Category Archives: Mental Health

The Caregiver’s Journey–Part 1

I recently attended a one-day conference (organized by Hospice Waterloo Region) for caregivers and professionals who support them.   As I sat with the other participants, and heard the stories of people who are actively being a ‘care partner’ for a loved one(s), I was struck by the love and dedication that helped them to make meaning of the difficult role that they had agreed to take on.  I was also aware of the feelings of exhaustion, frustration, fear and loneliness that many bravely shared as they told their stories.  This is the first in a three-part series on Care-giving.

The information in this post is a partial summation of  information that was presented by Dr. Virginia Wesson, Psychiatrist and Dr. Rhonda Feldman, Psychologist.   Both Drs. Wesson and Feldman see patients, and their families, at The Cyril & Dorothy, Joel & Jill Reitman Centre for Alzheimer’s Support and Training.

The Caregiver’s Journey

According to data presented that day, there are 3.3 Million caregivers in Ontario.  Of those, 500,000 of them are ‘young’ caregivers (falling between the ages of 6 and 25).  If as a society we were asked to pay for the caregiving services provided free-of-charge by loved ones, the bill would be in the Billions of dollars.  Wow!

Based on the numbers, if we are not personally affected  by the need to take care of a family member or friend, then we know someone who is–a friend, co-worker, other family member…the list goes on.  As people in our circle, how can we support them as they support others?  I suggest that a first step is to understand the path that they are walking.

Dr. Wesson believes that there are three stages to the caregiving process:  the early stage, the middle stage and the late stage.

The Early Stage

When a partner, spouse, close friend or family member has been diagnosed with a debilitating illness we often experience shock and grief.  While we may have suspicions that our ‘person’ has been struggling, having it confirmed can still be devastating.  We don’t know what the future really looks like, and we may feel that we are starting an ‘endless’ journey.

If we are the primary support, we can be overloaded with information by medical staff or our own research.  On the other hand, we may feel that we are being provided with little information and not sure where to turn.

Once the initial emotions subside, and if the disease in question is progressing slowly, the illness may intrude in our life, but we are able to carry on with a sense of normality.  You may be providing more emotional support vs. physical support for your loved one, taking on more of the hands-on chores that may now be more difficult and becoming a ‘manager’ of the care required by your loved one (i.e. managing medical appointments).

Coping Strategies for the Early Stage

It is during the early stage that you can start to put supports in place for the future.  Will there be physical changes that need to be made to your surroundings?  Are you aware of community organizations that can be called upon when needed?  How may other family members or friends can be asked for help?  What do you need to take care of yourself–such as self-care activities?

This is the time for planning.

The Middle Stage

By the time you have reached the middle stage, you have realized that your loved one isn’t going to get better.  Their illness is a constant consideration as you plan your day–both personally and professionally.  Some people may have decided to leave their jobs, or scale back their hours of work.  Many may be coping with the financial stresses brought on by the illness–either through loss of income or rising expenses.

Feelings of loneliness and overwhelm can be common at this stage–especially as your world is shrinking due to care-giving responsibilities that never seem to end.

Coping Strategies for the Middle Stage
  • Be realistic about what you are able to do.  Don’t be afraid to ask for help.
  • If you have not done so already, now is the time to call on your support system for help…friends, family members, outside organizations.
  • To the best of your ability, keep up with your self-care practices–eating well, exercise, and any activities that help you to cope.
  • Be aware of the abilities of your loved one, due to their illness.  It may be less frustrating when we understand that their actions are due to physical challenges vs. negativity.
  • Try to find any positive aspects or meaning  in the care-giving role.
The Late Stage

By this stage, caregivers may be feeling that “I can’t do this anymore”.  If they have had little or no support, they may be suffering from burnout.

There may be feelings of both internal and external conflict as the need to make decisions start to arise.  Internally, there’s the struggle between the guilt you could be feeling as it becomes more difficult to take care of your loved one in their home and the possibility of them moving into a place with full-time paid staff; and the recognition that continuing the current way of doing things is becoming impossible.

Family conflict may come into play if family members are not agreed on next steps, or resentments have come out regarding the sharing of care-giving duties.

