“I don’t know what’s wrong with me”
Through the last two years, we as therapists have noticed an increase in folks who have sought out therapy for the first time in their lives, because “they don’t know what’s wrong”. This has been a refrain for all of us at various times during the pandemic. It is upsetting, frustrating, overwhelming…(all the feels) to not feel like ourselves, and to have no idea how to pull out of it because everything that usually helps does not seem to be working.
When we are feeling unwell and our coping skills are depleted, our minds can spin out of control with “what ifs” around possible chronic mental health issues, diagnoses, dependence on medications and the need for professional intervention. It is a scary reality to think we are stuck and unsure if these feelings will ever relent.
As I sat down to write this blog, I decided to google “Am I depressed or…?” to see what popped up. Here is a small sampling: Am I depressed or sad, lazy, tired, bored, burned out, bipolar? WOW! What a laundry list of inquiries, ranging from questioning and attempting to label emotions to querying mental health and diagnosis. We as therapists are pleased that people are becoming more aware of their emotions and mental health, and how they both impact their day to day habits and quality of life. We also worry that the feelings of hopelessness and the overwhelming volume of information on mental health that is all over the internet can actually exacerbate symptoms, rather than providing comfort or relief.
There are literally thousands of tools, therapy interventions and medical treatments used to assess, diagnose and treat depression that need to be utilized by a trained professional. There are also many valid informational and educational pieces on depression out there that you can use to first sort through the symptoms you are experiencing, gain an understanding of the severity of them, learn how to assess and incorporate day to day habits that may help ease symptoms, and finally help you to make informed decisions about seeking professional support.
Here is one, from the Centre for Addiction and Mental Health (CAMH), that provide useful information on depression, diagnosis, coping and treatment. Remember that this is not to be used as a substitute for professional advice and support, but it is from an accredited, professional organization that aims to educate so that you can self-assess before making decisions about reaching out for support.
I think I am depressed…now what?
One of the most studied and supported treatments for depression comes from psychiatrist Aaron Beck, called Cognitive Behavioural Therapy (CBT). To put it very simply, one of the pillars of CBT is the Cognitive Triangle. This triangle helps us examine the intertwined relationship between our thoughts, feelings and behaviours. When you are doing CBT with a trained professional, you are learning how to identify negative and intrusive thoughts that impact how you feel about yourself, your situation and your relationships, which in turn impact the choices you make about how you behave or respond. Again, professional support to help with this triangle is just one of the keys to managing depression, but doing a self-assessment check-in on your own can be a powerful way to understand whether or not to seek professional support to confirm a diagnosis, or treatment to help manage these thoughts and make some changes for the better.
Check Your Thoughts
Many of us resort to googling information on any issue we are faced with, whether it be a leaky faucet or our mental health. We do this because it feels safer to “DIY” our problem, so that we don’t have to say it out loud (because that makes it more real), and so we can hopefully find a solution that we hope will be an easy fix. The other reason we often start with Google is because we are feeling some shame around the issue and the act of even asking for help. Many of us hold longstanding and firmly planted beliefs around the concept of admitting to a problem (think perfectionism) and asking for help (think “weakness”, “incompetence”, and feeling “less than”).
Challenge yourself to really identify your thoughts around what you are experiencing, and how these thoughts may be roadblocking your ability to manage your moods, relationships and overall functioning. It is so easy to believe everything that pops into our heads. The truth is, a lot of what we think about ourselves is hyper-critical, and is driven by fear and shame. Newsflash: we don’t have to listen to these messages!
Check Your Feelings
As therapists, we hear clients using “negative self-talk”, whether it be out loud, or in their heads to put themselves down, name call, and shame themselves for experiencing what are actually normal and healthy feelings. Throughout the pandemic, many of us have resorted to “numbing behaviours” such as scrolling through our phones or Netflix bingeing because we have just not had the will or the energy to identify feelings, much less actually feel them! If this sounds like you, try to get into the habit of asking yourself “what am I actually feeling right now?” Identifying the feeling and actually naming it will help you manage it, rather than pushing it further within by seeking quick fix and feeling-numbing behaviours that actually take us into a perpetual shame spiral of negative self-talk.
