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By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I’m curious about therapy, but not ready to commit to seeing someone on a regular basis. My aunt keeps encouraging me to read different self-help books. I assume it will be very difficult to follow through on all the advice in these books. Are they useful or a waste of my time? The answer: Fantastic question. You, like many people who have not tried therapy before, have some hesitations and apprehensions about making a regular commitment to undergoing treatment. This can be understandable if you have no reference point for what therapy may look like, if you have limited funds or coverage for treatment (this is unfortunately the biggest barrier for most people), or if you are not yet emotionally prepared to start to peel away the layers on some significant issue(s) in your life. Undertaking some self-directed work, with the aid of self-help books, can certainly be a great place to start. A plethora of self-help books exist on every topic under the sun. It can be overwhelming to know what to get given the range of books that are available. Start by doing your research. Look for recommendations from friends, read online reviews of books, and also look to reputable psychological/mental health websites that offer suggestions. If you visit my website and go to Individual/Employee Resources, you will see that I have listed a range of freely available and downloadable treatment materials that I have co-authored (on depression, coping with chronic health conditions, dealing with suicidality). I have also listed useful websites that offer other recommendations, as well as a list – by topic – of books and treatment manuals that I recommend. There are a few guidelines to follow as you are undertaking your search: find books that have been around for some time and that have solid reviews behind them; look for books authored by licensed professionals (where the author is described as being “registered” or “licensed” in their jurisdiction of practice) and look for words such as “evidence” or “research-based.” This will help ensure you are accessing high-quality resources. Certainly the level of benefit you obtain from self-help materials depends on a combination of the nature of your presenting issues, and the severity of those issues. Research supports the benefit of self-guided work (through self-help or self-management) of the common mental health conditions (depression and anxiety) when those issues are in the mild to moderate range of severity. As presenting issues move into more serious levels – for example, if you are experiencing a significant impact on your ability to fulfill your day-to-day obligations and tasks – then self-help materials are most helpful when they are augmented by the assistance of a health professional who helps you work through your difficulties. Also remember that you can meet a therapist once or twice to get further information without necessarily having to undertake an intensive course of treatment. In my practice, I see many high-functioning individuals who find a session every four to six weeks is enough to help keep them on track with other work they are doing independently in between our sessions. 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  Goals…we all set them – lose that last five pounds, eat better, quit smoking – but only a few of us actually find it easy to make those changes in our lives, particularly if we are changing long-standing patterns. One of the reasons that goals, like New Years Resolutions, often fail is that we aren’t setting effective and achievable goals. There is a major difference between wishing something would change and setting a goal to make that change and following through.
Fitness and diet goals are among the most commonly set goals (as well as the ones that so regularly fail). Many of us start the week strong, but by mid-week, we have lost sight of eating healthy or exercising and fall back into old habits. You don’t need a Ph.D. in health sciences to know that diet, exercise, and sleep are three of the most crucial things that can dramatically impact and – when properly addressed – improve both physical and psychological health. But the diet, fitness, and pharmaceutical industries are lucrative, multibillion-dollar industries for a reason: Most people struggle with sustaining long-term change in these areas. So, welcome to the club! What can you do to enhance the likelihood of sustainable change? Here are six steps to planning and executing your goal to increase the likelihood of success. 1. Pick a specific behaviour to change.Start with no more than one to two behaviours to change at a time.
2. Identify readiness to change. Before beginning, ask questions such as: “How ready am I?” “Is this the right time for me to make a change?” “What are the pros and cons of changing?”
3. Identify barriers. Anticipate setbacks. If we tried to make a change in the past, what got in the way of success?
4. Implement change. Approach behavioural change gradually. Make small, specific changes.
5. Revisit and revise. Do not get discouraged by setbacks. If we are not on track with the changes identified, work to identify the barriers again. Were our expectations too high? Was the specific goal we set too ambitious?
