by Andrew Neufeld | May 17, 2018 | Abuse, Addiction, Communication, Curiosity
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.
by Andrew Neufeld | May 10, 2018 | hope, Mental Health Disorder, Motivation
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 is part 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.
by Andrew Neufeld | May 3, 2018 | Anxiety, Depression, Mental Health Disorder
Anxiety and Depression account for the majority of mental health diagnoses in Canada. At any given time, at least 11.6% of Canadians aged 18 and over are dealing with a mood or anxiety disorder based on a survey in 2013. My experience suggests that this number is low, both because the statistics are now 5 years old, and because it’s based on self-report and we know that many people don’t report their struggles even when asked on anonymous surveys. One of the common questions we get here at Alongside You is how to support a friend or family member who is struggling with depression. In fact, we were asked again yesterday and that’s what instigated this article.
If you run a Google search on the subject, there are many articles on this topic, such as this one from the Mayo Clinic, or this one from HereToHelp. There are many great resources out there with many suggestions around educating yourself on depression, helping friends get exercise and eat healthy food, and similar tactics. These are all great suggestions and ideas and I encourage you to spend some time looking through the articles that are available.
In this piece, I want to take a slightly different road and look at how we can help a friend, family member, or other loved one who is struggling with depression in terms of how we need to be with them. This might sound a little strange because many of us (myself included) are practical, hands-on types who like practical strategies. The thing is, being who we need to be with people is a practical strategy, and it is very effective.
The Importance of Not Knowing
When we’re struggling with something, and certainly when that something is depression, we often feel misunderstood. We say things like, “They just don’t get it,” or, “Nobody understands how I feel,” and quite frankly, it’s usually true. Even for those of us who have struggled with depression in our lifetime, the experience of someone else may be very different. How it felt for us and how we responded may not line up with this person’s experience. If we assume we know how the other person is feeling, we run the risk of alienating them and making them feel even less understood than they already do.
So, our first job then is to listen and to listen to understand versus listening to respond. Often, especially when we’re under stress, we do the latter; we listen and feel the need to respond in the hope that it will help someone feel better or feel connected. Often, we’ll respond with something along the lines of, “Oh yeah, I totally know how you feel, I went through the exact same thing!” No, we didn’t. We may have been depressed, we even may have been through similar circumstances and reacted similarly, but we don’t know how they are feeling unless we ask and listen, and we most certainly didn’t go through the exact same thing. If we want to be helpful and fight against the alienation and isolation our loved one is likely experiencing, we need to listen to understand.
The Importance of Empathy
One of the greatest challenges we face in trying to support a loved one with depression is the fact that we don’t understand. In fact, this very thing often places a great deal of stress on us because we want to understand, we feel we need to understand. The fact of the matter is, we don’t need to understand to be helpful. If we build on this stance of not knowing, we can work toward understanding on a deeper level, understanding the emotional level, and by strengthening the connection between us. This, in a nutshell, is empathy.
Empathy is not our naturally occurring, number one go to strategy – our go-to natural strategy is usually sympathy. If you haven’t seen it already, I would encourage you to watch this short video of Brené Brown talking about the difference. When people are depressed, one of the most significant things that help is the connection with others. This is why empathy is so important – we can show empathy without understanding yet. It can be as simple as saying, “Wow, I don’t even know what to say right now but I’m glad you told me, and I’m here.” And yes, I totally stole that line from Brené Brown. I stole it because it’s that good. See, if we can admit our limitations and be vulnerable with our loved one that is struggling, not only do we encourage connection, but we model the vulnerability that they need in order to connect with us. If they can do this in return, it will directly combat those voices in their heads telling them that nobody cares, nobody listens, nobody understands, and they are not good enough.
Seeking Help
If we can do the two things above, we stand a greater chance of success in this third thing I’m going to talk about: getting help. Most of us are proud people – we think we can do it all on our own and further, we think we should. I remember when I was dealing with major depression I thought it was because I was doing something wrong, that I just wasn’t working hard enough, and that I was a failure. Part of the reason that I believed this is because to my knowledge at the time, nobody I knew, and none of my family had ever struggled with depression, and certainly not the suicidal thoughts that were commonplace for me. This is where vulnerability and even some self-disclosure on our part can be helpful, particularly if we’ve struggled with depression ourselves. Some careful self-disclosure can normalize the struggle, and fight against the negative self-beliefs.
If we can listen to understand, and show empathy, we send the message to the one struggling that it’s ok that they’re struggling, it’s ok that they don’t have it all figured out, and it’s okay to ask for help. Now, when I say it’s ok I don’t mean it’s pleasant, or that we should like being depressed, or anything along these lines. What I mean is that it’s not because of some inherent flaw in who they are that they are struggling, and it certainly isn’t because they’re not worth it.
