Category Archives: Pyschotherapy

From the Archives: When Life Throws You a Curve Ball

Anxiety, Pyschotherapy, Self-Care

Covid-19 has brought us all many curve balls in the past 14 months.  We have collectively had to adapt, pivot, react, adjust and so much more. I thought this post from the archives spoke to our collective need to be able to cope and that we don’t always cope as well as we might.  I hope you find a nugget or two in here that helps you manage the curve balls already thrown and any more that might be on their way.

From the Archives: When Life Throws You a Curve Ball

You don’t have to do it all. Sometimes life throws us a curve ball. Maybe we have been diagnosed with a serious illness. Our partner has ended the relationship or died. Something else happens, and we suddenly find ourselves living alone and struggling to cope.

It is at the curve ball points in life that people often seek out a therapist. When I’m working with people who are at this point, one of the common challenges they are encountering isn’t emotional but involves the regular tasks of life. They are stressed about home maintenance, groceries, laundry, auto repairs, cutting the grass/snow shovelling…all the ‘bricks and mortar’ things that need to be done, no matter what else is going on in life.

It is these seemingly ‘simple’ items that can make our situation appear to be even worse than it already is. Everything is overwhelming.

A Story…

Edith is a 40-year-old, parent of 10-year-old twins. She was diagnosed two years ago with fibromyalgia. By working with her doctor and making lifestyle changes, her symptoms had decreased significantly. Just as Edith thought that life was beginning to feel manageable, her long-term partner said that they wanted to end their relationship and was moving across the country.

Edith was devastated! Suddenly she became a single parent of twins as well as in charge of running the household on her own. The increase in stress led to an increase in her symptoms. Anyone of these changes in life situations would be enough to make someone feel overwhelmed. Unfortunately, Edith was handed both–with one exacerbating the other. Edith was having trouble coping.

The Power of Habit

One thing that is true about humans, is that we are ‘creatures of habit’. If we’ve done something for a while, we feel that we should continue to do it…and in the same way. On some level this mode of being serves us well. We don’t have to keep rethinking how to do routine tasks…we go on autopilot, leaving brain space to think about other things. However, sometimes this habit isn’t in our best interest. We need to make alterations. Habits are difficult to overcome when our lives are on an even keel, and when we are stressed we don’t usually have the mental space to make changes.

When I suggest to people that they may want to try something different, I’m often met with the response “but I’ve always done it that way” or “so and so will be so disappointed if I stop doing this” or “If I don’t do it, I’m failing as a …..”.

These comments especially come out at curve ball times, when we trying to cope with a new reality.

We Don’t Have To Do It All!

It often comes as a surprise to people that they don’t have to do it all. They are allowed to ask for help or ‘outsource’ tasks.

One of the best resources that I’ve found is the book CEO of Everything:? Flying Solo and Soaring by Gail Vaz-Oxlade and Victoria Ryce. While the title is aimed at ‘newly single’ people (either through death or divorce), the book is valuable in many situations.

Both the authors speak from experience (Gail through multiple divorces; Victoria because of the death of a spouse). Between the two of them, they cover everything from coping during the early stages of change to childcare to dating to housing. They share their thoughts and experience on what to look for as you make decisions on whether to outsource or not.

The thing that I appreciate most about this book is that it gives the reader permission not to have to do everything. In fact, the authors logically explain why it’s impossible–especially if you’re trying to cover the work of a missing person when life has been turned upside down.

Story Continues…

After a while, Edith realized that she needed help with her ‘to do’ list. She figured out what she could manage based on her health and time commitments. Talking with her therapist she was able to see how the difficult emotions of grief and guilt were getting in the way of making choices about what tasks she could let go of. Edith knew that, after her own self-care, her main priority was supporting her children through this change.

Once Edith became clear about where she wanted to focus her energy, she created the list of what else needed to be done and who could help. Even though Edith didn’t feel comfortable asking for help, she began to accept offers from friends and family. Thankfully, she could afford to pay someone for any other help she needed.

The road ahead for Edith and her children wasn’t going to be easy, and at least she had less on her plate taking up her time and energy.

But What if you can’t afford to hire someone?

Not everyone is as fortunate as Edith in being able to hire help. This is where your support system can come in–those friends and family members who help each other when the going gets tough. With an established support system, we’re less likely to feel uncomfortable asking for help.

However, not everyone has been able to create such a system, either due to being new to an area, work pressures, etc. So where can we look for help when facing a curve ball?

  • Talk to the people you know and explain what you’re looking for. You may not be able to get help for free, but there are often people who are willing to do work at a lower rate.
  • If you belong to a church group or other organization let people know that you need support. You don’t need to go into a lot of detail, and most organizations (especially religious groups) have committees or ministry staff set up to help.
  • Check with local high schools for students looking for volunteer hours. In Ontario, secondary students are required to complete 40 volunteer hours before graduation. Volunteering for household chores does count towards these hours–since they’re not being paid.

And now if you decide to get help for household repairs or chores, watch out for this guy! It’s some classic British comedy for the series Some Mothers Do Av Em. Enjoy!

 

Blaikie Psychotherapy is Going Online!

Pyschotherapy

Image of calendar introducing online therapy optionsIt’s almost the end of May, and as this pandemic rages on, many businesses have had to make decisions about how to meet clients’ needs as the world moved from ‘life as usual’, including moving online. Blaikie Psychotherapy is no exception. Since March 15, 2020, I have been providing client sessions by phone, while hoping that we would be meeting in-person before too long.

With the Ontario government’s May 14, 2020 announcement that psychotherapists could begin to provide in-person sessions with clients (assuming that proper safety precautions in place), I thought perhaps the time was coming. However, in an email sent to members the next day, the College of Registered Psychotherapists of Ontario (CRPO) stated that:

“Given that the risk of infection continues to exist, in cases where you have the option of providing e-therapy or in-person therapy, we advise that you still choose e-therapy. If you choose to provide in-person care, you should be clear as to why you have made this decision. Consideration should be given to the inherent risks given the client, your modality of practice and your ability to ensure the use of best practices for preventing and spreading COVID-19.”

