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.
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. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My wife is inconsolable after three miscarriages. What can I do? The answer: There are a number of things that may be help your wife through this difficult and understandably emotional time. First, resist the tendency to problem-solve. Let her know that you love and care about her, and that you want to support her as best as you can. Acknowledge that you don’t fully understand or appreciate what she is experiencing, but communicate that you want to understand. Then listen to her. Many men have a tendency to want to try to problem-solve or find a solution, but many women feel that they just need the opportunity to express what they are feeling. Being overly positive (e.g., “don’t worry, next time I know things will work out”) may feel invalidating to her. Ask her what you can do that would be helpful. We all cope in different ways and need different types of support from our loved ones. Ask her what you may be inadvertently doing or saying that is unhelpful. Ensure that you are present for any appointments that she is attending with respect to managing her health post-miscarriage, and also in terms of appointments moving forward to investigate causes of the miscarriages. Although the rates of having one miscarriage are quite high (15-20 per cent, with the bulk of these miscarriages occurring within the first seven weeks of pregnancy), the rates do increase with previous number of miscarriages and concerns your wife may be having about the viability of future pregnancies may be a realistic yet also saddening or frightening thought. Many women may experience a grief reaction, where they go through a number of emotional stages before they get to a stage of acceptance. These stages may include: denial that the loss has occurred; anger at having to deal with multiple losses; bargaining for the situation to be different; and sadness or depression. Keep in mind that you may be also experiencing your own emotional reactions to this, and ensure that you are getting the support you need as well. A number of factors impact the manner in which a woman copes with pregnancy loss: how early in the pregnancy the miscarriage occurs; the woman’s age; whether there are previous children; and the number of previous losses. These factors impact the bond a woman starts to make with her child (which is qualitatively different and often much stronger than the bond a father makes in early stages of pregnancy) and may amplify other worries, concerns or anxieties the woman has both about her fertility and the viability of having another child. At some point you both may benefit from speaking to a mental health professional, who can address if she is experiencing any clinical levels of depression or anxiety. 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’ve been seeing a therapist for 8 months. I’m unhappy with my life and feel like I’m not the best mother I could be. The thing is, I don’t feel like therapy is helping at all. My situation and my outlook hasn’t improved. Do I just need to be patient? Or does seeing a psychologist not help some people? The answer: At the risk of sounding biased, I firmly believe that we can all benefit from the support, perspective and guidance of an objective, competent, and specialized professional for various issues at different points in our lives. This is true for any area of life with which we are struggling – physical health (physician), our taxes (accountant), selling a home (realtor), or our emotional health (psychologist/psychiatrist). Although I don’t have enough information on your difficulties and history to provide you with a sense of how long you may need treatment for, I can let you know that the research indicates that individuals with the most common types of psychological concerns (i.e., uncomplicated depression, anxiety, and relationship difficulties) experience significant benefit after an average of 12-16 treatment sessions. Individuals with more complicated histories or concerns (such as childhood history of trauma or chronic suicidality) experience benefit with about 24 sessions. Certainly 8 months is a long enough period of time for you to have started to experience some significant benefits from therapy. It is wise of you to pay attention to the feeling you have that your current therapy is not helping you, as that is giving you an important message that you need to do something different. The beneficial impact of therapy is dependent on a number of important factors. Here are a few considerations: 1. As with any other relationship with a professional, a good fit between you and the service provider is important. I believe this fit is even more important to the success of a psychologist/patient relationship than others, given that patients are having to expose themselves emotionally and are addressing issues such as fears, insecurities, and other core vulnerabilities. Ask yourself whether you feel there is a good fit with the psychologist you are seeing in terms of their approach, style, and personality. 2. You describe feeling unhappy with life in general and with respect to your parenting style. Does the psychologist you are seeing have expertise in dealing with depression and mood issues? Parenting issues? 