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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  Loving-Kindness Meditation – Meditation for Self-Compassion
Meditation practices can seem intimidating but they don’t have to be. While many of us may think the point of meditation is complete stillness and thoughtlessness, that’s not the case. The goal of this meditation practice is self-compassion (learn more about self-compassion here), it’s a guided practice that focuses on the ways we can include ourselves in our circle of kindness. But before we get into the practice, let’s talk about what meditation is. What is meditation? There are countless definitions, approaches, techniques and schools of practice relating to meditation. However, at its core, meditation is a mental exercise that involves quieting the mind with simultaneous concentrated focus (typically on the breath or a mantra) for the purpose of attaining an enhanced state of inner awareness. What’s the difference between mindfulness and meditation? Counsellors and psychologists often speak about mindfulness, and others use these two terms interchangeably. Mindfulness and meditation are related but they aren’t the same thing. Mindfulness is about being aware, and psychologically present, in the moment. It focuses on paying attention to your present thoughts, feelings, urges and behaviours. Mindfulness can be practiced informally at any time and is often paired with simple breathing exercises. Mindfulness can be used in conjunction with meditation practices and can certainly help those new to meditation begin the process. How to Practice Loving-Kindness Meditation for Self-Compassion The goal of this meditation practice is to bring your awareness to the value of kindness and the importance of bringing yourself into your circle of kindness. Get into a comfortable position as you would with any mindfulness or meditation practice. Close your eyes full or partially and take a few deep breaths to settle in your body and into the present moment. Then put your hands over your heart to remind yourself you’re bringing not only your attention, but loving attention, to your experience. Feel the warmth of your hands, the gentle pressure of your hands, and feel how your chest rises and falls beneath your hands with every breath. Then bring your mind to a person or other living thing that makes you smile. This could be a child, your grandmother, your cat or dog – whomever naturally brings you happiness. Perhaps it’s even the bird outside your window. Let yourself feel what it’s like to be in the presence of that being. Allow yourself to enjoy the good company. Then, recognize how vulnerable this loved one is – just like you, subject to sickness, aging, and death. Also, this being wishes to be happy and free from suffering, just like you and every other living being. Repeat softly and gently, feeling the importance of your words; May you be safe. May you be peaceful. May you be healthy. May you live with ease. Remember that if you notice your mind wandering, slowly bring your attention back to the words and the image of the loved one you have in mind. Savour any warm feelings that may arise. If you have the time, go slowly. Then, add yourself to your circle of goodwill. Put your hand over your heart and feel the warmth and gentle pressure of your hand, saying: May you and I be safe. May you and I be peaceful. May you and I be healthy. May you and I live with ease. Visualize your whole body in your mind, notice any stress or uneasiness that may be lingering within you, and offer kindness to yourself. May I be safe. May I be peaceful. May I be healthy. May I live with ease. Then take a few breaths to just rest and sit quietly in your own body, savouring the goodwill and compassion you’ve found. Know that you can return to these phrases anytime you wish. Gently return back to the room, open your eyes if you closed them and enjoy the rest of your day. If you can, take the time to reflect on how this meditation practice impacted self-compassion. Did it feel weird to include yourself in your circle of kindness? Did you experience some resistance? If you were able to get past that, how did it feel? What were the impacts of providing yourself with self-compassion? Final Thoughts on Meditation for Self-Compassion Although meditation is a great way to practice self-compassion, it isn’t the only way. If you’re struggling with meditation, first we recommend being gentle with yourself and continuing to practice. Learning these skills that’s time and patience – remember that it’s okay for your mind to wander, if this happens simply notice and gently bring it back. 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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