Let's Share Emotions, Thoughts


Life's Favourite Song

Author: Natasha Anne Wheeler

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I walk along a rustic path
Leading to the key to my heart.
I stand alone on this trail
Never letting my dreams go frail,
Aware that I walk towards the light
Seldom faltering in the dreadful night.
Not knowing where this road may lead
Life sure is a mystery, yes, indeed!
I keep going, uncertain but strong
Humming an echo of life's favourite song.



Who Are You?

Author: Dr. Ali Khwaja

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Who Are You?

As an ardent student of human behavior, I often like to know how much time people spend in trying to understand their own self. Many of us take deep interest in analyzing, understanding and commenting on others. Not only those who are involved with us, but even about political leaders, film stars, celebrities etc. Hours are spent in idle conversations and comments about people whose lives we cannot (and should not) change in any way. But we do not spend even a fraction of that time trying to analyze and understand about ourselves.

You will live with yourself 24/7 X 365 for all the years of your life. You need to know your upbringing, attitudes, values, likes and dislikes. You need to introspect on what have been your achievements and your frustrations. You should evaluate what you have gained and what you have missed out in life. You should also be aware of the changes within you, how your aspirations and priorities evolve, what makes you happy or unhappy. Only if you do this periodically will you be able to face any challenges squarely.

In my training programs I often ask a question unexpectedly, “Who are you?” and ask them to answer immediately. It is amazing how many people flounder – they write the roles they are playing, ‘what’ they are, but many cannot really answer ‘who’ they are. Are you able to answer to yourself,

“Who are you?”

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Orientation to The Little Boys

Author: Dr. Ali Khwaja

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Orientation to The Little Boys

"We ask our daughters where they were, but we do not ask our sons where they were and what they were doing..."

Often I stop on the road and discreetly watch the cute scene of a little boy holding the hand of an even tinier sister or cousin and taking her to school. I often wonder what happens to these boys when they grow up and develop insensitive feelings towards the fairer sex. Is it their fault, or is it the upbringing we give them?

For years and decades I have been reading about the sporadic incidents of eve-teasing, molestation and harassment of women in different places and cultures. Of late, thanks to social media, a big uproar is created, and people even come on to the roads with placards and justifiable anger and protests. The poor police is often made the scapegoats, whether they use force or whether they keep quiet.

I have very often wondered why we are not looking at a long term solution. As Prime Minister Mr. Modi said, "we ask our daughters where they were, but we do not ask our sons where they were and what they were doing."

Can we not begin by giving a better orientation to the little boys around us while they are still in their innocence? Anyone taking the lead, I am willing to join.

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Happy Independence Day

Author: Dr. Ali Khwaja

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Happy Independence Day

The festival worth celebrating most, our country’s Independence Day, has just gone past.

Most of us were born after India gained independence, so we have not experienced what it is like to live under the control of a foreign power. When we go around a totally free, democratic, secular and unrestricted gigantic nation, we perhaps cannot visualize what it must have been to be asked to crawl on certain roads because the Britishers felt offended by the ‘natives’, or what it was to see signboards reading “Dogs and Indians not Allowed” in our own nation.

The one very important festival that binds us together whether we are Hindu, Christian, Muslim, Sikh, atheist or Banjara is our Independence Day. Let us not only celebrate this great day with all enthusiasm and from the heart, but let the spirit of Independence continue in our hearts many days after 15th August is over. Let us cherish and protect this freedom from restrictive practices, internal and external threats, and even from our own narrow-minded thoughts if they occur.

Happy Independence!


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Guru Purnima - What really is a Guru?

Author: Dr. Ali Khwaja

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Guru Purnima - What really is a Guru?

Guru Purnima came and went last month. Even the full moon was a little dull due to cloudy weather. I received many messages of gratitude and appreciation that warmed my heart – though personally I don’t believe that I have really been a Guru as such.