Coping Strategies for the Late Stage
  • As above, be realistic about what you can do…physically, mentally and emotionally.
  • Look to your medical supports for information about what can be expected during the late stage of illness and how much care will your loved one require.
  • Access mental health support either privately or through community organizations that specialize in your loved one’s illness.  Organizations such as Cancer Support Centres, Alzheimer Society, etc. have care-giver support groups.

While it may seem like it, as a care-giver you are not alone…no matter where you are on the journey.

Next week, we’ll look at care-giver burnout and further ways to cope.

And now…a TED talk on the positive effects of exercise on the brain…Enjoy!

 

The Anatomy of a Worry

The following content is a summary of information contained in The Cancer Survivor’s Companion:  Practical ways to cope with your feelings after cancer by Dr. Frances Goodhart and Lucy Atkins.  While the book is from the perspective of cancer patients, I believe that much of the information on worrying is applicable to all of us “worriers”.

We all worry.  It’s part of being human.  But if we look closely at a worry, what is it?  How does it work?  What is it made up of?  How do I cope with it?  Can I make it go away?  One way of dealing with a challenge is to intimately understand it–so let’s dissect a worry and see what makes it tick!

What Is A Worry?

Finances…health…job…family members…what others think of us…I bet that we can all give a list of what the topics that we worry about, but what actually is a worry?  Goodhart and Atkins define a worry as “a natural, instinctive, human response to a perceived threat”.  When we worry, we are afraid that something negative is going to happen.  Worries are future-driven.

While worrisome thoughts may cross our minds, worrying becomes a problem when we can’t stop and begin to ruminate on specific ideas.  These thoughts start to take over all of our brain space to the point that we can’t think about anything else. When worrying becomes out of control, we can’t determine between big and small things to worry about–we worry about them all equally.  Our sense of perspective is gone.

Worrying is such a common, human experience that you can buy something to do your worrying for you.  A Worry Bird!  They also come in a charm bracelet version, so you can take it with you!

How Does It Work?

There are four parts to a worry:  thoughts, behaviour, feelings and body sensations.  They are all inter-related and play off of each other.  A body sensation (perhaps a muscle spasm or stomach ache) triggers a thought about a threat which leads to feelings of fear.  This fear may then cause us to stop what we’re doing and focus on the subject that is worrying us (I’m getting sick or my boss wants to get rid of me…), then we’re off to the worry races.

Treating Worry as a Science Experiment

The key to coping with a worry is to learn to handle each of it’s parts:  thoughts, behaviour, feelings and body sensations.  When we can do that, we can break the cycle and decrease the control that worries have over our lives.

One of the ways to get a handle on worry behaviour is to treat it like a science experiment.  The more we know about an activity, the better able we are to change it.  When you find yourself caught in a worry, pay attention.  When did the worry start?  What were you doing at the time?  Was the trigger a feeling, action, body sensation or thought?  As we gather more information, we can start to see trends and triggers.

It’s Usually About Our Thoughts

For most of us, the worry trigger is our thoughts that are fed by thought traps.  Here are some common thought traps that lead us down the path of worrying.

  • Mind reading:  We are mind reading when we are making judgements about what others are thinking.  (“I know that she’s mad at me because she didn’t return my text”.)
  • Fortune telling:  None of us are able to predict the future.  When we make negative assumptions about what will happen, we are giving in to worry.
  • Thinking the worst:  When we are in a worry cycle, we never think the best, but of the most negative possible outcome.  (“My boss is looking for any reason to fire me…if I’m late, I’m going to lose my job.”)
  • Labelling yourself:  These are all the negative “I am” statements that we beat ourselves up with…”I’m lazy”, “I’m dumb”…
  • If…then thinking:  Logic stops being our friend when we link it to thinking the worst.  “If I don’t hear from the recruiter today, then I didn’t get the job.”
  • Should and oughts:  When we ‘should’ or ‘ought’ ourselves, we are putting unrealistic expectations or demands on ourselves.   “Even thought I’m feeling overwhelmed, I should be taking care of everyone else.”
  • Selective thinking:  When we only remember the negative parts of an interaction or situation and forget the positive parts, we are falling into the trap of selective thinking.

Now that we have gathered information, what’s next?

