by Brenna Jacobson | Dec 7, 2017 | Trauma Sensitive Yoga, Yoga, Yoga Therapy
Reality is that life is not peaceful. Trauma can arise from any number of daily things, seemingly small to one person, yet overwhelming to another. Having experienced trauma, whether recently or in the past, one can feel like something is broken within us, wrong with us, or we feel damaged. This is not so but is a part of the healing process and a normal response to internalizing a traumatic experience. Trauma Sensitive Yoga Therapy is not about fixing or changing anyone. It’s about learning how to find healing and support within, by empowering yourself to feel safe in your own body and mind and seeing the potential in yourself. By separating yourself from the traumatic event, you are able to witness and self-observe. Through witnessing awareness, you begin to look at it objectively and come to realize that you are not the trauma, it is something that happened to you.
Through your yoga practice, you can return to wholeness by seeing the experience from a place of comfort and safety within your own body, and in time, finding meaning in it. This will arise when the time is right for you. Post-Traumatic Growth will evolve, remembering that people don’t become great in spite of their challenges, but because of them. Eventually, your yoga practice will take you to that inner place where you can be the witness, and know that you can return to that place anytime during your practice or in your daily life. The change will come from that untouched true nature when you are operating not from brokenness, but from wholeness.
Trauma activates our Sympathetic Nervous System (SNS) for survival but leaves us frequently stuck in the fight or flight response. Yoga practices that can help us get back into the Parasympathetic Nervous System (PNS) include Therapeutic Yoga, along with talk and physical therapy, and meditation. In The Relaxation Response: Yoga Therapy Meets Physiology published in Yoga Therapy Today, Summer, 2017, Maggie Reagh, Yoga Therapy International renowned founder and teacher, lists restorative procedures under topics of Relaxing through Positioning the Body; Relaxing through Lengthening the Breath; Relaxing through Stilling the Mind and Balancing the Nervous System.
Utilizing guided meditation of Yoga Nidra allows healing to begin by building resilience to challenging circumstances that arise in our daily lives. In the International Journal of Therapy, No.19 (2009) p.123, David Emerson et al. state in Trauma-Sensitive Yoga: Principles, Practice, and Research, “Trauma exposure is ubiquitous in our society. Over half the general population report having had exposure to at least one traumatic event over their lifetime…research has shown that Yoga practices, including meditation, relaxation, and physical postures, can reduce autonomic sympathetic activation, muscle tension, and blood pressure, improve neuroendocrine and hormonal activity, decrease physical symptoms and emotional distress, and increase quality of life. For these reasons, Yoga is a promising treatment or adjunctive therapy for addressing cognitive, emotional, and physiological symptoms associated with trauma, and PTSD specifically.”
When we get stuck in the SNS, the brain is affected, the amygdala grows, making us more reactive, the hippocampus shrinks and we may lose perspective on time, the frontal cortex goes off-line, making it harder to make decisions or think things through. Trauma often makes us feel detached from our body, and sometimes feeling unsafe in our body. Dr. Herbert Benson of the Benson Henry Institute has found in Harvard University’s research that spending 20 minutes a day in the relaxation response can lower or turn off our stress genes. Through comforting Therapeutic Trauma Sensitive Yoga we experience the relaxation response of coming back to our body and mind. Yoga and guided meditation also help one to understand the significance of the breath. Controlled, yet easily learned, breathing is a powerful trigger to engage the relaxation response. Yoga Nidra supports organization of thoughts and flow of memories and puts us in touch with our physical self.
I hope this article helps explain some of the benefits of a yoga practice, particularly when we’re hoping to recovery from trauma in our lives. You may not think that yoga is for you – and you know what, I don’t blame you. For many, it’s an entirely new concept and outside of the box in terms of thinking of treatment. The research is showing that Yoga Therapy and Trauma Sensitive Yoga can be effective in helping reduce symptoms of trauma and change the physiology of our brain.
At Alongside You, we work as a team and I’m pleased to be able to work alongside the other staff in helping clients, many whom have benefitted from yoga therapy as an adjunct in their recovery. If you’re curious, please give me a call at (604) 283-7827 ext. 709 or contact me through the website here and I’d love to speak with you about how I might be of help.
by Richard Somerset | Dec 7, 2017 | Case Studies, Counselling
Narrative Therapy and Re-Authoring
Many titles have been heaped upon the late Michael White for his development of Narrative Therapy, ranging from genius to prophet to guru. These titles, I believe, provide a framework for the impact that his work has meant to the field of psychology and therapy. He has created a forum for individuals to reclaim their sense of identity and purpose and to begin to live into a new story. As Alan Carr writes, “within a narrative frame, human problems are viewed as arising from and being maintained by oppressive stories which dominate a person’s life. Human problems occur when the way in which people’s lives are storied by themselves and others does not significantly fit with their lived experience…Developing therapeutic solutions to problems, within the narrative frame, involves opening space for the authoring of alternative stories, the possibility of which have previously been marginalized by the dominant oppressive narrative which maintains the problem” (Carr, 1998, p. 486).
