“I remember the place” – a movement practice

I’d like to introduce you to a favourite sanity-inducing movement practice of mine. My acupressure teacher Arnold Porter taught it to me over a decade ago and I’ve been finding healthy perspective through it ever since. I believe it is from the Shin Tai Do tradition. 

While in this video I run through the phrases in succession, it’s often more powerful if you can pause at each one for as long as you like, with eyes closed, taking in the words. Thus it becomes more of a moving meditation. 

You might notice the phrases that hold a charge for you, pointing to something perhaps you long for or find especially difficult. Thus it becomes a kind of inner experiment.

It can become an intention-setting practice broadly, or if you repeat a particular line as a wish or a prayer.  Play with it as it serves you. 

Here are the written instructions. 

Posted in Anxiety, Depression, Mindfulness-based psychotherapy, Spirit | 2 Comments

The challenge for Millennials

Here is a super interview with Simon Sinek from an episode of Inside Quest about the challenges that Millennials face. These are the folks born roughly 1984-2000. 

I’m interested to hear what the Millennials watching this think. Is this true? Are you a slave to instant gratification? Do you need to learn patience? Are you addicted to social media? Do you want to make an “impact” and think that this should be easy? Do corporations need to value you more? What about relationships – are you any good at love?

Other offerings from Simon:

 

Posted in Addiction, Digital age, Relationships, Society | Leave a comment

5 unusual steps to reduce stress

“Is it normal to be so stressed?” “How do other people reduce stress? … Do they just breathe?!”

These are some questions that stood out to me over the last few weeks since I heard them repeatedly from different clients. To give you a picture, these are healthy women and men, with full-time jobs, who are either single or in healthy relationships. They are living the life they and most others aspire towards, at least on the outside.stress

They were concerned because their level of daily stress was far higher than they imagined it should be, given the “normal-ness” of their lives. They wondered what they were doing “wrong” or if others felt the same but kept it silent. 

Because others in their daily lives aren’t talking about or showing the same kind of stress they feel, they find themselves questioning their own ability to cope. They even doubted their mental wellness and felt more isolated as a result. 

The “new normal” stress level

Many clients complain about the “always on” state they are in. Some of the new normal influences are probably familiar:

  • 24/7 internet access on phones and widgets and an expectation of accessibility
  • Social media’s glamorous or uber-connected or otherwise unrealistic picture of what life could be
  • The sound-bite version of life created by the internet that evades people’s lived experience
  • Little real understanding (or practice) of what creates good emotional and mental health

Unfortunately folks often end up internalising the stress (i.e. “it must be me”), which only worsens self-esteem and a sense of isolation and then actually creates more anxiety and depression. This isn’t helped by the over-prescription of antidepressants and pharmaceuticals generally for diagnoses that I would argue are much more a result of an inherently stressful society/life than underlying mental illness. 

The shadow of productivity

We’re a culture obsessed with productivity and achievement. I think of it as an addiction.

I believe we have lost sight of how to lead satisfying human lives that include ritual, community and spirituality. We’ve lost the social structures that make the latter a normal everyday part of life. Our collective mental health is suffering.

I urge us all to build ritual, deeper community connections and spirituality into both our individual lives and into our social lives.

Reduce stress by moving from a human doing to a human being: 5 steps to sanity

1. Create a “Sabbath” one day a week
Put the phones and digital widgets away for a day. Plan time with family or friends, or time in nature. Intentionally slow down. Follow what feels good inside. Remember what Sundays used to be before shops were open 7 days/week and before the Internet took over.

2. Gather friends regularly for a pot-luck
Start building regular connections with people you like. One way is a shared meal on a regular basis. Perhaps involve a few friends and rotate the location. Or a soup share, where one person makes a big batch of soup once a week and the others come to pick up their jar.  

3. Create a self-care evening once a week
Think of it as a mini-Sabbath if that helps. When you want to shift gears after work for instance, consider how you make the transition, i.e change out of work clothes, add music, light a candle, add aromatherapy oils.

Consider making a list of activities you could do, i.e. yin yoga, follow the lead of your body in stretching/moving, a bath, non-doing time just sitting and noticing or listening to music, or find a book to guide you, e.g. the “Artist’s Way” by Julia Cameron. 

4. Join a community choir or dance group
Research shows singing together gives the quickest sense of connection out of any activity, but do what brings you joy. Just make sure you prioritize it so you do it regularly. 