Check Your Behaviours
Here comes your mother’s, fitness instructor’s, therapist’s, doctor’s voice: get plenty of sleep, drink lots of water, eat your vegetables, go for a walk, and practice mindfulness. “YUP, got it,” you are saying (me too). The issue for most of us is not that we need this knowledge, it is ensuring that we actually practice these behaviours.
Let’s go back to the thoughts part of this cognitive triangle. When we are feeling depressed, our minds generally block out these simple, yet challenging habits which we know in our heads will help us feel better. Depression can almost act like a magnet that keeps us attached to our bed, sofa, phone or computer screen, thereby blocking out the will to incorporate habits that will naturally increase the happiness chemicals in our brains and will contribute to us feeling even a little better. Again, the shame-spiral of knowing that you already know what to do to feel better but not being able to push yourself to actually do it is activated, thus leaving you feeling further down and depressed.
Just having a basic understanding of this cognitive triangle can be helpful to become more self-aware of our feelings, moods and behaviours. The smallest bit of self-awareness and the tiniest of changes is progress. Drinking one glass of water instead of none, reaching out to a friend to walk and talk, or getting into bed 15 minutes earlier than usual is all part of living the change.
So if you are reading this and still asking yourself whether or not you need help to cope with this post-pandemic reality, the answer is YES! We all do. The past two years have been a harrowing and traumatic experience for every single one of us. For some, emotional and mental health issues that existed before the pandemic have increased in intensity and severity. For others, the current set of circumstances has led to new and uncomfortable emotions that have taken a toll on quality of life.
Seeking the support of a qualified, experienced therapist will help you sort through your own cognitive triangle and make choices around the next steps to take to alleviate the symptoms on one end of the spectrum, to seeking out more intensive and long-term interventions on the other. Regardless, reaching out for professional help will ensure you are getting outside of your head and that you are not walking the path to feeling better all alone.Learn More
We at Maratos Counselling and Consulting Services hope you have had a safe holiday season. As we move into the New Year, you may be thinking it is time to seek out professional support.
Here are a few tips and strategies to get you started on your search.
Consider what type of support is feasible for you:
- We have many community resources that offer free counselling services. Those can be found here:
- BounceBack® is a free skill-building program managed by the Canadian Mental Health Association (CMHA).
- Call or search 211 Ontario. 211 connects people to the right information and services, strengthens Canada’s health and human services, and helps Canadians become more engaged with their communities.
Extended Health Coverage:
- If you have Extended Health Coverage as part of your benefits package, call and ask your provider if therapy provided by an RSW (Registered Social Worker) or RP (Registered Psychotherapist) is covered. This is often lumped together with other services, so be sure to ask for the maximum amount you have to work with. Please also consider discussing this with your therapist to plan out your sessions within your budget.
NIHB: The Non-Insured Health Benefits (NIHB) program provides eligible First Nations
and Inuit clients with coverage for a range of health benefits that are not covered through other programs.
Finding a therapist:
- Psychology Today is a good place to start to get an idea of who is in your area and what they might specialize in. There are several different search fields you can use to narrow your search including issues, ethnicity, sexuality, gender, etc. Be sure to spend some time reviewing the person’s profile, website, and other professional information they might have listed.
- Window shop. Most therapists offer some sort of free consultation call. This will give you an opportunity to hear the person’s voice, ask any questions you might have, and have a chat to see if there is a connection before committing to an appointment. Therapy is an investment. It is important to shop around and make sure there is a good fit. We understand this, so don’t worry about hurting our feelings, or continuing the search.
During your Consultation Call:
Questions you might ask during a consultation call:
- What does an average session look like?
- How active are you as a therapist? Am I expected to do most of the talking?
- What is your training?
- Asking personal details. You are welcome to ask whatever question of your therapist, and your therapist is welcome to only answer what they want to. Remember, we are trained professionals and if there is something we don’t want to answer, we most likely will tell you why. Having an open dialogue and boundaries is part of building a secure therapeutic relationship.
- Have you ever worked with… feel free to ask about a particular issue or topic you are wanting to focus on. Be open to their answer. Even if they may not have worked directly with a specific issue, the rapport between the two of you is the most important piece, and there still could be value in your work together.