3. In every single profession, individuals range in terms of their competence levels. Ensure that the psychologist is up to date on advances in treatment approaches, and takes an evidence-based treatment approach (which means providing treatment techniques that research has shown are effective). Ask the psychologist directly about the types of treatment approaches he/she uses and the rationale for such. 4. Finally, have you communicated with the psychologist about how you are feeling about treatment not being effective? A good psychologist will not get defensive, and will openly address your frustration with the lack of progress. He or she should suggest a different treatment approach, or suggest an alternate type of treatment and/or alternate professional. If, after considering the above and after having a candid discussion with your psychologist, you feel that there are still no shifts or improvements, I would suggest seeking out another psychologist. 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 daughter gets excellent grades and wants to be a doctor. She’s been accepted for pre-med at several schools with full scholarship. But now she’s talking about taking a year off before university. I think she’s scared that things won’t be as easy for her as in high school, but I’m worried that a year off will only deepen her anxiety and knock her careers plans off course. What should I do? The answer: As a parent, one of the most important things you want is to see your children be happy, healthy and thrive in their lives. The desire to protect your children and navigate them toward the best decisions is deeply ingrained. So it’s natural that this situation is creating some distress for you. First, congratulations on raising not only an intelligent, but what sounds to be an insightful daughter. The reality is that university is a very different playing field than high school, and her worry is not unwarranted. Worry or anxiety is not a bad thing; we have it for a reason. It mobilizes an action or a response to deal with a stressful (or perceived stressful) situation; it indicates to us that we value the thing we are feeling worried about; and it communicates to those around us that we may need some support. Your daughter’s response is a normal reaction to a coming and significant transition in her life. There are a few things I would suggest you do: Try to understand the depth of your daughter’s anxiety. Find out whether her desire to take a year off is fully precipitated by anxiety or if other considerations are playing a role. Give her reassurance about her ability to successfully cope with the transition. And openly communicate your concerns to her. Start by saying how proud you are of her and that your desire as a parent is to see her succeed and excel in life. Convey that you understand she is worried about things being harder at university and that she is right that things may be challenging. Let her know that you have confidence in her skills to adjust. Ask her what is motivating her to take a year off and what she wants to do in that time. Then listen. You indicate that you think her decision is motivated by fear, but this may be a very small part of it. She may be thinking that if she is going to take a break from school, now is the time before she starts to undertake a decade-plus of additional schooling. The reality is that it will be much more difficult to consider a year off once she begins her studies. Perhaps she is thinking of travelling, or working and making money. If she continues to live at home, establish some motivating parameters. For example, let her know that if she is not attending school she is expected to work and pay rent, and that she needs to increase her contribution to the household (through cleaning, cooking and so on). To calm your worry, remind yourself that for most young adults, a year of working in the real world at what will likely be a low paying, less than ideal job actually has the opposite effect of motivating them to go back to school sooner. Ultimately, you need to trust your daughter’s decision as she is an adult, and also have confidence that you have raised a young woman who will make the right decision. 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 don’t want children, but this upsets my family and in particular my parents who are looking forward to having grandchildren. How do I get them to understand once and for all that my husband and I are content in our lives and don’t want kids? The answer: Statistics from Canada, the United States and Britain all demonstrate converging trends: that conservatively, at least 20 per cent of women (and by extension couples) are no longer having children. By choice. The Gen Xers started the trend, and the Gen Yers are continuing it. Only time will tell what the next generation will do, but if the trends are any indication, they will probably follow in the footsteps of their prior generations. “That’s so selfish!” “But why not?!” “Who’s going to take care of you when you are old?!” scream the worried-and-equally confused friends and relatives of such couples. You and your husband are like many modern-day couples – choosing not to have children, and being comfortable with your decision. Likely, your decision was made as a result of a combination of factors: You may want to focus on your respective careers; you may want to have time and money to engage in other activities that may not be impossible, but certainly can be more difficult with children (e.g., extensive travel, living in an urban setting); and being content in your relationship of two, without feeling the need to expand. Or you may be concerned about your ecological footprint, about the world children are being brought into (environmentally, and otherwise) as well. Despite your decision being one that many couples are increasingly choosing, relatives (usually those from older generations) and friends or family who have kids – and could not imagine there life without them – may be utterly and genuinely confused by your