What to Ask During a Consultation 8 March 2022 Bliss Team No comments Categories: Communication, Individual Therapy, Relationship Therapy, Therapy, Uncategorised The consultation is a short and free phone call, approximately 15 minutes. This brief meet and greet is a great way to determine if a therapist will be a good fit for you. For the most part, consultations are informal and a way to get to know each other. It’s an opportunity for the therapist to get a sense of what your presenting challenge is or why you are seeking therapy. A therapist has an ethical duty to refer you to other therapists if they don’t feel as though they have the competency (i.e., skills, knowledge, etc.) to effectively work with you to meet your goals. Therapy and/or treatment does not take place during the consultation. The “work” begins when the first full session is booked, after the consultation. Instead, the consultation is a great opportunity for you to ask any questions that you may have about payment, schedules or the therapist’s competency with your presenting challenge(s) (e.g., client experience, education, therapeutic style and tools, and how they may approach treatment given your goals for seeking therapy). What Questions Should I Consider Asking? The consultation is not solely about the therapist providing you with their ideas for a treatment plan. You’ll need to consider whether you feel as though you are able to open up to them fully. We’ve created a list of questions to help with figuring this out! Keep reading to check it out ⬇ You won’t have time during the consultation to ask each and every one of the questions below, and there are likely questions you will also come up with that are specific to your lived experiences or what you are looking for in a therapist. In this case, it might help to select only those questions from the list that feel most important to you and/or to bring other questions to the consultation that may help you with deciphering whether this therapist could be a good fit, that is, that you’ll be able to be completely honest and transparent with them during your sessions. Some of these questions may also already be included in the therapist’s online bio. Feel free to research the therapists you’re interested in working with first, to see if you can find this information before bringing it up during your brief call. Click on the links below for examples! Where did you go to school and what did you study/Do you specialize in the challenges I am facing? How are you qualified to treat my problem? How are you a specialist in this area? Have you supported others like myself? If so, what was the outcome in those cases? What types of treatment styles would you consider using during our time together? How important is it for you to know about my past, my family, my relationships? Who will be talking more, you or me? Are you confrontational in your therapeutic style? Will you provide me with homework or assignments? Have you personally experienced the challenges I am facing, and how do you believe that will impact our sessions? How long have you been in practice? How often should I plan to see you? How many sessions do you believe it will take to reach my goals? How much will each session cost and do you offer direct billing to my extended health insurance provider? What is your cancellation policy? How will I know if our time together is working? Do you feel as though I could be a good fit? Is there any reason you feel I should consider finding another therapist and if so, could you provide me with a few referrals to reach out to? It is important to keep in mind that most of the health profession is predominantly made up of people who experience the most privilege. If you’re a person who experiences discrimination or society in a different way, such as a person of colour, a person who is part of the LGBTQI2S+ communities, an immigrant to Canada, etc., you will want to ask as many questions as possible in order to understand whether the therapist is culturally competent or sensitive to your unique needs. For example: Have you worked with someone like me before/what are your experiences with my identity and/or culture? What work have you done to learn more about my identity/cultural experiences? How are you continuing to learn about my identity/cultural experiences? Are you currently aware of the political events and the issues that I face? Do you operate from a racial justice and/or sexual and gender inclusive framework? Do you believe that we will be able to build a rapport based on trust, why or why not? Would you feel comfortable with me discussing the oppressions and discrimination I have experienced by those who you may identify or associate with? Do you receive a consultation with supervisors or other therapists who identify similarly to myself or share my cultural experiences? How do I know if a Therapist is a Good Fit? The fit is really important. Research has shown that a positive rapport between the therapist and client leads to greater treatment success and positive outcomes for the client. CLICK HERE to read more. If this is your first time seeking out therapy, try booking a free consultation with multiple therapists, that way you can really compare and contrast who is going to be the best fit for you. When shopping for a therapist, it helps to make a shortlist (e.g., your top 3). Select those who you feel could be the most supportive, given the reason you are seeking therapy. The majority of therapists are happy to set up an initial consultation to determine fit. During and after your consultation, you’ll want to reflect on how the meeting went. Check in with yourself to make sure that you actually want to move forward with the therapist. Here are some more questions to reflect on, to help with the decision-making process. Do I feel safe being vulnerable or authentic with this therapist? Do I feel as though I could trust this therapist? Do I feel comfortable with their body language and/or communication style? Do I feel heard or understood? Does this therapist seem knowledgeable and are they able to share their thoughts clearly/am I understanding them? Do I enjoy spending time with them or do I want to continue talking to them? Do I feel engaged? Does this therapist seem empathetic and compassionate? Does this therapist seem like my ally? Do our schedules align? How often are they able to fit me into their schedule (e.g., bi-weekly or monthly) and does this align with my own timelines for achieving my goals? Are the services offered by this therapist covered by my extended health benefits plan or provider? Are there any barriers or hurdles to booking appointments with them? If you answer “no” to most of these questions, or if you don’t have a good gut feeling overall, then continue to hold consultations with other therapists until you do. However, if you keep feeling uncomfortable, even after speaking with multiple therapists, then there may be more to check in on. Therapy, in general, can bring up nervousness or anxiety, especially if you have never seen a therapist before. It’s important to identify this feeling and acknowledge that it may not go away for at least the first 3 sessions until you develop a rapport with a therapist. What Next? Sometimes, the therapist that we really want to work with is very much sought after and will have a waitlist for new clients. When meeting during the consultation, ask the therapist how long they estimate before you will be able to meet. Given the estimation, you will be able to determine whether you would like to be added to their waitlist for when an appointment becomes available. If you decide that you need more immediate support, you may request referrals to other local therapists who may or may not have more immediate availability. Otherwise, if you decide to take a seat on the waitlist, just remember that there is no guarantee that a spot with this therapist will become available within that time period. It is very difficult to determine the wait period as it depends on a few variables. For instance, it’s not always known as to how long it could take for the therapist and their current clients to complete their work together. Once you have found the therapist you would like to work with and they do have availability to see you, the next step is to book your first three to four sessions. Booking multiple sessions at one time is often recommended during times when schedules are getting full. Most therapists, or clinics, really want to ensure that you are seeing your therapist whenever it works best for your schedule and your needs. However, there are certain therapists who are sought after for their unique expertise, times of the year, or even social events and climates (e.g., COVID-19) that will impact whether you will be able to book a session when you want or need it. So, our thinking is, why not book a block of appointments at once and then cancel and/or reschedule them (as per the cancellation policy!), as needed. The last things you may be asked to do before you have your first session will be to review and/or complete any important documents prior to your scheduled appointment time. For instance, you may be requested to review the therapist’s General Treatment Contract, to complete a more in-depth intake form or assessment, to review instructions or a troubleshooting guide for conducting Remote Psychotherapy, or to complete a COVID-19 Screener. From there you may only need to prepare yourself for what to expect from the first session. CLICK HERE to learn more. At Bliss Counselling + Psychotherapy, providing tailored services is our specialty! Regardless of the challenge(s) you are facing, our therapists will use a variety of psychotherapy and counselling approaches to ensure you receive the support you need. If you need some extra support with shortlisting therapists or are interested in booking a consultation with any one of our Bliss therapists, CLICK HERE or give us a call: 226-647-6000. Our admin team will be happy to narrow down the options and to support you in finding a therapist who could be the best fit! ____ Written by: Jess Boulé, Pronouns: they, them, theirs Jess is our Clinic Manager at Bliss Counselling. Jess is a Master’s graduate from the University of Guelph. During their degree, they focused on aging and end-of-life, human sexuality, the health and social experiences of LGBTQI2S+ people and communities, and evidence-based communication & teaching. Jess conducted research in order to inform more inclusive policies & practices, knowledge translation & mobilization, and business & program evaluation.
