Understanding Borderline Personality Disorder 12 March 2021 Bliss Team No comments Categories: Book Recommendations, Individual Therapy, Therapy, Uncategorised Please note that every person’s experience of borderline personality disorder (BPD) is different. The symptoms and ranges of BPD run both vertically (the number of symptoms experienced) and horizontally (the intensity of how they are experienced). If we also consider other factors that layer and intersect, such as life events (e.g., t/Trauma) and social positions (e.g., financial security, colour of skin, sexual orientation, gender, etc.), our end result is a very unique tapestry of experiences. “People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.” Dr. Marsha Linehan What is Borderline Personality Disorder? BPD is the most common personality disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). This manual is used by physicians and psychologists to make mental health diagnoses. Someone with a personality disorder typically faces unique challenges in: Relationships and social situations; Managing emotions and thoughts; Understanding how certain behaviours are creating problems and/or; Recurring difficulties in changing a mindset to suit different contexts. 75% of people with BPD self-injure one or more times. 10% of people with BPD take their own lives. What are the symptoms of BPD? The DSM-IV-TR lists 9 categorical criteria for BPD. A person must present with at least 5 of the symptoms in order to be diagnosed with BPD. The 9 symptoms can be summarized as: Frantic efforts to avoid real or imagined abandonment, significant fears of being alone; Unstable and intense interpersonal relationships; Lack of clear sense of identity; Impulsiveness in potentially self-damaging behaviours, such as substance abuse, sex, shop lifting, reckless driving, binge eating; Recurrent suicidal threats or gestures, or non-suicidal self-injury such as cutting, burning with a cigarette, or overdose that can bring relief from intense emotional pain; Severe mood shifts and extreme reactivity to situational stresses; Chronic feelings of emptiness, loneliness and neediness; Intense, frequent, short-lived and inappropriate displays of anger, depression or anxiety; Transient, stress-related feelings of unreality or paranoia. Inconsistent symptoms are the hallmark of BPD, which makes it difficult to define a single set of criteria for a diagnosis. This is further complicated, as research has shown that about 90% of folks with a BPD diagnosis, share at least 1 other major psychiatric diagnosis. What is it like living with BPD? “Prick the delicate ‘skin’ of a borderline and she will emotionally bleed to death.” Kreisman and Straus BPD has been described as emotional hemophilia. In the case of BPD, the client will have difficulties with moderating their feelings. Mood changes can come and go quickly and can shift from extreme joy to the deepest despair. A person with BPD may be filled with anger or despair one hour and then calm the next, with little understanding as to why. This then leads to feelings of insecurity, lower self-worth and inner criticism, which brings about more self-hate and depression. Symptoms, such as dissociation, can also interfere with concentration making it very difficult for folks with BPD to complete their tasks. Feelings of emptiness makes a person with BPD feel as though they have to do anything to escape, such as impulsive and self-destructive behaviours, so that they may feel something. People with BPD may also feel as though they do not have a core identity and to overcome their mostly negative self-image, they will create characters or codes. People with BPD may also experience splitting. Splitting can happen at any time, if they are under enough pressure, stress, anxiety, or anger. Splitting is when a person only thinks about a situation or person in binaries. It is the rigid separation of positive and negative thoughts and feelings about oneself and others. For instance, a person with BPD may only consider a context to be right or wrong, good or bad, or in black and white terms without any room for grey. A person with BPD may struggle to accept human inconsistencies or ambiguities, and as such favour predictability. When there is a miscommunication or when somebody they idealize eventually disappoints them in some way, or acts in a way that they did not predict, a person with BPD may look at them as though they cannot be trusted. When this occurs, the person with BPD has to make a decision to either restructure their strict and inflexible conceptualization of this person or to isolate themselves in order to preserve the “perfect” image they had created. Research shows that there is no definitive cause for BPD, rather it is a combination of genetic, developmental, neurobiological and social factors that contribute to its development. People with BPD may come from family backgrounds with parents who were indifferent, rejecting or absent. They may have also received little to no affection and/or experienced chronic abuse. A person with BPD will also seek out new relationships (i.e., partners and/or friendships) quite often. Once in a close romantic relationship they will both crave and become terrified of intimacy; fearing abandonment, they will cling to their partner, which will then lead to fears of enmeshment, so they push away. Because of this, they end up pushing away those they want to connect with the most. Of all the major mental health diagnoses, BPD is the most stigmatized. Stereotypes include viewing folks with BPD as dramatic, manipulative, unfeeling or lacking emotion, attention-seeking and/or narcissistic. They are consistently suspected of wrongdoing, carelessness, anger, and difficulties with building a regular routine. This leads folks with BPD to hide this part of themselves from others. For a person with BPD there are significant fears of abandonment and they will attach to a favourite person and rely on this person for emotional