Which made me think – what really is a Guru? Is it just the teachers who taught us through text books, is it the religious wise men who give sermons, is it the person who coaches you when you have exams and sees that you pass? Surprisingly my best and most effective gurus have been none of these – they have been people who encouraged me to think for myself, motivated me to progress without them being my crutches, cheered me on when I was doing something nice, and stood by me when I faltered.

Happy Guru Purnima

Some of my gurus have also been my worst critics who made all efforts to pull me down, and in the process lit a spark of determination in me that I should prove them wrong!

Many a time we do not realize how much we are learning from different people, leave alone acknowledging and appreciating them for what they have given us! Shall we start doing it now at least?

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When I write, I do so for myself

Author: Dr. Ali Khwaja

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When I write, I do so for myself

Sometimes people appreciate what I write, at times they say they do not understand, and some just ignore because they are too busy to read trivia. Of course in this age of Instagram and Twitter, perhaps reading a few paragraphs, and that too on paper and not on the mobile, must be quite a task to many people. But that does not discourage me, because I write for myself…..

I have always held the view that it is better to love than to be loved. Not many agree with me, at least not in practice. But I believe that when I love I am in control of myself, I am choosing to do what makes me happy. I am not dependent on anyone, not even on the person I love. Hence life is so much smoother and fulfilling.

Similarly, when I write I am bringing out my thoughts. Why should it be important to me whether others choose to read, agree, criticize, condemn, or as in most cases ……ignore? If you are reading this, don’t evaluate my expression. Use it to create thoughts and ideas of your own – and share it with others. You may have much more and better things to say than me, and there may be people who appreciate your inputs.

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If you …..

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If you are aware of your feelings and acknowledge it
If you accept yourself and love yourself
If you are a witness to your own truth and share it.
If you help another discover himself
If you relieve suffering and exude peace and happiness
If you share your unique points of view
If you give people diversion from their toil so that they are refreshed in their efforts
If you survive to tell someone else's story and your story

If you simply share …. A life that is shared is enriched



Expectations are not a straight line….

Author: Kumaraswamy S K

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'Expectations' is a very inevitable part of our life, each day starts with some or other expectation. We have various relationships and we have expectations from every relationship!

Father, mother, brother, sister, friends, husband, wife, uncle, and aunty, so on & on…. Some expect as responsibility, love, duty, “because I did this to you why not do for me”…. etc.

There has been a longlasting high degree of expectation from this relation of parents & children. All of us agree the degree of sacrice each parent takes up in g i v i n g b i r t h t o t h e children and to educate t h em t o b e a b l e & capable persons to lead a comfortable life, is phenomenal. Yes, Mother Nature has put this in our life... a circle which is never incomplete… today's parents are tomorrow's grandparents & today's children are tomorrow's parents. In this relationship knowing that I will be a father tomorrow, the children still do not fulll their responsibilities to the parents. These parents in turn crib that their child is not taking care of them, all this again there is something called EXPECTATIONS.

There are arguments that only when you expect, you get disappointed, so better not to expect anything from any one. Sounds good & right… isn't it… But can we really keep quiet without any expectations from our near and dear?

Maybe we can rationalize our expectations, balancing the priorities between parents (Duties as son) wife (forthcoming life with wife & child) one cannot be only towards one side. As parents we need to be proactive to be selfsuf cient nancially, not emptying our earnings, keep it for our last days.

You can be done with any relationship if you do not want but the marriage relationship is different. Expectations are very high in this relationship since there is only one individual in the relationship to fulll the expectations. This is one to one relationship, unlike siblings, friends etc.

Married relationship has that kind of ownership expectations. He or she belongs to me. Sometimes it's too suffocating, because anything more is poison. All need to have their own space, and expectations often turn out to be the demands. Most common expectations are: He or she does not spend enough time with me, does not love the same as earlier, has lost interest, does not care for me etc.