See, by spending time listening and understanding, spending time in empathy and connection, we are sending a strong message. That message is, “You’re worth it.” In my opinion, this is the single most important message for anyone to receive when they are dealing with depression because if their belief about themselves is that they aren’t worth it, then why would they tell anyone how they feel? Why would they open up to someone? Finally, why would they bother asking for help, because they don’t deserve it?
If we can help our loved ones come to a place of even beginning to understand that they are worth it, they are loved, and they are valuable then we stand a much better chance of succeeding at getting them the help they need. This is where we can again show vulnerability and explain that we love them, but we don’t possess the skills necessary to help them recover fully, the skills that a mental health professional does. This is also where we can reinforce that we’d like to help them get the help they need and that we will be there alongside them as they go through this. In fact, we can emphasize that we will go through this together with them.
How We Are With People Is Most Important
The reality is that helping a loved one who is struggling with depression is usually a start and stop, back and forth, messy process. Most of the time, emphasizing the practical strategies doesn’t work very well. Why is this? Because we don’t have the connection needed where the person will believe they are worth it, that they are loveable, and that recovery is possible. If we can be with the person on a deeper, empathic level, we give them the best chance possible to buy into the recovery process and we show them that they’re not alone.
If you’re reading this because you have a loved one struggling, or because you are that loved one struggling, I encourage you to take the first step toward recovery. If we can be of help to you, please don’t hesitate to ask. This is why Alongside You exists – because we believe that everyone is worth it. Feel free to contact us!
by Share Forde | Apr 26, 2018 | Anxiety, Depression, Dialectical Behaviour Therapy, Mindfulness Meditation, Therapeutic Yoga
“You are richer than you think.” This is the current slogan being used by Scotiabank. When I hear this slogan, I think of the clients who are participating in the various DBT groups here at Alongside You. DBT is the short form of Dialectical Behavioural Therapy, created by Dr. Marsha Linehan, who is a psychologist working at the University of Washington in Seattle. This treatment is the gold standard for clients struggling with unstable identity, risky behaviours, chaotic relationships and an inability to regulate emotions and urges. The DBT skills taught in our groups focus on Distress Tolerance and Crisis Management, Interpersonal Effectiveness, Emotion Regulation and Mindfulness. There has been much research supporting this form of therapy that it is now also designated as the gold standard for Borderline Personality Disorder. The skills are also very helpful for clients trying to manage depression, anxiety and substance misuse.
In addition to skill building, learning and participating in a group format has many other benefits. I have facilitated groups of various kinds for 40 years and have been witness to so much growth in so many clients that I can say with confidence that a group experience is a very rich one. Dr. Irwin Yalom describes in his book, The Theory and Practice of Group Psychotherapy that the following factors occur when participating in group therapy:
- Instillation of Hope
- Universality
- Imparting of Information
- Altruism
- Corrective recapitulation of the primary family group.
- Development of socializing techniques
- Imitative behaviour
- Interpersonal learning
- Group cohesiveness
- Catharsis
- Existential factors
Dr. Roy Mackenzie in his book, Time-Managed Group Psychotherapy, identifies learning factors such as
- Modelling
- Vicarious learning
- Guidance
- Education
- Support
- Self-revelation and Insight
As the late famous American poet Maya Angelou says, “we are more alike than we are different.” Why then do we sometimes we feel that we are left behind while others live their life without strife? This is certainly how it may appear on the various social media sites. More and more I see young clients who spend hours daily checking up on friends on the various social media platforms on the internet. It seems to me that it would be much more healthy to call a friend and plan to do an activity together. If we parallel play as young adults we are not growing psychologically. Attending a group is a good start to get back in the game of communicating both verbally and nonverbally with other people. People need people as we are social beings by nature. A group is a microcosm of society in general. When clients feel supported in a genuine way they are likely to experience some or all of the healing factors mentioned above.
Another factor involved in a group setting is the undercurrent explained by the psychoanalyst, Wilfred Bion, in his book Experiences in Groups. Bion says that there are three basic assumptions working alongside any working group. These are mostly unconscious but are helpful for facilitators to consider if a group they are running is starting to struggle. The first basic assumption is the dependency and this happens when leaders are dialectically idealized and devalued. The second basic assumption is pairing in which two group members bond in an attempt to overthrow the leader. The third basic assumption is fight or flight, which happens when the group has a common enemy. It can be a taxing job to be teaching skills as well as observing the group process and the underlying basic assumptions all at the same time. Extra training on group skills is highly recommended when moving from individual therapist role to a group therapist role. I believe that this is one of the reasons our groups are so effective here at Alongside You. We work diligently to create the best atmosphere for people to learn and to grow.
Groups are a dynamic force and when change happens to the individual group members this impacts and creates a vibration which results in changes to the whole group. Systems theory suggests that groups over time tend to develop a self-organizing nature which works to maintain stability and minimize threats. Through this, clients can experience a safe space to explore their challenges and their successes, and learn from, and encourage each other.