Getting to know Sheila & Acceptance and Commitment Therapy 16 February 2022 Bliss Team No comments Categories: Communication, Events, Individual Therapy, Inspiration, Relationship Therapy, Self Care, Therapy, Uncategorised, Workshops Sheila McDonough is one of our very own therapists at Bliss Counselling + Psychotherapy!. Sheila earned her undergraduate degree with a Major in Social Development Studies and a Certificate in Social Work from Renison University College at the University of Waterloo. Sheila is a Master of Social Work with a Degree from Wilfrid Laurier University in the individual, couple and family stream. Sheila specializes in individuals and relationships and is a Registered Social Worker and a member in good standing with the Ontario College of Social Worker and Social Service Workers and the Ontario Association of Social Workers. Where it all started: In her early 20s Sheila experienced delayed grief, which led her to engage in psychotherapy. Through this experience Sheila realized the value of psychotherapy. Following this experience, Sheila began her journey to become a psychotherapist. Sheila had been working in marketing and sales. Sheila realized her natural skills and talents were useful in developing the therapeutic alliance which is the curative factor in psychotherapy and in all helping professions. This shift in career focus has led Sheila to a very meaningful and satisfying career. She feels very honoured to walk with people as they reflect and work towards making meaningful changes in their lives. Sheila has worked as a Registered Social Worker for the past 15 years primarily in the areas of trauma and mental health. In those 15 years, Sheila has spent more than 10 years in a hospital setting providing outpatient mental health services, emergency mental health services and acute trauma treatment in the areas of sexual assault and domestic violence. In the last 2 years, Sheila has really enjoyed working more with couples. She loves helping couples improve their communication and create more loving and meaningful relationships. Sheila aims to hold each person in esteem, while challenging them to look at how they can change to improve the quality of their relationship. Sheila’s primary approach to working with individuals and couples focuses heavily on incorporating mindfulness. Sheila has studied and practiced mindfulness for more than 25 years. It is the cornerstone of the therapeutic approaches Sheila uses in her therapy sessions. Sheila is a lifelong learner and has postgraduate training in the areas of mindfulness, DBT (Dialectical Behavioural Therapy) and ACT (Acceptance and Commitment Therapy). Sheila believes present moment awareness is essential to making meaningful changes in our lives. Sheila uses an eclectic approach in therapy. This is why she values the ACT model. ACT embodies the main elements Sheila uses in her sessions (i.e. mindfulness, DBT, and compassion). ACT provides a framework to help people ground themselves and increase psychological flexibility. The approach allows a person to recognize a choice point to work towards meaningful change in their life. What is Acceptance and Commitment Therapy: ACT helps people open up and respond more effectively to difficult emotions and thoughts. ACT helps a person to recognize their personal values and to move toward more value based behaviours. When using ACT a client will be able to see how small subtle challenges in life can be traced to a conflict in their own value system. This increased awareness then helps the client with unhooking themselves from the negative cycle so that they may move toward who and what is important to them. Sheila loves the following quote and feels it embodies the essence of the ACT model: “Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” – Viktor E. Frankl We wanted to unpack the positive impacts of using ACT as an effective and evidence-based approach to therapy, so we interviewed Sheila to learn more. Here’s what she shared: How is ACT used in a therapy session? People will often want to get rid of unwanted thoughts and emotions. But, that’s not entirely possible. Instead, in an ACT session, clients are encouraged to accept these unwanted thoughts and behaviours, to cultivate present moment awareness, to learn how to recognize cognitive distortions and work towards value based and committed actions. How many sessions will it take to notice a positive change? The number of sessions will depend on each individual. Typically clients benefit from 6-8 sessions. Some clients may wish to pursue while others may wish to receive ongoing sessions (16-24), over several months or years. Some clients will attend a few sessions, then return in the future to explore their life in greater depth. Who would benefit from ACT? People with a wide range of challenges may benefit from ACT treatment (i.e. depression, anxiety, Borderline Personality, post traumatic stress symptoms stress, substance use and chronic pain) How might ACT be incorporated into a person’s life outside of the session? Clients learn how to ground themselves, to become an observer of their thoughts and feelings and how to work on committed action so that they may move toward who and what is important to them. Goals are set at the end of each individual or group session. Does ACT sound like an approach that you might like to explore? Look no further. Find out how to join our upcoming ACT Group Therapy! Sheila McDonough (MSW, RSW) and fellow Bliss expert Valentina Messier (RP,) are hosting an upcoming Acceptance and Commitment Therapy workshop series. This workshop series will be held virtually from the comfort of your home via Zoom. Heal through the power of connection in a small group setting! Prepare yourself to engage in group activities and discussions for 120 minutes, once a week for five weeks starting Saturday, March 26th and ending April 30th (excluding Easter weekend Saturday, April 16th). Are you ready to join Bliss Counselling + Psychotherapy’s 5- week virtual ACT workshop? Click here to take the next step in securing a spot in this upcoming group or to be added to the waitlist for future groups. Written By: Sheila McDonough (MSW, RSW) Edited By: Candice Mason (Customer Care Specialist) & Jess Boule (Clinic Manager)
Getting to know Valentina and Acceptance and Commitment Therapy 23 December 2021 Bliss Team No comments Categories: Communication, Events, Inspiration, Self Care, Therapy, Workshops WHO IS VALENTINA: Valentina is one of our very own therapists at Bliss Counselling + Psychotherapy practicing individual therapy. For as long as Valentina can remember, people have felt comfortable opening up to her. She has frequently had strangers join her while sitting on a park bench or at a coffee shop. Valentina feels a sense of value in being able to give others a safe space to listen and to understand them and their story. One day, Valentina connected with a person experiencing Schizophrenia, who shared more with her about their life and the challenges they had been facing. This conversation sparked a curiosity within Valentina that led her to pursue Psychology as her major. Her curiosity to truly see, understand, and accept people as they are, continued to grow and ultimately, lended to her pursuit of a career in Psychotherapy. Valentina obtained her undergraduate and graduate degrees in the United States, at Marquette University and Cardinal Stritch University, respectively. In addition to being a Psychotherapist in Ontario, Canada, Valentina holds a License of Professional Counselling in the state of Wisconsin. During her Clinical Psychology Master’s program, Valentina co-facilitated a Dialectical Behavior Therapy (DBT) group at Aurora Psychiatric Hospital in Wisconsin. This experience further stoked her interest in mindfulness and radical acceptance. She felt motivated to approach those around her with a sense of compassion in order to validate lived experiences and to support them in identifying their own strengths. After graduate school, Valentina began working with marginalized populations in Milwaukee, WI. As part of an interdisciplinary team piloting the CORE (Coordinated Opportunities for Recovery and Empowerment) Program, she actively supported those living with psychosis with the goal to improve the quality of their lives. Through a coordinated effort, Valentina was able to help foster independence for many young adults facing Schizophrenia. She and her colleagues approached hallucinations and delusions with acceptance, rather than dismissal or disapproval. With compassion, Valentina and her team validated their clients’ realities. She offered psychoeducation for families, created strength-based treatment and crisis plans, which incorporated both formal and informal support systems and strategies. Valentina hosted monthly meetings for each client and their circle of care, utilizing open communication and problem solving across the health care team to ensure that the client was well supported, and that ultimately their needs were prioritized. After a move to Canada, Valentina began providing psychotherapy online. It was during this time that she first heard of Acceptance and Commitment Therapy (ACT). Not knowing what it was, Valentina chose to dive into courses and literature. WHAT IS ACCEPTANCE AND COMMITMENT THERAPY: Acceptance and Commitment Therapy (ACT) is an evidence-based approach to therapy that uses Mindfulness to build awareness of our thoughts, emotions, and behaviours. With this awareness, we are able to observe patterns in our behaviours and thoughts. This then gives us the information we need in order to reflect on whether how we are operating in the world is meaningful and working for us, as well as how we might be able to add value to our lives. Rather than reviewing the content of our thoughts and feelings, we analyze their usefulness. For example, we may encounter a situation where we think, “I’m not good enough.” Instead of asking ourselves, is this thought accurate, ACT encourages us to ask ourselves: Am I placing my focus on one particular thought and is this helping me in some way? By placing my focus on this particular thought, is it bringing me closer to who I want to be? Are my patterns of thoughts and behaviours working for me? Certain therapeutic approaches, such as Cognitive Behaviour Therapy (CBT), ask us to seek out evidence for why we ARE good enough, that is, to consider alternative examples that could counter the negative thought pattern. For some, this is really effective. But, sometimes, there is no amount of evidence that can truly convince us that we are indeed good enough. This is why Valentina loves ACT; it looks at the function of thoughts and feelings rather than their accuracy. When we think, “I’m not good enough,” and then ask ourselves how that thought pattern is working for us, it’s easy to see that it isn’t. Our minds generally want to protect us from pain. Unfortunately, thoughts and feelings are often out of our control; there is no “Delete” button in the brain to get rid of them for good. So while it is important to acknowledge unwanted thoughts and feelings, expending too much of our energy analysing them will not actually change our lives for the better. Ultimately, we may not feel closer to achieving our goals or the life we want, so what could we do instead? Build self-awareness. When we are self-aware, we are able to acknowledge that something is not working. When we realize that something is not working, we can then begin letting go of the unhelpful thoughts and feelings that hook our attention. Mindfulness is incredibly useful for “unhooking” these thoughts. Not only does it bring us into the present moment, but it reminds us that we are not defined by our thinking or our emotions. We are simply observers of our experience. Through Mindfulness, we build flexible attention and foster acceptance of our experience. This approach is liberating and compassionate, it acknowledges and validates the painful experiences in our lives while at the same time giving us our power back. While it is natural for us to allow emotions to dictate our actions, we do not have to let them dominate our lives. Whether in the therapy room, or outside of it, we can approach life through this framework. We can practice mindful awareness in any setting and reflect on our values. The therapy room provides a safe, nonjudgmental space to open up about the painful experiences we encounter. As a Registered Psychotherapist (Qualifying) with almost a decade of experience and a fellow human, Valentina acknowledges everyone’s emotions as valid and offers understanding and compassionate support. We collaborate as a team to help take steps towards changing life for the better. Change can be intimidating, by having someone along for the journey, to offer encouragement, guidance and reminders of your strengths, can be incredibly helpful. Does ACT sound like an approach that you might like to explore? Then, join Valentina Messier (RP, Qualifying) and fellow Bliss expert Sheila McDonough (MSW, RSW) in our upcoming ACT Now For A New You In 2022 group workshop. The workshop will be held virtually from the comfort of your home via Zoom. Heal through the power of connections with up to ten other like minded individuals! Prepare yourself to engage in group discussions for 90 minutes, once a week for five weeks starting Saturday January 15th and ending February 12th. We’ve got all the information we need, we are interested so just click here to make the next step to booking into our group. Who is ready to join Bliss Counselling + Psychotherapy’s 5- week virtual ACT workshop? All the information is outlined and the interest has been sparked! Just click here to take the next step in securing a spot within the group. Written By: Valentina Messier Registered Psychotherapist (Qualifying) & Candice Mason, Client Services
