We’re here to help! Ring us at 226-647-6000.

What to Ask During a Consultation

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

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)

Different Therapeutic Approaches Used for Alcohol Addiction Treatment

Alcohol use is marked by an uncontrolled and compulsive need to drink. We may seek treatment regarding alcohol use, if we; feel a compulsion to drink, feel we no longer have control over how much we’re drinking, feel uncomfortable when we are unable to drink. Not having an alcoholic drink may lead to challenges in managing emotions and day to day responsibilities.

When seeking treatment for alcohol use, the first step may be to speak with a doctor and to create recovery goals. From this assessment, the doctor will advise the next step, which could include: a treatment centre (inpatient or outpatient), therapy (biofeedback, cognitive behaviour therapy, psychotherapy, family behaviour therapy, or holistic therapy) and/or a support group.

 

Types of Alcohol Addiction Treatment

 

i) Inpatient Rehab

Inpatient alcohol rehabilitation offers structured treatment to address multiple facets of a person’s addiction. During this treatment, the patient must live in a substance-free facility where they get round-the-clock support and medical care. Inpatient rehab is good for anyone with chronic addiction and those with co-occurring/behavioural disorders.

ii) Outpatient Rehab

An outpatient rehab program offers the same level of care, treatment, and therapies as an inpatient one. The only difference is that with the former, the person gets to live at their residence.  Outpatient rehabs allow for the individual to continue their daily routines such as: managing jobs, careers, and families.

This type of rehabilitation approach may be more appealing to those wanting to maintain their day to day routine. The challenges associated with having access to our home and the surrounding environments (e.g., LCBO, beer store, parties, etc.) could be triggering or create difficulties in maintaining sobriety. Having access to such things can create triggers and a challenge around maintaining sobriety.

Therefore, outpatient programs are best suited for those with mild addiction and have a strong support system around them.

Therapeutic Approaches Used for Alcohol Addiction Treatment

 

i) Biofeedback Therapy

Biofeedback therapy has been researched for over 25 years and has shown to be an effective treatment. The treatment process assists and teaches the client to produce more normal EEG patterns. Biofeedback therapy is a computer based, brain-training technique used to help with developing more control over brainwave activity resulting in improved life functioning.

During a typical treatment, sensors are placed on the scalp of a client to measure brainwaves through a computer software system. Each session ranges between 20-60 minutes and it is recommended that a person attend two to three sessions per week. 

These electronic sensors monitor the ongoing brain activity which is recorded as brain wave patterns. Once the therapist reviews the results, a conversation is had with the client to discuss and recommend additional psychological techniques for working through the addiction.

 

ii) Cognitive Behavioural Therapy

Studies tell us that Cognitive Behavioural Therapy (CBT) is a highly effective method for working through alcohol addiction. The therapist works towards identifying negative and destructive thought patterns and behaviours. The therapist uses CBT to work towards replacing the negative thoughts and behaviours with positive ones.

The success of CBT relies on the conversation between a therapist and the client. It is a solution-based therapy that relies more on constructive actions rather than the medical diagnosis itself. Common elements of CBT are – challenging and confronting fears, harmful beliefs, ways to improve social interaction, and coping skills to manage cravings.

 

 iii) Psychotherapy

During a psychotherapy session, the client discusses their personal challenges and difficult experiences with a registered social worker, registered psychotherapist and/or psychologist. This therapeutic approach can be used in individual, group and family settings.

The therapist uses the information collected to analyze a person’s long-standing issues, daily challenges, past traumas, fears, and personal difficulties. If the client wishes to see a psychologist, they would be able to receive a diagnosis and prescribed medication.

 

iv) Family Behaviour Therapy

Addiction has multiple facets. It affects not only the individual suffering with the addiction but those closest to the person such as family and friends. There are several cases where family members are unknowingly enabling the individual’s addiction. Family behaviour therapy addresses all these things.

During a therapy session in an addiction rehab centre, families work on setting goals, and learning behavioural techniques. The idea is to improve family dynamics and make it more conducive to encouraging recovery and healthy living. In doing this, it encourages healthy communication between family members. To foster recovery, family members are encouraged to work on their roles and partake in effective boundary setting moving forward.

Family behaviour therapy is highly effective in getting families to work as a cohesive unit. They learn to support and help each other to achieve sobriety goals. This type of therapy is typically conducted at a later stage of treatment, after alcohol detox is completed.

 

v) Holistic Therapy

Holistic alcohol addiction treatment focuses on healing a person’s mind, body, and soul. It takes into account the overall well-being of a person. This is achieved through managing physical withdrawal symptoms as well. 

Holistic therapies include:

  • Guided meditation
  • Mindfulness practices
  • Breathwork
  • Yoga
  • Acupuncture and acupressure
  • Massage therapy 
  • Sound therapy
  • Aromatherapy
  • Reiki

 

Finding Support Groups

 

After an individual has completed a rehabilitation program for their addiction it is suggested that they seek support through external groups. Being part of an external group support system assists in the transition from rehabilitation centre to navigating their new sober life.

Support groups are instrumental in encouraging long-term recovery and care both during and after rehab. They provide a safe place to speak with like minded individuals and seek a sponsor. Support groups such as some outlined below are easily accessible to those in all communities and offered at various times each week.

 

12-Step Programs

These are highly popular programs that are considered to be standard for sustainable recovery post-rehab. The program follows a 12-step model and 12 traditions that the participants complete. Each step allows the person to adapt to their surroundings and meet personal goals.

Narcotics Anonymous and Alcoholics Anonymous are the two most well-regarded 12-steps programs in the US and Canada.

 

Alcoholics Anonymous

Alcoholics Anonymous meetings offer a common ground for individuals to get together and share their stories with others who have lived very similar stories.Those who join AA meetings appreciate that they are able to relate and draw inspiration from others in the group through storytelling.