My goal when I co-facilitate our Dialectical Behavioural Therapy group is to have clients leave after 24 weeks being even richer than they think they are, as they carry their new tools to help them achieve a “Life Worth Living.” Feel free to contact us to learn more about Dialectical Behavioural Therapy.
by Andrew Neufeld | Apr 20, 2018 | Counselling, Dialectical Behaviour Therapy, Mindfulness Meditation, Trauma Sensitive Yoga, Yoga Therapy
When I meet with clients, I often remark that of the 168 hours in their week, I get 1 if I’m lucky. That’s assuming that I get to see them once per week, which is not necessarily the case. Most often I see clients every other week, or even further between sessions. In this case, the hours I don’t get to be with them becomes multiples of the 168. I highlight this because I want to encourage clients that as important as the work we do in-session is, it is truly what they do between sessions that promotes lasting change. It’s not that I discount the importance of what I do, I simply recognize the importance of what my client does day in and day out between our times together.
One thing that I love about Dialectical Behaviour Therapy (DBT) is the emphasis on skill development. In our DBT groups, we focus on both skills and process, but the homework in between groups is heavily focused on skill development. Whether it’s Mindfulness, Distress Tolerance, Emotion Regulation, or Interpersonal Effectiveness they’re working on, there are concrete activities and worksheets clients can follow in between sessions to work on these areas. Clients get all of these resources in a book as a part of the group and the clients who really work at this, come back each week with a well-worn book! It’s wonderful to see clients invested in their process.
One of the questions I am asked a lot is, “Why do you have so many different things at your clinic?” The answer to this is because we believe in a holistic approach to recovery. I’d like to highlight three things you can access in our clinic between counselling sessions that will promote your wellbeing and recovery in those in-between times. The great thing is that all of these also promote things you can do on your own at home that don’t cost more money!
Open Studio Sessions
One of the things people are most curious about in our clinic is our art studio. People regularly wonder why we have an art studio, but the answer is very simple: because it helps people recover. We do this both through 1:1 sessions, and our Open Studio Sessions. There is a large body of evidence showing the power of creativity and art to help people recover from mental health, chronic conditions, chronic pain, and more; it also helps people connect inter-generationally and with family members and friends. All of these are great things! In our studio, you can learn Mindfulness-Based Art Therapy (MBAT) techniques that you can use at home, and we can even help you figure out what materials you’ll need and give advice on where to source supplies for reasonable prices. Many of our clients come to the studio sessions to learn new techniques and then go home and use them in their daily life. You can come to connect or learn new things, and then work on them on your own at home!
Trauma Sensitive Yoga and Yoga Therapy
The second most surprising thing to people about our clinic is that we have a yoga studio. We have a yoga studio because we saw a need that people had that wasn’t being filled. As you might imagine, not everyone is comfortable with large studio yoga, particularly if they’re struggling with trauma, anxiety, depression, or other difficulties. Further, as wonderful as larger studio yoga is, it’s not specifically designed for people struggling with trauma and mental health, or physical health challenges. Our Trauma Sensitive Yoga (TSY) programs and Yoga Therapy programs are specifically geared toward helping people recover from these things. The techniques are evidence-based and the programs are designed specifically to each client’s unique needs. Once again, the goal is to help you recover and work on your own, in-between sessions. Our certified yoga therapist will work with you individually in our safe, trauma-informed space to design a program specifically for you that once you learn, can be done safely at home on your own. When you want to learn more or brush up on techniques, you can come back in for some sessions. It’s flexible, safe, and geared specifically to you and your unique needs.
Mindfulness Practice
Mindfulness has become something of a buzz-word in pop psychology, but that is not a bad thing! Mindfulness is the practice of focusing on the present, allowing your brain and body to calm and be in the here and now. We’ve written previously about it on our blog, and you can look forward to more articles on this in future. It’s a vital practice that supports holistic health in body, mind, and soul. We can approach mindfulness training in a number of ways here: individual sessions with our DBT therapists and the curriculum from the dialectical behaviour therapy programs, one on one sessions in the art studio with Meg Neufeld to learn Mindfulness-Based Art Therapy techniques, or with our yoga instructors using breathwork and yoga techniques. Once again, all of these are skills you can learn and take home with you and practice on your own!
