Category Archives: Pyschotherapy

Let’s Go Fishing…and Learn Something

“Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.”….Maimonides

When I think of fishing (which isn’t often), I think of two things.  The first is the gorgeous scenery in the Oscar-winning, 1992 movie A River Runs Through It.  For those who haven’t seen it, the story is about the two sons of a stern minister — one reserved, one rebellious — as they grow up in rural Montana. Fly fishing is a major theme in the movie.  Part of the landscape’s beauty may be due to the fact that one of the brothers is portrayed by a young Brad Pitt!

The second is self-sufficiency.  When we are able to feed ourselves, whether by growing, fishing, hunting or foraging; there is a confidence that comes from knowing that we are able to provide food for ourselves and loved ones.  Self-sufficiency is a value.  It is also be a component in therapy and mental health.

The Art and Science of Therapy

Therapy is a cross between art and science.  The tools that a therapist uses arise from specific theories that have been tested by research to show that they are helpful to clients.  Ideally, a therapist has studied a few different modalities of therapy and is able to have various tools in their tool belt that they can use.

The art comes in how to apply the tools.  Good therapy is molded to fit each individual client.  Individuals in pain are not like cars with faulty brakes–the same intervention doesn’t work for all!

Skill-building in Therapy

It has been my experience that clients don’t want to see a therapist for ever….and ethically, my role is to help them to feel better and move on with their lives.  One way that this goal is accomplished is through skill-building.

Skills come in all shapes and sizes…

A couple comes to therapy looking for relationship support.  As they describe what has brought them in to therapy, it becomes clear that communication is challenging, so we work on communication tools.  We work on spotting patterns that block positive discussions. We look at ways to get around this barriers as well as how to talk to each other to avoid their creation in the first place.

For individuals seeing a therapist for anxiety and depression, skill-building is a major part of therapy.  Clients will learn techniques to help lessen their anxiety as well as ways to monitor thoughts that may be contributing to their anxiety or panic attacks.  Similar tools can be used to manage anger.

For anxiety and depression, one of the skills that I teach the most often is a breathing exercise.  The free 20-minute download talks you through the exercise, as if you were in the office with me…though the wave sounds are only in the audio version!  You can find the exercise here (at the bottom of the Welcome Page).

My wish for clients, is that once they have learned and become comfortable with necessary skills, they will become self-sufficient in managing any remaining issues that brought them into therapy.

The Joy of Homework

Even more important than learning a new skill or coping strategy, is putting in the time to practice it.  This is the reason that I often suggest homework to clients.  Sessions usually last for 50 minutes, so the more work clients can do outside of our meetings, the more successful therapy will be.  Based on the theory of Experiential Learning, homework provides an opportunity to apply skills in different areas of life and in different ways–cementing the new ability into a client’s tool kit.  They have learned to fish!

If you’re curious about this connection, you can find out more by reading this previous blog post.

Back to Fishing…

When clients are able to leave therapy with the skills and tools that they need to help to keep themselves mentally healthy and/or better cope with life’s challenges, I believe that this is one indication of successful therapy.  To repeat  the quote by Maimonides,

“Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.”

And now…speaking about fish, who said they can’t be adorable, interactive and cute!  Enjoy!

Sharing is caring!

Art Therapy and Mental Health…Have you Doodled Today?

As we look for ways to improve our mental health, mindfulness exercises such as colouring seem to be gaining in popularity.  The following post from the archives speaks to this, as well as giving an exercise to try.  Enjoy! 

If you have been out in the world over the past year, you may have noticed the increase in the number of adult colouring books for sale.  They are everywhere!  You can pick one up when buying your groceries, refilling prescriptions or waiting for your flight at the airport.  They cover a range of topics, disciplines, genres, moods, spirituality and life events.

In the October 2016 issue of Psychology Today, Emily Silber reports that an estimated 12 million colouring books were sold in the U.S. in 2015, up from 1 million in 2014.

When reflecting on the growth of this popular item; Silber quotes clinical psychologist, Ben Michaelis, who suggests that “even if colouring does not help people process negative feelings directly, it may a least offer an effective form of relief”.

Art Therapy

While some people may balk at this popular culture activity, using adult colouring books could be considered a form or art therapy.  The Canadian Association of Art Therapy describes art therapy as “the combination of the creative process and psychotherapy, facilitating self-exploration and understanding. Using imagery, colour and shape as part of this creative therapeutic process, thoughts and feelings can be expressed that would otherwise be difficult to articulate.”

While art has been used since the beginning of human history as a way to share thoughts and ideas–the oldest cave painting was found in the El Castillo cave in Cantabria, Spain and dates back 40,000 years to the Aurignacian period–art therapy, as we know it, didn’t really start until the 1940’s.  The original art therapists were artists who recognized the value of creation on their own mental health, and chose to share the creation process with others.

If you are interested in a detailed history of art therapy, you can check out Art Therapy Journal for a wealth of information.

But What If I’m  not Creative and Can’t Draw?

While I am not an art therapist, in the past, I sometimes suggested a ‘drawing practice’ to clients–especially if they were working with anxiety and/or depression–as a way to calm their thoughts and shift their focus.  One of the most common responses that I heard was “I can’t draw” or “I’m not creative”.  The idea of being forced to create ‘art’ increased rather than decreased their level of anxiety.  So, instead I started suggesting a ‘mandala practice’.