A critical component of narrative therapy is the concept of externalizing the problem whereby the person objectifies or personifies the problem as a separate entity from the individual. In doing so, the person is able to “separate from the dominant story that has been shaping their lives and relationships” (White, 1988/9, p.7). When persons are able to externalize the problems they are then able to identify times when their experience contradicts the problem (White, 1988/9, p. 16). In the end, the problem becomes the problem allowing the person’s identity to become separate. The problem no longer represents the truth about who the person is and this realization unleashes incredible opportunity for hope and resolutions to occur as the person is able to step back and view the situation from a less personal and problem saturated perspective (White, 2007, p. 9). Carl Tomm suggests that externalizing the problem provides, “a linguistic separation of the distinction of the problem from the personal identity of the [person]. It opens ‘conceptual space’ for [people] to take more effective initiatives to escape the influence of the problem in their lives (Tomm, 1989, p. 54). Externalizing the problem and then becoming aware of ‘unique outcomes’ where the client finds that their life is no longer tied to these negative conclusions allows them to begin the process of re-authoring their story (White, 2007, p. 27).
Re-Authoring
The process of re-authoring allows a client suffering from substance abuse to begin to develop their story but to integrate significant unique outcomes that were out of step with the dominant storyline. These unique outcomes are the starting point for re-authoring. The therapist can support the client in exploring alternative storylines by having the client “…recruit their lived experience, to stretch their minds, to exercise their imagination, and to employ their meaning-making resources” (White, 2007, p. 62). In so doing, the client engages more deeply into their alternative stories and begins to root their storyline in a new history and perspective which establishes a new foundation for them to address their externalized problem. As the client steps to becoming the author of their life, they begin to play with the terms Jerome Bruner coined ‘landscape of action’ and ‘landscape of consciousness’ which, “…bring specificity to the understanding of people’s participation in meaning-making within the context of narrative frames” (White, 2007, p. 80). Michael White found that landscape of consciousness encountered too much confusion so he reframed the term to become the landscape of identity which, I believe, aptly describes what occurs when one re-authors their story and renegotiates their own identity. Using landscape of action and landscape of identity allows the therapist to build a context, “in which it becomes possible for people to give meaning to, and draw together into a storyline, many of the overlooked but significant events of their lives” (White, 2007, p. 83) which are crucial for re-authoring.
In January we’re launching our Recovery and Aftercare programs, and we would love to work with you to re-write your story in your recovery. Please have a look at the program on our website, and we would love to hear from you!
References:
- Carr, A. (1998). Michael White’s Narrative Therapy. Contemporary Family Therapy: An International Journal, 20(4), 485-503.
- Tomm, K. (1989). Externalizing problems and internalizing personal agency. Journal of Strategic and Systemic Therapies,16-22.
- White, M. (2007). Maps of Narrative Practice. New York, W.W Norton and Company Inc
- White, Michael, 1998/9. The externalizing of the problem and the re-authoring of lives and relationships. Australia, Adelaide: Dulwich Center Review
by Andrew Neufeld | Dec 5, 2017 | Announcements, Press Release
It’s been a difficult couple of months holding back on this announcement, but I’m excited to announce that we will be expanding to South Surrey and White Rock in January 2018! We have wanted to get into Surrey for a while to bring our services closer to home for some of our clients, and we have found a great space in the Morgan Crossing neighbourhood. For those of you wondering, yes, it’s right next to the shopping centre some of you love!
One of the challenges in expanding is that our goal is not simply to expand and build a brand. If we were a retail shop, expansion may come down to different goals and principles, but we’re not – we’re an integrated health clinic and our goal has always been to embed ourselves in the community, find out what the needs are, and try our best to meet those needs. So, our expansion needs to be intentional, meaningful, and to model after our growth in South Delta. We’ve been searching for the right location to allow us to do this, and I believe we’ve found a great space that will allow us to do exactly what we hope to do again – that is, get to know the community of White Rock and South Surrey, find out what the needs are, and bring those services that the community is asking for.
Thus, we are starting small. We’ve found a great space that our colleague, Dr. Jeff Morley has graciously allowed us to come into. It’s one large room that will allow us to provide individual, couples, and family counselling, neurofeedback, registered dietitian services, as well as bring our Dialectical Behaviour Therapy (DBT) group program to the area. Over the next year, I’ll be spending a great deal of time, along with my wife, Meg Neufeld, getting to know the community better and connecting with key partners to figure out the best way to serve the needs of the community.
Now, we have a bit of a head start. I had the privilege of working with White Rock Mental Health at Peace Arch Hospital for a number of years and have been able to build relationships with many of the agencies in the area. Scott McNeil, our associate, worked there as well as did Share Forde, who provides Dialectical Behaviour Therapy with us. There are some great resources already in the area, and we hope that, like in South Delta, our services will help to fill some of the gaps and that we’ll be able to work collaboratively with the community agencies that are already serving in the area.
Who is going to work in the new office, you might wonder? Well, that’s a great question. We’re kind of taking the same approach as we did in South Delta, that is, jumping off the proverbial cliff. I’ll be in the office there on Thursdays, and likely spending much of my Fridays in the community networking. We are working on hiring staff for the office, but as many of you know, we are very careful with who we bring on because we don’t want to simply hire a bunch of staff, we want to hire the right staff. So, we are building as we go. We have one staff hired, some of our South Delta staff will be working there as well, and we’ll be adding more soon. Stay tuned for more announcements on that front!
All this to say, we’re excited to be entering another community that is near and dear to our hearts. We look forward to bringing the same heartfelt, evidence-based, collaborative community care to South Surrey and White Rock that we’ve been providing in South Delta since 2015. We’d love your help! If you’ve benefitted from our services and know people out that way, please help us spread the word! We’re working on revamping our website and updating things, but in the meantime, here’s a google map of our new location, and the address:
208 – 2630 Croydon Drive
Surrey, BC
V3Z 6T3
Phone number and fax numbers, emails, and everything else remain the same!
