Vestibular Conditions: When the World Won’t Stop Spinning

Vestibular Conditions: When the World Won’t Stop Spinning

In Canada, anyone over the age of 40 has a 35% chance of experiencing a vestibular problem at some point in their lives. Vestibular conditions involve difficulty with balance, dizziness, and vertigo. They can also affect (and be affected by!) your mental health.

As a counsellor who has worked with thousands of clients with vestibular conditions, I can say without a doubt that these symptoms are not fan favourites! Feeling unsure on your feet or that you might fall over, or experiencing the nausea that can often accompany these symptoms, is alarming, upsetting, and demoralizing. If you can’t trust your body to keep itself upright it can be hard to relax. Often people with vestibular conditions cannot manage day-to-day tasks. Work, household chores, playing with or taking care of the kids, and more can all become difficult. Even getting up out of bed can be an unpleasant adventure! At the very least, feeling gross or worried can sap the joy out of a lot of normally fun or rewarding activities. It should be no wonder, then, that vestibular conditions are highly co-occurring with depression and anxiety.

 

Vestibular Conditions, Depression, and Anxiety

 

For people who are already experiencing anxiety or depression, adding a vestibular condition can make it a lot worse. If you are already having trouble getting out of bed because of depression, having the spins when you do certainly won’t help! Those who have struggled with anxiety and depression in the past can often see a return of their mental health difficulties along with the vestibular condition. It is certainly understandable that for someone who has gone through depression or an anxiety disorder, feeling helpless, overwhelmed or fearful because of their vestibular condition can trigger fears that they are sliding back into those mental health conditions.

Equally problematic is that anxiety and fearfulness can often make the experience of dizziness worse. People often feel sensations similar to dizziness when anxious, such as light-headedness. This can be misattributed to the vestibular condition, as these sensations don’t come with a clear memo as to what is causing them. (“I’m dizzy because of the concussion!”, as opposed to lightheaded because of the understandable anxiety.

Anxiety and depression can also hinder us in engaging in the activities that are useful in rehabilitating from a vestibular condition. They can lead to “catastrophic” all-or-nothing thinking. For example, “I’ll never get better!”, “I can’t do anything!”, “If I try going for that walk I’ll fall and break my neck!” and so forth. Furthermore, clients often struggle with having an “invisible injury”. They often can’t point to an obvious injury, like a leg in a cast, and may wonder if others doubt the severity of their condition, or may even doubt it themselves

 

Pathways Forward

 

Fortunately, there is a way out. Working with a vestibular physiotherapist can help to rebuild confidence in your capacities. They can provide treatments and exercises that can be done safely, without risking re-injury. Their deep knowledge and experience with these conditions can provide tremendous reassurance about what to expect with your condition, and what you can do safely.

In addition to this, working with a counsellor in conjunction with a vestibular physiotherapist (and other members of your health care team, like your family doctor), can really help you to adapt to the symptoms, provide coping skills to be more effective with them, as well as rebuild your hope in the future and faith in yourself. Working with both a counsellor and a vestibular physiotherapist is a “one-two punch” that I have seen be helpful for countless clients with vestibular conditions, providing the support and encouragement needed to help them get their lives back.

If you are interested in learning more about how counselling can help with your vestibular condition, please contact our reception team to request an appointment with me. We’re here to help!

How Can Therapeutic Dance/Movement Help Me?

How Can Therapeutic Dance/Movement Help Me?

Many people feel apprehensive or intimidated when they hear the word “dance.” Movement is a beautiful and intricate part of who we are. We are in constant motion, from blood flowing through our veins to neurons firing during thought processes and through the simplicity of breath. Our very existence depends on the continuous movement happening within the body.

Therapeutic dance, or movement, is a mind-body approach for working with emotions towards holistic wellness. We often dismiss the subtle signs of stress from our bodies until it becomes a chronic issue, preventing us from functioning in our daily lives. Therapeutic dance and movement explores the presence of emotions within the body and shows us how to care for the emotional symptoms that we may find.

What do you mean by emotions living in the body?