What is a Mandala and How Do I Practice It?

Mandalas have been with us for a long time.  The word ‘mandala’ is Sanskrit for ‘circle’.  In Hindu and Buddhist traditions it is a graphic symbol for the universe.  Famous mandalas in the Christian tradition can be seen in the Celtic cross and rose windows.

In some traditions they have been used as part of meditation practices and some people believe that they have magical properties.  In fact, meditation paths are often built to form a mandala.

For people who don’t feel that they are creative (everyone is, whether they realize it or not!) or think that they can’t draw, a mandala practice is ideal as it is unstructured and free-form.  The practice doesn’t require a large outlay of cash for art supplies or take up a lot of space.  All that is required is a blank piece of paper, pen or pencil, pencil or regular wax crayons and a drinking glass or pot lid.  Intrigued?

The Mandala Practice

The way of this practice is to do it daily–similar to meditation practice or breathing exercises.  Besides being an enjoyable activity, there are many benefits to creating mandalas on a daily basis.  It is a way to step into mindfulness as you focus on the act of making your own mandala.  As you work, you may notice your thoughts slowing down.  As you engage the decision-making part of your brain, the emotional part of your brain may experience a sense of calm.  Clients have reported feeling a sense of accomplishment when they complete their mandala.  You are giving yourself the gift of a ‘time-out’.

There is no right or wrong way to do this practice–the value is in showing up.  It can take as much time, or as little, as you like.

Ready To Give It A Try?

Assemble the necessary tools (pen or pencil, blank paper, pencil or wax crayons, pot lid or glass) and find a comfortable place to work.

Step One
Empty out the box of crayons where you can see all the colours and easily reach them. This is easy if when sitting at a table.  Take a minute and appreciate the range of colours.  Think about the colours that you are drawn to and those you shy away from.  Take a deep breath.

Step Two
Using the pen or pencil, on the blank sheet of paper, trace around either the glass or pot lid.  The goal is to have  a circle of a size that you are happy with.

Step Three
Look at the selection of crayons, and without over-thinking it, choose one that appeals to you.  Using that crayon draw a shape inside the circle.  It can be anything you chose.  When you feel that the shape is complete, stop and return the crayon to the pile.  Take a deep breath.  Select another crayon and either add to the shape, or create another shape inside the circle.

Step Four
Continue  Step Three, until you feel that your mandala is complete.  Again, don’t overthink it.  You’ll know when it’s finished.  The circle may be filled, or it may only have one or a few items in it.

Step Five
Initial and date the mandala and file it way.

When you develop a regular practice, over time, you will have a collection of mandalas.  It is often interesting to look back over the series (several months’ worth) to see how the drawings, colour choices and subjects have changed.

Most of all…have fun!

Ultimate Mandalas–Made of Sand! 

As well as having my own mandala practice, I have been fascinated by the Tibetan practice of making sand mandalas. Their creation and destruction can be viewed as the ultimate expression of impermanence and love for the benefit of others.  Below are two clips showing this amazing act of creation.  The first gives a sped-up overview of the process. The second shows the process in more detail.

Enjoy!

Sharing is caring!

Are You Ready to Change? Let’s Find Out!

One of the concepts in Buddhism is that ‘everything changes…nothing stays the same’.  While I have found this to be true, change can come in different ways.  Sometimes it’s foisted upon us, and sometimes we are the initiators.

The focus of this post is on changes that we put in place, and specifically, the mindset and process (Stages of Change) that make self-directed change possible.

Meet Phil…

Phil (age 60) has lived through a difficult five years.  His troubles started when the manufacturing company where he had worked since high school shut down, and he was unable to find a comparable job.  Phil, already somewhat of a curmudgeon, became more so as he chose to spend endless hours at home.  His wife, Joanne, worked long hours–leaving Phil alone for most of the day.

While he wouldn’t admit it, Phil missed his job and work friends.  However, he didn’t feel like getting in touch–it was too much effort.  Phil spent most of his days feeling angry, sad, lonely and incredibly bored.  Joanne suggested that he could take over some of the household responsibilities (it would make her life easier), but Phil believed that he hadn’t cooked dinner before, so why start now?  Instead, Phil started spending hours of his time on the internet watching episodes of his favourite 1970’s tv shows on or napping on the couch.  Due to his inactive lifestyle, Phil gained a lot of weight.  The more weight he gained, the less active he became.  Eventually, Phil decided that he didn’t care if he ever worked outside the home again and fell into a rut.

The second blow fell two years later.  Joanne, frustrated with Phil’s behaviour and tired of working long hours with little household or emotional support, decided to leave their relationship.  Phil was surprised as he didn’t think there was a problem.  He believed that Joanne wasn’t really going to leave, she was just mad because he wasn’t helping around the house.

Today, three years later, the couple are divorced, and Phil is living in a small apartment.  His lifestyle hasn’t changed.  If anything, he has moved from being a curmudgeon to being bitter.

The Stages of Change

According to the Stages of Change theory, there are five steps that we move through to make successful and lasting changes: pre-contemplative, contemplative, preparation, action and maintenance.

Using Phil as an example, it’s clear that he’s in the pre-contemplative stage.  While Phil is feeling bitter, chances are that he doesn’t want to change.  In fact, he may not even realize that he has a problem.  Phil has continued his lifestyle because on some level he believes that it’s working for him.