decision. First of all, give up the hope that your family will truly understand your decision, as they may never. You can, however, try to convey your reasoning. The approach you take needs to be a delicate balance between honesty and none-of-your-business. What you share is going to depend on who you are speaking to. For example, your parents may warrant a more detailed explanation than acquaintances you see a couple of times a year. Validate the concerns your parents have voiced: “I understand that you are really worried about us regretting this decision when we are older.” Then reassure them via a united front, “but we have both been very thoughtful about our decision, which was not made overnight, and we are confident we are doing the best thing for ourselves, our relationship, and our future.” And, if appropriate, explain why “both of us love the idea of having freedom and money to travel the world.” Once you have stated your case, wrap up the conversation and gently yet assertively curb repeat attempts others may make to probe more, while understanding that they are probably coming from a place of genuine care and concern. As a woman who has no children by choice (at least at this point in my life), my favourite retort to the “but that’s so selfish” comment is usually a genuinely perplexed expression inviting the person to please describe who I am being selfish toward, and how. Usually that stops the conversation quickly. 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:
There’s a couple who are both friends of mine, but they want very different things. As a woman, I understand my female friend’s desire for marriage, kids and the house in the suburbs. He’s not that into it, but follows along. I’m concerned he’ll end up miserable in a life he didn’t really want. Should I talk to him about my concerns, or just let it go? The answer: I have some questions that you need to be honest about answering: First, why do you think your friends have not considered these differences in their decision to stay together? Second, why is there a stronger loyalty you seem to feel toward your male friend? (Perhaps that is the friend you have the closer bond or longer history with?) Third, what you are trying to achieve by potentially raising these concerns with your friend? It is important for you to, very candidly, consider what your motive and intent is in having a conversation with your friend. Can you truthfully say that you have no hidden agenda or malintent in having this conversation? If yes, then keep reading. The issues that you may potentially raise (and I emphasize with, potentially), and the manner in which you raise them, are going to be dependent on a number of factors, not least of which relates to the history and nature of your relationship with each partner. You want to be mindful of not being disrespectful to either friend, and also not judge a situation without all the information. Have you considered possible explanations for why your friend is ostensibly just “going along” with things he may not want? Perhaps he’s shifted his perspective about what he wants in his life and what is important to him. Maybe the pros of being with a partner he loves and cares for – and compromising by living in the suburbs – outweigh the previous cons he felt about moving out of the city. Remain open to the possibility that there may be considerations both have had which you are not aware or privy to. Keep in mind that any time two individuals join lives in a partnership, there are inevitable personality and life-goal differences that must be dealt with, reconciled or overcome. This can include things such as the manner in which the relationship is formalized. It is not uncommon for people to feel that they, for example, never before considered kids or marriage, but then changed their mind when they met the right person. It sounds like you are concerned about your friend and simply want him to make life decisions that are the right decisions for him. As a friend, your role is to unconditionally and non-judgmentally support him. You may want to check in on how things are going and how he’s feeling. You could, for example, ask him how things are going between the two of them, or how he’s feeling about the direction their relationship is going. (“Wow, lots of changes you are making; how are you feeling about the big move to the suburbs?) Ask open-ended questions where you aren’t making any assumptions or judgments. That way, you open the channels of communication and allow him to talk to you if there really are things he’s concerned about. My experience is that when friends, even very close friends, get in the middle of relationships, it rarely ever turns out well. Be respectful of his partner (remember, she is also your friend!) and their relationship by not making any assumptions. Just make yourself available to be a listening ear if needed. 