6. Remember Rewards. Set milestones that help track progress and ensure to schedule in regular rewards for each achievement. Behaviour change can be challenging – especially if we have been developing the habit over a number of years. Remember these six steps and know you that success doesn’t happen overnight. Be consistent and know that we all face setbacks, it’s how we keep getting back on track that will eventually lead to permanent change. 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:
Lately I’ve been feeling uninterested in socializing. All I want to do is stay home and have netflix marathons. I’ve been feeling like this for about two months. Should I be worried I’m no longer wanting to spend time with friends and family – which I used to enjoy? The answer: All of us can benefit from the occasional TV binge. It can give us time to unwind from the day-to-day grind of our lives and give us an opportunity to recharge. However, if your tendency to avoid people has been going on for weeks or months on end, there may be cause for concern. Periods of feeling down or sad are common for all of us; most of the time when we feel this way, we aren’t depressed. Usually, mood changes will go away on their own within a few days or weeks, especially as stressors that commonly cause these mood changes start to resolve. For some people, mood issues may continue for weeks or longer. If you find that you have been feeling sad or down and have had little interest in things you normally enjoy, like spending time with friends, for an extended period, it’s possible you are struggling with an emotional problem like depression. Depression is one of the most common psychological health conditions and affects one out of four people over the course of their lifetime. Contrary to popular belief, depression doesn’t always mean feeling sad or tearful – for some people, a “depressed” mood may feel like irritability or frustration, and for others it may be associated with feeling “flat” or feeling “nothing.” Depression comes along with other problems that may include:
If you are feeling any of the above – particularly if you are having dark thoughts – you should speak to your family doctor or a psychologist or psychiatrist. There are very effective treatments for depression, including cognitive-behavioural therapy, interpersonal therapy and, for some people, medication therapy. With time and the right treatment, you can get better. You may be able to access free services through your local mental health agency (see www.cmha.ca for a Canadian Mental Health Association office near you). By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth Ahh, the joys of vacation! For many of us, vacations represent no alarm clocks and schedules, limited to no work, and minimized chores and responsibilities. For all of us, getting back into the flow of regular life and work responsibilities after an extended break can be tough. As humans, we are innately hedonistic and naturally gravitate toward things that feel pleasurable, enjoyable, and evoke a positive emotional state. We are also master acclimatizers. We physiologically and behaviourally adjust to whatever environment we are placed in. This is true for both relaxing situations or intense work situations.
It can take a few days to get into vacation mode (or longer if you’ve been in a very intense work situation). You might be sleeping way more than is usual (or needed), maybe even napping. You likely don’t feel as sharp mentally as you do when in work mode. The changes can be subtle, gradual, and happen without any conscious awareness – and they can have an impact on our general mood state and our levels of energy, attention, and focus. Because of this, it may take a few days to a few weeks to make the full transition out of vacation mode. Generally, the lack of motivation we may feel when getting back to work is much more attributable to the lower energy level and reduced focus that the body adjusted to than it is to anything else. Refocusing our energy and motivation It can be easy (especially on the heels of an extended vacation) to get stuck in the trap of ruminating on the reasons we are required to work. Not only does this type of thinking do nothing to change the situation, but it breeds negative emotions. Shifting the focus to the choice elements can help us feel more engaged, more quickly. So, we need to remind ourselves why we are doing the work that we do. Put pen to paper and consider asking these questions:
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:
It’s clear to our entire family that my adult sister has big emotional issues, but she won’t recognize this fact. How do I deal with her mood swings in a loving way, but also not promote further outbursts that seem to only be brought on for attention? The answer: Speaking to anyone who is in denial about their personal issues is difficult in the best of times. But the challenges become particularly amplified when a relationship with an immediate family member is potentially at stake. A sibling bond is unique and special in so many ways, given the shared experiences – after all, no one better understands parents and family issues better than someone who was raised in the same environment. Yet our sibling relationships are often the most complex as well, particularly when elements such as competition, jealousy or insecurity play a role. You care about your sister and want to be supportive, yet seem to be struggling with being available as a support for her, but also establishing boundaries for what behaviours of hers you will tolerate. The first thing you want to do is offer to provide support to your sister, if you haven’t already done this. (“I’m concerned about you, and want to help however I can.”) When communicating with her, ensure that she doesn’t feel ganged-up on by the family. Speaking to her one-on-one, without others there, is the most respectful way to approach this. Don’t be blaming or accusatory, and stick to the facts of what you observe, as well as the impact on you. (“I felt extremely hurt when you yelled at me last week for disagreeing with your opinion on what we should do for dinner.”) Ask her what you can do differently to help improve the relationship. Ask yourself what your contribution to her outbursts may be. When there is a long history of problematic behaviour in a relationship, friends and family members often, without even realizing it, react in sarcastic or passive-aggressive ways, given their understandably pent-up frustration. Be mindful of patterns that trigger her. Are there certain topics that push her buttons which you can simply avoid (say, talking about careers or relationships)? Identify your hard and fast boundaries in the relationship. For example, you may decide that you will no longer tolerate her yelling or using profanity in disagreements. Figure out what your response will be (for example, ending the visit). Verbalize what you are doing and why. (“I find myself getting very upset when you swear at me, and I’m choosing not to be around you if that’s how the conversation is going to go, so I am leaving.”) Then, consistently stick to this. Often, emotional outbursts get reinforced because the family doesn’t implement consequences to the behaviour. Your establishment of clear and consistent boundaries may serve as a catalyst for her to change. Finally, realize that the only actions you can control are those of your own. We are stuck with the family we have for the long haul, but remember that we can maintain love for them – without always having to like them. 