Help! What if my therapist isn’t the right fit?

Help! What if my therapist isn’t the right fit?

First of all, congratulations on completing what is often the hardest part of therapy: getting started! For most of us, we don’t usually book that first appointment without something urgent finally bringing – or dragging – us through the door.

There’s no judgment here: I spent years putting therapy off before I finally got started, and it wasn’t until I was working as a receptionist here at Alongside You (literally surrounded by therapists and people seeking therapy every day) that I knew I shouldn’t put it off anymore.

Often, it’s a time of crisis that propels us through the door. For you, maybe your mental health was under enough stress that your physical health was affected. Or maybe you came to realize that your relationships weren’t what you hoped they would be, or maybe something just hadn’t been feeling right in your life. For me, I was in real need of some support in my chronic pain journey, and was looking for some help in giving my frazzled nervous system a breather.

Whatever the reason is, recognizing you need help and getting started with therapy can often be the hardest part. But let’s say you’ve finally had that first appointment, or maybe you’ve even had a few at this point. What happens if the fit with your therapist just isn’t sitting right?

As someone who works behind the scenes in a counselling clinic and attends therapy myself, I’ve discovered that there are a few helpful tidbits to know when it comes to deciding whether your counsellor is the right fit for you. Here are a few of them I’d love to share:

Tips On How To Decide If Your Therapist Is The Right Fit

  1. It’s completely fine if your personality just doesn’t fit with your therapist’s. Therapists come in all kinds of flavours (kind of like ice cream) and it might take a couple tries to find one that works for you (kind of like sample spoons). A good therapist will want the best for you, and that means understanding if you would prefer a different match. Their feelings won’t be hurt – after all, many of our therapists have tried out a few counsellors of their own until they found a match they liked!
  2. Ask yourself whether you feel reasonably comfortable with your counsellor. A few good early indicators are feeling safe sitting in a room with them, feeling heard by them, and knowing that you won’t be judged in your vulnerability.
  3. Though it may surprise you, your counsellor doesn’t need to have many shared life experiences or even a similar outlook on the world in order for your therapy to work! Although it can be an added bonus when these similarities happen, they usually aren’t as necessary as they seem. For instance, some of our most skilled and qualified counsellors who offer assistance to parents don’t have any children themselves. But what they DO have is the training and experience necessary to help you and your kids.

    This can sometimes be a mental roadblock for people looking for a new counsellor, and I completely understand. Years ago, I spent some time searching for a new therapist, and as much as I wanted to connect with someone who had experienced chronic pain themselves, that didn’t end up being necessary for me. What it took instead was someone who had the training, skills, and care to help me start to heal my nervous system.

  4. You are allowed at any time to ask your therapist to try a different approach!

    I once (very awkwardly) shared with a therapist after our first session that I would do well with a more relaxed and informal approach, and he was able to adjust for our next session together. Of course, that didn’t mean that we stayed in that casual place all the time, but it helped make me comfortable enough at the beginning to lean into the process. Did I enjoy requesting a different approach, you ask? Nopity nope. But was it worth it? You bet.

  5. Not all therapists have the same training or areas of interest. If you’re looking for a particular kind of therapy, make sure to share that early on in the booking process, before you get paired with a counsellor. Clinical fit is one of our top priorities when pairing you with a therapist at Alongside You, and our Client Care Team is trained to match you with a counsellor who has the training, experience or interest that applies to your circumstances. Of course, it’s also totally fine if you don’t know what kind of therapy you’re looking for – for me, it took trying out a couple types before I landed on one that was particularly helpful for me.
  6. Be aware that starting over with a new counsellor will be, well… starting over with someone new. As tired as you may be with going over your history all over again, anytime you meet with a new therapist you’ll have that regular ol’ first appointment, where you’ll go over any details and get to know each other. If you’re wanting a new match this is 100% worth it, but it does mean that we don’t recommend switching counsellors often. We suggest giving your current situation a thorough try, unless you feel that it isn’t the right fit for you anymore.

    As for me, I recently booked a first appointment with a new counsellor and as much as I would have loved to just bring along some kind of personal Powerpoint presentation to breeze through my history and jump right into “the therapy”, I know this getting-to-know-you phase is actually an important part of the therapy itself. And I found myself enjoying the appointment and starting that new relationship more than I expected!