validation and security. Their favourite person becomes the source of their comfort and devotion. A BPD person’s favourite person can be anybody: a relative, parent, best friend, lover, or somebody they just met. The difference between a best friend and a favourite person, is related to the intensity of the thoughts that surround this person. A person with BPD requires compassion, understanding, acceptance, honesty, patience and love. They may not have grown up with either receiving or learning how to share these characteristics with their formative relationships, so accountability for behaviours that are challenging a relationship and empathy, are key. Of course a person with BPD will need to learn how to give themselves the love and compassion that they crave from others, as well. What can you do if you or a loved one is experiencing BPD related symptoms? It is important to recognize that there is no “cure” for BPD, rather somebody who experiences these traits and is receiving treatment may just have more time between self-harm episodes and/or coping strategies to support emotional regulation. Kreisman and Straus have described a structured method of communication, known as SET that can be used when communicating with a person who is in a BPD related crisis, or emotionally spiralling. Support – Use a personal “I” statement of concern to demonstrate a personal pledge to try to support the person in emotional crisis. For example, “I am really worried about how you are feeling.” Empathy – Acknowledge their chaotic feelings with a “You” statement. For example: “You must be feeling awful/scared/hurt/etc.” Truth – Emphasize that this person is accountable to their own life and that others’ attempts to help, cannot avert this primary responsibility. In this statement, you must acknowledge that there is a problem that exists and offer a solution for what can be done to solve it. This must be done in a matter of fact tone. For example, “Here’s what happened…These are the consequences…. This is what I can do… What are you going to do?” It is possible to have a healthy relationship with a person with BPD, especially if you are the favourite person. You can do this in 5 easy steps. Step 1 : Communicate The first step is to have a discussion, to acknowledge that you are their favourite person, and to determine if the relationship is mutual. Questions to reflect on and consider during this discussion are: What are each person’s needs? Are they currently being met? Has there been an instance where either person’s needs weren’t met, why might that be and how might you both be able to overcome this in future interactions? What are both of your feelings regarding space and emotional boundaries? Step 2: Avoid Assumptions BPD folks generally think in black and white (e.g., “they don’t love me anymore”). In order to avoid this assumption and the potential for an emotional crisis, or “testing” the favourite person to make sure they still do love them or won’t leave them, the BPD person should feel comfortable with being direct and asking for reassurance from their favourite person (e.g., “Is everything alright? I’m just worried because I haven’t heard from you in a while”). Step 3: Develop More Friendships It is comfortable and easy for a BPD person to give all of the love and everything they have to their favourite person, but it’s a lot of pressure to receive and also reciprocate as a single human being. This is why it is important for both the favourite and BPD person to have friends of their own that they enjoy spending time with. This will help the BPD person with the intensity of putting all of their emotional needs on one person, and will also help the favourite person to have other outlets and their own support. It’s important that the BPD person avoids scheduling their plans around their favourite person. Step 4: Limit Expectations This is one of the most difficult ideas for a BPD person to incorporate into their worldview, but it is to cultivate a mindset in which their favourite person may leave, by choice or not, and this is okay. This requires a mindful appreciation for enjoying the day for what it is. No matter what happens. It is not possible to control a person or to demand that they be committed to your relationship or friendship forever. Thinking of the future and the possibility that they could leave, may generate anxious thoughts and feelings of being abandoned. Instead, the BPD person can try practicing gratitude for the current state of their relationships. Step 5: Therapy & Medications Treatment for both the BPD and favourite person usually begins with education; discussing what is known about BPD and its causes, as well as how the BPD person can self-manage and prevent relapses. Therapy and counselling may also be offered at the individual or group level for both the BPD and favourite person. The BPD person may also wish to take prescription medications that align with their specific symptoms (e.g., mood swings or anxiety). There are a number of therapeutic tools that can be used in the treatment of BPD symptoms. The 2 major tools are cognitive behavioural therapy (CBT), which focuses on the present and on changing negative thoughts and behaviours, and dialectical behaviour therapy (DBT) which uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and the client’s emotional state. DBT helps clients to regulate intense emotions, to reduce self-destructive behaviours and to improve relationships. It’s important to remember that like any relationship, the connection you build will be at it’s healthiest if it is constructed on a foundation of trust, friendship, mutual respect and care, honesty and accountability. At Bliss, we want to help our clients navigate the complexities of BPD and help them live balanced, happy, fulfilling lives. If you need additional guidance, please book an appointment with one of our therapists who specialized in this area and will guide you through the therapy process in a safe, non judgemental