Coping Strategies

One you know your triggers, you are on the way to getting the upper hand on your worry.

If your trigger is a thought:

  • Write down your actual thought.
  • Compare the thought to any of the thought traps listed above.
  • Problem solve about what you can do, if your actual worry became real.
  • Being able to do this exercise takes practice, so in the beginning you can work with someone your trust.

If your trigger is a body sensation:

  • Slow your breathing–counting your breaths as you breath deeply is a useful technique.
  • Exercise–go for a walk, dance around your room, do a few yoga poses–anything that will help to release the energy surge that often accompanies worrying.
  • Relaxation techniques.  There are many guided relaxation exercises on-line.  Check out this link for an example.

If your trigger is a feeling:

Here’s a method for dealing with negative feelings.  Feelings are energy–they arrive, peak, and subside.  When we can recognize their pattern, we can practice sitting with them until they move on.

For example:  When a feeling of fear arrives, try not to get hooked into the ‘story’ of the fear, but watch the ‘fear’.  What does fear feel like in your body?  Do you feel hot or cold?  Does it sit in a particular part of your body that leads to a negative body sensation?  If you don’t feed your fear with thoughts, how big does it get?  How long does it last?  Over time, you will be able to ‘ride the wave’ of feelings/emotions.

If your trigger is a behaviour:

Sometimes a worry begins with an action.  For example, if you are coping with an illness, researching information on the internet may trigger worries about possible diagnosis or outcomes.

Once you know what the triggering behaviour is, you can avoid the behaviour when possible.

While worries are a fact of life, but they don’t have to let them control us.  We can get the upper hand!

And now…some classic Bobby McFerrin…enjoy!

 

Is This Normal?

Another common question I hear from clients during therapy is “Is this normal?”.  According to the Merriam-Webster dictionary, there are many definitions depending on the area of ‘normal’ you are looking at.  Since we’re not talking about the areas of science or math, I’m using the definition of “conforming to a type, standard, or regular pattern” as a jumping off point for this post.

Individually, we often come up with our personal idea of normal by looking and comparing ourselves to others.  That’s how we determine what is the standard or regular pattern.  However, what happens when what we are experiencing is unlike that of our those around us?

Another Definition

Miriam-Webster also defines ‘normal’ as “occurring naturally“.  From a life perspective, I think that this meaning is more helpful, and forgiving.  Every person is an individual–with their own reactions, thoughts, and feelings.  These occur naturally based on our experiences.

In Buddhism there is the concept that we are the sum of our experiences.  We can be a mixture of the happy five year old and the despairing teenager; the ecstatic newlywed and the stressed parent; the toddler and the senior.  It all fits organically into who we are at this moment.  Therefore, while there can be a range of ‘normal’, I suggest that this range is very broad.  The challenge comes when ‘our normal’ negatively effects our life or the lives of those around us.  That’s when we may want to seek help.

The Only Constant Is Change

Another Buddhist concept is that everything changes–nothing stays the same.  This means that we are constantly in transition.  Sometimes the changes are minor–we gain or lose a few kilos, we need to change our route to work, a house plant dies.  At other times, the changes are major–we lose a partner, or we get sick.  Changes don’t always have to be negative.  Maybe a new member joined our family or we started a new relationship, moved to a new city.

Dr. Jon Kabat-Zinn, in his book Full Catastrophe Living writes:

“Even inanimate material is subject to continual change:  continents, mountains, rocks, beaches, the oceans, the atmosphere, the earth itself, even stars and galaxies all change over time, all evolve, and are spoken of as being born and dying.  We humans live for such a brief time, relatively speaking, that we tend to think of these things as permanent and unchanging.  But they are not.  Nothing is.”

“The point is that life is constant change from the word go.  Our bodies change in countless ways as we grow and develop over the course of a lifetime.  So do our views of the world and of ourselves.  Meanwhile the external environment in which we live is also in continual flux.  In fact, nothing at all is permanent and eternal, although some things appear that way since they are changing so slowly.”

So if everything is in constant change, how do we find normal?