During group sessions many conversations are had around how recovery both impacted and improved the person’s life. AA meetings are held daily in community and/or church buildings allowing for those in recovery to attend as frequently as needed.

There are two types of meetings – open and closed. The former invites loved ones and family members to attend while the latter is solely for recovering individuals.

 

Narcotics Anonymous

Inspired by Alcoholics Anonymous, NA meetings create a sense of community for recovering addicts. Members get to meet and motivate one another by sharing their success stories and anecdotes. It helps each other to stay committed to living a drug-free life and avoid relapses. 

 

Conclusion

 

Alcohol addiction is one of the most common forms of addiction. It is highly treatable and there is plenty of help and resources available to achieve sustainable, life-long sobriety.

 

 

Written By:

Holly a freelance writer who loves to help those struggling with addiction. Holly’s own personal experience has inspired her to share resources and be part of others’ recovery journey. Holly has been sober for five years and counting. Holly is a frequent contributor to many addiction-related blogs and organizations such as the Addiction Treatment Division and Inpatient-Rehab.org.

 

References:

https://www.webmd.com/pain-management/biofeedback-therapy-uses-benefits

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897895/

https://www.yorkregiontherapy.com/biofeedback/

 

Revolution from the Couch: Integrating Social Justice into Therapy Practices

Therapy is envisioned as a safe, unbiased space. In the therapy office, clients are free to explore their past and future, free from judgement or contempt. Clients expect their therapists to provide impartial, supportive advice, without fear that their therapist will discriminate against them in any form. This is an important cornerstone of the practice of therapy.

However, this concept can also be misconstrued to mean that therapy is an apolitical practice. Therapists are thought of as neutral actors, who remove themselves from politics in the therapy room. 

While this may be the case for some therapists, therapy as a whole is deeply involved in politics and social justice advocacy. Many of the early developers of therapy as we know it were involved in politics and justice, such as those involved in the settlement housing movement. Therapists today deal with oppressive structures first hand – either through themselves or through their clients.

This is not to say that therapy has always been on the side of social justice. Practices like conversion therapy have caused damage to LGBTQ+ folks, setting back progress decades.

So, how are therapy and social justice intertwined? Can therapy truly be apolitical, or is neutrality no longer an option? And how can therapists use their practice to further social justice, while honouring the needs of their clients?

De-Centre the Self, Understand the Structure

It is a well-known fact among clinicians that poverty is linked with higher rates of depression and other mental illnesses. Those with mental illness can face barriers in education and employment that can push them into poverty; while those living in chronic poverty are more likely to develop a mental illness. A lack of access to resources and support can worsen mental health outcomes for those living in poverty.

Oppression also contributes to mental health conditions. Experiencing racism, for example, increases stress and affects mental health conditions such as PTSD, depression, and anxiety. Even just the fear of racism can heighten stress levels, according to multiple studies.

So where do therapists fit in? Therapy is often recommended as the first line of treatment for mental health conditions like depression and anxiety. Therapy often focuses on an exploration of the self to facilitate healing. However, for those who are oppressed, discriminated against, or living in adverse conditions, healing may be inhibited by structural issues like poverty. Without an acknowledgement or understanding of how certain conditions or societal issues can impact mental health, therapy cannot be truly effective.

If a therapist is unfamiliar with issues such as poverty, racism, dis/ableism, sexism, or capitalism, it is encouraged that they do research to understand the realities of these issues. Many clients who take part in therapy will have first hand experience with these issues, and may require support in that area.

Therapist practices can offer support groups directly related to structural issues such as racism or poverty, to ensure that the needs of their clientele are being met. They can also host workshops for their therapists to fill in gaps in knowledge.

Support Marginalized Voices, Professionally and Individually

Another way therapy practices can pave the way for social change is by opening up opportunities for marginalized folks. Marginalized groups face barriers accessing care, often due to cost or proximity. Providing sliding scales is one way therapists can make space for marginalized folks.

Accessibility is key to providing holistic care. There are many barriers to therapy – financial, physical, or logistical. Sliding scales and accessible features are one way practices can make their care more accessible. Hiring therapists who speak other languages can also provide a wider scope of care, as mental health care is in high demand for non-English speakers.

Marginalized individuals also face barriers to employment; hence, making the active choice to hire individuals from marginalized backgrounds is a concrete way to affect change. Marginalized voices have historically been excluded from health discourse, but they are essential for providing comprehensive care. Many employers create a statement to hire BIPOC (Black, Indigenous, and People of Colour) clinicians, which – when committed to – can make a difference in increasing diversity.

Uplifting marginalized voices is also key within the therapy room. A principal concept of client-centred care is that humans are autonomous and have the right to determine their own path. This ensures that recovery in the therapy room is partly, or completely directed by the client, so that they can meet their needs. For marginalized folks, this may be difficult, as biases or blindspots in the therapist may impede their ability to self-direct. Non-BIPOC therapists must be mindful and allow clients to describe their experience of oppression in their own words. Their job is not to minimize oppression, but to understand it and help the client move towards healing.

Giving marginalized voices a microphone, both in their healing and in their professional journey, contributes to the fight for social justice. It is just as important to listen to marginalized voices, as it is to speak up on their behalf.

Go Beyond the Couch

Care is not just about the individual, but also about the community. As we have discussed, many of the issues facing clients are structural – income inequality, discrimination, lack of affordable housing, etc. Some of these issues can’t be addressed in a therapy office, and must be taken to the streets. 

Some folks feel they cannot contribute to social change because they do not possess the required skills. The truth is that there are many ways to contribute to social justice. Perhaps you show up through protest or sign making; perhaps you write letters to political leaders or write social policy; perhaps you sell your crafts to fundraise for an issue close to your heart; or perhaps you provide home-cooked meals for those in need. Regardless, there are infinite ways to contribute to social change – and infinite reasons why.