Many times we live in our expectations framed by our own expectations, like I expect my husband to be like this, or wife to be like this, but the fact is whether he or she is wired for it. M a n y t i m e s o u r expectations are borrowed, looking at the others we frame our expectations. A couple behaves closely in a public place, seen by other couple, the expectations relate & start expectations why can't we be so… examples can be in hundreds.

God knows when we will be free from our unreasonable EXPECTATIONS.



Can Humans Survive Without Nature?

Perma-link for article: http://www.banjaraacademy.org/can-humans-survive-without-nature

When will we move from HDI to UDI, that is, from Human development Index to Universal Development Index ? It is because rather than nurturing the nature we have started abusing the nature. Rather than treating the nature as Source we have started using her as Resource. Trees are being cut brutally . Animals are being killed inhumanly. Even we are becoming Smarts- smart cities and smart villages . There is a need to redene smart in India.

Every entity has its own place in the universe . Every element of this universe needs to be duly respected. Where have gone the sparrows , butteries and glowworms? What is the rate of plantation of MicroWave towers? Is digital India the resolve to all the problems of India? Which are the considerations for new system designs and conversion? A sparrow is as signicant as a human baby. A tree is as important as a human being. A glow worm is as important as a saint. Tiger, deer and elephants are as important as human creature.

We have stopped realizing that the survival of human beings is directly proportional to the survival of the nature. We are depriving our children of their childhood. The beauties of the childhood are lost in the school curriculum framework. The children are deprived of the games, sports and nature. There is rarely drinking water in the schools. Children carry their own bottles. We the human beings have made our own lives miserable. Most of the problems are deliberately invented by the so called civilized, modern human beings.

What is the resolve? Let us not be over smart. There is a need to develop Universe Development Index considering the life expectancy of every organism, healthy culture of every organism and investment and income on every entity.



Positive to the End

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Positive reinforcement is always fantastic to hear and I have been blessed to have received an immense amount. It helps us warriors get through tough days and sometimes the words spoken can be exactly what we need to hear.

However, from your perspective, it can't be easy to respond to the news of a loved one b ein g d iagn osed with can cer. On e' s instinctive reaction is to let their own fears takeover, but most often that isn't what a new warrior needs to see or feel.

How one responds to news and acts spontaneously is of utmost importance. So as a resident of the cancer universe, I thought I could assist you in dealing with your own emotions or certain situations better while you support your warrior.

Of course this is only my perspective and each warrior responds differently, but I hope it benets you nevertheless.

Chronic Disease, not Terminal:

Cancer is no longer considered a terminal disease. Warriors live with cancer and they can function ne. There are numerable other diseases that are incurable but cancer fortunately has many treatments available. So yes, it is a tough journey but it doesn't always have a negative conclusion.

I don't know when my cancer will go into remission. It probably will or won't, but that's not going to stop me from planning the next fty years of my life. Hence if you hear of somebody's diagnosis, don't let fear of death cloud your emotions.

Gauge your emotions:

The reason I can battle cancer with strength is because nobody cries or acts weak in front of me. My support group is very matter of fact about my illness and we have normal conversations.

Therefore gauge your emotions and behavior around those in treatment. Also, this needs to be done each time you are around a warrior. Our own mood can be very erratic hence your emotions shouldn't burden further.

Some days I am happy to cry about my cancer with a friend but other times I have cut off from well wishers, because their perturbation was too overwhelming for me.

Take permission before sharing information:

When we know a cancer warrior and receive information about the d i s e a s e , t h e impulsive reaction is to share it with them. And you should!

It helps us gather points on how to care for ourselves while taking away the responsibility of nding the information single handed. However, it's polite to seek permission before you share.

Respect the morbidity:

Despite everything I say in my blogs, the rst reaction when I was diagnosed was 'tik tok there goes my clock'… and morbid thoughts come from time to time.

It can be difcult to hear a warrior talk about their death but be strong and listen to us. You don't have to say anything. One hug at the end of the conversation is all that is expected of you.

