Endorsements for 50/40

Dear Friends,

The book is going to the printer this Friday! We are very excited. Meanwhile, our wonderful publisher has collected some awesome endorsements for us. Check them out:


"Good, juicy, inspiring words and ways to live as a gloriously aging soul."
--- SARK author and artist of Fabulous Friendship Festival



What a treasure trove! 50 Ways To Leave Your Forties is a joyful, irreverent (and at the same time, very reverent) enthusiastic, and incredibly informative book. The authors present their suggestions for zestful and meaningful living in wonderfully inviting ways. I loved it!

--Sue Patton Thoele, author of Freedoms After 50, The Courage To Be Yourself, and The Mindful Woman


"So far, the statistics are convincing: everyone ages. How we age, however, is largely a choice. In 50 WAYS TO LEAVE YOUR 40s, Sheila Key and Dr. Peggy Spencer serve up a delectable recipe for healthy aging that is both delicious and joyful."

--Larry Dossey, MD, author of The Extraordinary Healing Power of Ordinary Things

Dipping into this treasure trove of a book makes me want to go back in time so I can leave my 40s again. 50 WAYS TO LEAVE YOUR 40s offers so many creative ideas, so much thoughtful information and is so darn much fun, I’m sure I’d do it more gracefully, heathfully, and happily the second time. Congratulations and thanks to Sheila Key and Peggy Spencer for giving all of us a life-affirming map to follow no matter what our age.

-- Judy Reeves, author of A Writer’s Book of Days

“Sheila Key and Peggy Spencer know that a new decade of life is the beginning,
not the end, of something great. With generous helpings of wisdom and wit, 50Ways to Leave Your 40s is a recipe for joy during what comes next.”

— David Niven, PhD, author of The 100 Simple Secrets of Happy People and The 100 Simple Secrets of the Best Half of Life

The Book is Done!

Finally, at long last! The infamous book is finished and on its way to the printer in a matter of days. The cover is what you see here. Publication date is mid-March 2008. Watch this space for more information and links. Post your email or snail mail address here if you want a notice when the book is available, or email me at pspencer@unm.edu. It has been a long and educational road, a lot of fun, and boy am I glad it is over! I know you'll love this book.

Urinary Tract Infections

Q: Are all UTI’s caused by sex?

A: Thank you for this great question. The answer to your question is, “No, but…”
UTI stands for Urinary Tract Infection. It might also be called a bladder infection or cystitis. We see a lot of it at the Student Health Center, mostly in women. It is often related to sex, but indirectly, and not always. To explain, I need to subject you to a mini anatomy lesson. Bear with me.

The urinary tract is the system of organs that makes, collects and excretes urine. You have two kidneys, one on each side, located roughly behind your stomach. Each kidney makes urine and sends it down two tubes called ureters to your bladder, which collects it. Your bladder is located inside your body above your genitals. It is a soft, stretchy container with thin muscles in its walls. When your bladder is full, the urine is expelled from your body through another tube called the urethra. You control this process by consciously relaxing a muscle called a sphincter, which opens the urethra. Your bladder helps by contracting the muscles in its walls. The outside end of the urethra, called the meatus, is at the tip of the penis in men. In women, the meatus is on the vulva, between the vagina and the clitoris. This anatomical difference is why women get UTI’s more often than men, and why it is related to sex, as I will explain, after a mini microbiology lesson. Hang in there.

Urinary infections are caused by bacteria. Bacteria are everywhere. You think you’re clean? You probably are, but that does not mean you are bacteria-free. We share our personal space with more than 200 species of bacteria. In fact, there are ten times more bacteria in our intestines than there are cells in our entire body! Imagine that. Now, before you get all grossed out, know this. These little guys are your friends. They are called, as a group, “normal flora,” and they do lots of good. Good bacteria crowd out and kill bad bacteria. They also stimulate our immune system and help it develop, and some of the bacteria in our gut even make vitamins that we can use.

What kind of normal flora you have depends on your genetics, your age, sex, nutrition, stress and hygiene. We all have bacteria on our external surfaces and some internal surfaces, like nose, mouth, throat, intestines, and vagina. As long as they stay where they belong, there’s no trouble. But sometimes during sex, some of these critters can end up where they’re not wanted, like in the bladder. This happens more easily in women, due to the proximity of the meatus to the vagina and anus. Fluid, friction, moving body parts…use your imagination and you can see how it happens.

