Tag Archives: mental health

Relax! You’re Ok Just As You Are…

I was planning this week to write on the importance of structure for mental health.  However, after a trip to my neighbourhood drug store, I decided to save that topic for another time.

Here’s what happened…while standing in a long checkout line at the drug store, I started reading the fronts of the magazines that were positioned on the way to the till.  Without exception they were all touting ways to lose weight…diet tips, recent celebrity fitness regimes, the next ‘slimming’ food choice…everything necessary to create the “New You”.  When I was in a similar lineup in December, these were the same publications that were pushing all the yummy, high calorie holiday treats!  A group of other women were also waiting in line and I asked them if they were feeling manipulated…they smiled.

The Art of Manipulation

I don’t like marketing; not all marketing, just the type that is trying to push me to purchase a product that I don’t need in order to make my life become as ‘perfect’ as the lives of the people in the advertisement.  Encouraging items that solve a problem, created by advertising departments, that I didn’t even know I had–until I came across their commercials (written, electronic or verbal).  These types of marketing are easy to spot and are the obvious forms of manipulation.

However, there are subtler forms that are harder to fight against because we don’t always know that we are being affected.  I suggest that one of these forms is the topics covered in mainstream magazines and how they are presented to potential readers.

The headings on the front covers of many magazines are designed to get us to buy the publication.  They do this by making us consciously (or unconsciously) question if we need the information contained in the magazine.  Unfortunately, the questions are not asked in a strength-based, straight-forward way.  For example, instead of advertising ways to reach a healthy body weight, they promise ways to ‘drop 25 lbs by eating soup’–the title illustrated by a model who may or may not be of healthy body weight.

We’re Not OK

The message we often get from media is that we’re not wonderful in our current form.

For fun, try this experiment.  The next time you pass a magazine rack, look at the headings on the cover (both large and smaller print).  Chances are that the contents are providing ways to change yourself.  Maybe it’s tips to adapt your personality, dating style, sexual ability, update your wardrobe, get ‘swimsuit ready’…the list is endless, depending on the time of year.  When we dig under the headlines, the bottom line is that we are being told that we’re not ok the way we are.  There is something we need to buy or change in order to become ‘acceptable’.

Granted, there are times when we need to make changes in order to take care of ourselves.  If we have reached an unhealthy weight or need to improve our interpersonal skills, then there is work to do.  However, at the same time, we also can accept that we are ok where we are (in this moment).

Acceptance and Mental Health

In graduate school, when I first heard about acceptance as a component of mental health, my alarm bells started to ring.  How can we be asked to accept the ‘unacceptable’?  How could I tell a future client living in an abusive relationship that acceptance was necessary?  Later, I learned that acceptance doesn’t mean that we condone negative behaviour, or situations where we are in emotional or physical danger.  It also doesn’t mean that we accept every bad thing that happens to us. Instead, acceptance comes from taking an honest and compassionate inventory of where we are at this time, and how we arrived here–knowing that we want to make some changes.  Acceptance means that we stop fighting or judging ourselves, for where we are, and putting that energy into moving forward in a new way (if we choose to).

I think that our ability to practice acceptance takes work.  Like a muscle, it gets stronger the more we use it.  I wonder what would happen if, on a daily basis, we took one thing about ourselves that we viewed with judgement and instead looked at it with compassion.  Chances are, our mental health would improve, and we’d buy a lot less magazines!

And now a wonderful teacher of self-acceptance…Enjoy!

 

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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.

 

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A Trip Through the Past: The Genogram

None of us were created out of the mist, but have generations of family members that came before us.  Even if we are no longer speaking to them, or know nothing about them, these people continue to  have an influence on us–even it’s unconscious.  How do we bring this influence into consciousness?  Enter the genogram!

A Geno-what?

Simply put, a genogram is a graphic representation of a family tree that displays detailed information about relationships among individuals. It is more complicated than a traditional family tree as it can include individuals’ characteristics, health history, cause of death, emigration patterns…basically anything that the therapist and/or client feel they would like to add to the document.

If you’re curious and want to discover more about the structure and history of genograms, you can check out this Wikipedia entry.

The Use of Genograms in Therapy

When I begin to work with a new client, one of the first things we often do is create a genogram. This is a joint process, and the document is created from the client’s perspective.  We start with the client and work outwards by adding partner(s), siblings, children, parents, etc.–going as far back as grandparents–though sometimes farther back if it will be useful.

Once we have the added the people, then we start to include ‘relationships’ between the client and key people on the chart.  Are they close or distant?  Who doesn’t speak to whom?  Who disappeared from the family never to be heard from again?