Have you ever noticed sayings like, “I have butterflies in my stomach,” “That gave me the heebie-jeebies,” or “My blood is boiling”? These sayings are examples of how we experience nervousness, fear, and anger in the body. Some people describe these feelings in their body as “gut feelings.” We often override gut feelings using the mind and ignore what is happening in the body. Learning to trust in the body’s wisdom is an important skill to possess in today’s fast-paced world.

In therapeutic dance and movement, the connection between the mind and the body is facilitated as a conversation used to achieve a deeper understanding of the self. Emotions in the body are made aware by paying attention to the subtle shifts in the body and linked back to spoken language.

What does an appointment look like?

Clients are often surprised that a session does not have to involve dance whatsoever. Sessions are NOT like a dance class, experience in movement is not even required. Therapeutic dance/movement is an approach that gives your body the space to express what words cannot. Do you ever move your hands when you talk? That’s a form of therapeutic movement! A session can consist of talking to someone, along with the optional invitation of moving, breath-work, or spontaneous dance. It’s entirely up to you! Another way to interpret therapeutic dance/movement is as a counselling session. Your whole body is invited into the conversation, and expression is created from the inside to the outside.

There have been times clients have said, “I’m not sure why I just did that.” The body knows what the mind may not understand quite yet. Therapeutic dance/movement helps to bring understanding and self-compassion to patterns of being. Session goals are co-created between client and practitioner. With this, a therapeutic movement session becomes a journey of creative expression and experiential processing.

What can therapeutic dance/movement help with?

Therapeutic dance/movement can help with anything, such as stress, pain, difficulty sleeping, relationship issues, chronic illness, temper tantrums, developmental disabilities, and neurodiverse diagnoses.

 Some other issues therapeutic dance/movement can support:

  • Feeling stuck
  • Feeling agitated or angry
  • Anxiety
  • Depression / low mood
  • Trauma
  • Autism Spectrum Disorder
  • Attention Deficit Hyperactivity Disorder
  • Tantrums and intense emotional upsets
  • Strengthening relationships

How Can I Start Moving?

Whether you want to start moving by speaking, storytelling, writing, drawing, or dancing, get your emotions moving today by calling our office to book a therapeutic dance/movement session. Have a quick question about therapeutic dance/movement? Click here to email our therapeutic dance/movement practitioner, Stefanie.

3 Ways To Support Your Teen Through The Pandemic

3 Ways To Support Your Teen Through The Pandemic

 
 

This pandemic is a challenge to people in all stages of life, but it is also uniquely affecting adolescents. In a period of time where their developmental task is to extend their social connections to include peers, they are being asked to do this in very constricted ways (virtually, or in small groups at school). The adolescents I see in my office are leaning on their parents and families in ways they never expected to have to do. If you parent an adolescent, your role in their life is significant. Here are 3 ways to support your teen through the pandemic.

 

Listen with openness, empathy, and curiosity

 

I am continually amazed by the resilience that adolescents demonstrate. Only they will ever know what it’s like to be a teen in the 21st century, about to launch themselves into the world but then asked to “stay put” (so to speak) for an additional year or so. It is important that they do so (for the safety and sake of the world they will grow up to live in and lead in the future) but right now, it’s hard. They need to be heard, and to feel understood in their experience.

Questions you can ask your teen include:

  • “What are the challenges you’re experiencing, socially, as a result of the pandemic?”
  • “What do you miss? What losses have you experienced?”
  • “What did you do today that made you feel good? What are you looking forward to this week?”
  • “What are you grateful for?”
  • “What could I be doing to support you in school right now?”

What is really important is how you ask these questions. Try to come to the conversation with openness to whatever they have to say. Reserve judgement, empathize with their unique experience, and remain curious about what this is like for them. Responses such as, “Is that right,” “Can you tell me more about that,” or “That’s interesting, I didn’t know that…” go a long way. Avoid the trap of “looking on the bright side,” dismissing what they share, or trying to compare what they’re experiencing to your own hardship. It may be tempting to downplay their concerns, but it’s essential that they have a place to speak openly. This really is as bad as they feel it is, even if it doesn’t feel the same way for you.

