What’s Your Bliss? Episode 1 with Valentina 10 November 2022 Jess Boule No comments Categories: Communication, Guest Post, Podcast, Relationship Therapy, Relationships, Sex Therapy, Workshops Welcome to What’s your Bliss – a podcast on what’s coming up in gender, sex and relationships, directly from our couch! Each episode our therapists will share stories, ideas, theories, perspectives and questions, intended to feed your curiosity about what brings you Bliss! For our first episode, Valentina Messier describes how she uses Acceptance and Commitment Therapy (ACT) in relationship and sex therapy! Considering multiple perspectives and the situation, anchoring yourself, and knowing your individual and relational values can be helpful tools that support your communication and the level of intimacy you share in your partnerships. LISTEN TO THE FULL EPISODE: https://www.blisscounselling.ca/wp-content/uploads/2022/11/001.mp3 FULL EPISODE TRANSCRIPT: Jess: Hey there! I’m Jess and this is What’s Your Bliss. [Intro Music] Jess: Welcome everyone to our very first episode of What’s Your Bliss, hosted by yours truly and on behalf of Bliss Counselling + Psychotherapy in Uptown Waterloo. What’s your Bliss is a podcast on what’s trending in sex and relationships, directly from our couch. I’ll go ahead and disclose right away that I am not a therapist, however I am a sex educator and activist and I have been working for Bliss for about 3 years now. When I started at Bliss, I was a Client Service Team member. I would sit at the front desk and chat quite a bit with our clients and then of course, our therapists. In probably about a minute or less I would learn so much about each of our therapists, who they are personally and professionally. I was then able to share some of these ideas with our clients calling in, which helped so much when they were looking for a therapist who could be a really great fit. At the time, when I first started working for Bliss, we probably only had about 8 therapists on our team. But, over the past few years we have grown into a roaster of about 30. Despite the challenges that COVID brought, our team somehow still has the same, if not deeper sense of intimacy that comes with being a small clinic. And now that there is more of us and we have so many more opportunities to connect (which I’ve got to say I am so grateful for!), there’s also a lot more ideas to share. I hear you asking, “Why am I not doing what I was doing before, why start a podcast and bring all of you into it.” Well, I’m no longer on the front desk. We’ve actually hired some new and wonderful people who are now flourishing and making that a role of their own. And while, I am still connecting with our therapists regularly to witness and to learn so many valuable insights from them – like a true educator or maybe even a really oddly proud parent, I have this idea or this need to share with all of you the stories, ideas, theories, perspectives and questions about sex and relationships that I hear in a day. So keep in mind that these are super informal conversations. We are not doing therapy here! But, our chats are intended to support your connection and to feed your curiosity about what might be your bliss. However, if you might like to speak to one of our therapists, give our office a shout! Those wonderful folks that I was mentioning before they would be super happy to help you out with finding someone on our team who could be a really great fit. So I guess with all that being said and out of the way with – are you ready for our first episode? Because I sure am! I have been waiting on this for a few months now. So let’s get this thing started with our very own Valentina to learn more about her bliss, which is the use of Acceptance and Commitment Therapy as a therapeutic tool or approach. So Valentina, maybe we could kick this thing off with you telling us a little bit about you first. Aside from Acceptance and Commitment Therapy what else is your bliss? Valentina: Yeah, so I can tell you about myself. I guess the obvious is that I am a Registered Psychotherapist here at Bliss. Um, but outside of work, I am also a cat-mom, I am a mom to be and I consider myself, creative. So I love like incorporating that in almost everything that I do. Whether it’s like cooking or um, doing some creative writing. Uh yeah… Jess: I didn’t know you got into creative writing. Valentina: I do yeah, it’s more just for myself as a means of expression, it’s not really anything I share with other people, but… Jess: Totally! So we’ll edit this out, you’re like, “Do not talk about my creative writing.” But that’s so cool. Like, what kind of things do you write about though? Just out of curiosity, I’m just being nosey now. Valentina: Yeah, so for me a lot of it is poetry. I like the word play component and… Jess: Yeah. Valentina: I usually try to draw from like feelings. So… Jess: Cancer right? Valentina: Yeah! Jess: Yes! This is um my partner, she like absolutely loves poetry and I feel this for anyone who either writes poetry or like really loves reading poetry is that they get like such higher, I don’t know how to say this, it’s like this higher vibration of thoughts. And she just gets so intentional with the words, like even with song lyrics and everything too, like…It’s so incredible. Valentina: Yeah, that’s like the first thing I pay attention to when I hear new music is like the lyrics and what story is being told. So. Jess: Yeah Valentina: That’s interesting Jess: And I’m sure that’s really like the perfect segue too because I’m sure that’s a lot of the skill that you bring into your therapy sessions. Valentina It is! It is and I think that in general, I have a curiosity about people and their stories and I try to bring that into our therapy sessions and I like to have a person centred approach and a strengths based approach when working with people. But, I also love to explore thoughts and feelings and get to know more of the context around a person and their life. So… Jess: And is that like… is that what drew you to ACT as well or? Like how does that fit in? Valentina: Definitely! It is something that has drawn me to Acceptance and Commitment Therapy. Um, Acceptance and Commitment Therapy looks a lot at context. Um sometimes the things that we do in one situation might not be appropriate