If you are a therapist, consider participating in community organizing. You will have a good idea of what issues are close to your clients’ hearts. Is it housing issues? Poverty? Hunger? Once you know, see how you can contribute to changing these issues. Showing up for your clients outside of the office is just as important as showing up for them in session.

Justice = Mental Health Care

Therapy is as much about changing an individual’s life as it is about changing the world. After all, creating self-reflexive, eternally curious individuals impacts the world in a positive way. However, therapists must go beyond the couch to provide authentic, socially just care. Show up for marginalized folks, professionally and individually. Uplift marginalized voices in your own life, in your community, and in your practice. Above all, keep in mind that social justice is more than a political movement; it is mental health care.

Links:

https://www.medicalnewstoday.com/articles/effects-of-racism#adults

https://ontario.cmha.ca/documents/poverty-and-mental-illness/

https://www.counseling.org/docs/default-source/Government-Affairs/why_social_justice_is_a_counseling_concern-1.pdf?sfvrsn=2

https://www.utpjournals.press/doi/abs/10.3138/CHR.82.1.55

 

Written by: Catiyana Adam

Catiyana, a music enthusiast, and avid writer. She has a keen interest in mental health, illness, and treatment, and is aspiring to be a therapist. Catiyana graduated from McMaster University in 2021 with a Honours Bachelor of Arts in Sociology. She focused on courses in health and illness, as well as families and feminist studies. She hopes to pursue a Master of Social Work at Wilfrid Laurier University next year. 

How Cognitive and Dialectical Behavior Therapy Works in Recovery

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/

 

Understanding Borderline Personality Disorder

Please note that every person’s experience of borderline personality disorder (BPD) is different. The symptoms and ranges of BPD run both vertically (the number of symptoms experienced) and horizontally (the intensity of how they are experienced). If we also consider other factors that layer and intersect, such as life events (e.g., t/Trauma) and social positions (e.g., financial security, colour of skin, sexual orientation, gender, etc.), our end result is a very unique tapestry of experiences.

“People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.”

Dr. Marsha Linehan

What is Borderline Personality Disorder?

BPD is the most common personality disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). This manual is used by physicians and psychologists to make mental health diagnoses. Someone with a personality disorder typically faces unique challenges in:

  • Relationships and social situations;
  • Managing emotions and thoughts;
  • Understanding how certain behaviours are creating problems and/or;
  • Recurring difficulties in changing a mindset to suit different contexts. 

 

75% of people with BPD self-injure one or more times. 

10% of people with BPD take their own lives.

 

What are the symptoms of BPD?

The DSM-IV-TR lists 9 categorical criteria for BPD. A person must present with at least 5 of the symptoms in order to be diagnosed with BPD. The 9 symptoms can be summarized as:

  1. Frantic efforts to avoid real or imagined abandonment, significant fears of being alone;
  2. Unstable and intense interpersonal relationships;
  3. Lack of clear sense of identity;
  4. Impulsiveness in potentially self-damaging behaviours, such as substance abuse, sex, shop lifting, reckless driving, binge eating;
  5. Recurrent suicidal threats or gestures, or non-suicidal self-injury such as cutting, burning with a cigarette, or overdose that can bring relief from intense emotional pain; 
  6. Severe mood shifts and extreme reactivity to situational stresses;
  7. Chronic feelings of emptiness, loneliness and neediness;
  8. Intense, frequent, short-lived and inappropriate displays of anger, depression or anxiety;
  9. Transient, stress-related feelings of unreality or paranoia.

Inconsistent symptoms are the hallmark of BPD, which makes it difficult to define a single set of criteria for a diagnosis. This is further complicated, as research has shown that about 90% of folks with a BPD diagnosis, share at least 1 other major psychiatric diagnosis.

What is it like living with BPD?

“Prick the delicate ‘skin’ of a borderline and she will emotionally bleed to death.”

Kreisman and Straus

BPD has been described as emotional hemophilia. In the case of BPD, the client will have difficulties with moderating their feelings. Mood changes can come and go quickly and can shift from extreme joy to the deepest despair. A person with BPD may be filled with anger or despair one hour and then calm the next, with little understanding as to why. This then leads to feelings of insecurity, lower self-worth and inner criticism, which brings about more self-hate and depression. 

Symptoms, such as dissociation, can also interfere with concentration making it very difficult for folks with BPD to complete their tasks. Feelings of emptiness makes a person with BPD feel as though they have to do anything to escape, such as impulsive and self-destructive behaviours, so that they may feel something. People with BPD may also feel as though they do not have a core identity and to overcome their mostly negative self-image, they will create characters or codes.

People with BPD may also experience splitting. Splitting can happen at any time, if they are under enough pressure, stress, anxiety, or anger. Splitting is when a person only thinks about a situation or person in binaries. It is the rigid separation of positive and negative thoughts and feelings about oneself and others. For instance, a person with BPD may only consider a context to be right or wrong, good or bad, or in black and white terms without any room for grey. A person with BPD may struggle to accept human inconsistencies or ambiguities, and as such favour predictability. 

When there is a miscommunication or when somebody they idealize eventually disappoints them in some way, or acts in a way that they did not predict, a person with BPD may look at them as though they cannot be trusted. When this occurs, the person with BPD has to make a decision to either restructure their strict and inflexible conceptualization of this person or to isolate themselves in order to preserve the “perfect” image they had created. 

Research shows that there is no definitive cause for BPD, rather it is a combination of genetic, developmental, neurobiological and social factors that contribute to its development. People with BPD may come from family backgrounds with parents who were indifferent, rejecting or absent. They may have also received little to no affection and/or experienced chronic abuse. 

A person with BPD will also seek out new relationships (i.e., partners and/or friendships) quite often. Once in a close romantic relationship they will both crave and become terrified of intimacy; fearing abandonment, they will cling to their partner, which will then lead to fears of enmeshment, so they push away. Because of this, they end up pushing away those they want to connect with the most. 