Coping With Change

When we think of change/transitions the concept of resilience comes to mind.  Resiliency is our ability to adjust and recover.  We build our resilience by practicing self-care (sleep, diet, exercise), having realistic expectations about what we can do, avoiding toxic thinking, being able to cope with ambiguity and uncertainty and developing a support system.

When we are able to cope, we are working towards a ‘new normal’.

A Story…

Peggy was an 84 year old woman who had lived in her home for 60 years.  When she arrived to the house as a newlywed, it was a mess.  The previous owner had let the place go, and it was in much need of repair.  Peggy and her husband Ron renovated the home themselves–learning the necessary skills as they went.  Once their children were born, the house moved from it’s new pristine condition to the patina caused by a busy family.

Peggy’s memories were tired to her home.  She could tell  you the origin of each bump on the wall or scratch on the floor.  When working in the kitchen, she could “see” the face of her late husband sitting at the table.  Peggy could “hear” the hurried footsteps of her children as they raced up and down the stairs.  On cold days, she could feel the draft coming through the living room window–the window that had defied their attempts at weather proofing.

Change Arrives

One night, Peggy awoke to the smell of smoke.  Looking outside her bedroom, she saw that the hallway was filled with smoke.  Peggy called 911 from her room and fire fighters were able to rescue her through the window.  As Peggy stood outside, it was clear that the house could not be saved.  The property was well insured.  Peggy would be able to afford a new place, but her home and many of her belongings were gone.

Peggy moved in with her son while the insurance was being settled.  Because she liked her privacy and independence, Peggy knew that living with either of her children was a short-term solution to her housing situation.  After a few months, Peggy found an apartment that she liked.  It was close enough to the library and her favourite grocery store that she could walk there when she wanted to.

The months between the fire and actually settling into her new home were busy. Peggy was distracted from thinking in any great depth about what had happened.  However, once the last of her new furniture was in place and all was quiet, the enormity of the change hit her.

Now what?

The New Normal

How many times have each of us, after a major change, said…”When things get back to normal…”?  But what if the change, like Peggy’s, is the new normal?  What if we have experienced a life-changing event?

Major changes, even good ones, usually involve loss.  Peggy’s loss is easy to see–her home and possessions.  However, some are more difficult to determine, and may not become apparent until we are faced with post-change life.

While Peggy liked her new apartment and it’s proximity to places she regularly visited, she missed the walk through her old neighbourhood.  She was accustomed to checking on the progress of her friends’ gardens or greeting the cat who lived on the corner.  At the beginning Peggy was a little late for appointments because she forgot to factor in the time it took for her to get from her unit to the parking garage.  In the kitchen, preparing meals too a bit longer as she had to hunt to find utensils that were in new places.

Everything felt difficult and feelings of grief began to emerge.

The Mourning Process

When we experience a loss, grief is a natural response.  For Peggy to be able to be able to move to and embrace her new normal, it was important for her to work through the tasks of mourning.  Peggy’s next steps:

Task 1:  Accept the reality of the loss.  Peggy has already started this task as she spends time in her new apartment and becomes aware of how much has changed–both large and small.

Task 2:  Process the pain of grief.  The key to completing this task is to give ourselves permission to feel pain.  Rather than turning away, we acknowledge that we are hurting and missing what we have lost.  When we pay attention to our pain, we may notice that it has isn’t as sharp as before, or doesn’t visit as often.  During the first year in her new home, Peggy would often find herself caught up in a grief cycle, as she moved through the “year of firsts”.  She discovered that if she sat with her tears, they would eventually subside. Peggy learned that she would feel sad leading up to a major family event or holiday.  These celebrations now took place at her son’s home as she no longer had the space.

Task 3:  Adjust to a world without what was lost.  As time went on, Peggy found that she thought about her house less often.  The depth and frequency of her sadness started to ease, and she started to think about what a future in her new home could look like.

Task 4:  Start a new life, while keeping a connection to what was lost.  One day Peggy was surprised to notice that she was looking forward to her walk to the library.  She had started to pay attention to the houses on her route, and was curious to see how a recently-started renovation was going.  When the next family event approached, Peggy suggested that it be changed slightly so that a new version could be held at her home.  As she became more comfortable in her apartment, she started to host smaller dinner parties for friends and family.  Peggy was starting to create new memories in her new home.

