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By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I keep having work dreams. Or should I say, nightmares. How can I make them stop? The answer: Ah, the dreaded workmare. Unfortunately, I have no magic wand to make work-related nightmares stop. The key is to first understand what factors contribute to the types of dreams we all have, as well as the function they serve. The next step is to then work to alleviate the causal factors. Scientific understanding about dreams and their associated meaning is, on the whole, pretty poor. What we do know is that our most vivid and memorable dreams occur during our deepest stage of sleep, known as the REM (rapid eye movement) stage. We also know that there are differences from person to person on how much we dream, or whether we even recall our dreams. The frequency and content of our dreams can be influenced by factors such as what we have eaten on a given day, how much alcohol we have drunk and myriad other physiological factors (for example, nightmares can be a side effect of some medications). We also know – most importantly – that our day to-day life situations have a significant impact on the content and intensity of our dreams. Stressful and, in extreme cases, traumatic life situations are among the most significant psychosocial factors that affect our dreams. Studies that have examined dream content show that we tend to have and recall more negative dreams than positive ones, with the underlying theory being that there is an adaptive function to have threatening dreams. Namely, having nightmares can help us to simulate actual or perceived threatening situations in a safe environment, allowing us to be more psychologically and cognitively prepared for the threats when they come up in life. Pay attention to what stresses you at work but also in your personal life. High levels of stress, as well as perceptions that we are in situations that are unpredictable and over which we have little control, can play a role. Make a list of all the significant stressors in your life. Order these from most stressful to least. Then ask yourself the following questions: Do I have any control over this stressor? What specific action can I realistically take that may help alleviate my stress? Then make an action plan to reduce the stressors over which you have some control. Stress builds when we become passive and immobilized, and taking some action (even if it’s not the “perfect” one) can help tremendously. In addition, having a consistent pre-sleep ritual can help to reduce the intensity and frequency of your nightmares. First, minimize talking or thinking about stressful situations right before bed. Relaxation or meditation strategies can help to slow down both your mind and body. Have a warm bath or listen to soothing music to distract your mind. Avoid reading books or watching TV or movies with upsetting content. If you are woken by a nightmare, get out of bed (staying there will help associate the nightmare with your bed). Do deep, diaphragmatic breathing for five to 10 minutes and then do something relaxing, such as having a warm glass of milk, before you get back into bed. 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 mother criticizes my weight every time I see her. I am overweight, but am well aware. Her comments do not help! How can I deal with her? The answer: Our relationship with our mother can be one of the most complex bonds we have. When the relationship is strong, positive and loving it can be a source of tremendous happiness and validation. When the relationship (or elements of the relationship) are less than ideal it can be a source of sadness, anxiety or even anger. As children, we are of course reliant on our parental figures for food, caretaking, safety and security. As we become older and independent, we no longer rely on our parents for these basic needs. Despite this, our need for acceptance and validation often remains strong, even as adult children. As such it can often be difficult to speak directly or assertively to our mothers about difficult topics. A certain amount of “motherly critique” is a normal part of the mother/child relationship. However, repeat criticisms about weight are both unhelpful and disrespectful, and can be damaging to your self-esteem and confidence. The best advice is to address your mother’s criticisms directly and assertively. Let your mother know that her comments are unhelpful, unnecessary and hurtful. Clearly let her know that you would like her to stop making these comments. Respectfully state the consequences if her statements don’t stop. For example, you could let her know that you need to end your visit with her if she begins to criticize you unfairly. The difficult (but important) part will be for you to follow through with the consequences if her behaviour does not change. Here are some tips for speaking with your mother in an assertive way: – Clearly describe the statements she makes that you find hurtful. Be objective, specific, and avoid being judgmental or criticizing her back. – Express how her statements impact you. Don’t assume that she will necessarily understand what the effect has been on you until you tell her. – Directly state what you need to see in terms of her behaviour change. Tell her clearly that you would like her to stop making comments about your weight. – Assert the consequences if her behaviour does not stop. – Express how much you value your relationship with her, and let her know that you are hopeful that things can continue to improve between the two of you. Remember to be clear, direct and do not make any apologies for establishing boundaries in your relationship with her. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  What is suicidal ideation? The signs one may be thinking about suicide