Different Therapeutic Approaches Used for Alcohol Addiction Treatment 15 November 2021 Bliss Team No comments Categories: Communication, Guest Post, Individual Therapy, Self Care, Therapy, Uncategorised Alcohol use is marked by an uncontrolled and compulsive need to drink. We may seek treatment regarding alcohol use, if we; feel a compulsion to drink, feel we no longer have control over how much we’re drinking, feel uncomfortable when we are unable to drink. Not having an alcoholic drink may lead to challenges in managing emotions and day to day responsibilities. When seeking treatment for alcohol use, the first step may be to speak with a doctor and to create recovery goals. From this assessment, the doctor will advise the next step, which could include: a treatment centre (inpatient or outpatient), therapy (biofeedback, cognitive behaviour therapy, psychotherapy, family behaviour therapy, or holistic therapy) and/or a support group. Types of Alcohol Addiction Treatment i) Inpatient Rehab Inpatient alcohol rehabilitation offers structured treatment to address multiple facets of a person’s addiction. During this treatment, the patient must live in a substance-free facility where they get round-the-clock support and medical care. Inpatient rehab is good for anyone with chronic addiction and those with co-occurring/behavioural disorders. ii) Outpatient Rehab An outpatient rehab program offers the same level of care, treatment, and therapies as an inpatient one. The only difference is that with the former, the person gets to live at their residence. Outpatient rehabs allow for the individual to continue their daily routines such as: managing jobs, careers, and families. This type of rehabilitation approach may be more appealing to those wanting to maintain their day to day routine. The challenges associated with having access to our home and the surrounding environments (e.g., LCBO, beer store, parties, etc.) could be triggering or create difficulties in maintaining sobriety. Having access to such things can create triggers and a challenge around maintaining sobriety. Therefore, outpatient programs are best suited for those with mild addiction and have a strong support system around them. Therapeutic Approaches Used for Alcohol Addiction Treatment i) Biofeedback Therapy Biofeedback therapy has been researched for over 25 years and has shown to be an effective treatment. The treatment process assists and teaches the client to produce more normal EEG patterns. Biofeedback therapy is a computer based, brain-training technique used to help with developing more control over brainwave activity resulting in improved life functioning. During a typical treatment, sensors are placed on the scalp of a client to measure brainwaves through a computer software system. Each session ranges between 20-60 minutes and it is recommended that a person attend two to three sessions per week. These electronic sensors monitor the ongoing brain activity which is recorded as brain wave patterns. Once the therapist reviews the results, a conversation is had with the client to discuss and recommend additional psychological techniques for working through the addiction. ii) Cognitive Behavioural Therapy Studies tell us that Cognitive Behavioural Therapy (CBT) is a highly effective method for working through alcohol addiction. The therapist works towards identifying negative and destructive thought patterns and behaviours. The therapist uses CBT to work towards replacing the negative thoughts and behaviours with positive ones. The success of CBT relies on the conversation between a therapist and the client. It is a solution-based therapy that relies more on constructive actions rather than the medical diagnosis itself. Common elements of CBT are – challenging and confronting fears, harmful beliefs, ways to improve social interaction, and coping skills to manage cravings. iii) Psychotherapy During a psychotherapy session, the client discusses their personal challenges and difficult experiences with a registered social worker, registered psychotherapist and/or psychologist. This therapeutic approach can be used in individual, group and family settings. The therapist uses the information collected to analyze a person’s long-standing issues, daily challenges, past traumas, fears, and personal difficulties. If the client wishes to see a psychologist, they would be able to receive a diagnosis and prescribed medication. iv) Family Behaviour Therapy Addiction has multiple facets. It affects not only the individual suffering with the addiction but those closest to the person such as family and friends. There are several cases where family members are unknowingly enabling the individual’s addiction. Family behaviour therapy addresses all these things. During a therapy session in an addiction rehab centre, families work on setting goals, and learning behavioural techniques. The idea is to improve family dynamics and make it more conducive to encouraging recovery and healthy living. In doing this, it encourages healthy communication between family members. To foster recovery, family members are encouraged to work on their roles and partake in effective boundary setting moving forward. Family behaviour therapy is highly effective in getting families to work as a cohesive unit. They learn to support and help each other to achieve sobriety goals. This type of therapy is typically conducted at a later stage of treatment, after alcohol detox is completed. v) Holistic Therapy Holistic alcohol addiction treatment focuses on healing a person’s mind, body, and soul. It takes into account the overall well-being of a person. This is achieved through managing physical withdrawal symptoms as well. Holistic therapies include: Guided meditation Mindfulness practices Breathwork Yoga Acupuncture and acupressure Massage therapy Sound therapy Aromatherapy Reiki Finding Support Groups After an individual has completed a rehabilitation program for their addiction it is suggested that they seek support through external groups. Being part of an external group support system assists in the transition from rehabilitation centre to navigating their new sober life. Support groups are instrumental in encouraging long-term recovery and care both during and after rehab. They provide a safe place to speak with like minded individuals and seek a sponsor. Support groups such as some outlined below are easily accessible to those in all communities and offered at various times each week. 12-Step Programs These are highly popular programs that are considered to be standard for sustainable recovery post-rehab. The program follows a 12-step model and 12 traditions that the participants complete. Each step allows the person to adapt to their surroundings and meet personal goals. Narcotics Anonymous and Alcoholics Anonymous are the two most well-regarded 12-steps programs in the US and Canada. Alcoholics Anonymous Alcoholics Anonymous meetings offer a common ground for individuals to get together and share their stories with others who have lived very similar stories.Those who join AA meetings appreciate that they are able to relate and draw inspiration from others in the group through storytelling. During group sessions many conversations are had around how recovery both impacted and improved the person’s life. AA meetings are held daily in community and/or church buildings allowing for those in recovery to attend as frequently as needed. There are two types of meetings – open and closed. The former invites loved ones and family members to attend while the latter is solely for recovering individuals. Narcotics Anonymous Inspired by Alcoholics Anonymous, NA meetings create a sense of community for recovering addicts. Members get to meet and motivate one another by sharing their success stories and anecdotes. It helps each other to stay committed to living a drug-free life and avoid relapses. Conclusion Alcohol addiction is one of the most common forms of addiction. It is highly treatable and there is plenty of help and resources available to achieve sustainable, life-long sobriety. Written By: Holly a freelance writer who loves to help those struggling with addiction. Holly’s own personal experience has inspired her to share resources and be part of others’ recovery journey. Holly has been sober for five years and counting. Holly is a frequent contributor to many addiction-related blogs and organizations such as the Addiction Treatment Division and Inpatient-Rehab.org. References: https://www.webmd.com/pain-management/biofeedback-therapy-uses-benefits https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897895/ https://www.yorkregiontherapy.com/biofeedback/
Revolution from the Couch: Integrating Social Justice into Therapy Practices 19 October 2021 Bliss Team No comments Categories: Individual Therapy, Inspiration, Relationship Therapy, Relationships, Therapy, Uncategorised Therapy is envisioned as a safe, unbiased space. In the therapy office, clients are free to explore their past and future, free from judgement or contempt. Clients expect their therapists to provide impartial, supportive advice, without fear that their therapist will discriminate against them in any form. This is an important cornerstone of the practice of therapy. However, this concept can also be misconstrued to mean that therapy is an apolitical practice. Therapists are thought of as neutral actors, who remove themselves from politics in the therapy room. While this may be the case for some therapists, therapy as a whole is deeply involved in politics and social justice advocacy. Many of the early developers of therapy as we know it were involved in politics and justice, such as those involved in the settlement housing movement. Therapists today deal with oppressive structures first hand – either through themselves or through their clients. This is not to say that therapy has always been on the side of social justice. Practices like conversion therapy have caused damage to LGBTQ+ folks, setting back progress decades. So, how are therapy and social justice intertwined? Can therapy truly be apolitical, or is neutrality no longer an option? And how can therapists use their practice to further social justice, while honouring the needs of their clients? De-Centre the Self, Understand the Structure It is a well-known fact among clinicians that poverty is linked with higher rates of depression and other mental illnesses. Those with mental illness can face barriers in education and employment that can push them into poverty; while those living in chronic poverty are more likely to develop a mental illness. A lack of access to resources and support can worsen mental health outcomes for those living in poverty. Oppression also contributes to mental health conditions. Experiencing racism, for example, increases stress and affects mental health conditions such as PTSD, depression, and anxiety. Even just the fear of racism can heighten stress levels, according to multiple studies. So where do therapists fit in? Therapy is often recommended as the first line of treatment for mental health conditions like depression and anxiety. Therapy often focuses on an exploration of the self to facilitate healing. However, for those who are oppressed, discriminated against, or living in adverse conditions, healing may be inhibited by structural issues like poverty. Without an acknowledgement or understanding of how certain conditions or societal issues can impact mental health, therapy cannot be truly effective. If a therapist is unfamiliar with issues such as poverty, racism, dis/ableism, sexism, or capitalism, it is encouraged that they do research to understand the realities of these issues. Many clients who take part in therapy will have first hand experience with these issues, and may require support in that area. Therapist practices can offer support groups directly related to structural issues such as racism or poverty, to ensure that the needs of their clientele are being met. They can also host workshops for their therapists to fill in gaps in knowledge. Support Marginalized Voices, Professionally and Individually Another way therapy practices can pave the way for social change is by opening up opportunities for marginalized folks. Marginalized groups face barriers accessing care, often due to cost or proximity. Providing sliding scales is one way therapists can make space for marginalized folks. Accessibility is key to providing holistic care. There are many barriers to therapy – financial, physical, or logistical. Sliding scales and accessible features are one way practices can make their care more accessible. Hiring therapists who speak other languages can also provide a wider scope of care, as mental health care is in high demand for non-English speakers. Marginalized individuals also face barriers to employment; hence, making the active choice to hire individuals from marginalized backgrounds is a concrete way to affect change. Marginalized voices have historically been excluded from health discourse, but they are essential for providing comprehensive care. Many employers create a statement to hire BIPOC (Black, Indigenous, and People of Colour) clinicians, which – when committed to – can make a difference in increasing diversity. Uplifting marginalized voices is also key within the therapy room. A principal concept of client-centred care is that humans are autonomous and have the right to determine their own path. This ensures that recovery in the therapy room is partly, or completely directed by the client, so that they can meet their needs. For marginalized folks, this may be difficult, as biases or blindspots in the therapist may impede their ability to self-direct. Non-BIPOC therapists must be mindful and allow clients to describe their experience of oppression in their own words. Their job is not to minimize oppression, but to understand it and help the client move towards healing. Giving marginalized voices a microphone, both in their healing and in their professional journey, contributes to the fight for social justice. It is just as important to listen to marginalized voices, as it is to speak up on their behalf. Go Beyond the Couch Care is not just about the individual, but also about the community. As we have discussed, many of the issues facing clients are structural – income inequality, discrimination, lack of affordable housing, etc. Some of these issues can’t be addressed in a therapy office, and must be taken to the streets. Some folks feel they cannot contribute to social change because they do not possess the required skills. The truth is that there are many ways to contribute to social justice. Perhaps you show up through protest or sign making; perhaps you write letters to political leaders or write social policy; perhaps you sell your crafts to fundraise for an issue close to your heart; or perhaps you provide home-cooked meals for those in need. Regardless, there are infinite ways to contribute to social change – and infinite reasons why. If you are a therapist, consider participating in community organizing. You will have a good idea of what issues are close to your clients’ hearts. Is it housing issues? Poverty? Hunger? Once you know, see how you can contribute to changing these issues. Showing up for your clients outside of the office is just as important as showing up for them in session. Justice = Mental Health Care Therapy is as much about changing an individual’s life as it is about changing the world. After all, creating self-reflexive, eternally curious individuals impacts the world in a positive way. However, therapists must go beyond the couch to provide authentic, socially just care. Show up for marginalized folks, professionally and individually. Uplift marginalized voices in your own life, in your community, and in your practice. Above all, keep in mind that social justice is more than a political movement; it is mental health care. Links: https://www.medicalnewstoday.com/articles/effects-of-racism#adults https://ontario.cmha.ca/documents/poverty-and-mental-illness/ https://www.counseling.org/docs/default-source/Government-Affairs/why_social_justice_is_a_counseling_concern-1.pdf?sfvrsn=2 https://www.utpjournals.press/doi/abs/10.3138/CHR.82.1.55 Written by: Catiyana Adam Catiyana, a music enthusiast, and avid writer. She has a keen interest in mental health, illness, and treatment, and is aspiring to be a therapist. Catiyana graduated from McMaster University in 2021 with a Honours Bachelor of Arts in Sociology. She focused on courses in health and illness, as well as families and feminist studies. She hopes to pursue a Master of Social Work at Wilfrid Laurier University next year.
