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Coping with Suicidal Thoughts

28/9/2023

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
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Coping with Suicidal Thoughts

If you’re thinking about suicide, you’re not alone. Many people have thoughts of suicide, for a number of reasons. Thoughts of suicide can be very scary and coping with suicidal thoughts may seem impossible. You probably feel hurt, confused, overwhelmed and hopeless about your future. You may feel sadness, grief, anger, guilt, shame, or emptiness. It’s easy to think that nothing can be done to change your situation. Your feelings may seem like they are just too much to handle right now.

It’s important to know that thinking about suicide does not mean that you will lose control or act on these thoughts. Having thoughts of suicide does not mean you are weak, or ‘crazy’. Many people think about suicide because they are looking for a way to escape the pain they’re feeling. Even though your situation seems hopeless and you wonder if you can stand another minute of feeling this bad, there are ways to get through this and feel better. You don’t have to face this situation alone. Help is available. 

Coping with Suicidal Thoughts Right Now

If you’re experiencing suicidal thoughts now and are possibly feeling unsafe, here are some things you can do right now. 
  1. Connect with others. If you’re feeling unsafe and have strong urges to hurt yourself, tell someone. If you can’t reach anyone or don’t have anyone to talk to in your personal life, call 1-800-SUICIDE (1-800-784-2433) in BC, or look up an equivalent hotline in your area. Don’t be alone. Ask someone you trust to come over. If you can’t have someone come to you, consider being in public, where there are other people. 
  2. Make your environment safe. Get rid of things that could be used to hurt or kill yourself, such as pills, razor blades, or guns. 
  3. Find a comforting distraction – a favourite show, music or a long bath for example. Do not use alcohol or drugs. 
  4. If you still feel unsafe, consider going to your local emergency room or call 911. 

Once you feel like you are out of immediate danger of harming yourself you can take the time to consider long term solutions to coping with suicidal thoughts. 

Make A Safety Plan

Making a safety plan can be very helpful in getting you through those distressing times where you feel unsafe. Having a plan ahead of time ensures you know who you can call and have those people prepared to support you, as well as what activities and places can help you to get through the worst moments.

One of the best people to make a safety plan with is a professional, as they are familiar with the process and can help you to brainstorm ideas for the plan when you’re feeling hopeless. If you’re not already connected with a registered psychologist or counsellor we suggest you do so. With the help of professionals and the support of family and friends, you can learn about what is causing your suffering and how you can change or manage it.

If you or someone you love is at immediate risk of injury or death, call 911.

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Breathing Exercises to Manage Stress: Four Stage Breathing

21/9/2023

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
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Breathing Exercises to Manage Stress

Breathing exercises can be very helpful tools for managing symptoms when our “fight-flight-freeze” stress response is triggered. And the great thing about breathing techniques is they’re easy – once we master the steps. One of my go-to breathing exercises, which we teach to many clients in our clinical practice group, is “four stage breathing”. This is a variant of the more common box breathing approach. Both can be equally effective approaches – it’s just about finding a style that works for you!  

What is Four Stage Breathing? 

Four stage breathing is a type of breathing technique that slows down our breathing actively and intentionally. It’s called four stage breathing as there are – surprise! – four stages to each full breath: two parts to the inhale, and two parts to the exhale. 

Why do breathing exercises work? And why is it important? Stress triggers our “fight-flight-freeze” response and when this response is triggered, we tend to shallow breathe.

So why is shallow breathing a problem? Shallow breathing can lead to a whole host of physiological symptoms – including for example, changes in body temperature, lightheadedness or dizziness, or feelings of derealization or depersonalization (where distance/perception can be altered).   

These symptoms can mimic anxiety – and so shallow breathing can inadvertently make subjective feelings of anxiety or stress worse. Four stage breathing helps anxiety by providing control over the physiological symptoms – and this, in turn, helps calm the emotional symptoms. 

The Technique: How to do Four Stage Breathing

First, ensure you are breathing in through your nose and out through your mouth. This naturally slows down the pace of our breathing.


Second, make each full breath last at least 10 seconds – 5 seconds on the inhale, and 5 seconds on the exhale.   

Break each inhale and exhale into two parts: On the first inhale, fill up most of your lungs; on the second inhale, think about ‘topping up’ your lungs with air. On the first exhale, push out most of the air, and on the second exhale think about fully emptying your lungs. This helps to maximize our lung capacity.

Repeat this cycle for 3-5 minutes.

When you are first learning four stage breathing, it’s important to practice when you are already relatively calm or feeling low stress – this can help build mastery. Then, over time, use it as a tool when you feel your stress or anxiety increasing.

 How I incorporate Four Stage Breathing into my life

 
  1. First thing in the morning. I’m a snoozer so I find it’s a great time to do a few minutes of breathing while lying in bed before getting going for the day. This can set the pace for the day.
  2. Before sleep. When my mind is spinning with all the day’s activities and next day’s to-do’s. This helps me wind down physiologically and start to get prepared for sleep.
  3. When I notice my body tensing up. For me personally, my neck and shoulders creep up, and that’s a great signal for me to relax my posture and do some breathing.