At Alongside You, our goal is to support you both in-session as we provide counselling, and outside of sessions to help you cope, grow, and thrive using holistic methods. This not only increases the effectiveness of your counselling, it also promotes autonomy, choice, and increases the chances of your recovery. Our belief is that all of our clients possess unique strengths and gifts that can be used to journey toward wholeness and resilience, and our job is to help identify these, support them, and encourage you. I hope this article gives you some ideas on how you can support yourself along the journey! If you are interested, feel free to contact us!
by Chantelle Phillips | Apr 11, 2018 | Counselling, Emotionally Focused Therapy, Group Therapy, Relationship
With an increasingly multicultural society, it is becoming more important than ever for therapists to consider the impacts of these different cultural aspects on their clients4. Today’s couples are becoming more diverse in terms of culture, socioeconomic status, ability, ethnicity, and religion, just to name a few. This means that we as therapists to adjust our practice appropriately. In this blog, we’ll look at how therapists can support diverse couples in relationships from different religious or faith backgrounds in a therapeutic setting.
The Challenge
Interaction among different religious, cultural, and ethnic groups has been shown to be beneficial in platonic relationships when the interactions are “amicable, positive, and voluntary”, but romantic relationships may present a greater challenge. Separately, marriage has been shown to positively correlate with physical and psychological health and religion has proven to be a protective factor for many; together, marriage and religion can spur additional external stressors. Differences in religion can often mean differences in culture, tradition, and ethnicity, which has the potential to create additional stress on the relationship. These external stressors often come in the form of extended family, or society as a whole, when traditions appear altered or compromised. Research has shown that these factors can have a detrimental impact on the psychological well-being of couples with different religious backgrounds.
There are particular factors within religiously diverse couples that can tip the scales in either a more positive, or more challenging direction. First, couples vary on how strongly they use religion to define a relationship. Religion may enforce particular “rules” to determine how interpersonal or family challenges are addressed, such as sexuality, parenting, or power. Second, religiosity exists on a spectrum, so factors such as religious practice, involvement, activity, and belief intensity all contribute to potential stress in a relationship; both individuals in a relationship can even be of the same religion and differ in the strength of religious faith or religious motivation. Third, underlying values may overlap in different religions allowing couples to find common ground; for example, many religions view extramarital sex as unacceptable. Couples from different religious or faith backgrounds can be successful if differences are addressed, understood, and respected; if left unaddressed these differences can become conflictual and threaten the relationship.
How Can We Help?
From a therapeutic perspective Emotionally Focused Therapy (EFT), a form of couples counselling has shown to be effective for addressing distress in relationships. EFT believes that relationship distress stems from perpetuating negative interaction cycles, which often result from unmet needs. For example, this could be shown in how a couple manages conflict; is the conflict discussed and resolved or does an argument ensue that leaves both parties angry and resentful? The goal of EFT is to develop secure attachment through identification, experience, and expression of emotional and attachment needs. The basis of EFT in the attachment is a leading reason why it is thought to be so successful as a couple’s therapy. From a diversity perspective, the ability to adopt EFT to accommodate different religious or faith backgrounds is why this form of therapy can be successful for a multitude of different couples.
There are three main stages to the EFT model of couples therapy: de-escalation, restructuring attachment interactions, and consolidation and integration. De-escalation involves learning about and understanding negative interaction cycles that are perpetuating distress in the relationship. This can relate back to the previous example; when conflict occurs in the relationship is there one party who actively wants to resolve the situation and one party who chooses to remove him or herself? Restructuring attachment interactions are all about shaping new core emotional experiences and interactions to lead to a more secure attachment. Change in EFT is not achieved through insight, catharsis, or improved skills, but rather from formulation and expression of new emotional experiences as it pertains to attachment needs and emotions. What does each partner need to feel heard and understood? Consolidation and integration are the final of the three stages in EFT and can also be referred to as withdrawer re-engagement. During this stage, the partner whom previously avoided conflict and engagement with their partner openly expresses attachment needs and is more open and responsive to their partner.
The rooting of EFT in emotion and attachment makes it very flexible and therefore adaptable to couples of many diverse backgrounds. At Alongside You we love working with couples from diverse backgrounds and we have specific training in Emotionally Focused Couples Therapy. If this article resonates with you and we can be of help, please let us know, contact us, and give us a shout
by Laura Paterson | Apr 5, 2018 | Communication, Connection
Note from Andrew
Hi everyone, I want to take a minute to introduce you to Laura. She’s a local South Delta resident who is going to be volunteering with us. She is a graduate student, currently enrolled at Trinity Western University, working toward becoming a counsellor. Her program works to provide counselling knowledge in different areas of mental health, multiculturalism, family domestic violence, career and vocational counselling, psychotherapy, sexual abuse, addictions, child protection and family and child therapy. Laura sees herself as a sounding board for people to become empowered finding solutions and to be a source of support during times of change or reevaluation. During her undergrad, she volunteered at a suicide crisis hotline and also worked at an afterschool program for at-risk youth where she discovered her passion for counselling. We’re excited to have her on board, and you’ll be hearing more from her in the coming months!
Technology: the new social drug?