As Peggy became more comfortable and life felt less difficult, she was approaching her “new normal”.

 Embrace YOUR normal!

‘Normal’ can fit into a broad range of thoughts, feelings and behaviours. So long as your normal isn’t negatively affecting you or others; then I suggest the wisdom of accepting what currently is.  Life can be stressful enough without comparing ourselves to others and questioning ourselves when our normal is different from someone else’s.

And now, a lesson in ‘normal’ from SpongeBob SquarePants…enjoy!

 

 

 

 

Boundaries Are Your Friend

For anyone who has had to deal with a troublesome nearby resident, they can understand the truth in the old saying “Good fences make good neighbours.”

Just as a fence is a physical boundary that allows for privacy and controlled interactions, emotional boundaries do the same.  In this post, we explore the wonder that is boundaries.

What are boundaries?

Simply stated, a boundary is a bottom line position, coming from an awareness of what we need and feel entitled to.  It takes into account the limits of our tolerance.  They are derived from our values and gut-level responses that define what we can accept in our relationships.

When we let others know what we will accept by setting limits, we are using boundaries.

Boundaries are not…

Melanie Beattie, in her book The New Codependency, explains that boundaries are not:

  • limits we set because someone told us to;
  • empty or angry threats;
  • attempts to control others;
  • limits we don’t or can’t enforce.
A Story…

Julie loved getting together with her friend Susan. The two women had met a few months previously when Susan moved into the neighbourhood. They had liked each other on sight, and would meet weekly at a nearby cafe to catch up on their lives, share stories and discuss current events.  However, after a few weeks things began to turn sour.  While Julie enjoyed their coffee dates, she started to feel annoyed by Susan’s frequent late arrivals.

At the beginning, Julie would dismiss her frustration as over-reacting.  It was only 10 minutes, and once Susan arrived the conversation would take over and all would be well.  In order to continue to enjoy her time with Susan, Julie started to make excuses for her friend–‘her life was busy’–‘she was unbound by rules, which was one of the things that made Susan so much fun’–‘she’s a free spirit’.  Eventually, these rationalizations stopped working, and Julie started to feel angry.

Julie had been brought up in a family where the consideration of others was a core value.  It was important to take other’s feelings into account when making decisions.  Behaviours such as punctuality were a sign of respect.  As Julie pondered these ideas and how they may be affecting her reactions towards Susan, she wondered what do to about this new relationship.  Should she stop meeting Susan for coffee?  What if she just put up with the status quo?  Maybe she should say something?

Why do we need boundaries?

We put boundaries in place for ourselves, not others.  For some people–especially those who identify as care givers–this idea is hard to wrap our brain around.  When I suggest the idea of setting a limit to clients, I’m often met with the response that to do so would be selfish.  However, boundaries are not selfish–they are a form of self-care.  Not only are they not selfish, but, when used well, can ease interpersonal interactions.

Sometimes we need to let our friends, family, coworkers, etc. know how we want to be treated.  Being able to clearly voice our boundaries is a way to do this.

Why we don’t have them?

In some families, boundaries are rare.  Being able to create and maintain boundaries is a skill, and if we grew up with adults who are unable to set limits, then we may repeat this family trait.  As children/young adults if we were able to start to put boundaries in place, and they were ignored by family members, then we often stop setting limits.  We learned that not having boundaries ‘normal’.  In order to learn about boundaries we need role models.

Other reasons why we may not have developed the ability to set limits:

  • We are overly dependent on others.  When we feel that we are unable to be alone or take care of ourselves, then we are more willing to accept negative behaviour from others.
  • We have low self esteem.  Perhaps we feel that we are not worthy of being treated well by other people, so we don’t set boundaries.
  • We don’t have the words.  Sometimes we are unable to find the words to express our limits.
  • We want others to like us.  If we care too much about what other people think of us, we may be afraid to risk their good opinion by putting boundaries in place.
  • We are “uber” caretakers.  As mentioned above, if we see boundaries as selfish, then we won’t enact them.
How to develop boundaries.