There is a very strong evidence-base on the benefits of breathing to reduce the frequency and intensity of the physiological symptoms associated with stress and anxiety-related. I encourage you to try four stage breathing regularly for a week – just a handful of times a day, for just a handful of minutes at a time and see how you feel.

Remember: when we are experiencing stress, the best thing we can do is focus on the things within our domain of control and breathing is one of them.


My daughter and I can’t stop snapping at each other. Help!

14/9/2023

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
The question:
 
My daughter and I are close, but we can’t seem to communicate well. She’s in her 30s, but as long as I can remember we lose our temper or snap at each other over the smallest or biggest things. This starts to get embarrassing when we’re among family or friends and can’t seem to talk politely. I’ve tried to talk to her about it but usually the changes are short-lived. Is it just too late and are we too set in our ways to change the behaviour?
 
The answer: None of us are ever too set in our ways to change our behaviour – we have free will over our actions and full control over the way that we choose to conduct ourselves with others.
 
Now, does this mean that changing the patterns of communication you and your daughter have will be easy or happen overnight? Of course not.
 
Family interactions are often the toughest to change. The dynamics that exist in families are long-standing, and the communication that we adopt is often established at a very young age. The more time that passes, the more resistant to change these patterns become.
 
Interestingly enough, we also tend to feel most helpless or give up the easiest when it comes to changing our family relationships. Strange, isn’t it, when most of us consider these to be among the most important and defining relationships in our life?
 
Start by stepping back and get a big-picture perspective on the reasons your communication is so poor. Is the way you communicate with each other similar to how you interact with others in your life? Does your communication represent a more pervasive style each of you has with others or is it limited to your relationship only? What types of issues trigger conflict? Do you each react to in-the-moment situations, or are there bigger underlying issues that have remained unsaid or unaddressed between the two of you?
 
Keep in mind that there is only one person’s behaviour you have control over – yours. You cannot, no matter how much you wish, force your daughter to act or react in a different manner. Be brutally honest with yourself about the elements you are contributing the situation. Ask a family member or friend whom you trust to weigh in objectively. What nonverbal behaviours (tone, posture, facial expressions) change for you when you are around your daughter? Are there hot-topic buttons that you purposely or inadvertently push? How do you respond when she gets snappy?
 
Once you have identified the verbal and nonverbal behaviours you bring to the mix, have a discussion with your daughter. Express to her that you want your style of communication to change. Let her know what you will work on adjusting (be specific and detailed). Ask her what else you can do that would make things better for her (there are likely things you do or say that trigger her that you may be unaware of). Be mindful of not reinforcing her behaviour. For example, if she gets short with you, do not engage or escalate your response – simply stay silent or walk away (assuming the behaviour does not violate a personal boundary or become abusive – in which case you would need to establish parameters).
 
Even if your daughter is unwilling to take a look at her contribution, it is almost impossible for her behaviour to not naturally start to change once you truly commit to changing yours. After all, communication is inherently bidirectional, and our responses are shaped significantly by the responses of those we are interacting with.

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

How to Get Over Someone Who Doesn't Love You Back

7/9/2023

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
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Ahhh, relationships…

​No matter what gets people through the therapy door, relationship-related challenges are often what keep people in the room – whether it’s our family relationships, social or work relationships, or our intimate relationships.


Our intimate relationships, in particular, can be so beautiful, and also a source of such angst – particularly when we are with someone who we may know is not the right fit for us, or who isn’t as invested in us as we are in them.

When they just aren’t that into you

We often intuitively know if someone is as “into us” as we are into them – but often we ignore these feelings. We may hold out hope that the person’s feelings will change or grow, we may try to convince ourselves that we don’t care as much as we do and can keep it casual, we may blame ourselves for not being ‘good enough,’ or we may excuse their behaviour by becoming overly empathetic to their plight to ‘figure things out’ at the expense of putting our own needs far below theirs.

Moving forward from unrequited love

When relationships are not mutually beneficial, it’s important to understand the reasons why and take steps to move forward emotionally. So, what can you do to move forward?
  1. Look at the reasons you have allowed yourself to remain so engaged in this hurtful dynamic. Why did you allow them to establish the on/off nature of the relationship when clearly this wasn’t what you wanted? Why did you remain with them – or go back to them – even though you knew they weren’t in love with you the way that you were with them? And why do you continue to allow them to engage with you now, despite the hurt you have endured? In my experience, this first step of self-reflection is the most important one – and the one that can lead to the most growth.
  2. Assert your position and gain control back. Likely, this is going to mean ending all communication with them. Express why you are ending communication with them – writing a letter or an e-mail may allow you to explain the impact they’ve had on you. Draw on trusted supports in your life to help keep you accountable – for example, agree to text a best friend when you have an urge to see or connect with the person who you know isn’t giving you the love you need.
  3. Stick to moving on and allowing yourself to be open to meeting someone who can provide you with the kind of love you deserve. Make a firm promise and commitment to yourself – and stick to it. It may be hard but remember – your intuition about your own needs and whether or not this person can meet them won’t fail you.
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Good luck with moving on and finding the love you deserve!

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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