5. Connect to the big picture
In our “always on” lives we can loose sight of the big picture. We are mortal. Life is short. We will die. Knowing this, how does it change the way you live your life?  

One way of connecting into the divine / the bigger picture is to pray. Another is to give gratitude. Another is to explore the stars and planets. Or do Qi Gong. Or visit your local waterfall. Whatever does it for you. Strengthen your relationship with whatever divine/big picture you can connect with. Join a faith community if that feels good. 

This article is reposted from my SoulSoil newsletter (March 2016). To subscribe click here.

Posted in Anxiety, Society, Stress | Leave a comment

The way the nightmares disappeared: a story about anger in grief

Anger is a normal part of grief but expressing it can be hard because we tend not to like to feel angry.  Anger can be taboo especially for women, and especially as part of grief. We may recognise it, but often we don’t know what to do with it. Sometimes we can get stuck in grief as a result.

The dream world gives us beautiful creative access to what is struggling to become conscious. That is, anger can be pushed into the unconscious if we’re not okay with it at a base level. The dreams’ rich imaginal world can be used as part of a therapeutic process.dream moon

Here is a story about attending to anger creatively through dreamwork.  This story is taken from my practice, with a client struggling with grief after a friend completed suicide. Names have been changed. 

Joanna had had a rough year: several deaths of (non-immediate) family members, then a month ago the suicide of a close friend.  Then even her cat had been put down the 1st day we met. Until the suicide she’d been managing well enough… some stress and strain on her relationship with her partner, but okay.

After the suicide she said she felt angrier and “not myself”. She said it was harder to deal with the stress. She felt worried that something would now either happen to her boyfriend or her sisters.  

nightmare-photo-by-arthur-tress-dream-collectorIt was our 2nd appointment together when she mentioned the nightmares. She had several a week; they were very intense and graphically violent and always about loosing people. She felt worried about going to sleep. I saw she was visibly disturbed by them as she talked. So with her permission we explored a bit more and I followed my intuition… here’s where it led. 

Grounding, then touching on pain, then grounding

We grounded first – stabilising in the here and now since she was clearly upset having mentioned the nightmares. She felt calmer again.

I invited her to picture the nightmare at a distance, staying connected with herself in her seat. I asked her if she felt okay telling me what happened in the dream. I asked her to keep noticing her level of upset inside as she talked. She recounted a nasty story of angry men attacking her and her boyfriend and slitting his throat. Her distress levels inside were suddenly high. I coached her to let go of the dream and we grounded together again in the here and now. 

Finding a protector

When she was more settled I asked what kind of defense she might need against those scary angry men. I invited her to use her imagination – dream time. She liked the idea of a “bubble protector” that her and her boyfriend could be in. Imaging that she felt stronger inside.

We went through the dream again, but with the bubble. She felt more control. In her imaginal world now the angry men couldn’t get them – they got angrier at first but then lost interest and left the couple alone. 

Becoming the angry part

I normalised the anger that had been showing up in her life, and again in her dream, saying that often these parts represent themselves through the dream world when we can’t deal consciously with them.

I asked her if she’d be up for taking on the role of the angry men in the dream. tunnel3She was. So as she went into it I coached her to feel the sensations of anger inside her body, and as she did, to push with her feet against the floor and the coffee table, and with her arms against the inside of the chair arms (ie pushing outward using the Deltoids and the Latissimus Dorsi – the big muscles involved in pushing/punching). She was able to do that.

I asked if there’s an impulse with her arms and she said she could imagine punching … so I held a padded chair out and invited her (staying tuned in inside) to push or punch it. She bravely pushed through the oddness of this scene and punched for a minute or so and then stopped and started crying. She felt a release, a shift. 

Towards a new beginning

In her imaginal world she was now in a tunnel.tunnel1 She said it felt safe but dark. She looked a bit scared still but calm. I asked what the scene needed – what wanted to happen. She imagined the sun in.  She saw her boyfriend nearby. He was safe. She moved towards him and the sunlight. 

Positive change

I’ve seen Joanna twice since then (over 3 weeks) and she has reported no nightmares. She had a dream instead of going canoeing with her boyfriend and having a good time. She also reported feeling more relaxed with her partner – she felt less reactive and was worrying less about him. 