We’re Going On-Line!

Cartoon image of online video chatBased on CRPO’s recommendation about returning to in-person sessions, I have decided to provide online client sessions beginning June 1, 2020. This service will be provided through the OnCall Health platform. On Call Health is very secure with the use of encryption and servers located in Canada. You can find more information about OnCall Health here. I will continue to provide telephone sessions for those of you who prefer that format.

I hope that we are able to meet in-person in the not too distant future. In the meantime, I’m getting my office ready for us to meet safely by putting new procedures in place, rearranging seating and looking into Plexiglas screens. My goal is that in-person therapy post-pandemic will be as safe as possible while creating the type of therapeutic relationships that were possible beforehand sanitizer and face masks.

So, let’s continue to wash our hands, wear our masks, practice physical distancing and be kind…And now, something to brighten your day…Enjoy!

 

At Blaikie Psychtherapy, Online Therapy is an Option

Pyschotherapy

When we think of taking part in counselling, we might imagine sitting in an office and speaking in-person with a therapist. Unfortunately, this often meant that mental health support was only available to those who had a care-provider in their area (rural areas are often under-resourced), and was able to make it into the office. If transportation was a problem, or a critical/chronic illness prevented someone from leaving home, therapy wasn’t a viable option.

Thanks to the internet, and the advent of online therapy programs, mental health support is now available to more people. I’ve been offering on-line counselling sessions since September 2018, through a program offered by OnCall Health, and it’s proving to be a good option for people who cannot make it into the office.

Due to CRPO regulations, I can only provide on-line therapy to Ontario residents.

How Does it Work?

It’s easy!? As long as you have a device that is able to download the OnCall Health application, you’re good to go. Here’s the process:

  • Contact Blaikie Psychotherapy in the usual way: my website, Psychology Today or Theravive.
  • When we have our initial phone or email conversation, let me know that you are interested in on-line therapy.
  • Once you have decided that you would like to be with me, I book the session through OnCall Health, and email you the Service Agreement and consent documentation that is usually completed in person at the first session. You will also receive payment instructions.
  • You will get the information from OnCall Health about downloading the app. I’ve found their technical support to be amazing. If you have any problems with the computer end of things, you only have to get in touch with them and they’ll walk you through it.
  • Email reminders of your sessions are part of the app.
  • At the agreed time, we both log onto OnCall Health, and the session begins.
Specifics About OnCall Health

After a lot of research, I specifically chose to use the OnCall Health platform for the? following reasons:

  • Confidentiality is a huge component and concern in any therapeutic relationship. OnCall Health ensures confidentiality by having encrypted communications and locating their servers in Canada vs the US.
  • Ease of use for both me and my clients. I spoke to colleagues who use OnCall Health and they had very positive things to say. The technical support is strong–which is especially helpful for someone like me who is not computer-savvy!
  • The quality of the on-line therapy experience. So far, my experience and those of my clients and colleagues who are using the platform, is that the transmission between client/therapist has been clear and in real-time. No lagging or weird voice delays.

Mental health support should be available to anyone who wants it, and online therapy is a step in that direction. If you are interested in exploring this option for therapy, please contact me at laurie@laurieblaikie.com.

 

Core Beliefs…We’ve All Got Them!

Life Review Therapy, Pyschotherapy

If someone asked you how you know something, what would you answer? I learned it at school. My parents taught me. I checked on Google.

When we’re talking about facts or skills, it’s often easy to remember how or when the information came to us. However, if I asked you about a personality trait or ability, such as if you are kind or able to keep a secret, your response may be, “I’m not sure, I just know (whether I am or not).”

Depending on the question, you may feel embarrassed or proud. Either way, there is an emotional charge that is a result of how you feel or what you believe about yourself, in the context of the trait or ability. In other words, my question would have come upon one of your core beliefs.

What Are Core Beliefs?

Core beliefs are the very essence of how we see ourselves, other people, the world, as well as the future. Our core beliefs then inform how we operate in the world. Below is a list of common negative core beliefs:

  • I’m not good enough.
  • I can’t get anything right.
  • I’m stupid.
  • I’m inferior/nothing/worthless.
  • I’m a bad person.
  • I’m insignificant.
  • I’m unattractive (ugly, fat, etc.).
  • I’m useless.
  • I’m a failure.
  • I don’t deserve anything good.
  • There’s something wrong with me.
  • I’m abnormal.

While it’s painful to think these things about ourselves, the pain is increased when these belief systems are used to navigate our way in the world. When we incorporate negative core beliefs into our psyche, they become self-fulfilling. We think we’re a failure, so we don’t try new things, which seems to prove that we’re a failure…and the cycle continues.

Where Do Core Beliefs Come From – An example.

A kindergarten class is preparing for the end-of-year concert. Everyone is working very hard to get the song right and the teacher keeps moving individual children around to maximize the quality of the sound.

In the back row stands a boy named Jeremy. Jeremy loves to sing and has been practicing the words every day as he walks home from school. Jeremy sings with enthusiasm and his teacher has moved him a few times in order to find the appropriate place for his ‘sound’. Finally, in exasperation, the teacher suggests that Jeremy not sing, but whisper the words, in order to fit in with the group. While Jeremy doesn’t completely understand what just happened, part of him sees that his way of singing doesn’t fit. Maybe he doesn’t fit? Maybe there’s something wrong with him? Jeremy grows up, never to sing again, and becomes hyper-aware of being ‘too much’ when out in the world.

Core Beliefs in Therapy

Often a key part of therapy is discovering our core beliefs (both negative and positive) and then exploring their history and validity. One way to do this is through life review therapy.

Life Review Therapy involves looking at our past from the perspective of today. The goal is to help the individual, couple or family to find meaning and resolution regarding a painful incident and be able to move on with greater awareness and sense of calm. Often the painful incident involves the creation of a negative core belief.