If we haven’t been able to develop the ability to create and set boundaries when growing up in our family of origin, all is not lost.  Like most skills, it is never too late to learn.  However, just as it’s harder to learn to ride a bike at the age of 30 than at age 5, learning to set limits in adulthood requires work and patience!

The first step is self-awareness–becoming in tune with our values and beliefs.  What is important to us?  How do we want to be treated?  What is acceptable?  No acceptable?

One way to finding the answers to these questions is anger.  Anger is a wonderful teacher as it shows us when our values and beliefs have been walked over.  In our story, Julie became aware of her bottom line about Susan being late because her value of punctuality and belief around respect were crossed.

Once we know what are boundaries are, it’s time to put them into words.  We’re defining a ‘bottom line’.  A standard way to do this is using the structure of “When you do this, I will do this”.  When creating a boundary it’s important that it be clear and enforceable.

The Story Continues…

After much thought, Julie decided that she valued her relationship with Susan enough that she didn’t want to end it before making an attempt to clear up this issue.  However, she was prepared to stop meeting with Susan if the tardy behaviour continued.

The next time the women met, Susan was late, and the following conversation occurred.

Julie:  “Susan, I really enjoy our coffee dates and getting caught up.”
Susan:  “Me too!”.
Julie:  “While they’re fun, I’m getting frustrated about your late arrivals.”
Susan:  “It’s usually only 10 minutes–15 tops.”
Julie:   “Ten to 15 minutes doesn’t seem to be a big deal, but in my family punctuality was important.  Being on time meant that you respected the person you’re meeting.”  So, in the future, I’m going to wait for five minutes.  If you’re late , then I’m going to continue on with my day.”
Susan:  “Hmmm…”

What happens when we set limits?

While we can control our boundaries and how we set them, we can’t control how they will be received.  Sometimes, other people hear what we are saying and accept our limit…all is well.  However, often things don’t run so smoothly.

If stating our bottom line is a new behaviour for us–especially in a long standing relationship–the other person could become angry, disbelieving or dismissive.  They may make attempts to make us feel guilty.

One common response is push back behaviour.   Push back behaviour is an attempt by others to test our limits to see if we are serious.  Are we going to enforce or follow through with what we said?  In some cases, the behaviour can become extreme as the other person hopes that the boundary setter will become so tired of the increased negative behaviour that they will give in.

While once understood, in some cases, push back behaviour can become almost humourous.  For example, a partner refused to do the couple’s laundry unless the other partner put the laundry in the hamper–leading to that partner to let the laundry to pile up to become laundry ‘mountains’!

Unfortunately, push back behaviour can become nasty and even dangerous.  Emotional and physical safety is a non-negotiable boundary.  If you are feeling unsafe, support is available by calling 911, the Sexual Assault Support Centre of Waterloo Region, Anselma House, Haven House and Mary’s Place.

The Final Chapter…

The next week Julie arrived at the cafe at the usual time. Susan wasn’t there.  As promised, Julie waited for five minutes and then left.  When Susan arrived 10 minutes later, she was told by the barista that her friend had come and gone.  Susan was annoyed and thought that Julie was being ‘childish’, but as she sat quietly with her coffee, she missed her friend.

The following week, Susan was only a few minutes late and apologized to Julie for her tardiness.

Julie still needs to enforce this limit as Susan doesn’t see punctuality in the same light as her friend.  In this way, Julie continues to enjoy her time with Susan without added frustration, and Susan knows what to expect if she is late.  As time evolved, the women were able to set up a system–when Susan knew in advance that she was going to be late, she contacted Julie ahead of time and they met a bit later.

And now…some great fence humour from Tim the Toolman Taylor…enjoy!

The Path to Forgiveness

In this post, we explore the concept of forgiveness…What is it?  Who benefits?  Why is it important? And, most importantly, how do we do it?

The idea of forgiveness is a difficult thing.  When we have been disappointed or hurt by someone else our instinct is often to recoil and protect ourselves.  When a person close to us breaks our trust, the last thing we want to do is forgive them.  On the other hand, when we have hurt others, forgiving ourselves can be just as difficult.

However, in order for  true healing to happen, walking the path to forgiveness is a necessary journey.

What Is Forgiveness?