atmosphere: Sheila Mcdonough Sergius Semuyeh Valentina Messier Josh Rinz Marni Moss You do not have to go through this alone. Bliss is here to support you. Written By: Jess Jess is our amazing office strategist at Bliss Counselling. Jess is a Master’s graduate from the University of Guelph. During this degree, they focused on aging and end-of-life, communication, human sexuality, LGBTQI2S+ health, inclusive practice and policies, knowledge mobilization strategies, research methods, and program evaluation. I would like to learn more about BPD, what other resources exist? For more information and support, please consider the following resources. Books Beyond Borderline: True Stories of Recovery from Borderline Personality Disorder by John G. Gunderson (edited by Perry D Hoffman) Building a Life Worth Living: A Memoir by Marsha M. Linehan Coping with BPD: DBT and CBT Skills to Soothe the Symptoms of Borderline Personality Disorder by Blaise Aguirre I Hate You – Don’t leave me: Understanding the Borderline Personality by Jerold J. Kreisman and Hal Straus Loving Someone with Borderline Personality Disorder by Shari Y. Manning Mastering Adulthood: Go Beyond Adulting to Become an Emotional Grown-Up by Lara E. Fielding The Dialectical Behaviour Therapy Wellness Planner: 365 Days of Healthy Living for Your Body, Mind, and Spirit (The Borderline Personality Disorder Wellness Series) by Amanda L. Smith The Mindfulness Solution for Intense Emotions: Take Control of Borderline Personality Disorder with DBT by Cedar R. Koons This is Not the End: Conversation on Borderline Personality Disorder by Tabetha Martin The Dialectical Behaviour Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation and Distress Tolerance by Matthew McKay, Jeffrey Wood, and Jeffrey Brantley Online Documents Borderline Personality Disorder: An Information Guide for Families by CAMH https://www.camh.ca/-/media/files/guides-and-publications/borderline-guide-en.pdf?la=en&hash=69DE097DD9DC16A66440FCD4573E73358AEEECEC Borderline Personality Disorder by the National Institute of Mental Health https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml DBT Skills Training Handouts and Worksheets by Marsha M. Linehan https://projecticee.files.wordpress.com/2018/12/lin-c-dbt-handouts.pdf The Overlap Between Autistic Spectrum Conditions and Borderline Personality Disorder by Dudas et al., (2017) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590952/
Chronic Wounds and Mental Health – An Overlooked Connection? 19 February 2021 Bliss Team No comments Categories: Guest Post When we think about our health, what often comes to mind are physical health issues like cancer, diabetes, and cardiovascular disease. These conditions do deserve significant attention, and certainly do pose a risk to our health. However, along with many of these conditions, there is another complication that does not garner as much attention, although it does significantly affect our health: our mental health. Chronic wounds are those wounds that do not heal in the expected time frame and do not follow the normal healing process. The result is an ongoing battle to overcome the wound and return to an active lifestyle. Coping with a chronic wound can feel like an uphill battle with no end in sight. This is also why chronic wounds can affect our mental health so dramatically – because they seem like injuries that cannot be overcome. What Is Mental Health? Mental health can simply be defined as the absence of mental illness. However, mental health deserves a much broader definition and more widespread recognition than it is given. It can be the difference between functioning at a satisfactory level and truly embracing and enjoying our lives, especially when it comes to chronic wound care The World Health Organization defines mental health as “subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one’s intellectual and emotional potential, among others.” Ultimately, our well-being includes the realization of our abilities, coping with normal stresses of life, productive work, and contribution to our community. Our mental health also affects how we think, how we perceive the world, the actions we take, and how we feel on a day-to-day basis. It can also contribute to how we handle life’s stresses, setbacks and failures, and our relationships. All in all, mental health encompasses just about everything we experience as humans, which is why it’s so important. According to the Centers for Disease Control, nearly one in five U.S. adults live with a mental illness (46.6 million in 2017), with an estimated 11.2 million adults aged 18 or older in the United States with what can be classified as a Serious Mental Illness. This means 4.5% of all U.S. adults cope with some form of mental illness. Many factors contribute to our ability to maintain our own mental health. These include any biological problems we may have, our life experiences, our family history, and any health conditions we are coping with – such as chronic wounds. How Do Chronic Wounds Affect Mental Health? According to the National Institute of Mental Health (NIMH), the presence of chronic conditions can increase the risk for mental illness. For example, conditions like Parkinson’s disease and stroke cause changes in the brain, which may trigger symptoms of depression. Depression is also common in people who have chronic illnesses such as cancer, coronary heart disease, diabetes, Alzheimer’s disease, HIV/AIDS, rheumatoid arthritis, lupus, and epilepsy, among others. Chronic illness can also cause feelings of illness-related anxiety and stress related to coping with wounds. Moreover, when depression and anxiety are present, the symptoms, as well as those of the chronic health condition, tend to be more severe. The NIMH also says people with depression are at higher risk for other medical conditions. As an example, people with depression have an increased risk of cardiovascular disease, diabetes, stroke, Alzheimer’s disease, and osteoporosis. One