The Example Continues…

Our young singer, Jeremy, is now 35 years old and has decided to see a therapist to deal with long-term social anxiety that has affected his life on many levels. He made his education and career choices (accounting) to fit in with his fear of interacting with groups of people. He choose a smaller post-secondary school and a program that would allow him to work somewhat alone.

Jeremy accepted a junior management position three years ago, and discovered that he is good at it. Due to his management skills, he was recently offered a promotion that will involve speaking in front of groups of people to present financial information. On one hand, Jeremy wants the promotion–he’s become bored with his current position and would like the extra income. On the other hand, he is terrified at the thought of presenting and ‘making a fool of himself’ in front of his colleagues.

With his therapist, Jeremy explores the history of his social anxiety. He talks about the thoughts that are linked to his feelings when having to interact with groups of people. They treat the process like a science experiment–looking for similarities in thought content and events. Jeremy reports that he’s afraid of being ‘out there’. He remembers that people are often telling him to “speak up” as they can’t hear what he has to say. This direction increases his anxiety as he swings between wanting to be heard and ‘being out there’.

During therapy, Jeremy remembers his kindergarten experience and is able to begin to unravel his current feelings and how this core belief has affected his life. Is this belief accurate? He was also able to process the anger that he feels on behalf of his young self towards his teacher and her actions.

Jeremy did accept his promotion and learned skills to cope with his social anxiety. A big piece of his ability to move forward was that he was able to question the negative core belief that was holding him back.

This is a very straight forward example and determining our core beliefs is not often this direct.

I invite you to think about your core beliefs. What are they? Do you know? How many of them are positive? Are they helping you to go the places in your life that you want to go, or are they preventing you from living your best life?

 

Let’s Go Fishing…and Learn Something

Mental Health, Pyschotherapy

“Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.”….Maimonides

When I think of fishing (which isn’t often), I think of two things.? The first is the gorgeous scenery in the Oscar-winning, 1992 movie A River Runs Through It.? For those who haven’t seen it, the story is about the two sons of a stern minister — one reserved, one rebellious — as they grow up in rural Montana. Fly fishing is a major theme in the movie.? Part of the landscape’s beauty may be due to the fact that one of the brothers is portrayed by a young Brad Pitt!

The second is self-sufficiency.? When we are able to feed ourselves, whether by growing, fishing, hunting or foraging; there is a confidence that comes from knowing that we are able to provide food for ourselves and loved ones.? Self-sufficiency is a value.? It is also be a component in therapy and mental health.

The Art and Science of Therapy

Therapy is a cross between art and science.? The tools that a therapist uses arise from specific theories that have been tested by research to show that they are helpful to clients.? Ideally, a therapist has studied a few different modalities of therapy and is able to have various tools in their tool belt that they can use.

The art comes in how to apply the tools.? Good therapy is molded to fit each individual client.? Individuals in pain are not like cars with faulty brakes–the same intervention doesn’t work for all!

Skill-building in Therapy

It has been my experience that clients don’t want to see a therapist for ever….and ethically, my role is to help them to feel better and move on with their lives.? One way that this goal is accomplished is through skill-building.

Skills come in all shapes and sizes…

A couple comes to therapy looking for relationship support.? As they describe what has brought them in to therapy, it becomes clear that communication is challenging, so we work on communication tools.? We work on spotting patterns that block positive discussions. We look at ways to get around this barriers as well as how to talk to each other to avoid their creation in the first place.

For individuals seeing a therapist for anxiety and depression, skill-building is a major part of therapy.? Clients will learn techniques to help lessen their anxiety as well as ways to monitor thoughts that may be contributing to their anxiety or panic attacks.? Similar tools can be used to manage anger.

For anxiety and depression, one of the skills that I teach the most often is a breathing exercise.? The free 20-minute download talks you through the exercise, as if you were in the office with me…though the wave sounds are only in the audio version!? You can find the exercise here (at the bottom of the Welcome Page).

My wish for clients, is that once they have learned and become comfortable with necessary skills, they will become self-sufficient in managing any remaining issues that brought them into therapy.

The Joy of Homework

Even more important than learning a new skill or coping strategy, is putting in the time to practice it.? This is the reason that I often suggest homework to clients.? Sessions usually last for 50 minutes, so the more work clients can do outside of our meetings, the more successful therapy will be.? Based on the theory of Experiential Learning, homework provides an opportunity to apply skills in different areas of life and in different ways–cementing the new ability into a client’s tool kit.? They have learned to fish!

If you’re curious about this connection, you can find out more by reading this previous blog post.

Back to Fishing…

When clients are able to leave therapy with the skills and tools that they need to help to keep themselves mentally healthy and/or better cope with life’s challenges, I believe that this is one indication of successful therapy.? To repeat? the quote by Maimonides,

“Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.”

And now…speaking about fish, who said they can’t be adorable, interactive and cute!? Enjoy!

Art Therapy and Mental Health…Have you Doodled Today?

Anxiety, Pyschotherapy, Self-Care

Anxiety has been a major hallmark of the Covid pandemic. Now, as more and more of us are getting our second dose of vaccine, for many of us, the anxiety is shifting to cover concerns about going back out into the world in ways that we haven’t been able to do since March 2019. 

Recently, I’ve been suggesting a mandala practice to clients who are looking for tools to cope with anxiety.  The following post from the archives speaks to this, as well as giving an exercise to try.? Enjoy!?

If you have been out in the world over the past year, you may have noticed the increase in the number of adult colouring books for sale. ?They are everywhere! You can pick one up when buying your groceries, refilling prescriptions or waiting for your flight at the airport. They cover a range of topics, disciplines, genres, moods, spirituality and life events.

In the October 2016 issue of Psychology Today, Emily Silber reports that an estimated 12 million colouring books were sold in the U.S. in 2015, up from 1 million in 2014.

When reflecting on the growth of this popular item; Silber quotes clinical psychologist, Ben Michaelis, who suggests that “even if colouring does not help people process negative feelings directly, it may a least offer an effective form of relief”.