 

Spend meaningful time together

 

I speak with a lot of teens who tell me how they’re secretly enjoying getting more time with their parents. I have been surprised to hear of how a lunch date with Dad, or a cozy movie night with Mom made an adolescent’s week. They still need you, more than they let on. Your role is important in their life, even well into adolescence. So, don’t discredit yourself – connection with you counts as socialization too!

Why stop at 3 ways to support your teen through the pandemic? If you’re running out of things to do together, consider how you might provide opportunities to do something new. Here are a few ideas on how to create meaningful connection together:

  • Try a new hiking or biking trail.
  • Drive to a new city nearby that you haven’t explored together (even if it’s not an alluring destination, perhaps there’s a new cafe you can stumble upon together).
  • Sign up for an online art class/project (I’ve heard these are fairly accessible in many areas). Buy supplies together, and make snacks to enjoy.
  • Dress up (or design and make clothes?!) for a fashion show, and do a photo shoot. You can include things like hair, make up, accessories, and make it a production they work toward.
  • Create a family recipe book. Invent new recipes to include.
  • Cooking competitions (take turns being the judge, or give limited ingredients and see what they come up with, or make it an online competition with them and their friends.
  • Help your teen reorganize, redesign, or redecorate their room.
  • Do exercise or yoga videos together.
  • Rent a karaoke machine! See if their friends want to do the same at their house and create a virtual karaoke night.
  • Start a small business together.
  • Have your teen teach you something they know a lot about.

Even if your time together is less elaborate, be present with them. Most teens are figuring out who they are, what they stand for, and what they want out of life, and you have the privilege of unfolding and exploring their inner world with them. Enjoy!

 

Check in on their mental health

 

See item #1: listening with openness, empathy and curiosity. Ask them questions about how they’re doing and really listen. See if you notice they’re exhibiting some of these signs:

  • Increased irritability or tearfulness
  • Changes in sleep or eating habits
  • Increased isolation (especially over time)
  • Lack of motivation, or not enjoying activities they normally would

If you do notice these things, seek mental health support, if they’re open to it. Remember that inquiring into their mental health does not intensify the problem, it only provides an opportunity to address what’s already happening.

I hope this has been helpful for you as you parent your teen in the middle of a very challenging situation. I know I said I’d give you 3 ways to support your teen through the pandemic and I may have overshot that a bit!

If you, or your teen, would like to talk to somebody about their mental health, we’re here for you. Contact us at Alongside You, and we’d be honoured to join you and your family as we journey through this pandemic together. You’ve got this!

You’re Not Broken, You’re Adapting

You’re Not Broken, You’re Adapting

 
 

Many people come to therapy with the belief that something is amiss, broken, or “wrong” with them. Sometimes I wish it were easier to convince people this isn’t true – most of the time, the people that come to sit in my office are “working” just fine. Have they been thrown an unfair number of lemons by life? Sure, maybe. Have they responded to those experiences creatively and adaptively, in a way that has both helped and hindered them? In every case, yes. That said, you’re not broken, you’re adapting.
 

How Does Adaptation Happen?

 

Genetics is one element that explains our wonderful human diversity, and another is environment and experience – we all have a rich tapestry of experiences, and no two tapestries are anything close to alike. Those tapestries, I believe, are all quite beautiful.1, I’ve noticed people generally prefer movies that end happily, but when it comes to art and music, it can be the mournful, the bleak, the dark, the unsettling and unresolved, that has more power and meaning for us.2 The darker shades in those tapestries are worth sitting back and soaking in, they touch us deeply. This is one of the many reasons I love my job so much. Another is that sometimes, one of my coworkers brings in muffins.

Ok, back to the thing. Neuroscience has known for many years now about the incredible plasticity of the brain, an organ that readily and creatively adapts to its environment. Most of us have heard that people who experience blindness have a more heightened sense of hearing and smell. One reason for this is that the brain takes unused real estate – certain areas devoted to visual processing – and The Man Who Mistook His Wife For a Hat, the neurologist Oliver Sacks shares stories of brain-damaged patients who have responded with unbelievable neurological adaptations. Sacks comments “…there is always a reaction, on the part of the affected organism or individual, to restore, to replace, to compensate for and to preserve its identity, however strange the means may be…” (p.6). Brains find a way to preserve and reinvent themselves in the face of damage, and people find a way to preserve themselves in the face of challenge. Trauma and anxiety are prime examples: a dog bite when you are three years old might give you a paralyzing fear of dogs for the rest of your life. Your three-year-old brain saw that your life was in danger and it made a high priority, instantly accessible file labeled DOGS = DEATH -> AVOID that pumps you full of anxiety and adrenaline when a dog might be nearby.