Back to Phil…

One day Phil returned from the store to discover that the elevator in his building wasn’t working.  This had never happened before!  As his apartment was on the third floor, Phil decided to take the stairs.  By the time Phil reached the top of the first flight, he decided to leave his shopping bag in the stairwell as it was ‘too heavy’ to carry.  Walking up the second flight, he decided to stop halfway to catch his breath.  Anyone watching would have seen Phil crawling up the third flight on his hands and knees–breathless, his face red and covered in sweat.

Reaching his apartment, Phil was scared.  What had happened to him?  What if his unit was on the fourth or top floor?  He wouldn’t have made it.  For the first time, Phil wondered if something might be wrong.  Phil had entered the contemplative stage.

The Contemplative Stage

People in the contemplative stage have started to understand that there is a problem and that maybe they need to do something.  This is the pro vs. con stage.  Phil may be thinking, “I’m out of shape”.  “What if the elevator breaks again?”  “What will I have to do to get back in shape?”  “To get back into shape, I might have to give up my daily bags of chips, but if I don’t, I may die in the hallway!”

During this stage, no action is being taken, but things are bubbling below the surface.  This stage can last a long time because we over-estimate the benefits of staying where we are and think that changing will require too much effort.

Phil Moves On…

Eventually the level of fear that Phil experienced that day decreased.  Once the elevator started working, he was able to get his bag of chips from the stairwell.  He didn’t change his behaviour, but each time he reached for a salty snack he remembered sitting on the flight of stairs, unable to move.

Phil started to become aware that he sometimes found it hard to get up from the couch or was out of breath if he stood for too long.  Putting on his pants, he noticed that his belt was on it’s last hole–how did that happen.  Perhaps it was time to do something!  Phil had reached the preparation stage.

The Preparation Stage

During this stage the person wanting to change is moving to outward behaviour–not only do they want to make a change, they are coming up with a plan.  For Phil, this meant using the internet to find ways to get back into shape.  He searched for blogs written by older men who were doing what he was thinking of.  He figured out that he would need to lose some weight, so he started researching a healthy weight for someone his age.  Realizing that he would need to move to a healthier diet, Phil called a ‘skinny’ friend to find out what he eats.  He decided to buy ‘one of those gadgets’ that will tell him how many steps he’s taken.

After all his research, Phil came up with his plan.  He decided that for two weeks, he would cut back to one bag of chips a week, walk 1500 steps a day around his apartment, and add a daily salad to his diet.  Phil decided that he would start his plan on June 1.  Phil was on his way to the active stage.

The Action Stage

At this stage, the person is changing their behaviour–making the change.  This is the exciting stage as it becomes clear that something is happening.  The person is committed to the change and is starting to reap the benefits of their first actions.  A positive feed-back loop is created…a behaviour change is made…a benefit is noticed…motivation to continue is created…

Unfortunately, this is also a dangerous time in the change process.  In the honeymoon phase of action, people can sometimes underestimate the amount of effort it takes to continue new behaviours over the long haul. It’s important to note that a change hasn’t been accomplished until you are able to maintain it.

Let’s Check In on Phil…

On June 1, Phil was ready to go.  He had his ‘gadget’ and a week’s worth of salad greens were ready in the fridge.  Seven servings of potato chips were packaged for his daily treat.

At the beginning, 1500 steps felt like running a marathon.  His daily bag of chips seemed to grow smaller as the days went by, and he decided that salad wasn’t his favourite food.  However, by reading blogs from others who were also working to improve their health, Phil was able to stick to his plan for the first week.

The second week didn’t feel as difficult, and one day he noticed that he had walked 2000 steps without really trying.  Near the end of that week, Phil decided that he wanted to create a new plan for the next two weeks.  He repeated this process and, after six months, Phil’s fitness level had improved, he had lost some weight, and spent more time out of his apartment.  His mood had improved.

All was going well until…

Welcome to the Relapse

One day Phil woke up and he didn’t feel like doing his walk through the neighbourhood.  He hadn’t slept well the night before and was in a bad mood.  This had happened before, and he had been able to move past it.  Today, something was different.  As he lay in bed he thought about all he had accomplished over the past six months he felt tired.  It suddenly occurred to him that if he wanted to keep in shape, this was a life-long project.  As a wave of overwhelm flooded over Phil, he decided to take the day off.  “No salad for me today!”  “No walk and I’m going to treat myself to two portions of chips!”  Phil felt better immediately and enjoyed his “day off”.

Sadly, as often happens, one day turned into a week, then two and before he knew it, Phil had slid back into some of his old habits.  It was only having to move to a bigger belt hole, that shocked Phil back into reality.

Relapse is very common as we work on making a change.  Once we realize that we need to keep working in order to make a change permanent, or we become over-confident that the change is permanent, and we don’t have to be aware of our behaviour any longer; we run the risk of losing ground.

However, all is not lost…there is the maintenance stage.

The Maintenance Stage

The purpose of the maintenance stage is to avoid relapse and consolidate the benefits that have started to pile up during the action stage.  It is during this stage that, based on what we have learned in the action stage and any relapses, we discover the minor tweaks we need to make to the plan(s) in order to remain successful in our new lifestyle.