You are Getting Very… Misinformed? The Truth About Clinical Hypnotherapy 27 August 2021 Bliss Team No comments Categories: Book Recommendations, Communication, Events, Grief, Individual Therapy, Inspiration, Life Coaching, Self Care, Therapy In your classic portrayal of hypnosis, you might find yourself staring intently at a swinging pendulum, and listening to a series of repetitive phrases until you are lulled into a state of suggestibility. In this state, a hypnotist could make you sing opera or cluck like a chicken. This isn’t a new idea – hypnotherapy has a long history of being falsely represented as a form of mind control. Clinical hypnotherapy, however, is quite different. Clinical hypnotherapists use hypnosis as a therapeutic tool. Hypnosis, a state of deep relaxation and heightened awareness, opens up the unconscious mind to suggestions. Unlike pop culture hypnosis portrayals, in clinical hypnotherapy, the client is always in control. The client’s brain is just more receptive to imagery, creativity, and new ideas. Clinical hypnotherapy can be a valuable tool for breaking habits, promoting relaxation, and even relieving pain. Hypnotherapy has a long history, and in the 1960s, it gained medical recognition as a legitimate form of treatment. Hypnotherapy is currently not regulated by a medical board, but most clinical hypnotherapists are well-trained and hold Master’s degrees or higher. I sat down with one of our practicing hypnotherapists, Stacey Fernandes (she/her/hers), who discussed with me the roots of clinical hypnotherapy, its applications, and misconceptions. What is Clinical Hypnotherapy? Like all legitimate therapeutic approaches, clinical hypnotherapy is grounded in scientific research. Clinical hypnotherapy has been proven to improve anxiety and depression, with or without adjunct treatment. It is thought to be most effective when combined with other talk therapy approaches such as Cognitive Behavioural Therapy (CBT). Hypnotherapy can be used in an individual or group setting. In both settings, hypnotherapy can be used to gain insight into one’s life, habits, and values. When hypnotherapy is done in an individual session, it is more tailored to the client, and parts can even be recorded and played back after the session is over. Often, participants in hypnotherapy groups will pursue individual hypnotherapy later. The typical trope of a client getting very sleepy before slipping into a trance is misguided and misinformed. In fact, Stacey notes that clients often feel re-energized following a session. Depending on the goals of the client, a clinical hypnotherapist can tailor the session to renew energy or restore peace. Each clinical hypnotherapist has their own style. Stacey shares that her own is very imagery- and nature-based, often involving meditations of forests, hammocks, or beaches. Some clinical hypnotherapists have more colour-based hypnotic scripts. Each hypnotic script is designed to evoke a feeling, action, or emotion. How Does One Become a Clinical Hypnotherapist? Stacey obtained her Master of Social Work degree before furthering her education as a hypnotherapist. It was through her college that she learned of a hypnotherapy training course in Costa Rica. The course was centred around “Breaking the Worry Trance” and was revelatory for Stacey. It was imagery-based, and has since informed Stacey’s own practice. To become a clinical hypnotherapist, Stacey did over one hundred hours of clinical training in Ericksonian hypnotherapy. Ericksonian hypnotherapy uses techniques such as metaphor and imagery to alter behavioural patterns. There are other types of hypnotherapy, which combine other therapeutic approaches, such as psychoanalysis or solution-focused therapy. How Does Clinical Hypnotherapy Work? Clinical hypnotherapy taps into our subconscious mind, moving us away from our analytical brain and into our receptive, creative mind. Often, our brain can meet new ideas with resistance or skepticism. Clinical hypnotherapists ask us not to ignore or avoid these feelings, rather to observe and normalize them. Stacey borrowed a metaphor from renowned hypnotherapist, Grace Smith, to describe how hypnotherapy works: “Picture a bouncer (conscious mind) at a nightclub (subconscious mind). Inside the club all the people are smoking cigarettes and a non smoker approaches the bouncer stating ‘I can help, I’ve read lots of books on wealth.’ The bouncer denies the request because they are unfamiliar, despite this person being safe and offering valuable information. Everyone in the club is very familiar with each other despite it being an unhealthy behaviour. Anything new gets blocked. The non smoker tries to tip the bouncer $100 and gets into the club. The person interacts with everyone by speaking on the microphone and engaging them to drink water instead and providing the benefits of hydration. Eventually everyone starts drinking water and feeling much healthier. Now if a person who smoked tried to get into the club the bouncer would deny them – they are unfamiliar!” This helpful metaphor illustrates how clinical hypnotherapy can be helpful for opening up and expanding our minds. Clinical hypnotherapy can be effective where other therapeutic approaches are not, and can be used to calm and alleviate anxiety. However, it is often met with resistance due to preconceived notions as well as unconscious biases. Yet, with an open mind and commitment to heal, clinical hypnotherapy can be incredibly effective. What Should I Know Before Seeking Clinical Hypnotherapy Treatment? I asked Stacey the question, “What would you tell someone who is thinking about starting clinical hypnotherapy?” and she had some great ideas. First of all, do your research. Since clinical hypnotherapy is not regulated the same way social work and psychotherapy services are, literally anyone can claim to be a hypnotherapist. You want to seek out someone who has other credentials, such as a Master’s Degree in Social Work, or Registered Psychotherapist status. Ask questions about your potential clinical hypnotherapist’s background, training, and experience. Many training courses have a required number of hours of practicing the craft; ask if your therapist has completed these, how many, and where. Inquire about their specialties, style, and interests. Book a consultation with the clinical hypnotherapist to see if you two are a good fit. Like any therapeutic relationship, you want to ensure you have similar styles, goals, and interests. If something feels off, or you don’t feel comfortable opening up to this person, consider looking elsewhere. Remember that clinical hypnotherapy is scientifically-backed, and evidence-based. Your clinical hypnotherapist should be adequately trained and qualified. Treat this like you are finding a new healthcare provider; you want to be confident that the provider has the skills and expertise you are looking for. If you are a beginner to clinical hypnotherapy, consider looking for a practitioner trained in Ericksonian hypnotherapy; this is listed as one of the therapeutic modalities in Ontario, along with Cognitive Behavioural Therapy (CBT) and Internal Family Systems Therapy (IFS). This means that it is recognized as effective by the regulatory board of Ontario for psychotherapy. Most importantly, approach clinical hypnotherapy with curiosity, open-mindedness, and willingness to learn. Embrace and question your skepticism, and move towards healing with patience and wonder. Interested in partaking in clinical hypnotherapy as part of your healing journey? Bliss is offering a virtual hypnotherapy group workshop this Fall, with the aim to Re-Charge and Re-Energize after a year and a half of pandemic life. Run by Bliss therapists, Stacey and Lindsay, it is an excellent opportunity to engage in clinical hypnotherapy. Are you interested in joining the workshop? Sign up today! . Contact community@blisscounselling.ca or call us at 226-647-6000. __________ Written by: Catiyana Adam and Stacey Fernandes Catiyana is Bliss Counselling’s Office Strategist, a music enthusiast, and avid writer. She has a keen interest in mental health, illness, and treatment, and is aspiring to be a therapist. Catiyana graduated from McMaster University in 2021 with a Honours Bachelor of Arts in Sociology. She focused on courses in health and illness, as well as families and feminist studies. She hopes to pursue a Master of Social Work at Wilfrid Laurier University next year. Stacey is a Registered Social Worker, traveller, and adventurer at heart. She is dedicated to learning and advancing her knowledge through workshops, courses, and travel. Stacey uses EMDR (Eye Movement Desensitization Reprocessing) as well as Hypnotherapy and other therapeutic methods in her sessions. She believes in communication, reflection, and slowing down.
How Cognitive and Dialectical Behavior Therapy Works in Recovery 30 July 2021 Bliss Team No comments Categories: Communication, Grief, Guest Post, Individual Therapy, Inspiration, Self Care, Students, Therapy, Uncategorised CBT (cognitive behavioral therapy) and DBT (dialectical behavior therapy) are similar forms of talk therapy, also known as psychotherapy. Both forms of therapy will help you to more effectively communicate, and both forms of therapy can help you discover more about the condition you’re using psychotherapy to address. Both cognitive behavioral therapy and dialectical behavior therapy are evidence-based, meaning a battery of hard data proves the effectiveness of both forms of talk therapy. These psychotherapies are proven effective for treating: Alcohol use disorder GAD (generalized anxiety disorder) Insomnia Major depressive disorder Panic disorders Phobias PTSD (post-traumatic stress disorder) Substance use disorder NAMI shows that roughly 10% of adults in the US will develop a substance use disorder in any given year, with around 20% of American adults also experiencing some kind of mental health condition during that same year. Both substance use disorders and mental health disorders are commonplace, then, and they also frequently co-occur in a dual diagnosis. With both of these conditions so prevalent, drug and alcohol rehab centers use therapies like CBT and DBT in combination with medication-assisted treatment to deliver holistic treatment that’s proven effective for treating a range of conditions. CBT 101 Cognitive behavioral therapy is a highly adaptable form of therapy applicable to many conditions from depression and anxiety to substance use disorder and alcohol use disorder. Once you master the basics, you’ll feel capable of more effectively controlling your emotions and your recovery. CBT sessions are delivered individually or in a group setting as appropriate. Whether one-to-one or as part of a group, you’ll work with a therapist to explore the close and interrelated nature of your thoughts, feelings, and behaviors. Cognitive behavioral therapy can help you view things more objectively, and you’ll also discover that you don’t need to allow how you think and feel to govern your behavior. CBT is a goal-oriented and skills-based form of therapy with a grounding on logic and reasoning. As you pursue a course of cognitive behavioral therapy, you’ll examine how your thoughts and feelings can influence your behaviors. This is especially valuable in the case of destructive or harmful behaviors. Beyond this, CBT will also help you to isolate the people, places, or things that trigger you to engage in self-defeating behaviors. Equipped with the ability to identify these triggers, you’ll then create healthier coping strategies for stressors. When triggered in a real-world situation outside the therapy session, you can implement these strategies rather than being guided by the automatic thoughts that can lead to poor behaviors if unchecked. This is perhaps the most powerful way in which CBT can minimize the chance of relapse in recovery. DBT 101 Marsha Linehan created DBT (dialectical behavior therapy) to treat patients with BPD (borderline personality disorder) when working as a psychologist at University of Washington. DBT has been used since the 1980s to treat a variety of mental health conditions, including: Bipolar disorder Depression Dual diagnosis Self-harm Substance use disorder Suicidal ideation Trauma caused by sexual assault When you engage with dialectical behavior therapy, you’ll learn to acknowledge discomfort or pain while still feeling “normal”. By equipping yourself with the skills to cope with life’s stressors, even in hostile environments, you’ll minimize your chances of engaging in negative or destructive behaviors. DBT sessions are delivered in a module-based format. You’ll empower yourself and your recovery by mastering the following techniques: Distress tolerance: DBT will teach you to better tolerate stressful situations and to more comfortably deal with volatile emotional issues without relapsing or experiencing symptoms of depression or anxiety Emotion regulation: Through DBT, you’ll gain a more thorough understanding of your emotions, and you’ll become more capable of resisting the impulsive and emotion-driven behavior you’re trying to eliminate Interpersonal effectiveness: Dialectical behavior therapy can help you to sharpen your communication skills, improving your interpersonal relationships at the same time Mindfulness: Instead of getting bogged down in the past or anxious about the future, DBT will help you to focus fully on the present with a mindfulness component to therapy applicable to many conditions How CBT and DBT Work for Recovery Your treatment provider will advise you whether CBT or DBT is most suitable for treating your condition. In the case of a personality disorder, for instance, DBT in combination with medication-assisted treatment is likely the most effective approach to treatment. Substance use disorder or alcohol use disorder, on the other hand, often respond best to treatment with cognitive behavioral therapy. The core focus of CBT is the interconnected nature of your thoughts, feelings, and behaviors. DBT acknowledges this interconnection, but focuses on mindfulness, acceptance, and emotion regulation. CBT is proven effective for treating: Anxiety disorder Depression Panic disorder PTSD (post-traumatic stress disorder) Sleep disorder DBT was created for the treatment of BPD, and is still commonly used in this area. There is also robust research on the effectiveness of DBT for treating: Anxiety disorder BPD with substance use disorder Depressive disorder Eating