by Andrew Neufeld | Jun 14, 2018 | Communication, Connection, Counselling, Depression, Mental Health
The deaths of Kate Spade and Anthony Bourdain, both by apparent suicide has the world reeling again. There have been numerous articles in response to this, calling for more mental health support, offering advice on how to reach out to loved ones, and more. One of my first thoughts was of how devastating substance abuse can be. I don’t know directly how much alcohol or drugs factored into the deaths of these two celebrities, but both had struggled with substances throughout their lives and it seems as though it likely influenced these most recent tragedies.
When we experience the death of a celebrity, a work colleague, a friend, or family member, one of the common struggles is wondering what could have been done? What if we’d just reached out more? What if we’d asked them how they were doing more? What if we’d encouraged them to get help more? The reality is that simply checking in on someone, or offering platitudes like, “Make sure you ask for help when you need it,” simply don’t work very often.
One of our staff pointed me to this article in which a group of friends held an intervention of sorts for a friend struggling with grief. What I appreciated about the article, from the perspective of the friend being intervened upon, was the comment that this approach could have easily backfired. This is very much true – it worked in her case, but on a different day, at a different time, or for any other number of reason the approach could have backfired. Still, she was grateful that they had intervened. So, here are some ways I’m going to suggest we can succeed in supporting friends when the stereotypical “reaching out” isn’t working.
Show Up
Most people struggling with mental health will tell you that it’s incredibly isolating. Isolation intensifies and worsens negative emotions and symptoms of mental health difficulties. It removes motivation, removes hope, and so much more. So, what this means is that when we ask, “Hey, how are you doing today? Have you gone outside for a walk? Is there anything I can do,” we are likely to hear, “I’m fine, it’s ok,” because giving any other answer requires motivation and hope, and effort, just like any other action on their part.
This is where we can show up. We know what our friends, family members, and loved ones need in general because it’s good for anyone: healthy food, going for walks, help with practical things in life. If we ask if we can do something for someone struggling, they’ll likely say no. If we show up and help, however, we are more likely to succeed, and more often than not, they will be grateful that we showed up and helped them.
Know Our People Well
In order to show up and be effective, we need to know what our friends, family members, or loved ones like, need, and long for. This requires us to know them well. It requires intimacy and vulnerability on both our parts, and we need to be working on this when times are good. If we rely on building this when things are bad, it will be incredibly difficult. There’s a tool I use when working with couples in therapy as we focus on building a foundation for their relationship and I think it can be helpful here. The Gottman Institute card decks are designed for couples, but they could easily be used for building interpersonal knowledge and intimacy in any relationship. The Love Maps and Open-Ended Questions card decks are particularly helpful for this – know that the language is geared for couples, but I’d love to see more of us using these in our other relationships. The more we know each other on a deeper level, the more we’ll be prepared to respond when someone is having a difficult time with mental health. We’ll know their wants, needs, desires, hopes, without even having to ask.
Be Willing To Take The Risk
Sometimes what we do as we try to help someone might backfire. If we show up unannounced to take someone for a walk because they can’t get out; if we show up with food and conversation when they can’t bring themselves to cook or to talk to anyone; if we show up and clean their house for them, these all may backfire. We might make them mad, we might embarrass them, we may even get the door slammed in our face.
We also might, just maybe, make the difference needed to help them move the next step forward, and they didn’t have to do it alone.
I often get asked the question, “What if I make things worse?” The reality is, it’s hardly possible to make things worse by showing empathy and love. For the sake of argument, even if we do, what then? Are they more depressed or more anxious? That’s a risk we need to be willing to take, and I can tell you that from my experience, it simply does not happen that way.
Get Help Yourself
Finally, if you try everything, you show up, you do for someone what they can’t do for themselves, and it’s not working, this is where a professional’s help can be a great asset. Trying to care for someone is difficult, especially when we don’t see results. It wears on us, it causes us distress, and we are now at greater risk for mental health difficulties ourselves. Sometimes we also just need an outside perspective from someone with experience with these issues. This is where a Registered Clinical Counsellor can be helpful in supporting you and providing outside insight into how you might help someone. RCC’s can also be helpful in connecting you or the person you’re concerned about with appropriate resources that may be helpful.
Don’t Give Up
Caring for someone who is struggling is hard. Don’t give up on them – try some of the strategies above, get some help for yourself if they won’t let you help them, and in case you missed it the first few times, don’t give up.
Feel free to contact us for help or counselling related matters. Our doors are always open.
by Andrew Neufeld | May 3, 2018 | Anxiety, Depression, Mental Health Disorder
Anxiety and Depression account for the majority of mental health diagnoses in Canada. At any given time, at least 11.6% of Canadians aged 18 and over are dealing with a mood or anxiety disorder based on a survey in 2013. My experience suggests that this number is low, both because the statistics are now 5 years old, and because it’s based on self-report and we know that many people don’t report their struggles even when asked on anonymous surveys. One of the common questions we get here at Alongside You is how to support a friend or family member who is struggling with depression. In fact, we were asked again yesterday and that’s what instigated this article.
