Lisa Shouldice MA, RP, CCP, Psychotherapist

I wrote this after having taken some time to allow myself to process the panic and calm my own central nervous system, allowing reflection time. I feel my role in this pandemic as a mental health provider/psychotherapist, is to be the eye of the storm, a safe place. Taking care of your mental health right now is so important. Please know that the measures being taken are not because, as a Canadian, you are at high risk to contact COVID-19. It is to slow down possible exposures to give the immune system a chance to catch up so it becomes another flu virus. The intention is not to create fear and panic. This panicked state actually leads to a lack of safety, extreme stress and problematic behaviours. There is no shortage of food and other supplies in Ontario. It is the inundation of the stores that is the issue. Even in Italy, with full lockdown, a family member is allowed to go to the grocery store. Take this time as a blessing to connect with friends and family and support each other. You do not necessarily have to stay at home if you are healthy. Simply be cautious. We are hard-wired for connection. Isolation will stress you. Please be careful about your social media time and presence right now. It is a way to connect but also an extremely toxic place right, creating fear and panic. And many jokes that make me laugh as well. Lol. I am gravely concerned about the erroneous information out there. I also am saddened that humans learn so slowly from the past. Fear actually creates problems that do not exist, you do not need to hoard and fight over resources. We need to stay strong in case this gets worse. You may enjoy the intellectual exercise of sharing conspiracy theory information but please note that it impacts people that are vulnerable with anxiety disorders, potentially isolated and scared already. And we are all vulnerable to fear right now. Let’s take this time to take care of each other. Social media can be problematic and has likely led to the current panic. This is what is actually new from pervious outbreaks. Please reach out and connect. We calm ourselves through others, which is a bit tricky right now. Be aware of exposing yourself to constant news updates. This can also feed fear. Take time to let your central nervous system return to baseline. Don’t spend time in unrealistic fears together. But support each other in real fears ex. economic. Learn to know the difference. Practice mindful hobbies while you have the time. Journal your fears, colour in adult colouring books, meditate and take walks. I offer online and distance sessions. Stay safe. Take care of your loved ones. We are in this together. I do not want to survive in a world in which we tear each other apart to do so. We are in this together.

Do You Have a Sensitive Teen?

Self-Harm and Finding a Path To Self-care

Self-harm is often a big, scary word for parents. So I wanted to put pen to paper to address it today for what it is, why it develops and what to do if you worry that your teenager may self harm (ex: cut themselves). It is estimated that anywhere from 14-39% of teens engage in self-harm behaviour. Maybe you have caught them and have no not idea what to do. You may just want to be able to bring up a difficult issue with your teen and do not know how.

Self-harm is an immediate, physical and intentional act to the body that is not a suicide attempt (Freedom from Self-harm, Gratz & Chapman, 2009). Self-harm is used and develops as a way of dealing with really difficult feelings. One of the reasons teenagers are vulnerable and at higher risk than other age groups, is related to development. It is an age when childhood ends and feelings and abstract thought develops. This happens very quickly and when feelings intensify, for social and biological reasons, learning how to deal or cope with these intense feelings must also develop quickly. This is a part of why teens are at risk for drug use, self-harm, drinking alcohol etc. It is a time they tend to pull away from parents, but need support the most. When emotional support develops in friendships, this can be wonderful, if your child has healthy friends. But it can lead to teaching each other dysfunctional behaviours, if this is all your child’s friends know. We can only support each other the best way we know how to. Teens can also be socially rejected and not have friendships, leading to isolation. During these important years there is a lot of reflection and identity development. While first break-ups and friendships changing are common, there may also be external stressors ex: parent’s divorce. This creates the perfect breeding ground for dysfunctional coping mechanisms to be tried and learned, if healthier ones are not as readily available.

While self-harm may seem scary and extreme to some of us, it is also a powerful way to redirect intense feelings. It releases serotonin, a neurotransmitter that regulates emotions. It also affects our natural endorphins, which can lead to a pleasurable, euphoric feeling. As a result, it can be very addictive when it is used regularly. Self-harm behaviours can decrease, distract from or help express intense feelings. So treatment for self-harm behaviours focuses on learning healthy ways to cope and communicate feelings.

It is important to check-in with your teenager and keep the lines of communication open, even when it seems impossible. Your teen needs to feel emotionally supported and learn to talk about their feelings in a healthy way. Your teen is more risk if your family is going through significant changes, they are socially rejected and tend to withdraw, or are “moody” rather than verbally expressive.