With thanks to several approaches I draw on in this work: the pendulation practice of Somatic Experiencing (from ground/calm, into a piece of pain, and back to ground), the embodied muscle work of Merete von Brantbjerg, perhaps an appreciation of jungian dream work I picked up from my mother, a Jungian Analyst and likely some Gestault work too. 

Posted in Anger Management, Creativity, Dreams, Grief | Leave a comment

Chicken dance wisdom

How do we change habitual unhelpful reactions? Or in simpler language, how do we change habits? I’ve been exploring possible approaches in a hands-on fashion. Here’s a story of (momentary) personal triumph that might appeal especially to parents of young children.  

This story was originally distributed in my SoulSoil newsletter. If you’d like to subscribe fill in the “Let’s Get Started” box in the right side-bar. 

The chicken dance: a personal story

My son Theo is 3 yrs old. Changing habits: chicken dance wisdomOn the evening in question, it was time to start the bedtime routine. The initial warning had been given and in response Theo was tearing around the house finding things to throw and bash into, leaping in delight knowing he was winding his tired parents up. He was being 3; duly pushing back. 

I needed to help him shift gears. I needed to shift gears myself. 

My head could see the comedy in this scene. My body was starting to react. It felt familiar from my childhood (my authoritarian father would inevitably emerge with a loud angry voice and I would be powered-over). Not something I want to repeat with my son. So as I said, my body was reacting… some inner logic like “my son is not obeying me, he should obey me, I’m angry, I will assert my power”. I felt very serious inside. My impulse was to grab him with some force. I knew I didn’t want to do that. 

I said to my husband “I know I should make this a game, but I really don’t want to”. He said “do it anyway”

And so I begrudgingly went to find my son, now jumping on the guest bed doing his crazy dance, and… I became a chicken.

I flapped my wings and ducked up and down with my chicken feet hopping on the ground. He stopped immediately. I said in my chicken voice “mommy chicken needs a baby chicken to follow”, and quick as lightening he was behind me laughing and clucking, and off we clucked upstairs to a smooth and remarkably pleasant bedtime. 

Parenting is indeed emotional rocket science. 

Changing habits generally is difficult, but our brains are so adaptable that with some rewiring through repetition, you might be surprised. 

Key elements of chicken dance wisdom include:

  • notice and accept own reactivity, i.e. use mindfulness (see Five A’s)
  • pause
  • know where reactivity comes from (having some understanding is helpful)
  • have some ideas of alternate approaches in your back pocket
  • decide to do something different in the moment even if it doesn’t feel good at first
  • use play
  • recruit helpers
  • see what happens
  • repeat

What habits do you want to change? 

  • Defensive or otherwise reactive to certain family members at Thanksgiving?
  • Want to start exercising but hate the reality?
  • Habitually shut down when you feel upset or vulnerable?
  • Overeat when you feel upset emotionally?

You can develop your own “chicken dance wisdom” to change unhelpful reactions into reasonable responses. 

Posted in Anger Management, Mindfulness-based psychotherapy, Parenthood, Relationships | 1 Comment

CBT for depression workbook

Whilst I’m no hardliner Cognitive Behavioural therapist, Cognitive Behavioural Therapy (CBT) can be a useful tool. I recently found a freely available workbook that is well organised and practical. I would recommend it to anyone struggling with depression as one approach to try. 

Antidepressant Skills Workbook

Antidepressant Skills Workbook

For more on why I’m not a hardline Cognitive Behavioural therapist read my Beyond CBT article.

The Antidepressant Skills Workbook (ASW) (Dr. Dan Bilsker, RPsych, Dr. Randy Paterson, RPsych) is a self-care manual is based on the experience of the authors and on scientific research about which strategies work best in managing depression. It provides an overview of depression, explains how it can be effectively managed according to the best available research, and gives a step-by-step guide to changing patterns that trigger depression. ” Source

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Tips for challenging family visits

As mostly rational, fairly successful adults, most of us lucky enough to still have living parents hope that family visits will be enjoyable, connective, potentially heart-warming experiences, at least in part. It seems though from my personal and professional experience that success in this, at least when in close proximity, is alarmingly rare. 

