One of the questions we get a lot is what are some of the specific Dialectical Behaviour Therapy (DBT) techniques that we teach clients? I think this is a great question and one that we can answer through some blog posts, so here’s the first one – I hope you like it!
Mindfulness is the at the core of dialectical behaviour therapy – it’s the foundation, if you will, that everything else is built upon. Mindfulness is the practice of being present in the moment, without judgement and without attachment to it. It sounds simple, but it is often very difficult for us to practice in our daily lives.
What are the goals of mindfulness, with respect to DBT, you might wonder? According to Dr. Marsha Linehan, the goals are threefold:
Reduce suffering and increase happiness
Increase control of your mind
Experience reality as it is
The mindfulness skills learned through engaging in dialectical behaviour therapy help clients create their own mindfulness practice. A mindfulness practice involves incorporating different skills into a routine practice that is woven into our lives as a foundation for doing life. This can involve any or all of the skills, meditation, contemplation, and mindful movement.
There are three core mindfulness skills in dialectical behaviour therapy and I want to introduce one of my favourites because it’s one of the ones I’ve found most helpful: Wise Mind.
The Wild Mind
You won’t find this terminology in any DBT books, but it’s what I call the dance between the two extreme states of our minds: logic vs. emotion. In DBT terms, we’d call the two polar opposites Reasonable Mind and Emotion Mind.
Often, we tend toward one or the other especially when we’re under stress. Those of us who are more naturally prone to logic will rely on this part of our mind to make everything rational, logical, and pragmatic at the cost of ignoring emotional content. Others more naturally drawn to emotion will rely on this part of the mind to make everything about mood, feelings, and impulses to do or say things.
As you can probably tell, both of these approaches are likely to create problems because they focus on one area at the cost of ignoring the other. So, what’s the alternative?
The Wise Mind
The concept of Wise Mind within the framework of mindfulness involves combining the two minds, Reasonable Mind and Emotion Mind into a new framework – Wise Mind. Wise Mind balances the Reasonable Mind and Emotion Mind and allows us to follow a middle path.
Another description of Wise Mind is something we often call wisdom. In this case, it’s the wisdom within each of us that combines both our more rational, reasonable mind with the emotion-focused part to create a full picture. This focus allows us to see, and value both reason and emotion, bringing the left and right brains together as one.
I was just remarking to a client that someone once described wisdom to me this way:
“Knowledge is knowing that a tomato is a fruit. Wisdom is not putting it in a fruit salad.”
Apparently, this quote came from Miles Kingston, a journalist and musician, and what I like is that it helps explain the difference between wisdom and knowledge. In our case, knowledge is what each of our minds is telling us – our reasonable and our emotion mind. Wisdom is knowing how to combine that information and knowing what to do with it – our Wise Mind.
How Can I Get Started Using Wise Mind?
Mindfulness takes practice, as does listening to Wise Mind. Here’s an example exercise that you can try right now to see if you can listen to your inner wisdom using Wise Mind. It’s taken from the Mindfulness Handouts in the DBT Skills Training Manual from Dr. Marsha Linehan:
Asking is this Wise mind?
Breathing in, ask yourself, “Is this (action, thought, plan, etc.) Wise Mind?”
Breathing out, listen for the answer.
Listen, but do not give yourself the answer. Do not tell yourself the answer; listen for it.
Continue asking on each in-breath for some time. If no answer comes, try again another time.
This may not come naturally to you at first, in fact, it probably won’t. Repeat this exercise and see if you can allow yourself to enter a mindful space where you can notice what your Reasonable Mind and Emotion Mind are telling you, and then listen to your Wise Mind to see how you can trust your inner wisdom and operate out of an effective, mindful place in your decisions.
The transition into parenthood can be a time full of tender and beautiful moments, and it can also be a time of immense difficulty. On social media, we see a lot of those beautiful moments, but we don’t typically see the difficult ones. Many parents are then caught off guard and may even feel isolated and ashamed for the difficulties and alterations in their own mental health that can come with childbirth. While conversations about the beauty are important, it’s also crucial to talk about the difficulties.
About 85% of mothers experience the Baby Blues, which is a period after giving birth where mothers and some fathers experience profound sadness and anxiety. Baby Blues typically lasts 2 weeks to one month as women’s hormone levels slowly return to their baseline. These perinatal hormonal imbalances can often affect a woman’s ability to respond to stress for a variety of biological reasons. On top of the physiological changes, there’s also an unimaginable number of new stressors that new parents may have never dealt with before.
Imagine if you were a lawyer for several decades, you were great at your job and thought of yourself as competent. All of a sudden, you were then thrown into a job as a chef at a high-level restaurant and everyone immediately expected you to know exactly what you were doing and to perform perfectly and instinctually. You may have read some books on cooking, but you find the high paced kitchen overwhelming and can’t always remember what you read when stressful situations arise, yet you feel ashamed for not immediately knowing how to adjust to this completely new career. That seems like a pretty unreasonable expectation for others to put on you and for you to put on yourself. Presumably, you would need a period of someone showing you how to do the job, you’d need support from your partner and friends with the stress of taking on a new career and you’d need time to eventually allow your own personality and creativity to catch up with the learning curve.
It’s not difficult to understand the need for a time of transition in a drastic career change, and yet, we as a society ignore this need for most parents new, especially women; we assume that parenthood and bonding with a new baby just come naturally and easily. In reality, new parents are often overwhelmed by the anxiety of not knowing what their baby needs at first and they need time to learn. Breastfeeding may be incredibly difficult and your baby might never take to it. Contrary to popular opinion on social media, that is okay! Fed is best, any way you can make that happen makes you a superhero whether it’s breastfeeding or formula.