- Logistical questions- What is your fee? Do you offer sliding scale fees? What is your cancellation policy? How do you accept payment? Am I able to contact you between sessions?
Questions the therapist might ask you. And don’t worry, if you don’t have an answer, that’s ok too. It can be all part of the journey:
- Have you ever been to therapy before? If so, how was your experience? Anything you liked or didn’t like?
- Is there something you’re hoping to focus on?
Check-in with yourself:
Listen to your gut. Based on a 15-minute phone call, what you are really looking for is:
- If you felt heard
- Do you feel there is potential for a deeper trust
- Are you curious about your future work together?
As you continue your work with your therapist, you will start to feel more confident in your fit. Remember you are also never “trapped” with that person. You are always welcome to make a change.
Booking your first appointment:
Your first session will most likely be an assessment, giving your therapist an opportunity to collect information and get a snapshot as to what is happening for you. Try to be patient and remember like any relationship, the therapeutic alliance will take time to grow.
The goal of therapy is not to “fix” you immediately, and healing takes time. This can feel uncomfortable, and it is recommended you give yourself 6 months to reflect and see if you notice any changes, realizations or growth in your thinking, behaviour, hopes or fears. If you feel that your work together isn’t where you’d like it, consider discussing this with your therapist or finding someone new with a different modality or style of therapy.
Our team can be viewed on our website or call us at 519-752-3653.
Written by Rebekah Laferriere, MSW, RSW
Maratos Counselling and Consulting Services
This has been a hard time for each of us as we collectively grieve. COVID-19 has created an undercurrent of anticipatory grief of what’s to come, while we all adjust to our new “normal”, continue to experience the up’s and down’s of being human, and attempt to hold on to hope that we can cobble together a normal we recognize after all of this.
We have passed the first wave of crisis. For many of us, the anxiety, denial or other initial reaction (thanks to our adrenaline) is starting to subside and we are realizing we can’t keep up the pace of white knuckling through this. We are now settling into accepting our situation for what it is today, and as such, we are being forced to get creative, and find new ways of managing our emotions, and our lives.
Five Ways to Create Your New Covid Normal
Adjust Your Achievement Mindset: Try to remember to “Keep it simple and small”. Set small goals or tasks each day to accomplish. We usually recommend starting with 3, and that includes hygiene, chores and nourishment!
Move It: David Kessler has noted “emotions need motion”. This is figurative and literal. Consider going for a walk, jumping jacks, lifting your canned goods or having a living room dance party. The energy we experience connected to our feelings needs to be released.
Feel the Feels: Connecting with your emotions – identify and describe where the emotions live in your body and what they look like. This will help to give you a sense of control separating the emotion from defining you, and identifying it as an experience you are having.
Journal! If this is new for you, start with making a list or picture of what makes your heart feel happy. It is an amazing place to park your thoughts.
Practice daily gratitude at the end of the day. (If you are struggling with this start simple and small. Ex. I’m grateful for my pillow)
Social Connection: Get social – call, text, email, video chat. Set time aside to connect. Attempt to cultivate social connections that you had in your pre-covid life. It may take some creativity, but you can do it!
Get offline. Try to keep an eye on how much time you are spending online. It can be an overload of information and it is important to be intentional about grounding in your present. Refer back to “Feel the Feels”. Be mindful of how you feel and how your body responds to watching or reading the news. If it feels bad (sore head, butterflies in your stomach, feeling anxious or teary), turn it off! No amount of watching news or scrolling through social media is going to change this!
Channel Your Creativity: Do something, anything creative!
Think of your five senses:
- Look: Read a book or poetry. Something light and fun!
- Listen: Listen to music or podcasts to match or improve your mood.
- Taste: Cooking or baking helps calm the nerves and nurtures and nourishes you and your family.
- Touch: Tactile activities such as colouring and crafts are a good way to channel creativity and calm your mind, distracting you from what is going on.
- Smell: Use a favourite soap in the shower, diffuse an oil, or burn or a candle. Scents can take us to a happier, calmer place.