  7. If you are feeling uncomfortable or anxious about your appointments, ask yourself: is my anxiety about the therapist, or therapy itself? If you’ve been in counselling before you likely know it isn’t always the most comfortable process. The discomfort you are feeling could be about the overall experience of therapy, rather than how you feel about the therapist themselves. In fact, as time passes and you get closer to working on some of the core issues and more challenging areas of your therapy, you might feel more tempted to withdraw from your therapeutic relationship in order to protect yourself from heading into that discomfort. This can be a very normal instinct, but is often really worth discussing or working through. And this leads us to my last (and most important!) suggestion…
  8. Tell your therapist how you’re feeling!

    It can be really helpful for your counsellor to know if you’re unsure that this is the fit for you, or if you’re not sure whether you want to continue. The truth is that your therapist will offer their best help and support when they have your feedback, and I think it’s even fair to say that most counsellors really appreciate these kinds of honest conversations with their clients, and would prefer to have them more often.

    If this kind of conversation feels difficult for you, you can always start by telling your counsellor, “There’s something I’d like to talk about, but it feels hard for me to bring up and I’m not sure how to start. Can we talk about our time here together?” This can be a good way to get the ball rolling, and for the two of you to work through your thoughts on your treatment. This way your therapist can help you unpack whatever next steps will be most helpful for you.

 

How Do I Talk To My Therapist About How I’m Feeling?

So… what now?

The first step it to connect with your current therapist! Feel free to use the example above if you’re not sure how to bring the subject up, and share with them how you’ve been feeling. Together you can start working through whether the best next step is to adjust and try a new approach, or to ultimately get connected with a new therapist.

If you do decide that you would like to try with a new counsellor, please make sure to first let your current counsellor know as a courtesy. Then, your next step would be to connect with our Client Care Team and we’ll help you find a new match. As always, we’ll consider your preferences and needs and do our best to find you a good fit.

If instead you decide to stick with your current counsellor, it could be that this kind of honest conversation is just what your therapy journey together needs!

Either way, this is your time and investment, and you deserve the best possible supports and tools in your walk towards greater health. Our job is to support you as best we can, and we’re honoured to do it.

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.

My Journey To Becoming A Counsellor – Bell Lets Talk Day 2022

My Journey To Becoming A Counsellor – Bell Lets Talk Day 2022

Director’s note: The following article is written by our Registered Clinical Counsellor, Marcia Moitoso, in conjunction with Bell Let’s Talk Day. If you haven’t met us yet, you’ll find out quickly that we’re about being real. We’re all here because we are on our own journey, and want to help others on theirs. Marcia’s article is a very real, personal account of her own journey with mental health and trauma and how it led her to where she is today. I want to express my gratitude to Marcia for being willing to share her journey with others, and I hope you find it helpful. Please be aware, the article describes some traumatic events that may bring up some emotions while reading. – Andrew
 

My Journey To Becoming A Counsellor

 

I came to a career in counselling as part of a long, arduous struggle with my own mental health. I want to share my journey with you as a way to show you that whatever you’re going through, you’re not alone, things can get better, and we’re in this together.

 

My Story

 
My story toward healing really begins at 20 years old, when I hit the lowest low and far more psychological pain than I could have ever predicted. Laying on the bathroom floor of the courthouse after a two-year court battle against the person who sexually assaulted me, I remember thinking this is it, I can’t imagine continuing to live at this point, how can I possibly keep going? Unfortunately, like many of us, I had been through a lot of sexual assault in my early years. I had always felt immense shame about everything that happened to me, believing it was my fault and so I never told anyone how I felt, kept it inside and instead coped with eating disorders, self-harm, and substance use. This last incident in my late teens was the straw that finally broke the camel’s back. I couldn’t keep going like this, something had to change or I didn’t think I’d survive.

I wrestled a lot with the urge to give up and give in to self-destructive impulses. One part of me wanted to survive and get better, a second part wanted to give up, and a third part of me wanted desperately to change the world for other women like me. Frankly, that part kind of wanted revenge (or at least justice) too. I think that third part of me is the one that started to carry me toward healing. At this time in my life, I was learning about feminism, and while it made me confront some very difficult truths about myself and what had happened to me and what I was also complicit in, it made me get in touch with all the rage I felt, and my rage (though sometimes overwhelming) motivated me toward change.