During this transition, relationships may also become strained. Partners often need to re-establish new roles now as co-parents which can take time and can be challenging at first. Some co-parents may find themselves pulling away from each other due to the stress of not sleeping, having less alone time and trying to figure out this new role. This relationship strain can be a particularly harmful consequence because new parents really need support, especially during the period of baby blues.
How can counselling help the Baby Blues?
Relationship counselling can be really helpful during the perinatal period. During pregnancy, new parents can prepare for their shifting roles through the counselling process and determine how to best support each other when their new family member comes along. It can also be helpful to seek/continue relationship counselling after the baby is born for the same reasons.
Similarly, mothers and fathers can also benefit from individual counselling, where they can learn to draw on their personal strengths to develop coping methods and better understand what their emotions are telling them. These skills derived in counselling can help new parents to best support themselves, their partners and their new baby as they embark on this new life transition that is both wonderful and stressful.
It is important to remember the phrase, “it takes a village to raise a child.” You don’t have to do all of this on your own and there is so much strength in reaching for help.
This post has been about the Baby Blues, which is different from postpartum depression in terms of length and severity. My next post will address postpartum depression, what to look for and how to find help.
Marcia Moitoso is the one of two new interns at Alongside You. Studying at Adler University she has a keen interest in reproductive mental health and we’re excited to have her on board!
One of the most exciting uses for neurofeedback therapy is in children struggling with Attention Deficit Hyperactivity Disorder (ADHD). ADHD can be one of the more difficult issues to treat and it causes a great deal of distress to many children, their parents, and school staff. We use neurofeedback (also called EEG Biofeedback) here at the clinic to help these kids reduce their symptoms and improve their functioning.
You might wonder, why would we use neurofeedback for ADHD? There are a few reasons we like it and they correspond to the results we see with the children we work with. I hope it helps explain the usefulness of neurofeedback for ADHD in children.
We often don’t notice the effects of poor sleep when we are children, but as a parent, I can definitely notice when my kids don’t sleep well. Further, now as an adult, I’ve become keenly aware of how lack of sleep affects my functioning. Neurofeedback can help the brain recalibrate and improve its function so that sleep improves, which in turn, improves attention, focus, and motivation – some of the core areas affected by ADHD.
Improved Attention and Focus
I have a number of clients with ADHD, and they know that my brain sometimes does the same things as theirs, and so if there’s a loss of focus in session, invariably one of us will turn our head and exclaim, “Ooh, squirrel!” This usually leads to a great deal of laughter and a refocusing in our session. Attention and focus are hallmark symptoms of ADHD, and neurofeedback can help with this by training the brain to function more optimally. Contrary to popular belief, children with ADHD aren’t overstimulated, they’re chronically under-stimulated. Because of this, their brain will find ways to stimulate itself, which usually means hyperactivity or fidgeting. Neurofeedback can help recalibrate and rewire the brain on this level and reduce the need for stimulation, improving these symptoms.
Neurofeedback Targets Brains At The Biological Level Without Medication
One of the most common interventions for ADHD is medication. Now, just to be clear, I am not anti-medication at all. It is a very useful tool and has its place in treatment. Medications, however, don’t always work, sometimes they have side effects that are worse than the condition being treated, and sometimes clients don’t want to be on medications.
Neurofeedback is another way of getting at the brain biology and rewiring it to improve functioning. It can also potentially augment the effects of medication if the medications are not working as well as they could. Sometimes neurofeedback can potentiate medications and lead to less medication being needed, or the ability to stop the medication altogether. Finally, if a client and or family does not wish to use medications, neurofeedback can do many of the same things medication can in helping the brain function better.
Neurofeedback Is Easy
Every parent knows that getting children to participate in treatment can be difficult, especially a child with problems with focus and attention and impulse control. This is one of the benefits of neurofeedback therapy – if a child can sit in a chair and look at a screen and listen to an audio, they can do neurofeedback. We can even show movies through our equipment to keep them engaged when necessary. We can also pair the neurofeedback with creating art, reading a book, or other activities to keep the child engaged.
Neurofeedback is flexible, straightforward, and easy for clients to participate in. We can adapt the environment and treatment to fit client needs and comfort. We can also tailor the treatment frequency to suit client availability and financial resources.
Neurofeedback Is Accessible
We know our clients lead busy lives, particularly when it comes to children and their activities. This is why we use equipment that we can send home with clients on a monthly rental basis. This has a number of advantages: accessibility, efficiency, and affordability. By doing home rentals, you can do neurofeedback in the comfort of your own home, on your own schedule. You can do training sessions as often as you like, which can help speed up the process and the results. It also makes things more affordable – for one monthly fee you can do as many sessions as you like, and you can even train the whole family for the same price!
Are You Curious About Neurofeedback?
I hope so! If you have any further questions, please give us a call and we’ll be happy to answer them. We can provide neurofeedback in our clinic, or we can send a rental unit home with you if it seems to be the best solution for you and your family. We love using neurofeedback to help children with ADHD, because we know it works, and we know kids love it. We love it because we see the results and the changed lives!
The age of technology brings with it many benefits – one of them is counselling online. It has many real positives for clients, and this is why we were one of the first adopters of online counselling platforms, even prior to the start of Alongside You. I have used online platforms to provide counselling for many years, and it’s a wonderful, highly effective tool to use.
What are the benefits of online counselling? Here are a few reasons online counselling is a great tool for the profession, and for clients alike.
