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By Xavier Mercader Psychological Impacts of Taking Care of a Child with a Heart Condition
I’m sure anyone who’s had a child, will agree that the birth of your first, is one of the most blissful moments in life. As new parents, you spent time reading about how to take care of a child (as if there was an actual manual for it). You prepare your future child’s bedroom, make lists of what they’ll need, buy clothes and attend prenatal classes. All in preparation for the day that will change your life. But no matter how well you think you’re prepared, whether or not you’re a first-time parent or if it’s your fourth child, I don’t believe anyone is ever fully ready for it. In my case, my wife and I were lucky – she had a really easy pregnancy. She felt great the entire time and was even going to the gym three days before her due date. Even the delivery felt easier than I thought it would – not that I was going to do the hard part – but men are usually more afraid than their pregnant counterparts; even if they won’t admit it. Our daughter was taking her time, so my wife was induced. The epidural shot worked great, and my wife was even able to take a nap before showtime. After forty-five minutes of active labour, we met our daughter and I even cut the cord without fainting! The first month felt like it went by in the wink of an eye. We were tired and obviously sleep-deprived, but we couldn’t be happier to have welcomed our daughter into our lives. The News During one of our regular check-ups, the doctor told us she noticed our little one had an odd way of breathing. So, we were referred to a pediatrician. The pediatrician didn’t see anything odd with her breathing but told us he could hear a murmur. He said it was probably just a murmur, but suggested it might be good to go to the ER to get it checked out. I don’t remember how many hours we spent at the ER or how many tests they ran. All I remember is hearing a doctor, at 2 AM, telling us “we are going to admit you” to the hospital. Our one-month-old daughter had a heart condition called Ventricular Septal Defect (VSD), that was causing her ventricular hypertrophy and as a result, was filling up her lungs with fluid. In one day, all that happiness and bliss turned into fear, uncertainty and doubt. We felt powerless, unable to do anything but sit and wait for the doctors to tell us the plan. How everything changedAfter a week, we were cleared from the hospital and given prescriptions to give to our daughter. Captopril to help her heart work better, and two diuretics – one to get rid of captopril once it had its effect as it has a certain level of toxicity, and the other one to reduce the fluid in her lungs. So as new parents, that a month before didn’t even know how to change a diaper, now had to cope with administering three different medications. Giving a child that young medication is extremely challenging; we had to ensure she swallowed them, without spitting them out or choking. Most times, we were lucky if she swallowed half. We were unprepared for this. One morning when giving her her medication, before leaving for work, I thought she was swallowing them just fine. Until she started to turn red. She was unable to breathe for a few seconds. I turned her over and patted her back till she finally spat it all out. I’ve never been more scared in my life. The thought that I could’ve lost her, had me shaking and as a result, I was unable to go to work. The days I did go to work were weird. Some days, it felt like everything was ok and other days, I could barely hold back tears. But most days when I came home I would find my wife crying. Typically I’m good at cheering her up, but this was different, there was nothing I could say or do to help. I worried about that a lot. I felt useless, unable to ease my wife’s pain. At times, being able to leave my place for a few hours, felt like a mental break from everything. But at the same time, I couldn’t stop worrying about my wife and daughter at home. It was tense 24/7. We would put our baby to bed, try to relax, watch some tv, but we couldn’t. Our Next Steps In another check-up, the cardiologist told us our daughter would likely need open-heart surgery. But all we could do is wait and see how everything goes. It would all depend on how well she was gaining weight. If she started to gain weight normally, it was possible she wouldn’t need the surgery. But if she continued below the growth charts, it would mean her heart condition was keeping her from growing normally (this is what they call failure to thrive). So, we tried our best to get her to eat better. But how would she gain any weight if she was taking two diuretics three times a day and she wasn’t finishing her bottles? Every time we went to her check-ups, she was below the growth charts. And every time we were told the same thing. “It’s too early to decide, let’s see how everything goes”. This made every feeding time tense. All we could think was “I hope she eats a bit more now”. After a few months of stress, we went from not wanting our baby to have surgery, to wanting her to have it. We didn’t actually want our baby to have to go through surgery, but we did want her heart fixed and to be able to leave the stress behind us. With time, our little one started to gain weight. We were told she was doing well but still needed to wait to decide about the surgery. Our, now toddler, was