If you run a Google search on the subject, there are many articles on this topic, such as this one from the Mayo Clinic, or this one from HereToHelp. There are many great resources out there with many suggestions around educating yourself on depression, helping friends get exercise and eat healthy food, and similar tactics. These are all great suggestions and ideas and I encourage you to spend some time looking through the articles that are available.
In this piece, I want to take a slightly different road and look at how we can help a friend, family member, or other loved one who is struggling with depression in terms of how we need to be with them. This might sound a little strange because many of us (myself included) are practical, hands-on types who like practical strategies. The thing is, being who we need to be with people is a practical strategy, and it is very effective.
The Importance of Not Knowing
When we’re struggling with something, and certainly when that something is depression, we often feel misunderstood. We say things like, “They just don’t get it,” or, “Nobody understands how I feel,” and quite frankly, it’s usually true. Even for those of us who have struggled with depression in our lifetime, the experience of someone else may be very different. How it felt for us and how we responded may not line up with this person’s experience. If we assume we know how the other person is feeling, we run the risk of alienating them and making them feel even less understood than they already do.
So, our first job then is to listen and to listen to understand versus listening to respond. Often, especially when we’re under stress, we do the latter; we listen and feel the need to respond in the hope that it will help someone feel better or feel connected. Often, we’ll respond with something along the lines of, “Oh yeah, I totally know how you feel, I went through the exact same thing!” No, we didn’t. We may have been depressed, we even may have been through similar circumstances and reacted similarly, but we don’t know how they are feeling unless we ask and listen, and we most certainly didn’t go through the exact same thing. If we want to be helpful and fight against the alienation and isolation our loved one is likely experiencing, we need to listen to understand.
The Importance of Empathy
One of the greatest challenges we face in trying to support a loved one with depression is the fact that we don’t understand. In fact, this very thing often places a great deal of stress on us because we want to understand, we feel we need to understand. The fact of the matter is, we don’t need to understand to be helpful. If we build on this stance of not knowing, we can work toward understanding on a deeper level, understanding the emotional level, and by strengthening the connection between us. This, in a nutshell, is empathy.
Empathy is not our naturally occurring, number one go to strategy – our go-to natural strategy is usually sympathy. If you haven’t seen it already, I would encourage you to watch this short video of Brené Brown talking about the difference. When people are depressed, one of the most significant things that help is the connection with others. This is why empathy is so important – we can show empathy without understanding yet. It can be as simple as saying, “Wow, I don’t even know what to say right now but I’m glad you told me, and I’m here.” And yes, I totally stole that line from Brené Brown. I stole it because it’s that good. See, if we can admit our limitations and be vulnerable with our loved one that is struggling, not only do we encourage connection, but we model the vulnerability that they need in order to connect with us. If they can do this in return, it will directly combat those voices in their heads telling them that nobody cares, nobody listens, nobody understands, and they are not good enough.
Seeking Help
If we can do the two things above, we stand a greater chance of success in this third thing I’m going to talk about: getting help. Most of us are proud people – we think we can do it all on our own and further, we think we should. I remember when I was dealing with major depression I thought it was because I was doing something wrong, that I just wasn’t working hard enough, and that I was a failure. Part of the reason that I believed this is because to my knowledge at the time, nobody I knew, and none of my family had ever struggled with depression, and certainly not the suicidal thoughts that were commonplace for me. This is where vulnerability and even some self-disclosure on our part can be helpful, particularly if we’ve struggled with depression ourselves. Some careful self-disclosure can normalize the struggle, and fight against the negative self-beliefs.
If we can listen to understand, and show empathy, we send the message to the one struggling that it’s ok that they’re struggling, it’s ok that they don’t have it all figured out, and it’s okay to ask for help. Now, when I say it’s ok I don’t mean it’s pleasant, or that we should like being depressed, or anything along these lines. What I mean is that it’s not because of some inherent flaw in who they are that they are struggling, and it certainly isn’t because they’re not worth it.
See, by spending time listening and understanding, spending time in empathy and connection, we are sending a strong message. That message is, “You’re worth it.” In my opinion, this is the single most important message for anyone to receive when they are dealing with depression because if their belief about themselves is that they aren’t worth it, then why would they tell anyone how they feel? Why would they open up to someone? Finally, why would they bother asking for help, because they don’t deserve it?