It wasn’t – and still isn’t – a straight line. I remember sitting in my very first counsellor’s office week after week and refusing to speak. She was kind enough, she would recommend interesting female empowerment movies and give me little snacks. I liked her, I just wasn’t ready to talk, and I’d had years of learning to push all of my emotions way down and disconnecting from my body and myself. I wasn’t ready for her to change that. She gave me the notes I needed for extensions on my university assignments that I couldn’t write because the flashbacks were so overwhelming, and I was grateful for that. I don’t think I’d have graduated without her. At that time I also started kickboxing at a small gym that quickly started to feel like a family. I didn’t have to talk, which was important to me back then, but I could punch and kick and secretly cry my heart out. It was everything; I started to feel what powerful could feel like.

But as life goes, more devastations occurred that set me off balance and back into my self-destructive behaviours. I left kickboxing and withdrew into my own world ruled by fear and dissociation. My social anxiety got to the worst point it had ever been, and I lost the majority of my friends. This was another point where I could have lost myself completely, but I had managed to retain one friend who wouldn’t let me go despite the many times I disappeared and definitely let her down. During this time I had started to realize that my self-destructive behaviours needed to stop, but I was still unable to ask for help or admit that I had a problem. I got lucky though, one night at about 2am this friend of mine texted me asking if I’d want to go and travel South America for a year by bicycle. I wanted to get as far away from the place where I grew up as possible, so I didn’t even hesitate, I immediately said yes and with very little planning we got out bikes and just went.
 

The Ride That Changed My Life

 
Since that time I’ve tried to put my finger on just what it was about that year on my bike that was so healing. I think it was a combination of things. I finally really felt like I had a friend who loved me unconditionally (she also had no choice because we depended on each other for survival, traveling by bike with almost no money). I also started to feel powerful and connected to my body for what it could do for me for the first time, instead of focusing on what it looked like or what other people wanted from it. For the first time my body was mine and it was carrying me thousands and thousands of kilometres just by sheer force and will. I also learned to get in touch with my intuition and figure out which situations felt safe and which ones I needed to get out of right away. I experienced some luck, and happened to meet incredible people in every place I went who reminded me that people actually are fundamentally good and that those few who did some bad things to me are not an indicator of all of humanity. And bonus: I didn’t have access to my unhealthy coping means of choice, so my addictions started to fizzle away.

I met so many people from so many backgrounds, and heard their stories of devastation and transcendence, and slowly I started to share mine too. Hearing about the ways people make meaning from tragedy and find ways to survive and make life beautiful again after being in the absolute gutter of life was healing beyond belief. I learned that suffering is part of living and that it actually connects us to others. We suffer tragedies and then we find each other and we heal together. After hearing from these beautiful people in various towns, I’d always have a day or a few of riding my bike to the next place, getting in touch with my body and mind and processing everything I’d heard. It was in one of these in-between cycling times that I realized I wanted to become a counsellor. It was actually a need. I was in awe of how incredible humans are, and their innate urge to move toward growth and healing, and I wanted to be a part of that for myself and for others.
 

The Journey Is Ongoing

 
When I moved back to Canada, I spent several years in personal counselling before going back to school to become a counsellor. I was finally ready to talk and ready to continue the healing that had started on my trip. I knew I couldn’t do it alone, and I knew the triggers would come back now that the excitement of cycling from country to country was over. I’m endlessly grateful for the counsellors who helped me. I started in CBT to rework my self-shaming thoughts and my social anxiety, then I moved into somatic trauma counselling to learn how to heal psychologically through the power of my body, and then I continued the trauma processing work through EMDR. I still have sleepless nights with flashbacks but they’re few and far between now, and when they happen, I know how to ground myself, breathe through it, and look for my body’s wisdom to heal and do what it needs to. I still sometimes get urges to go back into those self-destructive behaviours, but I now know what to do with those urges rather than giving in to them. I’ve developed great friendships, thanks to my counsellors who helped me get out of my own way and soothe my social anxiety. And every day I get the massive privilege of walking with my clients on their journeys toward healing. I’m still a work in progress and know I will always be, and so I continue to work on myself, see my counsellor, and challenge myself to talk to friends and my partner when I need to. I’m endlessly grateful to the people who have helped me along the way, and continue to help me. We’re all in this together and we all have the capacity to grow and heal even if it sometimes really doesn’t feel like it.