Of all the major mental health diagnoses, BPD is the most stigmatized. Stereotypes include viewing folks with BPD as dramatic, manipulative, unfeeling or lacking emotion, attention-seeking and/or narcissistic. They are consistently suspected of wrongdoing, carelessness, anger, and difficulties with building a regular routine. This leads folks with BPD to hide this part of themselves from others. 

For a person with BPD there are significant fears of abandonment and they will attach to a favourite person and rely on this person for emotional validation and security. Their favourite person becomes the source of their comfort and devotion. A BPD person’s favourite person can be anybody: a relative, parent, best friend, lover, or somebody they just met. The difference between a best friend and a favourite person, is related to the intensity of the thoughts that surround this person. 

A person with BPD requires compassion, understanding, acceptance, honesty, patience and love. They may not have grown up with either receiving or learning how to share these characteristics with their formative relationships, so accountability for behaviours that are challenging a relationship and empathy, are key. Of course a person with BPD will need to learn how to give themselves the love and compassion that they crave from others, as well.

What can you do if you or a loved one is experiencing BPD related symptoms?

It is important to recognize that there is no “cure” for BPD, rather somebody who experiences these traits and is receiving treatment may just have more time between self-harm episodes and/or coping strategies to support emotional regulation.

Kreisman and Straus have described a structured method of communication, known as SET that can be used when communicating with a person who is in a BPD related crisis, or emotionally spiralling. 

Support – Use a personal “I” statement of concern to demonstrate a personal pledge to try to support the person in emotional crisis. For example, “I am really worried about how you are feeling.”

Empathy – Acknowledge their chaotic feelings with a “You” statement. For example: “You must be feeling awful/scared/hurt/etc.”

Truth – Emphasize that this person is accountable to their own life and that others’ attempts to help, cannot avert this primary responsibility. In this statement, you must acknowledge that there is a problem that exists and offer a solution for what can be done to solve it. This must be done in a matter of fact tone. For example, “Here’s what happened…These are the consequences…. This is what I can do… What are you going to do?”

It is possible to have a healthy relationship with a person with BPD, especially if you are the favourite person. You can do this in 5 easy steps.

Step 1 : Communicate

The first step is to have a discussion, to acknowledge that you are their favourite person, and to determine if the relationship is mutual.

Questions to reflect on and consider during this discussion are:

  1. What are each person’s needs? Are they currently being met? 
  2. Has there been an instance where either person’s needs weren’t met, why might that be and how might you both be able to overcome this in future interactions?
  3. What are both of your feelings regarding space and emotional boundaries? 

 

Step 2: Avoid Assumptions

BPD folks generally think in black and white (e.g., “they don’t love me anymore”). In order to avoid this assumption and the potential for an emotional crisis, or “testing” the favourite person to make sure they still do love them or won’t leave them, the BPD person should feel comfortable with being direct and asking for reassurance from their favourite person (e.g., “Is everything alright? I’m just worried because I haven’t heard from you in a while”).

Step 3: Develop More Friendships

It is comfortable and easy for a BPD person to give all of the love and everything they have to their favourite person, but it’s a lot of pressure to receive and also reciprocate as a single human being. This is why it is important for both the favourite and BPD person to have friends of their own that they enjoy spending time with. This will help the BPD person with the intensity of putting all of their emotional needs on one person, and will also help the favourite person to have other outlets and their own support. It’s important that the BPD person avoids scheduling their plans around their favourite person. 

Step 4: Limit Expectations

This is one of the most difficult ideas for a BPD person to incorporate into their worldview, but it is to cultivate a mindset in which their favourite person may leave, by choice or not, and this is okay. This requires a mindful appreciation for enjoying the day for what it is. No matter what happens. It is not possible to control a person or to demand that they be committed to your relationship or friendship forever. Thinking of the future and the possibility that they could leave, may generate anxious thoughts and feelings of being abandoned. Instead, the BPD person can try practicing gratitude for the current state of their relationships. 

Step 5: Therapy & Medications

Treatment for both the BPD and favourite person usually begins with education; discussing what is known about BPD and its causes, as well as how the BPD person can self-manage and prevent relapses. Therapy and counselling may also be offered at the individual or group level for both the BPD and favourite person. The BPD person may also wish to take prescription medications that align with their specific symptoms (e.g., mood swings or anxiety). There are a number of therapeutic tools that can be used in the treatment of BPD symptoms. The 2 major tools are cognitive behavioural therapy (CBT), which focuses on the present and on changing negative thoughts and behaviours, and dialectical behaviour therapy (DBT) which uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and the client’s emotional state. DBT helps clients to regulate intense emotions, to reduce self-destructive behaviours and to improve relationships.

It’s important to remember that like any relationship, the connection you build will be at it’s healthiest if it is constructed on a foundation of trust, friendship, mutual respect and care, honesty and accountability. 

At Bliss, we want to help our clients navigate the complexities of BPD and help them live balanced, happy, fulfilling lives. If you need additional guidance, please book an appointment with one of our therapists who specialized in this area and will guide you through the therapy process in a safe, non judgemental atmosphere: 

 

You do not have to go through this alone. Bliss is here to support you.

 


Written By: Jess

 

Jess is our amazing office strategist at Bliss Counselling. Jess is a Master’s graduate from the University of Guelph. During this degree, they focused on aging and end-of-life, communication, human sexuality, LGBTQI2S+ health, inclusive practice and policies, knowledge mobilization strategies, research methods, and program evaluation.

 


 

I would like to learn more about BPD, what other resources exist?

 

For more information and support, please consider the following resources.

