Top down VS Bottom up Approaches to Health Challenges
Be it pain, illness or simply the maintenance of health, the equilibrium between top down and bottom up approaches are integral.
So what does that even mean?
Top Down refers to the cognitive approaches of understanding the physical, emotional and spiritual processes evolving within the body. It is primarily related to the thinking aspect of health.
This looks like thoughts such as:
What is going on in my body?
Why is this occurring?
How can I support my thinking so that I can feel as well as possible?
It’s related to the messages we can send down from the brain to body.
Bottom up refers to the recognition of the impact of bodily sensations in a felt sense that travel up from the body to the brain.
They might be sensations of pain, irritation, fullness, tension or relaxation, heightened breathing or slowed respiratory rate, racing heart or otherwise.
These are inputs that are involved in biofeedback. We can layer thoughts and judgements on these sensations, or suppress them. Or we can feel, process and integrate.
This all sounds very esoteric so why does this matter? Because its mind body balance.
Its the recognition that any approach to health needs an understanding of the potency of our thoughts, judgements expectations and internal dialogue.
Its equally the recognition that connecting with our felt bodily sensations and processing these can have profound effects on our wellbeing. While it can be overwhelming to be in our bodies for various reasons, little connections can be so helpful.
An example of application for fatigue
Top down processes
It must mean I have something seriously wrong with me
Life is so busy, I never get a chance to rest
I cant remember what its like to feel energetic
Theres no point seeing anyone, I might get dismissed
I cant slow down, I’m too busy with work
If I stop, things will fall apart
Intervention:
Identifying thoughts, fact checking them, perspective shifts, collaborative planning, processes for challenging unhelpful thoughts.
Bottom down processes (felt bodily sense related to fatigue)
Tense muscles, aching
Headache
Feeling sluggish and brain fog
Racing thoughts or difficulty with cognitive processing
Weakness in strength
Intervention:
Deep breathing, relaxation, music and yoga when tense, nutritional support, prioritisation of sleep, movement for body, stretching
Example approach to fatigue plan:
Medical check to exclude serious or modifiable causes
Self talk: Kindness and reduced catastrophising e.g its understandable i’m working hard and have young children, it wont always be like this.
Negotiation to include scheduled pockets of rest or alone time in the week with partner- in advance, recurring (every saturday AM 10-12)
Reverse sleep in for 2-3 nights per week
Order 2-3 meals per week for the next few weeks to take pressure off and ensure good eating
Start walking 20 minutes 3-5 times a week outside
5 minute stretch in the morning when getting up
Guided progressive relaxation activity before sleep each night
Our thoughts have impacts on our body. On how our body functions. Out bodily sensations are interpreted by our brain and can be judged and amplified or processed and reduced.
So often health is framed in silos of modalities when of course the reality is that we are all integrated .
If your dealing with a health issue or just wanting to improve your health, having a plan that includes addressing the cognitive aspects of management with the connecting to your body, can be very helpful and is an evidence-proven effective strategy to assist in recovery.
Juno Specialists Redefines Maternal, Women’s and Child Health.
Based in Richmond, Victoria. We bridge the gaps that exist within the current models of maternal, women’s and child healthcare. We bring together the best of modern medicine, progressive forward thinking, evidence-based practices and reclaim sacred ways. Medical + Allied Health, together.
We lead with deeply integrated care. We seek to inform and educate you. We allow time. We honour your autonomy.
We offer comprehensive one-on-one long appointments as standard with compassionate and knowledgeable practitioners. Our GPs also offer Iron Infusions and vaccinations. We provide forward-thinking, solution-creating services - our Breastfeeding Day Stay and Nausea and Vomiting in Pregnancy Fluid and Support Stay.
We provide:
Juno Specialists is located in Richmond on the banks of Birrarung and is easily accessible from inner eastern, northern Melbourne and beyond. We service all of Melbourne including Kew, Hawthorn, Abbotsford, Fitzroy, Fitzroy North, North Melbourne, Carlton, Burnley, Prahran, Clifton Hill, Brunswick, Coburb, South Yarra, East Melbourne, Northcote, Thornbury, Preston, Fairfield, Ivanhoe, Heidelberg, Toorak, Malvern, Camberwell, Balwyn, Mont Albert, Surrey Hills, Blackburn, Mount Waverley and beyond.
The space within Juno’s walls has been designed for you
A sacred space for you to feel completely supported. We have designed our space specifically with your needs, comfort and accessibility in mind.
We look forward to supporting you.