I hope my story encourages you, and reiterates that we are all on a journey toward hope and healing. If we can help you on your journey, please Developing a Healthy Sex Life After Sexual Abuse/Assault – Part 2

Developing a Healthy Sex Life After Sexual Abuse/Assault – Part 2

This article talks about some skills and strategies to heal the traumatized part of your brain and move toward the intimacy you deserve. If you missed the last article about the ways that sexual abuse/assault impacts intimacy and sexuality, I’d recommend going back and reading that article before beginning this one.

Remedies

Every nervous system is a little different. What works for one person may not work for another. There are many options for healing trauma and developing a healthy intimate and sex life, so I encourage you to choose options that resonate best with you.

Shift Ideas about Sex

A good place to start might be with the ideas you and your partner(s) hold about sex. Often survivors of sexual assault hold negative beliefs about sex. These beliefs result from parts of our brains confusing sexual assault (violence) with sex (consent, pleasure, equality). The two are not the same, and we need to rewire our brains to reflect this. I recommend having a look at Wendy Maltz’s comparisons chart here https://healthysex.com/healthy-sexuality/part-one-understanding/comparisons-chart/. This will help explain the difference between ideas about sex that come from experiences of abuse, versus healthy ideas about sex.

You can continue to develop a healthy sexual mindset by avoiding media that portrays sexual assault or sex as abuse or talking about sexual attitudes with friends or with a therapist. You can also educate yourself about sexuality and healing through books and workshops. One book I strongly recommend is Come as You Are by Emily Nagoski.

Communication with Partners

This may be the most important recommendation in this article. You cannot have consensual sex without communicating about it. That’s true for anyone, whether they’re an assault survivor or not. Sex remains a taboo subject in our culture, even though sex is very normal and most people have some form of sex at some point in their lives. When things are taboo and not widely talked about and understood, people develop feelings of shame about the taboo subject. Shame lurks in the darkness. This feeling of shame or embarrassment or even just awkwardness keeps many people from talking about sex with their partners despite engaging in sex.

  1. Consent is dynamic: It can be given and withdrawn at any time

All people, and especially survivors of assault/abuse need to be able to give and withdraw consent AT ANY TIME during a sexual or intimate act. Many survivors will experience flashbacks or triggers at various times through physical or sexual activities. Because they don’t feel safe to tell their partner to stop (often out of fear for making them feel bad), they will instead dissociate and push through the sexual experience. When you do this, you are telling your brain and body that what you feel doesn’t matter and that the other person’s pleasure or comfort is more important.

While it may feel frustrating to have to stop mid-sex or mid-kiss or mid-hug because something has triggered you, listening to your body will actually help the healing process go much faster. Each time you override what your brain and body needs, the trauma gets reinforced and the triggers continue to come back. Slower is faster when healing from trauma. This is something partners need to understand. If a survivor is saying no, it’s because they trust you enough to say no, not because they’re not attracted to you. Every “no” is sexy because it’s getting you closer to an enthusiastic, consensual “yes”

  1. Understand and Communicate your preferences

In addition to understanding and respecting the need to withdraw consent at any time, it’s important to talk about sexual preferences. What feels good, what feels neutral and what doesn’t feel good. Communicate when something felt uncomfortable and explore together to find what does feel comfortable. When sex is approached with curiosity and exploration rather than rigidness and shame, it becomes increasingly safe and pleasurable for both parties.

  1. The need to take a break

Sometimes survivors of sexual abuse and assault may need to take a prolonged break from sexual activity. This can happen when the individual is in a relationship or not. The break allows space to focus on healing and figuring out what feels good and what doesn’t without worrying about the anxiety of managing their partner’s advances. When you are ready to engage in sexual activity again, do so when you want it, not when you believe you “should.” You have a right to be an active participant in your own sex life. Communicate your likes and dislikes and give yourself permission to say no at any time.

How to Manage Triggers and Flashbacks

As mentioned above, some survivors will experience triggers or flashbacks during physical touch or sexual activity. Flashbacks and triggers are often thought of as images of the traumatic experience. But they can also be experienced as unpleasant sensations, or a lack of sensation, an experience of disconnection, or an experience of overwhelm. When this happens it’s important to stop whatever is triggering the flashback, i.e. stopping the sexual activity or the physical touch. When you have a flashback, a part of your brain thinks it is in the past when the trauma happened, You need to remind that part of your brain that you are in the present moment and that the danger has passed. Another word for this is “grounding.”

