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Giving Honest Advice to a Friend About Their Relationship Difficulties

31/8/2023

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
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People often turn to their friends for support with difficulties in their romantic relationship and bluntly ask for their opinion. Rarely, if ever, does any good come from providing candid opinions about others’ relationships – particularly when the stakes are high (if they’ve been together for a long time or have children, for example). Some of the difficult-category questions we receive may range from ‘do you like my partner’ to ‘should I stay with them’ or ‘do you think they are cheating?’.

The best general advice? Keep your unfiltered and unedited opinions to yourself. And if you feel tempted to do otherwise, rewind and repeat that mantra.

Brutal honesty is not always the best policy

When asked for a candid opinion from someone you care about, you want to be truthful. However, brutal honesty is not always the best policy, especially when there’s the potential to provide advice or input a friend may not be willing or open to receive.
Sometimes not providing our honest opinions can feel misleading or untruthful; however, if any of us went through life fully verbalizing the “bubble above our head,” it’s likely most of our relationships would end.

We make the best decisions for ourselves

Ultimately the people in a relationship are the ones that have to decide what to do next, and they are ultimately the only people who can come to a resolution about how their relationship should unfold.

So, when asked for advice in these types of situations your role is twofold: to provide friends support when they ask for it and help guide them toward making the best decision for themselves.

What are some ways we can approach situations where we are asked for our candid, unfiltered advice – and we know that advice is probably not what our friend wants to hear?
  • Listen to your friend’s concerns and ask them what is making them feel unsure. As a general rule, asking inquisitive probing questions is going to be a better and more helpful approach than giving your opinion.
  • Create a safe space where they can openly talk about their concerns – without worry about judgment or worry that you will share the conversation with others. Often, just listening and asking questions about their worries and fears can help someone to figure out a difficult situation for themselves.
  • Let them know that you will support them however you can, but that you are not in their shoes and that it’s not your place to tell them what to do. Let them know that you will support whatever decision they make. This is especially important if your friend is not yet ready to end their relationship, they may need to explicitly hear that you will support them in staying without judgment.
It’s important to qualify, however, that the only clear situation in which providing your candid thoughts would make sense is if your friend were in a situation where their physical or emotional safety or security was being jeopardized.

Remember, when it comes to other people’s relationships, good questions asked are better than candid opinions given!  

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.

Taking Medications for Sleep - Do They Work?

24/8/2023

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
Taking Medications for Sleep – Do They Work?

Do you struggle with sleep difficulties? Too much on your mind or too much on the go? This is a common problem in the fast-paced world we are living in. Many people are plagued with stress and worry thoughts that make it difficult to fall asleep. Have you used or considered using sleep medication to help you sleep? Many of us have because it seems like a simple and easy solution to our challenges. 

But are medications for sleep really a good solution?

Should you take sleeping pills?Sleep medication, both prescription and non-prescription, should only be used in conjunction with making lifestyle changes and should only be used intermittently, for a short duration of approximately 5-10 days.
 
More extended use leads to drug tolerance, dependence, withdrawal effects, side effects, and rebound insomnia (where sleep problems after medication cessation become worse than they were prior to taking medications). 


When taking sleep medications, it’s important to note that you should never mix them with alcohol, and you should always ensure you have allowed for at least 7-8 hours to sleep after taking medication, as it can affect your ability to function the next day.

What about melatonin? 

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I’m sure you’re thinking, ‘what about melatonin? It is natural isn’t it?’

Yes, melatonin is the key hormone that increases sleepiness. About 50% of people with sleep problems can benefit from up to 3mg of melatonin, taken 0.5 to 1.0 hours before bedtime.  

But, just because melatonin is a natural hormone doesn’t mean it should be used regularly. Melatonin can cause some side effects including:
  • headache
  • short-term feelings of depression
  • daytime sleepiness
  • dizziness
  • stomach cramps
  • irritability
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It can also interact with other medications. So, the answer to the question should you take sleeping pills? It should also be used sparingly and in conjunction with lifestyle changes, good sleep hygiene, and CBT.

Cognitive-behavioural treatment (CBT) is the most effective treatment for sleep problems, as well as associated mood and worry or anxiety issues, all of which commonly impact our ability to sleep. It may also be helpful to talk to your family physician to ensure there are no other underlying issues that may be impacting your sleep. 

If you’re still struggling with sleep difficulties, sign up for a video consultation with a counsellor at the Psychological Health and Safety Clinic.

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Do I have obsessive-complusive disorder?

17/8/2023

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
The question:

I have recently started checking and rechecking certain things, such as making sure that I’ve turned off the stove or locked the door, sometimes four or five times. Is this normal?

