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Somatic Psychotherapy

Somatic Psychotherapy

“On occasion, our bodies speak loudly about things we would rather not hear. That is the time to pause and listen.”  Verny, Thomas R

Somatic therapy, rooted in the belief that the body is where life happens, empowers individuals to take an active role in their healing journey. It harnesses body techniques to strengthen the evolving dialogue between the client and therapist, fostering a deeper understanding of the relationship between bodily experiences and mental states. By focusing on a holistic perspective, somatic therapy cultivates embodied self-awareness, guiding clients to tune into sensations in specific body parts. This approach has been found to be particularly beneficial for addressing issues such as eating disorders, body image issues, sexual dysfunction, chronic illness, emotion regulation, disassociation, and trauma.

Breathwork in somatic psychotherapy

Breathwork, a cornerstone of somatic therapy, has a rich and diverse history in the realm of physical, psychological, emotional, and spiritual healing. Its transformative power can alleviate psychological distress, soften character defenses, release bodily tension, and foster a profound sense of embodiment and tranquility. Somatic therapists employ breathwork techniques, from energizing the body for emotional processing to soothing and grounding hyperactive body parts, offering a hopeful path to healing and self-discovery.

Conscious breathing practices are used:

  • to help couples and families to connect through touch
  • assist in recovering from trauma
  • to promote sensory awareness,
  • and to access altered states of consciousness for healing purposes

What is disordered breathing?

Disordered breathing, a term often used in the context of somatic therapy, refers to a state where the physiology and psychology of breathing intertwine. It’s characterized by irregular breathing patterns, which can trigger anxiety or panic and disrupt cognitive processes like decision-making. These patterns can vary based on emotional states, with sighing, increased depth, or rate of breath often associated with anxiety and anger.

Irregular respiratory patterns could be associated with anger, guilt, or deep, weeping sadness. Hyperventilation associated with panic or anxiety creates lower levels of CO2 in the blood, often leading to decreased attention and mental impediments. Loss of concentration, memory loss, poor coordination, distraction, lower reaction time, and lower intellectual functioning are all associated with low CO2.

Feeling anxious: produces a distinguishing pattern of upper-chest breathing, which modifies blood chemistry. This leads to a chain reaction of effects, inducing anxiety and reinforcing the pattern that produced the dysfunctional pattern of breathing in the first place.

Body Posture: has also been cited as a factor in breathing efficiency and patterns. Somatic therapy tends to operationalize posture as a function of personality or character. Somatic therapists often note how one’s posture is presented when describing the emotional state. They track feelings and sensations in the body to help the client make sense of their experience in connection with their body.

What are some benefits of somatic psychotherapy?

  • The body is not just a location for distress but also for pleasure, connection, vibrancy, vitality, ease, rest, and expansion. Somatic therapy could make this easier to achieve through processing and resolving difficult bodily experiences.
  • Positive self-image: Somatic therapy can help clients feel a positive connection to their bodies and promote self-confidence.
  • Positive body image: Somatic therapy can enhance body connection and comfort instead of disrupting body connection and discomfort by pairing difficulty with enjoyable sensations to increase tolerance.
  • Enhance the body’s ability to experience and express desire by encouraging the client to Stay with and expand enjoyable sensations.
  • Encourages attunement of the body and enhances self-care instead of self-harm and neglect.
  • Provides a protective space where clients can re-associate with their bodily experience.

In conclusion, our bodies contain a complicated, unified, multilevel cellular memory system that allows us to be fully functional human beings, and attending to our body’s needs could enhance our overall mental and physical well-being.

If you are interested in somatic psychotherapy, please contact our Client Care Team to connect with one of our clinicians.


References

Stupiggia, M. (2019). Traumatic Dis-Embodiment: Effects of trauma on body perception and body image. In H. Payne, S. Koch, and J. Tantia (Eds.), The Routledge International Handbook of Embodied Perspectives in Psychotherapy (pp. 389-396). Routledge

Verny, T. R. (2021). The Embodied Mind: Understanding the Mysteries of Cellular Memory, Consciousness, and Our Bodies. Simon and Schuster.

Victoria, H. K., & Caldwell, C. (2013). Breathwork in body psychotherapy: Clinical applications. Body, Movement and Dance in Psychotherapy, 8(4), 216- 228. https://doi.org/10.1080/17432979.2013.828657

“It’s a Wonderful Life!” – Every parent’s response: “is it really?”

“It’s a Wonderful Life!” – Every parent’s response: “is it really?”

What does Family Systems teach about being Parent-Oriented?


Let me paint a fictional yet very real picture: 

“I can’t take it! This yelling is killing me,” Trish cried out to her husband in frustration.

Trish: 41 years old, married to Owen, mother of two boys (Jake, 9, and Sam, 14), and working part time at a Marketing firm – sat down with her head down. 

She went on, “I’m exhausted… and feel more tyrant than parent! I can’t take much more…”

So much for the classic Christmas exclamation (yes, I’m still in the Christmas/New Years reflective mode) we wish we could all shout from the rooftops: “It’s a wonderful life!” 

Trish’s internal dialogue: 

What an absolute battle! Shouldn’t swimming lessons be fun? Nevermind my lovely intentions for him to make some friends, something he is clearly struggling to do.

Our internal critics can be ruthless in their judgements: 

The tone you used was too intense! What sort of mother screams like this at her kids? Hopefully none of the neighbors heard that. It’s hopeless! I cannot stop this yelling. Am I just a bad mother?

It’s one of those moments when you have intrusive thoughts about how you wish you could escape all the commitments you have. You are trying to uphold an image of order and yet the cracks are forming and your will power is running dangerously low.

If this is you, breathe in and out deeply. Right now. Try it. It helps. Slowly breathe in and out again. Take your time. I’ll explain in a second. This is important.

There is hope.

There are new dance moves to learn! New songs you and your family can move to. 

There is hope.

Do you sense a little doubt rising up? If so, go ahead and acknowledge that part of you that is skeptical. Take a moment, and acknowledge that inner skeptic. Listen to what it’s saying. Makes sense. Change is difficult. We’ve gone down this road too many times. Hope often feels out of reach.