Grounding Strategies/Orienting back to the present moment

  • 5,4,3,2,1
    • Name 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, 1 you can taste
  • Deep breaths
    • Breathe in for 4, hold for 7, out for 8 (or any variation of that where you breathe out longer than you breathe in
  • Box breaths: in for 4, hold for 4, out for 4, hold for 4 (repeat 4 times)
  • Stand up and move your body – get the adrenaline out
    • Run on the spot, go for a walk, jumping jacks
  • Watch youtube video that makes you laugh (laughter is grounding)
  • Play a categories game
  • Say the alphabet backwards
  • Show these strategies to your partner and do them together

Once you’ve successfully grounded (and give yourself as much time as your nervous system needs for this, remember slower is faster), take some time to rest and find comforts. Your nervous system has just gone through a lot. It can also be good to think about what triggered you and to discuss with you partner how to change that in the future. You may want the help of a counsellor to determine this.

Counselling

Trauma counselling can really help you to overcome the impacts the trauma has on your life. You may also want to incorporate some couples counselling to help improve communication so that the two of you can work as a team on this.

There are 3 types of trauma counselling that can be beneficial. You may benefit from a mix of all three.

  1. Top-Down counselling:

This type of counselling helps you to change the thought patterns and behavioural habits that have formed as a result of the trauma. You will learn to notice the emotions and to change the behaviours and thoughts that tend to come as a result of the emotions. Some examples of this include CBT and DBT.

  1. Bottom-Up Counselling:

Emotions and survival responses are physiological. You may notice a tightness in your chest when you feel anxious, a lump in your throat when you feel sad, a pit in your stomach when you feel embarrassed, or any variety of physical manifestations of emotions. When we feel an emotion our bodies are automatically mobilized to do something with it. For example, if you see a grizzly bear, your body might instinctively run or freeze or even try to fight it. You don’t even have to think about it, your brain does it automatically! Your body also knows how to heal from the trauma, but often circumstances prevent us from being able to allow our bodies to do what they need to do. Bottom-up counselling approaches such as EMDR, Sensorimotor Psychotherapy, or Somatic Experiencing can help you to process the trauma by mindfully allowing your body and brain to do what it needs to do to heal. This will also greatly improve your relationship to your body

  1. Mindfulness Counselling or Practices

Through mindfulness practices you can train your nervous system (brain and body) to become fully present. You learn to notice when triggers are happening while keeping a foot in the present-moment so that you don’t become overwhelmed. With mindfulness you can learn to allow emotions to come and go naturally without being swept away. If you’d like to start mindfulness on your own I’d recommend starting with short 2 minute practices and slowly working your way up. Examples of mindfulness-based counselling include Mindfulness Based Cognitive Therapy and Mindfulness Based Stress Reduction.

I hope these tidbits can help you get started, or to continue on your healing journey. You deserve a healthy intimate life that includes boundaries, consent, pleasure and joy. Slower is faster; trauma takes time to work through, but it is very treatable, and you don’t have to do it alone.

Sources

Maltz, Wendy (2021). Healthy Sex: Promoting Healthy, Loving Sex and Intimacy. https://healthysex.com/

Nagoski, Emily (2015). Come as you Are: The Surprising New Science that will Transform your Sex Life. Simon & Schuster Inc: New York.

University of Alberta Sexual Assault Center (2019). Sexual intimacy after sexual assault or sexual abuse. https://www.ualberta.ca/media-library/ualberta/current-students/sexual-assault-centre/pdf-resources-and-handouts/intimacy-after-sexual-assault-2019.pdf

Developing a Healthy Sex Life After Sexual Abuse/Assault – Part 1

Developing a Healthy Sex Life After Sexual Abuse/Assault – Part 1

Note: This article speaks in broad terms about sexual assault and abuse. If you feel overwhelmed at any point reading this article, I encourage you to stop reading (or skip to the section on “grounding”) and allow your body to do what it needs to do to come back to the present. Whether it’s going for a brisk walk, doing some deep breathing, or calling a trusted friend. As this article will discuss, there’s no need to push yourself past the point of overwhelm. Healing can only take place with patience.

Many survivors of sexual assault face difficulties with intimacy and/or sexuality at some point in their lives. While this is a very common experience, it’s certainly not the case for all survivors. Traumatic events affect people in a variety of different ways dependent on each person’s life experiences and their unique nervous systems. This article will focus on the people who do struggle with sex and intimacy after traumatic events. It will show that even though it can feel really hopeless at times, there are some amazing ways forward to achieving a healthy and satisfying sex life. We have some powerful innate abilities to heal trauma, but it often takes patience, support and work to get there.