We look forward to serving the community in White Rock and South Surrey as we grow out there, and if you are a service provider in the area and would like to connect with us, please give me a call or contact us; and if you know of one we should connect with, please let me know!
by Andrew Neufeld | Nov 30, 2017 | Announcements, Recovery and Aftercare
At Alongside You, we’re always looking to see where needs are in the community and how we might be able to meet those needs. Together with our associate, Richard Somerset, we’ve found that there are areas of need in recovery and aftercare programs. Richard and I have worked for many years in addictions and recovery and one of the needs we’ve identified is services for people once they have come home from treatment centres. Of course, treatment centres are wonderful and needed, but what happens to clients when they come home?
In order to fill this need, we have been working on developing comprehensive Recovery and Aftercare programs for clients once they return home, as well as developing relationships with the major treatment centres to provide referrals for treatment for those that need it. The goal is to have a seamless transition and experience both going to, and coming back from treatment to support each client in their recovery.
One of the advantages we have at Alongside You is being able to provide all of these needed services under one roof. We’ll be able to handle individual, couples, and family counselling, neurofeedback, occupational therapy, yoga therapy and trauma-sensitive yoga, registered dietitian assessments and nutrition planning, therapeutic arts programs, and group therapy that incorporates process groups and dialectical behaviour therapy. Along with our community partners, we’ll be tying in exercise and martial arts programs, sober living activities, sober coaches, and more. Recovering from an addiction or problematic use of a substance is a long-term recovery process and we are here to provide the long-term support. We attended the Recovery Capital Conference of Canada this past September and one thing that was highlighted, that we see daily in our practice, is that it takes an individual’s brain two to five years to recover from misuse of substances. A 45-day stay at a treatment centre is a great reset and start to a recovery program, but it’s only the beginning. Our hope is that our Recovery and Aftercare programs will fill the void and support clients on the two to five-year journey it will take for their brain to rewire itself.
We can’t do everything at once, and so we’re starting with a three-month, recurring program that addresses the core needs we see from clients returning from treatment – that is, continued group work and individual counselling. Additional treatments and services are available as add-ons based on client need and interest to support the core program. We also want this program to be open to those who may have been able to stay at home and recover. We will be providing an assessment to see if our program is a good fit for those who may not even have gone away to treatment and are looking for an ongoing recovery solution closer to home.
We’re excited to launch these programs and meet more of the needs that we are seeing. At the end of the day, the number one focus for us is complete and comprehensive client care that is client-centred and recovery focused. Recovery Capital is the sum total of the resources available internally, and externally to people in recovery and our goal is to increase recovery capital in our community and with our clients. Recovery capital is client-centred, trauma-informed, and strengths-based. It builds on the internal resources of the clients, helping each of the clients rewrite their story and to have a life worth living. If we have a life worth living, we have a life worth striving for.
For more information as we launch our program in January 2018, please see our website. If you are interested in signing up, please give our office a call or contact us and we will be glad to start the intake process with you!
by Chantelle Phillips | Nov 22, 2017 | Dialectical Behaviour Therapy
You may have heard talk of DBT but have absolutely no idea what it stands for after all psychology loves its acronyms. DBT stands for Dialectical Behaviour Therapy, a newer therapeutic orientation that shares some similarities to CBT, or Cognitive Behavioural Therapy, but with many substantial differences. Originally developed by Marsha Linehan, DBT was first and foremost meant as an effective method of treatment for individuals with Borderline Personality Disorder (BPD) 1, 3. The scope of usefulness of DBT has expanded, incorporating primarily eating disorders, anxiety disorders, and mood disorders 1.
I have been lucky enough to be able to learn about and experience DBT through Share Forde and Kelly Williams at Alongside You 4. One thing that has become apparent to me throughout this learning is that everyone could benefit from the skills taught in DBT. Heck, I’m sitting there thinking, “Wow, I don’t even know how to handle these situations…” Dialectical Behaviour Therapy isn’t just for people with BPD, but rather for anyone and everyone looking to improve their coping and interpersonal skills.
The basic premise of Dialectical Behaviour Therapy is dialectics, which pays tribute to the philosophical principle of opposite truths 2. This idea posits that an individual can hold opposing viewpoints simultaneously while looking for truth in both positions; opposite views can exist in one person at the same time 3. This concept can often ring true in individuals struggling with suicidal ideation. It is entirely possible that an individual can both want to die and want to live while finding truth in both of those contradicting statements 3. These opposing viewpoints lead to tension and conflict, which may be necessary to bring about change 3. Dialectics identify multiple truths inherent in any situation and promote flexible thinking, a nonjudgmental stance, and active application of mindfulness 2.
DBT therapy is comprised of four main modules: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation 1.
Mindfulness
Mindfulness is the first core skill taught and one might say the most instrumental; without mindfulness, the other modules may prove ineffective. One of the main concepts of mindfulness first taught is “wise mind”. This is a construct that is returned to time and time again throughout skills training. Wise mind is the idea that every individual has a “rational mind” and an “emotional mind”, with the wise mind being a healthy balance of the two. If an individual is too far into rational mind then they are not experiencing any intuition, if an individual is too far into emotional mind they may not be able to make sound decisions. Returning back to the idea of dialectics there are truths inherent in both rational and emotional mind and it is important to learn to balance the two. The function of mindfulness is to train an individual to bring nonjudgmental awareness to the present moment 1. This is achieved by activating wise mind, where an individual can effectively observe, describe, and participate without judgment 1.