It can be surprising each time, if you’re anything like me, to experience intense reactivity, and to feel like a child again in the presence of your parents. Oh Lord, I say, can’t I get beyond this? Come on already. I’ve done some inner work, I realise xyz, and now I want to be an adult and have an adult relationship. So I’m still learning I guess. Here I share some of what I’ve learnt. If you too have not yet found the place of Zen when with your Family of Origin, this is for you. 

n.b. Since I don’t yet have adult children to find challenging, I write this from the adult child’s perspective. I should really interview my parents to bring a more rounded approach. Maybe in a sequel. Or a next life. Or give me 20 years and I’ll write it myself!

What’s going on? Why do I get so reactive?

Each person and each family system is different of course, but here are some factors that might be relevant;

  • Old wounds can still be sore. Difficult memories are held in our emotional (or limbic) brain. Unless we’ve done some healing (involving more than knowing and understanding the story) the old hurts may still be there, like it or not. 
  • Our style of attachment with each parent (see my post on Attachment style). Our attachment style will likely still be the same as when we were young. 
  • Each generation has different values and expectations. Each generation tends to challenge and react to the previous ones’ values. Neither is likely to change it’s deeply held value because of the other offering their perspective! 
  • Aging. Your parent is likely going through their own aging process, whether they are fighting it, ignoring it or embracing it. Aging in our society of anti-aging, is often not an easy process. They have their own experience and their own reasons. They may have different priorities now.  They may not be how you want them to be, or want what you want them to want. 

Some things I have learnt:

  1. We have 3 mothers and 3 fathers

    1. The mother and father we had
    2. The mother and father we wish we had
    3. The mother and father we currently have

At any moment all 3 characters can be present in our reactions.

Three Women 2005, by SACHA

Three Women 2005, by SACHA

For example, (A) if our parent criticised us in some way regularly when we were young, there may be left over hurt from that and a response, like a “hiding inside” feeling for example. At the same time, (B) we may have longed for a relaxed, easy going parent with whom we could settle in with and be ourselves – so there will be a longing for that and likely a frustration that it’s not a reality.  And then the reality of the changed parent we see before us, likely aging or at least maturing, perhaps retired, with their own emotional responses to their transitions and their own hopes and fears of us and our children if we have them.  We may have our own response to their situation (C) – perhaps wanting more/different for them, wishing they were a different character, not wanting them to be in pain, wanting them to accept help etc. 

2. Our limbic brain remembers

Difficult emotional experiences have been shown to be lodged in the midbrain in the limbic system. This limbic area is linked to the brain stem and together they seem to regulate the Fight/Flight/Freeze response. For more on the brain see Dan Siegel’s work (brain parts, hand map of brain-video).

Triune-Brain

Basically if we perceive a present-day threat (which may be as simple as a familiar feeling of how we felt trapped/threatened/etc as a child), our limbic and reptilian systems may go into “emergency mode” to prepare us as if there was a life/death threat. We may feel our heart beat more, a tight chest, blood rush to our limbs (Fight/Flight)… or feel shut down and frozen (Freeze). All this doesn’t help our adult selves respond in a civilised way. Our neotcortex thinking function in this situation effectively shuts down (again see Siegels’ hand model of brain). See below (#4) for ideas of how to calm your limbic brain.

What can I do?

If you’ve had a challenging relationship with one or both of your parents, don’t expect it to be different. Expecting otherwise is living with the idealised parent in the forefront and may set up up for failure. Prepare for it to be the same AND know what you can do differently.

1.  Plan a visit that respects your own boundaries

For example stay in a separate place, have your own transportation, just go for dinner not for the weekend. If sensing and setting your boundaries is challenging, practice and notice what your tendencies are and whether they are working for you. Take this opportunity to do some work on your ability to stand up for yourself. Even baby steps are steps. 

2. Have an alternative plan, a way out

Even if you don’t use it, your limbic system will settle better if it knows it’s not stuck in a situation, like it may have been as a child. So have a place to go if things go sour even if it’s a motel. 

Have people to visit or be close to who you like and who like you. This could mean sitting next to your brother at a potentially stressful dinner, or planning a visit with Aunt Allie, or having your old high school friend on text standby so you can go to her house if things get too much. 

Know places to go where you are comfortable and have a good time.

Remind yourself it’s not like it was as a child – you have more agency now, you can choose how to response, you can choose to leave. 

4. Yes AND 

If a parent will likely ask something that you feel pushes your boundaries in some way, practice your response. For example “So I hear you asking/saying…. [repeat essence of what they asked/said] and I can see why you’d want me to do that/why you’d think that… AND what I can do is/what I ask for is….”.