If we can help our loved ones come to a place of even beginning to understand that they are worth it, they are loved, and they are valuable then we stand a much better chance of succeeding at getting them the help they need. This is where we can again show vulnerability and explain that we love them, but we don’t possess the skills necessary to help them recover fully, the skills that a mental health professional does. This is also where we can reinforce that we’d like to help them get the help they need and that we will be there alongside them as they go through this. In fact, we can emphasize that we will go through this together with them.
How We Are With People Is Most Important
The reality is that helping a loved one who is struggling with depression is usually a start and stop, back and forth, messy process. Most of the time, emphasizing the practical strategies doesn’t work very well. Why is this? Because we don’t have the connection needed where the person will believe they are worth it, that they are loveable, and that recovery is possible. If we can be with the person on a deeper, empathic level, we give them the best chance possible to buy into the recovery process and we show them that they’re not alone.
If you’re reading this because you have a loved one struggling, or because you are that loved one struggling, I encourage you to take the first step toward recovery. If we can be of help to you, please don’t hesitate to ask. This is why Alongside You exists – because we believe that everyone is worth it. Feel free to contact us!
by Share Forde | Apr 26, 2018 | Anxiety, Depression, Dialectical Behaviour Therapy, Mindfulness Meditation, Therapeutic Yoga
“You are richer than you think.” This is the current slogan being used by Scotiabank. When I hear this slogan, I think of the clients who are participating in the various DBT groups here at Alongside You. DBT is the short form of Dialectical Behavioural Therapy, created by Dr. Marsha Linehan, who is a psychologist working at the University of Washington in Seattle. This treatment is the gold standard for clients struggling with unstable identity, risky behaviours, chaotic relationships and an inability to regulate emotions and urges. The DBT skills taught in our groups focus on Distress Tolerance and Crisis Management, Interpersonal Effectiveness, Emotion Regulation and Mindfulness. There has been much research supporting this form of therapy that it is now also designated as the gold standard for Borderline Personality Disorder. The skills are also very helpful for clients trying to manage depression, anxiety and substance misuse.
In addition to skill building, learning and participating in a group format has many other benefits. I have facilitated groups of various kinds for 40 years and have been witness to so much growth in so many clients that I can say with confidence that a group experience is a very rich one. Dr. Irwin Yalom describes in his book, The Theory and Practice of Group Psychotherapy that the following factors occur when participating in group therapy:
- Instillation of Hope
- Universality
- Imparting of Information
- Altruism
- Corrective recapitulation of the primary family group.
- Development of socializing techniques
- Imitative behaviour
- Interpersonal learning
- Group cohesiveness
- Catharsis
- Existential factors
Dr. Roy Mackenzie in his book, Time-Managed Group Psychotherapy, identifies learning factors such as
- Modelling
- Vicarious learning
- Guidance
- Education
- Support
- Self-revelation and Insight
As the late famous American poet Maya Angelou says, “we are more alike than we are different.” Why then do we sometimes we feel that we are left behind while others live their life without strife? This is certainly how it may appear on the various social media sites. More and more I see young clients who spend hours daily checking up on friends on the various social media platforms on the internet. It seems to me that it would be much more healthy to call a friend and plan to do an activity together. If we parallel play as young adults we are not growing psychologically. Attending a group is a good start to get back in the game of communicating both verbally and nonverbally with other people. People need people as we are social beings by nature. A group is a microcosm of society in general. When clients feel supported in a genuine way they are likely to experience some or all of the healing factors mentioned above.
Another factor involved in a group setting is the undercurrent explained by the psychoanalyst, Wilfred Bion, in his book Experiences in Groups. Bion says that there are three basic assumptions working alongside any working group. These are mostly unconscious but are helpful for facilitators to consider if a group they are running is starting to struggle. The first basic assumption is the dependency and this happens when leaders are dialectically idealized and devalued. The second basic assumption is pairing in which two group members bond in an attempt to overthrow the leader. The third basic assumption is fight or flight, which happens when the group has a common enemy. It can be a taxing job to be teaching skills as well as observing the group process and the underlying basic assumptions all at the same time. Extra training on group skills is highly recommended when moving from individual therapist role to a group therapist role. I believe that this is one of the reasons our groups are so effective here at Alongside You. We work diligently to create the best atmosphere for people to learn and to grow.
Groups are a dynamic force and when change happens to the individual group members this impacts and creates a vibration which results in changes to the whole group. Systems theory suggests that groups over time tend to develop a self-organizing nature which works to maintain stability and minimize threats. Through this, clients can experience a safe space to explore their challenges and their successes, and learn from, and encourage each other.
My goal when I co-facilitate our Dialectical Behavioural Therapy group is to have clients leave after 24 weeks being even richer than they think they are, as they carry their new tools to help them achieve a “Life Worth Living.” Feel free to contact us to learn more about Dialectical Behavioural Therapy.
