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By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  Recognizing that you are having emotional difficulties can be challenging to admit, but it’s the first step to getting effective treatment. So, good for you for getting there, but figuring out how to get the help you need can be another daunting step as there are so many different types of mental health professionals.
Psychologist vs Psychiatrist Psychologists and psychiatrists are both mental health specialists with expertise in assessing and treating emotional issues. They have approximately the same number of years of formal training. While there are some similarities between psychology and psychiatry, there are also some important differences in their type of training, focus and treatment approaches. We will address each of these topics below. Training
Focus
Treatment and Referral Process
Psychologists and psychiatrists have their own areas of expertise. Some individuals are matched with one or the other and see results, but you may also benefit from seeing both who work together to support you. Speak to your family physician to get some advice and guidance on who can best help you. Your provincial psychological association can also assist with answering questions about how to find a psychologist best suited to your needs. Editor’s Note: This post was originally published as part of a Globe and Mail “Ask the Psychologist” column authored by Dr. Samra, and has been edited and updated. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I have a 17-year-old son who suffers from autism. It can be difficult at times. When he eats, he can unexpectedly start acting up and make awful sounds. He will randomly pick up and turn things over. You can give him instructions as a parent and he decides not to move an inch. I love him, but I find myself struggling not to be angry at him for his worst actions. How can I find ways to cope with behaviour that I understand he may not be able to control? The answer: Raising a child with a pervasive developmental disorder can be one of the most personally taxing and challenging life situations a parent can find themselves in. First and foremost, you need to be gentle with yourself – you are only human, and feeling upset or even angry toward your son is a natural reaction that most parents with a special-needs child will experience. Most parents, however, feel reluctant to verbalize their negative feelings due to fear that they will be reprimanded or judged by others; suppressing these feelings will do nothing but amplify them over time. What’s important is that you get the support you need as you deal with the daily challenges of parenting your son, while of course remaining mindful of not inappropriately displaying your frustration to your son. Autism spectrum disorder (ASD) has the hallmark feature of impaired social interaction and is characterized by impairments in communication and repetitive, stereotyped behavioural patterns. Although there is no “cure” in the traditional sense for autism, symptoms often improve with age and treatment, with Applied Behavioural Analysis (ABA, a skill-oriented behavioural intervention that is highly structured and intensive) being the most strongly supported by research. This would be an avenue I would suggest exploring if you have not already. It’s important to keep in mind that repetitive or perseverative behaviours are not unique to individuals with autism; particularly when under stressors, many people will engage in some element of repetitive behaviours (e.g., nail biting, pacing, obsessive cleaning). Given your son’s age, I would guess you have spent countless hours over the years trying to understand and manage as best as you can your son’s behaviours. Over time, however, and given the number of years your family has been dealing with his autism, it’s natural to lose objectivity in understanding patterns that may exist, and there may be value in revisiting this. Specifically, pay attention to the days when the repetitive/perseverative behaviours are less frequent: What elements that occurred earlier in the day – and particularly in the hours leading up to mealtime – could account for this? Try to replicate the elements that seem to be associated with a reduction in his repetitive behaviours, and reduce or eliminate those that seem to play a role in exacerbating his symptoms. Most importantly, actively work to manage other stressors in your life that you do have control over. Pay attention to the usual factors that may reduce our threshold for stress; get adequate amounts of sleep, regularly exercise, eat healthy and minimize alcohol use. You can also join a support group in your community where you can get the emotional and logistical support that other parents with autistic children can offer. And make sure you schedule some “non-parenting time.” Don’t be shy to ask for help from your partner or family members, or you can implement external caretaking support if you are financially in a position to do so. Take the time away from parenting to do things that you enjoy: Meet a friend, go for a run, watch a movie – anything that provides you with much-needed relief from your responsibilities, for a little while. 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: There’s a group of us who hang out, and we are pretty sure that one of our friends is gay. We don’t care, we just wish he wouldn’t hide it if that’s the case. Should we ask him outright? The answer: Coming out is a deeply personal process that can be immensely difficult and challenging. I’m happy to hear that among your group, your friend’s sexuality is irrelevant (in a good way) and a non-issue when it comes to how you view him. It sounds like you will accept and support him when he does choose to come out. Whether you should ask him outright is a tricky issue. On one hand, there’s something to be said for communicating to him that you accept him regardless of his sexuality. However, you need to balance that openness with the need to not put him in a position where he’s forced to come out when he’s not ready. Asking him outright may put him in awkward position, and you need to respect that he will come out when he feels he is personally ready to do so. He may also feel that it’s important that he first comes out to certain people in his life – like his family – before anyone else, even your group of friends. Consider the myriad challenges your friend may be facing. He may be going through the personal challenge of accepting his own sexuality before he comes out to others. He may be unsure how to tell those close to him. He may not be sure what reaction he will get from family and friends – those that he cares about and whose opinions matter to him. The best thing you and your friends can do is ensure that you are mindful of actions that may inadvertently create an unsupportive environment. Pay attention to the language you use and the jokes you make. It often stuns me how frequently people, just in day-to-day conversation, with no malicious intent, use words that can alienate someone who is gay. Also, take some time to learn more about the experiences people have when they first come out, so you can better understand what your friend may be going through. PFLAG Canada has links to a range of resources and support agencies that you may find helpful. Pay attention to your friend’s behaviour: It may be indirect communication he is giving about his sexuality. Think about your responses to him. Not uncommonly, people “test the waters” with those close to them before they come out, by observing how people react to seemingly neutral situations or stories. Whenever the opportunity arises, let your friend know what he means to you and what qualities you value in him. If it is appropriate and not awkward, try to convey that you would accept him no matter what. When he does come out, offer to support him however you best can in coming out to other friends, family or coworkers. And, most importantly, let him know how you feel – which is that his sexuality makes no difference to how you view him and your friendship. 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 best friend is getting a divorce – and I’m ecstatic. His husband never treated him properly, and I think it’s long overdue. Do I have to act sad because my friend is? I’m trying to enforce the silver lining, but maybe I should just pretend to be devastated? The answer: The strongest friendships are based on a number of core elements: love, respect, trust, unconditional support and acceptance, and honesty. It sounds like you are struggling with knowing how to achieve a good balance between these different components of your friendship, all of which you value. On one hand, you are happy (and I suspect relieved) that your best friend is ending his relationship due to genuine concerns that you have had about him not being treated well. Your heart is in the right place here. You are making efforts to have him see the positive in the situation, which can help him to remain optimistic and hopeful despite his difficult current situation. On the other hand, you’re likely worried that your real feelings may not be perceived by your friend as supportive. Acting disingenuous never works out well in our close relationships. Inevitably our true feelings will come out, and there can be a negative impact on a relationship that can be difficult to repair. That said, you have to be sensitive and empathic to what your friend is going through. The most important thing right now is that you are the most supportive friend that you can be. Bite your tongue slightly on your true feelings (e.g., saying you feel “ecstatic” likely will not serve any useful supportive function, may come across as hurtful, and may be interpreted by your friend as a “I told you so” type of response). But you do not need to completely “act” in a way that is at odds with how you truly do feel (e.g., convey that you felt his husband did not treat him well). Your friend will likely read through any efforts you make to pretend that you feel otherwise and, as you are best friends, I would guess your friend already has a sense of how you feel about his situation. Ask your friend what he needs from you: tell him you love him, that you want to be supportive, and that you want to know what you can do that best help him. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. |
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