Art Therapy

While some people may balk at this popular culture activity, using adult colouring books could be considered a form or art therapy. The Canadian Association of Art Therapy describes art therapy as “the combination of thecreative process and psychotherapy, facilitating self-exploration and understanding. Using imagery, colour and shape as part of this creative therapeutic process, thoughts and feelings can be expressed that would otherwise be difficult to articulate.”

While art has been used since the beginning of human history as a way to share thoughts and ideas–the oldest cave painting was found in the El Castillo cave in Cantabria, Spain and dates back 40,000 years to the Aurignacian period–art therapy, as we know it, didn’t really start until the 1940’s. The original art therapists were artists who recognized the value of creation on their own mental health, and chose to share the creation process with others.

If you are interested in a detailed history of art therapy, you can check out Art Therapy Journal for a wealth of information.

But What If I’m ?not Creative and Can’t Draw?

While I am not an art therapist, in the past, I sometimes suggested a ‘drawing practice’ to clients–especially if they we’re working with anxiety and/or depression–as a way to calm their thoughts and shift their focus. One of the most common responses that I heard was “I can’t draw” or “I’m not creative”. The idea of being forced to create ‘art’ increased rather than decreased their level of anxiety. So, instead I started suggesting a ‘mandala practice’.

What is a Mandala and How Do I Practice It?

 

Mandalas have been with us for a long time. ?The word ‘mandala’ is Sanskrit for ‘circle’. In Hindu and Buddhist traditions it is a graphic symbol for the universe. Famous mandalas in the Christian tradition can be seen in the Celtic cross and rose windows.

In some traditions they have been used as part of meditation practices and some people believe that they have magical properties. ?In fact, meditation paths are often built to form a mandala.

For people who don’t feel that they are creative (everyone is, whether they realize it or not!) or think that they can’t draw, a mandala practice is ideal as it is unstructured and free-form. The practice doesn’t require a large outlay of cash for art supplies or take up a lot of space. All that is required is a blank piece of paper, pen or pencil, pencil or regular wax crayons and a drinking glass or pot lid. Intrigued?

The Mandala Practice

The way of this practice is to do it daily–similar to meditation practice or breathing exercises. Besides being an enjoyable activity, there are many benefits to creating mandalas on a daily basis. It is a way to step into mindfulness as you focus on the act of making your own mandala. As you work, you may notice your thoughts slowing down. As you engage the decision-making part of your brain, the emotional part of your brain may experience a sense of calm. Clients have reported feeling a sense of accomplishment when they complete their mandala. You are giving yourself the gift of a ‘time-out’.

There is no right or wrong way to do this practice–the value is in showing up. It can take as much time, or as little, as you like.

Ready To Give It A Try?

Assemble the necessary tools (pen or pencil, blank paper, pencil or wax crayons, pot lid or glass) and find a comfortable place to work.

Step One
Empty out the box of crayons where you can see all the colours and easily reach them. This is easy if when sitting at a table. ?Take a minute and appreciate the range of colours. Think about the colours that you are drawn to and those you shy away from. Take a deep breath.

Step Two
Using the pen or pencil, on the blank sheet of paper, trace around either the glass or pot lid. The goal is to have a circle of a size that you are happy with.

Step Three
Look at the selection of crayons, and without over-thinking it, choose one that appeals to you. Using that crayon draw a shape inside the circle. It can be anything you chose. ?When you feel that the shape is complete, stop and return the crayon to the pile. Take a deep breath. ?Select another crayon and either add to the shape, or create another shape inside the circle.

Step Four
Continue Step Three, until you feel that yourmandala is complete. Again, don’t overthink it. You’ll know when it’s finished. The circle may be filled, or it may only have one or a few items in it.

Step Five
Initial and date the mandala and file it way.

When you develop a regular practice, over time, you will have a collection of mandalas. It is often interesting to look back over the series (several months’ worth) to see how the drawings, colour choices and subjects have changed.

Most of all…have fun!

Ultimate Mandalas–Made of Sand!

As well as having my own mandala practice, I have been fascinated by the Tibetan practice of making sand mandalas. Their creation and destruction can be viewed as the ultimate expression of impermanence and love for the benefit of others. Below are two clips showing this amazing act of creation. The first gives a sped-up overview of the process. The second shows the process in more detail.

Enjoy!

Are You Ready to Change? Let’s Find Out!

Life Transitions, Pyschotherapy

One of the concepts in Buddhism is that ‘everything changes…nothing stays the same’.? While I have found this to be true, change can come in different ways.? Sometimes it’s foisted upon us, and sometimes we are the initiators.

The focus of this post is on changes that we put in place, and specifically, the mindset and process (Stages of Change) that make self-directed change possible.

Meet Phil…

Phil (age 60) has lived through a difficult five years.? His troubles started when the manufacturing company where he had worked since high school shut down, and he was unable to find a comparable job.? Phil, already somewhat of a curmudgeon, became more so as he chose to spend endless hours at home.? His wife, Joanne, worked long hours–leaving Phil alone for most of the day.

While he wouldn’t admit it, Phil missed his job and work friends.? However, he didn’t feel like getting in touch–it was too much effort.? Phil spent most of his days feeling angry, sad, lonely and incredibly bored.? Joanne suggested that he could take over some of the household responsibilities (it would make her life easier), but Phil believed that he hadn’t cooked dinner before, so why start now?? Instead, Phil started spending hours of his time on the internet watching episodes of his favourite 1970’s tv shows on or napping on the couch.? Due to his inactive lifestyle, Phil gained a lot of weight.? The more weight he gained, the less active he became.? Eventually, Phil decided that he didn’t care if he ever worked outside the home again and fell into a rut.

The second blow fell two years later.? Joanne, frustrated with Phil’s behaviour and tired of working long hours with little household or emotional support, decided to leave their relationship.? Phil was surprised as he didn’t think there was a problem.? He believed that Joanne wasn’t really going to leave, she was just mad because he wasn’t helping around the house.

Today, three years later, the couple are divorced, and Phil is living in a small apartment.? His lifestyle hasn’t changed.? If anything, he has moved from being a curmudgeon to being bitter.