Some of the time you can choose to do it there way, but if something really isn’t possible for you, say what you can do instead. 

5. If you get “flooded” self-soothe your limbic system

Couples therapist John Gottman says it takes 20 minutes to calm the physiological arousal system once it’s started. Here are guidelines (taken from John Gottman couples work).

6. Accept and be kind towards your experience

The “5 A’s”:

Attention: notice your experience (i.e. “tight chest”, anger, wanting to hide)

Acceptance: accept that these reactions are there for a reason, and it’s okay

Appreciate: your reactions likely kept you safe and were useful at earlier points in your life. 

Allowance: allow the feelings and reactions to be there. Don’t try to make it different. 

Affection: be kind towards the feelings, to your reactions, to the situation perhaps. 

7. Plan for success

What situations do you best connect with your parents? Try to set up some of those circumstance. 

Posted in Anxiety, Holidays, Relationships | Leave a comment

Victim, Rescuer or Persecutor? The Karpman triangle

Do you wonder what’s at play when you, or others around you, get stuck in conflict or in wonky relationship dynamics? Perhaps you feel pulled into a caretaker role, or feel helpless? Here’s a brief article taken from my latest SoulSoil newsletter. To subscribe, click here

The Karpman drama triangle (aka “drama triangle” or “victim triangle”) models the connection between personal responsibility and power in conflicts, and the destructive and shifting roles people play. It was developed by Stephen Karpman in 1968 and is still widely used. 

He defined three roles in the conflict; Persecutor, Rescuer (the one up positions) and Victim (one down position). Karpman placed these three roles on an inverted triangle and referred to them as being the three aspects, or faces of drama. We start in one position based on our core beliefs and then rotate through the roles.  

The roles:
 

  1. The Victim: The Victim’s stance is “Poor me!” The Victim feels helpless, hopeless, powerless, ashamed, and seems unable to make decisions, solve problems, take pleasure in life, or achieve insight. The Victim, if not being persecuted, will seek out a Persecutor and also a Rescuer who will save the day but also perpetuate the Victim’s negative feelings.
  2. The Rescuer: Rescuers see themselves as “helpers” and “caretakers.” They need someone to rescue (victim) in order to feel vital and important. The Rescuer feels guilty if he/she doesn’t go to the rescue. Yet his/her rescuing has negative effects: It keeps the Victim dependent and gives the Victim permission to fail.
  3. The Persecutor: Persecutors identify themselves primarily as victims. They are usually in complete denial about their blaming tactics. When it is pointed out to them, they argue that attack is warranted and necessary for self protection.

In each position we are getting unspoken / unconscious needs met without having to address the underlying issues (e.g. own anxiety, own responsibility). 

In this triangle everyone becomes a victim at one point: e.g. someone starting as a Rescuer “becomes a martyr, complaining loudly, After all I’ve done for you … this is the thanks I get!” “Forrest. 

Persecutors, on the other hand, see themselves as victims in need of protection. This is how they so easily justify their vengeful behaviour.

We “do” these roles to ourselves internally too. For example, we may harshly criticise ourselves (P), creating anger and self-worthlessness. “Inwardly, we cower to this persecutory voice, fearing it may be right (V). Finally when we can’t bear it anymore, we take ourselves off the hook by justifying, minimizing or indulging in some form of escape. This is how we rescue ourselves. This could go on for minutes, hours or days.” Forrest

How do I get off the triangle?

  • Get curious. Observe how you get hooked.
  • Explore the different “lives” of the different roles – how each feels, thinks and acts.
  • Look at the costs and trade-offs of each.
  • Often to get off, we may be seen by others as a Persecutor, e.g. “How can you do this to me?”

For more on the Karpman triangle please see the excellent article by Lynne Forrest: The Faces of Victim.  There is also a decent overview on wikipedia. (Both are my sources for the above info). 

My article on attachment patterns plays into the roles we take. As well, my latest article on the challenges of relationships for those growing up in dysfunctional families (e.g. children of alcoholics) affects the roles we take too. 