Motivate on Vertical Days

I learnt this interesting concept from a fellow warrior when I entered the cancer universe. She said 'Sonia, I have two type of days, vertical and horizontal. The days I am ne I am vertical- up and running and the days I am not, I'm horizontal- sleeping on my bed'. It's been the easiest way to explain to family how I am feeling each day.

Bald is beautiful but don't lie:

Cancer alters a warrior's looks. Yes, we brave the changes happening to our skin and the loss of hair. It is also very nice of you to say that we carry off the look well or still look good. But it ok to agree with us and say “we miss how you looked too”.

Develop an appetite for intensity:

Till I am positive, cheerful and hunky dory, I have a lot of people around me. The day I am feeling morbid or grumpy, not so many. Of course nobody wants to be around an unpleasant person but hey, I have cancer! I'm allowed this much. So be strong and hear us on our tough days. That is when we need you. Strength is contagious: When you interact with a warrior, do it with all your love and positivity. Be a catalyst of strength.

Sonia Boury student of DCS 2010 and daughter of Neelam Boury student of DCS 2012, passed away in April after a valiant three year battle with cancer.



Whither Education?

Author: Dr. Ali Khwaja

Perma-link for article: http://www.banjaraacademy.org/improvement-of-our-education-system-by-counsellor-author-life-coach-dr-ali-khwaja

Whither Education?

We talk so much about improvement of our education system, but nothing much seems to be happening. The reason becomes clear if you read these extracts from an article written by an eminent professor in a reputed University journal, and form your own opinion:

Quote: “Education is a process in which students acquire knowledge. How one perceives the knowledge and what is the process of coming to know are the pertinent questions here. The traditional method in which the learners receive the information passively is becoming outdated. Present practices are based on the beliefs that learners actively construct knowledge in their attempts to make sense of the world. Therefore learning should be emphasizing the development of meaning and understanding. Students should be able to acquire experiences and learn by themselves in various situations that they encounter over the course of their worldly lives.

Obviously, the traditional method fails to bring about desired outcomes Therefore there is a new trend i.e. constructive approach to bring out the desired outcomes in teaching learning process.”

The article further goes on….

“Constructivist teacher education generally reects 2 major traditions, the developmental and social reconstructions is traditions. Programs inuenced by the developmental tradition attempt to teach students how to teach in a constructive manner.” Unquote. Someone please explain what the enlightened soul is trying to tell us.

Some of our wisest and most eminent statesmen had predicted what may happen:

C Rajagopalachari, who later became the rst Indian Governor General of India, told in the 1930's about what will happen if India becomes a democracy: “Election replete with corruption, injustice and the tyranny of p o w e r , w e a lth and ine f  c i enc y o f administration will make a hell of life as soon as the freedom is given. Men will regretfully look back to the old regime of comparative justice, e f  c i e n c y , a n d h o n e s t administration. The only thing to be gained will be that we will be saved from the subordination and subjugation of foreign rule.” Unfortunately this has ltered into our education system. But ….. let us not give up hope. The more I interact with young people, the more optimistic I become that they will create a much better country and community than we have done.

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Love Served Children

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Asha with one of the first students of Gurukul

From Orphans to Children With Disabilities, This Bengaluru School Teaches All Equally and With Love

There is no admission or any other charge other than a reasonable monthly fee, and often parents are allowed to pay as per the financial capacity of the family.

Not all children can be toppers or achievers. Not all children enjoy going to school, and not all are welcomed in many schools. Children who have faced school refusal, physical or mental limitations and challenges, emotional disturbance, or inability to fit into a school – where do they go?

Group activity at Gurukul

Tucked into a small building in a suburb of Bangalore city is a Gurukul which insists that it is not a school. Established by highly qualified ladies who, after taking a break in their careers, wanted to do something meaningful for under-served children, they established this centre seven years ago in RT Nagar. The inspiring leader is Sonal Patel, who holds a post-graduate degree in law and is a qualified counselor and assessor. The core team consists of Jayanthi and Priti Chengappa who coordinate all the activities. Amazingly, more than a dozen very competent ladies lend their services unhesitatingly to whatever extent they can, either free or getting nominal honorarium.