It is during the maintenance stage that we learn to be gentle to ourselves.

Phil Maintains…

As Phil recovered from his relapse, he realized that getting back to his routine wasn’t as difficult as he had thought.  He wasn’t starting from the beginning because he already had a plan and skills that he had developed throughout the previous stages.  Phil realized that it was unreasonable for him to be so strict with himself about his behaviour.  He wanted to think about ways that he could keep improving his fitness level and lifestyle changes while still taking an occasional break.

Over time, Phil stopped seeing his relapse as a failure and instead as a learning opportunity.

The Value of the Stages of Change Theory

In this post, I’ve created Phil’s story relating to his desire to change his behaviours in order to improve his health.  His change process can be used for any change that you would like to make.  This particular theory is often used to help people overcome substance/alcohol addiction.  As well, you can determine where you are in the change process (i.e. which stage) and have a road map of where to go from there.

And now…in a nod to 1970’s memorabilia…a classic from the Partridge Family…enjoy!

https://www.youtube.com/watch?v=wAXFkUaQoAs&start_radio=1&list=RDwAXFkUaQoAs

Please note:  Due to the upcoming Ontario provincial election, youtube appears to be airing political ads before showing their clips.  Blaikie Psychotherapy has no control over what clip is shown and isn’t aligned with any political party.

 

 

 

 

 

 

 

 

 

 

Sharing is caring!

Once Upon a Time…

Once upon a time…this may be one of the most magical phrases ever written.  Young and old alike know that with these four little words they are about to be swept to another world…joy, sorrow, danger, who knows?  I suggest that when someone says “Once upon a time” we settle into our seats and prepare for a journey.

A Simple History of Stories

The ability to create, appreciate and share stories are part of what makes us human.  While no one has been able to say precisely when the first stories were told, historians suggest that storytelling was created as people started to form smaller and then larger clans/tribes.  Storytellers shared events between members of the tribe as well as pass them on to other tribes.  Until humans were able to write, storytelling was an oral tradition–relying on individuals’ ability to listen and remember.  Storytellers were respected as keepers of a clan/tribe’s history.

Over time, writing was created.  Depending on the era, stories were captured on stone, papyrus, parchment (dried animal skins), or forms of handmade paper.  Various methods of ‘printing’ were completed starting with handwritten characters to using tools such as reeds and ink, or carved wood blocks and ink.  Until the creation of the printing press (1440 -1450 CE), books were the property of the wealthy or religious orders.  As printing became cheaper and easier, written ‘stories’ from a wide-range of sources became available to anyone who could read.   If you’re interested in an in-depth history of printing, check out this site.

Today, stories are all around us…in print, digital and audio format.  We tell our stories through music, art, literature, etc.  Like in the past, stories continue to not only record events,but entertain us.  Stories can also affect our mental health.

Our Personal Stories

Many studies have been completed showing the correlation between ‘negative’ stories (violent video games, movies, etc) and increased incidents of violence, aggression and desensitization to violence.  On the positive side, this 2016 Huffpost (UK edition) article links watching comedies to improved mental health.  Both of these ideas could be a blog post on their own.  However, that’s not what I’m thinking about here.  I’m thinking about the stories of our lives and those that we tell ourselves.  While we can often choose what ‘outside’ stories we let influence us, our ‘internal’ stories are harder to avoid.  In fact, we often don’t even know that we are telling them.

Once Upon a Time…

Once upon a time, a long time ago, there was a little boy who wanted to learn to knit.  His mom was a knitter.  So were his grandmother and aunts.  He loved family gatherings when all his aunts would bring their needles and wool. After dinner, they would sit in the living room creating amazing things out of ‘sticks and string’.  The colours were wonderful and he’s watched his grandmother make him mittens in his two favourite colours.

His dad, uncles and older brothers were not knitters.  Instead, after dinner they would disappear to the den where they would watch sports, or to the garage where they would  build stuff using wood and cement.  Their materials were hard, not soft like wool.

As the little boy grew older, the men of the family started to invite him to join them in the den or garage.  His mother encouraged him to go with them, and he was subtly discouraged from following the women into the living room.  For his tenth birthday, the boy was given his own set of tools.  As his family members watched him open his gift, he felt pressure to like the tools, but he found it difficult to fake his enthusiasm.

The years went by and the boy became a man.  He remembered his desire to learn to knit, and would join the menfolk in the den or garage after dinner.  When he saw his wife and mother knitting in the living room, he ‘knew’ that this was a female activity.  If he told you this story (his story), he would tell you that there are things that men do and things that women do. It’s not manly for men to knit….so he won’t….no matter how much he wants to.

Our Stories in Therapy

We all have stories–it’s how we make sense of our lives.  When we are getting to know someone we share our stories; increasing, over time, their level of depth and intimacy.

People often come into therapy because of the pain of their stories.

Sometimes the story is traumatic and hard to live with. They need help sorting through the details, finding meaning and finding a place for it in the perspective of their life.  Sometimes people are hurting and don’t know why.  Often they have been telling themselves stories that don’t serve them, and they are unaware that they are whispering them to themselves.  In this case, the therapeutic work involves discovering these tales, testing if they are true and then deciding whether to keep or discard them…and write a new story.