 

Books

  • Beyond Borderline: True Stories of Recovery from Borderline Personality Disorder by John G. Gunderson (edited by Perry D Hoffman)
  • Building a Life Worth Living: A Memoir by Marsha M. Linehan
  • Coping with BPD: DBT and CBT Skills to Soothe the Symptoms of Borderline Personality Disorder by Blaise Aguirre
  • I Hate You – Don’t leave me: Understanding the Borderline Personality by Jerold J. Kreisman and Hal Straus
  • Loving Someone with Borderline Personality Disorder by Shari Y. Manning
  • Mastering Adulthood: Go Beyond Adulting to Become an Emotional Grown-Up by Lara E. Fielding
  • The Dialectical Behaviour Therapy Wellness Planner: 365 Days of Healthy Living for Your Body, Mind, and Spirit (The Borderline Personality Disorder Wellness Series) by Amanda L. Smith
  • The Mindfulness Solution for Intense Emotions: Take Control of Borderline Personality Disorder with DBT by Cedar R. Koons
  • This is Not the End: Conversation on Borderline Personality Disorder by Tabetha Martin
  • The Dialectical Behaviour Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation and Distress Tolerance by Matthew McKay, Jeffrey Wood, and Jeffrey Brantley

Online Documents

Tips for Handling Stress, Anxiety and Depression During the COVID-19 Pandemic

The current times, they sure are strange. It is perfectly normal during these tense times to be overwhelmed and to feel fear and anxiety when facing a new disease. Besides that, public health measures, such as social distancing and working from home, can make people feel isolated and lonely and increase stress and anxiety. 

Here are some tips that can help you cope with the challenges that the pandemic brings. 

Keep in touch with your loved ones

Don’t allow the feeling that you are on your own to take hold of you. It is more important than ever to stay connected with the people you love and trust during difficult times. Being cut off from the love, support, and close contact of family and friends can trigger depression or make existing symptoms worse.

Back when the first lockdowns began around the world, it was easier to think we could get through it on our own because we believed the restrictions would only be in place for a short period of time. As we enter 2021 still facing the same challenges, it is crucial that we realize we must stay in touch with our support networks to get through this.

If you can, meet the people you care about in person while adhering to the current social distancing measures. If not, use video calls and social media to maintain any form of contact. 

These times might even be an opportunity to reach out to the old friends you have fallen out of touch with. Remember, we’re all struggling, and everyone could use a bit of human contact.  

Talk about your feelings 

It is crucial to be able to admit to yourself that you are not feeling okay. Without acknowledging the emotions you are experiencing, you won’t be able to deal with them.

Once you manage to overcome this hurdle, it is equally essential not to keep all your negative emotions to yourself. If you don’t want to burden those around you, seek help from a professional. Doing this is the best thing you can do for your mental well-being. You can do so even without leaving the comfort of your home, as many places offer remote therapy or counseling. 

Remember to be kind to yourself

One of the trickiest things about anxiety and depression is their ability to self-perpetuate. Once you go down the spiral of depression, you have even less energy than before to deal with the negative things in your life. In turn, this makes you even more depressed or susceptible to depression, and the circle goes on. 

This is why you should do your best to remember that you have value and to practice self-belief. Self-belief incorporates self-care and believing in yourself, and as such, it can be essential for a healthy mindset during the Covid pandemic. 

Be supportive of others as well 

If you feel healthy and capable of doing something for those in need, do it. Helping others can help you as well as them. See if there are any local community groups that you could join to help people around you locally. (If you do go out to offer support or help to others, always follow social distancing guidelines when you are outside your home.)

Another option is to find a friend or family member nearby who is affected by Covid and try to help them. If you cannot help this way, try to be a little more understanding of other people’s concerns, worries, or behaviors at this time.

Take care of your body 

Many people reach for unhealthy coping mechanisms such as junk food, alcohol, or even drugs during uncertain times like these. Do your best to avoid these traps, as your physical health has a significant impact on how you feel. All these things might provide a short relief, but in the long-run, they’ll make your anxiety or depression symptoms much worse.

Try to eat healthy, well-balanced meals, drink enough water, and exercise regularly. Avoid smoking or drugs, and try not to drink too much alcohol. 

If you can, go for a hike or a bike ride, as those can help you clear your mind and reconnect with nature while simultaneously boosting your overall health. Getting fresh air and catching some rays is particularly important in the winter when the lack of sunlight lowers our levels of D vitamin, making us more susceptible to seasonal affective disorder.

Try to do the things you love

One of the worst things you can do for your mental health during this pandemic is to let the routine take over the control of your life. Being stuck in a rut is never a good thing, but during times like these, it can make you less likely to turn your attention and energy towards the things you love doing, the ones that can fill you with positivity. 

Focusing on your favorite hobby, relaxing, or connecting with others can help with anxious thoughts and feelings. If you cannot do the things you usually enjoy, think about how you could adapt them, or try something new.

This is also important: when the pandemic started, everybody talked about self-improvement and set up huge goals for themselves. As you might have seen already, most of those grandiose plans have failed.

It is essential to judge yourself on your own merits. Every small accomplishment counts. Even if all you do until the end of the pandemic is to stay safe and maintain your mental and physical wellbeing, that is no small feat, especially as we begin to realize this is a marathon, not a sprint.  

_____

Written by: Rebecca Brown

 

 

I’m Rebecca, a translator, avid traveler, and a bookworm. My job has given me the amazing opportunity to travel to dozens of countries around the world, and writing on Rough Draft gives me a chance to try to showcase some of them.

HOW TO TALK TO A LOVED ONE ABOUT THEIR MENTAL HEALTH

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

img_7993%25204_edited_edited.jpg


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.

Let’s Talk

It’s that time of the year again! Bell will be donating 5 cents to mental health initiatives in Canada for every:

 

  • Text (not iMessage) sent from a Bell customer phone;
  • Tweet or retweet that includes #BellLetsTalk;
  • Snapchat sent using Bell’s special filter.