Distress Tolerance
Distress tolerance can also be viewed as “crisis skills”. With distress tolerance skills training participants are given tools to aid in tolerating strong dysregulated emotions when a solution to a problem is not immediately presented 1. Some skills taught in this module are distracting or self-soothing activities, with a later emphasis on willingness and radical acceptance 1. Willingness and radical acceptance can be viewed as more difficult skills to learn, but tend to lead to more enduring life changes 1. Let me tell you, after learning about radical acceptance I can say without a doubt that it is one of the toughest skills and I will be hugely proud the day I can effectively utilize this skill. Radical acceptance is not saying something is right, fair, or permissible, but rather saying that what is, is and that it is outside our power to change in the moment.
Interpersonal Effectiveness
Relationship skills are divided into three sections: reaching goals, making and maintaining relationships, and maintaining self-respect 1. A common challenge to this module is the complaint that the skills taught are less effective when the other party is unwilling to engage in these techniques. If an individual is learning these skills so that they might better interact with family, friends, or partners, it stands to reason that the other party being privy to these skills would prove beneficial.
Emotion Regulation
Like all skills modules, it is imperative that mindfulness skills are constantly applied throughout training 1. Learning self-validation, naming, identifying, and triggering of emotions allows individuals an opportunity to become aware of the link between accompanying body sensations, thoughts, and actions 1. My favourite part of Dialectical Behaviour Therapy thus far is the idea of self-validation around emotions; no emotion an individual feels is “wrong”, but perhaps the way they are expressing it can be attended to. In other words, there is nothing wrong with feeling angry, anger is a natural emotional reaction to certain situations, but the purpose of DBT skills training is to ensure that the resulting behaviour of an emotion is effective. Whether or not an action is effective can be measured by whether it brings us closer to, or further away from, what we want (K. Williams, personal communication, January 18, 2018).
All in all, the more I learn about Dialectical Behaviour Therapy the more I find myself thinking, “it all makes so much sense!” The validation inherent in DBT provides a sense of not being broken, but rather just needed to make a few adjustments. As a student I balance dialectics every day thinking, “I can do this” and “there is no way I can do this”; this is all part of the learning process that I intend to keep following, because at the end of the day if we stop learning, we stop living.
Please call us at (604) 283-7827 if you have questions about what our DBT Group is about and if it’s the right fit for you.
If you’d like to learn more, please contact us.
[1] Lenz, A. S., Del Conte, G., Hollenbaugh, K. M., & Callendar, K. (2016). Emotional regulation and interpersonal effectiveness as mechanisms of change for treatment outcomes within a DBT program for adolescents. Counseling Outcome Research and Evaluation, 7(2), 73-85. doi:10.1177/2150137816642439
[2] Long, B., & Witterholt, S. (2013). An overview of dialectical behavior therapy. Psychiatric Annals, 43(4), 152-157. doi:10.3928/00485713-20130403-04
[3] Rizvi, S. L., Steffel, L. M., & Carson-Wong, A. (2013). An overview of Dialectical Behavior Therapy for professional psychologists. Professional Psychology: Research and Practice, 44(2), 73-80. doi:10.1037/a0029808
[4] Linehan, M. M. (2015). DBT skills training handouts and worksheets (2nd ed.). New York, NY: The Guilford Press.
by John Bablitz | Nov 16, 2017 | Counselling
You know those airline safety announcements where they tell you to put your own oxygen mask on before your child’s?
There’s a reason they do that. Without us making sure we are safe first, we can’t guarantee the safety of our child. If they pass out, you can protect them. If you pass out, they cannot help you.
Being a parent isn’t just about giving your child everything they need all the time. It isn’t just about telling them to brush their teeth more. It isn’t just about giving them all the right answers, or making sure they’re doing their homework. It isn’t just about encouraging them to ask questions and explore their world, telling them they can do whatever they put their mind to – though these are all wonderful, beautiful things. Being a parent is about being who you are. That’s who your child needs you to be.
Children need safety and security more than anything. They need to know, “I’m okay. Mom and Dad have got this. I can play and explore, and be everything I want, because I know I’m safe. I don’t need to worry.”
When they don’t know what to do in a situation, they look to you and wonder, “How is mom going to act here? What does she believe is important in the world? What are her priorities? How does Dad see himself? What does he care about?”
It’s the old classic line: do as I say, not as I do. We want the best for our children, because we love them. And we will make tremendous sacrifices to that end, which is an incredible testament to human love and attachment.
But, if we lose ourselves in the process, we can’t be the answers our children desperately need. We need to learn to take care of ourselves before our kids will internalize how important self-care is. Want your kids to brush their teeth at night? Brush alongside them. Care about your own health; not because you’re supposed to but because you genuinely believe that you’re worth taking care of (because you are!).
To be who you are means taking time for yourself. Time to rest, to reflect, to have fun, to connect with people you care about, to sort out what you believe about the world, to exercise – to learn and grow. To make yourself better and happier. Take a painting or cooking or music class if that’s what you’re into, even (actually, especially) if it feels like the world would end if you took just an hour for yourself. Go get a massage, or rehab for that old sports injury that’s been getting you down. If all of this seems like a fairy tale, I’d love to sit down and have a chat with you about it sometime. Parental guilt gets in the way of self-care a lot – and we give in. We say things like, “I can’t do that because my kid needs me,” or, “I can’t go get a massage because that’s selfish,” and more. What we model to our kids, and the resources we equip ourselves with matter.
When your kids see their parents loving themselves, they will love themselves too. They will grow up believing they’re worth something, just because we, who believe we are worth something, care so deeply about them.