Location, Location, Location
Over the years I’ve worked with clients all across BC, Canada, and in the USA using an online platform. One of the things that I’ve become aware of is that in remote areas, finding a counsellor with the expertise in specific issues can be a real challenge. As you might imagine, a small town up in northern BC often does not have the same resources that we have here in Greater Vancouver. Online counselling can provide access to expertise that doesn’t exist in outlying areas.
Time is money
It can be a real challenge for clients to see a counsellor during work hours. We make sure we have our services available in the evenings and on weekends, but as you might imagine, those times are very popular and fill up fast.
Online counselling can help with this – instead of needing to take time off for travel, and the time of the appointment out of the workday, clients can see a counsellor on their lunch hour, or before or after work much more freely. What may have otherwise taken 3 hours out of a day, can take an hour. It can also happen in the comfort of your own home or your office without the needed travel time.
Did I Mention Location?
One challenge that many of my clients have had over the years is that they travel for work. If you have a job that requires a lot of travel, it can be very difficult to schedule appointments with the consistency needed for counselling. This is where online counselling can be very helpful; I’ve worked with many clients who use our online platform when they’re out of town so that we can keep up with our appointments even when we’re not in the same location.
Some Things To Know About CounsellingOnline
As with any form of treatment, there are certain things clients should be aware of and think about prior to engaging in this service. In the case of online counselling, here are a few things to be aware of and think about before you decide if it is right for you.
Security is important
Any time you’re dealing with health information, security is important. Not only are there legislative mandates and laws counsellors need to be following, there is also your personal comfort with how your information is transmitted. Unfortunately, many times I see counsellors using technology that is not secure for online counselling. The most common examples are Skype, Google Hangouts and Facetime. None of these platforms are secure, and in my opinion, should not be used for counselling purposes. The reality is that the counsellor cannot guarantee the security of your video call and information on these platforms.
True security is found on platforms that use end-to-end encryption. What this means, in simple terms, is that a lock is put on the data on your end (the client) and it can only be unlocked at the other end by the professional, and vice versa. Skype, Google Hangouts and Facetime do not offer this protection. They have some encryption protection, but it does not end to end so there is a possibility that someone in the middle could see or read the data.
The other issue is data storage. To comply with health privacy laws in BC, and in Canada, the technology must store all data on servers on Canadian soil. Again, Skype, Google Hangouts and Facetime do not do this. They store data on servers all over the world, including the USA where your data may be subject to the Patriot Act and read at any time by the US Government.
We use a HIPAA/PIPEDA compliant version of Zoom, which is set up so that it does not store any data, at any time and offers end-to-end encryption. Previously, we’ve used Medeo which is used by many doctors in BC because it also offers a platform that complies with the legislation and privacy laws.
The difficulty for many professionals is that these platforms cost a fair bit of money. My position, however, is that it’s not ethical to provide online counselling without the proper security in place and this is why we choose to spend this money in order to offer this service to clients. With online counselling at Alongside You, you can be assured that your data is secure and complies with all of the proper legislation.
How comfortable are you in an online environment?
Some people love video chats and calls and do it regularly with friends and family. Some people prefer in-person connections. Others enjoy of mix of both. Counselling is an intimate, sometimes intense process and it’s important to think about whether you’d feel comfortable with this in an online environment.
Another consideration along this vein is do you have a safe, private space to make the call in? One of the benefits of coming to a counselling office is that it is a private, safe space. If you’re doing the counselling online, you’ll need a space of your own that can provide this for you. Your sense of safety is of utmost importance.
How comfortable is the counsellor with online counselling?
Counselling online is different for counsellors as well! It’s important to know, and ask, whether the counsellor you’re seeing enjoys online counselling and feels that it’s an effective method for them professionally. Do they have a lot of experience doing online counselling, and is it a method they enjoy? Their comfort is also important and it’s okay to ask them these questions!
At Alongside You, we don’t ask any counsellors to provide online counselling if they don’t have the experience, or if they don’t enjoy the platform. The counsellors here provide online counselling because they enjoy it and find it to be effective for them, and for their clients.
Is it appropriate for me to do counselling online for the issues I’m dealing with?
For most issues, counselling online is perfectly appropriate. There are a few situations where you may want to think about whether it’s a good idea. First, if you are dealing with severe suicidal thoughts and other self-harm or risky behaviour, online counselling may not be for you. Your safety is key and online counselling may not provide the necessary safety and environment for this type of work. This is a good thing to discuss with your counsellor prior to engaging in online counselling, and throughout the process to make sure it’s a good fit.
Second, sometimes couples counselling can be difficult online. So much of the counselling with couples depends on the emotional and relational dynamics that it’s hard to do if everyone is not in the same room. Again, it truly depends on the comfort of the client, and the comfort of the therapist as to whether it’s appropriate in these cases.
Finally, if your therapy involves live experiences (such as exposure therapy) this may not be the best format for you. There are safety concerns, and also practicalities that may make exposure therapy and other in-vivo approaches challenging.
This probably goes without saying, but I’ll mention it anyways. Online counselling requires a reasonable internet connection. It’s surprising how little speed it actually requires, but if you’re in an area that does not have decent internet service, online counselling may be a difficult thing. That being said, I’ve done it with clients in very remote areas, so even if you think it won’t work because of internet speed, it’s worth a try to find out!
Still have questions about counselling online?
Online counselling may be a brand new idea to you. I hope this article gives you a brief introduction to online counselling and things to think about. If you have any questions, or if you’d like to try it out to see if it’s a good fit for you please feel free to give us a call anytime, we’d love to hear from you!
