Denis Boyd & Associates

Lessons Learned on a Bike Ride

Tue, 21 Jul 2009 15:28:09 -0800

My wife and I recently completed a fairly long bike trip. What is considered "long" is, of course, open to debate but we were bike touring for over two months and for us, that seemed like quite a long time. It was long enough, in fact, that we learned lessons about our relationship and our lifestyle; lessons we probably never would have realized on a short jaunt around Stanley Park.

This bike tour involved cooking our own meals and sleeping in a tent for the whole two-month period. We experienced gusty winds, torrential rains, killer hail, days with a blazing hot sun, and nights with bone-chilling cold. And the mosquitos and black flies are a story of their own. We cycled up hills that never seemed to end and navigated roads that rattled our teeth. There were times when, hungry and thirsty, we would travel for hours looking for that lonely restaurant on our map only to find it closed when we got there. And there was considerable highway travel with trucks passing within inches of our handlebars and leaving a turbulent wake that threatened to either suck us under or blow us into a ditch. And this was just the fun part.

Actually, we did have fun. There was the serenity of cycling along a country road with little or no traffic, the scent of forests, flowers, and newly cultivated fields, the joy of seeing a wolf cross unperturbed in front of us, and the beauty of a pristine lake that shimmered as we passed. There were vistas around every corner and interesting friendly folks in every town we visited. At the end of the day there were spectacular sunsets, the comfort and safety of our little nylon home, and the sharing of our adventures and accomplishments of the day. We ate like lumberjacks and slept like babies .

We learned we could live quite comfortably in a 7'X 7' tent, with sleeping bags and a blowup mattress. We could exist on simple meals and very few creature comforts. We had no radio and no TV and didn't miss them for a second. We used free computers in town libraries to contact our family and friends. We could ride in the rain and stay warm and dry in our rain gear. We had flat tires and mechanical problems that slowed us down but never stopped our progress. We had times of intense thunder and lightening but always found shelter. In general, we felt self-sufficient, unencumbered, and free as the wind. It was the ultimate mental health break.

As a couple we learned to rely on one another as never before. We helped each other set up the tent, cook the meals, clean up, maintain the bikes, and do laundry. We governed our pace to enable us to stay together at all times. We took turns drafting behind each other to lessen the wind resistance and share the effort. We waited for one another when one of us needed a break. We shared our water and granola bars.

On this trip learned we could survive quite contentedly with very little. Our major concerns were the weather, our food and water, our bikes, our physical condition, and the ideal flat spot to pitch our tent. All our regular concerns about work, our lawn and garden, our families, and other normal responsibilities were, for the most part, temporarily shelved. Out of sight and out of mind. We felt like kids on the first day of summer holidays without a care in the world.

Leaving behind a comfortable lifestyle with all the amenities one could hope for is never easy. We had to step outside our comfort zone. We realized that complaining never helps anything and that we can be resourceful when the need arises. To stick it out when the going gets tough has its own rewards. But would we do a trip like that again? God willing and with good health we would do it again in a nano-second. Experiencing such freedom and personal growth was unexpected and we now appreciate how rare it really is. We are bonded more tightly as a couple and feel secure in knowing that our partner really is there when the need arises. A lot of lessons and a lot of memories will be with us for life.

Those wishing to learn more about our bike tour are invited to visit our travel blog at www.mytripjournal.com/rickjanBikeCanada2008.

Teens Who Cut

Tue, 21 Jul 2009 15:09:06 -0800

Maria is 14 years old. Two years ago she began to injure herself, dropped out of school, began using drugs and alcohol and eventually isolated all of her friends. Self injury involves the deliberate damaging of ones body. Cutting the skin with razor blades or broken glass is the most commonly seen method, while burning, interference with wound healing, self punching and scratching are among other examples.

Maria notes that when her peers discovered she was cutting she was ridiculed and shunned. Her parents and support systems became overwhelmed. They tried reasoning, pleading, bribing, grounding, and taking away privileges. At times they screamed and threatened to kick her out of the house. Nothing was working to reduce her self destructiveness.

While not all individuals who cut are diagnosed with Borderline Personality Disorder, in Maria's case it was quickly recognized that she struggled with BPD and recurring depression. Eventually a treatment program was developed to help her cope with her distressing symptoms. An important clue to discovering her diagnosis was the simple question of asking what she feels when she cuts. Her answer was "either nothing or everything". Maria states she often feels empty, as though she doesn't exist, like she is invisible. At other times she feels as though she is going to explode with feelings. Asking her to describe her emotions, she stares blankly as large silent tears pour from her eyes. She quietly says she really doesn't know how to discuss sadness, anger, or joy. She feels alienated from herself and her feelings.

