to share with you. The 8 topics are: 1. Microskills for wellness 2. Healing presence 3. Boundaries 4. Photobiomodulation 5. Vagus nerve 6. Psychedelics 7. A key val…
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Using Negotiation Skills to Communicate Effectively with Patients
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13:57Effective doctor-patient communication is crucial for effective patient care. Yet effective communication is challenging when visits are time pressured, and both clinicians and patients are often stressed. Using the tools of negotiation can help make doctor/clinician-patient communication more effective. This week I discuss an 8 step approach to ne…
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The Power of the Healthcare Provider Gaze: An Interview with Dignity Expert Harvey Chochinov MD, PhD
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41:50Harvey Chochinov, MD, PhD is an esteemed clinician and researcher in the field of palliative care. He shares his research on dignity, dignity therapy and the Dignity Question that is vital for providing the highest quality end of life care. You will be inspired by his work and learn tools that you can bring right to the bedside. You can find Dr. Ch…
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Integrative Health Coaching and Education: A Discussion with Michelle Pearce, Phd
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29:12Michelle Pearce, PhD is a psychotherapist, coach and integrative health educator who is passionate about guiding people to well-being. She shares her insights about health coaching, both private and group. She also shares information about the integrative health and wellness certificate program that she leads at the University of Maryland, Baltimor…
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Dementia: 7 Ways to Connect When Language Is No Longer Accessible
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10:12Dementia is hard on families. It is hard to watch a loved one decline, hard to provide personal care, and hard to lose the connection with the person that you once knew. One of the hardest things may be that the person loses their language, and language is often how we connect. This week I share 7 ideas for fostering connection with people with dem…
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Integrative Nutrition Coaching: An Interview with Joel Edman
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40:56Behavior change is hard. Integrative nutrition and wellbeing coaches are an important part of a healthcare team. Joel Edman, DSc, FACN is an integrative nutrition and health coach and he shares his wisdom this week about how to facilitate practical and realistic behavior change. Healthy nutrition, exercise and stress management is important for peo…
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A Surprising Cause of Pain in a Patient with Cancer: A Case Discussion
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12:09As clinicians it is crucial that we are aware of our blinders. Sometimes the obvious cause of pain isn't the actual cause of pain and we need to be willing to look past our first impressions. This week I discuss the case of one of my patients (de-identified of course). He had widely metastatic cancer and a pain that I couldn't control with medicati…
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How to Stay Sane in the Presence of Suffering - 6 Key Steps
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14:14It is painful to watch other people suffer, whether they are your patients or your loved ones. They may suffer with illnesses, such as cancer or dementia, or may suffer with emotional pain, anxiety or depression. You want to help, but don't want to be swallowed up by their suffering. Join me this week to learn six important ways to protect your own…
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Acceptance is Badass - A Reading From Coping Courageously
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14:43This week I share the story of one of my patients and the woman he loved. Nick was a man in his 20s with an advanced cancer and caring for him touched my heart. He had to face the difficult reality in front of him in order to create the life that he wanted. He embraced acceptance and it changed his future. Come listen to a reading from Coping Coura…
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BreathNote: A Powerful Tool for Using Your Breath to Improve Wellbeing
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30:40Breath is powerful. We carry it with us, it keeps us alive, and it can either increase our stress or reduce it. Slow breathing is a secret weapon for reducing the stress response, reducing anxiety and improving wellbeing. This week you'll hear from Fernando David Pinon and Nancy Estaphanous, the co-founders of BreathNote. BreathNote is a unique and…
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There is wonder in unexpected places. When you look for it you will find it, and when you find it life feels just a bit lighter. From an Uber ride that turned into an impromptu therapy session to a conversation in a wellness store that may just save a local business, this week we'll uncover the magic hidden within everyday interactions. How is this…
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Remote Neurofeedback: A Conversation with Francesco Amico and Alvaro Villegas
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41:37Neurofeedback is a brain-based treatment that is effective and safe. It can be used to manage ADHD, anxiety, depression, insomnia, Parkinson’s disease, mild cognitive impairment, post concussive syndrome and more. This week we have Francesco Amico, PhD and Alvaro Villegas who are experts in neurofeedback, especially neurofeedback that can be admini…
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