in another situation or the thoughts that we have during one period of our life may not be the same thoughts that we have later in life. And so, I just love looking at the big picture and how everything fits into that um … and looking at which factors in our lives motivate us. Whether it’s the feelings, whether it’s life circumstances and what that motivation leads to as far as what action we’re taking. And how that fits into the life that we want to create for ourselves. Jess: Yeah, if I’m understanding correctly, just like, ACT can help somebody almost not to think so black and white maybe. Valentina: Definitely! I think a lot of times when we find ourselves thinking black and white, we miss a lot of what’s actually happening. So I do encourage people to kind of explore that grey area, in between the black and white and ask questions like, “Well, what purpose does this thought have in my life or this behaviour have in my life?”; “How is it serving me?”; “What about my situation right now is leading me to feel the way I am feeling or act the way I am acting?” Jess: Mhmm. So you can really hear that piece around the values coming in, like “What are my values and is that actually in line with my values?” Valentina: Exactly. Jess: Umm… Is this something that you feel as though comes up with like premarital sessions that you do? Valentina: One thing I notice with couples, when it comes to communication, I catch people having these mental rules. Um, sometimes one partner feels things have to be run a certain way or be done a certain way and the other partner has a completely different mental rule for themselves and for how things need to be taken care of. Um, so it can be so useful to come back to values and ask what is the shared vision for the future of this relationship and what are the shared values that you both have and is sticking to these rules or clinging tightly to them, serving that shared vision, serving the relationship. Once we build awareness around our own thinking or these mental rules, it’s a little bit easier to let go of them and realize “Okay you know what, maybe I have these rules because of my own upbringing and the things I was exposed to myself. My partner has different rules because of their upbringing, their context and we don’t have to let that divide us. We can connect over something that is more meaningful and more important for us. Jess: I suppose though, I am curious if it, if ACT comes up with sex, but I also don’t know if that’s been coming into your sessions at all. Valentina: So I think that ACT can play a role with regards to issues around sex, I think a lot of times we get caught up in our head and that can take away from being fully present when we’re trying to sexually engage with a partner. Sometimes building awareness around our own thinking and realizing we might be having thoughts like, “My partner should be the one initiating” or “I don’t feel attractive” um, then we can better understand like what our barriers are and what’s getting in the way. And with ACT a big component is actually mindfulness practice. So learning to detach from some of those thoughts a little bit and shift your focus with some flexibility more towards the experience in the moment and one way of kind of detaching from those thoughts that might not be serving you in the moment when you’re trying to be sexually intimate with a partner is simply noticing and naming – which seems pretty um I guess simplest, but by saying I’m noticing my mind is having the thought that I’m not attractive or I’m noticing my mind is making a judgment about my partner. Even that moment of time where you’ve stepped back and noticed your thinking, that provides you with an opportunity where you can be conscious about what happens next. So if we bring it back to values, if sex is important to you because you value that connection with your partner, then you can ask “Is buying into this thought or buying into this judgment bringing me closer to that?” Or should I give myself permission to let go of that and try to focus in on what will actually bring me closer. Jess: And so what would you say could be the differences I suppose between ACT, CBT, DBT. Valentina: Yeah, that’s a really good question. With ACT, CBT, and DBT, there are some similarities. Like all of these approaches examine behaviours, thoughts, feelings but there are some differences. Um, one of the most notable differences between ACT and CBT is the way that we approach our thinking. So in CBT a lot of times what we are encouraged to do is challenge the content of the thoughts we have. So, I”ll give an example, if you have a thought, “I’m not good enough” and I think that’s a pretty common thought most people can relate to. CBT might encourage you to look for evidence that you are good enough and to try to counter that thought or to change that thought into something different. Um, whereas with ACT the aim is rather than assessing the content of the thought, we look at the function of the thought. So for some people, CBT can be helpful they’re able to kind of disprove their thought and they feel better but sometimes that’s not enough and they still find themselves feeling not good enough. With ACT if you’re looking at function rather than asking if this thought is true or is this thought false, what you’re doing is asking, “Is this thought helpful for me?”; “Is this serving me?”; “Is this bringing me closer to who I want to be or the life I want to have?” Regardless of whether or not it’s true or false. Jess: Yeah, yeah, I can absolutely see that and especially in the examples you have given now. If I’m feeling like, maybe that low self-esteem, body kind of feeling and I’m judging myself I might try to change my thought pattern to be like, “Well, I can see my partner is really enjoying this, so it’s okay!” Valentina: Exactly! So you’re looking for evidence like, “My thought is false clearly, like my partner is liking this so they must be attracted to me.” And so those are instances where CBT can be helpful but sometimes though it has its limits, where even when somebody is recognizing that the brain is pretty powerful and will say, “Well that doesn’t mean that your attractive.” It will kind of mess with you a bit. Jess: Exactly! That’s what I was going to say, it’s almost like there’s a lack of