disorders PTSD (post-traumatic stress disorder) CBT vs DBT for Treating Alcohol Use Disorder and Substance Use Disorder CBT and DBT can both be effectively used to treat alcohol use disorder and substance use disorder. A simple course of CBT will help you to pinpoint your triggers for substance use. You’ll also learn to implement coping strategies that don’t involve a chemical crutch. With DBT, you’ll dive deeper, examining the core issue. The mindfulness component of DBT can help many people with substance use disorder to better navigate the emotional imbalances confronting them. DBT vs CBT for Treating Co-Occurring Disorder DBT is proven effective for treating a variety of mental health conditions, from anxiety and depression to PTSD (post-traumatic stress disorder) and ADHD (attention-deficit hyperactivity disorder). These mental health disorders often co-occur with alcohol use disorder and substance use disorder. When DBT is used to treat a dual diagnosis like this, you can address both issues simultaneously through this form of therapy. CBB is used even more often for the treatment of dual diagnosis, delivered in combination with medication-assisted treatment if appropriate. There is a strong empirical evidence base demonstrating the effectiveness of cognitive behavioral therapy for treating substance use disorders. CBT vs DBT for Treating Anxiety Data indicates that CBT is more effective than CBT for treating anxiety. It’s also more effective for treating depressive disorders, phobias. CBT has also been shown to alleviate the symptoms of anxiety associated with PTSD (post-traumatic stress disorder) and OCD (obsessive compulsive disorder) in this meta-analysis of studies. CBT vs DBT for Treating Bipolar Bipolar disorder typically requires integrated treatment combining psychopharmacology with adjunctive psychotherapy. Both forms of psychotherapy are effective for treating bipolar disorder. With CBT interventions, you can manage unhelpful thought processes while establishing a relapse prevention strategy for episodes of mania and depression. With DBT interventions, you’ll learn to sharpen your focus, improve communication and social functioning, decrease negative, self-defeating behaviors, and more effectively cope with emotional pain. Final Thoughts Both CBT and DBT can be effective for treating substance use disorder, alcohol use disorder and a broad spectrum of mental health conditions. CBT can help you to recognise the triggers for poor behaviors with the aim of avoiding them, while DBT will empower you with superior emotional regulation and enhanced mindfulness. ___________________________________________ This is a guest post written by Joe Gilmore, a creator on behalf of Renaissance Recovery. Renaissance Recovery is a drug and alcohol rehab in Orange County dedicated to helping clients kick their substance abuse habit and establish long-lasting sobriety. You can view their website at the following link: https://www.renaissancerecovery.com/
New and Trending Research on Autism 28 June 2021 Bliss Team No comments Categories: Book Recommendations, Communication, Individual Therapy, Life Coaching, Relationships, Self Care, Therapy What is Autism Autism is hard to define. Not only because the definition itself changes all the time, but because it affects our perceptions, communication, social experiences, learning and behaviour; essentially, everything you need in order to get through the world. Any information that is being processed by the senses can easily over-stimulate an individual who is on the Autism Spectrum. On the other hand, an individual with Autism can also have difficulty processing input from their senses. This is why we discuss Autism, as a spectrum, and say,“If you’ve met one person with autism, you’ve met one person with autism.” How to diagnose ASD In order to be diagnosed with ASD, you need an assessment from a professional who can provide an assessment. This professional can be a doctor, social worker, psychiatrist, or psychologist, who are able to provide a screening using certain tools. In Canada and the United States, we use the DSM-5 as our tool for assessment and diagnosis of Autism Spectrum Disorder (ASD). The DSM-5 essentially is like a take out menu; you pick three criteria from column A, two from column B, and 1 from column C, D and E. The DSM-5 also uses a process called, scaling, where the person being assessed is also rated from 1-3 in terms of severity. This is more subjective, as diagnoses are not applied consistently in clinical practice, and as such are less useful from a treatment standpoint. However, the rest of the world uses ICD-11. The ICD-11 uses 3 subtypes or possible diagnoses: (1) Childhood, (2) Aspergers, or (3) Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). IDC-11 includes profiles such as Pathological Demand Avoidance (PDA) , a profile where those on the spectrum may avoid demands that would even be pleasurable for them. Since there are different tools that could be used in order to assess a person for ASD, it means that we aren’t all communicating or understanding ASD from the same reference point, or speaking the same language, and as a result, researchers are finding it difficult to collaborate and synthesize common or generalizable patterns. Another big concern in trending research is the discrepancies between the age of concern (i.e., when behaviours and traits become apparent) and the age of diagnosis. Parents and teachers alike are noticing behaviours such as missed milestones and other common traits in children quite young that could indicate ASD. But, it takes years for the diagnosis. This is an unfortunate reality when it is expected (across all neurodiverse people) that the earlier the diagnosis, the better. As a result, we are losing critical time. Currently, we aren’t really sure how to screen more effectively, although researchers are doing their best to try to close this gap. What is the importance of an assessment Sometimes, when we are faced with a number of challenges, we need support. Some people may wish to receive support without a formal ASD diagnosis. For others though, an assessment may help an individual with accessing additional therapy or support programs such as, disability credits (for the adult or family & caregivers of a child or teen), an Individual Education Plan (IEP), or workplace accommodations. What is it be included in an IEP The best IEPs should be a living document that is changed and updated regularly and follows the person with ASD throughout their educational career. IEPs are mandated to be updated at least once a year, in the Fall when the academic year begins. However, the most effective IEPs are updated throughout the school year, as new information becomes available (i.e., new assessments, new interests, new motivations for goals, etc). It’s important that it also be reviewed regularly with the child’s teachers to ensure that they are up to date on all of the important details. IEPs should also include information on practical supports and longer term goals. For instance, you can ask yourself or your child if they are struggling with processing reading, emotional self-regulation, or other daily tasks and brainstorm ways in which they will be able to receive support in these areas throughout the day. When considering long term goals, such as establishing greater independence and/or self-advocacy, you’ll also want to consider whether it is achievable. Basically, we don’t want to give somebody with an ASD diagnosis a tool they are unable to use. Some goals, like self-advocacy, are quite lofty for a person on the spectrum and need to be broken down into smaller skills or parts in order for there to be incremental progress and success. Legally, IEPs are also to include a transition plan, by the age of 16. This is a very integral part of planning the next steps, as this person reaches the end of high school. IEPs may integrate strengths-based approaches. Typically IEPs have focused on the student needing support, or to be assimilated in the classroom, rather than focusing on where the student is already demonstrating success. A strengths-based approach views neurodiversity as a normal variation of the human genome that doesn’t need to be fixed. When incorporating this approach, we are working to maximize the students strengths, talents, and interests as well as their deficits and restricted interests. This process is collaborative and includes the student’s goals so that it is a helpful resource and tool for the student. When we aren’t collaborative in this process, the student isn’t invested or engaged, and why would they be? They didn’t contribute to the creation of the IEP or share their perspectives, experiences, goals or interests, which may be vastly different from those being provided by the parents, caregivers or teachers. This approach also considers the functions of the behaviour, not just the problem behaviours. In doing so we are pulling back the outer layers, the outward reactions, in order to understand what is happening for this person and why. If, for instance, a student relies on behaviour for regulation, then what are we going to do to support them? What is something else that could fill that same function or regulation piece? There’s value in setting the bar high. But, it’s also good for students who struggle to feel success, even if it means breaking a goal down into its most elemental parts, so that the student can attain it, feel success, and improve their self-esteem. How to navigate transitions Transition strategies are used to support individuals with ASD during changes or disruptions to activities, settings, or routines, by planning ahead (front loading) before the transition occurs. Transition plans are used to create predictability and positive routines around transitions. They can be presented to the individual verbally, auditorily or visually such as: Visual schedule planning (e.g., a white board, paper, excel spreadsheet); Electronic (e.g., timers, calendars, colour coded schedules and spreadsheets); Social stories; Visual memory may be higher than audio, verbal or written memory. By providing a visual schedule of the plan, the individual will be better able to remember and regulate the progression of how things are going to go. You may also want to include different colours to distinguish the events and the individuals favourite activities into the schedule. This way the individual can see that these rewards or interests are coming too. Electronic transition tools are great indicators that there will be a transition as well. Using an app on a phone or tablet, also allows them to take ownership of the transitions. When presented well in advance, social stories can help with preparing for a new transition, such as going to the airport for the first time. In this example, you can write a story of what happens when we go to an airport and walk the individual through the series of transitions (e.g., when we arrive to the airport, we will have to park, then we will have to get our bags from the trunk, then we will have to walk across a bridge to the planes, then we will have to wait in line to weigh our bags, then we will have to show our passports to get our tickets, then we will have to go through security, etc.). You can also add to this by finding resources online such as written, audio or video stories, as well as photos, that explain why we are following these steps. What is the difference between meltdowns and burnout Meltdowns and burnout both occur when the demands of a situation exceed the individual’s coping skills. Meltdowns are brief, they last for minutes to hours. The function of this behaviour is to indicate to the individual that they have just crossed a threshold, and offers them a chance to withdraw or regain their sense of control. In order to fully understand the reason for the meltdown, we need to understand the motivation behind the behaviour so that we can make a plan for managing it in the future. ASD burnout is a newer topic in research. It was identified as a new ASD experience when individual participants described the experience to researchers, and it was found to be a common trait. Burnout lasts approximately 1-3 weeks. If this time is exceeded, that’s when professionals begin to question if there are concurrent challenges being experienced, such as depression and anxiety. Burnout is brought on by an extended period of masking. We see it in those with ASD, who have higher social skills who are camouflaging their autistic behaviours. This process can be emotionally, mentally and physically taxing, and ultimately leads to losses in function. These skills, that they use to manage, end up getting lost or reduced. Burnout is present in teens, young adults, and adults at any age. It can amplify stimming behaviours or sensory sensitivity. Burnout is usually seen during transition stages, when expectations and behaviours have to change. The individual usually has no idea that the burnout is about to happen, until it does. Repeated meltdowns can also result in burnout. One resource, “No More Meltdowns” by Jed Baker, provides practical solutions for structuring and managing meltdowns and burnout. Video modelling (e.g., we are going to go to the doctor, then to the playground, etc.) also helps the individual to understand the expectations. Social narrative power cards and comic strips also help. The individual can make their own and manage their own emotions, by for instance, giving themselves a power up, when needed. Whichever method is chosen, the most valuable aspect is to ensure that the individual with ASD is buying into the tools. Other supports include offering choice (e.g., to wipe the table now or in 10 minutes or choice boards) as it helps the individual move toward the activity or goal, and provides them with supportive lessons in terms of limiting choices and power over the decision making process. As rule oriented people, individuals with ASD may also appreciate systems that incorporate rules and offer explanations as to why the rules are the way they are. How does ASD impact sexuality and gender There is a lot of research that is coming out quickly, that is related to sexuality and gender among individuals with ASD. But, it is limited because such individuals are such a proportion of our population. What we do know from the research however, is that only 50% of students with ASD are receiving the same level of sex education as their neurotypical peers. These individuals are