Many of our adaptations are not all that dramatic and some are more complex. Maybe our dad told us not to be a baby when we cried, and so to preserve that relationship (our brain knew this was more important) we created a file that evokes anxiety when something might feel sad. Now, we are an expert at avoiding not only physical sadness, but things that even might make us feel sad based on our experiences.
 

What Do We Do About Our Adaptations?

 

Your adaptations are there for a reason, and that’s ok. They might not be as helpful as they once were – you’re an adult now, and dogs aren’t all that dangerous most of the time – they’re actually awesome. Avoiding sadness was functional before, but now you find yourself feeling depressed more often than not. In your last relationship, it made sense to be angry with your partner, because it felt like the only way to get through to them – but in your other relationships, that anger is less useful.

Adaptations in our life are unavoidable and necessary, and this is a good thing. If you lacked the ability to adapt, then I might agree that something is wrong with you. But I’ve never met anyone for whom that was true. You see, blind folks don’t tell their brains to reuse that real estate for hearing, brains just do it, which is so cool. And our brains, as wonderful as they are, don’t always make the best long-term choices. They find a way to stop us from driving after we have a bad accident, terrified that we might die, convinced that losing our job is better than death. When we are frustrated at ourselves and sad about the loss of that job, they talk us into pouring a drink, and when it works, they think “Perfect!” and they keep doing it. When people close to us start to bother us, they might solve the problem by helping us avoid relationships altogether (great idea for a week, but not for a year, or a lifetime). When our coworker brings in muffins, they talk us into stress-eating four of them, because the first one was oh. so. good. I think you get the point.
 

Working With Our Adaptations

 

We can get to know our adaptations, and be brave enough to set aside those we no longer need (and adjust the ones we do). We can come to see that our adaptations are actually strengths – the lengths that we go to in order to avoid something can spark incredible creativity. These are some things we might do in therapy. But first, we might work on the belief that there is something wrong with you in the first place – and, wouldn’t you know it, our brains are fantastic at holding onto those beliefs. So, if you take nothing else out of this article, make it the belief that you – whoever you are – are mostly just fine, and you are weaving a meaningful and worthwhile tapestry with the threads you are being given.

If you’re struggling with some of your adaptations, give us a shout. We’re here to help. Remember, you’re not broken; you’re adapting.

 
Notes

1. You’ll have to let me have this one – I’m an incredible, unabashed sap, for better and worse.
2. I have a client who is a fantastic artist, and I sometimes have the privilege of seeing some of what she’s made – it reflects her experiences, and it also connects me to some of my own. Art in many forms has that effect, and those who do it well are a real gift to the world. Meg, who runs the therapeutic art program here at Alongside You, often uses a wide range of colours and tones to create pieces that seem able to capture any mood under the sun – a few seconds soaking these in are seconds well spent.
3. On the tapestry metaphor note, his op-ed in the Times on his terminal cancer diagnosis is a worthwhile read along with this blog post – here’s a link to it.

ADHD and the Role Parents Play

ADHD and the Role Parents Play

 

ADHD and the Role Parents Play

 

Many parents wonder what role they should play in the lives of their child with ADHD. When answering an important question like this one, we like to start with the experts. In my professional readings, I often turn to the literature of Dr. Russell A. Barkley, PhD., a leading expert in the management of ADHD in children. He has a great perspective to start with when searching for insightful, research-based information around the struggles of children with attention problems and the challenges faced by their parents.