Sex is not the only way for bacteria to get near enough to the meatus to go in and cause a UTI, but it is the most common in college-aged people. One simple way to reduce sex-related UTIs is to urinate after sex. What this does is wash out any bacteria that have begun their sneaky trek up the urethra. Most of the time this works great. But if you find that you are experiencing burning when you urinate, blood in the urine, or the urge to go frequently, you might have a UTI. This goes for guys and gals. Please do not try to treat this yourself with cranberry juice, vitamin C or any other folk remedies. While some of these things can help you feel better, a true UTI is caused by bacteria, and the only way to kill bacteria is with an antibiotic.

Traumatic Stress Response

Remember the moment you heard about the shootings on the Virginia Tech campus? How you heard of it and where you were? Your reaction? The reactions of your friends and those around you?

Reactions to traumatic events are as varied as people are. Your response may be very different from your roommate’s or your mother’s. We’ll discuss what is normal and what is not, what to do now and when to get help.

Traumatic stress reactions can be loosely divided into physical and emotional, short term and long term. Many people initially feel shock and disbelief, even denial. Also common are anger, fear, anxiety, sadness, hopelessness, compassion, helplessness, and survivor’s guilt. You may feel emotionally numb, or conversely find that you are irritable and jumpy. Your moods may change back and forth quickly. You may struggle in your mind with why this happened, trying to find answers, to make sense of the tragedy. You may worry about something similar happening here. You may have physical responses, like nausea, headache, jitters, chest pain, trouble breathing, difficulty sleeping, or decreased appetite. All of these are normal. However, if you have severe emotional or physical symptoms in these first days, please get professional help.

This is already a stressful time on campus, with finals and graduations just around the corner. A background of existing stress can magnify the effect of a major tragic news event. If you have some kind of connection to Virginia Tech, your reactions may be even stronger. For example, if you knew one of the victims, or know a student at VT, or have friends or relatives or experience in the area, your feelings will probably be more intense.

If you have a history of previous trauma, as many of us do, the news of this tragedy might bring that past trauma to the front of your mind, and you might find yourself thinking, dreaming, reliving or having feelings about the other incident. The previous incident may seem totally unrelated, or it may be a similar event. This can be unsettling at best. The severe form of this kind of reaction is called PTSD, or Post Traumatic Stress Disorder, but most cases are milder, a temporary resurfacing of memories which fade into the background again.

How can you cope with your own feelings and thoughts during this time? Connect with those you care about. Spend time with friends. Call your family. Talk about your feelings and reactions, or write about them. Post your condolences online, along with thousands of others. Above all take good, healthy care of yourself. Eat well, get as much rest as you can, exercise. Avoid the temptation to “drown your sorrows” with alcohol or drugs. Again, if you’re having severe reactions, get help.

While initial reactions to trauma may vary in kind and severity, most people return fairly soon to a competent pursuit of their normal activities. You don’t forget, but you aren’t immobilized either. An abnormal response is when you are affected to an extreme, or when your feelings or thoughts persist after the initial shock period. Next week and beyond, if you find yourself unable to concentrate or sleep well, or if you are having trouble performing your usual activities due to continuing trauma responses, please seek help.
Delayed responses to trauma can happen up to weeks and months after the initial event. Keep this in mind as you observe and care for your own mental health in the near future.

Stinky Feet

Dear Dr Peg,

My girlfriend told me I have stinky feet. She thinks it might be a fungus thing and wants me to get it taken care of. I don’t notice it, but she said that her socks even stunk when she washed them with mine. I mostly wear the same pair of shoes, which my brother handed down to me, but I shower every day and put on fresh socks. I’m a clean person. Please help me. She’s sleeping on the couch.

Dear Fragrant Feet,

Your girlfriend is probably right (aren’t they always?). You likely have a fungal infection of the feet, also known as tinea (fungal infection) pedis (of the foot). This is also called athlete’s foot, but you don’t have to be an athlete to score this deal.

We all sweat, and sweat has odor. Foot sweat by itself can have a strong odor, but if your girlfriend’s socks pick up this odor in the washer, it is more likely to be caused by fungus. You said you don’t notice the odor, and she does. This is common. We adjust quickly to our own body odors and often don’t notice them, whereas others might.