able to play and do all the things other children do, so we started to relax slightly. We couldn’t stop worrying completely, but at last, we received some good news. At her last check-up, we were told she won’t need surgery after all. She will be able to live a normal life. The Connection with Mental HealthTaking care of a child with any health condition is sure to take a toll on the mental health of their parents. In my experience, parents feel stressed, depressed, helpless and a sense of unfairness asking themselves “why does this have to happen to OUR baby?” This feeling of unfairness, also makes us feel alone and isolated. I remember going to one last prenatal class to meet with the group of parents after all our babies were born, to share our experiences about giving birth. There were approximately 13 couples and most of them shared bad experiences: they had either during the final stages of pregnancy or during labour, but all of their babies were healthy. They had the ability to look back to those difficult experiences with a smile. When it was finally our turn, we didn’t have a bad labour experience to share, only our baby’s heart problem. And that made us feel very alone. What I Learned About Managing Mental Wellness Although everyone’s experience is different, the following are my personal tips for a parent dealing with a similar issue.
Conclusion Caring for a child with a heart condition or other illness is a situation that no parent is prepared for. It can be physically and emotionally taxing to not only manage the realities of a child’s illness, like giving my young daughter medication, but also the fears associated with the illness and the unknowns that can come with that. Even though during this time you likely want to spend all of your energy taking care of your child, it’s also important to take time for your own mental health. Overall, you will be better able to take care of your child and manage the illness if you’re also taken care of. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My boyfriend wants to take erectile dysfunction medication to enhance his performance. Why would he want to do that? I think our sex life is great, and I don’t want medication to make it unnatural and weird. The answer: There may be a number of reasons as to why your boyfriend feels the need to take erectile dysfunction medication – getting to the root is key. Relationships thrive on communication and that includes speaking to our partners openly about our sex lives. Erectile dysfunction is the inability to develop and/or maintain penile erection during sexual performance. It certainly affects a percentage of the male population. Psychological impotence (complication with erection due to stress or performance anxiety, rather than physical impossibility) is the most common contributor to erectile difficulties. The issue often gets resolved when a man’s anxiety dissipates. Most men will experience this at some point in their life, especially when they are highly stressed or are in the early stages of a relationship. But the difficulties are often short-lived and do not create continuing problems in a relationship. In these circumstances, pharmaceutical intervention is not necessarily successful and I would not recommend it. Erectile dysfunction caused by physiological or medical reasons – such as a health condition or side effect from other medications – is less common. In this scenario, age is a primary contributor. The National Institutes of Health estimate that about 5 per cent of 40-year-old men will experience erectile dysfunction on an ongoing basis, whereas the number rises to 15 to 25 per cent among 65-year-olds. Your partner does not have a medical reason for taking this medication as you have alluded, which means he’s part of a growing number of men who use erectile dysfunction medication in a recreational manner. There could be a number of contributing factors for this. Your partner may be curious about the extent to which his performance will be enhanced; he may be experiencing peer pressure; or if he has had too much to drink, he may take the medication to combat the negative impacts of alcohol on performance. I have two main concerns with recreational usage. For one, erectile medications have side effects. They place stress on the major organs – in particular the heart, liver and kidneys – and the long-term effects are unknown. Second, there is some emerging evidence that men may experience adverse impacts on their sexual function and become psychologically reliant on the medications. Start by explaining these concerns to your boyfriend – especially the latter as it may serve to be the strongest deterrent. Then try and understand where your boyfriend is coming from. Perhaps he has some insecurities about his performance that he’s been reticent to share. Having an open conversation about your perceptions and feelings surrounding your sex life may serve to ease his mind. Tell him how great you feel about your sex life and suggest ways to add spontaneity and excitement to your intimate relationship without the use of medications. 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:
We recently moved to a new neighbourhood, which means my daughter will be starting Grade 9 without the comfort of having her friends there too. She’s terrified of starting high school without familiar faces and as much as I try to reassure her that she will make new friends she is still extremely unhappy. What do I do? The answer: The transition to high school can be a difficult one for many teens – the shift from being a big fish in a little pond to a little fish in a big pond can feel intimidating and overwhelming. Add on to that the differing demands of high school, teenage hormones, and the absence of other stabilizing factors (friends) and a potential recipe for unhappiness can be brewing. For all of us, situations feel particularly stressful when they are (1) unpredictable and (2) out of our control. Try to be mindful of ways you can foster a sense of predictability and control for your daughter. As a parent your urge is to want to protect your child from any hurtful situation, and often the approach parents take is to try to reassure through telling (e.g., “you will make new friends;” “you’ll be fine;” “it’s not as scary as you think”). Unfortunately, this is not the most effective strategy. Think about times you were in a stressful or upsetting situation – likely, someone telling you it would be better didn’t work. Not only can this approach feel like it is minimizing the concerns we have, but it can feel invalidating of the feelings we are having. (Most people take this approach by the way – not out of ill will, but from a lack of awareness of knowing what to do or say.) All of us have a core fundamental need to feel understood and validated, particularly when feeling stressed. So start by focusing on simply listening to your daughter. Do not interrupt and do not problem-solve – just ask open-ended questions to understand what she is most scared about (“help me understand what you are most scared about and what you think it will be like”). Try to get her to be as specific as possible and to go through all the worst-case scenarios she is imagining (e.g., “I won’t have anyone to eat lunch with”). You must resist the urge to tell her she is inaccurate or that what she is fearing won’t happen. Instead, ask her how likely she thinks it is that those situations will arise. And ask her what makes her think that is going to happen. Try to get her to verbalize the worst outcome and ask her to think about what the most likely situation may be. Ask her to be specific about what she is most worried about (“if you got to school, and you had no one to eat lunch with, what is most upsetting about that to you?”). Have her think about how she would deal with the worst imagined situation (“if you were all alone at lunch, what things do you think you could do to make the situation better?”). Encourage her to talk to family friends or cousins that are a bit older and can provide her some words of advice and comfort, as that may help. Then, just be there for her as a listening ear particularly during the first few days and weeks of high school. 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 had a huge fight with my daughter. She had only moved out last September to go to university in another province, and was home for the holidays. She hasn’t had a great first semester, and perhaps we were being a bit too critical of her while she was here. We ended up having a bit of a blowout on the way to the airport. She rushed to her flight and I feel we didn’t get a chance to properly make up. I communicate the best when the other person is in the same room as me – how do I best reconcile with my daughter if she’s miles away? The answer: Expressing how you feel to a loved one – particularly when hurt feelings or conflict has arisen – is so very important. Surprisingly, however, most of us struggle to effectively communicate with those closest to us. We tend to have the most apprehension and hesitation about talking – and making sure we say just the right words – to those that know us best. This is often because of the history (good and bad) we have with those we love; the vulnerability we feel around those whose love and acceptance we desire; and the consequences we fear of being rejected by those we care about. It’s important for you to communicate how you feel to your daughter as soon as possible. Time unnecessarily prolongs hurt feelings and may lead to needless animosity that grows. Avoiding the uncomfortable can also result in an easily solvable conflict becoming a larger-than-anticipated source of negative feelings in your relationship with your daughter. For many of us, communicating an apology in person often feels easier. Because non-verbal signals (gestures, body language, touch, voice tone) comprise a more important part of our communication than the actual words we say, in-person discussions about serious topics are almost always preferable. Sitting face to face with someone provides us with important feedback on how the person we are speaking to is receiving our apology. As this isn’t possible for you right now, you need to go with a less comfortable means of communicating with your daughter – via Skype or phone would be my first recommendation (to retain some element of non-verbal communication); by e-mail or by text would be my second. Open up the lines of communication with a very simple message: “I’m sorry about the blowout we had. I love you and wish I could apologize in person.” Provide a specific apology for the things you said or did that you regret. Then listen to your daughter’s perspective. Make a concerted effort to understand how she is feeling and the challenges she is facing. Find out how you can best support her. Ask her what you can do to repair things, and how the two of you can move forward in a way where both your needs are being met. Have trust that the foundation of your relationship is a strong one, and that you will be able to effectively move on from this fight. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. The question:
I’m a 33-year–old woman, and I am smitten with a man. The problem is, he told mutual friends a month ago that he wasn’t interested in a relationship – but we email, text and flirt almost daily. We have so much in common and I feel challenged. Am I an idiot to let this go on – or will he come around? The answer: Being smitten with a man and engaging in flirtation with him in no way makes you an idiot! It is all part of being human and being attracted to someone. I think the subtext of your question however is more along the lines of “am I thinking our flirtation means more than he thinks it does”. This of course is a valid (and protective) question to ask yourself as it can potentially save you from feeling disappointed or hurt down the road. I have one question for you – and be brutally honest when you answer it: what do you really expect from him and the relationship? You say you have much in common and you feel challenged. I’m certainly not disputing that you may have things in common; clearly there is some level of friendship and attraction that is leading to almost daily contact. But I wonder about your perception of feeling challenged by him. Ask yourself if you feeling challenged by him is simply an artifact of him being unavailable for a relationship. You indicate that he has made it clear that he is not interested in a relationship. His behaviour seems to be inconsistent with what he has said, so I can appreciate this may be confusing. Did he indicate to mutual friends he doesn’t want to be in a relationship at all? That he doesn’t want a relationship with you specifically? Rather than trying to play a guessing game about where he is currently at based on hearsay from others, you may want to simply ask him directly. You have frequent enough contact that you probably can safely interject this question at some point in your communications. Then, take what he says at face value. All too often women tend to hold onto beliefs or hopes that they can somehow change a man and make him want to settle down, even when the complete opposite has been verbalized. (Men do this as well – but in my experience women do this more frequently.) Feeling “smitten” with him and hoping he will “come around” makes me think that you are already starting to feel invested emotionally in the hope that things will develop into something more than they have. It’s okay to continue to email, text and flirt daily if you are able to do so while keeping yourself emotionally distant, and if you are okay with the relationship never developing into anything more than it currently is. But, if you are secretly hoping that somehow he will change, I would suggest you curb the amount of contact and invest energy into someone who is wanting to pursue an actual relationship. 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 friend thinks her husband is cheating on her. They have been married for six years and have a child. From what she’s told me about their relationship, it seems like all the signs are pointing to infidelity: things have gone downhill fast and there is no intimacy. She’s asked me what my thoughts are. I think she would be better off without him, but how can I tell her the truth about my feelings? I don’t want to lie. The answer: Keep your opinions to yourself. And if you feel tempted to do otherwise, rewind and repeat that mantra to yourself. Rarely, if ever, does any good come from providing candid opinions about others’ relationships – particularly when the stakes are high given that there is a marriage and a child involved. I understand that your opinion is being sought and that, as a friend, you want to be truthful. However, brutal honesty is not always the best policy. You can still be forthright without necessarily revealing the entirety of your thoughts – this is not being dishonest. You’re simply being a helpful friend by respecting both the relationship and acknowledging that ultimately your girlfriend has to arrive at a decision about what to do next. If any of us went through life fully verbalizing the “bubble above our head,” it’s likely most of our relationships would end. The main consideration here is that you both have a suspicion, but no hard facts about whether or not he is cheating. They are ultimately the only people who can come to a resolution about how their relationship should unfold. As a result, there is little to no value in sharing your opinions. Your role therefore is twofold: to provide her support and help guide her toward making the best decision for herself and their child. Listen to your friend’s concerns and ask her what is making her feel suspicious. Discuss with her the options she thinks she has – waiting and seeing how things transpire, starting a conversation with him, getting more information on her suspicions, etc. Let her know that you will support her however you can, but that you are not in her shoes and that it’s not your place to tell her what to do. There are only two circumstances in which providing your candid thoughts would make sense: if you had objective, first-hand evidence that he was cheating, or if it was the early stages of a new relationship where the potential risks of providing your blunt opinion were low. Meddling in a marriage on limited information does not fit within either one of those situations. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