Suicidal ideation means thinking about or planning suicide or wanting to take your own life. This includes all thoughts from fleeting consideration to detailed planning. If you are thinking about suicide, you are not alone. Many people have thoughts of suicide for a number of reasons and the reasoning behind suicidal thoughts is not wrong. You may feel hopeless and think that nothing can be done to change the situation, but know that having these thoughts does not mean you are weak, or ‘crazy’. Often people think about suicide as a means of escape from their feelings, so just because you are thinking about suicide does not mean that you will act on those thoughts. Due to the stigma attached to mental health and suicidal ideation, those who experience these thoughts often feel as though they need to hide them from the people around them. Know that connecting to others when we are having these thoughts is extremely important and talking about mental health breaks down the stigma. Warning Signs of Suicidal Ideation Warning signs that you or a loved one may be thinking about suicide:
Causes of suicidal ideation Many people might think suicidal thoughts are attached to mental illnesses like depression or bipolar disorder but there are many causes of suicidal thoughts, some of which are circumstantial. As mentioned previously, suicidal thoughts often accompany thoughts of hopelessness, feeling out of control in life and/or feeling purposelessness. The circumstances that often cause these thoughts are relationship problems, trauma, substance use, a crisis of some sort, the pressure at work, a physical health issue, or financial difficulties. Taking Action If you are worried a loved one is thinking about suicide, ask. Asking will not make someone consider suicide if they weren’t already. If you are feeling suicidal, reach out for help. Know suicidal thoughts are common when one is feeling overwhelmed and hopeless, and when there seems to be no way out – but also know those suicidal thoughts won’t last forever, and that help exists. If you or someone you love is at immediate risk of suicide, call 9-1-1. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I’m afraid of swallowing pills. The size and shape of the pills makes no difference; I either crush pills into food or some other suspension, or avoid taking them altogether. The avoidance strategies I have tended to use are getting harder to manage as I get older. What can I do? The answer: Dysphagia – or difficulties with swallowing – can be related to a range of causes including fear, pain, or some other cognitive, anatomical or physiological problem. Fear and avoidance of swallowing pills is not an uncommon source of anxiety for people. Although it seems like a very simple and easy task to do, many adults and children will struggle with swallowing pills. The gag reflex is a very powerful – and in true danger situations, a biologically adaptive – reflex. Even having one past experience where you felt as though you were going to gag/choke can reinforce that fear. Assuming that there is no physiological basis for your difficulties and that the cause is fully psychological, there are some effective strategies to manage your symptoms: 1. Work on relaxation strategies. The fear of swallowing pills (even in the absence of any physiological problem) can lead to the throat tightening up. Learning relaxation strategies can be very helpful, as reducing your overall level of body tension (and also specifically working on relaxing the throat muscles) can help to lessen the automatic response you get when swallowing. Deep breathing and progressive muscle relaxation skills practiced in the minutes before swallowing a pill can be very helpful. 2. Target your fears/thoughts about gagging/choking. You likely have a number of automatic thoughts related to gagging/choking that contribute to your fear, such as: “I can’t swallow pills”, “I’ll never be able to do this”, “I hate this”, “I will choke”. Increase your awareness to inaccurate/catastrophic thoughts and actively replace them with more realistic thoughts (e.g., “I don’t like swallowing pills, but my doctor has told me there is no physical reason I can’t, and it’s never as awful as I think it will be”). 3. Visualize success. Picture yourself calmly and easily swallowing the pill. Repeatedly visualizing success can have a very real beneficial impact. 4. Gradually build up your tolerance. Teaching yourself to swallow pills is like building up any other skill: you need to gradually build up your tolerance. Start with very small-sized “simulation pills” and gradually build up the size. Be creative here (e.g., using sprinkles, tic tacs). You want to of course ensure you are only practicing with digestible food that won’t cause any health problems (talk to a doctor if you are unsure). 5. Practice, practice, practice! Avoidance of things we fear counter-intuitively increases our fear of those things. So, you need to practice a lot, and not avoid swallowing pills! It can be helpful when you are first building up your tolerance to swallow the pills when someone is around you (e.g., if your worry is about choking). Many people also find eating some food immediately afterward can help with lessening the unpleasant sensation/taste of swallowing the pill. Drink a lot of water before and after (cool or room-temperature) and take the pill during a time of day when you feel more relaxed and can dedicate some time to implementing your relaxation and realistic thought-replacement strategies. Note: It would be important to ensure you do speak to your family physician about this to first rule out whether there is any other contribution, as dysphagia is more common in older adults and could be possibly related to some change in muscle or nerve function. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. |
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