There are “fungus among-us” everywhere. We don’t have as many in our dry climate as someone who lives in say, Florida, but we have plenty. Fungi (the plural form) live on and off people, and on gym mats, shower stalls, rotting logs and old food.

A fungus is a life form. It is closer to a plant than an animal, but rates its very own kingdom in the 5-kingdom taxonomy of life forms. Within the kingdom Fungi there are over 100,000 species. A few of these have a special affinity for human skin. They cause ringworm (not a worm at all), jock itch, diaper rash and athlete’s foot, among others.

The ideal habitat for certain fungi is somewhere dark, warm and wet. Shoes fit the bill perfectly. You might have even inherited your tinea along with your brother’s shoes. That’s one reason that, although I’m a big believer in recycled clothing, I don’t recommend buying used shoes (or underwear or hats for that matter). Your brother might have had his own case of resident fungus, which went on living quietly in the cracks of his shoes until your feet came along and spiced up the place, allowing the fungi to multiply and prosper. And reek.

So what to do? Basically, the approach to tinea pedis is two-pronged. First, slaughter the beasts. Second, clean up the neighborhood so their skuzzy relatives don’t move in.

Killing fungus is a fairly straightforward proposition. There are a variety of anti-fungal products available over the counter at any pharmacy. I believe the creams and ointments work on the skin better than the sprays or powders, because they stick to your skin better. The usual dose regimen is twice a day, after washing your feet. Please note: if the fungus has gotten under your toenails, making them yellow and thick, you will need medical help.

You can kill the fungi in your socks by washing them in hot water. Add bleach to whites. Do the same with your sheets. Oh, and your girlfriend’s socks. You can also spray bleach (a 10% solution in water is strong enough) on any mold or fungus you see growing in your shower.

Getting rid of fungus in shoes is much more difficult. Wash them if they’re washable. Spray them with antifungal spray and put antifungal powder in them. Best is to accept that you might have to get rid of them and shell out some dough for a new pair or two.

Keep your feet as cool and dry as possible. Change socks twice a day. Try a pair of super-absorbent odor eating inserts. Change shoes often, or go without when you can. Open shoes or sandals give your feet more air, and fresh air is poison to foot fungi.

Here’s something that might surprise you. You can have “fungus feet” with no odor at all. You know those foot and heel cracks that so many people have? We think it’s just desert dryness, but often it is really a type of fungal infection. After-shower treatment with a pumice stone and antifungal cream will clear those cracks right up. Make this a regular part of your routine and they’ll stay gone.

Having tinea pedis does not mean you are unhygienic or somehow bad. It’s just an infection. And in spite of her socks taking on your Eau de Foot aroma, your girlfriend is not likely to catch it, unless she starts wearing your brother’s shoes too. People are much more likely to get tinea from the gym than from their partner. Take the steps above and soon she’ll ditch the couch and be back in your fragrance-free bed.

Molluscum contagiosum

Dear Dr. Peg,

I went to see my dermatologist a few days ago about small bumps I noticed on my penis. My dermatologist said they were molluscum contagiosum and she used a liquid nitrogen spray to freeze them off. I had 5 bumps and now they have all increased in size, popped, and are starting to scab up (as my dermatologist explained they would). Something I’ve noticed is that it seems like my penis is smaller now in its flaccid state. Is this common? Will it go back to normal size after the scabs fall off? I started to google side effects of liquid nitrogen and really got myself scared seeing things like necrosis and nerve damage. Have you ever heard of this?
Thanks. A very nervous guy.

Dear Nervous Guy,

Bottom line: liquid nitrogen treatment will not change your penis size. If that’s all you wanted to know, you can heave a sigh of relief and stop reading. If you want to learn a little more about this disease and treatments, keep reading.

Molluscum contagiosum is a skin infection caused by a virus of the same name. Humans are its only host. It is passed by skin to skin contact, or by skin to object (e.g. towel) to skin. Little kids get it from playing together and sharing toys. In adults, if it’s in the genital area, it’s assumed to be sexually transmitted. We see it quite often at the Student Health Center.

Molluscum contagiosum causes small firm bumps with waxy centers. They usually don’t itch or hurt. It can take weeks from the time of contact for the bumps to appear. If you leave them alone, they will go away eventually, but this can take several weeks to months. In the meantime, you are contagious. If you get treated, the duration of the infection is shortened, and your period of contagiousness is also shortened.