When we think of forgiveness, we may think of cheesy movies where by plot’s end, mortal enemies have become best friends–the closing scene showing them walking hand-in-hand into the sunset.  While this could happen in real life, forgiveness doesn’t usually look like this.

One way to describe forgiveness is to point out what it does not do.  According to Ron Pevny, in his book Conscious Living, Conscious Aging, forgiveness does not…

  • Mean that we have to ignore our hurt feelings.
  • Change the past, or assume that we have to forget what happened.
  • Mean that we have lost and the offender has won.
  • Excuse the act that did the wounding.
  • Absolve the offender of karmic or legal consequences.
  • Mean that we will resume a relationship with the other person–especially if it is not safe (emotionally or physically) to do so.

What forgiveness does is to provide the opportunity for healing and being able to move on with our life, without being limited by what happened.  According to Buddhist philosophy,  “Holding on to resentment is like picking up a hot coal with our hand with the intention of finding an opportunity to throw it at the one who has hurt us.”.

In The Book of Joy, Archbishop Desmond Tutu states,

“Forgiveness is the only way to heal ourselves and be free from the past.  Without forgiveness, we remain tethered to the person who harmed us.  We are bound to the chains of bitterness, tied together, trapped.  Until we can forgive the person who harmed us, that person will hold the keys to our happiness, that person will be our jailor.  When we forgive, we take back control of our own fate and our feelings.  We become our own liberator.”

When we can forgive, we are able to stop labeling our self as a “victim” and move forward from a place of growth.

Holding on to negative events that lead to ongoing feelings of resentment, anger, hostility may undermine our health.  In one study, psychologists asked people to think about someone who has hurt them, while monitoring their heart rate, facial muscles and sweat glands.  When people remembered these grudges, their heart rate and blood pressure increased.  However, when they were asked to think about forgiving these people, their stress responses returned to normal (Book of Joy, pg. 237).

Steps to Forgiveness

While it seems obvious that forgiveness is a good thing–for our physical and mental health–how do we do it?  Especially since rehashing the juicy details of past hurts can provide an addictive energy rush.

It’s important to remember that forgiveness is a process; one that is repeated over and over as new feelings and details arise as we work to let go.

Pevny breaks down the path to forgiveness into the following five steps:

  1. Uncovering and feeling what happened.  Before we can forgive, we need to be clear about what we are forgiving.  It’s important to explore the actual event–what were the circumstances?  Who said what?  What emotions did you feel?  Take your time and be gentle with yourself.
  2. Committing to forgive.  Forgiveness is a choice–sometimes a difficult one.  When we have held on to resentments for a long time, they become part of our story.  Forgiveness is choosing a new story.
  3. Humanizing the offender.  Forgiveness begins to happen when we are able to separate the person from the action.  To do this requires compassion and the ability to see the situation from the other person’s perspective.  Maybe there were things going on that you didn’t know?
  4. Honestly looking at your role in relation to the situation.  This is especially challenging when the emotions are still raw, so it’s useful to use your logic vs. emotions.  Human relationships are never simple.  As my grandmother used to say “It takes two to tango.”
  5. Forgiving and continuing to forgive.  Forgiving is an act of will–we choose.  This act will play out differently for each person.  For some, it’s a private, quiet letting go.  For others, they want to meet with the person involved and voice their forgiveness.  No matter how it manifests, forgiveness is an ongoing process.
What If I Need to Forgive Myself?

When we have hurt others, the feelings of guilt and shame that we carry can be overwhelming.  While we may be able to show compassion to others, doing so to ourselves is more difficult–if not impossible as we’re our own harshest critics.

Pevny suggests that the five steps are applicable to those working on self-forgiveness, and may include specifically asking for forgiveness from those we have hurt (if possible and appropriate).  However, sometimes the person we have hurt is ourselves.  Pevny writes:

“In a great many cases, what needs self-forgiveness is not harm done to others but personal weaknesses or perceived choices or actions that we feel have damaged our own lives.  Self-forgiveness depends upon our willingness to carefully examine our choices and actions and, in many cases, acknowledge that we did the best we could with the awareness we had at the time.  If we see that we did not do the best we could, it requires that we use our regrets not to berate ourselves but as important guideposts on our journeys into a positive, conscious future.  The biggest catalysts for our growth are often (perhaps mostly) what we learn from our mistakes, weaknesses and poor choices.”