Jayanthi motivating a child

It is unbelievable to see how this little unit has progressed, for when it started there was a teacher: student ratio of 10:1, i.e. 10 teachers and one kid! Patiently handling each little one who entered the premises, Gurukul graduated from a little space in the basement to its own airy and very welcoming 2nd floor with a little terrace and roof garden above.

Gurukul welcomes any child who is facing challenges, be they physical, mental or emotional. The loving ladies just sweep the child into their arms and slowly, gently assess his strength and weaknesses. They give unstinted love and affection in an environment where there are no blackboards, textbooks or rows of benches. Each child is lovingly and carefully guided to the right school or vocational training depending on ability, interest and willingness. Dozens of children have passed through the doors of Gurukul and many more keep coming in – whenever they do not or cannot go to a regular school.

Priti at work

Every child is welcomed in Gurukul, the quiet ones who just refuse to open their mouth and talk to anyone, to those who are so hyperactive that before you know it, they have gone on a toppling, tearing and breaking spree. It is amazing to watch how these children are allowed to be themselves when they climb up the stairs of Gurukul and start running around the entire place. Watched over gently but firmly, these children slowly mellow down – and then the assessment begins.

Every child is holistically assessed by more than one counsellor, and parents are interviewed extensively (most often separately). A detailed report is made out – without labelling a child or putting him down, but starting with many of his hidden talents that sometimes even parents may not be aware of. Then the challenges of the child are listed out, and finally a step-by-step action plan of how the child can be made to progress and overcome his hurdles is mapped out.


Gurukulers constantly keep in touch and liaise with a number of mainstream schools, integrated schools, schools that are sensitive to take a child who is a little different, and special schools. The report recommends what type of schooling would be most appropriate to the individual child, and a gentle counselling of the parents takes place to help them accept the limitations that the child may have. At times the child may require continuing at Gurukul for months, or even the entire academic year. The ‘Aunties’ allow them to do so. Even when a child has been put into a school, Gurukul continues to monitor his progress, even allowing the child to take a slow transition by spending some days in the school and some days in Gurukul.

Considering the fact that only children with difficulties come to Gurukul, the success rate is remarkably high. Almost all the children over the past several years have moved on to a better life, and most important – are happy with their growth, learning and what they are doing. Many of them come back in the summer vacation to get a booster dose of life skills and emotional intelligence. From challenged to bright and intelligent children who are restless and bored in classrooms, everyone loves Gurukul, and once they have been there, parents are assured that they will be guided correctly as to how to take the child along further.

Sonal, Jayanthi and Priti

There is no admission or any other charge other than a reasonable monthly fee, and often parents are allowed to pay as per the financial capacity of the family. The only condition Gurukulers put is that the parent should be genuinely interested in getting involved, exploring options and adapting to the needs of their child.

Learn more about the school here.

Contact at the email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

The original article appeared on betterindia.com



Before you can be with others, first learn to be alone

Author: Jennifer Stitt

Perma-link for article: http://www.banjaraacademy.org/before-you-can-be-with-others-first-learn-to-be-alone

Before you can be with others, first learn to be alone

In 1840, Edgar Allan Poe described the ‘mad energy’ of an ageing man who roved the streets of London from dusk till dawn. His excruciating despair could be temporarily relieved only by immersing himself in a tumultuous throng of city-dwellers. ‘He refuses to be alone,’ Poe wrote. He ‘is the type and the genius of deep crime … He is the man of the crowd.’