The Stages of Change

According to the Stages of Change theory, there are five steps that we move through to make successful and lasting changes: pre-contemplative, contemplative, preparation, action and maintenance.

Using Phil as an example, it’s clear that he’s in the pre-contemplative stage.? While Phil is feeling bitter, chances are that he doesn’t want to change.? In fact, he may not even realize that he has a problem.? Phil has continued his lifestyle because on some level he believes that it’s working for him.

Back to Phil…

One day Phil returned from the store to discover that the elevator in his building wasn’t working.? This had never happened before!? As his apartment was on the third floor, Phil decided to take the stairs.? By the time Phil reached the top of the first flight, he decided to leave his shopping bag in the stairwell as it was ‘too heavy’ to carry.? Walking up the second flight, he decided to stop halfway to catch his breath.? Anyone watching would have seen Phil crawling up the third flight on his hands and knees–breathless, his face red and covered in sweat.

Reaching his apartment, Phil was scared.? What had happened to him?? What if his unit was on the fourth or top floor?? He wouldn’t have made it.? For the first time, Phil wondered if something might be wrong.? Phil had entered the contemplative stage.

The Contemplative Stage

People in the contemplative stage have started to understand that there is a problem and that maybe they need to do something.? This is the pro vs. con stage.? Phil may be thinking, “I’m out of shape”.? “What if the elevator breaks again?”? “What will I have to do to get back in shape?”? “To get back into shape, I might have to give up my daily bags of chips, but if I don’t, I may die in the hallway!”

During this stage, no action is being taken, but things are bubbling below the surface.? This stage can last a long time because we over-estimate the benefits of staying where we are and think that changing will require too much effort.

Phil Moves On…

Eventually the level of fear that Phil experienced that day decreased.? Once the elevator started working, he was able to get his bag of chips from the stairwell.? He didn’t change his behaviour, but each time he reached for a salty snack he remembered sitting on the flight of stairs, unable to move.

Phil started to become aware that he sometimes found it hard to get up from the couch or was out of breath if he stood for too long.? Putting on his pants, he noticed that his belt was on it’s last hole–how did that happen.? Perhaps it was time to do something!? Phil had reached the preparation stage.

The Preparation Stage

During this stage the person wanting to change is moving to outward behaviour–not only do they want to make a change, they are coming up with a plan.? For Phil, this meant using the internet to find ways to get back into shape.? He searched for blogs written by older men who were doing what he was thinking of.? He figured out that he would need to lose some weight, so he started researching a healthy weight for someone his age.? Realizing that he would need to move to a healthier diet, Phil called a ‘skinny’ friend to find out what he eats.? He decided to buy ‘one of those gadgets’ that will tell him how many steps he’s taken.

After all his research, Phil came up with his plan.? He decided that for two weeks, he would cut back to one bag of chips a week, walk 1500 steps a day around his apartment, and add a daily salad to his diet.? Phil decided that he would start his plan on June 1.? Phil was on his way to the active stage.

The Action Stage

At this stage, the person is changing their behaviour–making the change.? This is the exciting stage as it becomes clear that something is happening.? The person is committed to the change and is starting to reap the benefits of their first actions.? A positive feed-back loop is created…a behaviour change is made…a benefit is noticed…motivation to continue is created…

Unfortunately, this is also a dangerous time in the change process.? In the honeymoon phase of action, people can sometimes underestimate the amount of effort it takes to continue new behaviours over the long haul. It’s important to note that a change hasn’t been accomplished until you are able to maintain it.

Let’s Check In on Phil…

On June 1, Phil was ready to go.? He had his ‘gadget’ and a week’s worth of salad greens were ready in the fridge.? Seven servings of potato chips were packaged for his daily treat.

At the beginning, 1500 steps felt like running a marathon.? His daily bag of chips seemed to grow smaller as the days went by, and he decided that salad wasn’t his favourite food.? However, by reading blogs from others who were also working to improve their health, Phil was able to stick to his plan for the first week.

The second week didn’t feel as difficult, and one day he noticed that he had walked 2000 steps without really trying.? Near the end of that week, Phil decided that he wanted to create a new plan for the next two weeks.? He repeated this process and, after six months, Phil’s fitness level had improved, he had lost some weight, and spent more time out of his apartment.? His mood had improved.

All was going well until…

Welcome to the Relapse

One day Phil woke up and he didn’t feel like doing his walk through the neighbourhood.? He hadn’t slept well the night before and was in a bad mood.? This had happened before, and he had been able to move past it.? Today, something was different.? As he lay in bed he thought about all he had accomplished over the past six months he felt tired.? It suddenly occurred to him that if he wanted to keep in shape, this was a life-long project.? As a wave of overwhelm flooded over Phil, he decided to take the day off.? “No salad for me today!”? “No walk and I’m going to treat myself to two portions of chips!”? Phil felt better immediately and enjoyed his “day off”.

Sadly, as often happens, one day turned into a week, then two and before he knew it, Phil had slid back into some of his old habits.? It was only having to move to a bigger belt hole, that shocked Phil back into reality.

Relapse is very common as we work on making a change.? Once we realize that we need to keep working in order to make a change permanent, or we become over-confident that the change is permanent, and we don’t have to be aware of our behaviour any longer; we run the risk of losing ground.

However, all is not lost…there is the maintenance stage.

The Maintenance Stage

The purpose of the maintenance stage is to avoid relapse and consolidate the benefits that have started to pile up during the action stage.? It is during this stage that, based on what we have learned in the action stage and any relapses, we discover the minor tweaks we need to make to the plan(s) in order to remain successful in our new lifestyle.

It is during the maintenance stage that we learn to be gentle to ourselves.

Phil Maintains…

As Phil recovered from his relapse, he realized that getting back to his routine wasn’t as difficult as he had thought.? He wasn’t starting from the beginning because he already had a plan and skills that he had developed throughout the previous stages.? Phil realized that it was unreasonable for him to be so strict with himself about his behaviour.? He wanted to think about ways that he could keep improving his fitness level and lifestyle changes while still taking an occasional break.