Treatment means removing the waxy centers. This is usually done with a tool called a sharp curette, with which we scoop out the center in one swift move. Yes, it hurts a bit, but only for a second. Alternatively, they can be treated with liquid nitrogen, like your dermatologist used. Nitrogen is normally a gas, at room temperature. It’s part of the air we breathe. When it’s cooled and pressurized, it is a very cold liquid. We use liquid nitrogen to treat various different skin conditions, including molluscum, warts, and small skin cancers. By freezing the lesion, we destroy most of it, and your immune system sends cleanup crews to finish up.

There are several other methods of treatment documented for molluscum, including various toxic solutions and lasers. As I said above, the bumps will go away eventually even without treatment, but since it is contagious as long as the bumps are present, I recommend getting them treated.

You asked about complications of liquid nitrogen freezing. This kind of treatment is also called cryosurgery or cryotherapy. As with any kind of intervention, there are possible complications. First of all, pain. It hurts to have tissue frozen, and the area usually stays tender for several days. Bleeding is common, under the skin as a ‘blood blister.’ Infection is possible but uncommon. If the site becomes opened or raw, cover with antibiotic ointment and a bandaid. Long term complications might include scarring, pigment changes, recurrence of the initial lesion, particularly warts, and yes, nerve damage. This last is very rare, I hasten to assure you.

The way your lesions blistered up and fell off is exactly the reaction we’re looking for. Once the underlying sore heals up, everything should be back to normal, including your penis size.

You mentioned that you did an internet search on liquid nitrogen. Let me take this opportunity to comment on internet searching for health problems. Many of our patients do this. Personally, I like it when my patients do some research ahead of time, if it is good research. I especially like it if they have new information for me and can teach me something. I would caution you, however, against sloppy googling. If you’re going to look up health conditions, use reputable sites. Googling by symptom can be especially problematic, because many symptoms can be caused by a wide variety of different illnesses. For example, fatigue can be caused by anything from stress to cancer. Dizziness can simply be from standing up too fast, or it could be from a major heart problem.

One excellent site is http://familydoctor.org. This site is created and maintained by the American Academy of Family Physicians, and can be searched by disease or symptom. A web search is never a substitute for a visit to the doctor, but it can provide you with lots of good information.

Sex in Midlife

You Still Got it Baby!

Remember when we were 18 and tried to imagine people over 40 having sex? We couldn’t, right? No way those old farts could still get it on! And who’d want ‘em even if they could? Now, look at us. We are those old farts. And we’re still “doing it.” Or are we? Does sex change in midlife? Does it get better or worse? Does it even happen? Or is laundry day the only time we shake the sheets?

It turns out there is no simple answer. Midlifers are all over the sexual map. More sex, less sex, higher drive, lower drive, new partner, old partner, no partner…it’s all there. The only thing that is constant across the board is change. Our priorities are changing, our relationships are changing, and none of us experience sex and sexuality the same way we did when we were twenty-something.

For one thing, we don’t have the bods we used to have, and that takes some getting used to. Youth defines sexuality, or so the ad execs would have you believe, and one thing we ain’t is young. The mortal flesh is settling; we’re not the Gumbies of yore. But you and I know that, beneath the wrinkles and the graying hair, we are just as sexy as we used to be. Probably sexier, given a half-life of experience under our belts (so to speak).

This is not to deny the very real physical and hormonal effects of aging. Drying tissues and waning libidos are common. Don’t let that rain on your parade. Gals, pick up your favorite personal moisturizer and guys, isn’t it a bit of a relief to have your gonads out of the driver’s seat? If not, or if you need more help, please do see your doctor.

My advice is this: Treasure your sexual self. Be open to change. Communicate with your partner. And seek help if you need it.

Herpes revisited - a followup Ask Dr Peg question

Dear Dr. Peg

Recently my girlfriend was diagnosed with vaginal Herpes Type 1 that I’ve given her orally. We are both pretty good kids and haven't kissed too many other people. But my question is, seeing as how it can pretty much be assumed that I’ve transmitted the disease to her, is there any danger in me continuing to perform oral sex on her? If I already have it and we know that between the two of us all we have is herpes Type 1, is there still a danger?

