By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I have an unexplained fear of flying. I’ve never been on a plane – never want to – but now my daughter moved to the States, and I would love to go visit without driving for 10 hours. How can I get over it – or can I? The answer: A fear of flying is one of the most common phobias. By definition, a phobia is an irrational fear of a thing, place or situation that is out of proportion to the actual danger posed. Although phobias sometimes begin following a fear-inducing situation (such as experiencing a very turbulent flight, for example), often people have no recollection of why or how their fear was created. And, not uncommonly, phobias can develop even when a person has never had an experience related to that which they are fearing, such as in your situation. Anxiety disorders – and phobias in particular – are highly treatable. The most effective treatment for phobias is cognitive behavioural therapy, which involves two key elements: 1) challenging the irrational, fear-inducing thoughts associated with the feared stimulus and 2) behavioural strategies involving an approach called “systematic desensitization”. Very simply, phobias persist if we continue to (without any persuasive evidence) think that a particular stimulus is fear-inducing. There are two common faulty patterns of thinking that individuals engage in that feed a phobia: probability overestimation and catastrophic thinking. Individuals consistently overestimate the probability of the worst negative outcome occurring. For example, you likely (without knowing it) are overestimating the likelihood that, for example, the worst imagined outcome of a plane crashing would occur. Obtain accurate statistics on imagined worst case outcomes. Then, be aware of the automatic phobic thoughts you are having, and replace them with more accurate thoughts. So, if you have the thought “So many things could go wrong; the plane might crash and I could die”, replace it with the more accurate and valid thought “Although plane crashes can occur, they are very rare. The likelihood of a plane crashing is extremely low, much lower than me dying driving my car, and I don’t avoid that”. Individuals also tend to engage in catastrophic, exaggerated thoughts about outcomes. Instead of thinking things like “I could never, ever get on a plane – it would absolutely terrify me and I would lose it”, trying replacing the thought with something more accurate like “Although it may feel extremely difficult I – like tens of thousands of people a day – could get on a plane. I may feel extremely anxious but I would be able to eventually get through it. With practice and time it will get easier”. There is an important behavioural component to overcoming phobias. Systematic desensitization involves two components: learning relaxation strategies and implementing them as one gradually exposes themselves to the source of their phobia. So in your case: thinking about flying, then watching a plane on TV, talking about you on a plane, going to an airport, etc. You systematically expose yourself to situations that elicit more and more fear while using relaxation strategies throughout. Working with a psychologist who specializes in cognitive-behavioural therapy for anxiety disorders/phobias can be tremendously helpful, and there is good evidence that significant benefit will be obtained following 8-16 sessions of treatment. So – yes, with some dedicated effort you will be able to get over your fear. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I have a hard time meeting new people. Everyone else seems so outgoing, posting personal items on Facebook and chatting up strangers in bars. How do get myself out there and noticed? The answer: Meeting new people can be a challenge at the best of times, and it just gets harder with age. Be mindful, however, that your perceptions of the ease with which other people meet is likely a bit skewed. It’s a hard thing for many people. Consider your reference points, as what we find difficult can feel even more challenging if we (mis)perceive them to be easy for others. Facebook and other social media sites are, in many respects, an artificial form of communication. There are certainly many positives that come with these sites, such as staying in touch with friends and sharing photos. Unfortunately, new technologies are leading to societal shifts in which people tend to engage in less direct communication (face-to-face or phone) and more indirect, ostensibly distant communication (online messaging, texting). This can lead to a false sense of connection with others. Interestingly, recent research has found an inverse correlation between the number of Facebook “friends” adolescents had and the number of actual close relationships they reported having. So what you see on Facebook is not necessarily an accurate reflection of how social or outgoing someone is. Similarly, bars are not the best place to judge how confident others seem to be, as interactions there are often enhanced by the presence of alcohol. I’m not sure what wanting to get “out there and noticed” means. Do you want to meet more acquaintances or friends? Do you want to meet people you can go to social events and activities with? Do you want to meet potential dating partners? Articulate and write down specifically what you want. Then determine ways to achieve your end goal. For example, if your goal is “having a running partner”, your list of actions may include “join a running club” or “strike up a conversation with runners I see frequently at the local track”. Identify the barriers that you have in talking to others. Do you feel insecure? Do you get shy and clam up? Do you have difficulty knowing how and when to start a conversation? If shyness or anxiety plays a role, I would suggest getting The Shyness and Social Anxiety Workbook: Proven, Step-by-Step Techniques for Overcoming Your Fears by Martin Antony and Richard Swinson, which is an excellent, evidence-based workbook with strategies to manage social anxiety. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I love my boyfriend very much, he is warm, loving and giving. However, when I imagine my life five years from now I have a hard time seeing him in it. We come from different academic backgrounds – I have a B.A. and a college certificate, he never finished college. I want to get married and have kids, and while he says he wants to, he only very recently starting saving. Sometimes I feel I’m being snobbish or not giving him enough time to change. After a three-year relationship, I don’t know whether to wait this out or to leave. This has consumed my thoughts for four months and is making me so anxious I almost have panic attacks. What should I do? The answer: The amount of distress you are feeling about whether or not to continue your relationship – and the fact that you are even questioning whether you see him in your future – is the biggest sign you have about what to do next. Fleeting doubts and questions about long-term compatibility are very normal and come and go even in long-term, solid relationships. Pervasive and significant doubts that last months or longer are not. Often, our emotional reactions provide us with useful information about our circumstances, even before we can verbally articulate what those reasons are. You are likely reacting to a number of factors, and you know at a gut level that the relationship, for a range of reasons, is not the best fit for you. You need to trust this reaction. All too often we go through life ignoring our intuition – despite the fact that it often tells us what we need to know. Think about the significant decisions in your life so far, with a particular focus on regrets you have or mistakes you made. Likely, your intuition almost always gave you a sign as to what to do, but you ignored it. There are clearly a number of very positive attributes about your boyfriend that you admire. However, the reality of long-term relationship success is that there often needs to be compatibility at a number of levels such as personality, interests, and finances. Are these differences that the two of you could potentially work through? Yes, of course. However, forcing the issue and trying to work hard at accepting fundamental differences between the two of you isn’t necessarily the best way to move forward given the extent of doubts you already have. You are clearly torn about what to do, and not yet ready to let go. Given this, the next step for you – both for peace of mind, and to do justice to the three years you have spent together – is to have some candid conversations. You will need to balance being respectful with being straightforward – for example, rather than specifically outlining the differences in education (which may feel very hurtful to him) you may say that you worry your personalities and career interests are very different. These conversations will likely be heart-wrenching, but it is what you need to do. Keep in mind that it is possible to have love for another person without being in love with them and spending your life together. And, it will be much less painful to end the relationship now, rather than down the road if you were married and/or had children. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
New Year’s always makes me anxious. All this talk of resolutions, starting fresh and getting everything done – why? Between problems with my marriage, children and work, I know I have a lot to figure out – but New Year’s just gives everyone I know a chance to ask insensitive questions about how am I going to change things in the next 365 days. How do I make it stop? The answer: Any time we have a strong emotional reaction to a situation, we should ask ourselves two key questions: Is my reaction accurate, realistic or appropriate given the situation? And if the intensity of the reaction seems mismatched to the situation, what is it that I am truly reacting to? The tradition of making New Year’s resolutions is a common one across the world. The new year, for many people across cultures and societies, represents a new start and new beginning. Virtually all people have rituals and traditions to celebrate the onset of a new year. So why has the tradition of resolutions been adopted and why has it stuck in so many parts of the world? What resolutions provide are an opportunity to reflect on the past and think about improvements one wants to make to their life. They symbolize a commitment to achieve personal goals, complete projects or break bad habits. Time and time again, the most common resolutions relate to diet, weight, smoking or substance use. Are resolutions themselves indicative of anything? If you look at the statistics, the answer is no. I came across one study that indicated 94 per cent of people forget what their resolution is by July! So why do people continue to make them? I think it really comes down to a light and fun tradition that ultimately reflects our wishes and hopes for positive future changes. I believe that all of us are fundamentally works in progress, and an important part of our personal journey involves identifying – and makes changes to – areas of our lives we are less than satisfied with. Your reaction, however, seems to represent something starkly different from a light, fun way to reflect on change. You indicate you have problems in important parts of your life, that you have a lot to figure out. Your perception of insensitivity seems to be a projection of the dissatisfaction you have with your life more than anything else. I would encourage you to spend some time thinking about why you are having such an intense reaction. It sounds like you are frustrated with life situations you may feel you have little to no control over. Ask yourself what changes you may want to make in your life, and what your perceived barriers are to making those changes. Maybe you aren’t in a position where you are able or wanting to make the changes you need, which is a perfectly acceptable. However, your dissatisfaction has very little to do with the question-askers. The answer to your question of how to make it stop is a simple one: You can’t stop others’ questions. Period. You can, however, abort the conversation with a simple, lightly delivered line: “I don’t believe in making New Year’s resolutions. What are yours?” Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I’m dreading seeing certain members of my family over the holidays. I wish I enjoyed spending time with them more but I end up feeling tense and uncomfortable. How can I make the best of it? The answer: You are not alone: The holidays are one of the most stressful times of the year for many people. Most of us are trying to do too much in too little time at this time of year. December and January are months where we incur the highest amounts of debt. The dark and dreary days negatively impact mood for many people and can compound existing stressors. Add to the mix the fact this is one of the only times of year that we are thrown together with our relatives – whether we like them are not – and you have a perfect recipe for stress! There are a number of things you can do to make the holidays go more smoothly:
Finally, try to find what humour you can in your family situation. Remind yourself that the season will soon be over, and you will get through it like you do every year. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My 12-year-old still believes in Santa. It’s embarrassing, but he’s still so hopeful and it’s endearing. I feel responsible. How do I tell him without crushing his spirit? The answer: The short answer? Tell him the truth. The longer answer is that, for me, one of the most amazing things about children is the innocence and enthusiasm of their beliefs. Parents can feel heartbroken, shattering these beliefs with the reality of life – particularly when they have such awe about the wonders of the world. However, this is a part of raising a child and preparing them for the real world. Remember that children can be cruel, and given that he is of an age where the majority of kids know and accept that Santa does not exist – let him know sooner rather than later so that he is not unnecessarily teased. Keep in mind that our modern day Santa has several core roots, including Saint Nicholas who was a historical saint and bishop from the 4th Century. So, there is in fact a historic Santa that does exist – just not the way your son (and most other children) believe. This is important to communicate to him when you break the news – so that he does not feel that he has been told a completely fabricated piece of information. See this as a teaching opportunity. You can introduce the topic by telling your child of Saint Nicholas and how he was recognized and admired for his secret gift-giving. You can talk about the value behind unconditional giving to those that are less fortunate and in need. And then you can gently let your son know that there are actually many “Santa-type” people in the world – that care for and give to others, such as parents, grandparents and other loved ones. Depending on his intellectual maturity, you can describe to him that the Santa portrayed in the media and in the public is a metaphor for or a symbol of those that give. And ultimately you can let him know that it is you, not the big man in red, who provides him with gifts. He may get upset or tearful. He may ask you why you have lied – and you should be honest. State that this is part of the tradition of Christmas, it is part of what makes Christmas fun, and that virtually all other kids (and likely you, at one point) believe in Santa. Remember – parents have been breaking the news that Santa really doesn’t exist for decades, and will continue to do so with no evidence of any long term damage to kids. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My mom is a terrified driver. She’ll stop in the middle of an intersection, paralyzed by fear. She’s recently been involved in a few traffic accidents, although none of these were her fault. She recently ended a 30-year marriage. Are these incidents related? I’m afraid to criticize but I’m concerned for her safety. The answer: Driving-related fears and phobias can be attributed to a number of causes. Some people are just naturally more nervous drivers – individuals who don’t drive often, older adults, and those who have moved from smaller communities to higher traffic-populated areas tend to be less comfortable behind the wheel. It sounds as though you have noticed some recent changes in your mother’s driving behaviour, both in terms of her fear (which I’m imagining she has told you about or you have witnessed directly) and also a higher than average number of accidents over the last short while. Even though the accidents were not her fault, there could be the possibility that she is engaging in less defensive driving behaviours which may indirectly have increased the likelihood of her being in several accidents in a short period of time. If she has recently ended a 30-year marriage she is likely under a higher than average level of stress (even if she chose to end the marriage) and it may be that her elevated stress is manifesting in her driving behaviour. When there is an increase in our baseline level of stress, we tend to have amplification of already existing fears or anxieties. For example, it could be that she was always a slightly nervous driver but the increased stress has now contributed to tipping that nervousness into more concerning fears. Being in a number of accidents over a short while can in and of itself lead to an increased fear of driving, which may from the outside look out of proportion to the severity of accidents that occurred. A number