validation in it of being like, that thought is also okay, right? Valentina: Right! Jess: But does it actually serve what I’m trying to do here or the goal that I’m trying to achieve, essentially. So is that where ACT gets its name from…? Like Acceptance and– Valentina: Commitment Therapy. It is related to that. ACT is a third wave cognitive behaviour therapy. The first wave of cognitive behaviour therapy was the behaviour component and then the second wave was the cognitive component and now this third wave focuses on acceptance. So we shift away from trying to get rid of unwanted feelings and broaden our focus to incorporating more meaningful action and accepting those feelings in our life and I want to clarify that a lot of people don’t like hearing accepting unwanted feelings, but what I mean by accepting is acknowledging that they are part of our reality not necessarily approving of them. Like clearly, they are unwanted- you’re not approving of them but recognizing when we have no control of that. Most of us might wish we had like a delete button in our brain where we could just get rid of thoughts we don’t want or get rid of feelings that are bothersome to us, but we don’t have that power. So a lot of our control actually lies within our actions which is part of why we call it ACT and um, part of letting go of that struggle is accepting, the acceptance part, um what the reality is and then we commit to values guided action. So it is Acceptance and Commitment Therapy. Jess: Yeah! Um. Who do you think could benefit from ACT? You know? Like I know we’ve talked about um folks in relationships or doing premarital counselling or folks who it sounds like, may be having some challenges with sex and intimacy with their partner. Uh…who else could be like a really good fit for ACT? Valentina: Yeah so, I may be biased because I love this approach, but I think that most people would benefit from ACT. And the reason why I think this is because so much is based on function. Like all of us have the capacity to ask ourselves how things are working in our lives. Um, and we all have the capacity to explore our personal values and those things that add a sense of meaning to our lives. Um, sometimes when we utilize like a thinking sort of approach where we’re sort of examining our thoughts we might get the feedback that, that sort of top-down, using the tops of our brains and trying to move down approach doesn’t work for people who are experiencing trauma or trying to get through post traumatic stress. However, with ACT there is this experiential component as well, which is that mindfulness piece where we get in touch with the sensations of the body. Um, so I think even for those individuals, ACT can be effective. So it’s kind of both a top-down and a bottom-up approach. Jess: Yeah. Valentina: I love using it, when I am working with individuals who have anxiety or depressive symptoms. I also find it helpful when someone’s had like a big transition in their life or if they’re trying to make a decision like, “Do I stay in this relationship, do I leave?”or “Do I stay in this job or do I look for something else?” Um, I think if you’re feeling like you’re struggling to kind of have your actions align with where you want to be in life then ACT would be a great approach for you. Jess: Yeah, so anyone who is basically feeling kind of stuck – a little stuck right now. Valentina: Yeah, it’s great for that for sure. Jess: Oh, well I can buy into that! Um.. Oh actually that was something, when you were mentioning the piece around um it either being like top-bottom or bottom-up or bottom to top, and that there’s like an ability for like using ACT to regulate emotions, is that… was I understanding that correctly? Valentina: Mhmm. Yes. Jess: Okay, so something that I think heard a lot with ACT is dropping Anchor! Valentina: Yes, yes. I love this concept of dropping anchor. It’s also known as grounding, but I like calling it dropping anchor too because it kind of conjures up this image of a storm, like an emotional storm and you are dropping anchor to steady yourself. You’re not getting rid of the storm, you’re just dropping anchor to keep yourself steady. You’re not getting rid of unwanted things, but you’re able to manage in that context and so dropping anchor is essentially is getting in touch with your senses. So it might involve on the movement in your body as you’re breathing it could involve sounds around you or visually what is surrounding you. I love focusing on points of contact or like the feeling of my feet against the floor or my back against the chair. The reason why we focus on these things is because they are all happening in the here and now and they’re easily accessible. So it can really be something that is useful when we find ourselves in a storm and uh, there is research behind mindfulness as well with regards to changing brain structures. So, actually if you practice dropping anchor with some consistency you can reduce the size of the amygdala in your brain, and that’s kind of that survival response centre. Jess: Yeah! Valentina: So that results in less intense anxiety experiences for people. Jess: Absolutely – I had no idea that it could reduce the size of the amygdala! That in and of itself is really incredible. Holy! Valentina: Yes, I love incorporating dropping anchor and any sort of mindfulness practice for that reason. Jess: I bet and that was the thing… what appealed to me with this dropping anchor idea is that it’s one of those handy tools where you can take it anywhere with you. Valentina: Yes! Jess: You know, what I mean? I’ve heard of folks who um, use it line at the cash and they are starting to feel impatient or frustrated in that moment and then they’re like, “Okay, this is a moment when I need to drop anchor.” Valentina: Oh yeah! Or when you’re like stuck in traffic and finding yourself frustrated, Jess: Oh God yeah, I could have used an anchor today. Absolutely! You know I’ve heard of, I’ve heard of ACT being used as you’re saying like we’ve gone through individual and now we’ve talked about relationship sessions – it’s also been used in groups right? Valentina: It has been! And I actually co-facilitate a group with one of my colleagues. Um, and there are some unique benefits of group work versus individual. So of course in an individual