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  We know sleep is a critical contributor to our overall state of physical and psychological health. One of the most important functions of sleep involves allowing our bodies and our brains to recover and recharge. Sleep is even more important for children, as it directly impacts mental and physical development The topic of children and sleep can be a challenging one though. Children don’t typically understand the importance of sleep and aren’t intrinsically wired to maintain a sleep schedule and structure without external guidance. So, as a child develops, it’s up to their caregivers to manage their sleep schedule and ensure they’re getting enough sleep. Managing children’s sleep problems can be hard enough but teenagers may be even more challenging. We will also address teenagers’ sleep challenges here.
Children and sleep Sleep patterns and needs change drastically across age ranges. For instance, those who have experienced a newborn know that sleep happens whenever the child feels like it, making the parents’ sleep schedule highly irregular. Fortunately, between the age of 6 months to 2 years, children typically begin to develop more of a regular sleep pattern. Once this happens, it’s possible to start implementing proper sleep hygiene principles. Sleep Hygiene for Children Here are 5 effective sleep tips for children aged 2-13 years that can help children with sleep problems:
Sleep hygiene is always the best place to start when it comes to managing sleep challenges but what if it isn’t enough? What if sleep hygiene doesn't work? Sleep hygiene should always be tried first when it comes to sleep challenges. For children and adults alike, maintaining consistently good sleep hygiene is typically enough to help with sleep problems. It’s important to note that sleep hygiene will likely take a few weeks, or longer, to have a noticeable impact on your child’s sleep. So be patient and consistent with their bedtime routine. If your child still has sleep problems (such as not being able to fall asleep, or waking up in the night) some other home treatment options have been found to be effective. For example, research has found white noise played over the course of the night was able to help children with ADHD get to sleep faster and stay asleep longer. Weighted blankets are also demonstrating some preliminary and promising effects on sleep for children with Autism Spectrum Disorder. Teenagers and Sleep Another age category that tends to have significant sleep challenges is teenagers. Despite the traditional angsty know-it-all attitude and resistance some teens may have to regular sleep, their brains are still developing as well as their bodies changing, so sleep is just as important during these years as it was when they were younger. What impacts teenagers’ sleep? Many of us can remember being a teenager and wanting to stay up excessively late, resisting structure and schedule in terms of sleep. And, as a result, feeling constantly sleep-deprived or irritated and grumpy as a result. This is not just rebellious teenager behaviour. Research has shown in the teen years circadian rhythms change drastically, as do hormones. Teenagers don’t just want to stay up longer, their body is telling them to. All the while their schooling starts just as early, if not earlier than it did when they were younger. The net result is sleep-deprivation, as environmental expectations make getting the required amount of sleep more difficult. So, how can we support our teenagers in getting better sleep?We may think that allowing them to sleep in on the weekends to catch up on sleep is the best thing we can do. It isn’t. Letting them sleep in actually makes things worse, as this disrupts the body’s internal clock even more. Remember – a consistent bedtime and wake up time is an important aspect of sleep hygiene – and as such, keeping a consistent schedule is still the best thing for teenagers. Since their circadian rhythms are changing and impacting the time they want to sleep, it can be helpful to adjust this sleep rhythm. This can be done by adjusting their light exposure, such that light is increased in the mornings and decreased at nighttime. Effectively adjusting light exposure involves (1) exposing oneself to natural light (even it it’s cloudy) shortly upon waking up in the morning, and (2) removing light in the evenings by ensuring lights are dimmed. There are blackout blinds/curtains, and discouraging use of screens like smartphones, TV’s and computers before bed. Final Thoughts If your child or teenager still has significant sleep problems or other contributing health issues (physically or emotionally), it’s recommended you speak to a medical professional. Sleep is a very important and incredibly complex process, so when presented with recurrent issues it should be addressed by a qualified healthcare professional and not self-diagnosed or self-medicated. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  A divorce, particularly when children are involved, can be one of the hardest life experiences to deal with. Certain times of the year – holidays, birthdays, etc. – amplify the pain that comes along with not having the same once-intact family configuration. Parents typically make arrangements that determine which holidays or portions of holidays they will be able to spend with their children. This often leaves one parent alone and it can be challenging for that parent to not focus on the sadness and loneliness. The first few holidays following a divorce will be the most challenging as the family establishes a new normal around the occasion. So, let’s talk about how to manage family holidays following a divorce.