The answer:

Virtually all behaviours – obsessive and compulsive behaviours included – exist on a continuum of severity level, and most people will experience mild forms of most “psychological” symptoms at some point in their life.
 
Checking and rechecking behaviours are very common, and not necessarily of concern unless they take up a significant period of your time, get in the way of you being able to do other things in your life, and create ongoing distress or anxiety.
 
Only about 2 per cent of the adult population will experience clinical levels of these symptoms that would constitute a diagnosis of obsessive-compulsive disorder (OCD). True OCD has some very clear markers. First, there are persistent, repetitive and intrusive/interfering thoughts (obsessions), behaviours (compulsions) or both.
 
  • Obsessions include thoughts, urges or visual images that are much more extreme than simple worries about real life problems. Individuals will try very hard to ignore or suppress these thoughts as they create significant anxiety or distress. Common obsessions include: fears of contamination, bodily germs or uncleanliness; sexual-related obsessions; fears of becoming violent or aggressive; and obsessions about exactness/precision.
  • Compulsions are repetitive behaviours or actions, and may include mental acts that a person feels driven to engage in due to some obsession or other rigid rule. Common compulsions include: checking; ordering things; hand-washing; praying; counting; and silently repeating words or numbers.
  • Symptoms of OCD cause significant disruption in a person’s daily life. They affect one’s quality of life, they interfere with one’s ability to carry out other regular responsibilities (e.g., work, parenting), and they take up an hour or more of one’s day. The obsessions and compulsions feel excessive or inappropriate, and create significant distress and anxiety.
  • Experiencing periods of recurring thoughts or behaviours – such as the compulsion of checking/rechecking that you are describing – is very common and completely normal. Often, these behaviours will increase during times of high stress or pressure, and will usually naturally resolve within a few weeks or months.
 
Try to identify other stressors in your life at the current time, and work to resolve those. It can also be very helpful to actively set limits on the number of times you check or re-check (e.g., setting a maximum limit of 2 or 3 times) as this can effectively reduce the behaviour.
 
If you find your symptoms may meet criteria for a diagnosis of OCD, speak to a family doctor, psychologist or psychiatrist. There are very effective treatments for OCD.
 
For most, a combination of cognitive-behavioural therapy (incorporating a treatment approach called “exposure/response prevention”) and medication treatment can lead to very positive improvements in symptoms.

​Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail.

4 Ways to Manage the Physical Symptoms of Stress

10/8/2023

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
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Stress is a common and normal – and something we all experience on a day-to-day or certainly week-to-week basis. It’s our body’s innate defense mechanism against a perceived threat or danger. Our stress response – also known as the fight, flight, or freeze response – can be brought on by anything, such as change, an argument we had with our partner, or an upcoming work deadline that we need to meet. 

While the way we experience and manage stress varies between individuals, stress can usually have both positive and negative effects. When it’s short in duration, it can keep us focused and motivated. But when we’re in a heightened state of arousal for a long period of time, stress can be harmful to our emotional and physical well-being.

The connection between our physical & mental health

Medicine – and society in general, for that matter – are increasingly recognizing the intertwined nature of our physical and emotional health. Gone are the beliefs of traditional medicine that purported that we could somehow separate our physical state from our psychological, emotional, and spiritual well-being.
 
The experience of stress manifesting itself as physical symptoms is a common one: Most people who are dealing with chronic stressors experience some impact on how they feel physically. 
 
Research demonstrates the comorbidity rate between physical and emotional health conditions (those with psychological conditions who will also experience impairing physical symptoms) to be as high as 80 per cent, and vice-versa.

How we experience stress

The way our stress reveals itself depends on myriad factors, including our childhood history; personality and genetic predispositions; how we observed our parents dealing with stress; and whether or not overt emotional displays were viewed as ‘acceptable’ ways to communicate stress in our family.
 
Individual differences exist in the degree and intensity to which emotional issues manifest physically, but the most common physical symptoms are stomach/gastrointestinal problems (tension, nausea, constipation, diarrhea), pain (headaches, back pain, chest tightness), appetite changes and sleep problems.
 
What can we do about it?

So how can we effectively manage stress when the physical symptoms become distressing and potentially damaging? A good first step is to consult with your medical doctor. They can offer objective input into the contributors of your physical symptoms and ensure that nothing more serious is going on.

Next, get very structured and rigid about ‘the usual suspects’ – sleep, diet, and exercise. Aim for a minimum of 7 to 8 hours of sleep, ensure you are getting at least half an hour of movement in a few times a week, ensure you are eating healthy meals a few times a day (with an emphasis on plant-based and non-processed options), and reduce and ideally eliminate the use of substances, such as alcohol or smoking.
 