Lastly, when you make time for yourself to grow, recover, and rest, the time you spend with your child, your partner, and your friends and family will be of such better quality. You will have more to give in that time. Even if the world is falling down around you, you will be able to cope better with that stress. If you’re the type who likes hard evidence for this type of stuff, I’d encourage you to check out the work of Dr. Dan Siegel, or check out this playlist of TED talks about the importance of self-care.
One other thing to remember, this is a lifelong journey – it’s not a quick fix. But taking the first few steps toward taking better care of yourself, or even just towards believing that you’re worth caring about – those are some of the best steps you can take. You will be really, really glad you did, and your kids will be better for it!
We know this is hard to do as parents, if we can be of any help as you walk through this, please give us a call, we’d love to help!
If you’d like to learn more, email me directly at john@alongsideyou.ca.
by Meg Neufeld | Nov 9, 2017 | Articles, Chronic Illness, Creative Arts Programs
You wake up and it’s still there; that dull pain in your body that reminds you of your chronic condition. You feel like staying in bed all day, but you know that would leave you in even worse shape. So, what can you do to get through the day? Here are five ways to manage daily chronic pain:
- Begin to breathe – with intention.
Yes, breathing is essential to live, but doing mindful breathing can calm our body, focus our mind, and alleviate stress. Sit comfortably with your eyes open or closed. Start by breathing in and out, noticing the rise and fall of your breath, and the sensations in your body (shoulders, stomach, nostrils). Notice all the sensations all around you (smells, sounds, presence). Take deep breaths through your nose as slow and controlled as possible, and exhale through your mouth as slow and controlled as possible. Try to make this process of breathing in and out last for a total of 7 seconds or more. Refocus your gaze to end the exercise.
- Be realistic of daily goals.
The busyness of life doesn’t stop for someone who has chronic pain. Those of us who have daily pain, however, need to prioritize daily activities and goals based on how we are feeling on any given day. It’s a hard pill to swallow realizing that we can’t do it all. Start with having just one or two things on your “to do,” list for the day, week, or month. Empty the dishwasher, check. Pick up library books, check. Starting small and completing a short list of manageable goals will reward you with a great sense of accomplishment.
- Get moving.
Even though our natural tendency is to want to curl up in a ball when we are in pain, staying stationary is one of the worst things we can do. Our brain and body need stimulation and range of motion to heal and to cope with pain. Staying active may look different to people based on their pain. For some, a successful active session can be as simple as walking down the block and back each day and for others, doing moderate cardio activity for 20 mins a couple times of week is right for them. Change it up every once in a while to make exercise fun and interesting. Don’t forget to add some intensity or to lengthen the duration of your exercise sessions every now and then. Doing too much too soon may backfire, but test your limits – you never know if you can do something until you try!
- Rest well
Alternate your day between periods of activity and periods of rest. Start by setting aside just 30 mins of your day to rest your body and mind well. By well, I mean ‘set the stage’ to help you have the best rest possible. Based on your pain, find a comfortable place to rest with some of the following: low light, heat pack, ice packs, eye patches, soft music, a mindfulness meditation app or even have a hot bath. Maximize your time of rest and it will help get you through other parts of your day!
- Tap into your spiritual side
Yes, this may be uncharted territory for some, but reading, journaling, praying, making art, or listening to something meaningful can help you to self-reflect, manage your emotions, set goals, and can really put things in perspective. There are times in your chronic pain experiences where you will need to draw inner strength, so make sure to build it up!
For many of us, chronic pain is here to stay so we might as well learn how to cope….HAVE HOPE.
Want to learn a new way to cope with your chronic condition or chronic pain? I am leading a new course on chronic condition and chronic pain management through mindfulness based art practices in January. See below and check it out, I’d love to have you!
Learn more
Meg Neufeld, (MA) is the co-founder of Alongside You, an integrated health clinic that offers yoga, pelvic rehab, registered dietitian services, clinical counselling, group therapy, and therapeutic arts. As a cultural anthropologist and an artist herself, Meg seeks to make art accessible to people of different abilities, diagnosis and age. She is trained in Mindfulness-Based Art Therapy practices and has a particular interest in using art as a pain-management strategy in her own life.
by Meg Neufeld | Oct 31, 2017 | Chronic Illness
What is chronic pain?
Most of us have felt physical pain before: we’ve pulled a muscle, had a headache or bumped our funny bone (which really isn’t very funny at all!). The pain we experience is our body telling us something is wrong and after a period of rest and healing (up to three months), we can typically go back to normal activities. Chronic pain is when our brain is in an ongoing state pain and heightened sensitivity that persists longer than 3-6 months. Despite common understandings of pain as being a purely physical reaction, pain is actually directly linked to our brain and nervous system. This video highlights the complexities of our brain and nervous system and identifies the ways in which medication, exercise, diet, medical procedures and emotional processing can help retrain the brain and improve the quality of life for those who suffer from chronic pain.
Whether persistent pain takes the form of back pain, migraines, arthritis, fibromyalgia, endometriosis, lupus, other invisible illnesses, the chronic pain experience affects the body, mind, and soul. While each person’s experience with pain is different, there is a range of common threads:
- Everyone has their own definition of a good day and a bad day. Simple tasks may be manageable one day and not the other.
- In order to “self-manage” daily symptoms, there is a constant need to balance or carefully plan periods of rest, work, exercise, social activities, diet, sleep, and spiritual connectedness.
- It is challenging to talk to family and friends about our pain. The impact on family and friends can be devastating as roles, expectations, and relationships change because of the pain.