When asked to describe the circumstances behind the various cuts on her body, she is able to let the cuts talk for her. The deep one on her arm was the result of being rejected by her peers after being told she was a freak. She recalls going blank as though she was starting to die or disappear. The cut served the purpose of letting her feel something, albeit pain, and reminded her that she was in fact still alive. The cuts on her stomach occurred when she thought back to past abuse by a relative. This time she was flooded with so many painful feelings that she cut to stop the emotional pain from overwhelming her and focused on the physical pain.

The reasons are complex, varied and unique for each individual. Maria noted that for two years everyone around her talked a lot about what she needed to do to change. The problem was that nobody was listening to her profound statement "I don't know why I do what I do, all I do know is that I either feel nothing or everything". It is as though her nervous system is hard wired to experience basic human emotion on an intense and dramatic level. If she doesn't release the intensity by cutting or anger, she may shut down, dissociate or engage in other behaviors to blank out the painful feelings.

As therapy progressed, Maria's behavior became less destructive. She gradually became able to recognize and discuss her emotions. She learned to simply observe her emotions without becoming overwhelmed by the intensity. In turn, this allowed her to develop strategies to solve her problems without harming herself. Most importantly, her parents learned to validate her emotions. She can now say she is sad or angry without being told that she shouldn't be feeling a certain way or that she has no right to feel the way she does because she is loved, has a nice home, material objects, etc. Her parents now work with her to brainstorm ideas on how to address the challenges she faces. In the past they would have dictated what she should do and how she should feel.

If you know someone who sounds similar to Maria, please remember not to dismiss their feelings. The feelings are real and valid and to have their expressions of emotion shot down or dismissed is a painful and invalidating experience. They learn quickly to not trust what they feel. In many cases, it has been shown that cutting is not a suicide attempt but rather a manifestation of the tremendous internal pain they experience. Those who cut are often traumatized further by the understandable but misguided labels that others apply to them of being nothing more than dramatic and manipulative.

Like Maria, many teens who cut are extremely sensitive. They feel their own pain on a profound and intense level. They also tend to be highly intuitive and empathic with respect to the suffering of others. These troubled but exceptionally sensitive people are in need of therapy by a professional who can understand the dynamics behind their pain. If you are seeking assistance for yourself or a loved one, please ensure that the attending therapist has a sound knowledge of the treatment needed to address this challenging struggle.

Highly Sensitive Persons

Tue, 21 Jul 2009 14:50:52 -0800

The word "sensitive" means many different things to many different people. For psychologist, Elaine Aron, Ph.D., "highly sensitive" has a quite specific meaning. Her research, which draws on biological, cognitive and personality findings, suggests that about 15-20% of the population qualifies as "highly sensitive." This term refers to people whose nervous systems are easily overwhelmed, whether by harsh sounds, unpleasant lighting, having too much to do, or violent films. Highly Sensitive Persons (HSPs) are usually introverted and reflective; they need a lot of time to dampen down their environments, and may even need to retreat into quiet, darkened rooms to get their nerves settled and functioning again after being severely stressed. When faced with jobs that exhibit loud noises, chaotic environments, large crowds, or violent situations they may experience considerable discomfort and and steer away from these activities. Nevertheless, their emotional awareness and highly-tuned sensitivity does not prevent them from contributing a great deal to our world. In fact, many of the great thinkers and artists have been HSPs.

Dr. Aron's research, and her books for the general reader, talk about how to know if you, or people you are close to, qualify as HSPs. She also writes about how the HSP can adapt him or herself to life, making the most of what are limitations and not feeling bad about them. It is not worthwhile for the HSP to try to "toughen himself up," since the condition is constitutional, temperamental, the way he is made. Rather than trying to force himself to change his spots, the HSP can seek out situations that suit and encourage him. One young HSP woman decided to train as a librarian although she reported still being upset, six months later, by a horror film she'd seen at Halloween.

If you are interested to see if the term applies to you, check
www.hsperson.org, and take the Self Test. Like most other psychological traits, being highly sensitive is a continuum: you could be an extreme type, a mild type, or an almost type. For many people who feel bad or inadequate about being highly sensitive--what's wrong with me?--understanding that up to a fifth of other people share this quality can be encouraging. He or she will probably seek out a partner who is OK with their need for a low-key life, and maybe someone who is better at coping with the rougher aspects of life.

HSPs can benefit greatly from meditation on a regular basis. Still, being an HSP is not always a clear-cut matter. One can be an HSP, and also a sensation seeker: someone who enjoys risky, fast, intense experiences. People with both traits presumably take long, calming breaks in between their high-sensation experiences. John Lennon, for example, often spent many hours a day staring at the wall, lounging, reading, daydreaming, and watching TV with the sound off.