Rewriting our Stories…Sometimes We Need Help

Whether we need to forgive ourselves or others, walking on this path gives us the opportunity to rewrite our story–and sometimes the stories of others.  And we know that the journey isn’t easy.  Self-care is important.  If you start on this journey and feel that you are losing your way, please reach out to a trusted friend, family member or professional to provide support.  Sometimes, our hurts are too big walk up to on our own.

And now…a quick lesson in self-compassion.  Enjoy!

 

 

 

Let’s Get Past the Stigma! A New Resource for Mental Health

One of my roles as a psychotherapist is to be an advocate for those who experience mental health challenges.  A positive way to do this is to help raise awareness about brain health as well as attempt to dispel common negative beliefs about mental illness and the individuals coping with the challenges it can bring.

Sometimes this feels like an uphill battle.

Some Numbers on Mental Health

According to the Centre for Addiction and Mental Health (CAMH), in any given year, 1 in 5 Canadians experiences a mental health or addiction problem.  By the time Canadians reach age 40, 1 in 2 have–or have had–a mental illness.  That’s 50%!

Coupled with statistics regarding the stigma of mental illness and we have a major problem.  A 2008 survey by the Canadian Medical Association (CMA) reveals the following disturbing statistics:

  • Just 50% of Canadians would tell friends or co-workers that they have a family member with a mental illness, compared to 72% who would discuss a diagnosis of cancer and 68% who would talk about a family member having diabetes.
  • 42% of Canadians were unsure whether they would socialize with a friend who has a mental illness.
  • 55% of Canadians said they would be unlikely to enter a spousal relationship with someone who has a mental illness.
  • 46% of Canadians thought people use the term mental illness as an excuse for bad behaviour, and 27% said they would be fearful of being around someone who suffers from a serious mental illness.
Effects of the Stigma

A big outcome of the stigma about mental health is that individuals, family and friends don’t reach out for the help and support that they need.  A person suspecting that they may be suffering for anxiety, depression, burn-out they could choose to suffer in silence rather than seek help.  I suspect that the more severe the mental health issue, the less chance there is of disclosure–unless the problem has reached a level where it is impossible to hide.

Having a friend or family member dealing with a brain health challenge is difficult and can negatively affect relationships.  Due to the stress of support, caregivers can not only experience compassion fatigue, but anger and guilt (resulting from feelings of anger).  Once again, the stigma of mental illness may prevent people from getting needed support.

In some cases, a mental health diagnosis is not provided for fear that the individual would be stigmatized for the rest of their life.  This can be a problem as it may prevent people from obtaining necessary social supports and funding that would help to make their lives easier.

A Light in the Darkness

The Mental Wellness Network of Waterloo Region was formed in 2012 under the name “The Waterloo Region Mental Health Work Group.” The group came together after a local Waterloo Region community picture identified healthy eating, physical activity, and mental health as three key areas to focus local policy advocacy work.

After working with the Sustainable Societies Consulting Group and consulting with the local community on how to promote mental health, The Mental Wellness Network of Waterloo Region recently launched this website.  The goal of the site is to promote well-being.

The website is organized around three main areas:  Mental Health and Wellbeing (including a list of local crisis resources and contact information); Ways to Wellbeing in the areas of connection, exercise, mindfulness, learning and volunteering;  and a Resource section for both individuals and professionals.

I heartily recommend this site. Not only is the information useful, but the resources and contact information are local to Waterloo Region.  The website looks at mental health as part of holistic wellness–encouraging us to look at ourselves from the perspective of body, mind and spirit.

Decreasing the Stigma Around Mental Health

Hopefully websites such as this one will help to lessen the negative impressions of mental health struggles and the individuals who strive to cope with the impacts on a daily basis.

When speaking with someone who is feeling shame about their decision to seek help for mental illness, I will ask if they would have the same hesitancy if they were dealing with a broken leg or chronic pain.  Mental health deserves the same consideration.

Canadians Are Not Alone

This powerful, nine minute TED Talk shows that as Canadians we are not alone in our stigma about mental health.

Take care.