- Pain is challenging to treat. The constant rotation of medical appointments, medications and medical procedures can be exhausting and what may work for one person, may not for another.
- Chronic pain goes hand-in-hand with mental health and evokes strong emotions as attempts are made to cope with a loss of purpose, former abilities and relationships.
How can we tackle chronic pain?
The chronic pain experience is riddled with complexities; it has both physiological and psychological components, making a holistic approach in tackling chronic pain the most effective way to approach treatment planning. This video highlights the importance of a multi-disciplinary approach. As a result, we need to find ways to reboot our nervous system, learn productive skills to manage our symptoms, help educate others on chronic pain experiences, and strive to have a better quality of life.
HOW MINDFULNESS-BASED ART ACTIVITIES CAN HELP PEOPLE WITH CHRONIC PAIN
“Art gives a face to the ambiguity of chronic pain …
it gives a visual expression to something that is often elusive.”
–Dr. Steve Feinberg, American Chronic Pain Association
What are the overall health benefits of making art?
Using art for its health benefits is widely becoming a critical component of healthcare. Art helps us explore, practice and develop our creativity as a means to promote health and well-being. Making art has several benefits in key areas:
- Mental Health: Making art reduces stress, protects against depression and anxiety, can improve self-confidence[i] and encourages positive self-care. Doing something creative in a supportive and safe environment encourages experimentation and risk-taking, two essential qualities of the art-making process.[ii]
- Social Health: Those that participate in creative activities are more likely to have wider social networks with people from different backgrounds, have a sense of belonging, and are less likely to be socially isolated and lonely.
- Brain Health: Art making is an effective preventative tool in managing symptoms of diseases such as Dementia, Alzheimer’s disease, and other chronic conditions. It also improves memory processing, problem solving, and helps to maintain neuro-spatial functions as we age.
- Emotional Health: Creative engagement can provide a healthy outlet or path to healing for those who have suffered trauma, abuse, or significant life changes. Doing something creative can act as a distraction tool and is another way to preserve self-identity and move forward.
Using Mindfulness-Based Art Therapy (MBAT) techniques to tackle chronic conditions
According to Jon Kabat-Zinn, a leading researcher on mindfulness-based programs, mindfulness is, “the ability to become fully present in this moment, in a particular way, with a non-judgmental attitude.” [iii] Combining mindfulness skills while making art can be an effective way to manage symptoms of depression and anxiety, improve pain tolerance, and elevate the quality of life of people with chronic pain [iv] [v] and illness,[vi] including those with arthritis[vii], Dementia and Alzheimer’s disease[viii], and cancer.[ix]
Why does MBAT work for chronic pain management?
Mindfulness is a frame of mind; a decision is made to intentionally pay attention to the present moment when doing an activity. It is an effective way for the brain to concentrate on surrounding senses other than the pain itself. It involves resting the physical body (doing body scans) and the psychological mind. Art therapist and facilitator Margaret Jones Callahan describes mindfulness-based art therapy (MBAT) as the “appreciative inquiry mindfully applied to the empty page or the open space. The practice of holding one’s awake attention fully in the present moment, non-judgmentally, while in the act of creating and expressing,[x] acknowledges the presence of pain and helps to get through it, moment by moment. While mindfulness is the lens in which to approach a particular moment, making art is the vehicle with which you experience it. Mindfulness-based art therapy:
- Promotes both the healing and rehabilitation process and is a way for chronic pain sufferers to “’lose themselves’ in the moment,”[xi] (also known as “being in the flow”) giving the nervous system a break.
- Provides temporary respite from physical symptoms of pain (headache, nausea)
- Is an effective method of distraction and promotes positive self-management skills to filter emotions and is a way to express suffering.
- Can build social alliances, companionship, and social affirmation, creating a wider support system with family, friends, and peers. Making art with others lends another way to talk about or communicate with others about pain experiences.
- Allows space to be self-reflective and helps monitor growth and progress in a visual manor.
- Affirms a sense of control over surroundings in the decision-making process of selecting colour, shape, and images.
At its core, MBAT, strives to create a peaceful environment where one can be completely absorbed in the moment while immersed in the process of creation. Along with healthy changes to our diet, sleep, and exercise regimes and with attentiveness on empathy, intentionally putting time aside to do something creative (read, write, paint, knit, sing, do yoga[xii], or dance) can help lower stress levels, give our nervous system a rest, and helps to promote self-care habits. By using a variety of creative processes, health difficulties can be better expressed, understood, accepted, and transformed.[xiii]
If you’d like to experience how MBAT can help you manage your chronic condition, please feel free to give me a call, or email, or come to our Open Studio Sessions where we go through many of these techniques! Give art a try!
[i] McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 40. In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
[ii] McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 41. In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
[iii] Jon Kabat-Zinn. http://www.mindfulnesscds.com
[iv] Ann Behav Med. Eds. Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis.2017 Apr;51(2):199-213. https://www.ncbi.nlm.nih.gov/pubmed/27658913
[v] Kabat-Zinn, J., Lipworth, L. & Burney, R. J The clinical use of mindfulness meditation for the self-regulation of chronic pain. Behav Med (1985) 8: 163.