Once Upon a Time…Continued…

One day the man realized that he wasn’t happy.  He couldn’t put his finger on it.  Something was missing.  He decided to talk to someone and made an appointment with his friend’s therapist.  At the first session, the therapist asked him what he liked to do.  Did he have any hobbies?  “Nope”, replied the man.  “Well”, said the therapist, “if you could have any hobby, what would it be?”.  The man thought, the expressions on his face moving from joy to despair.  “What’s going on?” ask the therapist.  The man told his story…and the process began…

And now…one of my favourite stories…Enjoy!

 

 

Sharing is caring!

8 Frequently Asked Questions About Therapy

When someone learns that I’m a psychotherapist, I’m often told that they think they should “talk to someone”, but that the whole idea is overwhelming and scary.  I understand their fear and hesitation.  Talking to someone that you don’t know about personal things is really difficult…and that’s after you’ve gone through the process of finding someone.  The goal of this post is to answer some of the frequently asked questions that I get, in the hope that contacting a therapist will be less intimidating and you will be able to find the right therapist for you.

Why would I want to talk to a therapist?

People usually decide to talk to a therapist when the pain of what they are trying to cope with becomes too big for them to handle on their own and they recognize they need help.  For more ideas, this previous blog post gives 10 reasons why you may want to see a therapist.

How can I find a therapist?

Once you’ve decided that you would like to speak to a therapist, here are a few different ways to find one:

Referral from a friend or family member.  While seeing a therapist is not something we often share with others, in our close relationships we may know of someone who is.  If you feel comfortable disclosing to this person, you can ask if they are happy with their therapist and ask for their contact information.

Web Searches.  You can search on-line for a therapist in your  area.  Psychology Today and Theravive are two sites that provide listings of local therapists.  Professionals on both sites have been vetted for their credentials.  There is detailed information about their specialties and links to the therapists’ website if they have one.

Health Professional Referrals.  Medical professionals (doctors, chiropractors, massage therapists, naturopaths) often have a referral list for therapists.  There is a connection between physical and mental health.  Sometimes health professionals will suggest counselling and provide a list of potential therapists.  If not, and you want a referral, all you need to do is ask.

What should I be looking for?

There are lots of very good therapists out there–doing all types of therapy.  However, studies show that more important than the type of therapy, the biggest indicator of client success is the therapeutic relationship that develops between the therapist and client.  In other words…there needs to be a ‘good fit’.

If possible, have a phone or email conversation when you first make contact with a potential therapist.  Ask if this person has experience in helping people to deal with your area of concern.  If that goes well, then book a first meeting.  You will have to pay for the first session, but it’s money well-spent if you decide that this isn’t the therapist for you.  Trust your instincts.  Your friend may feel comfortable with their therapist, but that doesn’t mean she’s ‘your’ therapist.

What happens in a therapy session?  Do I have to lie on a couch?

Lying on a couch is no longer required!  Instead, clients come into an office (that’s usually quite comfortable) and talk to the therapist.  Sometimes the therapist will have a plan for what to talk about during that session; at other times, the client drives the conversation.

I’ve found it helps clients to have an idea of what will happen in a session, so I have a basic structure.  The session starts with the client telling me about what has been happening for them since our last meeting.  We check in on any homework that was suggested.  I ask the client if there is anything they want to talk about.  Normally the client has outlined goals for therapy (what they would like to be different when therapy is finished) and that always provides areas for conversations.

This is your therapy, so again you get to choose!

How long will I be in therapy?  Do I have to go forever?

While therapists learn various types of therapies (Cognitive Behaviour Therapy, Emotionally Focused Therapy, etc.), therapy is also an art.  Every client is different, with different needs for the amount of time they will be seeing a therapist.

Personally, I operate from the perspective of ‘this is your therapy’ and you get to choose.  If a client is in crisis, then I suggest meeting weekly until things become more stable.  Once the crisis is past, we move to bi-weekly or even monthly.  It depends on what the client chooses as well as what is in their best interest therapeutically.  Ethically, a therapist shouldn’t want a client to have to come forever.  The overall goal is that people feel better and go back to their lives.

Once clients ‘graduate’ from seeing their therapist, many treat their therapist as one more tool in their health toolbox–checking in when necessary.

How does confidentiality work?

Basically, whatever you say in therapy, stays in therapy.  However, there are times when a therapist is legally obligated to break confidentiality:

  • Harm to self or others.  If a therapist believes that you are in imminent danger of hurting yourself or someone else, a family member, police or ambulance will be called to ensure safety.
  • A child under the age of 16 or older adult in care is in danger.  In these cases Family and Children’s Services or the police will be called.
  • Your files are subpoenaed by the court or by the College of Registered Psychotherapists.
  • A client experienced a health emergency during a session.  In this case, medical staff would be provided only with necessary information.  No information  about why a client is in therapy will be shared.

Some therapists (myself included) carry confidentiality into the community.  I inform clients that if I see them in the community I will not say hello.  I don’t want to put anyone is a situation where they have to explain how they know me.  I am always open to speaking to clients outside of the office, but they get to make first contact.

My benefits plan covers services provided by a psychiatrist, psychologist, psychotherapist or social worker.  What’s the difference?

Since each of these professionals can provide mental health services, it can be confusing to figure out which one is right for you.  The best way to explain it is by breaking down the services they provide.