The deaths of Kate Spade and Anthony Bourdain, both by apparent suicide has the world reeling again. There have been numerous articles in response to this, calling for more mental health support, offering advice on how to reach out to loved ones, and more. One of my first thoughts was of how devastating substance abuse can be. I don’t know directly how much alcohol or drugs factored into the deaths of these two celebrities, but both had struggled with substances throughout their lives and it seems as though it likely influenced these most recent tragedies.
When we experience the death of a celebrity, a work colleague, a friend, or family member, one of the common struggles is wondering what could have been done? What if we’d just reached out more? What if we’d asked them how they were doing more? What if we’d encouraged them to get help more? The reality is that simply checking in on someone, or offering platitudes like, “Make sure you ask for help when you need it,” simply don’t work very often.
One of our staff pointed me to this article in which a group of friends held an intervention of sorts for a friend struggling with grief. What I appreciated about the article, from the perspective of the friend being intervened upon, was the comment that this approach could have easily backfired. This is very much true – it worked in her case, but on a different day, at a different time, or for any other number of reason the approach could have backfired. Still, she was grateful that they had intervened. So, here are some ways I’m going to suggest we can succeed in supporting friends when the stereotypical “reaching out” isn’t working.
Most people struggling with mental health will tell you that it’s incredibly isolating. Isolation intensifies and worsens negative emotions and symptoms of mental health difficulties. It removes motivation, removes hope, and so much more. So, what this means is that when we ask, “Hey, how are you doing today? Have you gone outside for a walk? Is there anything I can do,” we are likely to hear, “I’m fine, it’s ok,” because giving any other answer requires motivation and hope, and effort, just like any other action on their part.
This is where we can show up. We know what our friends, family members, and loved ones need in general because it’s good for anyone: healthy food, going for walks, help with practical things in life. If we ask if we can do something for someone struggling, they’ll likely say no. If we show up and help, however, we are more likely to succeed, and more often than not, they will be grateful that we showed up and helped them.
Know Our People Well
In order to show up and be effective, we need to know what our friends, family members, or loved ones like, need, and long for. This requires us to know them well. It requires intimacy and vulnerability on both our parts, and we need to be working on this when times are good. If we rely on building this when things are bad, it will be incredibly difficult. There’s a tool I use when working with couples in therapy as we focus on building a foundation for their relationship and I think it can be helpful here. The Gottman Institutecard decks are designed for couples, but they could easily be used for building interpersonal knowledge and intimacy in any relationship. The Love Maps and Open-Ended Questions card decks are particularly helpful for this – know that the language is geared for couples, but I’d love to see more of us using these in our other relationships. The more we know each other on a deeper level, the more we’ll be prepared to respond when someone is having a difficult time with mental health. We’ll know their wants, needs, desires, hopes, without even having to ask.
Be Willing To Take The Risk
Sometimes what we do as we try to help someone might backfire. If we show up unannounced to take someone for a walk because they can’t get out; if we show up with food and conversation when they can’t bring themselves to cook or to talk to anyone; if we show up and clean their house for them, these all may backfire. We might make them mad, we might embarrass them, we may even get the door slammed in our face.
We also might, just maybe, make the difference needed to help them move the next step forward, and they didn’t have to do it alone.
I often get asked the question, “What if I make things worse?” The reality is, it’s hardly possible to make things worse by showing empathy and love. For the sake of argument, even if we do, what then? Are they more depressed or more anxious? That’s a risk we need to be willing to take, and I can tell you that from my experience, it simply does not happen that way.
Get Help Yourself
Finally, if you try everything, you show up, you do for someone what they can’t do for themselves, and it’s not working, this is where a professional’s help can be a great asset. Trying to care for someone is difficult, especially when we don’t see results. It wears on us, it causes us distress, and we are now at greater risk for mental health difficulties ourselves. Sometimes we also just need an outside perspective from someone with experience with these issues. This is where a Registered Clinical Counsellor can be helpful in supporting you and providing outside insight into how you might help someone. RCC’s can also be helpful in connecting you or the person you’re concerned about with appropriate resources that may be helpful.
Don’t Give Up
Caring for someone who is struggling is hard. Don’t give up on them – try some of the strategies above, get some help for yourself if they won’t let you help them, and in case you missed it the first few times, don’t give up.
Feel free to contact us for help or counselling related matters. Our doors are always open.
For a long time, a friend of mine (we’ll call her “Shirley”), genuinely hated a coworker of hers. Shirley wasn’t just bothered by this coworker, she genuinely couldn’t bring herself to think about them without being filled with a bitter anger, which ruined her evening on more than one occasion.
Notice that I don’t say Shirley didn’t have a “good” reason to hate this coworker – the person had deeply hurt her, and the organization that employed them both had failed to act appropriately in this situation, which made Shirley feel invisible, unsafe, and very, very angry. She had carried this anger for over a year, and it was taking a toll on her mentally, emotionally and physically.
For most of us, there has been a person in our life against whom we’ve carried a grudge of some kind. People hurt each other – it’s the price we pay for being able to have satisfying relationships; and, regrettably, these hurts are not always resolved. Shirley had been hurt, and like most of us, the very last thing she wanted to hear from a friend was that she needed to forgive and move on (this is not great advice, but is given more commonly than one might think).
For some people “forgiveness” is a bit of a dirty word; that is, how can we forgive someone who clearly doesn’t deserve it, especially if they don’t seem to understand the pain they’ve caused – or even seem to care? A better question to ask, perhaps, is, “What is forgiveness? And why should I forgive?”