sharing the same physical and sexual experiences as their peers, but are receiving less education on the topic, have fewer social supports, as well as a reduced understanding and application of social skills and awareness of social aspects. As a result, younger individuals with ASD are at a higher rate of sexual exploitation, especially online. The most common and fastest growing areas of vulnerability and exploitation are those who are in their tweens and teens. People online will ask them to do and say sexual things. They are then recorded, threatened, blackmailed, and bribed into doing more sexual things online. This is especially dangerous for neurodiverse individuals, because of the combination of lacking: (1) theory in mind, that is, they don’t understand that people would have a different motivation than theirs; (2) social skills, which prevent them from finding support or finding their way out of these situations; and (3) any preventative legal protections. Research has also been finding a strong connection between ASD and gender expression. For instance, studies have found that there is a higher prevalence of ASD in trans-individuals. There is also an overrepresentation of Individuals with ASD in gender clinics reports. There’s debate as to what the connection could be. For instance, when there are assessments being done, there are some ASD specific assessment concerns such as research which was exploring sensory factors of restrictive interests. In this study, the researchers noticed that young boys with ASD who were interested in sparkly, silky things and long hair. This finding aligns with social scripts of femininity or feminine interest. As a result, this interest could be a behaviour exhibited by somebody whose is questioning or considering their gender, but it could also be a sensory factor. Issues related to gender and sexuality are typically ignored when overlapping with a disability, generally, whether it’s physical or invisible. There is an assumption that the complexities that accompany gender and sexuality cannot exist, once somebody is diagnosed with ASD. These issues that are related to gender and sexuality, end up being treated as an obsession or transient phase. But there is some question around whether or not this is an issue of perception. For instance, a person with ASD may think, “I am a man, but I love baking… maybe I am a woman.” By assigning baking as a women-only interest, there may be an issue with being unable to distinguish a gender identity through the ambiguities of social scripts. This is why it is so important to discuss topics of sexuality and gender, as well as the assumptions of categorization or black and white thinking (i.e., that it has to be this or has to be that). Individuals with ASD also place less importance on social norms and don’t necessarily read social cues so they may not conform to gender binaries or scripts, as they feel less social pressure to follow these norms. Where to receive additional support and resources If you are interested in: Updating your tools and strategies for working with individuals with ASD; Creating an effective and strengths-based IEP; Learning more on the functions of ASD behaviours and regulation strategies; Mastering skills like advocacy, goal setting, and independent living skills; Exploring sexuality and gender as it relates to ASD; Understanding the rights for accommodations as an ASD person at school or in the workforce; Finding ways to connect with self and others Then, book an appointment with Josh and receive support that is uniquely tailored to your needs. CLICK HERE to view his online schedule and find a date/time that works best for your schedule. ___________ Written by: Josh Rinz Josh Rinz (MA, RP, AAT) has a Bachelor of Science in Biology from the University of North Carolina and a Masters of Theology, specializing in Spiritual Care and Psychotherapy from Wilfrid Laurier University in Waterloo, ON. Josh is a leading expert in the mental health field, especially when it comes to working with neurodiverse children and adults, as well as their caregivers! He is committed to quality, evidence-based therapeutic practices that work in collaboration with his clients to improve their emotional, cerebral, spiritual, and relational wellbeing. Josh brings an enthusiastic and innovative approach to therapy. Working with diverse individuals, families, and caregivers, he believes in the importance of creating a safe and engaging space where clients can explore their personal stories and discover their sense of hope within. Josh has the training, the experience, and a very special interest in working specifically with adolescents on the autism spectrum, as well as neurodiverse people and those with additional special needs and considerations. He strongly believes in supporting the whole ecosystem of an individual, which includes providing specialized support to the families and caregivers.
Understanding Borderline Personality Disorder 12 March 2021 Bliss Team No comments Categories: Book Recommendations, Individual Therapy, Therapy, Uncategorised Please note that every person’s experience of borderline personality disorder (BPD) is different. The symptoms and ranges of BPD run both vertically (the number of symptoms experienced) and horizontally (the intensity of how they are experienced). If we also consider other factors that layer and intersect, such as life events (e.g., t/Trauma) and social positions (e.g., financial security, colour of skin, sexual orientation, gender, etc.), our end result is a very unique tapestry of experiences. “People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.” Dr. Marsha Linehan What is Borderline Personality Disorder? BPD is the most common personality disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). This manual is used by physicians and psychologists to make mental health diagnoses. Someone with a personality disorder typically faces unique challenges in: Relationships and social situations; Managing emotions and thoughts; Understanding how certain behaviours are creating problems and/or; Recurring difficulties in changing a mindset to suit different contexts. 75% of people with BPD self-injure one or more times. 10% of people with BPD take their own lives. What are the symptoms of BPD? The DSM-IV-TR lists 9 categorical criteria for BPD. A person must present with at least 5 of the symptoms in order to be diagnosed with BPD. The 9 symptoms can be summarized as: Frantic efforts to avoid real or imagined abandonment, significant fears of being alone; Unstable and intense interpersonal relationships; Lack of clear sense of identity; Impulsiveness in potentially self-damaging behaviours, such as substance abuse, sex, shop lifting, reckless driving, binge eating; Recurrent suicidal threats or gestures, or non-suicidal self-injury such as cutting, burning with a cigarette, or overdose that can bring relief from intense emotional pain; Severe mood shifts and extreme reactivity to situational stresses; Chronic feelings of emptiness, loneliness and neediness; Intense, frequent, short-lived and inappropriate displays of anger, depression or anxiety; Transient, stress-related feelings of unreality or paranoia. Inconsistent symptoms are the hallmark of BPD, which makes it difficult to define a single set of criteria for a diagnosis. This is further complicated, as research has shown that about 90% of folks with a BPD diagnosis, share at least 1 other major psychiatric diagnosis. What is it like living with BPD? “Prick the delicate ‘skin’ of a borderline and she will emotionally bleed to death.” Kreisman and Straus BPD has been described as emotional hemophilia. In the case of BPD, the client will have difficulties with moderating their feelings. Mood changes can come and go quickly and can shift from extreme joy to the deepest despair. A person with BPD may be filled with anger or despair one hour and then calm the next, with little understanding as to why. This then leads to feelings of insecurity, lower self-worth and inner criticism, which brings about more self-hate and depression. Symptoms, such as dissociation, can also interfere with concentration making it very difficult for folks with BPD to complete their tasks. Feelings of emptiness makes a person with BPD feel as though they have to do anything to escape, such as impulsive and self-destructive behaviours, so that they may feel something. People with BPD may also feel as though they do not have a core identity and to overcome their mostly negative self-image, they will create characters or codes. People with BPD may also experience splitting. Splitting can happen at any time, if they are under enough pressure, stress, anxiety, or anger. Splitting is when a person only thinks about a situation or person in binaries. It is the rigid separation of positive and negative thoughts and feelings about oneself and others. For instance, a person with BPD may only consider a context to be right or wrong, good or bad, or in black and white terms without any room for grey. A person with BPD may struggle to accept human inconsistencies or ambiguities, and as such favour predictability. When there is a miscommunication or when somebody they idealize eventually disappoints them in some way, or acts in a way that they did not predict, a person with BPD may look at them as though they cannot be trusted. When this occurs, the person with BPD has to make a decision to either restructure their strict and inflexible conceptualization of this person or to isolate themselves in order to preserve the “perfect” image they had created. Research shows that there is no definitive cause for BPD, rather it is a combination of genetic, developmental, neurobiological and social factors that contribute to its development. People with BPD may come from family backgrounds with parents who were indifferent, rejecting or absent. They may have also received little to no affection and/or experienced chronic abuse. A person with BPD will also seek out new relationships (i.e., partners and/or friendships) quite often. Once in a close romantic relationship they will both crave and become terrified of intimacy; fearing abandonment, they will cling to their partner, which will then lead to fears of enmeshment, so they push away. Because of this, they end up pushing away those they want to connect with the most. Of all the major mental health diagnoses, BPD is the most stigmatized. Stereotypes include viewing folks with BPD as dramatic, manipulative, unfeeling or lacking emotion, attention-seeking and/or narcissistic. They are consistently suspected of wrongdoing, carelessness, anger, and difficulties with building a regular routine. This leads folks with BPD to hide this part of themselves from others. For a person with BPD there are significant fears of abandonment and they will attach to a favourite person and rely on this person for emotional validation and security. Their favourite person becomes the source of their comfort and devotion. A BPD person’s favourite person can be anybody: a relative, parent, best friend, lover, or somebody they just met. The difference between a best friend and a favourite person, is related to the intensity of the thoughts that surround this person. A person with BPD requires compassion, understanding, acceptance, honesty, patience and love. They may not have grown up with either receiving or learning how to share these characteristics with their formative relationships, so accountability for behaviours that are challenging a relationship and empathy, are key. Of course a person with BPD will need to learn how to give themselves the love and compassion that they crave from others, as well. What can you do if you or a loved one is experiencing BPD related symptoms? It is important to recognize that there is no “cure” for BPD, rather somebody who experiences these traits and is receiving treatment may just have more time between self-harm episodes and/or coping strategies to support emotional regulation. Kreisman and Straus have described a structured method of communication, known as SET that can be used when communicating with a person who is in a BPD related crisis, or emotionally spiralling. Support – Use a personal “I” statement of concern to demonstrate a personal pledge to try to support the person in emotional crisis. For example, “I am really worried about how you are feeling.” Empathy – Acknowledge their chaotic feelings with a “You” statement. For example: “You must be feeling awful/scared/hurt/etc.” Truth – Emphasize that this person is accountable to their own life and that others’ attempts to help, cannot avert this primary responsibility. In this statement, you must acknowledge that there is a problem that exists and offer a solution for what can be done to solve it. This must be done in a matter of fact tone. For example, “Here’s what happened…These are the consequences…. This is what I can do… What are you going to do?” It is possible to have a healthy relationship with a person with BPD, especially if you are the favourite person. You can do this in 5 easy steps. Step 1 : Communicate The first step is to have a discussion, to acknowledge that you are their favourite person, and to determine if the relationship is mutual. Questions to reflect on and consider during this discussion are: What are each person’s needs? Are they currently being met? Has there been an instance where either person’s needs weren’t met, why might that be and how might you both be able to overcome this in future interactions? What are both of your feelings regarding space and emotional boundaries? Step 2: Avoid Assumptions BPD folks generally think in black and white (e.g., “they don’t love me anymore”). In order to avoid this assumption and the potential for an emotional crisis, or “testing” the favourite person to make sure they still do love them or won’t leave them, the BPD person should feel comfortable with being direct and asking for reassurance from their favourite person (e.g., “Is everything alright? I’m just worried because I haven’t heard from you in a while”). Step 3: Develop More Friendships It is comfortable and easy for a BPD person to give all of the love and everything they have to their favourite person, but it’s a lot of pressure to receive and also reciprocate as a single human being. This is why it is important for both the favourite and BPD person to have friends of their own that they enjoy spending time with. This will help the BPD person with the