Coping with this situation isn’t a matter of “silver lining” your life, but working to find meaning in your day. Remember, it’s ok to not be ok, and there are people who want to help. Build your support system with friends, family or a professional. So ask for help. We are all in this together. Most of us welcome a chance to hear a friend’s problems and feelings, even when we have our own “stuff” going on. Helping each other makes us feel useful! And if that doesn’t work, remember that many therapists are offering online and video sessions. Get creative as to where your session can be held (on the phone while you walk, in your car, front porch, basement, etc.). Professional help remains covered under your employer’s benefit plans, and some is being offered for free right now. Google it!
Some information sourced from HBR article “That Discomfort You’re Feeling is Grief” by Scott BerinatoLearn More
When a family spends time together, they learn about each other.
One simple way is to ask the “what as good about your day? What was not so good about your day?” questions, going around the table at dinner. This facilitates conversation and gives everyone a chance to share. Even though our worlds are much smaller, you will be surprised at how everyone has had ups and downs. As parents, use this to stay in tune with what your kids are feeling, how they are experiencing this situation, and what they need from you and each other.
And YES, work really hard to eat together. It should be MUCH easier now, as nobody is going anywhere. Make eating together a top priority TODAY. A structured conversation will help identify holes and challenges in our family rules and values and will help you relax or tighten them up where needed.
We have gone through the stages of grief in mourning the loss of our “normal” everyday. We are now several weeks into this isolation, and my guess is, you are settling into the “new normal”.
Most families suffer due to a lack of structure and routine. Have a family meeting to build a VERY SIMPLE daily schedule. What needs to be included? Basic needs of course, but what about exercise, creative time, academics? Set and enforce a schedule, and don’t be afraid to use technology to help with this (family schedules, setting timers, making lists, etc.). Don’t forget to schedule fun. Lots and lots of fun.Learn More
Think about how your family communicates. Do you listen to respond, or do you listen to really listen? Think about it.
Learning how to be a good listener means shutting your mouth. Enough said. Try it. Interrupters unite! I come from a long line of interrupters. If you need a “talking stick” (or hockey puck, stuffed animal, etc), get one! Whoever holds the speaking object has the floor.
Next, think about how you show others that you are listening. Do you nod, paraphrase their statements, state your understanding, empathize? The ways in which you show family members that their stories, their experiences, their feelings are important will begin to cultivate understanding, create connection and attachment.Learn More
READ THIS IF YOU HAVE SCHOOL AGE KIDDOS AND/OR TEENS
Talk, talk, and talk. Have a chat about how the kids think parents can help them develop these values and the habits that go with them. Start with brainstorming and then move to develop some concrete rules around conduct and behaviour in the home. Parents, be vulnerable. Share how it is hard for you to maintain the self-discipline to “walk the walk” every day. Share your struggles and make yourself human. This is especially applicable to parents of school-age children and teens. Let your kids contribute! LISTEN, LISTEN, LISTEN, parents. You will learn a lot about your kids if you ask them to contribute and you exercise your parenting muscle to set boundaries that fit your values. Stand strong. The kids will resist. But it is time to re-define normal and re-set the boundaries in your home.
READ THIS IF YOU HAVE LITTLES
Parents of little ones are not getting a break from parenting. It is little ones, sun up (or before) to sundown (or after). You have lost your extended family connections and external supports such as daycare, and you and the kids are feeling this. Think about using technology to help foster the connection, and hopefully give you a break. Have grandma read a book or tell a story on facetime, do regular activities over facetime that your kids enjoy…baking, colouring and crafting. ASK. FOR. HELP. Don’t be a hero. Ask those who you love for some facetime or an ear. Talk about what you are feeling. Share these thoughts with your support system. But try not to focus on the negative too much. Tell friends and family about the funny stuff the kids did, and listen to their stories as well. We know this isn’t much. We know this isn’t the level of connection you have enjoyed. But we have to focus on re-defining our expectations.
Talk to your spouse, or even text when you have a free minute, as you might not get a good chunk of time to hash out this heavy stuff. Even little tidbits of info will help you develop a better understanding of your values as a couple, the discrepancies you may note from your families of origin and then develop a value system that is right for YOUR family.
Time for a reminder here. What we are all being asked to do right now is REALLY, REALLY HARD.