Forgiving is not the same as forgetting (nor do these two things necessarily need to come as a pair). Forgetting is putting the hurt completely out of our minds, forever. Forgiveness is much more complex. Everett Worthington is a psychologist who has devoted much of his career to studying forgiveness, and he breaks the word into two main categories: ‘decisional,’ and ‘emotional’. Decisional forgiveness involves a cognitive decision to let go of the negative feelings we hold towards the person who has hurt us, whereas emotional forgiveness takes that a step further, replacing those negative feelings with positive ones like compassion and empathy. The person we are forgiving does not even need to be part of the process. We can forgive a deceased or estranged loved one that has no chance of ever receiving or reciprocating our gesture. We can also forgive someone as part of a relational gesture, regardless of whether or not the person chooses to, or is able to receive it.
It’s also possible that we might offer emotional forgiveness and have the person that hurt us accept it with genuine humility and remorse, which for everyone I’ve ever known, is a powerful experience. There is a famous scene in Les Misérables where a priest shows kindness to Jean Valjean, a man who hours before stole thousands of dollars worth of his property and knocked him unconscious after being shown kindness and trust. Valjean is completely and utterly undeserving. This scene brought tears to my eyes; there is something about undeserved forgiveness that can break down the most hardened exterior.
Forgiveness is pretty much always hard, no matter your situation. It doesn’t always go the way we hope it might. But one thing is certain: the resentment you are carrying is most likely hurting you a lot more than it is hurting the other person.
Resentment takes a toll on us; it takes energy to harbour a grudge (like carrying around a weighted pack). We are not required to forgive, but it is healthy for us in almost every conceivable way. Research shows that it improves heart health, immune system function, your gastrointestinal system, brain functioning and perhaps biggest of all, it reduces stress. Much research suggests that it also reduces rumination, which has been reliably linked to depression, anxiety, anger-related disorders, obsessive-compulsive disorders, post-traumatic stress disorder, and psychologically related physical disorders.
For this reason, we can choose to view forgiveness as something we are doing for ourselves, rather than the offender. We can decide to try to let go of a grudge without actually feeling any different – and that is OK.
Try this: hold your arms out in front of you, with your hands clasped tightly together, as though you were clasping your resentment between them. Hold this for a minute (Not exhausted? Try two minutes), and then let your arms drop and relax. What did you notice? This is what happens internally when we let go of a grudge – we are releasing tension. Try it while actually picturing a minor grudge you are holding, and see if it makes you feel any different towards that grudge.
Lastly, I want to acknowledge that things are not that easy. In many ways, we cannot just decide to forgive, and all hurts are definitely not created equal. However, if you recognize that you might be carrying a grudge (big or small) that is actually hurting you more than it’s helping, and you feel you can’t get over it, there are lots of options to help yourself with it:
Try cognitively deciding you want to commit to forgiving, even if you don’t feel like it, as a gift to yourself. If you want to take this a step further, try Everett Worthington’s evidence-based REACH forgiveness worksheets (available here for free). Many people have found these exercises very helpful.
Talk through what you are experiencing with a trained therapist. Even just putting words to your experience and having them heard and understood can be very relieving, and therapists are trained to help you recognize and navigate challenging circumstances.
Read stories of people who have forgiven under seemingly impossible circumstances, and try to be curious about your reactions to these stories. Do you agree with them? Do they make you angry? Humbled? Chances are, reading others’ experiences with hurt and forgiveness will help you feel less alone, and even just the experience hearing those stories can shift some of the weight. If you are part of a faith community or come from a faith background, try talking to a spiritual leader about what your faith says about forgiveness, and question what you find.
Most of all, remember to give yourself some grace as you wade through this process; forgiveness is both one of the most difficult and most rewarding things a person can go through. If you have any question regards on forgiving and forgiveness, feel free to contact us.
Akhtar & Barlow have a few good articles out. This 2018 meta-analysis provides evidence for reduced depression, stress, anger, and hostility, as well as increased positive affect, related to forgiveness:
Akhtar, S., & Barlow, J. (2018). Forgiveness therapy for the promotion of mental well-being: A systematic review and meta-analysis. Trauma, Violence, & Abuse, 19(1), 107-122. doi:10.1177/1524838016637079
Akhtar, S., Dolan, A., & Barlow, J. (2017). Understanding the relationship between state forgiveness and psychological wellbeing: A qualitative study. Journal of Religion and Health, 56(2), 450-463. doi.org:10.1007/s10943-016-0188-9
Baldry, A. C., Cinquegrana, V., Regalia, C. & Crapolicchio, E. (2017). The complex link between forgiveness, PTSD symptoms and well-being in female victims of intimate partner stalking. Journal of Aggression, Conflict and Peace Research, 9, 230-242. doi:10.1108/JACPR-08-2016-0247
Orcutt, H. K., Pickett, S. M., & Pope, E. B. (2005). Experiential avoidance and forgiveness as mediators in the relation between traumatic interpersonal events and posttraumatic stress disorder symptoms. Journal of Social and Clinical Psychology, 24(7), 1003-1029. doi:10.1521/jscp.2005.24.7.1003
When I sat down to write this, the first thing that came to mind was a poem by Elizabeth Barrett Browning, titled, “How Do I Love Thee? (Sonnet 43).” The opening line says, “How do I love thee? Let me count the ways,” and continues to explain in great detail, all the different ways the subject loves the other. This is how I feel about counselling and its importance – there is no simple way to summarize why counselling is important because, in my opinion, the importance of it is endless in usefulness and application. So, I’ll offer three reasons counselling is important to start the conversation off.