My intention today is to make sure you are aware of your teenager’s vulnerability, so you can do your best to stay close. Connected teens are protected teens.

Lisa Shouldice MA, RP, CCP

Toronto Individual, Couple & Family Psychotherapist

416-953-6880

www.lisashouldice.com

Come Start Your Healing Journey...

Do you frequently worry and feel panicky with a racing heart? You may be experiencing anxiety. 12% of Canadians suffer from some type of anxiety. So approximately, one out of every 12 people reading this article struggles with anxiety. The most common type is Generalized Anxiety Disorder (GAD) which may consist of hot and cold flashes, racing heart, tightening in the chest &/or escalating worries and obsessive thinking. Feeling irritable or restless is often described to me by clients. These feelings need to persist for over 6 months for the purpose of diagnosis by your doctor or a mental health professional.

Many people who do not have regular anxiety have at least one panic attack in their lifetime which includes a sudden surge of intense fear, feeling you cannot breathe and many describe feeling like they are dying. This often results in trips to hospital emergency because people tend to think they are having a heart attack. Panic attacks are not physically harmful as your heart is beating fast, but nice and regular. You are not going to die but it is horribly uncomfortable and often seems to come out of nowhere.

Physiologically, anxiety increases arousal as it is autonomic and neuro-endocrine activation. The chemicals released in our body take time to break down so their affect lingers. Deep breathing from the diaphragm will help to begin that breakdown in the body. Try to breathe from your belly, keeping your chest still. Take in three big, deep breaths before starting to slow your breathing down, until you are breathing deeply and comfortably from your diaphragm. It only takes three deep breaths to feel calmer.

The reason I feel anxiety is an important experience to talk about and be aware of is the intense impact it can have on daily life. When people come to my office and we begin to talk, it is usually around the third one-hour session I have with them when they start to talk about anxiety and its impact on their lives in a deeper, connected way. It leads to realizations that their life has been created around avoiding feeling anxious. So they may not go to social engagements, even with close friends, avoid spiritual or religious ceremony etc. as they are afraid of feeling panicked in public. Fear of change may leave them in unsatisfying jobs that do not challenge them because they know exactly how to be and function in their current workplace. Sometimes we do not even know we have done this until we start to talk about it.

As a Psychotherapist I know anxiety is a pervasive and, unfortunately, common experience. But it is also the mental health struggle that is the most responsive to treatment. So getting help works! It the meantime eliminating caffeine, alcohol and exercising or meditating daily is a great start.

Breathing Meditation

Sit in a comfortable position. Avert your eyes to the floor or close them, whatever feels more comfortable. Breathe through your nose. Inhale and exhale slowly through your belly, rather than your chest. Inflate your belly like a balloon and deflate it, like a balloon. This deepens the breath, it is too shallow in the chest. Breathe deeply and naturally, slowing it down. Focus on your breath and the feeling of it entering your nostrils and exhaling out of your nostrils. In with the good energy, out with the bad…as thoughts intrude, observe them and let them go. Refocus on your breath…

This morning I am taking the time to read "Freedom From Self-Harm- Overcoming Self-Injury with Skills from DBT and Other Treatmenents by Kim Gratz & Alexander Chapman.  As a psychotherapist that has supported clients with complex trauma, self-harm is an issue I have worked with often. Self-injury is a coping skill that is used to deal with intense affect.  People tend to discover its powers during a time in their lives when they are struggling. The biggest issue with using self-injury is actually how addictive it is.  It releases endorphins very quickly and generously into the body, a feat few other coping tools or skills can claim.  It is also found to be used more often within the Lesbian, Gay, Bisexual and Trans populations.  Huh? Interesting isn't it?  Why is this?  There is currently only speculation but a few educated guesses can be suggested.  The vast majority of people start self-harming as teenagers, a time when emotions are high and the body is changing.  This can be an even more difficult time for the LGBT population as many of them feel discriminated against and different at a time when everyone is striving to be the same.  It is hard to discuss sexuality and becoming an adult with friends when everyone seems to have a different experience than we do, often resulting in feelings of isolation and loneliness. Unfortunately, discrimination is alive and well, despite recent changes ex: in Trans policy and related surgeries.  The shame and secrecy around self-injury is intense and for us LGBT folks it may only be another secret in our lives.  So please tell someone you trust!  And there is help out there to help control it and learn to cope in healthier ways.  Choose a professional, including a doctor, that understands self- injury and can be a support rather than create further shame for you. Sending love and light!