What is the hardest thing about communicating with your kids?Learn More
Take some time to think about the vision you have for your family. Think back to when you looked at your sweet, delicate infants for the first time. I am sure you had dreams for your babies from day one. You jumped ahead to the distant future, picturing them as an astronaut, a physician or a judge. However, once reality kicked in, you knew that you needed to examine your family values and think about how you were going to instill the good habits, self-discipline and other characteristics such as empathy, sensitivity and kindness into that little human.
Then, the small person started to develop a mind of their own. You worked hard all day and had to dig deep to be consistent with applying the rules and guidelines you put in place in order to teach and instill those values. Your little human went to school, and then learned that there were plenty of people out there who did not share the same values, which set up a whole new set of obstacles for raising that well-rounded, self-disciplined, kind and caring human. Oh yeah, then they discovered the internet…
Fast forward to today. We are settling into a new lifestyle. Our world has slowed down, and we are limiting our contacts. Opportunities to re-acquaint ourselves with our families abound. Let’s talk tips for pressing the re-set button in your family and using this time to build strength.
Instructions: Take a half-hour at the dining room table to place these values in the “Absolute, not-up-for-discussion” pile, the “Nice to have, but not on top of the heap”, and finally the “Nice, but not important to us pile”. Next, review the piles, make sure your absolutes are clear and then pick your top ten and rank them. Those, my friends, are your family values.
P.S. If you really want to have fun, have everyone do their list independently and then reconvene to see what you came up with, and THEN figure out your top ten. This may take awhile…however consensus building helps foster co-operation, respect and the ability to agree to disagree.
Once you have your values secure, keep them on the fridge or in a central location. Littles or the more creative among you can create a poster using colour and images. You can frame it and everyone will commit to look at it EVERY SINGLE DAY.
How did you do? Did you learn anything about your family and the values that you hold individually and collectively?Learn More
So here we are, settling into Covid Family Life. This is a time marked with uncertainty as to where this is going, and for how long. Most of us have experienced the roller coaster of emotions associated with this experience. From shock, to sadness, depression, anxiety and back through again. Hopefully, you are moving into accepting this situation for what it is today, and are now thinking about how you are wanting to travel through it as a family.
Ironically, as difficult as this time is to endure, many people have enjoyed the slowed pace and the ability to really enjoy each other, and think about putting some family habits and systems in place that we have lagged on a little. You can do this too! But you need to follow the first guiding rules:
- NOBODY, NO FAMILY, NO PARENT is perfect
- Be forgiving of yourself and each and every member of the family as they adjust to these times and struggle to manage emotions
- Be patient. Change takes time.
Over the next couple of weeks, we are going to provide some tips for helping and even improving your family dynamic during our social (read physical) distancing. We are hoping that this will be a virtual family therapy of sorts. You don’t have to be dysfunctional, riddled with conflict or in crisis to need family therapy! In fact, it is our belief that every family could benefit from using these tips to open conversation and foster connection.
Share some of the biggest challenges you have experienced as a family since the Covid situation began.Learn More
I am often asked by people what is the best therapy “advice” that I have ever given. It may appear that answering this question would be difficult because I see a wide variety of individuals who come to me with a wide variety of reasons for seeking therapy. However, the question is not a difficult one for me to answer at all. The reason is because I generally don’t give advice!
Let me explain. Think about a time when you were confused, overwhelmed and in emotional pain. Quite likely, you sought the advice of a close friend or family member whom you trusted. You told your story, you cried or yelled, you got a supportive hug and then waited for your support person to tell you what to do to “solve” the problem. You then took their advice, felt 100% better and moved on with your life? Right? I highly doubt it! Even if your support person offered advice, you likely met that advice with a “yeah…but” reason for not taking it (that is if you didn’t just meet it with an outright “NO!, I can’t do that!”). Or, maybe you can think of a time that you took someone’s (well-intentioned) advice quite literally. What happened? Were you thrilled with the results? Did following the advice seem inauthentic? Did the following through with the advice lead to further problems?