Well, as a therapist and fellow human (who is new to the parenting game), I want to encourage you and share some steps you can take to become that peaceful presence you long to be within your family.

Take the First Step.

I want to encourage you: walking up those stairs to confront your child, to investigate the brewing chaos, or to engage in the struggle to get your kid to swimming lessons is so important. Being a parent is a sacred duty. As much as I can through the medium of a blog, I want to say this: Well done! Parenting is so important.

Some of the biggest names in psychology and parenting – Gordon Neufeld and Gabor Maté – together wrote a book called Hold Onto Your Kids and they repeatedly highlight the importance of our children being attached or connected to us as their parents. Perhaps this seems obvious but, in fact, researchers are seeing a trend of children becoming increasingly more attached to their peers than their parents. This means our kids are getting their cues or primary validation from their friends over us, their parents. Do your kids lean towards being peer-oriented or parent-oriented? A helpful sign is who do they turn to when in crisis? Or this: when your child is freaking out at you it’s a sign of their safety with you. 

Whatever the answer may be, your involvement is critical. And that means walking up those stairs over and over again.

I think of the movie It’s a Wonderful Life where George Bailey doubts whether his life has made any difference in light of the chaotic forces of big business creeping in and widening the inequality gap. In a moment of despair George wishes he had never lived! The classic parental exclamation: “is anything I am doing making a difference!?” Spoiler warning. George Bailey gets his wish to see what his community would look like if he never lived…and what does he discover? His life, in fact, has positively impacted countless lives. This movie is a beautiful witness to the power of a life well lived. The takeaway? Our lives, our love, and each little decision we make has a significant impact in ways that, more often than not, we will never see.

Your attention, your love, your concern for your kids, even if it comes across not perfectly, is worthwhile, essential and life changing.

Take the Next Step.

So back to our main question: how do we end this seemingly endless screaming match and attain that wonderful life we all want?

Deep breath in. And breathe out slowly. 

Here’s an answer according to Family Systems research:

One of the best things you can do for your kid is to focus NOT on your kids but to focus on yourself.

What? This is a strange invitation indeed. 

Hal Runkl, a seasoned family therapist, puts it this way, “We all feel incredibly anxious about our kids, and their choices, and we don’t know what to do about it. We fret and worry about how our kids will turn out. Inevitably, we’re so focused on our kids that we don’t realize when this anxiety takes over—and we get reactive.” (Runkl, 2009, p. 9). 


Hal continues, “First, it’s a given that there are things in this world we can control and things we cannot control. Now ask yourself this question: How smart is it to focus your energy on something you can’t do anything about, something you cannot control? Answer: Not very. Follow-up question: Which category do your kids fall into? In other words, are your children something you can control or something you cannot control? Here’s an even tougher question: Even if you could control your kids, should you? Is that what parenting is all about? And what if it’s not the kids who are out of control?” (Runkl, 2009, p. 11). 

Compelling right? Take a moment to think about that paragraph. Not fully sold yet? That’s okay. Stay with me just a bit longer so I can paint a picture of what this sort of parenting might look like. 

So the natural next question to ask is: what does it look like to focus on ourselves as parents? 

Take A Different Step.

It means doing what I got you to do above.

First, breathe in. Breathe out. 

Then, acknowledge the parts of yourself that rose up (the inner skeptic we acknowledged earlier). 

And then finally, move towards your kids.

Hal Runkl puts it this way: calm down, grow up, get close.

This sort of parenting is less about mastering the available parenting techniques but harnessing what Edwin Friedman (another family therapist) calls a “non-anxious presence.” It’s less about skills to learn and more about managing our anxiety. It’s difficult but doable. And it works! 

The power of harnessing a non-anxious presence is that if change occurs in one part of the family system, it affects the entire system. When anxiety rises in one person, it instantly impacts the entire family system. Like certain house heating systems: if the temperature drops, instantly the heating system alters to adjust the temperature. Thus, as the parent, when one lowers their own anxiety (perhaps through our three steps – calm down, grow up, and get close) you will immediately impact the entire family. In fact, our heightened anxiety often creates the very outcomes it seeks to prevent (check out counterwill and Otto Rank for more on this).

This is why the first step of harnessing a non-anxious presence is breathing or getting calm. This aligns with new research that teaches us about mirror neurons which activate in those around us in response to our emotional state (Rizzolatti & Craighero, 2004). Our brains are beautifully programmed to be really good at mirroring, or “getting in tune” with those around us. So, as you manage your breathing in high intensity situations, it will impact those you are around. So, first: calm down. Breathe.

Think Things Through.

Some questions to ponder related to our first step: what situations with your children make you the most reactive? What is said that typically triggers you? What are you feeling at that moment? Have you ever remained calm in the midst of family chaos? How did that affect those around you? 

The second step – grow up – is about how we handle the anxiety that is inherent in our families. It’s about avoiding speedy responses (emotional reactivity), increasing our self-awareness, and taking time to really think. 

Can you, in the heat of the moment as you walk up the stairs in response to the apparent chaos brewing, acknowledge the sadness, anger, and anxiety in you that is rising up? 

Hal puts it this way, “the only way to retain a position of influence with our children is to regain a position of control over ourselves” (Runkl, 2009, p. 16). Part of growing up, and thus infusing peace into our families, is our ability to embrace the emotional intensity present, the painful words unleashed, and the immediate discomfort for long-term pay-off. This is the process of maturity: our sacred responsibility as parents. 

“I hate you!” “You’re no fun… I want to go out Friday night.” “I don’t know how to do this homework!”

Cue anxiety. Do you feel it in your shoulders? This anxiety leads to two usual responses: Scream or avoid! Instead, each time this anxiety rises up it is an opportunity for us to grow up. And this process of pausing, thinking, and becoming aware of our own emotions, gives us enough space to think and respond from a non-anxious position… or as close as we can get to it.

So, the second step is to grow up: embrace your own anxiety, name the thoughts and emotions that come up, and take a moment to think.

I’ll keep the third step simple. The final step is to get close, which simply means remaining connected. From this place of calm move towards your kids. 

The Take Home Message. 