Like many poets and philosophers through the ages, Poe stressed the significance of solitude. It was ‘such a great misfortune’, he thought, to lose the capacity to be alone with oneself, to get caught up in the crowd, to surrender one’s singularity to mind-numbing conformity. Two decades later, the idea of solitude captured Ralph Waldo Emerson’s imagination in a slightly different way: quoting Pythagoras, he wrote: ‘In the morning, – solitude; … that nature may speak to the imagination, as she does never in company.’ Emerson encouraged the wisest teachers to press upon their pupils the importance of ‘periods and habits of solitude’, habits that made ‘serious and abstracted thought’ possible.

In the 20th century, the idea of solitude formed the centre of Hannah Arendt’s thought. A German-Jewish émigré who fled Nazism and found refuge in the United States, Arendt spent much of her life studying the relationship between the individual and the polis. For her, freedom was tethered to both the private sphere – the vita contemplativa – and the public, political sphere – the vita activa. She understood that freedom entailed more than the human capacity to act spontaneously and creatively in public. It also entailed the capacity to think and to judge in private, where solitude empowers the individual to contemplate her actions and develop her conscience, to escape the cacophony of the crowd – to finally hear herself think.

In 1961, The New Yorker commissioned Arendt to cover the trial of Adolf Eichmann, a Nazi SS officer who helped to orchestrate the Holocaust. How could anyone, she wanted to know, perpetrate such evil? Surely only a wicked sociopath could participate in the Shoah. But Arendt was surprised by Eichmann’s lack of imagination, his consummate conventionality. She argued that while Eichmann’s actions were evil, Eichmann himself – the person – ‘was quite ordinary, commonplace, and neither demonic nor monstrous. There was no sign in him of firm ideological convictions.’ She attributed his immorality – his capacity, even his eagerness, to commit crimes – to his ‘thoughtlessness’. It was his inability to stop and think that permitted Eichmann to participate in mass murder.

Just as Poe suspected that something sinister lurked deep within the man of the crowd, Arendt recognised that: ‘A person who does not know that silent intercourse (in which we examine what we say and what we do) will not mind contradicting himself, and this means he will never be either able or willing to account for what he says or does; nor will he mind committing any crime, since he can count on its being forgotten the next moment.’ Eichmann had shunned Socratic self-reflection. He had failed to return home to himself, to a state of solitude. He had discarded the vita contemplativa, and thus he had failed to embark upon the essential question-and-answering process that would have allowed him to examine the meaning of things, to distinguish between fact and fiction, truth and falsehood, good and evil.

‘It is better to suffer wrong than to do wrong,’ Arendt wrote, ‘because you can remain the friend of the sufferer; who would want to be the friend of and have to live together with a murderer? Not even another murderer.’ It is not that unthinking men are monsters, that the sad sleepwalkers of the world would sooner commit murder than face themselves in solitude. What Eichmann showed Arendt was that society could function freely and democratically only if it were made up of individuals engaged in the thinking activity – an activity that required solitude. Arendt believed that ‘living together with others begins with living together with oneself’.

But what if, we might ask, we become lonely in our solitude? Isn’t there some danger that we will become isolated individuals, cut off from the pleasures of friendship? Philosophers have long made a careful, and important, distinction between solitude and loneliness. In The Republic (c380 BCE), Plato proffered a parable in which Socrates celebrates the solitary philosopher. In the allegory of the cave, the philosopher escapes from the darkness of an underground den – and from the company of other humans – into the sunlight of contemplative thought. Alone but not lonely, the philosopher becomes attuned to her inner self and the world. In solitude, the soundless dialogue ‘which the soul holds with herself’ finally becomes audible.

Echoing Plato, Arendt observed: ‘Thinking, existentially speaking, is a solitary but not a lonely business; solitude is that human situation in which I keep myself company. Loneliness comes about … when I am one and without company’ but desire it and cannot find it. In solitude, Arendt never longed for companionship or craved camaraderie because she was never truly alone. Her inner self was a friend with whom she could carry on a conversation, that silent voice who posed the vital Socratic question: ‘What do you mean when you say …?’ The self, Arendt declared, ‘is the only one from whom you can never get away – except by ceasing to think.’