Psychiatrist:  A psychiatrist is a medical doctor (MD) who has done extra training in psychiatry.  Psychiatrists are able to diagnose a mental health issue, such as schizophrenia, and prescribe any necessary medication.  Some psychiatrists provide therapy to their patients, but due to the shortage of psychiatrists, in my experience they usually  provide diagnosis and medication management.  Psychiatrists may refer their patients to counsellors for therapy.

Psychologist:  Psychologists hold at least a Masters degree in psychology.  They are qualified to diagnose mental health issues, but not prescribe medication.  Some will do counselling.

Social Worker:  Social workers can be put broadly into two camps…clinical (do counselling) and community.  Community social workers do such activities as working for Family and Children’s Services providing case support and assessments, helping governments or local agencies with social policy, etc.  Social workers can either have a Bachelors degree (BSW) or Masters degree (MSW).  All social workers must belong to the College of Social Workers in order to practice.

Psychotherapists:  Psychotherapists are counsellors.  That is our speciality.  We hold a Masters degree (or equivalent) in psychotherapy and must be registered with the College of Registered Psychotherapists of Ontario (CRPO).  If I have a suspicion that a client may be dealing with a specific issue that would benefit from a diagnosis or an exploration of the use of medication, I will suggest that the client talk to their family doctor.

I don’t have benefits, and can’t afford to pay out of pocket.  Is there anywhere I can go?

Seeing a therapist is expensive and not everyone is covered under benefits.  Some therapists provide a sliding scale or see different groups of clients at a discounted rate.  Many agencies (KW Counselling, Carizon, etc.) have a sliding scale based on income.  As well, agencies such as KW Counselling offer free weekly drop in counselling services.

Making the decision to talk to a therapist takes courage…and studies show that counselling works!

And now…Bob Newhart shows us the type of therapist we may not want to see.  Enjoy!

Sharing is caring!

Travel and Therapy–Both Are Adventures

As I continue on my travels, the following post from the archives explores how we can have adventures (in therapy) without even leaving home!

In February 2015, I was able to spend two weeks in Thailand.  While it was a once-in-a-lifetime, amazing trip; getting to my destination was a challenge.  Travel time was over 24 hours door-to-door, including 22 hours on three separate planes.  I arrived in Bangkok feeling exhausted, disoriented and overstimulated.  After leaving cold and snowy Waterloo, walking into a hot and humid Bangkok evening was a shock.  Thailand is 11 hours ahead of Waterloo, making jet lag a factor.

After a good sleep and breakfast, I started taking in my surroundings and appreciating where I was.  Everything was completely different from what I was accustomed to–the food, language, population density, weather, currency and customs.  I had no idea how to get where I wanted to go.  I had been set down into a different world!  Fortunately, I was travelling with family members who knew Thailand well.  They led the way.  I was able to relax into the experience and know that I was safe–even if not always comfortable.

The Connection Between Travel and Therapy

During my trip back home, I mulled over my experiences and wondered about the similarities between travel and taking part in therapy.  Here are a list of the correlations I discovered.

Travel and therapy are often started by choice.
In come cases, people are mandated to attend therapy (court ordered or at the strong request of family and friends). However, individuals, couples and families usually seek therapy because they find themselves at a difficult point in their lives and want some help. When we travel, we usually begin the journey, not because we are in crisis, but because we want to explore new places.  Unless we’re being forced to attend a particular out-of-town event (weddings of third cousins, once removed!) we get to choose.

Therapy and travel can be uncomfortable at the beginning.
Long distance travel is uncomfortable–first and business class passengers, and NEXUS Card holders excepted!  The long lines, security checks, boarding, cramped seating, baggage claims…the list goes on.  However, once you arrive at your destination, the hope is that the scenery, people and once-in-a-lifetime experiences are worth the discomfort.

Let’s look at the similarities with therapy.  At the beginning of a plane trip, you are checked by airport security–questions asked, carry-on searched, and shoes, belts and coats removed.  In therapy, you are not asked to remove your shoes, but the therapist can ask some uncomfortable questions as he or she starts to learn your story about what brings you into therapy.  The topics discussed in sessions can be painful and bring up feelings of guilt, anger, sadness, fear or other difficult emotions.

On long flights, it’s important to bring things that will help you to be comfortable–a neck pillow, warm socks, music.  Therapy is no different.  Sometimes clients will carry something into a session that has meaning for them and provides stability (a picture, piece of jewelry, favourite article of clothing).

I usually check in with clients after a therapy session as to how they plan to take care of themselves for the rest of that day as they make themselves comfortable while their emotions ebb and flow.

Travel and therapy can land us in new and wonderful places.

Travel brochures are created to entice us to take trips.  I grew up in a time when booking on-line wasn’t possible, and the walls of the travel agent’s office were full of racks of booklets touting possible destinations.  Browsing the pamphlets, it was easy to imagine myself hiking across England or lounging on an island beach.

Unlike travel, there may not be exciting brochures promoting therapy.  My office doesn’t have pictures of happy families, loving couples or emotionally centered individuals. The reason for this is that therapy is completely individual.  Unlike a packaged tour, you get to pick where you go in therapy.  What are your goals?  Where do you hope to be at the end?  Your therapy is your therapy. I often ask clients to imagine that if I could wave a magic wand, how would their life be different after we had finish our work together–and that is the road map that we keep in mind when meeting.