Over time, Phil stopped seeing his relapse as a failure and instead as a learning opportunity.

The Value of the Stages of Change Theory

In this post, I’ve created Phil’s story relating to his desire to change his behaviours in order to improve his health.? His change process can be used for any change that you would like to make.? This particular theory is often used to help people overcome substance/alcohol addiction.? As well, you can determine where you are in the change process (i.e. which stage) and have a road map of where to go from there.

And now…in a nod to 1970’s memorabilia…a classic from the Partridge Family…enjoy!

https://www.youtube.com/watch?v=wAXFkUaQoAs&start_radio=1&list=RDwAXFkUaQoAs

Please note: Due to the upcoming Ontario provincial election, youtube appears to be airing political ads before showing their clips. Blaikie Psychotherapy has no control over what clip is shown and isn’t aligned with any political party.

 

 

 

 

 

 

 

 

 

 

Once Upon a Time…

Life Review Therapy, Pyschotherapy

Once upon a time…this may be one of the most magical phrases ever written.? Young and old alike know that with these four little words they are about to be swept to another world…joy, sorrow, danger, who knows?? I suggest that when someone says “Once upon a time” we settle into our seats and prepare for a journey.

A Simple History of Stories

The ability to create, appreciate and share stories are part of what makes us human.? While no one has been able to say precisely when the first stories were told, historians suggest that storytelling was created as people started to form smaller and then larger clans/tribes.? Storytellers shared events between members of the tribe as well as pass them on to other tribes.? Until humans were able to write, storytelling was an oral tradition–relying on individuals’ ability to listen and remember.? Storytellers were respected as keepers of a clan/tribe’s history.

Over time, writing was created.? Depending on the era, stories were captured on stone, papyrus, parchment (dried animal skins), or forms of handmade paper.? Various methods of ‘printing’ were completed starting with handwritten characters to using tools such as reeds and ink, or carved wood blocks and ink.? Until the creation of the printing press (1440 -1450 CE), books were the property of the wealthy or religious orders.? As printing became cheaper and easier, written ‘stories’ from a wide-range of sources became available to anyone who could read.?? If you’re interested in an in-depth history of printing, check out?this site.

Today, stories are all around us…in print, digital and audio format.? We tell our stories through music, art, literature, etc.? Like in the past, stories continue to not only record events,but entertain us.? Stories can also affect our mental health.

Our Personal Stories

Many studies have been completed showing the correlation between ‘negative’ stories (violent video games, movies, etc) and increased incidents of violence, aggression and desensitization to violence.? On the positive side, this 2016 Huffpost (UK edition) article links watching comedies to improved mental health.? Both of these ideas could be a blog post on their own.? However, that’s not what I’m thinking about here.? I’m thinking about the stories of our lives and those that we tell ourselves.? While we can often choose what ‘outside’ stories we let influence us, our ‘internal’ stories are harder to avoid.? In fact, we often don’t even know that we are telling them.

Once Upon a Time…

Once upon a time, a long time ago, there was a little boy who wanted to learn to knit.? His mom was a knitter.? So were his grandmother and aunts.? He loved family gatherings when all his aunts would bring their needles and wool. After dinner, they would sit in the living room creating amazing things out of ‘sticks and string’.? The colours were wonderful and he’s watched his grandmother make him mittens in his two favourite colours.

His dad, uncles and older brothers were not knitters.? Instead, after dinner they would disappear to the den where they would watch sports, or to the garage where they would? build stuff using wood and cement.? Their materials were hard, not soft like wool.

As the little boy grew older, the men of the family started to invite him to join them in the den or garage.? His mother encouraged him to go with them, and he was subtly discouraged from following the women into the living room.? For his tenth birthday, the boy was given his own set of tools.? As his family members watched him open his gift, he felt pressure to like the tools, but he found it difficult to fake his enthusiasm.

The years went by and the boy became a man.? He remembered his desire to learn to knit, and would join the menfolk in the den or garage after dinner.? When he saw his wife and mother knitting in the living room, he ‘knew’ that this was a female activity.? If he told you this story (his story), he would tell you that there are things that men do and things that women do. It’s not manly for men to knit….so he won’t….no matter how much he wants to.

Our Stories in Therapy

We all have stories–it’s how we make sense of our lives.? When we are getting to know someone we share our stories; increasing, over time, their level of depth and intimacy.

People often come into therapy because of the pain of their stories.

Sometimes the story is traumatic and hard to live with. They need help sorting through the details, finding meaning and finding a place for it in the perspective of their life.? Sometimes people are hurting and don’t know why.? Often they have been telling themselves stories that don’t serve them, and they are unaware that they are whispering them to themselves.? In this case, the therapeutic work involves discovering these tales, testing if they are true and then deciding whether to keep or discard them…and write a new story.

Once Upon a Time…Continued…

One day the man realized that he wasn’t happy.? He couldn’t put his finger on it.? Something was missing.? He decided to talk to someone and made an appointment with his friend’s therapist.? At the first session, the therapist asked him what he liked to do.? Did he have any hobbies?? “Nope”, replied the man.? “Well”, said the therapist, “if you could have any hobby, what would it be?”.? The man thought, the expressions on his face moving from joy to despair.? “What’s going on?” ask the therapist.? The man told his story…and the process began…

And now…one of my favourite stories…Enjoy!

 

 

8 Frequently Asked Questions About Therapy

Pyschotherapy

When someone learns that I’m a psychotherapist, I’m often told that they think they should “talk to someone”, but that the whole idea is overwhelming and scary.? I understand their fear and hesitation.? Talking to someone that you don’t know about personal things is really difficult…and that’s after you’ve gone through the process of finding someone.? The goal of this post is to answer some of the frequently asked questions that I get, in the hope that contacting a therapist will be less intimidating and you will be able to find the right therapist for you.

Why would I want to talk to a therapist?