setting when you’re using ACT with a therapist, you get that full hour of air time, you get to explore on a deep level some of your own life experiences and your personal values, which is wonderful. Uh. A group setting however, has a lot of benefits that you don’t necessarily get in the individual group. When you’re working with a group you have this gift of different perspectives so it allows you to more easily see things in a new light. At the same time, hearing from other people, you start to recognize that you have a shared experience. Where before you might have felt alone in your experience now there are these other people who are sharing with the group that they also resonate with those same feelings so it can be a really validating experience to be working with a group. I think it’s also the preference for some people who don’t necessarily feel comfortable having all of the air time, they’d rather be a listener at times and then share when they feel comfortable, um, so that’s another perk of working in a group. There are some differences as well with the group, my colleague and I, we have an agenda for each week and there’s a psychoeducation component. We do start each session with a mindfulness exercise and then we allow for some various exercises around values and some discussion so it’s a little bit more structured than what you might find individually. Ideally, doing both would probably cover all the bases and be great. Jess: That’s incredible! And does anybody need anything to prepare for the group? Is there any homework they should do before jumping into a group setting? Valentina: So we usually have a 15 minute consult with people who are interested, where we talk about what to expect with the group. There’s not really any homework that needs to be done, Sheila and I – my colleague and I, we’re pretty prepared and we guide people through it so there’s nothing really to be afraid of. Jess: Oh that’s incredible, so me, if I don’t know my values and I’m feeling stuck – I’m all set to go? I can jump right into this course? Valentina: Right! We’ve got some tools to help identify values. Jess: Amazing! Well thanks so much Valentina for doing this with me! Valentina: Yeah, thanks so much for having me! Jess: And thank you all so much for joining us and for listening to our first episode here with Valentina. Like I said at the very beginning if you are looking to book an appointment either with Valentina or with another one of our therapists here at Bliss or to join in on some of our group therapy sessions that we’ve got going on, please give us a call at the office or send us an email. I hope that you all have a blissful rest of your days! [Outro Music] DID YOU ENJOY THE SHOW? LET US KNOW! Share your feedback with the author of the show, Jess Boulé (jess@blisscounselling.ca) or leave us a review on LibSyn!
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/
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.
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.
HOW TO TALK TO A LOVED ONE ABOUT THEIR MENTAL HEALTH 6 November 2020 Bliss Team No comments Categories: Communication, Guest Post, Life Coaching, Relationships, Uncategorised Being open about our mental health is not a given. Many people living with mental health concerns and emotional pains, or wounds, feel uncomfortable sharing their experience with those around them, and understandably so. Discussions around mental health may still be considered ‘taboo’ for some folks.Despite mental health being a difficult conversation, the reality is that an estimated 1 billion people around the world have concerns about their mental health. During COVID, these conversations may be unavoidable, as families and households are spending more time together in close proximity. Why is Mental Health Taboo? Mental health can be a difficult topic for people for a variety of reasons. Depending on our race, gender, upbringing, religious background, world views, many factors can affect how we relate to and view mental health. I’m sure many can relate to the idea of men having to present as ‘macho’, as the ‘bread-winner’ and being ‘strong’, while women may relate to the stereotype of having to present as ‘vulnerable’ and ‘agreeable’ or ‘passive’.These stereotypes impact the way society views and accept one another. When we do not fit into some of these narrow views of how we “should” identify or present ourselves, it may make others feel uncomfortable, and we may end up feeling unaccepted, or unwanted. Our mental health is affected by these societal values and standards, but some of the challenges we face can also be caused by them. For example, many of us struggle with our mental health when we feel a loss of purpose, community, or understanding. As humans, we need purpose. It’s an evolutionary survival trait. We seek a community for the same reason. There is safety in numbers and we crave to be understood, accepted and welcomed in our groups.When people hold cultural, religious, gender-related biases within their values, it can create a disconnect in our ability to feel understood and to feel as though we relate to those around us. These biases, that to a certain degree, we all have, can make us feel uncomfortable when discussing certain topics, such as mental health. If I was brought up by a family and community who value traditions in gender and hetero norms, and I was born as someone who was gay, for example, I may struggle to come to terms with who I am, but more so, those around me may not be willing to listen to or try to relate to who I am. Essentially… mental health is taboo because we make it so. How to Talk to Someone Struggling with their Mental Health Before opening a dialogue with someone about their mental health, it’s worth taking a step back and asking ourselves these questions.Can I put aside my opinions, which have been formed through my very unique life experiences, to try to approach this situation from a place of open understanding and empathy?In other words, can I appreciate that my opinions and values have been shaped by my very unique experiences throughout life and that those experiences differ wildly from those around me? We are all individuals with very different lives. What may seem normal or a given to one person may be completely foreign to another.Am I ready to