The world of technology has given people new ways to connect, share, and keep up to date with friends and loved ones. In just about 20 years we have gone from not having an email to being able to watch the live stream of our friends’ daily activities. We have the ability to show the world what we want of ourselves whenever we want to. There has been a recent wave of new types of social networking sites (SNS) as well as a flood of concern for the young people of this generation who are growing up in a technological age.
The purpose of this article is not to deter anyone from using social media websites (or else you wouldn’t be reading this). The hope is that by the end of this article you will have gained some awareness of how SNS’s, particularly Instagram, can affect our mental well-being as well as behaviours. Having an honest conversation with ourselves about our purpose for sharing and posting particular content could be helpful for identifying a particular need that has not been met in our personal lives.
Instagram is sometimes called the new Facebook. When a user scrolls through the home page of Instagram they will see only pictures with captions underneath that have a limit of 2200 characters but rarely exceed 20 characters. The captions are very small and the photos people share take up the entire screen of the smartphone.
Studies involving college-age students have identified that larger amounts of time spent on SNS’s are correlated with a greater body dissatisfaction. Women are more likely to have greater body dissatisfaction than men because they tend to compare themselves to members of the same sex more frequently. Comparing oneself to one’s peers on an SNS has also been shown to lead to emotional eating for girls.
Research is also highlighting that the more followers someone accumulates on Instagram the more selfies that person will post, almost as if they feel they are in demand. Students who take more selfies to show off their appearance are more likely to believe they are perfect but also believe that no one else sees them that way. This form of narcissism can be referred to as vulnerable narcissism. This is in contrast to grandiose narcissists who believe they are perfect and insist that everyone around them agrees. Murray’s research also shows that young adults and adults who take selfies to show off their appearance report characteristics of fragile self–esteem and a tendency not to reveal their weaknesses. This could show that people who are vulnerable narcissists use their physical appearance selfies to declare a sense of confidence through social media, where it feels safe. In short, people are using social media because it makes them feel better in the moment but has the opposite effect long-term. It may be important for us to keep this in mind next time we scroll through our Instagram feed and find a gorgeous peer who seems to have it all. It may be wise to give it a second thought – appearances are not necessarily what they seem.
All of this information brings up the question of what people are trying to do on social media. Many people seem to be after a sense of connection – but this usually isn’t the result. Research is showing that people who post a high amount of self-pictures on Instagram are much lonelier than either passive browsers or users who use it to message people. In other words, on social media, the harder we try, the lonelier we become!
Fortunately, if you identified with any of the people groups, it doesn’t have to stay like that. Social media can be a great distraction from loneliness or insecurities. However, distractions do not fix the problems just like comparing yourself to others and getting likes and comments from strangers won’t make you like yourself more or feel happier in the long run. Admitting that we are not perfect can be scary and difficult but it can be empowering if we are willing to put down our quick fixes and honestly evaluate things we may like or may try to ignore about ourselves. Perhaps the first step might be putting down our phones and getting off social media for a bit and meeting a friend in-person at a coffee shop?
by Andrew Neufeld | Mar 29, 2018 | Dialectical Behaviour Therapy, Education, Mental Health Disorder, Relationship
One of the most common questions I get from people when I give talks on Borderline Personality Disorder (BPD) and Dialectical Behaviour Therapy (DBT) is the question of how to support someone with BPD? So many individuals, couples, and families are struggling with how to love, care for, and support someone in the midst of what often feels like total chaos and painful experiences.
Shari Y. Manning, former President and CEO of Behavioral Tech and Behavioral Tech Research, the research organizations founded by Marsha Linehan to provide training in BPD, wrote a book on just this, titled “Loving Someone with Borderline Personality Disorder” and in it she focuses on how to keep the out of control emotions from destroying relationships between individuals with BPD and their families and other supports. She highlights the difficulty of balancing compassion for the person, while still wanting to help them find ways to change their behaviour and managing their emotions.
I’ll admit that it’s not easy to help someone struggling with BPD. It may seem that they are manipulative, egocentric, and focused on their own needs exclusively. The reality is that it’s not actually too far from the truth. The key to supporting someone with BPD without losing our own sanity, in my mind, is in our approach and how we frame what we’re observing. This is where Dialectical Behaviour Therapy (DBT) skills come in handy for us as well.
Interpersonal Effectiveness and Manipulation
Let’s talk for a minute about the idea that people with BPD are manipulative. It’s common to hear, both amongst clients with BPD, support systems, and yes, even professionals. I remember years ago that I used to get very angry when I heard this because I felt very compassionate toward clients with the borderline personality disorder and their need for help. Then it dawned on me – that is, they are being manipulative. And so are we.
See, manipulation is nothing new in relationships. We do it all the time – in fact, as I said to my intern John this week in supervision, we’re all in relationships to get what we need from the other person. None of us would be in relationships if this weren’t true. The difference is, we do it in a mutually beneficial way that serves everyone involved. The fact remains, however, that we’re all trying to get what we need from others, we just have more ability to do so effectively. This is what interpersonal effectiveness skills in DBT do for clients and for members of support systems; they teach us how to get what we need from others in an effective way.
