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By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I have a close friend I’ve known for 20 years who still can’t control her temper. Once or twice a year she completely loses it – yelling, screaming at me, an adult version of what you expect from a four-year-old’s tantrum. Later she’s ashamed and mortified. What can she do? What can I do? The answer: No matter how hard we wish, we simply do not have the ability to change other people. The only person we have control over is ourselves, and that alone can be difficult to do even in the best of times. So, there are only two things you can do: Monitor – and, more importantly, modify – your responses to your friend’s tantrums, and offer to support her if she wants to make changes. One of two things usually explains the presence of longstanding, ingrained behaviours that have lasted decades; the most likely situation is that your friend’s intermittent outbursts are working for her. Ostensibly, they allow her to communicate her distress to those around her. Likely, her outbursts have the actual effect of modifying the behaviours of those in her environment. But unfortunately, the negative consequences (feeling shame, feeling mortified) haven’t been sufficient in motivating her to make changes to her behaviour. Another less likely, but certainly tenable, possibility is that she truly has wanted to change, but hasn’t found the tools she needs to do it. By tools, I mean alternate strategies to manage and cope with trigger factors, and effective ways to communicate how she is feeling to others. Tantrum-like behaviour, for children and adults alike, is really just communication behaviour. Psychological or substance-use factors can certainly contribute (a personality disorder, or alcohol or drug use), but essentially she is making a decision to act or react in a particular way. Ask yourself: How do you respond to her behaviour? It sounds as though, at some level, you have tolerated her actions. What factors trigger her to react this way to you? What do you do (or not do) after she reacts this way? And, have you given her feedback about the impact on you? What contribution do you make to the situation, if any? I do not ask this in a blaming way, but I want to ensure that you are not engaging in similarly inappropriate behaviour toward her. Assuming that you do not play any significant role in her behaviour, you need to have a very blunt conversation with your friend. Let her know in no uncertain terms that the way she acts is unacceptable, and although you have tolerated it, you will not continue to do so. Let her know that you value her friendship and are prepared to help her develop skills that can better control her anger. Offer to help her understand what her triggers are, and seek professional help from a mental-health professional with expertise in anger-management skills. The Anger Management Sourcebook, by Glenn Schiraldi and Melissa Kerr, offers cognitive-behavioural strategies that teach people to identify personal triggers of anger – and better cope with those feelings. 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 has been pining over a guy who is stringing her along. It’s been over a year now. How do I convince her it’s time to move on? The answer: Unfortunately, when it comes to matters of the heart, there is very little if anything that any of us can do to “convince” someone to feel (or not feel) a certain way. That said, watching someone you love and care about be in a relationship with someone who is not treating them well, or where they are not getting what they deserve, can be nerve-wracking and frustrating. Remember that your primary role as a friend is to love and unconditionally support her and her decisions. At the same time, be honest about how you feel. You don’t have to pretend that you like the guy she is interested in. If you haven’t already done so, let your friend know that you love her. Describe the type of person you would like to see her with, and communicate why that is important to you (e.g., “you are such a kind and caring person, you deserve to be with a guy who is there for you when you are having a bad day, not someone who takes a week to get back to you”). Let her know that you are there for her and will always support her decisions, but that as her friend you want to also be honest about how you feel. You can be specific about the types of behaviours you see this guy engaging in that worry or concern you. Convey that you understand she cares for this guy. Try not to be overly critical, as bad-mouthing him may alienate your friend, or lead to her feeling that you are criticizing her. Try to understand what it is that is keeping her hooked with this guy: attempt to genuinely understand things from her perspective. Be open to the fact that there are elements of the ‘relationship’ that are working well for her. Ask if she is happy and okay with the situation. If the answer is yes, your job as a friend may be to simply accept her decisions and not judge. If the answer is no, try to understand what is keeping her engaged. Does she feel like she doesn’t deserve any better? Is she insecure? Is she having a hard time meeting other people? If so you may want to try to focus on talking about these things with her, and being a supportive friend that helps her to problem-solve ways to overcome the barriers that keep her in this relationship. Ultimately, though, remember that it remains her decision, and that your role is to support and accept (not necessarily agree with) your friend’s decisions. 