listen and be there for this person regardless of my opinions around mental health?How can we respond when someone shares something with us that we cannot relate to or understand? When we can’t relate to an experience, it can be really difficult to listen with intent. If someone is approaching us sharing a hardship, and we don’t recognize the situation as a hardship, that doesn’t mean it isn’t difficult for the person in question. For example, if someone loses their pen and has a panic attack, someone who has never experienced this feeling may consider that person is ‘over-exaggerating’ or ‘crazy’. However, for this person, they may be experiencing obsessive-compulsive symptoms. Their perspective may be that they’ve just lost the item that made them feel safe and in control of their anxiety. Not everyone can relate to this feeling, but that doesn’t mean it isn’t real. And just like people with a herniated disk, people with obsessive-compulsive symptoms need to be given time and support to recover. During COVID, it is particularly important to be mindful of respecting one’s personal space. Conversations can get heated, and living in close proximity to our loved ones can cause discussions to escalate without an escape or a break. If you notice a conversation becoming confrontational or unproductive, honour yourself and your loved one by taking a step back from the conversation, revisiting it at a time when the people involved are ready to speak calmly and listen with intent and empathy.Am I Mentally Prepared to Listen about this Person’s Experience with Mental Health?It’s important to check in with our own mental health before opening our hearts and ears to anyone else. It’s like the aeroplane safety videos say, put on your own safety equipment before helping others, because you won’t be much help if you don’t. Simple Rules to Abide By Listen. Many people with mental health concerns are in need of someone to share with. A lot of the time, talking things through and verbalizing our anxieties can put them into perspective. Take some of the pressure off of yourself, you don’t have to have any answers to fix your loved ones mental health. Offering your time and attention, showing you care and are there to support them, is enough.Mirror their tone. It’s super common for people to use humour as a defence mechanism. If the person you’re talking to is laughing about their own mental health, it could be that they are doing it to cope through the conversation, in which case, if it comes naturally to you and you’re comfortable with the person, you can laugh too. If they aren’t laughing though, neither should you.Be careful with recommendations. ‘Oh you have X? I’ve heard Y is the BEST for treating X!’ – If they’re talking to you about X, they’ve probably heard of Y. Heck, they may even have tried it already! Recommendations are fine and may be appreciated, but just recognize that the person hearing your suggestions may… Not be ready to hear it; Not be ready to take the information in; Already have tried it; Just want to talk and share their frustrations.Unless you’re a healthcare provider with experience in the mental health space, you likely aren’t going to know enough to be able to recommend specific treatments. By all means, offer help in researching treatment plans, but you shouldn’t assume to know what is best for the individual unless you have had formal training. Remember, we’re all different! What worked for a friend in a similar situation may not work for everyone. We all have unique reasons for our mental state, and we all have different responses to types of therapy, treatment and medication.How to Access Support If you’re doing research looking for suggestions for your loved one for treatment, here’s what you need to know. Currently, worldwide, access to in-person therapy is limited due to COVID. In certain areas, in-person therapy may be an option. For the areas that it’s not, there are online treatment plans available.Online therapy allows people to get help from the comfort of their homes, which for many, is incredibly convenient in 2020. The best form of treatment known for folks who are experiencing obsessive-compulsive symptoms is a form of therapy known as Cognitive Behavioural Therapy (CBT) and Exposure and Response Prevention (ERP). This approach is available online as well as in-person. There are also self-help practices that people with mental health concerns may wish to try, such as meditation or breathing exercises, but depending on the severity of the challenges or symptoms, seeking professional help may be more suited.When speaking with a loved one about mental health, remember to approach the conversation with empathy and patience. Seeking help for our mental health is tough, and the person struggling may need time before they can ask for the help they may need. Discuss options with them in an open-minded way without expectations. If your loved one has shared that they are planning to harm themselves or others, seek urgent support by calling 911, going to your nearest Emergency Department, or by reaching out to HERE 24/7. _______ Written by: Gabie Lazareff Gabie Lazareff is a certified health coach, yoga teacher and freelance nutrition & wellness writer. After years of navigating the messy waters of mental health, her mission is to share her experiences and advice with others.
The Mental Load 27 February 2020 Bliss Team No comments Categories: Communication, Relationship Therapy What is the mental load? The mental load is emotional labour. It’s those things that we do that we don’t physically see but are constantly at play in partnerships. Although this load can be carried by partners of either gender, current statistics suggest that it is “typically” carried by women. The issue with the mental load is that it often breeds resentment in relationships can affect them on many levels – mental health, intimacy, desire. Carrying a greater mental load doesn’t mean that one partner doesn’t want to assist, it may just be that one person is better at organization or planning; they may do it willingly at first but over time, it starts to take a toll on the individual and ultimately the relationship. Some examples of the mental load include: Planning family get-togethers/functions, children’s birthdays, religious occasions; Noticing when household