Dear Kisser,

This is a great question, because it brings up two issues: virus spread, and herpes in relationships. I’ll address them one at a time. In my column Curious About Cold Sores, I explained that there are two Types of Herpes Simplex viruses, Type 1(HSV1) and Type 2 (HSV2). Usually HSV1 lives on the face and HSV2 lives on the genitals. However, as you and your girlfriend so clearly illustrate, Herpes viruses are flexible, and can take up residence in either location.

I’m not sure exactly what you mean by danger, but I’m guessing you are referring to contagion. As it stands now, you have oral herpes and she has genital herpes, both HSV1. You have already passed the virus to her genitals, so continuing to perform oral sex on her won’t do anything, except make her happy. Go for it.

It is possible, but unlikely, that she could now develop oral lesions and/or that you could develop genital lesions. Once you have one established herpes site on your body, it’s rare to develop another, probably because your immune system makes antibodies to the virus. Also, now that you have HSV1, you are less likely to catch HSV2. There appears to be some cross-protection in the antibodies that are formed. Finally, people with HSV1 tend to have fewer recurrent outbreaks than those with HSV2. So you could even consider yourself lucky.

The second issue this brings up is how to handle herpes as a couple. What do you do if one of you has it and the other doesn’t? How do you talk about this with a prospective partner?

The couples I’ve known who deal with herpes in the healthiest way are those who tell me, “We have herpes.” In other words, they see it as a shared problem. They don’t expend a lot of energy trying to prevent passing it to each other, or let it put a crimp in their sex life. Their love for each other and their desire to express that love sexually overrides their worry about contagion.

I’m not suggesting you blithely rub your open sores all over each other. It still makes sense to avoid contact with open sores, for comfort’s sake if nothing else. I’m just pointing out that, for the sake of your relationship, it makes sense not to obsess about it. And medically speaking, herpes is very rarely a big deal.

If you have herpes and are in a new relationship, I think it’s only fair to inform your prospective partner before you have sex. Ideally, you’ll be close enough emotionally by that time that you can talk freely about such things, and figure out how you as a couple want to handle the situation. I realize this isn’t always easy, since our society still has lots of judgment and stigma around sex-related topics of any kind, and having a sexually transmitted infection can be emotionally upsetting. If you need help, the medical practitioners and/or the counselors at the Student Health Center would be happy to meet with you and your partner to answer questions and help you discuss it together.

Hooked on Hookah - the latest Ask Dr. Peg column

Dear Dr Peg,

Some friends introduced me to Hookah smoking a few months ago, and we’ve been getting together to smoke a couple of times a week. It’s fun to hang out, and the smoke smells nice. I know cigarette smoking is dangerous, so I’ve never done it, but hookah smoking is safe, right? Doesn’t the water filter out all the bad stuff from the smoke? And isn’t hookah tobacco healthier than the tobacco in cigarettes?

-Hooked on hookah

Dear Hooked,

I’m sorry to disappoint you, but you are wrong on all counts. As usual, I’ll start with the basics.

What is a hookah? A hookah is a water pipe. Other names for hookah include nargile, sheesha, okka, kalyan and hubbly-bubbly. It is a device for smoking a flavored tobacco mixture. The mixture is placed in a small bowl at the top of the device. From the bowl, a hollow pipe leads straight down into a chamber called the base, which is partly filled with water. The pipe extends below the surface of the water. From the side of the base, above water line, a hose leads to a mouthpiece. To smoke a hookah, you light a piece of charcoal, place it on top of the tobacco mixture, put the mouthpiece in your mouth, and suck hard. The smoke goes down the pipe, bubbles up through the water into the air at the top of the base chamber, up the hose and into your lungs. Hookahs can be quite ornate and beautiful, and can cost hundreds of dollars.

Hookahs have been around for centuries, probably originating in the Middle East or India, where it is a common social custom for men to gather, smoking and chatting for hours. In the US, the hookah has become very popular in recent years, especially with young people of both sexes. Hookah smoking is promoted as an aesthetic social activity, touting the sweet smell of the tobacco and the bubbling sound of the water as pleasant, relaxing influences. A typical hookah session lasts 2 or 3 hours and involves several friends smoking from the same pipe. Commercial Hookah bars have sprung up all over the country. There are at least five here in Albuquerque, where you can go just to smoke.