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 family is dealing with very difficult neighbours. It’s causing us so much stress that we are considering moving from our great neighbourhood to a nearby community. At the same time, my wife and I have anxiety over uprooting our young children. I’m tormented over what will be best for our family in the long run. Should we stay or move? The answer: There are two distinct, yet overlapping issues you are faced with: One, the immediate concern of how to effectively approach and personally cope with the situation regarding your neighbours; and two, whether moving your family is the right long-term solution to a possible perpetual problem. It’s going to be difficult to come to a balanced decision about the second issue until you sort out the first. All too often, we tend to adopt knee-jerk reactions when we are put in high-stress situations. In-the-moment-solutions that we come up with seem to be the only viable options we have. Unfortunately, however, our decision-making when under high emotional distress is often skewed, and we don’t consider all of the pertinent factors that would help make a more rational decision. This happens as stressful situations elicit a fight-or-flight response in us, which is a very strongly engrained, adaptive response that ensures survival. However, unless you and your family are in acute danger or threatening situation from your neighbours (which doesn’t sound to be the case), the response may be mismatched to the situation. Start by thinking rationally about your situation. Writing down the issues can often help provide some perspective. Be specific and detailed in outlining the issues you have with your neighbours. Sit down with your wife and do the following:
Currently you are only weighing the pros and cons of a move as being the only solution, but there may be other less intrusive options. Ultimately, if you have exhausted all other realistic possibilities, and if the issues with your neighbours are significant in severity and impact, a move may be the decision you and your wife arrive at for the long-term. Keep in mind that you may encounter a similar problem in a new neighbourhood and that a moving each time is not an effective long-term coping strategy. 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 have a friend who is a bit of a control freak. Whenever we’re making plans, she needs to organize. How do I get her to loosen her grip and allow other people to have input and make decisions? The answer: None of us have the power to make anyone else do something or become someone they’re not. So the goal of having her “loosen her grip” is likely going to fail if you target that directly. What we all can do is be mindful of our own limits and boundaries and behave in a way that demonstrates behaviours consistent with how we want to live, and do not inadvertently (or directly) reinforce behaviours in others that we do not want to see. Start by reflecting on what it is that you mean when you say she’s a “control freak.” Global and judgmental phrases (even if they are limited to what you are saying in your own head) are often unhelpful and rarely lead to productive solutions to interpersonal behaviours. Shifting the language we use when we speak to ourselves is much more than just semantics – it has a strong impact on how we view others and, more importantly, shapes our behaviour. What is your friend doing that makes you view her as a control freak? Be specific. Does she want to take the lead in planning where you go? Do things have to be on her schedule? Is she unwilling to entertain others’ suggestions? Imagine that you videotaped your friend’s interactions and were describing only what you could see her doing or saying that makes you think she has a high need for control. This is key: You want to describe her behaviour without being clouded by your assumptions (which may be inaccurate) of what you think her motives are. Also pay attention to what you may be doing to reinforce her behaviour. Do you tend to acquiesce to her suggestions? Do you defer taking the lead in suggesting things to do? Does she take the lead in planning because you are leaving plans until the last minute? Once you’ve examined what she is doing that bothers you and what your contribution may be, articulate for yourself what it is that you would like to see done differently. Write these things down. We get an objectivity when we write things that is different than just letting thoughts swim in our head. Use statements that are focused on things within your control (“I would like to meet for dinner at restaurants that I choose at least half of the time we get together.”). When you have articulated what changes you would like to see, start to shift your behaviour to facilitate this happening. For example, the next time you make plans to get together, suggest where you would like to go and what you would like to do. If she pushes back or tries to convince you otherwise, give her gentle yet respectful feedback (“The last number of times we got together I went to the places you chose, and I’d really love it for us to go to a place I choose this time.”). If she continues to push back, you may need to provide stronger feedback (“I feel frustrated that our plans are almost always what you want to do. It’s really important to me to make sure we both have a say in what we do when we get together. Would it be okay if I made our plans this time?”). Let her know your friendship is important to you and you want the two of you to find a balance that works for both. Ask her for her input as to how she thinks both of you could have your needs met. And involve her in the problem-solving process (“How do you think we can arrive at something that works for both of us?”) as this is more likely to contribute to her level of engagement. Remain respectful yet assertive. 