Let’s put this all together:

Your kids are fighting upstairs. Your heart rate starts to increase.. Angry thoughts start to arrive: “I’ve got dinner to make…I just put out five different fires today and now this kid is at it again!” These intrusive thoughts and more flood your brain. 

Here is what you need to do.

Walk upstairs… slow your pace… (unless danger is truly on the table… but it probably isn’t)…. Breathe in and out… attempt to slow your heart rate… even a little bit. Become aware of the part of you that is angry… where do you experience it? What is its job for you? Then, enter the room…

In conclusion, peace enters our families not in the way we expect, not through focusing on our kids – something we cannot or shouldn’t control – but through focusing on ourselves. Calming down, growing up, and getting close.

 

References

Neufeld, G., & Maté, G. (2004). Hold On to Your Kids: why parents need to matter more than peers. Vintage Canada. 

Rizzolatti, G., & Craighero, L. (2004). The mirror-neuron system. Annu. Rev. Neurosci., 27, 169-192.

Runkel, H. E. (2009). Screamfree parenting: The revolutionary approach to raising your kids by keeping your cool. Broadway. 

Are You New to this Therapy Thing?

Are You New to this Therapy Thing?

New to Counselling?

Are you new to this counselling thing? Are you contemplating giving it a try? Do you need to go to counselling? Or just curious as to what the fuss is all about? 

Well, here’s my attempt at giving you a little glimpse into the beauty of this phenomenon that is growing in its cultural acceptance and perhaps this can help you figure out whether signing up for counselling is the next right move for you. I speak as a fellow human who has attended counselling and as a therapist who has sat opposite to many who have courageously sought out help through the medium of therapy.

Here are some stats to gain a wider picture:

  • Statista conducted a survey of 1,650 people ranging from 18 years and older in 2020 via telephone interview. They asked the respondents, “in the past 12 months, have you received any counseling or treatment for your mental health?” 43.7% of respondents from British Columbia said “yes.” New Brunswick wins (or loses depending on how you look at it…) at 60.1% of respondents responding with “yes.” Manitoba was the lowest at 27.7%. 
  • Another study found that between 2019 and 2021 the percentage of adults who had received mental health treatment in the past 12 months grew from 19.2% to 21.6% (Terlizzi & Schiller, 2022). 
  • Statistics Canada found that in 2018 17.8% of Canadians aged 12 and older reported needing some help with their mental health. This is around 5.3 million people. That’s a lot of people! Out of that 5.3 million, 43.8% reported that their needs were either not met (they did not go to therapy) or were partially met (they went to therapy but it was not enough).

What do these three sources tell us? 

Simply put, therapy is being accessed more and more. Perhaps, we are catching on to the fact that our mental health is worth investing in. It really is. Gone are the days when therapy was reserved for those that we lazily labeled (or diagnosed) with words like “crazy” or “problematic.”

5.3 million Canadians acknowledged the need for assistance with their mental wellbeing. 

Deeper than just being accessed more, these studies are perhaps a helpful reminder that you are not alone, not part of a small fringe group, but… dare I say… human. Not yet got this “life” thing figured out. Normal? I think so.

 

What Does Therapy Look Like?

So, if you’re new to this or not yet bought into it, give me a moment to paint a picture of what it looks like: 

You arrive in a cozy office, sit in the waiting room, another fellow human – your counsellor – will arrive and call your name, together you’ll enter a room with a couch and perhaps a few chairs. You sit down. And then…

This is what you may see on the outside but so much is happening internally. 

You are setting out on a grand adventure. 

You are escaping the noise and bustle of every-day life.

You are marching out into battle. 

You are sitting by a warm fire on a stormy winter evening.

You are resolving unfinished business.

You are tending a wound that no-one around you sees.

You are aspiring and hoping for who you could become.

You are settling into who you are, becoming more at home in your own skin.

If you break your arm, you go to a doctor. This doctor will first assess your injury and then set you off on a path of healing and recovery – aligning your arm, bracing it, and advising you on what activities may or may not be achievable in light of your wound. 

In a similar way, you may have experienced various psychological/relational/emotional challenges – a huge setback in your work life and left feeling fragile, recurring conflict in your most intimate relationships, abuse from people that were supposed to be your protectors – and the question remains: where do I go to sort through/respond/heal these challenges?

The added challenge of mental health is its invisible quality, which leaves us vulnerable to the pushback: “is this just in my head? Can I just push through and deal with this?” A broken arm just seems so simple and obvious. However, mental pain and suffering left unattended can fester in similar ways than an untreated wound. Though, it may come out in angry outbursts, tension in your shoulders (perhaps its not so invisible…), the inability to know what you feel, a low sense of self-worth, or intrusive thoughts that plague you every time you slow down. 

This is where counselling becomes useful in attending to your mental well-being. It is true that humans are resilient and often, even after experiencing traumatic life events, people bounce back with courage and vitality. And yet, counselling is a protected space to address and tend to our relational, emotional, personal challenges.

 

How does counselling accomplish change?

At very least it accomplishes this through undoing our unbearable aloneness. Dr. Diana Fosha passionately declares that our relational, emotional, personal challenges largely stem from “being alone in the face of overwhelming emotion” (Fosha, 2000). Thus, therapy, at its best, works to undo aloneness.

Judith Herman, the legendary trauma therapist, writes that “the fundamental premise of the psychotherapeutic work is a belief in the restorative power of truth-telling” (Herman, 2015, p.181). In the presence of another human, can you share honestly how you are doing? Can you express, in detail and with clarity, the truth of your being? As you dive into the biggest challenges that seem to plague your life through this act of “truth-telling”, you are met with wise attentiveness and deep compassion.

Bessel Van Der Kolk, the medical director of the Trauma Center in Brookline, Massachusetts, says “being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives” (Van der Kolk, 2015, p. 81).

 

A Safe Relationship

Do you have relationships marked by trust, safety, honesty? How can you tell?

Bessell highlights the importance of each of us being heard and seen by another person in our lives. We need to be held in someone else’s mind and heart. He writes, “no doctor can write a prescription for friendship and love; these are complex and hard-earned capacities” (Van der Kolk, 2015, p. 81).