[vi] “The Art of Pain Management.” American Chronic Pain Association: https://theacpa.org/uploads/Art_and_Music_final.pdf
[vii] Reynolds, Frances and Sara Prior. Strategies of Adapting and Replacing Artistic Leisure Occupations to Maintain Participation and Identity: A Qualitative Study of Women with Arthritis. Journal of Activities and Adaption and Aging, March 2011. http://www.tandfonline.com/doi/abs/10.1080/01924788.2010.545970?journalCode=waaa20
[viii] Quintana Hernández DJ et all. The effects of a neuropsychology program based on mindfulness on Alzheimer’s disease: randomized double-blind clinical study. Revista Espanola de Geriatria y Gerontologia [2014, 49(4):165-172]
[ix] Monti, Daniel W., Caroline Peterson, et al. A Randomized, Controlled Trial of Mindfulness-based Art Therapy (MBAT) for Women with Cancer. Thomas Jefferson University, Philadelphia, PA, Psycho-Oncology 15:363–373 (2006)
[x] Callahan, Margaret Jones. Mindfulness Based Art: The Sparks Guide for Educators and Counselors. Friesen Press. 2016.
[xi] Dr. Daniel Potts. How art therapy enhances the life for Dementia Patients. 2014 http://www.alzheimers.net/2014-04-29/art-therapy-for-alzheimers/ Accessed September 15th, 2016
[xii] Ward et.al. Yoga for functional ability, pain and psychosocial outcomes in musculoskeletal conditions: a systematic review and meta-analysis. Musculoskeletal Care. 2013 Dec;11(4):203-17. doi: 10.1002/msc.1042. Epub 2013 Jan 9. https://www.ncbi.nlm.nih.gov/pubmed/23300142 Ward L1, Stebbings S, Cherkin D, Baxter GD.
[xiii] McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 40. In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
by John Bablitz | Oct 19, 2017 | Articles
Whether you have kids or not, you’re likely aware that the parenting experience is often extraordinarily challenging. Young children are wonderfully headstrong, and their deep sense of fairness ensures that rules, when enforced (regardless of their rationality), carry the risk of tears, screaming, or both. The temptation to rationally explain to an upset four-year-old why he “can’t” hit his baby sister, or draw on the floor, or keep the dead bird he found in the backyard, is a trap many of us fall into – and it turns out not to work very well.
Kids often appear selfish, and rightly so: they haven’t had a chance to develop the higher order brain structure that adults have (the human brain generally takes until the age of 25 to fully develop). Consider this long developmental span (and the frustration that means for parents!), a trade-off for humans being so incredibly awesome; other species’ brains develop quite quickly by comparison. Childhood is the time when our brain does almost all of its developing.
From the time we are born, our “base” brain is the most active, controlling all of our necessary biological functions such as breathing, heart rate, thirst, temperature and so on. As we go through childhood, our “emotional,” brain develops: it controls emotion, facilitates the formation of our significant trusting relationships, assigns significance and memory to events, and determines much of our motivation, among other things. It isn’t until late childhood and early adulthood that we really begin to develop our executive brain, which allows us to reason and act appropriately and flexibly to the situations we encounter. Since the “emotional,” brain is associated with survival functions, negative emotions feel intensely painful and threatening to children, and trivial issues may seem like a matter of life and death. We can’t expect kids to simply “behave,” because we have told them something 1000 times – biologically, they are in survival mode.
Another fun fact – kids have very little conscious awareness of when they’re tired, or hungry, have extra energy that needs expanding, or have had enough attention (which is a real need for all of us). They also aren’t yet endowed with the ability to ask for what they need when they need it: rarely will you hear your child politely ask you for “a moment of your time at your earliest convenience.” We have the responsibility of ensuring their four “tanks,” are as full as possible: their hunger tank, their sleep tank, their exercise tank, and their connection tank. Kids’ appetites for attention are great, but not insatiable; often once they’ve had their fill of it, they will generally run quite nicely on their own.
A central task of what we call brain-based parenting is that of building resiliency – preparing our child’s brain for the stressful situations it will encounter as an adult; i.e., not getting what they want, or enduring conflict, sadness, and heartbreak. We can do that with consistency, love, and warmth, amongst other things. It’s important for us to remember during a meltdown that our child’s brain is overloaded; they couldn’t behave, even if they really wanted to. Young children, especially, are physically incapable of holding mixed feelings. The best thing we can do is provide the connection and safety they need to make it through. They may not be able to regulate alone, but we can help them to do so.
When your child has a meltdown, or you sense one coming, remind yourself that this is normal, which will be especially difficult in public if you’re feeling the acute shame of the scene you might be creating. Then, try some of these techniques:
- Take a moment to gather them with eye contact or touch and warmth when possible (Gordon Neufeld calls this “collecting”). By doing this, you activate the attachment response, inviting them into relationship and reinforcing your unwavering desire to understand them.
- Crouch to at or below their eye level. Dan Siegel and Tina Payne Bryson, authors of The Whole-Brain Child, show how getting down to a child’s level keeps threat-level low (imagine being confronted by someone four times your size!). By towering over a child, we risk activating and overloading their mid-brain circuitry beyond what it can handle.
- Listen to their screams or cries with as much empathy as you can muster. Pretend, if it helps, that the two of you are teaming up against the tantrum. Hold them if they need to be held, hear them if they need to be heard, no matter how inane their words might seem. Sometimes a warm and simple, “I can tell that you really, really want to keep that dead bird,” goes a long way towards making them feel heard.
- The calmer you are, the easier your child can use your calm to help regulate their own emotion. If the normally safe mom and dad are in panic or anger mode, it’s hard to blame kids for feeling overloaded. You can also teach your kids to breathe deeply when they are feeling overwhelmed, sad or stressed. Our bodies respond very well to deep breaths when stressed.
- Be curious about what is going on in yourself and in your child. This is a teaching moment for both of you. See if you are able to notice and observe your own impulsive reactions to your kids’ actions. These situations can be seen as a challenge to overcome, rather than a disaster to stop or avoid at any cost.