People usually decide to talk to a therapist when the pain of what they are trying to cope with becomes too big for them to handle on their own and they recognize they need help.? For more ideas, this previous blog post gives 10 reasons why you may want to see a therapist.

How can I find a therapist?

Once you’ve decided that you would like to speak to a therapist, here are a few different ways to find one:

Referral from a friend or family member.? While seeing a therapist is not something we often share with others, in our close relationships we may know of someone who is.? If you feel comfortable disclosing to this person, you can ask if they are happy with their therapist and ask for their contact information.

Web Searches.? You can search on-line for a therapist in your? area.? Psychology Today and Theravive are two sites that provide listings of local therapists.? Professionals on both sites have been vetted for their credentials.? There is detailed information about their specialties and links to the therapists’ website if they have one.

Health Professional Referrals.? Medical professionals (doctors, chiropractors, massage therapists, naturopaths) often have a referral list for therapists.? There is a connection between physical and mental health.? Sometimes health professionals will suggest counselling and provide a list of potential therapists.? If not, and you want a referral, all you need to do is ask.

What should I be looking for?

There are lots of very good therapists out there–doing all types of therapy.? However, studies show that more important than the type of therapy, the biggest indicator of client success is the therapeutic relationship that develops between the therapist and client.? In other words…there needs to be a ‘good fit’.

If possible, have a phone or email conversation when you first make contact with a potential therapist.? Ask if this person has experience in helping people to deal with your area of concern.? If that goes well, then book a first meeting.? You will have to pay for the first session, but it’s money well-spent if you decide that this isn’t the therapist for you.? Trust your instincts.? Your friend may feel comfortable with their therapist, but that doesn’t mean she’s ‘your’ therapist.

What happens in a therapy session?? Do I have to lie on a couch?

Lying on a couch is no longer required!? Instead, clients come into an office (that’s usually quite comfortable) and talk to the therapist.? Sometimes the therapist will have a plan for what to talk about during that session; at other times, the client drives the conversation.

I’ve found it helps clients to have an idea of what will happen in a session, so I have a basic structure.? The session starts with the client telling me about what has been happening for them since our last meeting.? We check in on any homework that was suggested.? I ask the client if there is anything they want to talk about.? Normally the client has outlined goals for therapy (what they would like to be different when therapy is finished) and that always provides areas for conversations.

This is your therapy, so again you get to choose!

How long will I be in therapy?? Do I have to go forever?

While therapists learn various types of therapies (Cognitive Behaviour Therapy, Emotionally Focused Therapy, etc.), therapy is also an art.? Every client is different, with different needs for the amount of time they will be seeing a therapist.

Personally, I operate from the perspective of ‘this is your therapy’ and you get to choose.? If a client is in crisis, then I suggest meeting weekly until things become more stable.? Once the crisis is past, we move to bi-weekly or even monthly.? It depends on what the client chooses as well as what is in their best interest therapeutically.? Ethically, a therapist shouldn’t want a client to have to come forever.? The overall goal is that people feel better and go back to their lives.

Once clients ‘graduate’ from seeing their therapist, many treat their therapist as one more tool in their health toolbox–checking in when necessary.

How does confidentiality work?

Basically, whatever you say in therapy, stays in therapy.? However, there are times when a therapist is legally obligated to break confidentiality:

  • Harm to self or others.? If a therapist believes that you are in imminent danger of hurting yourself or someone else, a family member, police or ambulance will be called to ensure safety.
  • A child under the age of 16 or older adult in care is in danger.? In these cases Family and Children’s Services or the police will be called.
  • Your files are subpoenaed by the court or by the College of Registered Psychotherapists.
  • A client experienced a health emergency during a session.? In this case, medical staff would be provided only with necessary information.? No information? about why a client is in therapy will be shared.

Some therapists (myself included) carry confidentiality into the community.? I inform clients that if I see them in the community I will not say hello.? I don’t want to put anyone is a situation where they have to explain how they know me.? I am always open to speaking to clients outside of the office, but they get to make first contact.

My benefits plan covers services provided by a psychiatrist, psychologist, psychotherapist or social worker.??What’s the difference?

Since each of these professionals can provide mental health services, it can be confusing to figure out which one is right for you.? The best way to explain it is by breaking down the services they provide.

Psychiatrist:? A psychiatrist is a medical doctor (MD) who has done extra training in psychiatry.? Psychiatrists are able to diagnose a mental health issue, such as schizophrenia, and prescribe any necessary medication.? Some psychiatrists provide therapy to their patients, but due to the shortage of psychiatrists, in my experience they usually? provide diagnosis and medication management.? Psychiatrists may refer their patients to counsellors for therapy.

Psychologist:? Psychologists hold at least a Masters degree in psychology.? They are qualified to diagnose mental health issues, but not prescribe medication.? Some will do counselling.

Social Worker:? Social workers can be put broadly into two camps…clinical (do counselling) and community.? Community social workers do such activities as working for Family and Children’s Services providing case support and assessments, helping governments or local agencies with social policy, etc.? Social workers can either have a Bachelors degree (BSW) or Masters degree (MSW).? All social workers must belong to the College of Social Workers in order to practice.

Psychotherapists:? Psychotherapists are counsellors.? That is our speciality.? We hold a Masters degree (or equivalent) in psychotherapy and must be registered with the College of Registered Psychotherapists of Ontario (CRPO).? If I have a suspicion that a client may be dealing with a specific issue that would benefit from a diagnosis or an exploration of the use of medication, I will suggest that the client talk to their family doctor.

I don’t have benefits, and can’t afford to pay out of pocket.? Is there anywhere I can go?

Seeing a therapist is expensive and not everyone is covered under benefits.? Some therapists provide a sliding scale or see different groups of clients at a discounted rate.? Many agencies (KW Counselling, Carizon, etc.) have a sliding scale based on income.? As well, agencies such as KW Counselling offer free weekly drop in counselling services.

Making the decision to talk to a therapist takes courage…and studies show that counselling works!

And now…Bob Newhart shows us the type of therapist we may not want to see.? Enjoy!