Ideally, we have a guide for the journey.

Because I had never been to Thailand before, I really appreciated that my family members knew the terrain.  When I became overwhelmed trying to negotiate the traffic in Bangkok or find our hotel in Chiang Mai, I was able to relax because they knew what they were doing.

While you are the expert on you; during therapy, your therapist is your guide and companion.  Just as I was comfortable with my children showing me around Thailand due to our relationship, it’s very important that you feel that you can rely on the therapist that you have chosen.  When trust has been developed, you are able to relax into the process knowing that your therapist is knowledgeable and has your best interest at heart–even when the going gets tough.  Therapy is often a process of two steps forward/one step back, and it’s important to know that it’s normal to temporarily move backwards.

After travel or therapy, we never quite look at our world in the same way again.

Therapy and travel change the way we see the world. What we see, we can’t ‘unsee’.  After spending time in numerous Buddhist temples and studying the intricate mosaics, I now have a greater appreciation for any mosaic pieces that I encounter at home, or anywhere else that I travel.

When I work with clients, I often explain how certain ideas are relevant to their situation. A popular theory, Triangulation, describes how we often get pulled into being a third person in difficult relationships. This is done in the hope that our involvement will decrease the level of stress felt by the original two people.  Once clients have learned this idea, they often report that they see the dynamic everywhere–at home, work, with friends.  Not only can’t they ‘unsee’ the behaviour, but now they have tools to prevent themselves from being pulled in.

Finally, we are stronger than we think.

Both travel and therapy can be hard.  Depending on the type of travel you like, you may be backpacking and staying in hostels, trekking up the side of mountains and tenting on ledges, or driving a camper van and looking for places to sleep on the spur of the moment. Travel requires ingenuity and stamina.  Even on tours, where everything is provided, can be grueling–ten countries in ten day?!

We are no different during therapy.  Instead of exploring different countries, we’re exploring our past–including the sad and messy bits that we would rather pass over. This too takes strength, stamina and courage.  And we do the work, because the result is worth it.  The plan is that we will feel better at the end of the therapy process than we did at the beginning.

One of the benefits of travel is that we get to do and see things that we don’t at home. Since elephants are not usually found in Kitchener-Waterloo, here’s a video of a baby elephant from a sanctuary in Chiang Mai, Thailand.  Enjoy!

 

 

Sharing is caring!

It’s the Middle of February…Are We Having Fun Yet?

A colleague greeted me today with the announcement, “I’m so done with winter.”  I think that many of us would agree…the recent snow, fluctuations in temperature that bring the gift of freezing rain, clearing the driveway yet again.  A local newscaster announced yesterday that there is a shortage of sidewalk de-icer!

Seasonal Affective Disorder

All fun aside, some people need spring, and the longer hours of daylight, for bigger reasons than to get a break from the cold and dark.  These are people who suffer from Seasonal Affective Disorder (SAD).

SAD is a type of depression that is related to the change of season.  It is experienced by individuals who are not usually depressed at other times of the year.  It often begins, and ends, at the same time every year.  While most people who suffer from SAD do so in the winter, some may do so in the summer instead.

How Do I Know If I Have Seasonal Affective Disorder?

There are a variety of symptoms that people coping with SAD are dealing with.  These include:

  • Low energy
  • Moodiness
  • Irritability
  • Problems getting along with other people
  • Hypersensitivity to rejection
  • Heavy, “leaden” feeling in the arms or legs
  • Oversleeping
  • Appetite changes, especially a craving for foods high in carbohydrates
  • Weight gain
What Causes SAD?

While there are no known clear-cut causes, we do have some ideas of what may bring on SAD.

  • Your biological clock (circadian rhythm).The reduced level of sunlight in fall and winter may cause winter-onset SAD. This decrease in sunlight may disrupt your body’s internal clock and lead to feelings of depression.
  • Serotonin levels.A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression.
  • Melatonin levels.The change in season can disrupt the balance of the body’s level of melatonin, which plays a role in sleep patterns and mood.
What Can I Do?

There are many ways that you can cope with SAD symptoms.   Depending on the severity of your symptoms, some or all may help.

Increase Your Exercise
While it’s easy to hunker down during the winter, especially when feeling depressed, increasing your level of exercise has been shown to improve negative effects of SAD. Exercise releases endorphins (the ‘feel good’)  hormone as well as improving seratonin levels.

Cut Back on Simple Carbs
During cold days, when we spend more time on the couch, we may also be spending more time with white pasta, candy, potato chips, cookies and other ‘comfort’ foods. Unfortunately, these foods cause sharp spikes in our glucose levels that play havoc with our moods.  If you’re suffering with Seasonal Affective Disorder, it’s a good idea to pay special attention to eating well.

Take Advantage of Natural Light
When possible open your drapes or shutters to let in the sun (when it makes an appearance!).  Spend time outside by going for a walk, shoveling the driveway, or inviting friends over for a snowball fight or snowman-building competition.  As long as you dress warmly, it can be fun.

Use a Natural Spectrum Energy Light
If Mother Nature doesn’t provide enough natural light, box light therapy is an alternative. Natural spectrum energy lights mimic the sun’s rays.  While data on the results of these lights is mixed, many people say that they are helpful.