Posted in Anger Management, Anxiety, Relationships, Stress | Leave a comment

Did you have an alcoholic/dysfunctional parent growing up? Relationship “compass” rewiring please

Adults who grew up in homes where one or both parents were alcoholics (aka Children of Alcoholics or COAs), or where there was other significant dysfunction, often have the hardest time navigating intimate relationships as adults.family-fight-jpg

We humans tend to internalise the models our parents or caregivers showed us, using those as blueprints for our adult relationships. So with wonky internal models these adults have to do the hard work of resetting that original wiring in order to have a different experience in adult relationships. The equivalent, I reckon, to emotional rocket science. 

I’ve written before about relationships – topics such as boundaries, attachment style and interpersonal conflict. Now I’ll focus now on some common factors COAs have in common, and some resources that might help on the brave journey of re-wiring.

First a caveat; dysfunction can come in all sorts of shapes and sizes.  The impact of these dynamics and experiences on a child will depend on their temperament, their role in the family, other resources and supports available to the child, how protected they were, and how chronic the dynamics were, amongst other factors. And yet sometimes the struggles taken into adulthood are fairly similar.  

Common struggles of children from alcoholic or dysfunctional homes 



In my practice I see clients who grew up with significantly dysfunctional parents struggle with similar things:

  • knowing what a healthy relationship feels like
  • getting getting stuck in the helper/understander role and minimising or ignoring their own needs
  • black and white thinking (aka all or nothing thinking)
  • repetitive unhelpful dynamics in relationships (e.g. persuer/distancer) and difficulty in shifting them
  • shame and self-blame
  • over-reacting to present situations because it reminds them (unconsciously perhaps) of  past situations
  • self esteem often suffers; depression and anxiety are common.

I found a list from Alcoholics Victorious that is more detailed:

  1. Guessing at what is normal.
  2. Difficulty having fun.
  3. Judging themselves mercilessly.
  4. Difficulty with emotional relationships.
  5. Feeling “different” from other people.
  6. Tendency to be impulsive.
  7. Either super responsible or super irresponsible.
  8. Desperately seeking approval and affirmation.
  9. Suffering from chronic anxiety.
  10. Lacking self discipline.
  11. Compulsive liars.
  12. Suffering from a critical deficiency of self-respect.
  13. Fear and mistrust for authority figures.

How to change these patterns?

Ah, the million dollar question that I get asked a lot. I don’t feel like an expert here since I haven’t done specific research on the topic in relation to COAs but here’s my take: 

1. Awareness (+ Courage + Vulnerability)

I think awareness is the first step. Awareness of patterns, attachment style, the impact the past has had, the capacity and strength in the present, coping strategies. i.e. shedding light on what is unconsciously causing suffering.

But courage needs to come alongside awareness. Courage to be vulnerable. Courage to see ones patterns clearly. I am often so impressed with the courage and vulnerability I see in clients, and their commitment to change. And indeed sometimes it’s harder for people to garner all that gusto. Fair enough. I’m sure there’s a good reason. It’s certainly a process to get to the “I’m ready for change” place. Exploring the ambivalence is a key part to change. 

2. Skill-building – both inner and outer relating skills

This could involve psycho-edcuation and then practice in skills such as assertiveness, emotional regulation, boundaries, communication, internal dialogues (with different parts of the self), developing the internal “adult”, healing the internal “child”.

3. Healing and new development of self

Through elements in #2 (above) a new sense of self can develop over time. Old wounds can be healed so they carry less weight. The new “you” might include a new respect for self, a new language to navigate your internal world, an ability to stay connected through difficulties, a greater ability to have fun, and feel like you’re directing your life in a healthy direction. 

Progress isn’t typically linear; sometimes it’ll be easier, sometimes hard again. But it is possible to change your relationship “compass” over time.

Resources – Books

Many of these are applicable to anyone with relationship struggles, not just those from dysfunctional or alcoholic homes

David Richo 

– When the Past is Present
– How to Be an Adult
– How to be and Adult in Relationships



Karyl McBride

- Will I ever be good enough: healing the daughters of narcissistic mothers
 


Janet Woititz

- The Intimacy Struggle
– Lifeskills for the Adult Child

- Adult Children of Alcoholics
 


Nancy Benvenga

- Healing the Wounds of Emotional Abuse
 


Eliana Gil

- Outgrowing the Pain: A Book for and About Adults Abused As Children 
 


Charles Whitfield

– Healing the Child Within 
 


Stephanie Donaldson

- The Narcissistic Family: Diagnosis and Treatment
 


John Bradshaw

– Healing The Shame That Binds You
 


Other book list – http://www.isurvive.org/resources/books-you-may-find-helpful/
 

 