Often a useful component is the addition of a few words describing each person on the chart.  As a client tells their family history/personal story, additions are made to the chart. For example, perhaps emigration is a large part of a family  history, which effects the relationships between members that stay in the country or origin and those that leave.  It’s also interesting to track items such as divorce, suicide and drug/alcohol use over the generations.

While genograms follow a definite structure and use specific symbols, each chart is as individual as the person creating it.  In fact, their usefulness is due to their flexibility as we can include any information that feels important to the creators.

The genogram is a ‘living document’ and the product of an iterative process.  As more information comes to light during the course of therapy, it may be added to the chart.  We can also go back to the chart during sessions to confirm thoughts or perceptions when needed.

The Client Response to Creating a Genogram

Ideally, creating a genogram is an enjoyable activity. It can be interesting to look at our family history from this perspective.  When I ask clients what they think of the process, I often hear about how they never thought of their family in this way and are enlightened when they start to see the patterns that emerge.

Clients often apologize when they don’t know information for the chart.  However, it’s all good information–even not knowing is valuable.  Why don’t they know?  What does this say about their family system? It’s acceptable not to know as it’s all grist for the mill.

The Use Of Genograms In Couple Work

Genograms can also be completed when working with couples.  In this case, we complete a chart for both partners–‘marrying’ it into a whole picture.  It’s often fascinating to see how family of origin pieces affect their current relationship and how each person is being affected by family history.

The Benefits of Creating a Genogram

Besides showing multi-generational patterns, one of the benefits of completing a genogram is that it puts some distance between the clients and the current concern(s) that brings a couple or individual into therapy.  We can see the challenge from another, less-personal perspective.

Another benefit is the unveiling of family secrets.  Holes in family of origin information often point to family secrets.  Why don’t we know what happened to Great Uncle Ed?  Why did Cousin Louise disappear only to return suddenly?  How come no one talks about Aunt Nancy?  Family secrets are important as they are part of the rules that govern families. As these rules often affect our core beliefs and subsequent mental health, it’s important that we explore them.  A genogram is often the first hint that a secret exists.

A third benefit of a genogram is as a tool to encourage interactions between family members.  While in grad school I created a complex genogram as part of a family of origin course.  In order to fill in missing information, I had to initiate conversations with family members that wouldn’t have occurred otherwise.  While these talks were not always easy, the results were worth the effort, both for information gained and relationships renewed.

It’s Not Our Ancestors’ Fault–At Least Not Intentionally

One of the pitfalls of a genogram is the possibility of blaming our family for our current struggles. While they may have a part to play–especially as patterns are repeatedly acted out, at the end of the day it’s safe to say that parents desire to love their children unconditionally and attempting to do their best.  However, this doesn’t always seem to be the case.  Why?

Dr. Gabor Maté, in his book, When the Body Says No:  Exploring the Stress-Disease Connection, writes about how multi-generational stress and trauma affect the ability of parents to attach to their children.  It is well-documented that our attachment style (secure vs. insecure) is a key component of our mental health and the way we interact with others. Our ability to handle stress is deeply related to brain development, both before and post birth, as much of our brain development continues well into the first years of age. Therefore, if our grandparents were stressed and unable to attach securely to our parents, it affected our parent’s brain development and their ability to attach…and on it goes.

Dr. Maté states:

“Parenting styles do not reflect greater or lesser degrees of love in the heart of the mother and father; other, more mundane factors are at play.  Parental love is infinite and for a very practical reason:  the selfless nurturing of the young is embedded in the attachment apparatus of the mammalian brain…Where parenting fails to communicate unconditional acceptance to the child, it is because of the fact that the child receives the parent’s love not as the parent wishes but as it is refracted through the parent’s personality. … For better or worse, many of our parenting attitudes and responses have to do with our own experiences as children.  That modes of parenting reflect the parent’s early childhood conditioning is evident both from animal observations and from sophisticated psychological studies of humans.” (p. 211-212)

What Do We Do With The Information?

Once we have looked at and integrated the information from a genogram, what do we do with it?  Awareness is the key.  When we begin to notice patterns, both in ourselves and in our relationships with others, we have taken a big step in making things better.  We can choose to do something differently.  We can choose not to continue the pattern to our children and grandchildren.

The “7th generation” principle taught by Indigenous tribes and Native Americans say that in every decision, be it personal, governmental or corporate, we must consider how it will affect our descendants seven generations into the future.  This also relates to taking care of our mental health.  When we do the hard work of healing the results of multi-generational stress and trauma, we not only benefit ourselves and those we are currently in relationship with, but also generations to come.

Now for some vintage comedy…family dynamics from the Carol Burnett Show.  Enjoy!