Reason #1: Safety
Many of us have wonderful families, friends, and colleagues. But, how often do we feel completely safe discussing our innermost difficulties, the things we’re struggling with, the things that we’re afraid of, or perhaps the things we’re ashamed of? The reasons people come to counselling are many, whether it’s anxiety, depression, addiction, relationships, or otherwise, sometimes we just can’t bring ourselves to talk about these things with the people we have in our inner circle.
This is one reason counselling is important – a place of safety. By coming and entering the counselling room, you are entering into a space that was set up specifically to provide safety; the ambiance of the room, the highly trained professionals ready to engage in dialogue, the confidentiality provided by the interaction, and more. If we are to wrestle with our deepest longings, we need to feel safe and this what counselling provides.
Reason #2: Empathy
Empathy is key to our wellbeing and our functioning. In order to feel safe and feel connected to others, we need empathy. This is different than sympathy, which I’ve covered in previous articles because sympathy drives connection away. Empathy is healing, change making, and supports the re-wiring of our brains.
Empathy helps us feel known, understood, and validated; many times, this is what is missing in our personal lives. Sometimes this is because we are not surrounded by people who are capable, or willing to provide this for us; other times, it’s because we’re not in a place personally where we’re able to open ourselves to this possibility and this is where the skill of the counsellor comes in. Through counselling, we can experience empathy in a 1:1 relationship with the counsellor, evaluate our relationships, and if there are things preventing us from accepting empathy from others, work through these things will a skilled professional.
Reason #3: Guidance
When I went through my clinical training, one thing that was impressed upon us is that we’re not here to give advice. While I don’t disagree that this is not our primary function, I do disagree that we never do this. Sometimes counsellors are there to give advice. Depending on the client’s cultural background, they may actually be quite frustrated by not getting advice at times. What a counsellor is more apt to do on a regular basis, however, is to give guidance. Sometimes it’s guidance on a specific issue (i.e. school counselling, career counselling), and sometimes the guidance is in the form of a sounding board, offering alternatives to how the client is thinking about different issues.
Sometimes the guidance is more pointed – in my work I often see clients who have been through the various mental health systems without success and my clinical expertise and knowledge of the system is helpful in navigating next steps in looking for treatment and recovery.
As I mentioned at the beginning, this is just scratching the surface of why counselling is important, but I hope it’s a good introduction for you. In future articles, we’ll explore in specific detail how counselling is important for specific issues. If you have any questions about this, feel free to send us a message through the contact form and we’ll be happy to answer your question in a future article.
My family and I have been watching the reincarnation of American Idol recently, and the finale was this week. Much to Meg’s great pleasure, Maddie Poppe won. As usual, the show was full of twists and turns, silliness, and some incredible musicianship. I’ve enjoyed the fact that they’re allowing contestants to use musical instruments in this go ‘round – and I personally loved the resurgence of classic rock through the contestant, Cade Foehner. As I sat there watching the finale last night I reflected on the season and something struck me, and it was rather surprising.
See, the title of this blog isn’t just clickbait. The three judges this year on American Idol were Lionel Ritchie, Katy Perry, and Luke Bryan. While each of these musicians and artists are icons in their own right, particularly Lionel, I noticed something that made me pause. I’d previously grown tired of American Idol because it was overly negative, Simon Cowell was rather irritating to me, and I didn’t like the absence of instruments. This season, the judges were very positive, the personalities of the judges clicked well, and there were musical instruments involved. What I noticed, however, is that it was overly positive. Granted, each of the final 24 contestants was very talented, there weren’t an abundance of critiques.
My belief is the constructive criticism is crucial to personal and professional growth. These contestants are on the show because they’ve “made it,” and know it all; they’re there to learn and, hopefully, make it as a professional musician and artist. Much to my surprise, I found Katy Perry to be the most helpful judge and the one who offered the most useful feedback to the contestants. I’ll admit, this took me by surprise – before this when I thought of Katy Perry I thought of teen pop anthems, and some weird looking sharks roaming the stage. So as the season finished last night, my thoughts went to wondering, “what can we learn about life from Katy Perry?”
I’ve picked three things that stood out to me that we can learn from the quirky being that is Katy Perry.
One thing that we learn pretty quickly in watching Katy Perry in her live shows, or on American Idol, is that she is an odd duck. She’s quirky, she marches to the beat of a different drum, and let’s face it, she’s downright odd sometimes. But, she’s unique and there’s nobody else like her. She knows who she is at the moment, and she embodies that with all that she has.
Our wellbeing depends on our acceptance of self. Now, I have no idea how accepting of herself Katy Perry actually is because I’ve never even had a conversation with her. From outward appearance, however, she seems to own her own quirkiness and oddities and has a clear idea of who she is at the moment. If we can do just this – accept ourselves and own who we are at the moment, it will have a positive effect on our wellbeing.
Tell the truth
Contrary to some of the other judges, I found that Katy was pretty up-front in her truth-telling with contestants. If they nailed the performance, she told them; if the performance stunk, she wasn’t afraid to speak the truth. Knowing where we stand in relationships, in our work environments, and in our pursuit of dreams requires honest, open feedback from those around us. In return, those around us depend on the same.
If we can surround ourselves with people who we can speak truth to, and who will do the same for us in return, we can grow and move forward in life and have confidence in where we stand in our progression. How do we do speak the truth when it’s difficult though?
Encourage others as a matter of practice
As constructive and critical as Katy Perry was this season, she has coupled the criticism with encouragement. It was clear in her feedback that she was giving it so that the contestant could grow and get better at their craft. If we can provide constructive criticism along with encouragement, we will encourage growth in others. If we surround ourselves with those that can do this for us, we’ll get the same in return.