In his book, Taking Charge of ADHD: The Complete, Authoritative Guide For Parents, Dr. Barkley describes the role of the parent of a child with ADHD as that of a skilled executive, who acts as a team leader on behalf of the child, treating the child’s teachers, therapists, coaches or physicians as personal advisors. To assume this role fully, parents learn how to take on the headspace of a high-functioning executive, one who uses planning, prioritizing, problem solving and goal-setting skills to get the job done and ensure success for their child. In doing so, these parents (nicknamed “executive parents” by Dr. Barkely) develop their own confidence and fortify their roles as true case managers; ones who are in charge and ones who determine, to a great extent, how the care for their child takes shape.
 

Why Parents Need to Become Executive Parents

 

“Wait a second,” you might think, “Why this is role necessary when many children with learning and behavior problems already have case managers in the school system who consult with teachers, develop IEP goals and carry out recommendations? Isn’t that enough?” Ultimately, we find it is still the parents themselves who tend to be the best case managers of their children’s supports, as they are the ones who know the child best and can best advocate for their needs.

Parents who take on this executive role eventually learn to be proactive and are prepared to lead the way for other people involved in supporting their child over the long haul. Executive Parents understand that even though other individual children may be maturing faster and becoming more independent, children with learning and behavior challenges like Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) and Specific Learning Disability (SLD) may struggle more than others their age, needing longer periods of parental support and management. These Executive Parents learn how to act as advocates, working with others to provide the resources that the child needs over time.

The Executive Parent that Dr. Barkley envisions also understands that only they can make their child’s success their number one priority. Of course, school personnel can provide special education services, physicians can provide medical consultations, tutors can provide academic support and coaches can assist with athletics – but in the end, it’s ideal if a parent can coordinate these services in a way that works for their child. That’s not to say that specialized and skilled professionals aren’t valuable, but they cannot replace the wisdom and dedication that parents bring to the table.

It’s important to note that while the image of a highly functioning executive may bring the image of a task master to mind, parents should instead aim to operate as a decision-maker and problem-solver on behalf of their child. The child is still viewed as a complete person, with skills, competencies, feelings and preferences of their own, and above all, the potential to succeed!
 

It’s Okay That You’re Still Learning

 

Learning these “Executive Parent” skills won’t come all at once, and that’s okay. The more you learn to take this role on, the more you will develop your voice, learn how to get the information you need, ask helpful questions, and make your feelings heard. Learning these skills over time will help create more clarity around which choices to make for your child, too. And over time, you can take your place walking alongside them, clearing the way for their best interests and taking your rightful place as their biggest fan.

I know that doing all of this as a parent is difficult. It can be overwhelming to take on this role with your child sometimes, and it can also be hard to understand the systems that your child is having to operate within through school and other activities. I’d love to be a help to you and your child as you navigate this together. If I can be of any help, please don’t hesitate to contact me.

Pandemic Tips for Teens

Pandemic Tips for Teens

 

My Best Pandemic Tips For Teens

 

I see a lot of clients in the high-school-or-close-to-it age bracket, who I tend to think are getting hit worse than anyone right now by this pandemic. Teens, this article is for you. Some of you love that you spend less time in school now, others hate it; some of you are going insane being cooped up inside, and some of you relish not having to deal with people quite as much. Whatever the case, a lot of us want tools (this is probably the thing I am asked most commonly for). While I love talking to people, if it’s just tools you want (and most commonly it isn’t), here are some of my best pandemic tips for teens!

Your Brain and Your Emotions Play Tricks on You

 

In the 13-22 or so age range, you feel feelings more intensely than your 25+ year old counterparts. It’s just how the brain works. This has both advantages and disadvantages: your lows are lower, and your highs are higher. Your lows will suck, and it’s likely that the adults in your life will struggle to relate to that, try as they might.

What To Do With The Lows

 

Unfortunately, we are a culture that tends to discourage negative feelings, especially strong ones. Many teens I see believe that there is something wrong with them, or that they are mentally unwell, both which are quite often untrue. While it is taboo to say, a good many of our minds will travel to a place that says we would be better off dead, and the world would be better off not having us. I really hope you’re not there, but if you are sometimes, come talk to us about it. Or to someone else – anyone you trust. It’s surprisingly normal. Please trust me when I say that difficult feelings are important, and worth experiencing (though they are best experienced alongside someone we trust). If you want someone to talk to but don’t want anyone else to know about it, send us an email and we will see if we can help, or point you to someone that can.