I went to the opening night of the Disney-Pixar Movie Inside Out, last night.  What a fabulous production!  It was laugh out loud funny, exciting and made you laugh and cry.  But what struck me was the teachings on emotional intelligence.  The major points in the movie includes learning to accept all of our different feelings, including the ones we struggle with.  They keep us safe and help us process loss as well as protect ourselves.  But what I loved the most was the subtle nuances of the movie and it seems obvious that someone had done their research!.  The "Train of Thought" being derailed the more sad and depressed the main character, Riley gets was duly noted.  We know as mental health professionals that it is harder to think and make decisions when we are depressed and anxious.  The letting go of old memories we no longer need and the important and integrated role of each different feeling creating Riley's perosnality was an amazinjg ride.  I also thought it was poignant that Joy was the leader and predominant feeling and needed to learn to appreciate Sadness.  Each feeling characrer is absolutely adorable and loveable in a completely different way.  What a great movie to address emotional intelligance and self acceptance.  I also believe that mental health awareness is improving exponenitally and becoming less of a taboo sublect.  A great way to help this along.  BRAVO!!!!

We live in a world where 20% of Canadians will be challenged by a mental health issue at some point in their lifetime. Most Canadians are also indirectly affected by having either family members or friends that struggle. Canadian youth are one of the groups the most effected by this reality (CMHA http://www.cmha.ca/media/fast-facts-about-mental-illness/). How do we keep our young families healthy in this environment? How can families be a preventative tool to buffer its members from experiencing Anxiety and Depression?

It is important to first start with strengthening the foundation of your family and keeping it strong. The foundation of a family is only as strong as the person (single parents) or committed/marital relationship that heads it. Therefore, if you are a single parent you need to put your mental health and wellness first. If you are a couple with a young family your relationship needs to get consistent, regular maintenance. I know this may be shocking to those of you who strongly believe putting the kids first is paramount, but this simply does hold up in research looking at children’s mental health and wellness. If the foundation of a family is strong the children, and later adults, are healthy and contributing people, with high self esteem.

So I challenge single parents to have a self-care plan in their lives that is a priority. Please don’t put yourself aside for months at a time. For you married couples it is important to put time aside for connecting with each other, including date nights. Get babysitters! They are worth it! The attitude that you will focus on your marriage after the children get older, tends to leave couples disconnected, depressed and less able to support each other in problem-solving.

I want to leave you with a few tips on creating and maintaining a healthy family.

• Create an environment of “no secrets” in your family. Have an open dialog where your children can talk about their feelings and feel heard.

• Remember that your family is only as healthy as every single member. If a family member is struggling (ex. Acting out, isolating) they are the teacher or emotional barometer in your family. Support them to figure out what is wrong. Address it.

• Youth need to feel connected to their families. Even though they may resist this in teenage culture. Do things together. Stay connected.

• Every family member needs to feel useful and important. Give tasks to every member at an appropriate developmental level.

• Make decisions and enforce them. If your children question you, explain your decisions in a developmentally appropriate way.

• Expect and insist on respect.

As a Psychotherapist I have a dream. I wish our culture would be committed to more open dialog on mental health and difficult feelings. We are all struggling and it would enable more support. Use these tips to start creating this culture within your family.

I read an article from the Globe and Mail last night that is currently circulating on social media sites as of yesterday.  The residential school report came back and has decided that what Canada has done to Aboriginal people and their families is a cultural genocide.  People are angry.  I need to address this. As a non-Aboriginal person that believes a part of my calling as a Psychotherapist includes the honour and privelege of supporting Aboriginal people on their healing path, I cannot believe people are angry about this.  To do the work I do, I have had to admit and accept that I am a colonizer.  No, I did not directly harm anyone, but I live with the benefits of living on Canadian land everyday.  I also live with the sadness that my people could not be excited to learn from another incredible people and respect and share space.  If they had, I truly believe our environment and personal relationships would be different today.  I am saddened by missing out on these possibilities.  I sit with Aboriginal people everyday who struggle with trying to reclaim their lost culture. To find a way to relearn and embrace their culture and walk with pride.  I see the trauma and the effects of colonization and the residential school legacy.  It is hard to admit my people did this.  Deliberately.  And I cannot sit back and lie to myself.  If we come from a place of compassion we can look at each other in a new way.  We can grow and heal together.  We can be enriched for our time together.  I am truly sorry.  It will never be enough. But if I am able to face this truth, HISTORY DOES NOT HAVE TO REPEAT ITSELF.