Travel and Therapy–Both Are Adventures

Pyschotherapy

As I continue on my travels, the following post from the archives explores how we can have adventures (in therapy) without even leaving home!

In February 2015, I was able to spend two weeks in Thailand. ?While it was a once-in-a-lifetime, amazing trip; getting to my destination was a challenge. ?Travel time was over 24 hours door-to-door, including 22 hours on three separate planes. ?I arrived in Bangkok feeling exhausted, disoriented and overstimulated. ?After leaving cold and snowy Waterloo, walking into a hot and humid Bangkok evening was a shock. ?Thailand is 11?hours ahead of Waterloo, making jet lag a factor.

After a good sleep and breakfast, I started taking in my surroundings and appreciating where I was. ?Everything was completely different from what I was accustomed to?the food, language, population density, weather, currency and customs. ?I had no idea how to get where I wanted to go. ?I had been set down into a different world! ?Fortunately, I was travelling with family members who knew Thailand well. ?They led the way. ?I was able to relax into the experience and know that I was safe–even if not always comfortable.

The Connection Between Travel and Therapy

During my trip back home, I mulled over my experiences and wondered about the similarities between travel and taking part in therapy. ?Here are a list of the correlations?I discovered.

Travel and therapy are often started by choice.
In come cases, people?are mandated to attend therapy (court ordered or at the strong request of family and friends). However, individuals, couples and families usually?seek therapy because they find themselves at a difficult point in their lives and want some help. When we travel, we usually?begin the journey, not because we are in crisis, but because we want to explore new places. ?Unless we’re being forced to attend a particular out-of-town event (weddings of third cousins, once removed!) we get to choose.

Therapy and travel can be?uncomfortable at the beginning.
Long distance travel is uncomfortable–first and business class passengers, and NEXUS Card holders excepted! ?The long lines, security checks, boarding, cramped seating, baggage claims…the list goes on. ?However, once you arrive at your destination, the hope is that the scenery, people and once-in-a-lifetime experiences are worth the discomfort.

Let’s look at the similarities with therapy. ?At the beginning of a plane trip, you are checked by airport security–questions asked, carry-on searched, and shoes, belts and coats removed. ?In therapy, you are not asked to remove your shoes, but the therapist can ask some uncomfortable?questions as he or she starts to learn your story about?what brings you into therapy. ?The topics?discussed in sessions can be painful and bring up feelings of guilt, anger, sadness, fear or other difficult emotions.

On long flights, it’s important to bring things that will help you to be comfortable–a neck pillow, warm socks, music. ?Therapy is no different. ?Sometimes clients will carry something into a session that has meaning for?them and provides stability (a picture, piece of jewelry, favourite article of clothing).

I usually check in with clients after a therapy session as to how they plan to take care of themselves for the rest of that day as they make themselves comfortable while their emotions ebb and flow.

Travel and therapy?can land us?in new and?wonderful places.

Travel brochures are created to entice us to take trips. ?I grew up in a time when?booking on-line wasn’t possible, and the walls of the travel agent’s office?were full of racks of booklets touting?possible destinations. ?Browsing the pamphlets, it was easy to imagine myself hiking across England or lounging on?an island beach.

Unlike travel, there may not be?exciting brochures promoting therapy. ?My office doesn’t have pictures of happy families, loving couples or emotionally centered individuals. The reason for this is that therapy is completely individual. ?Unlike a packaged tour, you get to pick where you go in therapy. ?What are your goals? ?Where do you hope to be at the end? ?Your therapy is your therapy.?I often ask clients to imagine that if I could wave a magic wand, how would their life be different after we had finish our work together–and that is the road map that we keep in mind when meeting.

Ideally, we have a guide for the journey.

Because I had never been to Thailand before, I really appreciated that my family members knew the terrain. ?When I became overwhelmed trying to negotiate the traffic in Bangkok or find our?hotel in Chiang Mai, I was able to relax because they knew what they were doing.

While you are the expert on you; during therapy, your therapist is your guide and companion. ?Just as I was comfortable with my children showing me around Thailand due to our relationship, it’s very important that you feel that you can rely on the therapist that you have chosen. ?When trust has been developed, you are able to relax into the process knowing that your therapist is?knowledgeable and has your best interest at heart–even when the going gets tough. ?Therapy is often a process of two steps forward/one step back, and it’s important to know that it’s normal?to temporarily move backwards.

After travel or therapy, we never quite look at our world in the same way again.

Therapy and travel change the way we see the world. What we see, we can’t ‘unsee’. ?After spending time in numerous Buddhist temples and studying the intricate mosaics, I now have a greater appreciation for?any mosaic pieces that I encounter at home, or anywhere else that I travel.

When I work with clients, I often explain how certain ideas?are relevant to their situation. A popular theory, Triangulation, describes how we often get pulled into being a third person in difficult relationships. This is done in the hope that our involvement will decrease the level of stress felt by the original two people. ?Once clients have learned this idea, they often report that they see the dynamic everywhere–at home, work, with friends. ?Not only can’t they ‘unsee’ the behaviour, but now they have tools to prevent themselves from being pulled in.

Finally, we are stronger than we think.

Both travel and therapy can be hard. ?Depending on the type of travel you like, you may be backpacking?and staying in hostels, trekking up the side of mountains and tenting on ledges, or driving?a camper van?and looking for places to sleep?on the spur of the moment. Travel requires ingenuity and stamina. ?Even on?tours, where everything is provided, can be grueling–ten countries in ten day?!

We are no different during therapy. ?Instead of exploring different countries, we’re exploring our past–including the sad and messy bits that we would rather pass over. This too takes strength, stamina and courage. ?And we do the work, because the result is worth it. ?The plan is that we will feel better at the end of the therapy process than we did at the beginning.

One of the benefits of travel is that we get to do and see things that we don’t at home. Since elephants are not usually found in Kitchener-Waterloo, here’s a video of a baby elephant from a?sanctuary in Chiang Mai, Thailand. ?Enjoy!