Do you feel a desire to be met with this sort of attentiveness and care? Does it feel too good to be true? Too simple? Fair responses. A helpful question to explore is what the costs are for not receiving this hard-earned capacities? 

I know I need them. And as I step into vulnerability—this act of receiving and trusting—I find myself walking lighter, thinking with greater clarity regarding my relationships and problems, and feeling more at home in my body and in this world. Perhaps you could call it feeling mentally healthy.

I encourage you to find relationships that are characterized by these qualities. Whether or not they are counsellors. It will change your life. It’s changed my life.

Here at Alongside You, these quotes inspire our work; We offer award-winning counselling services that are shot through with these qualities: a safe context to be seen, held in the mind of another, and this “hard-earned” love that Bessell speaks about. If you wish to learn more, contact us to see how we can help.

 

References

Elflein, J. (2022, August 31). Adults who received past-year Mental Health Counseling Canada 2020. Statista. Retrieved from, https://www.statista.com/statistics/1328941/adults-who-received-past-year-mental-health-counseling-canada-by-province/ 

Facts and figures. Fraser. (n.d.). Retrieved from, https://vancouver-fraser.cmha.bc.ca/impact/influencing-policy/facts-and-figures/#:~:text=Between%2019.6%25%20and%2026.2%25%20of,a%20mental%20illness%20each%20year. 

Fosha, D. (2000). The transforming power of affect: A model for Accelerated Change. Basic Books. 

Herman, J. L. (2015). Trauma and recovery. Basic Books.

Statistics Canada. (2019, October 7). Mental health care needs, 2018. Health Fact Sheets. Retrieved from, https://www150.statcan.gc.ca/n1/pub/82-625-x/2019001/article/00011-eng.htm 

Terlizzi, E. P., & Schiller, J. S. (2022). Mental health treatment among adults aged 18-44: United States, 2019-2021. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.

Van der Kolk, B. A. (2015). The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma. Penguin Books.

Why I’m Optimistic in 2023

Why I’m Optimistic in 2023

Finding Hope in a World Full of Challenges

Reflecting on the past year, it’s easy to feel discouraged. We are facing multiple ongoing crises in mental and physical health, the environment, economic inflation, political divisiveness, civil unrest, and war. Social injustice remains rampant. These concerns should not be dismissed, and I want to start by emphasizing that optimism in no way neglects their importance. Nor do encouraging statistics take away from the fact that every needless death is a tragedy.

However, it’s also important – for our own sanity – to consider the good news. I often describe to my clients how our brains are hard-wired to pay more attention to negative events or feelings than positive ones. This is a well-studied psychological phenomenon known as negativity bias. It can lead to rumination and even depression. We recall criticism better than praise. We remember negative events more strongly than positive ones, and think about bad things more frequently than good things. Counterintuitively, our brains do this for our own benefit. It is far more important for survival to know where the dangers are than to take time to appreciate the wonders of life!

We see this reflected in our news and social media: negative and alarming news grips our attention, and so it gets more airtime. We click more frequently on alarming headlines, so they get published more often. This amplifies the illusion that the world is threatening by default.

We cannot make effective change when trapped in a state of despair. To avoid such a toll, it is important to balance our negativity bias with mindful awareness of what’s going well. And it turns out there are many, many good things happening!

Discovering Optimism

One antidote to the prevailing doom-and-gloom narrative of our time can be found in Matt Ridley’s Book The Rational Optimist. He uses hard data and historical analysis to show that we have made incredible progress in recent centuries, and this trend of increased prosperity is likely to continue as we innovate and adapt to ever-changing circumstances.

Another important book is the late brilliant physician Hans Rosling’s Factfulness: Ten Reasons We’re Wrong About the World–and Why Things Are Better Than You Think. He writes:

“Every group of people I ask thinks the world is more frightening, more violent, and more hopeless—in short, more dramatic—than it really is.

Uncontrolled, our appetite for the dramatic goes too far, prevents us from seeing the world as it is, and leads us terribly astray.

Step-by-step, year-by-year, the world is improving. Not on every single measure every single year, but as a rule. Though the world faces huge challenges, we have made tremendous progress. This is the fact-based worldview.”

Such thinking is not new, either. Even back in 1830, British historian Thomas Macaulay posited:

“Hence it is that, though in every age everybody knows that up to his own time progressive improvement has been taking place, nobody seems to reckon on any improvement during the next generation. … On what principle is it that, when we see nothing but improvement behind us, we are to expect nothing but deterioration before us?”

So, what exactly is all this progress that thinkers like Ridley, Rosling, and Macauley are talking about? Here are some examples.

Good News for a Change

Poverty is declining.

Globally, the number of people living below the poverty line (defined as living on less than $2.15 USD a day, in 2017 dollars) fell from 2.01 billion people (37.8% of the population) in 1991 to 648 million people (8.44% of the population) in 2019. It is still too early to calculate precisely how the covid-19 pandemic affected this trend; preliminary estimates indicate it may have pushed 70 million people or about 9% of the population back into extreme poverty in 2020. Yet the overall trend continues as it has for past decades. In 2017 renowned economist Max Roser commented that “Newspapers could have had the headline ‘Number of people in extreme poverty fell by 137,000 since yesterday’ every day in the last 25 years.” For more insights, see his excellent research website Our World in Data.

Population growth is stabilizing.

Although the global population is still growing, the rate of growth has been slowing down since 1968 in an accurately predicted manner. The population is expected to peak somewhere around 10.4 billion people in the year 2100, and then decline. With reduced poverty comes gains in education and health, and declines in child mortality, all of which are associated with lower birth rates.

The rapid decline in child mortality deserves its own emphasis: Hans Rosling once stated that “child survival is the new green.” According to his educational website Gapminder.org, “saving poor children is an important factor in ending both poverty and population growth. The death of children is not holding back population growth. It is one of the reasons poor people still have many children.” People have less children when they do not need to worry about whether or not those children will survive to adulthood.

Medical advancement continues at an astonishing pace.