items are running low, making a plan to go and pick up the items or even requesting the items be picked up; Purchasing and wrapping gifts; Keeping track of school functions, ensuring homework is completed, remembering parent teacher nights; Planning date nights or family vacations; Arranging children’s camps, summer caregivers; Meal planning; Taking family photos; Children’s immunization schedules and; Cleaning up prior to guests arriving. Below is a chart (adapted from the Gottman institute) to use as a way to assess the workload that can often lead to resentment and a list of common chores and things involved in our day to day lives that can add up, depending on how we have decided to share the load. There is no such thing as 50/50 split. It should not be what we strive for. But, this is an easy way to see where we can re-evaluate how tasks are considered and distributed. Please use the chart as a tool to see how the workload is dispersed. This can help couples consider alternative options and gain insight into how the “load” is distributed. Remember even doing this together is a way to build connection and have important conversations with your partner. You don’t have to agree. You just need to listen to one another. Common household roles and responsibilities: (feel free to add any additional ones that are not on the list) Creating grocery list Grocery shopping Cooking dinners Making lunches Washing dishes Emptying dishwasher Drying dishes Menu planning Cleaning the shower/tub Cleaning the toilet Cleaning bathroom counters Replacing toilet paper Washing and putting out clean towels Cleaning kitchen counters Emptying garbage/green bin Taking out garbage/recycling/ green bins Getting the care services Putting gas in the care Getting the mail Sorting the mail Sending mail Paying bills Doing laundry Folding laundry Putting laundry away Ironing Sweeping the floors Mopping the floors Changing the light bulbs Repairing/replacing appliances Cleaning out the fridge Cleaning the stove Making the bed Shopping for new clothes Planning trips/vacations Home repairs Buying new furniture Redecorating Buying household items Sewing/mending clothes Cleaning cabinets Organizing cabinets Mowing the lawn Gardening Weeds Snow removal Cleaning up the leaves Going to the bank Donating old household items Preparing for guests Buying gifts for family/friends Taking kids to school Taking pets to boarder Arranging childcare Arranging pet care Spending time with kids Planning family outings Feeding the pets Meal prep for the kids Grooming the pets Taking kids to the doctor Scheduling doctors appointments Immunization schedules Picking up medications Taking kids to the dentist Taking the kids for haircuts Walking the dog Taking pets to vet Carpooling to activities Arranging carpools Supervising homework Supervising bathing Putting toys away Responding to kid’s emotions Dog training Supervising bed time Taking care of a sick child Attending teacher meetings Dealing with the school Arranging play dates Holiday preparation Shopping for holidays Decorating for holidays Arranging date nights Planning weekends Initiating sex or intimacy Financial planning Making big purchases, ex. Cars Managing investments Planning for retirement Arranging time with friends Doing taxes Handling legal matters Watering the plants Changing the furnace filter Refilling the water softener Buying stamps Changing the water filter Keeping track of birthdays, anniversaries Vacuuming Renewing insurance for home and car Researching purchases Sending out thank-you cards Initiating emotional connection Initiating difficult conversations Purchasing new electronics for the home Signing up kids for camps/activities Cleaning windows Cleaning mirrors Dusting Cleaning up spills Cleaning the inside of the car Washing the car Cleaning rugs Creating a budget Cleaning the gutters Hiring a housekeeper Finding a tutor Finding a therapist Making store returns Getting cash for the sitter, cleaning company Paying membership dues Packing for vacations Calling the cable/telephone company when issues arise Planning physical activity Reading books about parenting/relationships Arranging santa/easter bunny/tooth fairy rituals Keeping track of where items are put in the home Checking for expired food items Arranging care for aging parents _______________________________ Written by Tammy Benwell Tammy Benwell is a Registered Social Worker at Bliss Counselling who holds an undergraduate degree in Social Work from the University of Waterloo and Master’s degree in Social Work from Wilfrid Laurier University. Her formal training focused on interventions for individuals, families, and groups, across various therapeutic orientations. Tammy has been afforded extensive opportunities working in mental health, supporting clients with various mental health challenges, including depression, anxiety, bipolar disorder, schizophrenia, and trauma. Tammy can assist individuals with relationship struggles, codependency, infidelity, separation and divorce, substance abuse, low self-esteem, family concerns, and life transitions. She has additional training in the areas of trauma counselling, and has been trained in EMDR through the Niagara Stress and Trauma Clinic. Tammy believes in fostering a collaborative, therapeutic relationship within which clients are best able to direct their own care. In addition to providing therapy to individuals, couples, and families, her work has also involved finding community supports for clients in distress, assisting with life transitions, and enhancing effective interpersonal communication styles. Tammy embraces an eclectic therapeutic orientation in her practice, tailoring interventions to meet the client’s individualized needs. Tammy’s philosophy is best described as one which helps clients understand their role and their ability to achieve their desired happiness.