Resources – Groups (in Hamilton area)


Since codependent tendencies (CODA’s description) are common for adults who grew up in dysfunctional households I include these groups:

 (let me know if you know of other relevant resources please. I’m always learning…)

Posted in Addiction, Anxiety, Depression, Relationships | Leave a comment

Mental/emotional health help in Hamilton 101

People seeking help with their mental and emotional health are often understandably confused about where they should go.  Psychologists? Social Workers? Psychotherapists? Counsellors? Psychiatrists? What’s the difference? What’s covered by Ontario Health Insurance Plan (OHIP)? What’s free? What do I actually need and want?  Here I try to explain how it works in Ontario. Or at least how I understand it. I’m happy to be further informed if you know more/different from what is below.

The system is complicated and dare I say it, underfunded, but there are good resources out there. So here goes…

What’s the difference between a Psychotherapist, a Counsellor, a Psychiatrist and a Psychologist in Ontario?

What’s the difference between psychotherapy and counselling?

What is covered under my insurance?

If I’m struggling with my mood or mental wellness, who am I meant to turn to out of all of these professions?

Can I get free counselling?

help?

 
What’s the difference between a Psychotherapist, a Counsellor, a Social Worker, a Psychiatrist and a Psychologist in Ontario?

Generally speaking, the difference is in training and approach to mental wellness. Some of these practitioners will work in community-based agencies, some in private practices.

Title Training Regulating Body Typical skill area/orientation
Psychologist PhD or other Doctoral level degree (often research-based)

College of Psychologists of Ontario

  • Registered Psychologist

Psychologists can do more assessment (e.g. they can diagnose mental illnesses). Psychologists can work in agencies or in research environments, or in private practice. The therapy-focused work they do is similar to that of Psychotherapists.

  • private fees are often in the $170/hr-range
  • fees typically covered by extended medical insurance
Psychotherapist

Masters level (MA – Masters of Arts, MSW – Masters Social Work, MEd. – Master of Education) usually. 

College of Psychotherapists of Ontario (formed in 2015).

  • Registered Psychotherapist

Psychotherapists and Counsellors can either work in private practice or in agency settings.

  • a 50-60 minute talk/listening-based appointment. 
  • an orientation to your goals.
  • often an encouragement to do homework between sessions and build your own skills, so if you are self-motivated you will get more out of this. (This applies to most counselling or psychotherapy).
  • private fees are typically around $100-$120/hr-range, but there is no guidelines for fee range set externally.
  • fees can sometimes be covered by extended medical. Ask your employer. 
  • if agency-based, appointments may be limited in number and/or include fees (sometimes income-based). 
Counsellor none specified though often counsellors have an Masters degree

Counselling is not a regulated profession in Ontario, so there’s no regulating body.

 

Counselling is now a more general term applicable to many areas, e.g. volunteer post-partum counselling, credit counselling etc. Counselling used to be ubiquitous with psychotherapy but since the College of Psychotherapists came into effect it has changed. 

  • Counsellors typically focus on short-term brief therapy or support.
  • Private fees maybe covered under “Mental Health” but this is less common
  • Counsellors can work in private or agency settings. 
Psychiatrist MD (Medical Doc) with specialisation in mental health College of Physicians and Surgeons of Ontario 

Psychiatrists are part of the medical system and covered by OHIP.

You need a referral from a GP to see a Psychiatrist typically. The Psychiatrist could be linked to the Doctors office (as in the case of the Hamilton Family Health Team approach) or through a department at St Josephs or another hospital.

Typically psychiatrists use diagnosis and medication when treating mental health challenges.

  • intake process likely with a nurse
  • short appointments typically
Coach May have a coaching certificate None as such. Similar to counsellors (above).
  • Short-term, solution-based, proactive, goal-oriented, practical. (e.g. I want to figure out how to build my own business, or loose weight etc)
  • Focus on here and now rather than exploring past
  • Not recommended for people struggling with mental health concerns necessarily – more for people who are highly functioning and have a sense of a goal and want to move forward. 
  • Fees range, but often include paying per month or for several sessions as a package. 
  • Online or phone coaching is common so being local isn’t necessary.
MD Psychotherapist A Medical Doctor (MD) degree plus additional training in psychotherapy College of Physicians and Surgeons
  • Covered by OHIP if under their MD licence. 
  • Can be challenging to get an appointment since this is a popular avenue and there aren’t that many practicing.
Social Worker BSW – Bachelor of Social Work, or a MSW -Masters of Social Work 

Ontario College of Social Workers and Social Service Workers 

  • Registered Social Worker (RSW)

Can work in a private practice, an agency, a hospital, and other settings. Varied roles including psychotherapy, case management, resource finding, advocacy. 