Life expectancy is rising everywhere. People around the world are living longer and healthier lives, thanks in part to advances in medicine as well as increased access to nutrition and education. From vaccines that have eradicated deadly diseases like smallpox and polio to new treatments for chronic conditions, the progress in medicine is astounding.

For example, new medical technology allows us to identify cancer and other diseases earlier, leading to better treatment outcomes. Targeted therapies are becoming more widely available, less invasive, and more effective than traditional treatments like chemotherapy. Midstage trials are providing renewed hope for the development of vaccines against various cancers.

Genetics represent another marvel of medical advancement. Knowledge about the genetic basis of diseases helps improve diagnoses and treatments. Researchers are making significant progress in developing gene therapies that can cure sickle cell disease, HIV/AIDS, and other debilitating diseases. Genetic testing is now available for certain inherited conditions, like Huntington’s disease, which can help people make more informed decisions about their health and their future.

We are also making progress towards treatments for amyotrophic lateral sclerosis (remember the ice bucket challenge in 2015?) and Alzheimer’s disease. The development of robotics has transformed surgical procedures, resulting in faster recovery times and fewer complications. Telemedicine makes healthcare more accessible and convenient. Wearable tech like smartwatches and fitness trackers can monitor vital signs and alert patients and their physicians to potential health issues.

Mental health care is advancing too!

Technology is helping mental health treatment as well. Our clinic and many others offer secure telehealth appointments, so that remote clients can get the same treatment as everyone else. We utilize cutting-edge measurement-based care platforms such as Greenspace to monitor mental health outcomes and help clients gain insight into treatment progress. Apps like How We Feel and Calm help clients develop emotional intelligence and mindfulness skills in an easy, approachable way. Neurofeedback is another relatively recent technology that provides an excellent alternative (or complement) to traditional talk therapy.

There are many more examples of medical innovation, and it may take time for some of these gains to become sufficiently accessible. But every day we are making great steps towards a healthier world.

There’s still time for the environment.

There’s no denying the reality that ecological sustainability and preservation are serious concerns. It seems likely we will overshoot 2.5°C of global warming, leading to severe weather events, expansion of deserts, food insecurity, animal species extinction, and economic harm. However, we can take solace in the fact that many initiatives are working, and progress is being made.

Many countries have reduced their greenhouse gas emissions while increasing their GDP. The world is making great strides towards clean and sustainable energy. Renewable energy sources like solar, wind, and hydro are becoming more accessible and affordable. Even though nuclear energy has suffered tragic accidents, it remains one of the safest and cleanest forms of energy when compared to death rates from air pollution created by fossil fuels. Fourth-generation nuclear reactors currently being developed will be even smaller, safer, and more efficient with far less nuclear waste produced.  Scientists are making important discoveries towards fusion power, which has the potential to radically transform the world’s energy usage.

Another real concern is deforestation, but let us remember the wise words of Mr. Rogers concerning catastrophes: look for the helpers. Organizations like Cool Earth, which I fundraised for in 2019 and continue to support, are doing excellent work in this field. And we have data to support progress: a 2018 study published in Nature (one of the top scientific journals) identified with confidence that global tree cover has increased 7.1% since 1982.

Less harm from natural disasters

Furthermore, improvements in infrastructure and emergency preparedness have significantly reduced annual deaths from natural disasters, which were 3.7 million in 1931 and only 13,008 in 2022. Although we cannot prevent events like earthquakes, we can prevent high losses of life. The numbers prove that our efforts are working.

Admittedly, the tasks ahead will not be easy. But there is strong evidence that human effort and adaptability will allow us to fight current environmental threats and build a more sustainable world.

The world is more peaceful than ever before.

Given the widespread destruction and devastation in the first half of the 20th century, it is notable that the world has not seen a major global conflict in the past 78 years. Even considering the recent Ukraine conflict, warfare today is less frequent, less lethal, and more localized. While nobody knows the future for certain, there are reasons to believe that this calm and stability will persist. The globalization of trade means that the citizens of other countries are worth more to a nation alive than dead. As quality of life improves, we have less reason to engage in the discomforts of violence and vengeance. Institutions such as the United Nations have been developed to foster diplomacy, and cooperation has become more productive than armed invasion.

Violent crime is trending downwards as well. And the number of terrorist attacks and deaths from terrorism around the globe has dropped markedly since the 1970s (contrary to the over-representation of terrorism in the media, it accounted for just 0.05% of global deaths in 2017).

Overall, a person born in the world today is far less likely to be a victim of violence than a person born at any prior time in human history. That’s a remarkable achievement!

Basic needs are becoming more affordable.

It may be hard to believe, but it’s true: basic needs such as food, water, healthcare, housing, and education are becoming more affordable around the world. We owe this development to government and non-profit initiatives to reduce basic costs to individuals and families, as well as advances in technology, transportation, agriculture, and the global economy (lower prices stemming from businesses competing on a global scale).

The International Telecommunications Union, a United Nations agency, reported in 2022 that the price of mobile-broadband services has dropped to just 1.5% of gross national income per capita. Almost two-thirds of the world population has access to the internet. This number continues to rise, along with ownership of mobile phones. With more accessibility and affordability, the world is also becoming increasingly connected. I believe that will be a very important part of furthering communication and cooperation to solve global challenges.

What Now? “Learned Optimism.”

I hope these examples have conveyed that there are many reasons to see hope in all our futures. Our natural negativity bias can lead to a sense of learned helplessness. I firmly believe in countering it by cultivating learned optimism. We are better equipped to take on problems when we have an accurate, factual view of the world. The overwhelming evidence shows that the future is looking positive!

Here’s another piece of good news: the myth-driven stigma around accessing mental health care is disappearing rapidly.

In my clinical work, I often draw upon dialectical behaviour therapy (DBT), which teaches skills to strengthen emotional resilience and build a life worth living. These skills include radical acceptance (seeing situations as they are and focussing on what you can control rather than what you cannot) and checking the facts (developing a more accurate and realistic understanding of a situation rather than relying solely on assumptions and emotions).

Therapy can be useful in overcoming negativity and developing a more positive outlook on life. This is not simply turning a blind eye to suffering. Instead, it is about developing the skills to face challenges with a helpful and more effective outlook.