Why Individuals with BPD Behave the Way That They Do
I remember back many years ago when I began working with individuals with developmental disabilities, we often repeated the phrase with staff and caregivers, “All behaviour is communication.” This is a very important concept and applies just as much to kids and adults alike, as well as individuals with BPD. When we can’t use words to communicate, we use actions. Further, when we see the often extreme behaviours of individuals with BPD, it’s important we remember what is happening to them at that moment, and how it got that way.
Personal history
We’ve learned from research that individuals with BPD have reasons for interacting with the world in the way they do, just as we all do! Linehan’s theory from 1993 is the most substantiated, and it suggests that BPD can be the result of the interaction between biological and psychosocial factors, including adverse childhood experiences. One of the predominant factors is invalidating developmental contexts where emotional expression is invalidated in childhood. Further research suggests that between 30%-90% of individuals have experienced abuse and neglect in their lifetime. This has a significant impact on the developing brain.
Brain Function
What we also know from brain science, and certainly I’ve observed this in my clinical work, is that individuals who have histories of abuse, neglect, invalidating emotional environments, and other traumas, have brains that are more sensitive to danger. The limbic system is designed to keep us safe and also regulate our emotions. At its’ best, it keeps us safe when we’re in danger, and regulates our emotions to keep us at an even keel. At its’ worst, it’s being triggered in situations that aren’t dangerous and causing us to react in ways that would make sense if we’re in danger but make no sense when we’re not. It’s also important to remember that when this system is acutely active, it shuts down our frontal cortex, which is where our rational thought mechanisms are housed. So, when we’re in danger, as I often say to clients, we can’t think to save our lives. This is the brain state that individuals with BPD are in when they react in extreme ways. Their brains are in full-blown fight or flight mode and simply reacting, trying to do anything they can to be safe. Most often, they turn to their closest relationships.
Relationships as Safety
Ever heard the idea that we hurt the ones we love the most? This is often the case with individuals with BPD when they react in extreme ways. But why is this? Many people with BPD have a very externalized locus of control, meaning, they don’t believe they can contain their own emotions, especially when they’re overwhelmed. You know what? They’re right. When they’re in fight or flight the mechanisms in their brain responsible for regulating emotions and behaviour are not rational, and are just reacting and they can’t contain it. This is simply a more extreme version of what happens to all of us. So then, what’s the difference?
I believe the difference is the level of fear experienced in these moments. The idea of not being able to contain extreme emotions would be, I imagine, quite terrifying. Coupled with the fear of being left by the people they are closest to, the proverbial pot boils over and they have to do something extreme to get attention. I often hear, “Oh they’re just attention-seeking,” to which I reply with an emphatic, “Yes, of course, they are!”
Remember the idea that all behaviour is communication? When people with BPD are at this heightened state they are unable to communicate effectively and are doing their darndest to communicate their pain and fear to us, asking us to help them contain it. What may look to us like someone simply showing out of control behaviour, I believe, is a desperate attempt at seeking safety and containment.
Can you imagine what it would be like to be in this position? Having BPD, feeling so unsafe and so in pain that you have to go to such extreme lengths to try to get help? I can’t. The idea of being there is far too terrifying to me. Quite frankly, I don’t want to know what it feels like to be in that place, but it gives me a great deal of compassion for those who are.
What Do We Do To Help?
One of the best ways to be supportive is to help those struggling with BPD to get the help they need. Dialectical Behaviour Therapy (DBT), on an individual basis as well as in skills groups, is very effective in helping those with BPD manage their symptoms. With the right help, individuals with BPD can learn the skills they need to manage their emotions and relationships and ultimately, have a life worth living! This was Marsha Linehan’s goal in developing DBT, to help those struggling with suicidal thoughts have a life worth living. We’re proud to say that our DBT programs have been effective at doing just that for our clients, and we’d love to help even more people this way.
We have often been asked if we run groups for family members and other supports who are trying to help someone with BPD. Unfortunately, we don’t at the moment but it’s on our radar. We are looking into doing exactly this in the future. What we can do, however, is teach DBT skills on an individual or family basis for those supporting someone with BPD. We have a number of counsellors available for this, and you can talk to Doug, Share, or Kelly about this if it would be helpful.
Education is also very important as once we understand what is happening, it gets less scary. There are many books that can be very helpful. Here are a few ideas to get you started:
Stop Walking on Eggshells by Paul Mason
Loving Someone with Borderline Personality Disorder by Shari Y. Manning
DBT Made Simple: A Step-by-Step Guide to Dialectical Behavior Therapy by Sheri Van Dijk
Finally, self-care is absolutely paramount to your survival for yourself and the person struggling with BPD. As the airlines often remind us, we need to put our mask on before we can help anyone else! If we don’t take care of ourselves, we will flip our lids and react in much the same way as those we’re trying to help.