intensity of putting all of their emotional needs on one person, and will also help the favourite person to have other outlets and their own support. It’s important that the BPD person avoids scheduling their plans around their favourite person. Step 4: Limit Expectations This is one of the most difficult ideas for a BPD person to incorporate into their worldview, but it is to cultivate a mindset in which their favourite person may leave, by choice or not, and this is okay. This requires a mindful appreciation for enjoying the day for what it is. No matter what happens. It is not possible to control a person or to demand that they be committed to your relationship or friendship forever. Thinking of the future and the possibility that they could leave, may generate anxious thoughts and feelings of being abandoned. Instead, the BPD person can try practicing gratitude for the current state of their relationships. Step 5: Therapy & Medications Treatment for both the BPD and favourite person usually begins with education; discussing what is known about BPD and its causes, as well as how the BPD person can self-manage and prevent relapses. Therapy and counselling may also be offered at the individual or group level for both the BPD and favourite person. The BPD person may also wish to take prescription medications that align with their specific symptoms (e.g., mood swings or anxiety). There are a number of therapeutic tools that can be used in the treatment of BPD symptoms. The 2 major tools are cognitive behavioural therapy (CBT), which focuses on the present and on changing negative thoughts and behaviours, and dialectical behaviour therapy (DBT) which uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and the client’s emotional state. DBT helps clients to regulate intense emotions, to reduce self-destructive behaviours and to improve relationships. It’s important to remember that like any relationship, the connection you build will be at it’s healthiest if it is constructed on a foundation of trust, friendship, mutual respect and care, honesty and accountability. At Bliss, we want to help our clients navigate the complexities of BPD and help them live balanced, happy, fulfilling lives. If you need additional guidance, please book an appointment with one of our therapists who specialized in this area and will guide you through the therapy process in a safe, non judgemental atmosphere: Sheila Mcdonough Sergius Semuyeh Valentina Messier Josh Rinz Marni Moss You do not have to go through this alone. Bliss is here to support you. Written By: Jess Jess is our amazing office strategist at Bliss Counselling. Jess is a Master’s graduate from the University of Guelph. During this degree, they focused on aging and end-of-life, communication, human sexuality, LGBTQI2S+ health, inclusive practice and policies, knowledge mobilization strategies, research methods, and program evaluation. I would like to learn more about BPD, what other resources exist? For more information and support, please consider the following resources. Books Beyond Borderline: True Stories of Recovery from Borderline Personality Disorder by John G. Gunderson (edited by Perry D Hoffman) Building a Life Worth Living: A Memoir by Marsha M. Linehan Coping with BPD: DBT and CBT Skills to Soothe the Symptoms of Borderline Personality Disorder by Blaise Aguirre I Hate You – Don’t leave me: Understanding the Borderline Personality by Jerold J. Kreisman and Hal Straus Loving Someone with Borderline Personality Disorder by Shari Y. Manning Mastering Adulthood: Go Beyond Adulting to Become an Emotional Grown-Up by Lara E. Fielding The Dialectical Behaviour Therapy Wellness Planner: 365 Days of Healthy Living for Your Body, Mind, and Spirit (The Borderline Personality Disorder Wellness Series) by Amanda L. Smith The Mindfulness Solution for Intense Emotions: Take Control of Borderline Personality Disorder with DBT by Cedar R. Koons This is Not the End: Conversation on Borderline Personality Disorder by Tabetha Martin The Dialectical Behaviour Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation and Distress Tolerance by Matthew McKay, Jeffrey Wood, and Jeffrey Brantley Online Documents Borderline Personality Disorder: An Information Guide for Families by CAMH https://www.camh.ca/-/media/files/guides-and-publications/borderline-guide-en.pdf?la=en&hash=69DE097DD9DC16A66440FCD4573E73358AEEECEC Borderline Personality Disorder by the National Institute of Mental Health https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml DBT Skills Training Handouts and Worksheets by Marsha M. Linehan https://projecticee.files.wordpress.com/2018/12/lin-c-dbt-handouts.pdf The Overlap Between Autistic Spectrum Conditions and Borderline Personality Disorder by Dudas et al., (2017) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590952/
Chronic Wounds and Mental Health – An Overlooked Connection? 19 February 2021 Bliss Team No comments Categories: Guest Post When we think about our health, what often comes to mind are physical health issues like cancer, diabetes, and cardiovascular disease. These conditions do deserve significant attention, and certainly do pose a risk to our health. However, along with many of these conditions, there is another complication that does not garner as much attention, although it does significantly affect our health: our mental health. Chronic wounds are those wounds that do not heal in the expected time frame and do not follow the normal healing process. The result is an ongoing battle to overcome the wound and return to an active lifestyle. Coping with a chronic wound can feel like an uphill battle with no end in sight. This is also why chronic wounds can affect our mental health so dramatically – because they seem like injuries that cannot be overcome. What Is Mental Health? Mental health can simply be defined as the absence of mental illness. However, mental health deserves a much broader definition and more widespread recognition than it is given. It can be the difference between functioning at a satisfactory level and truly embracing and enjoying our lives, especially when it comes to chronic wound care The World Health Organization defines mental health as “subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one’s intellectual and emotional potential, among others.” Ultimately, our well-being includes the realization of our abilities, coping with normal stresses of life, productive work, and contribution to our community. Our mental health also affects how we think, how we perceive the world, the actions we take, and how we feel on a day-to-day basis. It can also contribute to how we handle life’s stresses, setbacks and failures, and our relationships. All in all, mental health encompasses just about everything we experience as humans, which is why it’s so important. According to the Centers for Disease Control, nearly one in five U.S. adults live with a mental illness (46.6 million in 2017), with an estimated 11.2 million adults aged 18 or older in the United States with what can be classified as a Serious Mental Illness. This means 4.5% of all U.S. adults cope with some form of mental illness. Many factors contribute to our ability to maintain our own mental health. These include any biological problems we may have, our life experiences, our family history, and any health conditions we are coping with – such as chronic wounds. How Do Chronic Wounds Affect Mental Health? According to the National Institute of Mental Health (NIMH), the presence of chronic conditions can increase the risk for mental illness. For example, conditions like Parkinson’s disease and stroke cause changes in the brain, which may trigger symptoms of depression. Depression is also common in people who have chronic illnesses such as cancer, coronary heart disease, diabetes, Alzheimer’s disease, HIV/AIDS, rheumatoid arthritis, lupus, and epilepsy, among others. Chronic illness can also cause feelings of illness-related anxiety and stress related to coping with wounds. Moreover, when depression and anxiety are present, the symptoms, as well as those of the chronic health condition, tend to be more severe. The NIMH also says people with depression are at higher risk for other medical conditions. As an example, people with depression have an increased risk of cardiovascular disease, diabetes, stroke, Alzheimer’s disease, and osteoporosis. One explanation for this is that mental illness may interfere with the ability to cope with chronic health conditions. For example, with mental illness present, a person may find it more difficult to seek care, take prescribed medication, eat well, and exercise. Lastly, preliminary research suggests that symptoms of depression and anxiety can cause signs of increased inflammation, changes in the control of blood circulation and heart rate, increased stress hormones, and metabolic changes that increase the risk of diabetes – all of which impact our health and our ability to cope with chronic health conditions. How Can Mental Health Be Improved While Coping with Chronic Wounds? The process of wound healing comes in four stages and it’s imperative to maintain mental health throughout each of them. While the most common treatment strategies for mental illness include cognitive behavioural therapy (CBT), medication, such as selective serotonin reuptake inhibitors, (SSRIs), and, in the most severe cases, electroconvulsive therapy (ECT), there are many lifestyle changes that we can incorporate every day to improve our mental health. Psychology Today suggests the following nine, all of which apply especially to chronic wound care patients: Be positive. While it is easy to overlook the automatic thoughts that run through our heads, when combined, they can add up to a negative outlook. When we see life through a negative lens, we tend to focus more on the things that confirm that belief. On the other hand, when we incorporate positive thoughts, these often lead to positive interpretations. For example, rather than saying, “I can’t do anything right,” try saying, “It didn’t work out this time, but I will try again.” Be grateful and write it down. It’s now clear that feelings of gratitude do significantly affect our mental health. When we can find things in our lives to be grateful for, not only do we feel differently, we also act differently – in ways that often lead to additional mental health benefits. One quick way to start is to keep a gratitude journal, or better yet, try practicing three acts of gratitude every day. Focus on what we can control, and be in the moment. Both ruminating about the past and forecasting the future can cause feelings of regret, depression, and anxiety. We can’t do anything about the past or the future. However, what we can do is stop and choose to focus on what we can control – our actions in the present moment. One easy way to do this is to simply pay attention to your routine activities and the thoughts that accompany them. Get active. Exercise is one of the most palpable ways to gain a sense of control. When you exercise, despite what else is happening in your life, you remind yourself that you can do something positive for your mind and body. Further, exercise increases stress relieving and mood lifting hormones, which have both an immediate and ongoing effect. Exercise can be incorporated in 30-minute blocks, or you can simply look for small ways to increase your activity level, like taking the stairs, going for a walk, or playing with your dog. Eat right. What we eat provides our brain with the ingredients to function well and improve our mood. Carbohydrates increase serotonin, which makes you happy, while protein-rich foods increase norepinephrine, dopamine, and tyrosine, which help keep you alert. Fruits and vegetables provide nutrients that feed every cell in the body, including mood-regulating brain chemicals. Lastly, foods with Omega-3 polyunsaturated fatty acids (found in fish, nuts, and flaxseed) can improve both our cognitive function and our mood. Open up. When we bottle emotions up, we don’t give ourselves an opportunity to cope and find creative solutions. We also dampen our ability to recognize our own habits, which may be contributing to how we feel. On the other hand, when we open up to someone else, we can pinpoint the positive aspects in other people (such as feeling valued or experiencing a sense of trust) and overcome our own biases. Do something for someone else. Like acts of gratitude, being helpful to others has a beneficial effect on how we feel about ourselves. Moreover, being helpful helps us feel valued, which contributes to positive self-esteem and helps us find a sense of meaning in our lives. Chill out. Sometimes in moments of high stress what we really need to do is step away. Often by simply slowing down, we can gain a greater perspective on what is going on, and in the process, find a positive solution. You can start with focusing on something that brings you positive feelings, such as a person that you love, an experience you enjoy, or something you are grateful for. You can also talk a walk, spend a moment in nature, or close your eyes and visualize yourself feeling calm and at peace. Get a good night’s rest. Sleep deprivation has a significantly negative effect on our mood, and sadly many of us don’t get enough sleep. Sleep can be improved with a few daily habits such as going to bed at a regular time each night, avoiding caffeinated beverages for a few hours before sleep, shutting off screens before bed, or incorporating relaxing activities before bed. There are many powerful components of mental health, like enjoying our lives, feeling as if we are striving toward something important, utilizing our skills, and seeking to reach our full potential, to name a few. And while chronic health conditions are often an overlooked deterrent to mental health, incorporating daily habits -i.e. replacing automatic negative thoughts with positive ones, performing acts of gratitude, staying in the moment, exercising, eating well, opening up, being helpful, taking time out, getting enough sleep, etc. – we can combat mental illness even amidst difficult chronic health conditions. Written By: Claire Nana Claire Nana, LMFT, is a Licensed Marriage and Family Therapist who specializes in post-traumatic growth, optimal performance, and wellness. She’s written over thirty continuing education courses on a variety of topics from Nutrition and Fitness, Mental Health, Wound Care, Post-Traumatic Growth, Motivation, Stigma.