If you’re struggling with negative thoughts or feelings of helplessness, it’s important to remember that you don’t have to face these challenges alone. Consider reaching out to our team of skilled clinicians to explore therapy options and start building a more helpful future.

Using Art and Mindfulness for Pain Control

Using Art and Mindfulness for Pain Control

Using Art and Mindfulness for Pain Control

 

“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

 

It’s Not Easy Being In Pain

 

How many of us have pinched a finger in a door, have sprained or broken a limb, have woken up with a back ache or gone to bed with a searing migraine? In some form or another, we can relate! After all, we are human. For some of us, however, either due to injury or illness, the pain never goes away. Day in and day out, pain follows us all the time. It is no surprise then, that pain impacts all aspects of our lives: our sleep, our ability to work or go to school, and even our social connections and family relationships. Using art and mindfulness for pain control can be an extremely helpful tool for our journey. Before we get into that, let’s look at some of the information on chronic pain and illnesses.

 

The Statistics

 

Did you know that nearly 8 million people in Canada live with chronic pain (or pain that persists for than three months)?i This means that 1 in 5 people suffer from prolonged pain. 1 in 5 children and youth experience ongoing pain and 1 in 3 adults 65 and older experience chronic pain.ii This can include but is not limited to conditions such as endometriosis, cancer, neurological disorders, fibromyalgia, and Lupus.

Like other chronic illnesses, the chronic pain experience is also impacted by other factors such as poverty, mental health and substance use issues, diversity in gender, race, ethnicity, abilities, and concurrent medical conditions.iii

 

The Stigma

 
Some of us have been on the receiving end of a dirty glare when parking in a handicap space, using the elevator meant for those with physical disabilities, or for not offering your seat on a bus to another person with physical disabilities. If only they knew! Because chronic pain is largely invisible, those affected by it can often feel disbelieved, unheard, or dismissed. The stigma builds as individuals are labeled as a “problematic and frequent patients,” mainly because they seek medical treatment regularly. The huge range of symptoms that one can have related to chronic pain makes it difficult to reach a diagnosis and plan for treatment. What begins is a search for effective, compassionate and quality help.
 

Facing Challenges

 
For people living with chronic pain or illness, getting help is not always straightforward.
In my own pain experience and in my work with others with chronic conditions, this seems to be a reoccurring experience. Navigating through our medical system is complex and confusing at times. For patients with chronic pain it’s certainly not a walk in the park!

To be fair, medical professionals do their best to care for their chronic pain patients but struggle to work within a health care system that is not always well-equipped to manage the complex nature of pain. With nearly 900,000 British Columbians without a family doctoriv, the limited amount of time with each patient, and long wait times in walk-in clinics and emergency wards, medical professionals are not always able to spend the time they need or want to with their patients.

As a result of this, chronic pain sufferers are faced with considerable challenges when seeking help?

  1. The need to review their medical history for every new practitioner. With each new doctor or specialist, patients are asked to review their medical challenges and ‘pain history’ and it is exhausting! If there is no continuity of care or no regular doctor who can follow your progress and prescribe effective treatments, those with chronic pain can be left with feelings of despair and frustration.
  2. Self-advocacy is hard. With many chronic pain symptoms being invisible, those of us with chronic conditions need to be forthright, consistent, and clear when we articulate our symptoms, and defend our state of being and need for treatment. This not a skill that everyone has and it forces already vulnerable people to go outside of their comfort zone or find an advocate who can be their spokesperson.
  3. It is hard to get timely help. It can take many months and even years to see specialists, receive surgery, or gain access to public pain programs. In the meantime, patients are left to cope, to seek out alternative forms of treatments. Sometimes it’s hard to know where to look, and see if they are accessible (financially, geographically, or demographically).
  4. Building a support network is not always easy or within reach. With prolonged reliance on friends and family for practical, financial, physical, emotional, and spiritual support, those with chronic pain may be left with changed or strained relationships. Asking for help regularly or relying on others may not always be an option due to life circumstances. Feelings of loneliness and of being a burden often weigh heavily on those with prolonged pain.

 

How Do We Address These Issues and Improve Quality of Life?

 
How many times have you heard, “You’re going to have to learn how to live with your pain?” We groan, yes, but it’s true. There is no magic wand, so how do we do this? The chronic pain experience is riddled with complexities; because it has both physiological and psychological components, taking a holistic approach in tackling chronic pain is the most effective treatment plan in retraining our body and brain. For a good discussion of the importance of a multi-disciplinary approach to pain management, check out this video.

When used together, interventions such as pain medication, surgical procedures, counselling, body work (occupational therapy, physiotherapy, massage therapy, exercise, acupuncture), and the arts (visual, performance, music, dance, literary), can reboot our nervous system, teach us productive skills to manage symptoms, and help us to connect with ourselves and others and have a better quality of life amidst our pain experiences.
 

The Role of Art and Mindfulness For Pain Control

 
Using the Arts and mindfulness for its health benefits is widely becoming a critical component of healthcare to positively enhance, impact, healv and strengthen overall health and well-being.vi Research shows that mindfulness, or the act of paying full attention to the present moment without judgement,vii is a very effective practice to provide relief for both physical and psychological symptoms of chronic pain. Jon Kabat-Zinn, leading researcher of MBSR (mindfulness-based stress reduction) advocates that mindfulness can alleviate symptoms of pain, reduce stress in the body, alter our negative thought distortions to more positive ones, create emotional balance, and enhance overall health.viii

It’s no surprise then, that combining the art making process with mindfulness can be an effective way to tackle pain management. The very act of creativity and expression can promote body awareness,ix be an effective practice for rehabilitation and lead to significant life changes. It also offers a tangible and fun way to learn mindfulness skills, and encourage self-compassionate creativity.
 

What types of art activities can we do to learn mindfulness?