 

More than just one conversation is needed, especially when we consider the number of people in Canada who are impacted by mental health challenges.

For instance, 20% of Canadians experience mental health challenges in any given year. By age 40, approximately half of the population have or will experience a mental health illness. Suicide is one of the leading causes of death from adolescence (15-24; 24%) to middle age (25-44;16%), with men being 4 times more likely to die by suicide when compared to women (1). Other populations such as First Nation, Metis, Inuit and LGBTQI2S youth, as well as federal inmates are at a higher risk for suicide as well (2).

Since 2010, Bell Let’s Talk has contributed significantly to mental health initiatives in Canada by funding community-based programs, educational resources, and anti-stigma and mental health awareness campaigns (3; 4). However, it’s important to remember this initiative isn’t called “#LetsTalk” and that this kind of activism is a form of marketing that is intended to promote a positive corporate message.

It’s without a doubt that more accessible resources and services are required now that there is a greater awareness of Canadians’ mental health needs. At Bliss Counselling, we will do our best to remove the barriers to accessing our mental health resources. We strive to provide an inclusive, safe, comfortable, compassionate and affordable space to talk about life’s challenges. If at any point we are unable to meet your needs, we will refer you to resources that will.

So… #LetsTalk today, tomorrow, and all of the days that follow.

If you would like to talk to somebody immediately about your mental health concerns, please call HERE 24/7 at 1-844-437-3247. If you would like to schedule a time to talk to one of our therapists, click here to book your consultation or contact us by phone or email. We are here to help!

10 Ways to Add Mindful Moments to Your Day

These days when everything seems chaotic, it can be very hard to focus on certain tasks at hand and to find the time to do everything that is expected of us. Having so much on our plate makes it much more difficult to live a truly fulfilling life and to think about what is important to us.

One way to improve the quality of our lives is to consider living in the moment and practicing mindfulness. While this can be quite a difficult feat to achieve in this digital age, there are still things that we can do. We’ve made a list of ten ways to support you in adding mindful moments to your day. Take a look.

Start your day in the positive way

First things first, try to start your day in the most positive way possible. If you get out of bed all grumpy and nervous, it’s only natural to feel like that throughout the rest of the day as well. There are many ways to set a more positive tone for the day. For example, you can stay in bed a few minutes longer and think of affirmations to tell yourself, like “I am smart, kind, and I continue to grow,” “I am doing my best and am worthy of desire,” “I am loved,” etc. You can also get out of bed and look at yourself in the mirror. Cheerfully greet and assure yourself by listing several positive things that await you during the day. Another idea is to make space for gratitude. Name three things, people, or places that you have felt especially appreciative for in the day, month, or year. Finally, a great way to achieve mindfulness in the morning is by setting a few minutes aside and focusing on your breathing or following a guided meditation. Meditation, just like yoga, has many benefits for our mental health. Just a few minutes without your phone and the various notifications pouring in can help a lot.

Engage in meaningful conversations

Being mindful in social situations is also a great opportunity to work on this practice. When spending time with our loved ones and colleagues, make sure you are present in that moment. Really listen to what they are saying and process this information. Try your best to not get distracted by your own thoughts and just nod along to their stories. If you happen to get distracted, practice self-compassion. Acknowledge that your mind is feeling busy and do your best to bring your focus back to your friend. Listening and showing an interest in others is a form of care that can leave people feeling loved. When we receive care, we are more likely to return the favour. Seeing as how we have many conversations on a daily basis, you should have no trouble developing your mindful listening skills further.

Be present when eating

It happens way too often that our mind simply wanders off during meals. If we eat in front of the TV and computer or while playing on the phone, we don’t pay attention to what we eat. This could lead to eating more food than we really need or want, which could also affect our mental health. Try to focus on your food and enjoy the pleasure it brings along. Chew slowly, taste each flavour and notice every texture. There is no need to rush so really take in every aspect of the dish in front of you, from the colour, to the smell, to the temperature. Take small bites, feel the intention and let yourself be fully present in the experience.

Deal with the household chores

Doing chores around the house is just something that you can’t avoid, so why not make the most of it and turn it into a great mindfulness practice? The next time you have to deal with these tasks, think of some ways for how you can use them to create mindful moments and not just rush through everything. For example, when grocery shopping, choose your ingredients with the utmost care. When making a meal, notice how you are peeling, cutting, and cooking your food. Take note of the smells this activity is producing. If you’re doing laundry, really feel the textures of the clothes and dedicate yourself to folding them. By thinking of the details, you will really be in tune with your surroundings.

Go for a walk

An easy way to be mindful during the day requires you to leave the house and just roam around. This simple activity can do wonders for your mental health. However, we often tend to listen to music, podcasts and audiobooks while walking and even text and talk on the phone. In order for this experience to be truly mindful, you need to do your best to connect with the world around you. Notice the little things, take in the sensations around you like smells and sounds, feel the ground beneath your feet and so on. Meditating outdoors like this can help you de-stress and soothe your body and mind.

Ride your bike

Another activity that can bring you closer to nature is cycling. Just like walking, cycling can help you clear your mind, de-stress and put you in a better mood. The same rules apply here as well – take off your headphones and take in your surroundings. When going out cycling, try not to plan your route but go where the road takes you. That way, you will have to stay mindful of everything that is around you, especially if you stumble upon an unfamiliar track. You will have to keep an eye out for any bumps in the road, the other cyclists or pedestrians and any other obstacles you might encounter. Listen to your body and do your best to stay in the moment. If you feel your thoughts wandering, refocus once again on what you are doing. However, unlike walking, you will need some equipment to make this possible. Luckily, if you turn to companies like Bikes Online, you can find everything from bikes that will help you conquer the roads and bags you will need for your water all the way to spare parts for your trusty steed.