Make a Point of Socializing
When we’re feeling depressed, often the last thing we want to do is be with other people. However, this is often what is needed.  If possible, plan a regular get-together with friends–even a coffee date will do.

Meet with a Therapist and/or Medical Professional
As with any form of depression, sometimes it becomes difficult to cope with.  If you are feeling unsafe, hopeless, attempting to self-soothe with self-harming behaviours, alcohol or drugs, feel that SAD is taking over life or are experiencing suicidal thoughts, reach out for professional help ASAP.  You don’t have to cope with this alone.

And now…here’s a break from the winter.  No sunscreen required!  Enjoy!

 

 

Sharing is caring!

The Meaning of Life…What’s Yours and Why Should You Care?

This week’s post asks us to think about the meaning of life from different perspectives–it’s own meaning and why it matters.  Enjoy this popular post from the archives!

What is the meaning of life?  Big question.  If you asked Douglas Adams (creator of the Hitchhiker’s Guide to the Galaxy series) he would answer “42”.   If you asked Thomas Merton (monk, writer, social activist and mystic) he would reply that “Love is our true destiny. We do not find the meaning of life by ourselves alone – we find it with another.”; and if you asked Dr. Seuss (writer), he would tell you that “sometimes the questions are complicated and the answers are simple”.

How would you answer?  What gives your life meaning?  Is it your partner, your family, your passions?  Perhaps it is your spirituality or how your beliefs lead you to interact with the world. While your meaning may be similar to that of others, it will be as individual as your own fingerprint.

No matter what gives your life a sense of meaning, the key is that you have discovered meaning, and it’s something that you have to find yourself.  No one else can tell you your meaning of live.

The Importance of Meaning

When we haven’t found a sense of meaning in our lives, or have lost our sense of meaning, we run the risk of wandering aimlessly. We drift from one thing to another–looking for purpose in random activities.  We can experience feelings of disillusionment as we are never quite satisfied by our activities.  In our pain, we may become selfish.  Some people try to self-soothe with substance use, retail therapy, etc. Ultimately, we can reach a place of asking “What’s the point?”.

Alternately, when we’re in touch with our meaning, we operate from a sense of purpose. We focus on what we believe to be important, and this belief helps us to structure our activities, allocate our resources and provides contentment and a sense of accomplishment.  We believe that we are on the earth for a reason.

Searching for Meaning

If you are struggling with a lack of meaning in life, a wonderful resource is “Man’s Search for Meaning” by Dr. Viktor Frankl.  Dr. Frankl was a recognized Austrian neurologist, psychiatrist and published author when, in 1942, he and his family (wife, parents and two siblings) were deported to the Nazi Theresienstadt Ghetto and ultimately to various other camps.  Only Dr. Frankl and his sister survived.

“Man’s Search for Meaning” is Frankl’s description of his time in the camps and his observations.

Based on his experiences, Frankl believed that people are primarily driven to find meaning in their life, and that it is this sense of meaning that enables people to overcome painful experiences.  Dr. Frankl makes a key point, that while we cannot choose what happens to us, we can choose our reactions.

Meaning and Psychological Resiliency

Psychological resiliency is the ability to bounce back from negative events and stressors. Having a sense of meaning in life increases our level of resiliency.  Dr. Frankl discovered that prisoners who had been able to attach some meaning to their camp experience (whether through helping a friend, or staying alive in order to reconnect with loved ones) were more resilient to the horrors of camp live.  Those with greater resiliency choose how to view and respond to their experiences in the camps.   As their sense of meaning rose, so too did their ability to choose their responses. Ultimately, their resiliency increased.

Frankl also observed that once someone had lost their sense of meaning (perhaps when learning of the death of a loved one), their resiliency decreased, they ‘gave up’ and soon died.

How Is This Helpful?

Most of us go through periods when we feel that we have lost our sense of meaning and purpose…when we wake up in the middle of the night wondering ‘What’s the point?’.  It’s important to recognize that this is normal.  One of the wonderful challenges of being human is that we develop and learn.  In doing so, we can outgrow our current sense of meaning and then need to look for a new purpose–in a continuing cycle.

By recognizing the importance of meaning and resiliency, we can choose not to give up or fall into the trap of aimless wandering.  Instead we can choose to spend time exploring what has given us focus in the past and look for new versions of those activities or beliefs.  We can be mindful of our levels of resiliency and aware of what our struggles teach us.

We can continue to evolve.

If you are curious about Douglas Adams’ answer of ’42’, here’s a quick peek at a snippet of The Hitchhiker’s Guide to the Galaxy.  Enjoy!

Sharing is caring!

10 reasons to talk to a psychotherapist

I often ask clients that “If I could wave a magic wand, what would be different in your life?  “. This question is the beginning of setting goals for the work that we will do together to help reach that new place.  The following post from the archives, outlines ten reasons to talk to a psychotherapist.  If any of these apply to you, please reach out to a therapist that you can trust.  It can make a big difference in your life!

It was all going so well until…. The only constant thing is change.  It’s true, and how do we cope when the changes are not positive, on our timetable or by our choice?  Sometimes life gets messy and we need help to cope with the stains.

Let’s explore times when you may want to talk to a therapist. Continue reading 10 reasons to talk to a psychotherapist

Sharing is caring!

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.

 

Sharing is caring!