 
There are a wide variety of artistic activities that can help us learn to be mindful. Here are a few ideas:

  • Activities such as drawing, paper marbling or knitting can provide temporary respite or healthy distraction from physical symptoms of pain,xi xii and allow chronic pain sufferers to lose themselves in the moment or artistic process.xii xiii
  • Reflective journaling and guided meditation connects both the physical body and the psychological mind, using the art making process to encourage positive self-care, and experimentation and risk-taking, two essential qualities of the art-making process.xiv
  • Creating a self-portrait or vision board is a way to explore understandings of self, improve self-confidence,xv process suffering or significant life changes, and provide a visual representation of the life you want to have moving forward.
  • Making art with others in a supportive environment can help us feel connected and understood by talking to others about pain experiences,xvi building companionship, and having a sense of belonging, and decreasing social isolation and loneliness.
  • Selecting from a range of colours, shapes or images in an art activity encourages experimentation,xvii affirms a sense of control over surroundings and the decision-making process, and builds upon and improves cognitive functions (memory processing and problem solving).xviii

 
Using art and mindfulness for pain control, along with healthy changes to our diet, sleep, and exercise regimes and with attentiveness to empathy and creativity 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 help us build our resilience. xix

I hope this article has given you a taste of the benefits of using art and mindfulness for pain control. If you want to try something fun, meet others who understand and support you, and learn how to manage symptoms through the process of creating, join us in our Pain in the Arts class, where we will learn how to make art with a mindfulness lens.

If you want to learn more about our Arts in Health Program at Alongside You, please visit our page on Arts in Health.
 
 


i. Canadian Pain Task Force Report. 2021 Accessed July 13th, 2022. Link
ii. Canadian Pain Task Force Report. 2021 Accessed July 13th, 2022. Link
iii. Canadian Pain Task Force Report. 2021 Accessed July 13th, 2022. Link
iv. Xu, Xiao “Nearly 900,000 British Columbians don’t have a family doctor, leaving walk-in clinics and ERs swamped.” Globe and Mail. April 29 2022. Accessed July 13th. Link
v. Fancourt, Dr. Daisy; Warren, Katey and Augusterson, Henry. “Evidence summary for policy: The role of arts in improving health and wellbeing.” Report to the Department for Digital, Culture, Media, and Sport. April 2020. Accessed July 5th, 2022.
Link
vi. Link
viii. Gardner-Nix, Dr. Jackie and Lucie Costin-Hall. The Mindfulness Solution to Pain. New Harbinger Publicaitons, Inc. 2009: vii.
ix. Callahan, Margaret Jones. Mindfulness Based Art: The Sparks Guide for Educators and Counselors. Friesen Press. 2016.
x. Ann Behav Med. Eds. Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis.2017 Apr;51(2):199-213.Link
xi. 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.
xii. Dr. Daniel Potts. How art therapy enhances the life for Dementia Patients. 2014. Accessed September 15th, 2016. Link
xiii. “The Art of Pain Management.” American Chronic Pain Association: Link
xiv. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 41. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
xv. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 40. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
xvi. 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)
xvii. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 41. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
xviii. 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]
xix. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 40. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.
Arts In Health – Why We Should Be Using Art In Healthcare

Arts In Health – Why We Should Be Using Art In Healthcare

What is Arts in Health?

 

The idea that The Arts have a role in the health of individuals and communities has a long history in cultures around the world.i Arts in Health (also known as Arts in Medicine or Art in Healthcare) incorporates The Arts (visual, performing, literary, music, and dance) to support and enhance the continuum of care and plays a critical role in the overall health and well-being of people seeking help for various conditions.

This growing field of research and inquiry is developing world-wide, especially in The United Kingdom, Australia, the United States, and across Europe.ii Increasingly, medical professionals are ‘socially prescribing’ non-medical, community-based activities and services that provide patients and practitioners greater health options when faced with complex medical and social problems.iii Though not as developed as in other countries, there are various health initiatives that incorporate The Arts with diverse creative holistic approaches to health across Canada.iv

This multi-disciplinary approach to health is becoming recognized both as an effective and creative way to positively impact health outcomes in both inpatient and outpatient healthcare and community settings, and boost mental, emotional, social, physical and brain health.

Specifically, participating in the art-making process:

 

  • Reduces stress, anxiety and depressionv
  • Improves self-confidence,vi self-awareness and empowermentvii
  • Encourages positive self-care skills
  • Provides a supportive setting to socialize, decreasing loneliness and social isolation
  • Is an effective preventative tool to manage symptoms of chronic pain and illness, and diseases such as Dementia, or Alzheimer’s disease
  • Improves and maintains neuro-spatial functions, memory processing and problem solving as we ageviii
  • Fosters emotional resilience, confidence, and personal growth
  • Is a healthy outlet and distraction tool to heal from physical, emotional, and psychological issues

To learn more, check out this infographic based on the research of Alain De Bolton and John Armstrong “Art As Therapy.”

 

Where does Arts in Health take place and what does it actually look like?

 
If you have ever been to a museum, a hospital, or community-based care home, you have most likely come across both art work and programs that fit under the umbrella of Arts in Health.

Museums and art galleries are accessible places where art can be viewed, questioned, created and bought. Artists and craftspeople are culture makers; they often play a huge role in cultural education and wellness. They are catalysts and bring people together through exhibitions, celebrations, ceremonial performances, and demonstrations. Artists can also showcase their work and sell their handcrafted art pieces.

Art work or painted murals are displayed in hospitals in hallways, waiting rooms, intensives care units, palliative and hospice wards, treatment and operating rooms and children’s wards. Outdoor art installations are also found on hospital grounds, music is played in high stress areas to benefit the patients and health-care staff, art activities are used at bedsides or during treatment (chemotherapy, radiation, and dialysis).

Community-based organizations such as rehabilitation and addiction centres, women’s shelters, day programs for people with diverse abilities, and immigrant services are just a few examples of where recreational forms of art-making are used to strengthen, to heal, and to communicate.
 

Who Benefits from Arts in Health Programs?