How to Explore Your Sexuality As You Age! 1 October 2019 Bliss Team No comments Categories: Communication, Self Care, Sex Therapy, Sexual Wellness Today is International Older Persons Day! International Older Persons Day was passed by the United Nations in 1990 to raise awareness of issues that affect older people in society and to appreciate the contributions they have made to their communities. But, who is an older person and how do you know? Who is an Older Person? It depends who you ask! When we’re thinking about national policies, research, programs and services, and other benefits or entitlements, the government will define an older person chronologically as 65 years of age and older. On the other hand, if we consider recreational supports or when discounts might become available, we may consider an older person to be someone 50 years of age and older. Based off of appearance alone, we may try to categorize a person as either younger or older, but if we were to ask somebody if they feel they are an older person, they may or may not consider themselves to be. This is because the process of aging is a subjective experience! Don’t get me wrong, there are objective aspects to aging too… like the biological changes our bodies encounter with time. For instance, as we grow older our skin becomes more wrinkled and less elastic, while our hair thins and becomes grey. We experience losses in muscular strength, joint flexibility, as well as bone strength and mass, which could leave us feeling frail. Our cardiovascular system becomes less efficient and our lungs become less elastic, especially when we are exerting more energy. Our immune system’s ability to fight off illnesses declines with age, so we may become more susceptible to illnesses. There are changes to our kidneys, which could increase the length of time that a drug stays active in our bodies. We may also notice that our vision, hearing and cognition are affected, and that there is a decline in the hormones our bodies are producing. However, all of these changes to the body vary from person to person and are impacted by so many factors that we both can and cannot change, such as: genetics, sex, race and ethnicity, substance use (e.g., cigarette, alcohol, etc.), level of physical activity, nutrition, gender, medications and therapies, race or ethnicity, education, income, occupation, relationship status, and where you live. With these changes to our bodies, the nature of our relationships and roles in our communities also change. So when we ask somebody if they are an older person, there is a lot to consider! They may need to think about their physical and mental health, their (dis)abilities, whether they are giving or receiving care supports, the number and quality of social connections they may have, their level of activity and engagement in their communities and perhaps whether they are following certain aging stereotypes or social scripts. What are Aging Stereotypes? Even though research has found that aging is a complex process that is distinct to the person and their circumstances, we continue to perpetuate misconceptions of aging which impact how we think about and interact with older persons. Aging stereotypes are myths that often go unchallenged. These stereotypes may also include ideas around who is considered beautiful and sexy or how people should dress and behave once they reach a certain age. Sometimes they can be positive by viewing older persons as active, healthy and wise. But more often than not, they are negative and depict aging as undesirable because of illness, loneliness and a lack of capacity for decision-making. Any stereotype, whether positive or negative, has the ability to reinforce ageism, that is, discrimination, oppression, and exclusion based on a person’s age. For instance, one study found that very active older adults wanted to stay physically and mentally active so that they could avoid becoming old (e.g., frail, dependent, diseased). To actively resist aging stereotypes may be empowering for these older adults, but it also perpetuates ageism and the fear of illness, rather than acceptance for a natural process. Similar experiences also come up when we think about an older person’s sexuality… When older persons integrate aging stereotypes into their perceptions of self they may feel sexually invisible and could experience an altered sense of body image because of it. Feeling a lower sense of confidence and self-esteem, older persons may limit themselves from expressing their sexual needs and desires out of the fear of being judged. When older persons reject aging stereotypes or aging sexual scripts they may reject bodies that are aging naturally and may place importance on medical interventions (e.g., Viagra). Physical limitations that impact sexual functioning could be seen as inevitable and fraught with frustrations, disappointments, distress, and other barriers when it comes to being able to have sex or to openly discuss their sexual health needs and desires. For these older persons, they may be focusing on trying to conform to a certain sexual standard, or trying to have “normal” sex, instead of exploring their true sexual abilities, pleasures and desires. What is Sex? Most of us were taught that “sex” had to include a penis being inserted into a vagina. But, your definition of sex can include whatever activities arouse you and bring you pleasure, whether you are having sex with partners or going solo. It should describe what you can do and want to do now – not what you wanted or used to do in the past. Take a moment to think about how you define “sex.” Consider these questions: Does it include the kind of sex you’re having? Does it include intimacy and connection? Do you feel aroused or does it bring you pleasure? Is it what you feel you are supposed to want? Is it possible to have right now, given your circumstances? Does it involve one partner or more partners? Does it include solo acts (i.e., self-pleasure and masturbation)? Recently, we have been having more conversations that normalize aging sexuality and there has been greater research to depict that older persons are sexually active well into later life! Even if older adults are having less sex, or experiencing sexual limitations and greater health concerns, it does not mean that they are having less quality or enjoyable sex. For instance, a Canadian study found that older persons have great sex regardless of ability, age, or illness when they move away from “normal” sex and adapt their sexual activities to meet their needs and abilities. Some ways older persons have done this is by: Being present in the moment; Creating a connection and being intimate with their partners; Being open in their communication; Remaining authentic about