What does one smoke in a hookah? Typically, the mixture is 1/3 tobacco and 2/3 flavorings. The flavorings may include molasses, dried fruit, honey and other ingredients. The resulting aroma was likened to a baking apple pie by one hookah-selling website. Sounds pretty benign, doesn’t it? It isn’t. Like many fads, it has been hyped with false claims in order to increase its popularity and profits.

What are the dangers of hookah? Tobacco is tobacco, no matter how you get it, and tobacco smoke is hazardous. In fact, hookah smokers get more smoke than cigarette smokers, and here’s why. Cigarette smoke is uncomfortably hot if you inhale it deeply. Hookah smoke has been cooled by its passage through the water. In addition, you have to inhale hard to pull the smoke through the hookah. The result is cooler smoke going farther into your lungs. Add to that the duration of a typical hookah session, and the result is huge volumes of smoke being deposited into your lungs. A study done by the World Health Organization showed that one hookah session of a mere few hours can deliver as much smoke into your lungs as 100 cigarettes. Five packs! It’s a rare cigarette smoker who gets that much in one day.

Tobacco smoke contains nicotine, a highly addictive substance that is not filtered out by the water in a hookah. In addition to nicotine, you are pulling other dangerous substances through that hose. Tar is not water-soluble, so it comes on through the pipe, the same amount in one session as in a whole pack of cigarettes. Tar causes cancer. Other carcinogens (cancer-causing agents) also make it through, like heavy metals and carbon monoxide. In fact, because of the charcoal which is burned on top of the tobacco mixture, hookah smoke has a higher level of heavy metals and carbon monoxide than cigarette smoke. Hookah smokers risk cancer of the lung, lip, tongue and bladder.

As you doubtless know by now, tobacco smoke affects the cardiovascular system, causing an increased blood pressure and heart rate, and increasing the risk of heart attack and stroke. Smoke of any kind is also a lung irritant, which can trigger asthma and allergies. And of course, there are all the second hand smoke issues to consider.

In addition to the tobacco, there are the smoked flavorings to consider. Unfortunately, nobody has yet studied the effects of inhaling dried apricots, but I would bet they aren’t all good.

Finally, think about sharing the mouthpiece. It’s like kissing everyone in the group. Hookah pipes can spread herpes, flu, strep throat, a cold, even tuberculosis. And wiping it on your sleeve doesn’t sterilize it.

I’m a big believer in social gatherings and relaxation time. By all means, gather away, and relax like crazy. But if you are concerned with the health of your young lungs, think about gathering around a cup of tea, or relaxing with exercise and a bath instead of a water pipe. And if you are already addicted to any form of tobacco, I strongly urge you to quit. The Student Health Center has people and programs to help you.

Hakomi Therapy - Mind, Body, Heart

“How do you stand in relation to these many realms?” This is the literal translation of the Hopi word Hakomi, the name adopted by Ron Kurtz for a psychotherapy technique developed by him and his staff in 1980. A more modern translation might be “Who are you?” The Hakomi Method is an efficient and powerful process for discovering and then studying mind/body patterns and core beliefs as you experience them (www.hakomiinstitute.com).

Hakomi is a unique form psychotherapy that honors the interconnectedness of body, mind and heart. Drawing on concepts and techniques from Buddhism to Neurolinguistic Programming, and based on the precept that we all have innate wisdom and goodness, Hakomi provides a nonjudgemental and nourishing environment for exploring the self at a natural pace. The basic structure of Hakomi is 1) the establishment of a client-therapist relationship that allows the client to feel safe to honestly and fully explore their own experience, 2) careful observation of present life experiences, including body awareness, in a way that leads to the discovery of core material, and 3) willing modification and healing of core material to enhance growth and wholeness.

The following passage from the Hakomi Institute website describes the essential concept of core material. Core material is composed of memories, images, beliefs, neural patterns, and deeply held emotional dispositions. This material shapes the styles, habits, behaviors, perceptions, physical postures and attitudes which define us as individuals. Our responses to the major themes of life--safety, belonging, support, power, freedom, responsibility, appreciation, sexuality, spirituality, etc.—are all organized by our core material.

Some of this core material is helpful to us. Some, the result of difficult experience or trauma, limits our access to the person we want to be. Hakomi is a gentle yet profoundly powerful way to transform and heal. Visit the Hakomi Institute website (www.hakomiinstitute.com) to find a Hakomi therapist near you.