Managing Your Highs

 

Since your highs will be higher, that’s a good thing to take advantage of. You can enjoy a movie or YouTube clip way more than most of us can, you can get more joy from spending time with friends (please do this), you can laugh harder and longer, your runner’s highs will be higher. You can feel closer to your pet than we can, which I’m a little jealous of – pets are awesome (at the risk of making a few enemies, especially dogs). Use that – when you’re up, relish it and use the energy it brings.

If there was a pill that would cost nothing, that you could take that would help you sleep better, improve your mood, boost your immune system, help your brain and memory function better, reduce anxiety and depression, reduce stress, and generally make you feel better about yourself, would you take it? I think everyone probably would. Surprise, there is. Bet you didn’t see that coming in an article on the best pandemic tips for teens, did you?

The Magic Pill That’s Free

 

There is indeed a mysterious, free pill. Most people get really excited about this until they hear what it is. It’s exercise. I know that trickery was the last thing you probably wanted to hear, but exercise is literally one of the best things anyone can do for themselves, period. Doesn’t matter what it is, just get moving, and if you can, get your heart rate up. It might be hard at first, but the more of it you do, the better you’ll feel. I should also tell you that you should be sleeping more, but you know that already, and you probably aren’t going to. If you want help in that department, talk to your doctor. In addition to exercise, you can also try cutting out screens in favour of books in the couple hours before bed, or at the very least get yourself a pair of extremely trendy blue light blocking glasses.

You Already Have Skills That You Don’t Realize

 

Because you’re a human being, you have a whole bunch of adaptations the you’ve obtained over the course of a long life. These are great at getting you through tough times. One of my adaptations I used when I was younger was daydreaming, and another was making a joke out of everything. Some other common ones are overthinking/rationalizing, using alcohol or drugs, playing too many video games, or gluing oneself to TikTok.

Some of these are better than others, and they are mostly OK if used sparingly. Though we don’t want to overuse our adaptations, you have them for a reason – they’ve worked before, and they’ll work again. Don’t be too hard on yourself for using them, and I would probably recommend expanding your repertoire to include some more healthy ones.

Exercise (again), art, writing, music, hobbies, gardening, spelunking – the list goes on. If you’re feeling angry or stressed and are already not going to do your homework anyway, you could split your time between something mindless like video games, and something a little more mindful like going outside and collecting a bunch of bugs, or baking some cookies. If your parents hassle you about it, tell them a counsellor said you were allowed to. Probably do the bugs and cookies first – video games are hard to stop once you start. Healthier time-wasters will also give you a little mental boost in case you do decide you want to actually do some homework.

Make Good Use of Your Energy

 

Try to notice where your energy is going. Maybe you’re worrying a ton about your grades, and it’s exhausting. Maybe you don’t care at all about grades, but your parents do, and a lot of your energy goes to fighting with them. Maybe someone at school is really bothering you and it is eating you up inside. Maybe you’re in love and can’t think of anything else but that person you want so badly to be with. Maybe you’re putting everything you have into YouTube or Fortnite, hoping to make some money off streaming someday.

There is nothing wrong with any of these, but anything can be a drain on your mental and emotional resources. Make a list of the things that are the most draining: your biggest worries, the things you are committed to (sports, etc.), tough relationships. Divide this list into things you might be able to change, and those you can’t. The things you have a little more control over are great targets, and even the things you feel totally helpless about may not be as impossible as they seem. If you have a counsellor, talk to them about these things – it is likely you are burning more fuel in a given area than you have to be. These are also the things that can take you into dark places, or towards less healthy coping strategies.

Be Kind To Yourself

 

Above all, be kind to yourself. So far, I haven’t spent time with someone I didn’t end up liking, and this is because all of us are likeable. Seriously – I know that sounds stupid, but it’s true. You can’t be perfect, and you’re going to come out on the other side of this ok. As I’ve said already, come talk to us if you would like to – even if we can’t help, we can likely direct you to someone who can.

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