Celebrate the little things

In such hectic times, it’s not uncommon to stay focused on your overall goals. However, in order to be mindful, you have to enjoy even the little things. Thinking only about the big picture can lead to a lot of stress and planning that can be overwhelming. So, it would be best to start celebrating even the smallest of your achievements during the day. To avoid robotically doing tasks one after the other without actually realizing what you’ve done, you should stop after every completed task and congratulate yourself for doing it. You can even reward yourself by taking a break, stretching or having a healthy snack. This will allow you to appreciate your end goal even more. Sometimes it can be difficult to identify and celebrate what we have accomplished throughout the day. We may feel as though we haven’t really done anything. In these moments, remember that doing small tasks like getting out of bed, brushing our teeth, eating breakfast, for meal prepping for later, or even breathing, are all very important acts of self-care that deserve positive recognition.

Do things one at a time

We know that some people consider multitasking to be a great skill that helps us do more in a short time but the truth is that it only makes us less productive. We are spread too thin and, therefore,energy much faster. Plus, we are more likely to make mistakes. So, instead of trying to juggle several obligations at once, we should deal with one thing at a time. Finishing one task before starting another one will not only ensure we do it mindfully and properly but it will also allow us to celebrate it once it’s done. The great thing is that this can apply both to our private and professional life and help us thrive and be more connected to the world around us.

Schedule time to do nothing

Doing nothing may be perceived as laziness but, actually, having some time to yourself without any obligations is a necessary form of self-care. Even if it’s just five minutes, you need to take this time to do nothing and be truly in the here and now. You can just sit outside in the sun, lie in your bed or look through the window. Turn off all electronics and do your best to avoid any distractions. If you consider this to be your break from work, know that you will return to the task at hand refreshed and relaxed.

Make time for yourself before sleep

Before you turn in for the night, you can do a similar ritual to the one we suggested for the morning. You can stand in front of the mirror and tell yourself how good your day was and go through everything that you’ve managed to achieve. Try to quiet stressors or negative thoughts and energy which might still be on your mind. You can also do some meditating to calm yourself down as that might help you sleep better and wake up well-rested.

As you can see, there are so many ways how you can introduce mindfulness into your everyday routine and these ten are only scratching the surface. From developing a morning and evening routine, to implementing some exercise and learning how to enjoy the little things, you should be able to find the approach that will fit you just right.

_____________________________________________________________________

Written by : Helen Bradford, Pronouns: She/Her/Hers

Helen Bradford is a journalism student who always seeks new ideas to write about. She enjoys blogging about beauty, health and style trends for women. When she’s not writing, she spends her spare time being active through fitness and traveling.

The Polyamorous Principle of Compersion

Compersion is the warm, enjoyable, and downright pleasurable feelings that we experience when our partners’ are cultivating good feelings with or from other people. The principal of compersion originates within consensual non-monogamous relationships (e.g., polyamory, swinging, open relationships, etc.). If we are thinking in binaries, compersion opposes jealousy and monogamous ideologies that are rooted in possessing, or “mate-guarding,” our partner’s affection for ourselves. 

 

If one partner is experiencing jealousy in their relationship, we might describe them as being in pain from the perceived threat of their significant other receiving care from or giving attention to another person. With jealousy, there is a sense of entitlement over a partner (i.e., feeling that we are owed our partner’s attention) and a fear of loss due to comparing ourselves to another. Anthropologists suggest that jealousy may be present in all cultures, but that it varies in the amount and intensity across communities and seems to be most prevalent among cultures where there is strong or aggressive masculine pride, or patriarchal standards (Peluso, 2008). 

 

Jealousy is most often known for leading to losses in affection, self-esteem and mistrust, as well as feelings of insecurity, anxiety, and rejection. For instance, in a recent study (Mogilski et al., 2019), the researchers found that when monogamous participants considered their partner as being involved with another person, they reported greater emotional distress than those who were consensually non-monogamous. Jealousy can create tones of possessiveness, aggression, and manipulation in a relationship and subjects all those involved to stress, and in more extreme cases, depression, abuse, suicide, and/or homicide (Harmon-Jones et al., 2009). So it’s no wonder that jealousy is one of the most common reasons that romantic and intimate relationships dissolve! 

 

Some researchers suggest however, that there are benefits to milder forms of jealousy (Rathus, Nevid, Fichner-Rathus, McKay, 2015). From this perspective, jealousy may serve as a way to show how much we care for our partners. But we have to consider to what extent this might be. Are you feeling occasional self-doubts or are you feeling consumed by your fears and overly dependent on your partners?

 

None of this is to say that we should try our best to avoid jealousy or hide our experiences of jealousy from our partners. It’s quite the opposite. Consider instead that milder forms of jealousy may be a signal of care when we are feeling challenged with openly communicating the emotions we are experiencing in our romantic and intimate relationships. Rather than falling into the pits of jealousy, or supressing it completely, what if instead it could be tamed? 

 

Enter compersion. Unfortunately, limited research exists on compersion, especially in comparison to jealousy. From what we do know, compersion is sensitive and empathetic to other people faring well or experiencing joy, and as a reflection of this, we feel positively of the situation too. Compersion is not the masochistic pleasure (i.e., enjoyment from emotions that are construed or socially constructed as “bad”), pride, or vicarious enjoyment. Rather, it requires learning to appreciate others’ as they flourish. 

 

In order to tame jealousy, we must understand the more deeply rooted issues and unpack our underlying concerns, which are often related to the fact that we enjoy affection and we care about ourselves. Jealousy is a response to vulnerability, as other people shape how we engage and feel connected in our communities. Perhaps our attachments to those we view as sources of security, feel susceptible to instability. When we are attached to another person, we feel a great sense of pleasure and dependency. However, dependency can feel like a great risk, as it comes with the potential for harm and abandonment, as well as losses in terms of support, pleasurable companionship and connections, or our relational identity. Ultimately, dependency can feel as though it is destabilizing our self-concepts (i.e., our beliefs of ourselves and others). 