Our son, who was an excellent student and athlete, suddenly dropped out of university and left his summer job in order to pursue a relationship with a woman. He says he is not interested in various possibilities, and that he needs to figure out what to do in life. What should we do? The answer: Watching a child of any age make decisions that you feel aren’t in their best interest is always difficult for a parent. It sounds as though you have understandable concerns that your son is giving up positive opportunities (education, athletics) that would help him build a stable future, in exchange for a relationship that may be temporary. As your son is in university I will assume that he is a young adult – this is important because your influence on your child’s life is dependent upon a number of factors, one of which is age. If he were underage, certainly your role and responsibility would be greater and a more assertive approach may be needed; conversely, if he were in his 30s or 40s, your role would (despite your best intentions or wishes) be quite different, and he likely would be less open to your opinion or advice. I would suggest having a heart-to-heart conversation with your son. Let him know that you want to speak with him about some things that he may not necessarily agree with, but that feel very important to you to bring up. Emphasize that you care for him, and that your only wish is that he have a stable and successful future. Tell him that first and foremost, it is important to you that your discussions do not create any conflict/divide in you and your wife’s relationship with him. Convey your concern and worry that he may be making decisions that, at least from your perspective, would ensure a good future. Let him know that you appreciate that he is trying to figure out what he wants to do in life. Also let him know that you understand that he cares for the woman he is with – this is very important as blaming or bad-mouthing her will only serve to further alienate him. Ask about, and genuinely try to understand his perspective and what has led to his decisions. (It may be that he has thought through his decisions well, even though you may have a hard time understanding or agreeing with them.) It sounds as though you feel his decision to abandon other pursuits is fully attributable to the woman he is with, but it may be that he was already considering making some changes, and that the relationship simply became a trigger. Remain supportive, and stay focused on keeping an open and respectful relationship with your son. At the end of the day, you need to trust his decision as he is an adult. Try to keep the channels of communication open, and let him know that you are always there to provide parental advice when or if he needs it. 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 suppose this is a problem of old age, but I think constantly about my ex-husband, who has been dead for almost 40 years. Could this be from unresolved trauma? It was not a happy marriage. The answer: Regularly thinking about someone who was an important part of your life – good or bad – even years or decades after they have died is not unusual. Grief is a mysterious creature and the process can be so unpredictable, and so very individual. Thoughts of someone who has died tend to be more frequent and intense when the death was of someone particularly close (a partner, a child). The grieving process is protracted when the death is untimely, unexpected or particularly traumatic or tragic. Having unresolved or complicated emotions from the relationship while the person was alive can also play a role, as you have alluded. As a society, we are strangely ill-equipped to deal with death. I am often asked questions about how long it will take to “get over” a loss, or how one can deal with “unresolved issues” when it comes to their grieving. My experience – both personally in dealing with the death of my father, as well as professionally – is that we never really get over the death of someone that was an important part of our life. We simply learn to cope better over time. Whether your thoughts are a problem depends on a few factors. First, when you say “constantly,” what do you mean? I have many patients who will describe thinking on a daily basis about their deceased loved one. A fleeting thought on most days, even decades later, is not necessarily unusual. Consider the intensity of the emotions associated with thoughts of your ex-husband. Are they neutral thoughts that pop in and out of your head, and don’t interfere with your day-to-day activities? Or, do you find you get stuck in a ruminative state that causes a high degree of emotional stress? There is no magic formula for how long it takes to cope well after a death. But most people will find that it can take from a few months to a few years to get back to their usual mood and activities, and have thoughts of their loved one without breaking down or becoming overly emotional. Four decades later, you still sound disturbed by the quality or quantity of thoughts you are having about your ex-husband – so clearly something needs to change. Spend some time reflecting on what impact his death