their desires and needs; Being receptive to new ideas and taking safe sexual risks; Feeling vulnerable; Exploring all of the ways of being sexually expressive and; Being transcendent and letting go of goal oriented sex. By letting go of aging stereotypes and goal oriented sex, or sex which focuses on achieving orgasms, older persons are able to achieve great sex that goes beyond functionality, medical interventions, physical limitations and penetration. What are 10 Ways to Compensate for the Changes that Come with Aging? Accept Change: If you enjoyed sex when you were younger, there is no reason why you can’t continue to as you age (unless, of course, you don’t want to !). The only thing is that you may need to let go of some of your past sexual expectations, so that you may embrace and explore your new sexuality. Do your best to accept the changes you are experiencing and remember that aging is a natural process. Track Your Responses: Track what time of day you feel aroused or responsive, especially if you are taking medications or have any medical conditions as these tend to affect our arousal and response drive at different times of the day. When you feel it, go with it! If you can’t act on it right away, try scheduling partnered or solo sex accordingly. Schedule Your Sex: If you struggle with getting aroused or reaching an orgasm, it will help to start scheduling weekly partnered or solo sex. The more you practice the easier it will be for your blood to flow the next time. Scheduling sex isn’t spontaneous, but it will help with building anticipation… Talk About Sex: You may not have been brought up to talk about sex, but it’s the only way you will get what you want. Your sexual needs and desires change over time, so be sure to communicate them to your partners. Remember while you are discussing your desires to use “I” statements and to explain what you mean, avoid blaming or judging yourself or your partners, talk about it while you aren’t having sex, be curious and ask your partner what they would like, make a plan to incorporate your desires and check in with each other regularly. Being playful, using humour and gentle teasing can really lighten the mood! Find New Positions and Toys: If you are experiencing physical limitations consider which positions, toys or other technologies may more easily or better support you during partnered or solo sex. For instance, is there a cushion that you could prop under yourself to help with weight distribution (e.g., the Liberator), is there a toy that you could use hands free or with limited hand movements (e.g., the Satisfier, the DiGit, the Wand, the Perfect Stroke, the Fleshlight with suction cup, etc.)? Exercise 30 Minutes Before Sex: Increase your blood flow to speed up arousal, function, and pleasure. You only need to raise your heart rate enough so that you breathing quickens, but you can still talk. Try dancing, walking, or any other activity that will get your blood moving! Avoid Eating Before Sex: When our digestive systems are in full swing it slows down our blood flow, which keeps it from reaching our genitals as quickly. So whether you’re having partnered or solo sex, try to plan your meals afterward. Focus on Intimacy and Touch: Sometimes we may not actually be looking for sex, instead it could be intimacy and to be touched, held, looked at, admired, smiled at, to laugh, or to feel a loved, a connection, or safe and secure. Take your Time: Spend more time on pleasure and intimacy. Draw out foreplay so that it is a before and after sex experience! Find ways to relax and be comfortable with partners or on your own. Use Lube: With age, our skin thins and hormone production declines. This means our bodies are producing less natural lubricants and that our skin is more susceptible to tearing . To avoid this, try using a personal lubricant! There are many types of personal lubricants (i.e., water, silicone, oils, hybrids, flavours, etc.). Click here for a guide that will help you choose one that is right for you. Remember to also keep the lines of communication open with your doctor! There are normal changes related to aging and these could be creating limitations to sexual functioning… but there are changes that may not be! For instance, diabetes and cardiovascular issues affect blood flow and could be limiting arousal and response. Although some older persons may experience greater excitement and sexual desire after menopause, others may have vaginal pain or itching and burning around their vulva. These cases should be explored further with your doctor, or a specialist like a urologist, gynaecologist, pelvic floor physiotherapist, and/or a certified sex therapist. When having sex, there’s also a higher chance of transmitting sexual infections, no matter your age. There are many different types and sizes of condoms that you can be using whether you’re having penetrative or oral sex with long-term, new, or casual partners, or even while sharing toys. Check-in with your doctor if you have any questions or concerns and request more information, as well as regular STI screenings. Now… Go celebrate International Older Person’s Day by having sex! Where Can I Learn More About Older Persons’ Sexuality? Catie’s Safer Sex Guide How do older people discuss their own sexuality? A systematic review of qualitative research studies (Gewirtz-Meydan et al., 2018) McMaster: Optimal Aging Portal Naked at our Age: Talking out Loud About Senior Sex (Joan Price, 2011) Senior Planet: A Senior’s Guide to Lubrication Sex After Grief: Navigating your Sexuality after Losing your Beloved (Joan Price, 2019) Sexual Health and Aging: Keep the Passion Alive (Mayo Clinic, 2017) Sexuality in later life (National Institute on Aging, 2017) Stereotypes of Aging: Their Effects on the Health of Older Adults (Rylee Dionigi, 2015) The Components of Optimal Sexuality: A Portrait of “Great Sex” (Peggy Kleinplatz et al., 2009) The Ultimate Guide to Sex After 50 (Joan Price, 2014) _______________________________________________ Written by: Jess Boulé, Pronouns: they, them, theirs / she, her, hers Jess is our office strategist 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, communication, human sexuality, LGBTQI2S+ health, inclusive practice and policies, knowledge mobilization strategies, research methods, and program evaluation.