 

 

 

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Experiential Learning Theory and Mental Health…Is There a Connection?

As a therapist, one of my professional goals is that the people I work with will leave therapy with a greater understanding of the issues that brought them to see me, as well as tools to cope if the challenge should occur in the future.  As a way to work towards this understanding and skill development, I often ask clients to complete homework assignments.  The assignments may be to reflect on part of our discussion, practice a new skill or write a letter (not to be sent) to a difficult person.   Over time, I have found that clients’ willingness to complete homework outside of our sessions has a positive influence on their therapeutic success.  Because of a presentation I recently heard on Experiential Learning Theory, I now have a clue as to why.

What Is Experiential Learning Theory (ELT)?

Simply put, the theory is based on the idea that people learn through “discovery and experience”.

Imagine that you want to learn how to ride a bike.  If someone told you how to ride a bike or you read “Bike Riding for First-timers”, you could gain theoretical knowledge about physical balance or types of bikes. You may even get an idea of how to fix a bike, but would this information be useful in fulfilling your desire to race through the neighbourhood on your own steam?

Instead, now imagine that you are standing beside your ‘new-to-you’ bike.  You are brimming with determination to start riding.  My guess is that you would be using a process of ‘trial and error’ to figure out how master this new skill.  Learning would involve finding ways to sit on the seat, pedal, turn and stop–while not falling off.  It would take time, and while a book or lecture could be helpful, their content may make more sense after your had the experience of actually playing with your bike.  This is experiential learning!

David Kolb and the Experiential Learning Cycle (Kolb Learning Cycle)

In 1984, David Kolb (social psychologist) coined the term “experiential learning” when he published Experiential Learning:  Experience as the Source of Learning and Development.

Kolb’s cycle has four parts:  experience (doing something), reflection (review what was experienced), conceptualization/generalization (making sense of what happened and the relationships between these elements, and experimentation (putting what was learned into practice).  When we see how what we learned is useful in our lives, we’re more likely to retain the knowledge.  The gift of this cycle is that it is a cycle–we can keep repeating the process as a way to fine-tune our knowledge when learning a new skill.

Let’s return to the bicycle example–you want to learn how to ride your bike.  To begin (experiential stage), you straddle the bike, sit on the seat and put a foot on a peddle.  So far, so good.  However, as soon as you start to lift your second foot off the ground, you feel a loss of balance and find yourself on the ground!  The reflective stage starts as you think about what just happened (one second sitting on your bike, the next lying on the ground).  As you make sense of this experience (conceptualization/generalization) you may be thinking about how unsteady you felt as you moved for the second peddle.  You may decide to go back to “Bike Riding for First-timers” and re-read the section on balance–this time with a new perspective.  Finally, after your bruises have healed, you will return to your bike and apply what you have learned (experimentation).  As you repeat this cycle, you will roaring around the streets in no time!

What Does ELT Have To Do With Mental Health?

As I was listening to the presentation, I was thinking not only about how this could explain the success of therapy homework, but also how it could affect the development of phobias and be used in their treatment.

Phobias are learned behaviours–based on previous experiences.  Common treatments for phobias are Exposure Therapy (treating the avoidance behaviour by helping individuals to slowly become acclimatized to the phobic trigger) and Cognitive Behaviour Therapy (CBT)(exploring thoughts around the feared object, as well as develop alternative beliefs about the phobia and its effects on their life).

If we bring in the Experiential Learning Cycle, can the Learning Cycle help to explain the creation of a phobia?  There was the original experience (for example being bitten by a small dog).  A time of reflection–“I was just bitten by a small dog!” followed by conceptualization/generalization–I put my hand out and a small dog bit me, so small dogs bite.  Finally, experimentation when we put what was learned into practice–“I’m staying away from small dogs!”… and a phobia may be born.

On the other side, does CBT and  Exposure Therapy use ELT concepts to help people explore and unlearn the basis of the phobia–especially when used together?

I’ll Keep Suggesting Homework

Experiential Learning Theory has confirmed for me the value of therapy homework, as the homework is assigned based on a specific client experience.

Let’s take the example an argument with a co-worker.  In therapy we would reflect on the argument, look at past incidents with the co-worker, and talk about emotions connected to this event.  We would explore possible ideas of what could be done differently in the future.  We may move into role-playing a specific communication skill or conversation.  The resulting homework would be to practice the skill, and perhaps, have the conversation with the co-worker.  The cycle continues at the following session when we debrief the homework, fine-tune and explore where to move from that point.

Experiential Learning Theory In Practice

Here’s a great example of experiential learning.  Thankfully, most people don’t have this experience on network television!  Warning…there are lots of bleeps due to language.  Enjoy!

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