Suffering through tantrums alongside your child will help you understand and know their needs at a deeper, more intimate level, which will strengthen the bonds between the two of you and help you to see the signs earlier next time. I use the word suffer intentionally; these situations aren’t fun. We’re going to feel like we’ve screwed up time and time again, are going to acutely feel the disapproving glares of strangers at the supermarket, and may try the techniques in this post only to find they often don’t seem to work. Above all, try to find some grace for yourself. Maybe your own tanks need refilling, or your brain needs a break – we’re all just learning. Maybe this time he can just keep the stupid bird, and when he’s asleep, it will miraculously find its way to bird heaven.
If you have questions about this, or you’d like to learn more, there are many resources for brain-based parenting across the lifespan. Search the web, check out the list below, or email me directly at john@alongsideyou.ca.
Dan Siegel and Tina Payne Bryson: The Whole Brain Child
This is a great book with lots of information on brain development strategies for raising calmer, happier, more empathetic kids.
Check out Vancouver-based child psychologist Gordon Neufeld, including his best selling book Hold on to your Kids
Try these five short and easy videos on brain-based parenting from Dr. Carrie Contey.
by Chantelle Phillips | Oct 13, 2017 | Counselling
Growing up I remember hearing colloquialisms such as “suck it up”, “rub some dirt in it”, or “laugh it off.” These phrases seem automatic and designed to negate any potentially uncomfortable discussion of how a person might truly feel in a given situation. For myself, this brings up concerns that we are teaching children how to repress and avoid their emotions. Do some of these phrases actually serve a purpose? Can someone really just “laugh it off,” if they are sad, hurt, or even depressed? The answer is no, but fear not, there is a time and place for humour!
Resiliency
Humour serves as an important tool to mediate embarrassment or discomfort, to distract, to entertain, and, apparently, to develop resiliency [1]. Although humour is the not the “cure-all,” answer to mental health, it can serve as a protective factor and help to develop resiliency. Protective factors simply refer to qualities, characteristics, or circumstances which allow a person to develop a support system of coping skills, resources, and people to rely on in times of need. In other words, think of humour as a preventative tool in your tool belt; humour may not fix a situation, but it may help to mediate some of the more negative effects.
Trauma
Trauma is becoming much more of a frequent topic of conversation, news media, and professional circles. It seems that the main topic surrounds why some people react differently to the same or similar experiences. Why do two soldiers return from the same combat zone, having had similar experiences, but only one soldier experiences post-traumatic stress?
There is now talk of something called post-traumatic growth (PTG), which is a phenomenon where people are able to grow in positive ways after experiencing trauma [2]. Of course, this phenomenon has those of us in the mental health field wondering how we can predict PTG and what we can do preventively to resource people before they experience trauma. What factors buffer the potentially devastating impact of trauma? While it’s a complex question without one answer, humour can be a resource. Humour can be a tool through which people are able to view a painful reality with a defiant attitude and a bit of a buffer [2]. Humour has the unique capacity to transform a negative situation into something positive; however, there needs to be an understanding that humour is multidimensional and not all humour elicits positive effects [2].
Benefits for Counselling
There are four types of humour: affiliative, self-enhancing, aggressive, and self-defeating. Whereas benign types of humour, such as affiliative and self-enhancing have shown positive effects in lowering incidence rates of depression, anxiety, and stress, aggressive and self-defeating humour has shown to have negative effects [2]. Affiliative humour refers to the tendency to say funny things, tell jokes, and exchange witty banter, whereas self-enhancing references a humourous outlook on life [3]. One study by Sirigatti and colleagues (2017) has shown positive correlations between self-enhancing humour and overall life satisfaction, self-esteem, optimism, happiness, and psychological well-being.
So we have determined that like all things there is a balance. Some types of humour can create a more positive mindset and overall feeling, while more negative, self-deprecating humour does the opposite (Gladding, Wallace, & J, 2016). Some humour can hurt instead of fostering healing [4]. However, let’s focus on the positive. There is some truth in the saying “laughter is the best medicine.” Although laughter definitely is not “medicine,” nor a curative remedy, it leads to strengthening physical and mental well-being and is positively correlated to longevity. Humour can help with the constructive expression of strong feelings, offer perspective and balance, and assist in coping [4].
In conclusion, no, you can’t just “laugh it off,” but like with anything in life, our outlook can greatly affect how we deal with the obstacles that arise. Can positivity and optimism really hurt too much? If you’re having a tough day, week, or even if you’re not, just remember to take a second to enjoy yourself and laugh.
Q: What do you call a cow on a trampoline?
A: A milkshake!
References
[1] Tucker, T. M. (2017). Resilience development through humor. Dissertation Abstracts International, 78.
[2] Boerner, M., Joseph, S., & Murphy, D. (2017). The association between sense of humor and trauma-related mental health outcomes: Two exploratory studies. Journal of Loss and Trauma, 22(5), 440-452. doi:10.1080/15325024.2017.1310504
[3] Gladding, S. T., Wallace, D., & J, M. (2016). Promoting beneficial humor in counselling: A way of helping counselors help clients. Journal of Creativity in Mental Health, 11(1), 2-11. doi:10.1080/15401383.2015.1133361
[4] Sirigatti, S., Penzo, I., Giannetti, E., Casale, S., & Stefanile, C. (2016). Relationships between humorism profiles and psychological well-being. Personality and Individual Differences, 90, 219-224. doi:10.1016/j.paid.2015.11.011