Quite likely, you have seen one or more of these scenarios play out. Your plan to seek advice and support from your family or friend can sometimes lead to you feeing more frustrated, confused, judged and upset than before you started! The reason for this, is that in order for us to solve the dilemmas that face us, we need to come up with the solution ourselves. We need to create a “buy in” to our solutions. Although friends and family can offer support, their well-intentioned offers of advice are based on a variety of factors: their morals and values, their personal experiences, their biases (toward you or the other party in your conflict), among other things. Taking advice can often lead to more confusion and a lack of a “buy in” to the solution as we didn’t come up with it ourselves!
This does not mean that seeking the support of friends and family is a bad idea! Quite the contrary! We all need support to hear our stories, dry our tears and give us hugs. In fact, quite frequently, the simple act of telling our story to someone else can produce clarity that letting our problem run “the internal loop” between our heads and hearts cannot.
However, time and again, I have people confirm for me that seeking therapy allows them to tell their story to a “neutral, third party” who is only privy to their perspective. A good therapeutic relationship can help you “re-focus the lens” through which you are viewing the problem. Talking about your issues and feelings can help you gain insight and start to see things differently and with clarity. The good news is that the therapeutic relationship supports you in this, but ultimately, the change in perspective is yours, and yours alone.
Now the cynic within you may say, “YES! That’s precisely the problem with therapy…the therapist only hears one side of the story!”. My answer to this is a resounding “YES! You’re right!” However, a skilled therapist is trained to listen, ask questions skillfully and support the individual in reflecting upon their situation. These questions and reflections have the effect of encouraging the client to see their troubles from a different point of view, and sometimes, even cause a shift in perspective about the problem or their relationships with others who are involved with the problem. It is hoped that this shift in perspective can open up dialogue and help the person move toward solutions.
That is why therapy does not include advice-giving. If the purpose of therapy is to increase perspective, reduce discomfort and move toward solutions, then individuals who seek therapy with these goals in mind are sure to work through their issues and ease their discomfort.Learn More
All of us have attempted to change or modify our behaviours at one time or another. That all means all of us have experienced the frustration when change does not come easily, or it does not come at all. In the 1980’s, researchers Prochaska and DiClemente developed the Transtheoretical Model to explain how people embark on a path toward change. This biopsychosocial model integrates information from previous research and provides a theory of change that can be applied to anyone who is attempting to change anything within themselves.
The foundation of this theory lies with the consistent stages of change that people travel through when they are attempting to modify their behaviour. Although each person will spend a different amount of time at each stage, the journey through the stages is consistent and the tasks required to move forward to the next stage are common to all who are moving from struggle to success in changing habits and behaviours.
Studies have shown that only a minority of people who are attempting to change can achieve long term success without guidance and support. Use of the Transtheoretical Model in therapeutic coaching results in improved outcomes for most people, as it incorporates assessing readiness for change, and principles promoting balance and self-determination in setting small goals along the way. This differs from most people’s thoughts about change, as it proposes that successful change occurs in small increments and with a series of changes over time, and does not simply focus on a culminating event (such as quitting smoking or losing pounds).
Simply put, an individual needs to assess where they fall on a continuum of stages of change before they can take action in formulating a change strategy.
The stages are as follows:
- Precontemplative (not ready to think about change)
- Contemplative (getting ready to change and making plans)
- Preparation (ready to put the plan into action)
- Action (taking active steps to change and engaging in change)
- Maintenance (using the skills learned to maintain the change behaviour)
As people travel through these changes, their choices and decisions start to shift in favour of the change (think about a “pro and con list”). As they become more motivated toward change, and they see success, the “pro-change” list starts to become longer, and overshadows the “con-change list”. In short, the advantages of change (such as weight loss and improved health) outweigh the disadvantages (such as the time and energy it takes to count calories and exercise).
Successes lead to increased confidence and commitment to change and ability to counter or avoid potential “relapse” situations that can sabotage change. That’s an interesting part of this theory too…it incorporates the concept of “relapse” into the model. It recognizes that people may (and likely will) “fall off the wagon” from time to time. However, the higher one is on the change continuum, the quicker they can recover from the relapse by utilizing the strategies and techniques that they used to move their way up in the first place. In addition, by recognizing relapse as a reality, one can develop strategies for managing difficult or challenging situations that may threaten their change BEFORE they occur.
If you are considering changing a habit or behaviour in some part of your life, consider this information, and think about how some extra support through therapeutic coaching could help you achieve your goals.