had. Do you feel that there were unsaid things that you want to communicate to him that you never did? Do you have anger or regret at yourself for not doing things differently, such as leaving the marriage earlier? Are there elements of self-blame or shame for decisions you did or didn’t make? Have you made efforts to move on in your life, or is your past relationship still affecting current-day decisions? Doing some soul-searching on the above can help you move forward. Start by writing down your thoughts in a journal; every time you get stuck on a thought, note what it is specifically that’s in your head, and what it means about your life now. This can be a very powerful exercise. If you find this doesn’t make things better, joining a grief support group or seeking the help of a therapist may be of benefit. 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  Valentine’s Day isn’t Designed for Queer Couples
Valentine’s Day is a consumer ‘holiday’ that we’re bombarded with starting in the middle of January – whether you like it or not. Not only are red, white and pink treats and branded presents at almost every store, but we are shown images of happy couples in advertisements everywhere. Not only is this challenging for those who are single around Valentines Day, but it can also be challenging for those who identify somewhere on the LGBTQ+ spectrum. Valentine’s Day isn’t designed for queer couples. Why isn’t Valentine’s Day Queer? For many folks who identify as queer, Valentine’s Day is a reminder that their identity isn’t represented which can make them feel invisible or unimportant. It does this by reinforcing the idea that ‘ideal’ and happy relationships are heterosexual, monogamous, sexual and romantic. And really anyone who doesn’t fit into that ideal feels as though they’re failing somehow. Think about the things we are surrounded by this time of year. Jewelry commercials are almost always depicting cisgender heterosexual couples and upholding the traditional gender norm of ‘the man’ giving a beautiful and expensive gift to his female partner. We see the same ideas reflected in the products; such as “His & Hers” monogrammed items and cards specifically address to husband/wife or boyfriend/girlfriend. And if/when we attempt to participate in Valentine’s Day we are likely to be met by heternormative assumptions. For example, “oh your boyfriend will love this” when purchasing a gift. Or having a server at a restaurant assuming your gender or relationship status. Yes, queer representation and queer-focused products do exist, and this continues to improve – but the ones that are available are not easily accessible. And the images we are bombarded with are of straightness. Though being queer does not mean we have to reject Valentine’s Day as a whole. We all deserve to be able to celebrate our love no matter what it looks like. Many in the queer community are already good at subverting the norms, reclaiming and celebrating all types of love. So, how can you celebrate Valentine’s Day as a queer person? 1. Have a movie night in with your loved one(s) or your close friends. Valentine’s Day does not have to be about romantic love, so spend the day with people that you care about and find some great queer-focused films to watch together. Consider this list as a great starting point. 2. Buy (or make) a queer-friendly Valentine’s Day card. It’s less likely that you’re going to walk into a Hallmark store and find a card that represents your identity so start thinking about it early. Give yourself to find some cool cards online (Etsy is a great place to start) or consider making your own. 3. Support queer businesses. 4. Go out with a group of queer couples (or as singles) to increase your visibility. 5. Consider making a Valentine’s donation to an LGBTQ+ organization rather than buying presents. If you’re in Vancouver consider one of the following options:
Remember that Valentine’s Day is just another day and regardless of how you feel about it, your relationship status, or your sexual orientation or gender identity you are valid and you will get through the day. Try to surround yourself with positive representations of queerness and queer love and remind yourself that love doesn’t have to look the way it’s advertised to you. Keep doing you! For those who don’t identify as LGBTQ+ but also don’t love the way relationships are represented during Valentine’s Day or simply want to support your queer friends during this time of year what can you do? How to be a queer ally during Valentine's Day 1. Don’t assume someone has plans for Valentine’s Day. Meaning, don’t ask what their plans are unless you explicitly know they plan to celebrate it. This not only helps to support queer folks who don’t want to celebrate Valentine’s Day but also those who are single and don’t want to be reminded they don’t have plans (or at least not traditional plans). 2. Don’t assume the gender of someone’s partner. (Really you should never assume someone’s gender.) 3. Don’t make assumptions about or judge how someone chooses to celebrate Valentine’s Day. Remember – Valentine’s Day is ultimately about celebrating love – which at its heart involves connection and unconditional acceptance. Consider ways you can connect and unconditionally accept yourself and others around you this Valentine’s Day. 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. |
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