Sometimes it’s hard to learn who we are and accept ourselves; sometimes we aren’t sure how, to tell the truth to others or to ourselves; sometimes we have a hard time being encouraging because we’re stressed out; sometimes we don’t have a community around us that encourages us. This is where a registered clinical counsellor can be helpful sometimes. Sometimes we need that outside perspective on some of these issues or some guidance and encouragement on how to organize our lives so we have what we need to grow. If this is you, we’d love to help. Feel free to contact us.
Having a child with an addiction can be one of the most terrifying things as a parent. Depending on the level of the addiction, it can mean different things. Sometimes our kids start with curiosity and dabbling in marijuana. Sometimes it’s a harder drug like cocaine, ecstasy, MDMA, or even heroin. Sometimes it’s all of the above. You might notice the subtle changes – maybe their grades are slipping a bit, or they’re staying out later with friends, or they’re not as interested in hobbies they used to enjoy. Sometimes it takes a more significant turn and they stop their hobbies altogether, stop going to school, or even stop interacting with the world on a grand scale and isolate themselves in their room, hardly ever coming out.
I hate to say it, but this isn’t going to get any easier with the legalization of marijuana coming in July. I’ve spent a great deal of time in the past months speaking with various agencies about this, and although it will still be illegal for minors to consume marijuana, the legalization is most definitely going to change the landscape, and in significant ways. While I’m not going to go into that today, what parents should know is that this isn’t going to get easier; it’s going to get more difficult.
So, how can you help your teen? That’s a huge question and we’ll be writing more about it in the weeks and months to come, but here are three things that I think parents should know that will hopefully help.
You are right to be concerned if your child is using substances.
I’m often surprised by how nonchalant people are with alcohol and marijuana and teens. It’s not uncommon for teens to try these two substances, but I am concerned by how unconcerned many parents are that their teens are using these two in particular. In my experience, they have almost been filed in the “benign,” category of substances. While they are potentially better than crack cocaine, MDMA, or heroin, they are far from benign and I want to highlight one particular reason: brain development.
Our brains are constantly changing and developing, even into adulthood, but the most crucial time period is from the time we’re born, until approximately 25 years old. Yes, our brains are still developing up to the age of 25. Even more important, as highlighted in the article I just linked to, is that the part of the brain that controls rational processes is one of the last to develop, and doesn’t fully develop until the mid-20’s. This means that the part of the brain that might help a teen work through whether drugs are a good idea isn’t fully functional until well after high school is over.
The take-home message here is two-fold: using substances as a teen has the potential to negatively impact brain development, and the part of the brain that might help them understand this and make good choices isn’t fully functional until they’re 25.
What you do matters.
As parents, one of the most important things we can do is help educate our children on the impacts of substances, and this needs to happen before there is a problem. Now, I get it. It’s an awkward and even scary conversation for some parents. It’s not totally dissimilar to having the “sex talk,” which is equally awkward and equally important. However, it’s also our responsibility as parents to have the discussion. If we want our kids to make good choices, they need the information in their repertoire before they need it, not afterward. If you don’t know enough to educate your child on substance use, please start by educating yourself. There are many resources online, and many community groups that can help. Most importantly, make sure your child knows that if they run into difficulties with substances, they can come to you for help and make sure that they know they will not get into trouble if they ask for help.
An equally important thing to know is that our kids watch what we do and are impacted by the example we set. If we aren’t using substances responsibly, we really can’t expect our kids to and we can’t expect to have credibility when we’re speaking about it with them. To push this even further, we may even be using substances in what we feel is a responsible way, but our kids may not understand that – this goes back to the brain development part. I’ve worked with many families who bring teens in with concerns about their substance use, and when I speak with the kid, it comes out that the parents likely have substance use issues that aren’t being dealt with. As parents, we need to lead by example. This increases the likelihood that our kids will make good choices, and if they run into trouble, that they will seek appropriate help.
Finally, if you’re in a situation where your kid is using substances and you’re having a hard time dealing with it, get help for yourself. It’s heart-breaking, it’s stressful, and it’s lonely because often we feel the need to hide our difficulties as families and hide what our kids are struggling with. Even more so, it’s hard to see our kids in pain. If that’s the case, reach out to get some help. There are community resources available, and it’s something we do a lot of work with and we’d love to help you if you’re in this difficult place.
Focus on the relationship.
Sometimes it’s all we’ve got. It’s also where we get any foothold and any credibility with our kids when they’re struggling. Remember, if your kid is struggling with substances, there is always a reason, and it’s not as simple as “peer pressure.” Peer pressure is a misnomer. Sure, sometimes it happens but in my experience, it’s rarely the reason kids are using substances. People use substances as a means to manage pain, and teens are no different. Be it mental, emotional, or physical pain, this is most often the reason and we need to be sensitive to that.
If your kid is struggling and they won’t get help, be there for them. Sit with them, express your love for them, express your concern for them and your desire to help. Avoid condemning them, shaming them, or anything that resembles this (and this is hard). Your kid will not turn around and stop using substances because they hear you say that drugs are bad. They may turn around, however, if they hear you say that you love them, and you’re worried about them, and you’re there to help when they’re ready. And, as I mentioned above, until they’re ready, I’d highly recommend you seeking help for yourself while you’re waiting for them to come around. It’s a tough road, and sometimes a long one while we wait for our teens to be ready for help.
If you’re on this journey with your child, whether they’re a teen or an adult, know that you’re not alone. You’re not alone in your suffering, and you’re not alone in feeling lost, and maybe even hopeless as you watch your child suffer. We’re here to help.
We were talking around the office this week about how there seems to be a week for everything. Admittedly, when we plan our calendar it’s sometimes difficult to keep up. Sometimes I wonder why we need a week for everything – and even, why we need a mental health week. To help us understand why we need a mental health week, I want to tell you a story.