 

Overcoming jealousy then, requires reflection and nurturance. We must reflect on social constructions of romantic ideals, like commitment, exclusivity, and competitive mating, and consider whether we would like to endorse these perspectives in our own relationships. This kind of reflection requires us to interrogate notions of power, social structures, identities and norms and to consider notions of consent and autonomy (i.e., the ability to make decisions for ourselves). We must too contemplate the ways in which we would like to communicate with our partners, and whether this consists of transparency, openness, accountability, and empathetic understanding for each other. Further, we should also reflect on our own expectations and boundaries. Ask yourself:

 

What do you want from a romantic relationship and why?

Are you bound to social standards or are you driven by your own personal desires?

Are you feeling too dependent on your partner?

Are you feeling insecure, and if so, what might be triggering these feelings and how could they be managed?

What affirmation are you looking for from your partner?

 

By doing this, you can begin to tame some of jealousy’s worst manifestations by slowly exposing yourself to new ideas and affirmations. Jealousy is fear-based, and therefore, thrives in silence and isolation. Try communicating these fears with others, practicing positive affirmations (e.g., “It’s okay to feel jealous”), and expressing love. 

___________________________________________________________________

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.

What you need to know about the 2019-2020 Human Development and Sexual Health Curriculum

Last year, Doug Ford promised voters that if the Conservatives were elected, they would repeal the controversial 2015 Health and Physical Education Curriculum introduced by Kathleen Wynne and the Liberals.

At the time, Wynne stated that the 2015 curriculum brought Ontario in line with other provinces. In the fall of 2014, the Ministry of Education consulted around 4,000 parents across Ontario, 2,400 educators and other stakeholders, 700 students, as well as police, academics, and other community organizations. Ford however, insisted that parents were not consulted and as promised, he scrapped the 2015 curriculum last summer and replaced it with an interim version that was a combination of the 1998 and the 2010 revised curriculums. Read more about the interim version here.

On Wednesday August 21, the province released the 2019 Revised Health and Physical Education Curriculum, Grades 1-8, to be implemented this September. This new curriculum collected feedback from more than 72,000 parents, students, educators, employers, and organizations across the province. It covers topics on mental health, healthy relationships, cyber-bullying, consent, cannabis, vaping, concussions, body image, LGBTQ experiences and communities, homophobia, and gender identity and expression.

Human Development and Sexual Health is only one part of the Health and Physical and Education Curriculum, but it is the only component that parents/caring adults may exempt students from learning this school year. In comparison to the 2015 Human Development and Sexual Health component, there are very few differences:

(1) Body appreciation is now a mandatory topic in grade 2.

(2) Gender identity and sexual orientation have been removed as  subtopics of invisible differences in grade 3. Mental illness has been included instead.

(3) The topics of sexual orientation are mandatory in grade 5 (2019), instead of grade 6 (2015).

(4) Gender identity and expression is now a mandatory topic in grade 8 (2019), instead of grade 6 (2015).

(5) Sexually explicit media (i.e., pornography) is now a mandatory topic in grade 6.

(6) Transsexual (i.e., a person who transitions from their sex assigned at birth) and intersex (i.e., a person born with male and female sex characteristics, typically assigned one or the other at birth) has been removed from the topic of gender identity in grade 8 and there is no explicit mention of them elsewhere (aside from the Glossary of Terms). Male and female, which are sexes assigned at birth, remain a topic of gender identity. Pansexual and asexual are now included in the topic of sexual orientation.

(7) Pleasure has been removed from the topic of decision-making skills in grade 8.

(8) Greater focus on consent and the legal age of consent, personal boundaries, respect for others, avoiding assumptions, discrimination (e.g., homophobia/racism), body image, mental health, and that decisions regarding sexual activity be made in consideration to being in a loving and healthy relationship.

(9) Minor edits to the terminology/language being used throughout the document (e.g., STBBIs, unplanned pregnancy/becoming a parent, self-awareness, self-acceptance, etc.)

For more detail on each topic and to compare the differences between the two curriculums, click here Comparison of Curriculums.

If a parent/caring adult wishes to opt a student out, they will be given a form 3 weeks before the lesson is to be taught. This form will need to be returned up to 5 days before the class. The form will offer the following three options:

(1) The child may remain in the classroom, but is not to be involved in the lesson.

(2) The child may be removed from the classroom and kept in a safe and supervised location elsewhere on school property.

(3) The child may be removed from the school.

As parents and caring adults who are looking to exempt students from the Human Development and Sexual Health component, ask yourselves why this is may be important to you:

How might the topics be conflicting or challenging your personal values and beliefs?

What are the short and long term benefits and harms of discussing certain topics?

What is missing from the curriculum?

Will you have these conversations instead, and to what capacity or with what resources?

This curriculum was designed in order to keep all children healthy and safe in Ontario. Many of these topics are in line with human rights at both the federal and provincial level. But, diverse perspectives about sex, sexuality, gender identity and expression, media, consent, joy, and respect (among others!) are still missing. You can address these gaps by having conversations about human development and sexual health regularly with your kids. Although they are not available yet, the Ministry of Education will be releasing online resources this 2019-2020 school year so that parents/caring adults can discuss these topics at home, once they feel ready to do so.

For more information on all of the topics being taught in the new Health and Physical Education Curriculum, click here. You can also compare the Human Development and Sexual Health components to other educational resources that describe the appropriate age to discuss sex and sexuality with children, such as About Kids Health and Caring for Kids.

Follow us on Facebook, Instagram, and Twitter for ideas and resources on when and how to have more ongoing talks about sex and sexuality with your kids!

______________________________________________

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.

Let us help you find your perfect match.

General Contact
Will you be submitting your receipts to your extended health benefits or insurance provider?