of factors can contribute to quite significant driving-related phobias developing from even minor accidents. Some of the factors include previous number of accidents, physical/emotional health history, other existing stressors, and the nature and circumstances of the accident. Finally, it is important to keep in mind that other changes in her physical or cognitive health status may be influencing her driving-related fears and behaviours. Health conditions that in particular impact one’s cognitive processes or eyesight (e.g., cataracts, stroke, early onset dementia) can also play a role. I can appreciate the concern about not wanting to criticize, but given the safety risks (both to your mother and to other drivers) this is something you need to bring up with her. Take a non-accusatory approach with her. Explicitly state that you don’t want to come across at all critical, but that you have concerns about her safety and have been worried about her recent accidents. Make sure you emphasize that you know they were not her fault, but that you are concerned nonetheless. Be specific and objective about the concerns you have (i.e. give specific examples that lead you to say she is “terrified” or “paralyzed by fear”). Offer to go to her family physician with her. This can be helpful to ensure she has had an examination of her physical function, including eyesight. If it seems that stress-related causes are the sole cause of her fear, the most effective treatment is cognitive-behavioural treatment (which focuses on addressing anxiety-related thoughts and behavioural responses to these thoughts). Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My teen daughter is fat. She’s way over her normal BMI, and I’ve tried talking to her – politely – and asking if she wants to go to the gym together, or work out a healthy meal plan. It just seems to make it worse – she eats way more after our talks. What can I do? The answer: There are two main things you need to consider: the factors that contribute to your daughter’s current weight and the manner in which your concerns have been communicated to her. You say that your daughter is “way over” her normal Body Mass Index (BMI). I will assume that she falls close to or within the “obese” range. By definition, obesity is a medical condition where amount of body fat may adversely and significantly impact health, including increasing the likelihood that one will develop a range of serious health conditions and contributing to shortened life expectancy. For these reasons, expressing your concern and trying to improve your daughter’s health is important. Try to support her to make some changes. For all of us, our weight is the result of many factors – including those that are out of our control (e.g., genetic predisposition) as well as factors that are controllable (e.g., eating habits, exercise/activity levels). Unidentified or untreated health conditions (e.g., thyroid dysfunction) may also play a role. For this latter reason, ensure your daughter has had a recent medical examination. Unfortunately there is considerable stigma in our society regarding weight issues. I wonder to what extent your daughter has dealt with teasing or negative attitudes from family, friends, and kids at school. This could likely be contributing significantly to her feelings of low confidence and self-esteem, including feelings of shame and even low mood or depression. Your daughter may feel hopeless – particularly when kids deal with obesity from a young age, they may develop strongly ingrained beliefs that nothing they do will be effective in terms of changing their situation. You indicate that your daughter eats “way more” after your talks. Many individuals (even those that do not struggle with obesity) engage in emotionally-driven eating and this leads me to think she is likely becoming highly stressed after your conversations. Think about how you are approaching these conversations: it is important to remain non-judgmental, non-accusatory and supportive in your verbal and non-verbal communication. Express to her genuinely why you are concerned about her weight rather than telling her what to do (as this may come across as lecturing and critical). Ask her what her goals for weight/food/exercise are, and if there are ways that you can support her goals. The reality is she may find it too difficult to speak openly to you given history. Offer to help her find a professional (family doctor, dietitian, nutritionist, psychologist) with whom she could speak to openly and confidentially. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
Almost three years ago my partner committed suicide. He suffered from depression. We were only dating for a year, but I find his death still gets to me. It’s especially difficult now for me to date people. I used to be a very patient, happy, joking person. Since it happened, I feel as though it’s a charade I’m putting on so my friends and family don’t notice the change. How can I move on? The answer: The death of someone we love is one of the most difficult life experiences we will ever face . As a society, we are terrible at dealing with and talking about death. We are never taught in schools what to say to someone who loses a loved one, despite the fact that all of us will, at some point in our lives, have to deal with the inevitable losses of those we care about. Dealing with a death that occurs from suicide only adds more layers of complexity, confusion and, in some cases, self-blame that further amplifies what is often a difficult recovery to begin with. Those that are closest to someone who dies by suicide (partners, parents, children) are left with the biggest burden to carry. They are often left with myriad emotions: sadness, guilt, anger. Recreating past conversations, thinking you could have done or said something differently, questioning why you weren’t ‘enough’ for the person to not take their life – all are common thoughts for survivors. Unfortunately so much misinformation, stigma and shame continues to be associated with suicide, making it even more difficult for your support system to know what to do or say, which then further prolongs the grieving process for survivors who are struggling to make sense of the nonsensical. I’ve lost both an aunt and a cousin to suicide – and one of the things that stood out to me so strongly was how uncomfortable so many people were about their deaths. Friends and family that I knew to be caring and otherwise articulate stumbled through awkward conversations. Some avoided the topic altogether, others became visibly distressed, and others made well-meaning comments that were ultimately unhelpful. These are common themes I have heard again and again from patients and friends who have been affected by suicide. When we talk about “moving on” or “getting over” a loss, what we really mean to do is find effective ways to cope. This includes maintaining positive memories and thoughts of your partner, while still getting back to all of the elements that make life worth living – which, in your case, includes dating. It makes absolute sense that it’s difficult for you to date – you are in a self-protective mode, not wanting to make yourself vulnerable to another potential loss. There is no magic formula for how long or what the grief and recovery process looks like, as it is so individual. There is one thing I can say with certainty, however: Not processing your loss – having to present a facade to those that are close to you – will only prolong the ordeal. I would start by opening yourself up to the idea of speaking about your loss, as there is so much therapeutic value in simply talking through the thoughts and emotions you’ll have inevitably bottled up. Consider approaching those closest you: Tell them you don’t need them to say anything, that you just want to talk through what’s in your head. If you feel reticent to approach those you know, I would strongly suggest seeking the support of a psychologist or other registered mental health/grief professional that has expertise in suicide to help you move on. I would also seek support online. Some recommended websites are www.suicide.org, www.survivorsofsuicide.com and www.allianceofhope.org. Have faith that with time and with the support of someone you trust, you will be able to move forward in your life. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I’m in my early 30s and I do want kids – eventually, just not now. I just don’t feel ready, yet as a woman I know the clock’s ticking. How do I prepare myself for what I imagine will be a sea of change in my life? The answer: The short answer? There is no way to fully prepare (ever) for the changes children bring! Now, for the longer answer … Our societal demographics are changing substantively, particularly for women. More women are pursuing higher levels of education. They are putting off co-habitating with partners or getting married (or remaining single by choice). An increasing number are becoming the primary household breadwinners. They are waiting longer to have children, and many are choosing to not have kids at all. As a woman in your early 30s, it is good to hear you recognize that on one hand you realize you aren’t quite ready for kids, yet on the other hand understand that there are some biological considerations you need to be mindful of. Unfortunately, the plethora of images we see in the media, particularly of celebrities who are having children well into their 40s, leads many to have a false perception of the ease with which a woman can get pregnant as she ages. The reality is that fertility starts to decrease as a woman moves into her mid to late 30s. The risk of pregnancy complications and health issues (both for mom and baby) also rise. While it’s true that many women can easily get pregnant and carry the baby healthy to term even well into their 40s, a significant number do struggle and encounter fertility or pregnancy-related difficulties as they age. The question of how to prepare oneself for the significant life changes that come along with having a child (or children) is one I am often asked. The reality is this is almost impossible to do. If you were to ask any parent this question, he or she would tell you the same thing. However, there are a number of life situations you can think about in order to prepare. Are you in a stable, respectful, loving relationship? Having a child to either “save” a failing relationship or in spite of significant relationship issues because of the perceived pressures of the proverbial clock ticking is almost always a bad idea. Are you in a secure position financially? Can you manage the increasing financial demands a child or children will place on you? Designing a baby budget is a great idea to gauge your position in this regard. Do you feel like there are dreams you have that are immensely important to you that you want to achieve before having a child (e.g., backpacking across Europe for a few months)? If so, plan this into your life. Are you willing to accept that for a fair number of years your primary focus in life will shift significantly and you will have no choice but to sacrifice most things in your life for children? When you think about not being ready, what does that mean to you? Put pen to paper and try to articulate in clear, specific words what your fears are. This may help identify how to best move forward. There is no rule book that can help you prepare for the myriad changes children bring to your lifestyle, and at some point you need to weigh the pros and cons and take a leap of faith. Working toward creating a stable life circumstance with respect to relationship, finances and emotional health is the best thing you can do to prepare. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. |
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