Arendt’s warning is well worth remembering in our own time. In our hyper-connected world, a world in which we can communicate constantly and instantly over the internet, we rarely remember to carve out spaces for solitary contemplation. We check our email hundreds of times per day; we shoot off thousands of text messages per month; we obsessively thumb through Twitter, Facebook and Instagram, aching to connect at all hours with close and casual acquaintances alike. We search for friends of friends, ex-lovers, people we barely know, people we have no business knowing. We crave constant companionship.

But, Arendt reminds us, if we lose our capacity for solitude, our ability to be alone with ourselves, then we lose our very ability to think. We risk getting caught up in the crowd. We risk being ‘swept away’, as she put it, ‘by what everybody else does and believes in’ – no longer able, in the cage of thoughtless conformity, to distinguish ‘right from wrong, beautiful from ugly’. Solitude is not only a state of mind essential to the development of an individual’s consciousness – and conscience – but also a practice that prepares one for participation in social and political life. Before we can keep company with others, we must learn to keep company with ourselves.Aeon counter – do not remove

This article was originally published at Aeon and has been republished under Creative Commons.



The brain and the gut talk to each other: how fixing one could help the other

Author: Antonina Mikocka-Walus

Perma-link for article: http://www.banjaraacademy.org/the-brain-and-the-gut-talk-to-each-other-how-fixing-one-could-help-the-other

File 20170705 15991 khi2jp People with chronic bowel conditions may need to use the toilet 20 to 30 times a day. daveynin/Flickr, CC BY Antonina Mikocka-Walus, Deakin University

It’s widely recognised that emotions can directly affect stomach function. As early as 1915, influential physiologist Walter Cannon noted that stomach functions are changed in animals when frightened. The same is true for humans. Those who stress a lot often report diarrhoea or stomach pain.

We now know this is because the brain communicates with the gastrointestinal system. A whole ecosystem comprising 100 trillion bacteria living in our bowels is an active participant in this brain-gut chat.

Recent discoveries around this relationship have made us consider using talk therapy and antidepressants as possible treatments for symptoms of chronic gut problems. The aim is to interfere with the conversation between the two organs by telling the brain to repair the faulty bowel.

Our research found talk therapy can improve depression and the quality of life of patients with gastrointestinal conditions. Antidepressants may also have a beneficial effect on both the course of a bowel disease and accompanying anxiety and depression.

What are gastrointestinal conditions?

Gastrointestinal conditions are incredibly common. About 20% of adults and adolescents suffer from irritable bowel syndrome (IBS), a disorder where abdominal discomfort or pain go hand-in-hand with changes in bowel habits. These could involve chronic diarrhoea and constipation, or a mixture of the two.

IBS is a so-called functional disorder, because while its symptoms are debilitating, there are no visible pathological changes in the bowel. So it is diagnosed based on symptoms rather than specific diagnostic tests or procedures.

People with chronic gut conditions can experience severe pain that affects their quality of life. from shutterstock.com

This is contrary to inflammatory bowel disease (IBD), a condition where the immune system reacts in an exaggerated manner to normal gut bacteria. Inflammatory bowel disease is associated with bleeding, diarrhoea, weight loss and anaemia (iron deficiency) and can be a cause of death. It’s called an organic bowel disease because we can see clear pathological changes caused by inflammation to the bowel lining.

Subtypes of inflammatory bowel disease are Crohn’s disease and ulcerative colitis. Around five million people worldwide, and more than 75,000 in Australia, live with the condition.

People with bowel conditions may need to use the toilet 20 to 30 times a day. They also suffer pain that can affect their family and social lives, education, careers and ability to travel. Many experience anxiety and depression in response to the way the illness changes their life. But studies also suggest those with anxiety and depression are more likely to develop bowel disorders. This is important evidence of brain-gut interactions.