 
Along with other therapeutic interventions such as counselling, neurofeedback, Dialectical Behavioral Therapy (DBT), Cognitive Behavioral Therapy (CBT), occupational therapy and physiotherapy, The Arts allows us to discover, explore, practice, connect not only with others, but with ourselves. More specifically:
 

  • Kids and Teens: Approximately 20% of Canadian youth are affected by a mental illness or disorder.ix Extracurricular activities such as art making can be especially beneficial for both teens and children because it provides a fun, non-threating, and inclusive setting where they can be introduced to new skills, learn coping strategies, shore up defenses and can develop deeper understandings of themselves and others.x
  • Socially Isolated Individuals: Approximately 1 in 5 Canadians say that are not satisfied with their number of friends.xi Loneliness is real. Making art with others can promote social satisfaction and allow individuals to connect with others with similar interests
  • Caregivers or other individuals with overwhelming stress and anxiety: Using The Arts is good place to begin when coping with the stresses of everyday life. Picking up a paint brush or writing in a journal can be small but positive self-care steps to improve everyday life
  • Individuals with diverse needs, abilities, and diagnoses: People with diverse physical, intellectual, developmental, and emotional needs thrive when art activities are tailored to suit their individual interests and needs. Those with chronic pain or illnesses also benefit from the art making experience which helps in pain management
  • Individuals who just want to have fun! Making art in a beautiful space with a variety of different art, alongside others can really boost our mood. We can also receive individualized and collective support and guidance while working on creative projects
  •  

    Who is considered an Arts in Health practitioner?

     
    Arts in Health practitioners are composed of a variety of individuals: professionally trained artists, artists-in-residence, expressive arts practitioners (who use multiple forms of art), arts or health educators, art consultants, community-based support staff, other health-care professionals, recreational instructors in hospital or community programs, or other creative individuals who incorporate art in health disciplines.xii

    These practitioners provide patients, family members, and caregivers with opportunities for creative engagement in a variety of ways. Many artists are involved in fundraising efforts for health-related causes. From auction items, art commissions, internet sales, art shows, and community events, artists are uniquely woven into the commercial market, bridging artistic development to benefit healthcare initiatives. It is common for artists to work as educators inside schools or workplaces. They lead students, teachers, businesses and organizations in creating collaborative art pieces, and provide training and professional development on how to practice self-care and how to infuse wellness in their classroom or organization.

    Artists have always played a pivotal role in places of religious expression and places of worship, such as churches, mosques, temples and more. They help bridge creative expression (music, building architecture, prayers) with spiritual health and healing.

    Musicians, performance artists, dancers, visual and literary artists play a huge part in improving our collective quality of life, especially during challenging times. Throughout the pandemic, we have seen how The Arts have brought us together and helped us cope anxiety and stress.
     

    So why does Arts in Health matter?

     
    Increasingly, the health-care system is going thought a shift, one that focuses on treating the whole person (body/mind/soul), not just the condition. Medical programs are integrating the arts into training, teaching and research because of the overwhelming evidence-based research that shows a direct correlation between healing and the arts.xiii

    This infographic provides a great visual on the importance of community-based Arts in Health.

    Both on an Individual and community level, at Alongside You, we seek to reduce the burdens of illness, to foster connection, provide hope and build resilience so we can help others live vibrant and thriving lives. It is for these reasons that we offer Arts in Health programs at Alongside You. If you have any questions about how our Arts in Health programs can help you on your journey, please reach out to me and I’ll be glad to hear your experience and talk about how including arts in your health plan could help!
     

    “An active engagement with the arts – whether as a participant, or as a viewer – is one effective way for individuals and communities to address issues of public health. We recognize that prevention and health promotion are important in avoiding the costs and issues associated with acute care later on, down the road. This is where the arts are effective in health promotion.”

    – Sarah Chilvers, (former Program Director for Health and Social Development for the Vancouver Foundation)


    i. Clift, Stephen, and Paul M. Camic (eds). Oxford Textbook of Creative Arts, Health, and Wellbeing: International Perspectives on Practice, Policy and Research. Oxford University Press. 2016. Page 3.

    ii. Clift, Stephen, and Paul M. Camic (eds). Oxford Textbook of Creative Arts, Health, and Wellbeing: International Perspectives on Practice, Policy and Research. Oxford University Press. 2016. Page 4.

    iii. Wouldn’t it be great to have this in Canada?

    iv. To name a few: Dalhousie University’s Medical Humanities Program called Heals, that combines the arts and humanities with healthcare; The University of Prince Edward Island’s Advancing Interdisciplinary Research in Singing (AIRS) Research Environment that connects researchers across discipline with singing and well-being; McGill University’s leading researcher in neurosciences, Daniel Levitin’s work on the impact of music and the brain; Arts Health Network is hub that links research in arts and health knowledge across Canada; In Manitoba, University of Victoria’s Health Initiative (UHI) aims to enhance health research, healthy aging, indigenous health, and mental health.

    v. Repar, Patricia Ann DMA; Patton, Douglas Med. Stress Reduction for Nurses Through Arts-in-Medicine at the University of New Mexico Hospitals. The Departments of Music and Internal Medicine.

    Holistic Nursing Practice: July 2007 – Volume 21 – Issue 4 – p 182-186. University of New Mexico. Accessed July 14th, 2022. https://journals.lww.com/hnpjournal/Abstract/2007/07000/Stress_Reduction_for_Nurses_Through.4.aspx

    vi. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 40. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.

    vii. McNiff, Shaun. Chapter 2: The Role of Witnessing and Immersion in the Moment of Arts Therapy Experience. P. 41. In In Mindfulness and the Arts Therapies: Theory and Practice. Laury Rappaport ed. Jessica Kingsley Publishers. 2014: 38-50.

    viii. Zeki, Semir. Art and the Brain. Journal of Consciousness Studies 6(6-7). 1999. Accesses September 14th, 2020. Link

    ix. Canadian Mental Health Association Statistics: Mental Health and Mental Illness. Link

    x. Coholic, Diana. Arts Activities for Children and Young People in Need. (2010). P. 11.

    xi. Canadian Mental Health Association. Coping with Loneliness. Link

    xii. Dewey, Patricia, Bettes, Donna et.all. Arts, Health and Wellbeing in America. (2017). Accessed July 15th, 2022. Link

    xiii. This is evident with the growing recognition amongst Canadian physicians the establishment of medical schools such as Queens University, Memorial University of Newfoundland, the University of Alberta that bridge medical training with The Arts.