  • In a private practice setting where psychotherapy is offered, fees are usually $100-$120/hour.
  • Fees often covered by insurance. 
Art Therapist Registered Art Therapist (ATR). Masters-level degree. Not a regulated profession in Ontario. Many are members of the College of Psychotherapists. 

Art therapists can work in private practice and in agencies. Many work with children and many offer services in group format.

  • Fees for private practice are similar to Psychotherapists. 
  • Fees less likely to be covered by insurance typically unless supervised by a Psychologist.

 

What’s the difference between psychotherapy and counselling?

Generally speaking counselling is more skills-based and short-term. Psychotherapy is more in depth, looking at the family in which you grew up, and bringing in the unconscious. In psychotherapy the relationship between the client and counsellor is particularly important, providing the basis for healing. That said the terms have (until recently in Ontario) been used fairly interchangeably, the difference resting in individual practioners. 

In Ontario there is now a College of Psychotherapy, so anyone practicing the “act of psychotherapy” now needs to be a member of that college. Members of that college are now called Registered Psychotherapists. (I’m one of those). 

 

What is covered under my extended health insurance?

Insurance plans differ a lot… even if you have the same provider as your neighbour, your employer has it’s own arrangement with the insurer. So check your coverage with your employer.

Specifically check:

  • how much is covered
  • what providers (see above list) are covered
  • when your coverage roles over each year

Since the College of Psychotherapists (my governing body) is new and the system is changing, it is also worth directly asking your employer if Psychotherapists are now covered. It’s only if there is demand from employees to the employers that insurance companies will start to cover RP’s services. 

It’s often “Psychological Services” that are covered, which typically means Psychologists. Now, some Psychotherapists receive supervision through a Psychologist and can therefore bill through them. This is what I do to make my services more accessible. Talk to me if you are interested. 

 

So if I’m struggling with my mood or mental wellness, and want professional help, who do I contact?

Good question.Your doctor may be the best point of initial contact if you are struggling. Doctors may prescribe medication (anti-depressants, anti-anxiety meds). They also ideally have the skills and sometimes time to listen to your concerns and refer you on as needed. Some doctors offices give access to Mental Health Counsellors (see below e.g. HFHT). There are also hospital or community-based support groups your doctor can refer you to. 

Alternatively you can either pay out of pocket (see above fee estimates) or pay upfront and have your fees reimbursed by your extended medical insurance to access private psychotherapy. Either ask around to find a personal referral to a Psychotherapist,  Social Worker or Counsellor in your community or check the searchable listing at Psychology Today.

Or if you can’t pay regularly (at least for 6-10 sessions) keep reading…

 

Where can I get free counselling?

If you are in Hamilton (Ontario) and want to talk to someone and you can’t afford the fees or don’t have extended benefits, here are some ideas:

  • If your doctor is with the Hamilton Family Health Team (HFHT) or the McMaster Family Health Team you may be able to access counselling through the Mental Health worker at your doctors office. Both teams offer psycho-educational group support as well. Enquire at your doctors’ office. 
  • Call Coast Mental Health for support and/or local resources.
  • Catholic Family Service provides walk-in counselling (fees based on income) and short term therapy ($90/hour) as well as other mental health and wellness programming.
  • If you think you may “qualify” for some Mental Health services at St Joes there can be group or individual counselling available (many groups require a referral from your doctor)
  • The Women’s Centre at Interval House offers some counselling and programming for women.
  • Try accessing resources linked to your need (e.g. addiction, trauma, post-partum etc) or your sexual identity or culture or religious affiliation (e.g. queer, Muslim etc) and tap in to local supports that way. 
  • The Red Book lists all sorts of community supports that may be appropriate to your needs.

(I will keep building this resource list as I learn more, so feel free to email me with your ideas.)

 

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