I hope this has been helpful – if our team can be of any help to you as you support someone with BPD please feel free to give us a shout. Our Dialectical Behaviour Therapy program is comprehensive, and we would love to teach you the skills needed to be a solid support, for yourself and your loved ones with BPD!
by Andrew Neufeld | Mar 15, 2018 | Anxiety, Neurofeedback
Anxiety is one of the most common mental health difficulties in Canada, and across the world. No doubt you’ve seen numerous articles on the subject, describing what anxiety is, why we suffer from it, and what to do about it. One of the questions I get asked quite frequently is whether neurofeedback can fix anxiety. It’s a great question, and here’s my answer!
Why Neurofeedback?
The premise of neurofeedback is that if we are stressed out, anxious, depressed, or are suffering from others negative symptoms, our brain is likely to be operating less than optimally. Neurofeedback is a tool that helps train the brain to adjust how it is operating so that it can function more optimally and efficiently. You might think of it as gym training for the brain. The fact that it is training is an important distinction – it is not a treatment for a specific symptom, it is a training that helps your brain optimize itself over time and learn how to do so for the long term.
What is Neurofeedback?
You may never have heard of neurofeedback before, so here’s a quick primer on dynamical neurofeedback, which is the main type of neurofeedback we do here at Alongside You. Dynamical neurofeedback uses EEG equipment and software to monitor your brain activity, and feed information back to the brain about what it is doing. A crude analogy is to equate the neurofeedback system with a giant mirror being held up for the brain so that it can see its own processes and gain the information it needs.
Why does the brain need this information you may wonder? See, the wonderful thing about our brains is that they are self-regulating. If given the necessary information, our brains can change themselves to function more optimally, back within the parameters they were designed to operate within. The brain doesn’t need us to push it, or pull it in any particular direction if we can provide the brain with the information it needs. This is what dynamical neurofeedback helps the brain with. Our primary system monitors the brain, and feeds back information 256 times per second, allowing the brain to see what it is doing and adjust accordingly.
Can Neurofeedback Fix Anxiety?
There are numerous theories as to why people get anxious. There are personality factors, biochemical factors, life factors, brain function factors, and many more. The trouble with trying to fix anxiety by any means, is there are no guarantees. This is true of counselling, psychiatric medications, and every other form of therapy or treatment out there. I’ve been in this field long enough to know that none of the treatments or therapies we employ can be guaranteed to fix what ails us. This is, however, different than asking whether something can be helpful with anxiety, and if we ask this question, the answer with regard to neurofeedback is a resounding yes in my experience. I’d like to share three ways I see neurofeedback being helpful for anxiety.
3 Ways Neurofeedback Can Help Your Anxiety
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- If you have been on medication, maybe some have worked really well or some have not. Often there are side effects to medications and in some cases, the side effects are worse than the symptom you’re trying to treat. Another concern can be when medications work for a time and then stop working. Sometimes people just simply don’t want to take medications for various reasons. This is where neurofeedback can be helpful and this is because neurofeedback is another way of working with the brain biology without the use of medications.
- If our brains are not functioning optimally when we’re anxious, neurofeedback can train our brain to function better. What’s important about this is that we’re not simply treating, or masking undesirably symptoms, we’re helping the brain function better and learn how to do this long term. Again, the analogy of going to the gym is helpful. If you get injured playing sports, you can simply take some medication to mask the pain. More effective, however, is going to the gym, under the guidance of a physiotherapist or other rehab professional, and working on the muscles, joints, and other areas to rehabilitate the injury and hopefully prevent a new one. This is what neurofeedback does for your brain.
- One of the main triggers for anxiety is the activation of the central nervous system (CNS) and interaction with the autonomic nervous system (ANS). In fact, some of the most exciting research coming out right now around anxiety, depression, and trauma has to do with the CNS and ANS, and particularly, the vagus nerve (but that’s a whole topic on its own). Check out this article if you want to geek out on this information. One of the most exciting things for me in working with my clients with anxiety is that neurofeedback can directly influence the CNS and ANS and induce the relaxation response, lowering the triggers for anxiety. This is especially exciting for those suffering from generalized anxiety because it is one of the most difficult forms to treat by other modalities. I can tell you that in my experience with clients, as well as my own personal experience with a generalized anxiety disorder, neurofeedback has been one of the most helpful things I’ve ever seen or experienced, both personally and professionally.
If I’m Interested in Neurofeedback What Should I Do?
If you’re interested in neurofeedback for your anxiety, please give us a call. It’s not necessarily a fast treatment (in our experience and the data for the system we mainly use, 12-20 sessions is the average), but it’s an effective tool that has long-lasting effects and trains your brain to function better for the long term. It can be used in conjunction with medications, and it actually has the potential to reduce the need for medication and enable a lowering of doses in some cases. Neurofeedback is an exciting tool in our toolbox, and another way to we can bring holistic, integrated approaches to care for our clients. As you can probably tell by now, I’m pretty excited about this.