explanation for this is that mental illness may interfere with the ability to cope with chronic health conditions. For example, with mental illness present, a person may find it more difficult to seek care, take prescribed medication, eat well, and exercise. Lastly, preliminary research suggests that symptoms of depression and anxiety can cause signs of increased inflammation, changes in the control of blood circulation and heart rate, increased stress hormones, and metabolic changes that increase the risk of diabetes – all of which impact our health and our ability to cope with chronic health conditions. How Can Mental Health Be Improved While Coping with Chronic Wounds? The process of wound healing comes in four stages and it’s imperative to maintain mental health throughout each of them. While the most common treatment strategies for mental illness include cognitive behavioural therapy (CBT), medication, such as selective serotonin reuptake inhibitors, (SSRIs), and, in the most severe cases, electroconvulsive therapy (ECT), there are many lifestyle changes that we can incorporate every day to improve our mental health. Psychology Today suggests the following nine, all of which apply especially to chronic wound care patients: Be positive. While it is easy to overlook the automatic thoughts that run through our heads, when combined, they can add up to a negative outlook. When we see life through a negative lens, we tend to focus more on the things that confirm that belief. On the other hand, when we incorporate positive thoughts, these often lead to positive interpretations. For example, rather than saying, “I can’t do anything right,” try saying, “It didn’t work out this time, but I will try again.” Be grateful and write it down. It’s now clear that feelings of gratitude do significantly affect our mental health. When we can find things in our lives to be grateful for, not only do we feel differently, we also act differently – in ways that often lead to additional mental health benefits. One quick way to start is to keep a gratitude journal, or better yet, try practicing three acts of gratitude every day. Focus on what we can control, and be in the moment. Both ruminating about the past and forecasting the future can cause feelings of regret, depression, and anxiety. We can’t do anything about the past or the future. However, what we can do is stop and choose to focus on what we can control – our actions in the present moment. One easy way to do this is to simply pay attention to your routine activities and the thoughts that accompany them. Get active. Exercise is one of the most palpable ways to gain a sense of control. When you exercise, despite what else is happening in your life, you remind yourself that you can do something positive for your mind and body. Further, exercise increases stress relieving and mood lifting hormones, which have both an immediate and ongoing effect. Exercise can be incorporated in 30-minute blocks, or you can simply look for small ways to increase your activity level, like taking the stairs, going for a walk, or playing with your dog. Eat right. What we eat provides our brain with the ingredients to function well and improve our mood. Carbohydrates increase serotonin, which makes you happy, while protein-rich foods increase norepinephrine, dopamine, and tyrosine, which help keep you alert. Fruits and vegetables provide nutrients that feed every cell in the body, including mood-regulating brain chemicals. Lastly, foods with Omega-3 polyunsaturated fatty acids (found in fish, nuts, and flaxseed) can improve both our cognitive function and our mood. Open up. When we bottle emotions up, we don’t give ourselves an opportunity to cope and find creative solutions. We also dampen our ability to recognize our own habits, which may be contributing to how we feel. On the other hand, when we open up to someone else, we can pinpoint the positive aspects in other people (such as feeling valued or experiencing a sense of trust) and overcome our own biases. Do something for someone else. Like acts of gratitude, being helpful to others has a beneficial effect on how we feel about ourselves. Moreover, being helpful helps us feel valued, which contributes to positive self-esteem and helps us find a sense of meaning in our lives. Chill out. Sometimes in moments of high stress what we really need to do is step away. Often by simply slowing down, we can gain a greater perspective on what is going on, and in the process, find a positive solution. You can start with focusing on something that brings you positive feelings, such as a person that you love, an experience you enjoy, or something you are grateful for. You can also talk a walk, spend a moment in nature, or close your eyes and visualize yourself feeling calm and at peace. Get a good night’s rest. Sleep deprivation has a significantly negative effect on our mood, and sadly many of us don’t get enough sleep. Sleep can be improved with a few daily habits such as going to bed at a regular time each night, avoiding caffeinated beverages for a few hours before sleep, shutting off screens before bed, or incorporating relaxing activities before bed. There are many powerful components of mental health, like enjoying our lives, feeling as if we are striving toward something important, utilizing our skills, and seeking to reach our full potential, to name a few. And while chronic health conditions are often an overlooked deterrent to mental health, incorporating daily habits -i.e. replacing automatic negative thoughts with positive ones, performing acts of gratitude, staying in the moment, exercising, eating well, opening up, being helpful, taking time out, getting enough sleep, etc. – we can combat mental illness even amidst difficult chronic health conditions. Written By: Claire Nana Claire Nana, LMFT, is a Licensed Marriage and Family Therapist who specializes in post-traumatic growth, optimal performance, and wellness. She’s written over thirty continuing education courses on a variety of topics from Nutrition and Fitness, Mental Health, Wound Care, Post-Traumatic Growth, Motivation, Stigma.