To my Quaran-tine: How can we navigate our relationship during a pandemic? 14 February 2021 Bliss Team No comments Categories: Book Recommendations, Communication, Self Care, Sex Therapy, Sexual Wellness Due to the restrictions on dating activities that would normally happen during Valentine’s Day, couples may feel like it’s going to be just another day. Which can be disappointing to those who enjoy taking a break from the repetitiveness of everyday life relationships. This is a universal conflict for all couples, new or old, healthy or strained. COVID-19 did not just impact how people meet, but also the exploration of romance and even how much time people spend together. For partners who are living together and are spending more time with each other at home throughout COVID-19, emotional connection has improved; physical connection on the other hand has not. The amount of time spent with partner(s) does not necessarily equate to “quality time”. For instance, more time together could mean more conversations about things each person isn’t happy with within their relationship or changes they might like to see. Some partners may realize they aren’t as compatible with each other and may be starting to realize that they want different things. Some relationships may be trying to work through betrayal, such as infidelity, and are finding it difficult to not be able to take space from their partner(s), as they try to figure out what they want. If we layer in those relationships who have children, it’s even more difficult to have privacy and to take time to grieve aspects of the relationship when the kids are around and people are isolated from their support systems, like family, friends, co-workers. For those who are dating, there is also a lot more communication and negotiations of boundaries during COVID-19. For instance, folks may be asking themselves: Is it safe to be discussing COVID-19 related precautions with this new person? How do we discuss and navigate consent? Should I be isolating after sharing a physical connection, and if so, for how long? Are relationships that came to fruition during the pandemic going to last past the pandemic? A list of common challenges people have felt in their relationship during COVID-19 includes: Experiencing Low sexual desire and desire discrepancy Sharing less physical intimacy or avoiding sex Overcoming infidelity Finding ways to effectively communicate feelings and listen to alternative perspectives Managing erectile dysfunction & rapid ejaculation Exploring sexuality Reconnecting sexually Wanting to open up the relationship Sometimes when there is a crisis, it can either connect and bring partners closer or it can have the opposite effect. It’s important to remember that relationship bumps are inevitable, pandemic or not, No matter the situation, great new things will come from this, even though it’s hard right now. At Bliss, we want to help our clients through these challenging times. Navigating relationships during COVID-19 can be hard, but not impossible. Here are some tips from our very own therapists who specialize in sexual health and wellbeing in relationships: Have separate time You’re not going to desire someone when you spend all of your time with them. Do what you can to separate yourself. That could mean, self-care, taking up jogging, biking, connecting with friends, and having outdoor hangouts in safe ways. Do not feel guilty for taking time for yourself. Increasing pleasure and fun Figure out target specific activities you can do at home, or outside, these can be brainstormed with your therapist. Some activities you can discuss with your partner(s), or date are: Exercising Board Games Movie Marathons Puzzles Planning Future Fun Events Cooking Together DIY Spa Dates Bubble Baths Colouring Dressing Up For A Date Night In Reading To Each Other Paint Night Online Classes Yoga Stargazing Create a Photobook Of Memories Long Drives Bake Off Share Your Favourite Stand-Up Specials Streamline a concert together Make (chocolate) fondue together Make breakfast in bed Recreate your first date, from home! Make your own valentine Ask conversation starters, or quiz yourselves on your love maps! Write each other a poem or haiku Write each other love or gratitude letters Cook a romantic dinner, with candle light and all (some of these ideas are great for an COVID friendly Valentine’s) Open Communication Anxiety about COVID-19 leads to stress and irritability in the relationship. Effective open/transparent communication around what you are going to do is key. Whether it is with your partner(s) or someone you’re dating. If you have the same perspective, it’s okay. If you have two different perspectives, or pre-existing anxiety and OCD, it will affect the relationship. So, discussing boundaries and negotiating “dating terms” should be at the forefront of conversation. Managing Stress If you find yourself being hypervigilant in managing emotions, minimizing conflict, protecting kids from the tension or outburst, you may be giving yourself additional unnecessary stress. In managing stress levels, remember that you cannot control anyone else’s emotions except your own. You must let your partner(s) regulate themselves. For those in couples or individual therapy, this is something you can talk to your therapist about. Finding ways to regulate your own emotions will help in figuring out how to move forward with your partner(s) with no resentment. It’s really important to normalize your experience and your partners’ relationship concerns. Our therapists here at Bliss validate client’s emotions and experiences while supporting them in reframing thoughts, changing habits, breaking patterns, and getting out of cycles they may be stuck in. Navigating relationships during a pandemic can be hard. Give yourself more credit, and Happy Valentines Day! Resources: Come As You Are by Emily Nagoski, for desire/arousal in women. Better Sex Through Mindfulness: How Women Can Cultivate Desire by Lori Brotto Not Always In The Mood by Sarah Hunter Murray, for low desire in men and myths around male sexuality Esther Perel – Infidelity Written By: Raman Dhillon Raman Dhillon is the office strategist & digital content manager and helps assist our clinic/operations manager Jess. Raman has a background in Psychology & Literature from the University of Waterloo, and more recently a Post Graduate Degree in Mental Health and Addictions from Humber College. Raman has experience with client-centered intervention as well as holistic assessment. She’s very interested and well versed in different therapeutic approaches such as mindfulness, naturopathy, and art therapy. Raman loves merging her two passions, mental health, and art to convey messages, psychoeducation, and awareness to the masses.
Tips for Handling Stress, Anxiety and Depression During the COVID-19 Pandemic 7 January 2021 Bliss Team No comments Categories: Uncategorised The current times, they sure are strange. It is perfectly normal during these tense times to be overwhelmed and to feel fear and anxiety when facing a new disease. Besides that, public health measures, such as social distancing and working from home, can make people feel isolated and lonely and increase stress and anxiety. Here are some tips that can help you cope with the challenges that the pandemic brings. Keep in touch with your loved ones Don’t allow the feeling that you are on your own to take hold of you. It is more important than ever to stay connected with the people you love and trust during difficult times. Being cut off from the love, support, and close contact of family and friends can trigger depression or make existing symptoms worse. Back when the first lockdowns began around the world, it was easier to think we could get through it on our own because we believed the restrictions would only be in place for a short period of time. As we enter 2021 still facing the same challenges, it is crucial that we realize we must stay in touch with our support networks to get through this. If you can, meet the people you care about in person while adhering to the current social distancing measures. If not, use video calls and social media to maintain any form of contact. These times might even be an opportunity to reach out to the old friends you have fallen out of touch with. Remember, we’re all struggling, and everyone could use a bit of human contact. Talk about your feelings It is crucial to be able to admit to yourself that you are not feeling okay. Without acknowledging the emotions you are experiencing, you won’t be able to deal with them. Once you manage to overcome this hurdle, it is equally essential not to keep all your negative emotions to yourself. If you don’t want to burden those around you, seek help from a professional. Doing this is the best thing you can do for your mental well-being. You can do so even without leaving the comfort of your home, as many places offer remote therapy or counseling. Remember to be kind to yourself One of the trickiest things about anxiety and depression is their ability to self-perpetuate. Once you go down the spiral of depression, you have even less energy than before to deal with the negative things in your life. In turn, this makes you even more depressed or susceptible to depression, and the circle goes on. This is why you should do your best to remember that you have value and to practice self-belief. Self-belief incorporates self-care and believing in yourself, and as such, it can be essential for a healthy mindset during the Covid pandemic. Be supportive of others as well If you feel healthy and capable of doing something for those in need, do it. Helping others can help you as well as them. See if there are any local community groups that you could join to help people around you locally. (If you do go out to offer support or help to others, always follow social distancing guidelines when you are outside your home.) Another option is to find a friend or family member nearby who is affected by Covid and try to help them. If you cannot help this way, try to be a little more understanding of other people’s concerns, worries, or behaviors at this time. Take care of your body Many people reach for unhealthy coping mechanisms such as junk food, alcohol, or even drugs during uncertain times like these. Do your best to avoid these traps, as your physical health has a significant impact on how you feel. All these things might provide a short relief, but in the long-run, they’ll make your anxiety or depression symptoms much worse. Try to eat healthy, well-balanced meals, drink enough water, and exercise regularly. Avoid smoking or drugs, and try not to drink too much alcohol. If you can, go for a hike or a bike ride, as those can help you clear your mind and reconnect with nature while simultaneously boosting your overall health. Getting fresh air and catching some rays is particularly important in the winter when the lack of sunlight lowers our levels of D vitamin, making us more susceptible to seasonal affective disorder. Try to do the things you love One of the worst things you can do for your mental health during this pandemic is to let the routine take over the control of your life. Being stuck in a rut is never a good thing, but during times like these, it can make you less likely to turn your attention and energy towards the things you love doing, the ones that can fill you with positivity. Focusing on your favorite hobby, relaxing, or connecting with others can help with anxious thoughts and feelings. If you cannot do the things you usually enjoy, think about how you could adapt them, or try something new. This is also important: when the pandemic started, everybody talked about self-improvement and set up huge goals for themselves. As you might have seen already, most of those grandiose plans have failed. It is essential to judge yourself on your own merits. Every small accomplishment counts. Even if all you do until the end of the pandemic is to stay safe and maintain your mental and physical wellbeing, that is no small feat, especially as we begin to realize this is a marathon, not a sprint. _____ Written by: Rebecca Brown I’m Rebecca, a translator, avid traveler, and a bookworm. My job has given me the amazing opportunity to travel to dozens of countries around the world, and writing on Rough Draft gives me a chance to try to showcase some of them.