Please contact us or give us a call if you have any questions or if you want to explore whether neurofeedback might be right for you. We’d love to chat!
by Chantelle Phillips | Mar 8, 2018 | Communication, Counselling, Mental Health Disorder
Suicide. To most this can be a feared word, much like, “He Who Must Not Be Named,” but as Hermione Granger would say, “fear of a name only increases fear of the thing itself.” 1 While a helpful illustration, we shouldn’t let the Harry Potter quote take away from the gravity of the subject of suicide. With knowledge comes power and although there are things in life that may ultimately be outside of our control, it is important for us to be informed.
One author writes, “stigmatization of…mental health disorders is alive and well,” and perpetuated by misinformation, miscommunication, and media sensationalization, despite the best efforts of good intentioned campaigners. 2 Those with mental health disorders are often painted as “crazy,” “violent,” or “untrustworthy,” but could these descriptors not also be attributed to those without mental health disorders? I am certain that most of us could think of someone in our life that we have a colourful moniker for, much like those aforementioned, that does not have a mental health disorder. The truth of the matter is that research shows that individuals living with mental illness are more likely to harm themselves than others.2 Stigma can produce profound impacts, including social disgrace and shame, which then serve as obstacles to identifying and acting on warning signs of suicide.3 Individuals may recognize warning signs for suicide as easily as they do those for physical ailments (e.g. heart attack or stroke) but tend to respond less urgently.3 All this to say, if we want to do something to reduce suicides, we need to reduce stigma, and be aware of the warning signs.
Determining the risk of suicide for an individual with one hundred percent accuracy is impossible. Suicide assessments consider a complex interplay of variables encompassing risk factors, protective factors, and warning signs. Due to these complexities, it takes much training, supervision, and experience to thoroughly conduct suicide risk assessments and should only be done by an experienced professional.
So if suicide risk assessments can only be completed by trained professionals what can you do? If you are concerned about a family member, friend, or colleague there are ten common warning signs to be aware of6 :
- Ideation or communication about suicide
- Substance abuse
- Purposelessness
- Anxiety or panic
- Trapped feelings
- Hopelessness
- Withdrawal from social groups
- Agitation or irritability
- Reckless behaviour
- Mood changes
An important thing to remember is that nothing is certain. Warning signs are just that, signs. The presence of a warning sign does not automatically mean that an individual is suicidal, just as the lack of warning signs does not automatically mean that an individual is not suicidal. The purpose is to recognize the signs and start the conversation, get more information, or seek the help of a professional. Let’s start treating mental health like physical health and take preventative measures to ensure the health and safety of our loved ones.
Resources
Crisis Intervention and Suicide Prevention Centre of BC
Anywhere in BC 1-800-SUICIDE: 1-800-784-2433
Mental Health Support Line: 310-6789
Vancouver: 604-872-3311
Sunshine Coast/Sea to Sky: 1-866-661-3311
Seniors Distress Line: 604-872-1234
Online Chat Service for Youth: www.YouthInBC.com (Noon to 1 am)
Online Chat Service for Adults: www.CrisisCentreChat.ca (Noon to 1 am)
S.A.F.E.R (Suicide Attempt Follow-up Education & Research)
8:30 am to 4:30 pm Monday to Friday Call: 604-875-4794
Aboriginal Wellness Program (AWP) Vancouver
Call: 604-875-6601
In an emergency call 9-1-1.
[1] Rowling, J. K. Harry Potter and the Philosopher’s Stone. (1997). London, England: Bloomsbury Publishing Plc.
[2] The Lancet. (2013). Truth versus myth on mental illness, suicide, and crime. The Lancet, 382(9901), 1309. doi:10.1016/S0140-6736%2813%2962125-X
[3] Rudd, M. D., Goulding, J. M, & Carlisle, C. J. (2013). Stigma and suicide warning signs. Archives of Suicide Research, 17(3), 313-318. doi:10.1080/13811118.2013.777000
[4] Fowler, J. C. (2011). Suicide risk assessment in clinical practice: Pragmatic guidelines for imperfect assessments. Psychotherapy, 49(1), 81-90. doi:10.1037/a0026148
[5] Granello, D. H. (2010). The process of suicide risk assessment: Twelve core principles. Journal of Counseling & Development, 88(3), 363-371. doi:10.1002/j.1556-6678.2010.tb00034.x
[6] Wu, R. (2017). Individual Appraisal for Counsellors in Practice. Suicide risk Ax. [PowerPoint slides]. Retrieved from https://adler.hotchalkember.com/courses/15984/files/743942?module_item_id=36008