To my Quaran-tine: How can we navigate our relationship during a pandemic? 14 February 2021 Bliss Team No comments Categories: Book Recommendations, Communication, Self Care, Sex Therapy, Sexual Wellness Due to the restrictions on dating activities that would normally happen during Valentine’s Day, couples may feel like it’s going to be just another day. Which can be disappointing to those who enjoy taking a break from the repetitiveness of everyday life relationships. This is a universal conflict for all couples, new or old, healthy or strained. COVID-19 did not just impact how people meet, but also the exploration of romance and even how much time people spend together. For partners who are living together and are spending more time with each other at home throughout COVID-19, emotional connection has improved; physical connection on the other hand has not. The amount of time spent with partner(s) does not necessarily equate to “quality time”. For instance, more time together could mean more conversations about things each person isn’t happy with within their relationship or changes they might like to see. Some partners may realize they aren’t as compatible with each other and may be starting to realize that they want different things. Some relationships may be trying to work through betrayal, such as infidelity, and are finding it difficult to not be able to take space from their partner(s), as they try to figure out what they want. If we layer in those relationships who have children, it’s even more difficult to have privacy and to take time to grieve aspects of the relationship when the kids are around and people are isolated from their support systems, like family, friends, co-workers. For those who are dating, there is also a lot more communication and negotiations of boundaries during COVID-19. For instance, folks may be asking themselves: Is it safe to be discussing COVID-19 related precautions with this new person? How do we discuss and navigate consent? Should I be isolating after sharing a physical connection, and if so, for how long? Are relationships that came to fruition during the pandemic going to last past the pandemic? A list of common challenges people have felt in their relationship during COVID-19 includes: Experiencing Low sexual desire and desire discrepancy Sharing less physical intimacy or avoiding sex Overcoming infidelity Finding ways to effectively communicate feelings and listen to alternative perspectives Managing erectile dysfunction & rapid ejaculation Exploring sexuality Reconnecting sexually Wanting to open up the relationship Sometimes when there is a crisis, it can either connect and bring partners closer or it can have the opposite effect. It’s important to remember that relationship bumps are inevitable, pandemic or not, No matter the situation, great new things will come from this, even though it’s hard right now. At Bliss, we want to help our clients through these challenging times. Navigating relationships during COVID-19 can be hard, but not impossible. Here are some tips from our very own therapists who specialize in sexual health and wellbeing in relationships: Have separate time You’re not going to desire someone when you spend all of your time with them. Do what you can to separate yourself. That could mean, self-care, taking up jogging, biking, connecting with friends, and having outdoor hangouts in safe ways. Do not feel guilty for taking time for yourself. Increasing pleasure and fun Figure out target specific activities you can do at home, or outside, these can be brainstormed with your therapist. Some activities you can discuss with your partner(s), or date are: Exercising Board Games Movie Marathons Puzzles Planning Future Fun Events Cooking Together DIY Spa Dates Bubble Baths Colouring Dressing Up For A Date Night In Reading To Each Other Paint Night Online Classes Yoga Stargazing Create a Photobook Of Memories Long Drives Bake Off Share Your Favourite Stand-Up Specials Streamline a concert together Make (chocolate) fondue together Make breakfast in bed Recreate your first date, from home! Make your own valentine Ask conversation starters, or quiz yourselves on your love maps! Write each other a poem or haiku Write each other love or gratitude letters Cook a romantic dinner, with candle light and all (some of these ideas are great for an COVID friendly Valentine’s) Open Communication Anxiety about COVID-19 leads to stress and irritability in the relationship. Effective open/transparent communication around what you are going to do is key. Whether it is with your partner(s) or someone you’re dating. If you have the same perspective, it’s okay. If you have two different perspectives, or pre-existing anxiety and OCD, it will affect the relationship. So, discussing boundaries and negotiating “dating terms” should be at the forefront of conversation. Managing Stress If you find yourself being hypervigilant in managing emotions, minimizing conflict, protecting kids from the tension or outburst, you may be giving yourself additional unnecessary stress. In managing stress levels, remember that you cannot control anyone else’s emotions except your own. You must let your partner(s) regulate themselves. For those in couples or individual therapy, this is something you can talk to your therapist about. Finding ways to regulate your own emotions will help in figuring out how to move forward with your partner(s) with no resentment. It’s really important to normalize your experience and your partners’ relationship concerns. Our therapists here at Bliss validate client’s emotions and experiences while supporting them in reframing thoughts, changing habits, breaking patterns, and getting out of cycles they may be stuck in. Navigating relationships during a pandemic can be hard. Give yourself more credit, and Happy Valentines Day! Resources: Come As You Are by Emily Nagoski, for desire/arousal in women. Better Sex Through Mindfulness: How Women Can Cultivate Desire by Lori Brotto Not Always In The Mood by Sarah Hunter Murray, for low desire in men and myths around male sexuality Esther Perel – Infidelity Written By: Raman Dhillon Raman Dhillon is the office strategist & digital content manager and helps assist our clinic/operations manager Jess. Raman has a background in Psychology & Literature from the University of Waterloo, and more recently a Post Graduate Degree in Mental Health and Addictions from Humber College. Raman has experience with client-centered intervention as well as holistic assessment. She’s very interested and well versed in different therapeutic approaches such as mindfulness, naturopathy, and art therapy. Raman loves merging her two passions, mental health, and art to convey messages, psychoeducation, and awareness to the masses.
You Could Be Sleep Deprived: What It Does and What to Do About It 23 July 2018 Bliss Team No comments Categories: Guest Post, Self Care Sleep plays an indispensable role in overall health and wellness. When the body doesn’t get enough rest, the consequences can affect thinking ability, appetite, and your professional and personal relationships. What Happens to Your Body During Sleep Deprivation Even one bad night of sleep can change the mind and body, and prolonged sleep deprivation only causes these changes to worsen. While you sleep, the brain gets to work cleansing itself of toxins while pruning and strengthening connections made during the day. If you’re not getting enough rest or if you frequently wake throughout the night, your critical-thinking skills, decision-making abilities, and reaction times all slow down because the brain isn’t getting the time it needs for self-maintenance. Your body also changes how it controls appetite when tired. The body releases more of the hunger hormone ghrelin and less of the satiety hormone leptin, leaving you hungrier and less full. Not only do you feel hungrier but the body craves high-fat snacks and sugary treats because the reward center of the brain gets a bigger “hit” from those foods when you’re tired. It becomes difficult to maintain your physical health without enough sleep. Certain areas of the brain also begin to function differently when sleep deprived. The amygdala, which processes emotions, becomes more sensitive to negative thoughts while the prefrontal cortex, which applies higher reasoning to feelings becomes less active. Consequently, irritability, aggression, sadness, and anger can have more influence on your daily interactions. Maintaining both professional and personal relationships becomes harder due to the emotional changes that take place during sleep deprivation. Make a Change for Better Sleep While sleep may be a necessary biological function, that doesn’t mean that it’s always easy. There are many environmental factors as well as personal habits and behaviours that can be altered to affect your sleep positively. The bedroom and everything in it should support healthy sleep. For example, a comfortable mattress with breathability and support eliminates physical discomforts and distractions. Blackout curtains and noise absorbing decor that keep light and sound to a minimum can help reduce wakefulness or waking too early. You can also develop habits that support healthy sleep like: Keeping a Consistent Sleep-Wake Schedule: The body loves a consistent schedule because it allows it to follow natural 24-hour cycles called circadian rhythms. When you go to bed and wake up at the same time every day, you give your body a chance to adjust and strengthen its response to these cycles. Developing a Regular Bedtime Routine: Routines help the brain know when to time the release of sleep hormones. A bedtime routine can also help relieve stress and calm the mind. Reading a book, meditation, and taking a warm bath are all bedtime routine favourites because of their relaxing effects. Regularly Spaced and Timed Meals: Try to eat your meals at roughly the same time every day and keep them evenly spaced throughout the day. Meal timing and spacing plays a role in the proper timing of the sleep-wake cycle. Shut Off Your Screens: Televisions and other electronic devices can give off a blue light that suppresses sleep hormones. You can either shut them off two to three hours before bed or turn on the low blue light setting if the device has one. Everyone will have a sleepless night now and then. However, if the problem becomes chronic, you can take steps to improve your chances of getting a full night’s rest. About the Author: Amy Highland is a sleep expert at SleepHelp.org. Her preferred research topics are health and wellness, so Amy’s a regular reader of Scientific American and Nature. She loves taking naps during thunderstorms and cuddling up with a blanket, book, and cats.
Avoidance versus Self-Care? 6 December 2017 Kelly McDonnell-Arnold No comments Categories: Guest Post, Self Care, Therapy You’re at home watching your favourite TV show, when Netflix asks you the judgmental question: “Are you still watching?” (Yes, Netflix, This is Us brings me to tears every time and I need to know what happens next.) You realize that one episode turned into several, and more than a few hours have gone by. But, hey, what’s wrong with a little relaxation and enjoyment during your time off? The answer is “nothing” if what you’re doing is practicing self-care. However, what we categorize as personal care can actually be its cleverly disguised twin – avoidance. Both can involve enjoyable activities and time spent on oneself, but they are actually quite different. THE PURPOSE OF AVOIDANCE AND SELF-CARE Avoidance and self-care serve distinct purposes, but because the means of expression are similar, we can easily fool ourselves into believing one is the other. Here are the primary differences between the two: The purpose of avoidance: To numb out, ignore, or escape from a