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 group of us who hang out, and we are pretty sure that one of our friends is gay. We don’t care, we just wish he wouldn’t hide it if that’s the case. Should we ask him outright? The answer: Coming out is a deeply personal process that can be immensely difficult and challenging. I’m happy to hear that among your group, your friend’s sexuality is irrelevant (in a good way) and a non-issue when it comes to how you view him. It sounds like you will accept and support him when he does choose to come out. Whether you should ask him outright is a tricky issue. On one hand, there’s something to be said for communicating to him that you accept him regardless of his sexuality. However, you need to balance that openness with the need to not put him in a position where he’s forced to come out when he’s not ready. Asking him outright may put him in awkward position, and you need to respect that he will come out when he feels he is personally ready to do so. He may also feel that it’s important that he first comes out to certain people in his life – like his family – before anyone else, even your group of friends. Consider the myriad challenges your friend may be facing. He may be going through the personal challenge of accepting his own sexuality before he comes out to others. He may be unsure how to tell those close to him. He may not be sure what reaction he will get from family and friends – those that he cares about and whose opinions matter to him. The best thing you and your friends can do is ensure that you are mindful of actions that may inadvertently create an unsupportive environment. Pay attention to the language you use and the jokes you make. It often stuns me how frequently people, just in day-to-day conversation, with no malicious intent, use words that can alienate someone who is gay. Also, take some time to learn more about the experiences people have when they first come out, so you can better understand what your friend may be going through. PFLAG Canada has links to a range of resources and support agencies that you may find helpful. Pay attention to your friend’s behaviour: It may be indirect communication he is giving about his sexuality. Think about your responses to him. Not uncommonly, people “test the waters” with those close to them before they come out, by observing how people react to seemingly neutral situations or stories. Whenever the opportunity arises, let your friend know what he means to you and what qualities you value in him. If it is appropriate and not awkward, try to convey that you would accept him no matter what. When he does come out, offer to support him however you best can in coming out to other friends, family or coworkers. And, most importantly, let him know how you feel – which is that his sexuality makes no difference to how you view him and your friendship. 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  How to support a friend or loved one who is suicidal
A friend or loved one is an important resource and source of support for those who are feeling suicidal. Even if you don’t feel as prepared to support someone you care about through these times, there are ways you can be supportive. Just know that you don’t always have to know exactly what to say or do. Often being present with someone is enough to keep them distracted and safe. As well as being aware of warning signs of when they’re high risk can help ensure they get the support they need during a crisis. The most important thing is to be there for your friend or loved one, and listen without judgment. Validate that their pain is real, and remind them that you are there for them. Ask them what they need, and what would be most helpful for them. If you feel additional support is needed, don’t hesitate to encourage them to seek professional help—and offer to help them do it. Steps to Support a Friend Who is Suicidal So, what are the things you can do to support someone who is suffering from mental health challenges and may be considering suicide? 1 Know the signs. Admitting to someone that you’re struggling is a challenging thing for many people, but sharing that you’re thinking of suicide is often even harder. Many people hold back admitting their thoughts of suicide out of fear of how people will react. So, knowing the signs can help you to provide the appropriate support. Most of the signs are around hopelessness; some of these signs include a preoccupation with death, getting their affairs in order, saying goodbye and withdrawing from others. 2 Listen attentively and without judgement. If someone does come to you with their thoughts of suicide, try to remain calm and listen to them attentively and without judgment. Focus on just being with the individual and allowing them an opportunity to express their emotions without interrupting or giving advice. 3 Start the conversation. Suicide is incredibly challenging to talk about or even raise – so if you are concerned, you can be helpful by asking your loved one gently but directly if they’re suicidal. This lets them know that it’s okay to talk about it with you and creates a space where they can express their thoughts. Be direct and ask if the person is considering suicide rather than hinting at it or implying it. 4 Evaluate their risk. Once someone has shared their thoughts of suicide, it is important to determine their level of immediate risk; are they just thinking that death may be a nice option if it somehow just happened (passive suicidal ideation) or are they actively wanting to do something to hurt themselves (active suicidal ideation)? There are a few questions you can ask to determine their level of risk:
5 How to take action.
Final Thoughts Know that there is only so much you can do to support someone and it can feel defeating if you have done everything you can but the person you care about is still struggling. Do everything you can, but know you can’t do everything. Make sure that you, as a support system/caregiver, are also making time to take care of yourself. Giving to others can be emotionally draining and you are only able to continue to help if you take care of yourself first. Note: if you are struggling to provide support and don’t know what to do at any point, you can also call the suicide crisis line for information, resources and suggestions that can help you to support your loved one. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The Question:
My friend is convinced she has wrinkles and needs to get botox. She has absolutely no wrinkles that I can see (in fact, her skin is wonderful). I am concerned about her warped perception of her appearance. Why can’t she be happy with how she naturally looks? The Answer: A woman's relationship with her appearance is one of the most complicated relationships she will encounter in her lifetime. The relationship is mitigated by a number of factors, that includes a strong sense of self, confidence in other traits and attributes she possesses, and her overall sense of happiness. Our modern day society, however, is wreaking havoc on the self-image of even the most secure women, and I am seeing in increasing number of particularly younger, objectively attractive women in my practice who are consumed with undergoing procedures to further enhance how they look. I think this is an artifact of a number of factors. We live in the age of a technological revolution where we are literally bombarded with myriad images, on every medium and form, that set expectations for what society’s ostensible “standards” are for beauty. One would be hard pressed to find a television show or film without a star that has either privately or – as is the current trend – publicly pronounced the cosmetic surgeries she has had. Gone is the shame and stigma with undergoing enhancement procedures. And, gone are the days where cosmetic surgeries were only for the very rich and famous. The last decade has witnessed an explosion of the range of available cosmetic procedures and clinics, and the drastic drop in costs has made many of these services accessible to the every-woman. Virtually all of us engage in some element of appearance enhancement – ranging from the clothes we wear, the grooming practices we engage in, and the makeup we put on. A decision to engage in something more significant (and arguably not benign in terms of long term health impacts) is a very personal decision. As a friend, your job is to support and not judge your friend for the very personal decision she is making; however, as a friend, it is also your job to (respectfully and kindly) express the concern you have to her. Start a dialogue with her about her reasoning for wanting to get botox. Most importantly, listen to her reasons, as that may give you an indication whether her decision is a temporary knee-jerk reaction to fleeting insecurity or unhappiness, or if it is a well-thought out, considered decision to engage in a procedure, fully understanding the potential risks. If the former, try to listen to support your friend as best as you can and ask her what you can do to help. Encourage her to defer the decision until she is in a better place emotionally. If the latter, focus on keeping your opinions to yourself, and maintaining the friendship. 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 father overworks himself because he was laid off a number of years ago and he hasn’t made as much money, or pension, since then. He feels like he needs to work six days a week, and take any overtime offered by his current job, to make as much money as he can before retiring in a few years. But I see how tired and quiet the long days are making him, and he is becoming a wreck behind the wheel, driving too slowly and missing familiar turns in traffic. How can I get him to recognize that his health is more important than work? The answer: It can be upsetting to watch your father overwork himself at an age when you would hope he has the luxury to slow down and relax in anticipation of enjoying his upcoming retirement years. It’s interesting how difficult it can be to cope with a transition in roles: as our parents get older, as children we end up inevitably being placed into the caretaking/protective roles our parents once served for us. There are two distinct issues – your father’s decision (albeit not necessarily by voluntary choice) to work an inordinate number of hours to plan for his future, and the possible safety risks posed to both himself and others on the road. It can be helpful to parcel these two issues out and address them separately. Confounding them will probably lead to frustration for both of you, and may place your father in a defensive position. Try to understand where your dad is coming from. It can feel awful to be in a position where you are uncertain about your future, particularly as we age. Your father is probably worried and anxious about the future, as well as frustrated or even anger at himself or his past circumstances. The reality is he may well need to be working the level he is to have a future that he once imagined. During a time when you are both feeling relaxed, start a conversation with your dad about his future. Talk generally about what his hopes and dreams are for retirement. This may help you get a picture of what he is working toward. Then gently inquire about whether the means he is currently adopting (i.e., hours worked) are necessary to achieve those goals. Offer to help him with his planning – you may suggest that he may find it helpful to sit down with a financial advisor who can help him map out his plans in more detail. Keep the conversation light and supportive, and be mindful that he probably will have a lot of pride around these issues. In a separate conversation, express your concerns about his health. Describe what you are seeing – be specific and objective (for example, have you directly observed his driving difficulties?). Tell him directly how you feel – that you are worried and want to see him as healthy as possible. Ask if there are things that you can do that may help. Offer to go to his family physician with him to talk about possible causes and contributions. It’s amazing how often parents – or any family member for that matter – will be more willing to heed the advice from a professional. If he is resistant, and you have concerns about his driving, you have an obligation to inform his family doctor. Consent issues do you not apply here – meaning that if you have some concern of risk, it is in your right to call his physician (the doctor cannot release any information back to you without your father’s consent). You can’t magically get your father to value his health more than work, but you can guide him toward possible solutions that improve his situation, and most importantly make it safe for him and others around him. 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  How to be a good LGBTQ+ Ally
LGBTQ+ individuals experience discrimination and harassment; this directly and negatively impacts their mental health, and LGBTQ+ adults are more than twice as likely to experience mental health conditions and are at higher risk for suicidal thoughts and behaviour. Homophobic/queerphobic slurs are the biggest contributor to the harassment of LGBTQ+ people at work, and in general. Most of the time these slurs are used unconsciously and are not intended to be harmful. Though regardless of the intent these words do cause harm. So here are some tips on how to be a good LGBTQ+ ally: 1) Educate yourself on the LGBTQ+ community.Knowledge is power, this not only helps you to have the information you need to approach LGBTQ+ people with respect, but it gives you the opportunity to support them through starting to educate others as with some of the examples below.