Another way to effectively manage stress is to incorporate deep breathing and mindful practice into your daily routine. Even just five minutes at a time, a few times a day, can be extremely helpful. If you need help getting started, or a refresher on these techniques, we put together two short videos on mindfulness and 4 stage breathing for guidance.
 
Finally, learn the basics of cognitive-behavioural therapy (CBT). CBT is an effective evidence-based stress-management approach, which helps you change unhelpful cognitions (thoughts, feelings, and beliefs) that contribute to your stress. CBT provides strategies for problem-solving to tackle primary stressors in your life (such as finances, relationships, or work-related challenges) and teaches behavioural strategies, like breathing and relaxation, to target the physiological manifestation of your stress.
 
Stress is no match for a healthy body and mind

Stress can be harmful to our physical and mental well-being when not managed accordingly. But with proper sleep, diet, exercise, and mindfulness and meditation practices, we ensure our body’s innate response is kept in check (and reserved for moments of real threat and danger!).
 
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.

Helping Someone Who’s a Workaholic

3/8/2023

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
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Is someone you care about working themselves so hard it may be damaging to their health? Maybe they aren’t just exhausted, but are starting to isolate themselves? Or they’re tired enough that they’re putting themselves at risk every time they drive home – many people don’t consider the fact that tiredness at the point of exhaustion is the same as impaired driving. Or, they may be engaging in unhealthy behaviours such as excessive drinking or overeating as a way to self-soothe or self-medicate.

When putting in a few too many hours becomes a problem

With overworking there are two major issues: The person’s decision to work an inordinate number of hours, and the resultant impacts on their health.
Keep in mind that the person’s decision to work the number of hours they are working may not be completely voluntary. There are a number of reasons a person may need to – or feel they need to – work these hours, some of which may include: high living expenses or debts, significant changes to life circumstances, working following a period of unemployment or preparing for retirement.

Have empathy & be kind

Whatever their reason, try to understand where they are coming from. It can feel awful to be in a position where you are uncertain about your future, particularly as we age. They are probably worried about the future, as well as frustrated or even angry at themselves, or their past circumstances. The reality is that they may need to be working at the level they are to pay the bills or have the future they once imagined.

Starting a conversation

First, ensure the conversation takes place during a time when you are both feeling relaxed. Remember to keep the conversation light and supportive, and be mindful that they probably will have a lot of pride around these issues. Start with a conversation about their future and talk generally about what their hopes and dreams are. This may help you get a picture of what they’re working toward.
Gently inquire about whether the means they are currently adopting (in other words, the hours worked) are necessary to achieve those goals. If appropriate, offer to help them with planning – you may suggest that they could find it helpful to sit down with a financial advisor who can map out plans in more detail.

Key messages to communicate

After you’ve had the opportunity to talk with your loved one about the future and gained some insight into their goals and underlying values associated with work, then, in a separate conversation, you can express your concerns about their health. Here are some suggestions about how to approach this topic:
  • Describe what you are seeing. Be specific and objective. For example, have you directly observed their driving difficulties, or unhealthy alcohol or food patterns – or other problems that have resulted from overwork? Imagine being a fly on the wall and describe what you have seen specifically – such as “I’ve noticed over the past few months that your after-work drink has turned into half a bottle or more – I wonder if this has helped manage the stress you’re under?” rather than “I know you’re using alcohol to deal with stress”. Acknowledge and validate how the unhealthy behaviour may be serving some useful function.
  • Tell them directly how you feel. Share that you are worried and want to see them as healthy as possible and that you don’t want your intent to come across as critical or judgmental.
  • Ask if there is anything you can do that may help. Offering to help or support them may be the lifeline they need to take a step back from work or change their unhealthy work patterns.
  • Offer to go to their family physician with them to talk about possible causes and contributions. It’s amazing how often people will be more willing to heed the advice from a professional.
  • If they are resistant to make a change, and you have concerns about their driving, you have an obligation to inform their family doctor. Consent issues do not apply here – meaning that if you have some concerns about risk, it is in your right to call their physician (the doctor cannot release any information back to you without the individuals’ consent).

Unfortunately, you can’t magically get your loved one to value their health more than work, but you can guide them toward possible solutions that improve the situation. Visit MyWorkplaceHealth.com for more workplace resources.

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.

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Dr. Joti Samra is a Founding Member of the CSA Technical Committee that developed the CSA National Standard for Psychological Health & Safety in the Workplace and informed the ISO standard
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