Understanding the Impacts

Sexuality and the Central Nervous System – Stress and Love

Sexuality is impacted by the emotional systems managed by a very primal part of your brain often called “the reptilian brain.” This part of your brain is responsible for stress feelings as well as love feelings, all of which have helped us to survive as a species. Stress and love are also the main emotions that impact intimacy and sexual desire.

Stress responses are the neurobiological processes that help you deal with threats. Your brain prioritizes one of the following three main components based on survival needs: fight (anger/frustration), flight (fear/anxiety), or collapse (numbness, depression, dissociation).

Love is also a survival strategy; it’s the neurobiological process that pulls us closer to our tribes and bonds humans together. Love is responsible for passion, romance, and joy. It’s also responsible for the agony of grief and heartbreak.

Common Reactions

When a person lives through a traumatic event, the stress response in their central nervous system (brain and body) often gets locked into survival mode. It has detected that there is danger and so it learns that it must always be scanning for any sign of danger. As a result, there are two very common reactions to sexual trauma that affect a survivor’s sex life.

  1. Sexual Avoidance/Difficulty Experiencing Pleasure

The main function of the central nervous system is to prioritize survival needs in order of importance. For example, if you can’t breathe, you’re unlikely to notice that you’re hungry until you get oxygen again. Similarly, although love is indeed a survival mechanism (bringing us together with our tribes), the brain tends to prioritize attention to stress over love because stress points to a more immediate threat: the possibility of another dangerous and violent act.

After a sexual assault, sensations, contexts and ideas that used to be interpreted as sexually relevant (like physical touch) may instead now be interpreted by your brain as threats. So sexual situations actually make your brain sound the “danger” alarm bell. Our central nervous systems confuse sex (an act of consent, equality and pleasure) with sexual assault (an act of violence and power over another). Remember, your nervous system’s primary function is to keep you alive and safe, so anything that feels in any way similar to a violent situation from the past will sound your brain’s alarm bell.

Basically, you may be experiencing love or desire, but your brain is still stuck on survival mode. This makes it almost impossible to experience pleasure, desire and closeness.

  1. Engaging in Compulsive Sexual Behaviours

Remember how love is also a survival strategy? It draws us closer to others and makes us feel whole. So instead of stress hitting the sexual brakes, some people get locked into patterns of feeling out of control sexually and having multiple partners. In this case, sometimes the innate survival strategy prioritizes closeness for that feeling of being whole; however, when this is a survival mechanism, it’s often happening from that “collapse” stress response, or a more dissociated place. People stuck in this pattern may experience a brief feeling of relief but may still struggle with the deeper components of intimacy.

  1. Additional common symptoms
  • sexual avoidance/anxiety
  • sex feeling like an obligation
  • dissociation during sexual activity/not present
  • negative feelings associated with touch
  • difficulty achieving arousal/sensation
  • feeling emotionally distant
  • flashbacks/intrusive thoughts or images during sexual activity
  • engaging in compulsive sexual behaviours
  • difficulty maintaining an intimate relationship
  • vaginal pain in women; erectile dysfunction in men
  • feelings of shame
  • negative beliefs about sex

This is a short list of reactions, there are many more impacts on a person’s sense of self and experiences in relationships. If you’d like to get a better sense of how your traumatic experiences may have impacted your sex life, you can have a look at Wendy Maltz’s Sexual Effects Inventory here https://www.havoca.org/survivors/sexuality/sexual-effects-inventory/

Remedies: Developing a Healthy Sex Life 

This short article was just to give you an idea of some of the many ways that sexual assault can impact intimacy. These impacts sometimes show up directly after the assault and sometimes show up years later.

Stay tuned for the next article which will talk about some of the many ways to heal the parts of your brain that are impacted by the trauma and to help you to find safety and pleasure in intimacy.

Sources

Maltz, Wendy (2021). Healthy Sex: Promoting Healthy, Loving Sex and Intimacy. https://healthysex.com/

Nagoski, Emily (2015). Come as you Are: The Surprising New Science that will Transform your Sex Life. Simon & Schuster Inc: New York. 

University of Alberta Sexual Assault Center (2019). Sexual intimacy after sexual assault or sexual abuse. https://www.ualberta.ca/media-library/ualberta/current-students/sexual-assault-centre/pdf-resources-and-handouts/intimacy-after-sexual-assault-2019.pdf

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