2) Don’t make assumptions. Assumptions are typically based on stereotypes as well as conflate heterosexuality as the ‘norm’. A simple change we can make to be more inclusive of LGBTQ+ people is to not make assumptions about gender identity based on the way someone looks as well as not assuming the gender of someone’s partner. 3) Don’t ever out someone. If someone comes out to you that means they trust you, so don’t break that trust by outing them to others. 4) Be conscious of your language. We form habits around the use of some words or phrases and sometimes forget the intent behind those words. For example; ‘that’s so gay’. Although this phrase is becoming less common it used to be used to describe something that was seen as negative. Take a moment to think about how using phrases such as this could have a negative impact on people in the LGBTQ+ community. 5) Don’t let slurs slide. Addressing others’ use of slurs can be a bit more challenging. When addressing problematic language consider the context of the situation, it may make more sense to bring it up with the person later rather than confronting them in public or in front of friends or colleagues for example. Consider whether or not they’re using the slur intentionally. If you are unsure assume they’re not, approach the situation calmly and explain that their use of language is offensive. Consider asking them questions regarding the reasoning behind the use of this language. 6) Don’t allow others to make queerphobic jokes. Simply asking someone to explain the punchline of a problematic joke can help them to understand why it is problematic. 7) Stand up for others. This may look like standing up against harassment or bullying, this is particularly important in the workplace. But it can also mean ensuring that everyone is treated equally, for example; making sure that people are using the correct name and pronouns for someone. 8) Make space for LGBTQ+ voices. Final Thoughts When you first start to learn about the LGBTQ+ community and how to be an advocate for your friends and co-workers it can feel a bit daunting. Don’t worry, that’s normal. There is a lot of diversity in the LGBTQ+ community and you are not going to gain a comprehensive understanding of the community overnight. But we all have to start somewhere, educating ourselves on the basics and being able to recognize problematic language and behaviour is a great place to start. Know that you don’t have to be an expert to stand up and let someone know that their words or behaviours are problematic. The first step in being a good LGBTQ+ ally is your intention to do so. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My parents are aging and showing signs of slowing down mentally. I’m concerned about Alzheimer’s some time down the road, but they don’t even notice it. They say I’m overreacting. How can I get them to acknowledge that they may need help sooner rather than later? The answer: Having a discussion with a parent about age-related changes can be one of the most difficult conversations you may have. A myriad of factors are probably converging to make this hard: your desire to be respectful and kind toward your parents; the challenge in having them recognize and accept changes that may truly be subtle and unbeknownst to them; pride on your parents’ part; and, possibly some sadness and worry about the changes you are witnessing. Your attempts to have a conversation about the changes with your parents have been met with some resistance, which is not an unexpected parental response. There are reasons for this: there may be changes that you are noticing that your parents are either (a) unwilling to see or (b) truly don’t recognize; or, you are in fact overreacting. The best first step is to get a professional opinion on whether the concerns you have are warranted. I suggest making a detailed list of the changes you are observing. Be as specific and comprehensive as possible, and articulate it in writing. Be objective in your descriptions: (“last week, mom asked me five times when I am next coming over, even though virtually every week I go over on Sundays”) – rather than making judgments or assumptions (“mom is losing her memory”). Then, make an appointment with your family doctor to obtain an opinion on whether there is cause for concern. Assuming there are red flags, the next step would be to gently start more dialogue with your parents while keeping in mind you may need to have multiple conversations. Approach your discussions from a position of care and concern, don’t blame or point the finger, and be mindful of not conveying any frustration you may be experiencing. Be specific in expressing the concerns you have, staying away from judgmental or labelling language. It is important to let your parents know that although these are difficult conversations to have, you are motivated by love and concern for them. Be sure you take the time to allow them to express their feelings and perspective as well. Let your parents have control in the conversation by asking them what they think would be good next steps (“what can I do to help?”; “what are you most comfortable with doing?”). Recognize that they may be frustrated, sad, or angry about changes that they are noticing but finding hard to accept as they transition to another stage in their life – from that of caretaker to possible dependent. You may also find it helpful to enlist the support of another relative or family friend whom they trust. If you continue to be met with resistance, I would suggest making an appointment with your parents’ family doctor to communicate your concerns. The doctor cannot, without your parents’ permission, release any information to you, but you are able to share information with the doctor that may be helpful for planning purposes. 