I have a courageous young friend who has battled mental health for many years. This has involved many different treatments, counsellors, psychiatrists, medications, trips to the hospital, and more. This friend has an incredible family, many supportive friends, and others in the community who have been there to help and encourage. When things first began at a very young age, it was tough. For many years things were not stable, and treatments didn’t seem to help. Then, things changed. Life got better, treatments started helping, and things became stable for a number of years. Lately, things have been more difficult again, and life has come to a bit of a standstill. It’s discouraging. It’s disconcerting. It’s heartbreaking. On the upside, the family, friends, and community are still here, but it’s back to square one with treatment planning.
As I reflect on this, it occurs to me that this is exactly why we need a Mental Health Week. It further occurs to me that the things I feel my friend may need to hear right now may also be what others struggling with the mental health need to hear. This may also be true in terms of what we all need to hear about mental health.
Mental health issues are physiological issues that are no less physiological than cancer, diabetes, heart disease, or any other physical illness.
Often, we hear that mental health is “just in our heads.” This is neither biologically accurate, nor helpful. Mental health is in our head, in our bodies, and in our spirits. Mental health difficulties may involve imbalances in neurotransmitters, physical changes in the structures in the brain, changes in our central and autonomic nervous system, and even changes in function in just about every organ in our body; in addition, it may involve changes in our view of ourselves, our identity, our spirituality, and our belief systems.
What mental health is not, is a result of an individual being a categorical failure as a human being, because they’re not strong enough, because they aren’t trying hard enough, or because they don’t measure up. We don’t say these things of someone with heart disease, cancer, diabetes, or otherwise; we need to stop saying these things to ourselves, and others who struggle with mental health.
We are not defined by our illness.
There is a strange phenomenon, it seems, that when someone struggles with mental illness they become defined by it, both in their own minds and especially in the minds of the public. It’s not uncommon to hear someone say in conversation, “Oh, they’re a schizophrenic,” or, “he’s just an addict,” or similar. Sometimes, however, it’s us saying the same things about ourselves. The problem is that in both cases, it can become a self-fulfilling prophecy, and the struggle becomes perpetuated.
See, if we’re reduced to being a schizophrenic, an addict, or simply someone who is mentally ill, we lose our true identity. We are no longer a brother, a mother, a father, a sister, a CEO, a firefighter, or an accountant. We are no longer the beloved child of our parents, the one who wears his or her heart on their sleeve, or the one who uses art to enliven the lives of ourselves and others.
If we’re reduced to our illness, we have no identity other than that – the illness. This causes us to lose our perspective on ourselves, our loved ones, and those around us who are in the midst of some of the most difficult times in our lives. If we are reduced to our illness, then there is no hope, we are simply sick, or weak, or worse.
There is always hope.
I don’t believe in hopeless cases. There, I said it. If I did, quite frankly, I’d have the worst job in the world. Now, this doesn’t mean that everyone will recover fully and not have to deal with whatever mental health issue it is that plagues them; it doesn’t mean that we’re going to have the grand life that we see everyone around us having on Instagram (which isn’t true anyway, but that’s another article); and it doesn’t mean we’re going to be happy all the time.
What it means, is that although we struggle with mental health, we have not lost our identity; rather, both we and those around us may have lost sight of who it is that we are, and now our job is to get back to our core. It is time to get back to having lived a life worth living and to get back to the essence of what makes us unique.
We are born with natural gifts and abilities, and usually, they are the first things to go when we struggle with mental health or other issues. A little-known fact about me is that I’m a classically trained pianist. I played piano for many years, training with the Royal Conservatory of Music and then training in jazz and blues. Now I play a number of different instruments when I make the time. I love music, it’s one of the few things that no matter what place I’m in, brings me joy. This is true whether I’m playing it myself or listening to one of the greats on a recording.
Music is what has kept me balanced throughout my life when I’ve let it. When I was at my worst, struggling with depression and anxiety, I didn’t pay nearly enough attention to music. It was too much effort, it didn’t seem worth it, I just couldn’t. See, music is a double-edged sword for me – I also have had very high expectations of myself, and historically, I expected to be the best, to never make mistakes, etc., etc., etc. My identity at times became my ability to perform. I’d lost my way.
The truth, however, is that music ispart of the core of who I am. When I was trained in The Birkman Method, this came out in spades – right at the top of my interests and passions. I knew this already, however, because when I was able to play music in my recovery, for the joy of it, and the emotional processing of it, and not for the expectation to perform, it helped my recovery more than anything else.
“Music gives me hope.”
Sometimes I work with clients who have lost hope, and I can understand why they have. Their depression is unrelenting, they’ve just discovered their partner has had an affair for the past 10 years, their teenage son is addicted to heroin, or otherwise. Life can be incredibly painful.
Sometimes my job as a counsellor is to hold hope for my clients and to hold hope for those who are struggling until they can hold it themselves.
One thing that I have learned in over a decade of doing this work is that there are no hopeless cases – there is always hope. If you’re reading this and you’re the one struggling, hold on. If you don’t have hope, find someone who can hold it for you. If you’re the one who cares for someone in the struggle, hold hope for them. Encourage them daily. Don’t give up, life can get better for them, and for you.
This is why we need a Mental Health Week. We need a reminder that mental illness is real, and it is physiological, and it is not because we’re weak. We need a reminder that we are no more defined by our illness than we are the size of our shoes. We need a reminder that there is always hope for us and always hope for those we love.
We need a reminder that life can be worth living once again if we keep going.