Missing the kids – and the sadness and loneliness that comes along with that – is not an emotion to shove away. Our emotions are a signal to our brain and body that we are experiencing something that impacts an important part of our life, and what we value. Those emotions validate how important the kids are, how important family is, and that we wish the situation were different. All too often we want to shove away our negative emotional states. But that rarely turns out well, as emotions often rear their heads later on. Our emotions also provide us with the motivation to take some kind of action, to do something differently. So, how do parents manage holidays, especially when a divorce may mean spending them alone? How to Manage Family Holidays Following a Divorce
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 hate giving and receiving gifts. It seems so materialistic to me – but everyone around me seems to just love it at this time of year. Is there something wrong with me? How can I mentally get behind the idea of gift giving? The answer: Christmas has become an increasingly commercialized holiday: you are not alone in your feelings about gifts. I would challenge your perception that everyone around you seems to love it at this time of year – although many people outwardly may seem to love the holiday season and all the associated traditions. I think if you were to ask people, you’d be surprised at how many share your sentiments. The Christmas holiday itself is religious – but more broadly is viewed by even those with non-religious views as being a time of celebration, love, and giving. The gift component can take away from the true spirit and intent of Christmas, particularly when an emphasis is placed on what one “wants” and is “getting”. The reality is that the holiday season can also become a hugely taxing time of year from a financial perspective. Unfortunately, the focus on gift giving adds to the social pressure that many feel to “keep up with the Joneses”. The net effect is that individuals often get in real financial debt, which is one of the biggest reasons why the Christmas holidays (and the January aftermath) become the most stressful time of year for many. Instead of trying to accept something that is inconsistent with your beliefs, speak openly with your loved ones and others that you exchange gifts with about how you feel. I think you may be surprised at the reaction that you get. Do not be shy about expressing your underlying reasons, which stem from the values you hold. Indicate that you feel that the holiday season and gift-giving is becoming overly materialistic, and that you would like to think of adding some new traditions this year. Propose setting a monetary limit or gifts, or only giving hand-made gifts. Suggest keeping the gift giving for children only. Think about having a Secret Santa gift exchange (where everyone brings one gift, and each person receives only one). Or, propose adopting a family in need and providing gifts to that family. 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:
I’m a guy who loves his girlfriend, but that doesn’t mean I’m not attracted to other women. I’m in my 20s and making good money. Is it a bad idea to sow my wild oats now, before I’m fully committed? The answer: Umm … the fact that you are asking whether you should “sow your wild oats” – with your financial situation being one of the highlighted reasons why – tells me you need to do some serious thinking about what you want at this point in your life, and what you want to do about your relationship. Out of fairness to your girlfriend, this is something you should figure out sooner rather than later. There’s no judgment here: How you approach dating, and whether you have regrets about not dating more people before becoming more committed, is something only you can answer. Some people can be immensely happy, fulfilled and have no regrets despite having only one partner in their life; others feel that the best thing they could have done was to get dating “out of their system” before they got married or started a family. Don’t become overly distressed just at being attracted to someone. I see many people in my patient practice that are in loving, committed relationships, and who remain faithful to their partners, but find themselves attracted to others. These feelings are a natural part of being human; they often pass and usually mean nothing. It’s not whether you are attracted to other people that’s a problem – it’s what you do based on the attraction. Ask yourself: Do you find yourself getting too caught up in the attraction? Do you start to fantasize about being with someone else on a regular basis? Do you have thoughts of wanting to cheat on your girlfriend? If so, these are strong signs that you are not ready to be settling down at this stage in your life.You say you love your girlfriend. Do you picture being with her long-term? Could you imagine yourself married to her, or having children with her? Does the thought of her in your foreseeable future create positive feelings (comfort, peace, security, happiness, joy)? Or do you find yourself feeling anxious or stifled when you imagine this? And finally, how do you feel when you think about ending the relationship with your girlfriend? How do you feel when you envision her dating someone else? Keep in mind that dating life may not be what you imagined it to be, that you’d need to have a clear break in your relationship in fairness to your girlfriend. Realize that she will likely move on and may not be there if you were to decide to go back to her. Ultimately you need to trust your gut feeling and go with what seems to be the right thing for you. If it is dating other people, end things with your girlfriend in a respectful way and move on. You’re better ending things now when you are still young, and before things get more serious. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Emory Oakley. Emory is a writer and LGBTQ+ educator who regularly discusses the intersections of queer identities and mental health. How To Be A Good Trans Ally – Learning About Gender
I’m a transgender male and use the pronouns he/him/his or they/them/theirs. I’ve been out as transgender for five years and started my medical transition three years ago (when I started testosterone). Accurate pronoun use is always important, but it can be particularly important during the first few stages of transition because it helps a person feel validated in their gender as well as accepted. When someone is referred to with the wrong pronoun, it can make them feel disrespected, invalidated, dismissed, alienated, or dysphoric (often all of the above). One of the first questions cisgender people generally ask when the topic of pronouns is brought up is; how am I supposed to know which pronouns to use? How To Be A Good Trans Ally 1) Start by educating ourselves about the use of pronouns. In school, we’re taught about the use of pronouns in a binary manner: he/she for individuals, and they/them for plural. But this language needs to be updated to include the use of singular they/them pronouns. They/them pronouns are used for individuals who identify as non-binary, genderqueer, genderfluid or whoever chooses to use them. 2) Do not make assumptions about what pronouns a person uses.Just because someone presents a particular way, doesn’t mean they use the pronouns we assume they do. It can be helpful to practice using they/them pronouns and defaulting to using they until you find out what pronouns a person uses. Alternatively, you can default to simply using the person’s name. 3) If you’re unsure of someone’s pronouns, ask. Try one of these options: “Hey, what are your pronouns?”, “What pronouns do you use?”, “I was just wondering how you’d like me to address you.”, “I just want to make sure I’m using the correct language to refer to you.” Note: Avoid language around preference; pronouns are not a preference, they’re a requirement. 4) Start with yourself. An even easier way to start a conversation about pronouns is to start with yourself. Do this by introducing yourself with your name and pronouns, then give the other person the opportunity to do so as well. For example, I would say, “Hi, I’m Emory, I use he/him pronouns.” Doing this in a group setting where everyone states their name and pronouns, regardless of gender identity, can help to make the experience less tokenizing for trans people. It’s a good approach to give pronouns first, so it’s not required for others to ask or make the wrong assumptions. 5) Names are incredibly important. Not every trans person has legally changed their name but that does not mean you have the right to call them by their birth name (even if you know it). Respect the name they told you to call them by. If you’re struggling to make the change practice in the mirror or with another friend. 6) Be aware of gendered language. Pronouns aren’t the only important aspects of gendered language. Some examples of regularly used gendered language include “Good Morning, ladies!” or “you guys”. Even using phrases we may think are more inclusive like “ladies and gentlemen” can be problematic. It’s important to be conscious of language and the assumptions we are making based on that language. Often the language we think is inclusive isn’t, due to the fact that it doesn’t include anyone who falls outside of the binary. Here are some examples of more gender-inclusive language:
Other Important Things to Note About Gender Gender and pronoun use is an important part of being a good trans ally. Here are some other things that may come up as you learn about gender identity and appropriate pronoun use so you can avoid some simple mistakes.
Final Thoughts Learning to be more gender-inclusive can feel daunting because it seems like there’s so much to learn. And for many, the learning process must begin with unlearning ideas about gender and the gender binary. But using the correct name and pronouns is a huge part of being a good trans ally and can make a huge difference in trans peoples lives. So, it’s important to educate yourself and continue to practice with inclusive language. I hope now that you know how to use pronouns correctly, doing so isn’t as scary or as challenging as you originally thought. All it really takes is good intentions and breaking down your assumptions about gender. |
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