How the brain speaks with the gut

The brain and gut speak to each other constantly through a network of neural, hormonal and immunological messages. But this healthy communication can be disturbed when we stress or develop chronic inflammation in our guts.

Stress can influence the type of bacteria inhabiting the gut, making our bowel flora less diverse and possibly more attractive to harmful bacteria. It can also increase inflammation in the bowel, and vulnerability to infection.

Ever ‘gone with your gut’ when making a decision? You’re probably receiving signals from your gastrointestinal tract, which communicates directly with your brain. from shutterstock.com

Chronic intestinal inflammation may lower our sensitivity to positive emotions. When we become sick with conditions like inflammatory bowel disease, our brains become rewired through a process called neuroplasticity, which changes the connections between the nerve signals.

Anxiety and depression are common in people suffering chronic bowel problems. Approximately 20% of those living with inflammatory bowel disease report feeling anxious or blue for extended periods of time. When their disease flares, this rate may exceed 60%.

Interestingly, in a recent large study where we observed 2,007 people living with inflammatory bowel disease over nine years, we found a strong association between symptoms of depression or anxiety and disease activity over time. So, anxiety and depression are likely to make the symptoms of inflammatory bowel disease worse long-term.

It makes sense then to offer psychological treatment to those with chronic gut problems. But would such a treatment also benefit their gut health?

Gut feeling: how your microbiota affects your mood, sleep and stress levels

Inflammatory bowel disease

Our recent study combined data from 14 trials and 1,196 participants to examine the effects of talk therapy for inflammatory bowel disease. We showed that talk therapy - particularly cognitive behavioural therapy (CBT), which is focused on teaching people to identify and modify unhelpful thinking styles and problematic behaviours - might have short-term beneficial effects on depression and quality of life in people with inflammatory bowel disease.

But we did not observe any improvements in the bowel disease activity. This could be for several reasons. Inflammatory bowel disease is hard to treat even with strong anti-inflammatory drugs such as steroids, so talk therapy may not be strong enough.

Talk therapy may only help when it’s offered to people experiencing a flare up in their disease. The majority of the included studies in our review were of people in remission, so we don’t know if talk therapy could help those who flare.

On the other hand, in our latest review of 15 studies, we showed antidepressants had a positive impact on inflammatory bowel disease as well as anxiety and depression. It’s important to note the studies in this review were few and largely observational, which means they showed associations between symptoms and antidepressant use rather than proving antidepressants caused a decrease in symptoms.

Studies show talk therapy improves the symptoms of irritable bowel syndrome. from shutterstock.com

Irritable bowel syndrome

When it comes to irritable bowel syndrome, the studies are more conclusive. According to a meta-analysis combining 32 trials, both talk therapy and antidepressants improve bowel symptoms in the disorder. A recent update to this meta-analysis, including 48 trials, further confirmed this result.

The studies showed symptoms such as diarrhoea and constipation improved in 56% of those who took antidepressants, compared to 35% in the group who received a placebo. Abdominal pain significantly improved in around 52% of those who took antidepressants, compared to 27% of those in the placebo group.

Symptoms also improved in around 48% of patients receiving psychological therapies, compared with nearly 24% in the control group, who received another intervention such as usual management. IBS symptoms improved in 59% of people who had cognitive behavioural therapy, compared to 36% in the control group.

Stress management and relaxation were found to be ineffective. Interestingly, hypnotherapy was also found effective for bowel symptoms in 45%, compared to 23% of control therapy participants.

What now?

Better studies exploring the role of talk therapy and antidepressants for symptoms of inflammatory bowel disease need to be conducted. We should know in a few years which patients are likely to benefit.

The ConversationIn the meantime, there is enough evidence for doctors to consider referring patients with irritable bowel syndrome for talk therapy and antidepressants.

Antonina Mikocka-Walus, Senior Lecturer in Health Psychology, Deakin University

This article was originally published on The Conversation. Read the original article.


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