task, problem, or difficult emotion. The purpose of self-care: To respond to your physical, mental, and emotional needs in order to care for your overall well-being. HOW TO TELL THE DIFFERENCE Both of these strategies are forms of coping; however, only one of them provides a long-term solution. (I’ll explain that more in the section “Why it matters.”) First, ask yourself what the intention is behind the behaviour or activity. For example, let’s say you cancel an outing with a friend. If you cancelled because you had a long day and need to rest, then that’s self-care. However, if you cancelled because you feel anxious about meeting new people, then that’s avoidance. Next, check in with your ability to manage whatever you are trying to avoid. This is known as your distress tolerance. Part of healthy emotional management is knowing when you cannot deal with something in the present moment. For example, if you are dealing with a family crisis but also have to be at an important business meeting, it makes sense to intentionally put your personal matters aside during the work day. However, what differentiates this from avoidance is the awareness and the follow-up. With healthy coping skills, you will be able to revisit and address the issue when you have the time and space to do so. It can be hard to distinguish between self-care and avoidance, but being aware of your emotional state can help you better identify your needs and act intentionally on them. It also requires some honesty with yourself. Is it that you can’t deal with a particular emotion or situation, or is it that you don’t want to? Using our earlier example, perhaps you realize that meeting new people makes you anxious, but realize that you have developed some tools to help you manage those feelings and you could challenge yourself to keep the commitment. However, sometimes the answer to “Can I manage this?” is “No, not today.” Great! Knowing your limits and meeting your needs falls under self-care. If the idea of meeting new people is overwhelming today, perhaps you reschedule for another evening and prepare accordingly. WHY IT MATTERS Avoidance feels like it protects us from the things that scare or overwhelm us, but in reality it just sustains them. In other words, we feel better in the moment, but are worse off in the long run. For example, imagine that you have an assignment to complete but that you feel too overwhelmed to deal with it, so you end up on Buzzfeed instead. You now have to pull an all-nighter and are not sure if you will make the deadline in time. While procrastination (aka avoidance) decreased the stress temporarily, it ultimately created more anxiety and panic. This, in turn, can lead to further avoidance of those difficult emotions, with the subsequent sensation of “spiralling out.” Instead of ignoring those overwhelming feelings, let’s imagine instead that you dealt with them directly and in the moment. Perhaps you don’t even start the task immediately because you think a 10 minute meditation might be helpful to ground you. Even though this is delaying the activity, it isn’t avoidance. If you look back to the purpose of self-care, you can see that you’re addressing an emotional need instead of ignoring the emotion altogether. By doing so, you manage the anxiety and proceed with the assignment. Acknowledging your emotions and taking care of your needs allows you to get through a difficult situation, which brings me to my next point. LIVING FULLY Whether it’s drinking to forget a traumatic memory, exercising to quell the feelings of loss, or scrolling through Instagram to drown out negative thoughts, these strategies prevent us from ever truly addressing the underlying causes of our pain. Try as we might, there is no way to cut out the bad without simultaneously cutting out the good. Therefore, these avoidant strategies deny us the opportunity to find joy, contentment, release, and forgiveness. If we put aside the avoidance and acknowledge the hurts, then we have a real chance at living the lives for which we long. ADDITIONAL RESOURCES: Being with Stressful Moments Rather Than Avoiding Them Whole-Hearted Living: Experiential Avoidance (This article was originally published on Stephanie’s Blog). Stephanie Huls is a Registered Social Worker and private therapist at Reflection Counselling Services in Waterloo. She offers counselling services to adults and teens on a variety of issues and is passionate about helping people find the path to the lives they wish to lead. She prides herself on being open about her own experiences in counselling and has a personal understanding of how bumpy that path can be.
What Is Happiness? 11 May 2017 Bliss Team No comments Categories: Guest Post, Individual Therapy, Life Coaching What do Taylor Swift, that guy whose best attempt at romance was to send you a picture of his junk, and bell hooks have in common? Well, if we managed to look past the catchy lyrics, the nauseating brocabulary, and the penetrating eloquence, we’d see that they all just want to be happy. But what is happiness, anyway? I know it seems like a question for philosophers, but as a therapist I’ve learned that how we define happiness actually has serious implications for our mental health. Most of us grow up believing that happiness is the emotion we feel when things go our way. Good grades, good relationships, good job, good health, that sort of thing. Most basically, it’s about the presence of pleasure and the absence of pain. This concept of happiness is so normal that it seems weird even to think about it. The bad news is, this happiness has a serious dark side. For starters, it’s actually impossible to control things so that we only feel pleasure and never feel pain. Built right into gain, praise, pleasure and life are loss, blame, pain and death; trying to cling to one side of the coin while rejecting the other is like, well, trying to cling to one side of a coin and rejecting the other. The other problem is that when we try to cling to