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 husband is overprotective of our teen daughter. I worry about her as well but he is downright irrational. How can I get him to relax and give her independence? The answer: The reality is that there are some worries about a teenage daughter that are different than the concerns that come along with parenting a teenage boy – concerns about safety and risk. Fathers often tend to be more protective of girls, and will often cite “knowing what teen boys are like” as an explanation. First, ask yourself whether the issues you are having with your husband truly have to do with his overprotective stance toward your daughter, or whether other difficulties the two of you are having are influencing your feelings. I mention this as it is not uncommon for couples to have other underlying marital issues that manifest as parenting-related differences. If there are other relationship issues, you may want to focus on what those are and try to identify ways to talk about and address the non-parenting related challenges. If the issues are primarily stemming from differences in parenting approach, address this issue directly. Start by having a calm conversation with your husband. Time the conversation for when you are getting along with each other, and not in the midst of a disagreement. Have the conversation privately, without your daughter present. Parents should always present a united front when speaking to their children about rules, responsibilities and expectations. Ask your husband what his concerns are. Be open to at least understanding (not necessarily agreeing with) where he is coming from. When parents are being overly strict or setting rigid rules, this is often coming from a place of fear and concern about their child’s well-being and welfare. Try to take a problem-solving approach. Understand what steps can be taken to alleviate the concerns he has. For example, his concerns about her safety when out at night may translate into a black and white approach where he says she simply can’t go out at night. Instead, you may try to come up with some less rigid options that satisfy both of you. Gradually provide your daughter more and more responsibility in a way that your husband’s concerns about her are put at ease. You may decide to establish a curfew that is much earlier than what you think is reasonable or age-appropriate, but then discuss how to gradually modify this over time as your daughter builds up her trust and your husband builds up his comfort. You may ask her to provide a text update every hour on the hour when she is out, and then gradually reduce the frequency or expectation of contact over time. Decisions about what age-appropriate activities are for your daughter (e.g., when dating is appropriate, what curfew is appropriate) are very personal and family-specific decisions and there are no easy answers to these issues. You will both need to compromise and may need to agree to disagree on some points about what rules are appropriate for your daughter. 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 think it’s time for my 80-year-old mother to go into a nursing home in the next year or two. She is still healthy but not as strong as she once was. How can I broach this subject with her and prepare her? The answer: Speaking to a parent about transitioning to a nursing home can be one of the most difficult conversations you may have. It may be emotional on a number of levels for both you and your mother. But having conversations about this well in advance is one of the best things you can do, to give everyone time to mentally prepare for the upcoming changes. Before broaching this subject with your mother, you may want to spend some time thinking about what you want to say, what options there are, what timelines might make sense, and who else that is close to you and your mother could possibly get involved in the discussion (e.g., your father if he is in the picture, siblings, an aunt or an uncle). Use your judgment on who best to involve. You want to remain sensitive to not having your mother feel she is being “ganged-up” on by having too many people present, but there can be value in considering having someone else present that is close to her, and who she feels also has her best interests at heart. Let your mother know in advance you’d like to set some uninterrupted time to speak with her about some concerns you have about her health and/or living situation. This can help to make her feel like she is not being taken off guard. Try to identify an optimal time (e.g., when she is feeling relatively well physically, in a comfortable environment such as her own home, during a time of day when her energy level is reasonably high). Keep in mind that you may need a number of repeat conversations over time to get to a workable solution. Start the first conversation by genuinely letting her know how you feel. Express that you love her, that this is a hard conversation for you to have, and that you are only speaking to her out of concern for her for health and well-being. Describe the concerns you have about her health. Try to be as specific and objective as possible. Let her know you can imagine how difficult it may be for her to start to think about moving to a supported living environment. Take the time to ask her how she feels and what is important to her. Appreciate that she may get upset, defensive or sad – this is all part of the process of making such a significant change in living status. Listen to her concerns. Remain gentle and empathetic in your tone. Try to understand her concerns and perspective, and to the extent possible and reasonable involve her in all important decisions. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. |
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