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 have been a career woman for over two decades, but I’ve recently been fired (I deserved it, and the industry knows it – no one will hire me now.) I’ve had thoughts of picking up and moving across the world – I’ve got no roots in Canada – but is that just a flighty response? Should I start over at 39? The answer: You are engaging in very black-and-white, catastrophic mindset – a normal way to a view a situation when emotions are high – but I wonder how realistic and accurate your thoughts that “the industry knows it” and “no one will hire me now” are. Ask yourself a few questions: What is the evidence that these thoughts are true? What would I say to a friend in the same situation? Thoughtfully answering these questions may help you to arrive at more balanced, accurate thoughts. That said, losing one’s job falls at the top of the list of stressful life events. You are likely experiencing a range of intense emotions, including worry/anxiety, confusion, sadness, or even anger. Your reaction may be amplified by feelings of guilt (our ability to accept difficult situations is even more challenging when we feel – accurately or not – that our actions contributed directly to the situation). Furthermore, working in a smaller or specialized industry area may worsen the impact if you feel that the news of the firing has spread. My very first suggestion is avoid making any rash decision until you’ve had some time to allow the intensity of your reactions settle. Emotionally-driven decisions often tens to be impulsive. Intense emotions also naturally lead us to experience an intense stress reaction – also known as the “flight, fight or freeze” response. This refers to the three ways we respond when under an acute stressor: by fighting back (retaliating, aggressing), by flight (fleeing, avoiding), or by freezing (becoming immobilized). Your urge to pick up and move across the world sounds like a knee-jerk response to avoid your current situation. This may, right now, feel like the only viable solution. Avoidance actually works as a short-term strategy: it removes us from our present distressing situation and can temporarily reduce any fear/anxiety. This isn’t a long-term strategy, however, as it does not tackle the issues that contributed to the situation to begin with. I don’t mean to suggest that moving away is necessarily the wrong solution. What I am suggesting is that you want to ensure that you are mindful that any decision you do make is approached in a thoughtful, informed manner and not driven by avoidance. I would suggest giving yourself a few weeks to allow the intensity of the situation to go down. Speak to a trusted colleague in the industry may help provide some perspective. Then brainstorm all the possible options you have (in addition to leaving the country) and generate the pros and cons of each before making any decision. 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 hearing more and more about relationship agreements – like the one between Facebook’s Mark Zuckerberg and his wife – in which partners commit to certain behaviours in a formal document. Do you think this is healthy for a relationship or is it just weird? The answer: Virtually every type of relationship – whether it’s romantic, a friendship or one between a parent and child – has a set of norms. These are implicit or explicit “agreements” that usually develop naturally over time. For couples, these agreements may include such things as who is responsible for which chores, how much alone time/couple time they spend, who handles the finances and so on. These agreements are usually implicit; they tend to be more explicitly articulated when things aren’t working well in some areas. This often manifests in the form of conflict, disagreements or arguments. Healthy couples will, throughout the course of their relationship, negotiate and renegotiate their terms depending on what is happening in their individual and collective lives. For example, when a couple has a baby, often there is a dramatic shift in roles and responsibilities, and a natural and organic shift in relationship “agreements.” These norms or agreements are a healthy part of a relationship. All of us value some element of predictability and control in our lives, and there is something to be said for having relationship expectations articulated, assuming that they are fair, acceptable and demonstrate respect for each partner. The notion of a formal relationship document – a written contract that sets out these details – takes the notion of informal agreements to a whole other level. Certainly the increased complexity of relationships and their configurations necessitates the growing use of written, legally binding documents (i.e., cohabitation and prenuptial agreements) to protect respective partners’ interests in situations of a dissolution, divorce or death. With the divorce rate being as high as it is, couples meeting and and living together or getting married in older age, and the increasing prevalence of blended families, having these types of agreements is prudent – not doing so can have a significant impact on the financial situation of one or both parties. But formalizing in writing the very natural parts of a relationship adds a clinical, cold level to the natural fluidity that can make relationships so wonderful. Drawing up formal relationship agreements is really a statement that speaks to the importance a couple put on one another. But how is this executed in real life? Consider the much-publicized requirement that Priscilla Chan put on Mark Zuckerberg to commit in writing to one date night and 100 quality minutes together a week out of his apartment or Facebook office. What happens if one person is in the hospital for pneumonia for a week? What if a family member dies? What if there is an urgent, non-negotiable work or personal commitment one week? Does 400 minutes one week cancel out what is required for the remaining month? Can you “bank” relationship commitments? Although relationship agreements may work for some couples, articulating roles, responsibilities and each others’ expectations is likely much more effectively done the good old fashioned way – over time and through discussion. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. |
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