pleasure and avoid pain, we tend to act in less than awesome ways. Addiction, abuse, neglect, deceit, manipulation, people-pleasing and even more macro level issues like economic exploitation and environmental destruction can all be traced back to a fundamental attachment to pleasure and avoidance of pain. The worst part? Even when we do manage to grab onto this happiness, it tends to be pretty superficial, and it disappears all too quickly. In summary, the conventional brand of happiness kind of sucks. The good news is, there’s a competing vision of happiness: not the presence of pleasure and absence of pain, but a life lived in accordance with one’s values. Our values are what we cherish most deeply – depending on the person, they could be stuff like compassion, adventure, family, love or humour – and, if we want to get really philosophical about it, they’re an expression of our most authentic selves. The happiness of authenticity has nothing to do with feeling good and not feeling bad. This type of happiness recognizes that humans just sometimes feel terrible and sometimes feel great, sometimes win and sometimes lose. With this happiness, we shift our focus from that fact – which we can’t control – to what we can control, that is, whether or not to act in alignment with our values regardless of the circumstances. The added bonus is that if we’re not chasing pleasure and avoiding pain, we’re much less likely to be awful to each other and ourselves. The best part? Acting in alignment with our values leads to a deep, lasting contentment that makes pleasure and pain seem feeble in comparison. It also happens to be the foundation of unshakable self-esteem. But don’t take my word for it; experiment with chasing this second type of happiness rather than the first, and see how quickly it changes everything. (This article was originally published in the February 2017 issue of The Community Edition.) John is a therapist and coach with two Master’s degrees in counselling and four years of clinical experience. He is self-employed at Transformation Counselling and works with adolescents and adults on issues ranging from trauma and addiction to dating and spirituality. In his spare time, he loves to hike, reflect on the meaning of life, and eat nachos.
Redefining Productivity – The Bliss Way 17 June 2016 Bliss Team No comments Categories: Individual Therapy, Life Coaching Productivity cannot always be measured by how much has been crossed off of your daily to-do list or the number of job ladders climbed in your life. Tallying tasks or goals completed will leave you feeling overwhelmed and frustrated on days when you simply couldn’t do all that you had anticipated, or after a year that didn’t produce the outcomes you had hoped for. We all have those days, and those years, but if you focus on what you didn’t accomplish you will miss out on all of the things you did right! Here are a few alternate ways to determine whether you have been productive: If you did something that will help you out in the future. This could include learning a new skill that does not apply to your current job simply because it interests you (who knows when you will need it!), or working on some aspect of yourself that is holding you back emotionally, physically, or spiritually. Do not discount what you accomplished just because it doesn’t have immediate results. If you did something that builds or strengthens a relationship that is important to you. Spending time with people we love or enjoy being around can feel like a distraction from our real work, especially when we are busy, but prioritizing relationships is highly productive and important to present and future wellbeing. You may not have gotten the position you wanted at work, but you have someone to lean on when disappointment comes your way. Another position will open up eventually, but that relationship will fade without due attention. If you spent some time on self-care. Taking care of your self might feel a bit indulgent at first, but in reality its positive effects spill over into all other aspects of your day! It will make you a better friend, partner, parent, co-worker, or boss – what could be more productive than that? Do things that make you feel content or centered, things that remind you of the joy of living or that make you feel more fully yourself. If you did something that reflects your core values. Taking time out of your day to do things that make you feel like the best version of yourself is equally important. If you value being a good friend, listening to a friend vent on the phone for half an hour is not a waste of time. If you value being kind, then taking a few extra seconds to hold open a door or to help a stranger carry something to their car is not ruining your grocery shopping schedule. Your values should not be abandoned for the sake of efficiency. If you conquered something that was causing you anxiety, or dealt with something that was stressing you out. Okay, so this one might be more obviously productive. It certainly feels good when we finally take our car in to figure out what that funny noise is or when we finally have that conversation with our co-worker that we have been dreading. These things are productive in a way that is more tangible to ourselves and others, and might even allow us to check something off of our ‘lists’. But what about the things that aren’t typically on your list, like taking time out of your day to write about a fear that has been overwhelming you lately, setting aside some time to meditate before you try to get the kids ready for school, or visiting a therapist to discuss coping methods? These small things may feel like they are eating up valuable time, but they are truly invaluable when you consider the relief they will provide. Have you been feeling self-conscious and socially anxious because all of your clothing feels outdated or uncomfortable? Then, YES – a shopping trip just might be the most productive thing you do today. By Ariel Benwell