HSPs sometimes have to learn to be assertive in a world that may assume gentleness means weakness. Other people may find HSPs to be unusually sympathetic and good listeners. The HSP is someone who can come into a stimulating environment and make the adjustments--lowering the lights, rearranging the seating--that render everyone more comfortable.

Some substance abusers are HSPs who use their substance to keep their nervous systems soothed. The self-aware HSP knows just how much stimulation she can take before needing to shut down for the day, and will retreat to her place of calm and refuge to refuel. The most important thing for the HSP is to accept and value his or her unique sensitivities, and make use of them.

The Conflict Habit

Tue, 21 Jul 2009 14:36:07 -0800

Some people like conflict. There is something almost addictive about the adrenalin release that occurs when pent-up frustrations are vented, arguments are won, and another is proved wrong. Yet in all my years of working with couples and families, I have never heard anyone say "We want more conflict!" or "Could you help us create more chaos in our life?" Consistent patterns of frequent or high conflict result in damaged relationships with those closest to us. Yet even though people don't want the damage to continue, often it seems they can't help themselves from repeating negative behaviours.

Why are people stuck in these damaging repetitive habits?

This question can be answered by asking a few more.

1) Could conflict actually be comforting at times? Yes, if it continues old patterns of chaos introduced in one's own family of origin. We are comfortable with familiar patterns of behaviour, even if they are dysfunctional.

2) Does conflict serve more than one purpose? Yes - it can keep a couple at a 'safe' distance from each other - if you prevent someone from getting too close, then you don't have to be vulnerable and reveal parts of yourself that you are insecure about. Years ago John Powell wrote a very simple book entitled, "Why am I afraid to tell you who I am?" His answer essentially was "Because if I tell you who I am, and you don't like me, that is all I have." We protect ourselves from rejection by keeping others distant. There is risk involved in creating a relationship of vulnerability and trust. Conflict may also fulfill the purpose of maintaining a specific power balance. Certain individuals may be afraid of losing "power" in a relationship if they allow the other to "win", so they keep their winning stance at all costs.

3) Is it possible to end old habits of continued conflict? Yes, if you sincerely make a decision to create and practise new ways of connecting and communicating.

The impact of conflict

Conflicts escalate quickly when we give or receive highly aroused, negative emotion such as anger, critical judgement or disrespect. Whenever emotional arousal is very high, quality of judgement suffers, and the emotional balance needed to communicate effectively is lost.

Angry responses are often accompanied with defensiveness resulting from an underlying sense of being emotionally, mentally and/or physically threatened. The body responds to threat (either internal or external) by eliciting an adrenalin response or a stress reaction - we are set up to either "fight or flee". Physiologically our body is prepared for action - but this is accompanied by reduced analytical skills. This response is not helpful when it comes to calmly and rationally resolving problems. Defensiveness occurs in heated moments followed by criticism, invalidations, refusals to listen and harsh sarcasm which undermine the safety and trust in a relationship.

Changing the habits of conflict

Commit to creating new patterns of resolving differences. Make a concrete decision regarding what you want your relationship to be like. Write it down.

Set an interpersonal goal for yourself. Specify an action you will take when potential conflict arises. A goal such as calming yourself for 5 seconds before responding to criticism may thwart escalating defensiveness.

Practise calming yourself daily. Use relaxation strategies. Objectively rate an event in light of the anger it deserves versus the level of actual anger it elicits for you. Practise bringing your levels of anger down with an imaginary dimmer switch.

Take a "Time Out" when conflict heats up. Best discussed and agreed upon before you are in conflict, this is an agreement you both make to take a break to calm down. Decide together when the "Time In" will be rescheduled to resolve issues.

Become aware of your triggers. Specific things others do can create an intense negative emotional response on your part. Is it when you feel ignored or hear a certain tone of voice? The more you are aware of the triggers in your life, the less potent they will be, especially if you can envision calm responses.

Understand the others' sensitivities. Overreactions are often the result of defensiveness and self-protection against similar cues to past woundings. Don't use this against them.

Take responsibility for your own words and behaviour. Avoid blame. Avoid rationalizing your poor treatment of another.

Leave conflicts positively. Let the other know you care about them no matter what your differences are. In this way you let them know that your relationship is more important than "being right".

Learning to resolve our differences with calm dialogue increases our understanding of others. Even established patterns of conflict can be changed to habits of connection and closeness, when we act on our commitment to change, one day at a time.

Best Years of Their Lives?

Mon, 25 May 2009 10:29:29 -0800

Often times I hear people tell youth their teen years are going to be the 'best years of their lives'. Every time I hear this, I shake my head. Having worked with a teenage population for a couple years has opened my eyes to all the new challenges and difficulties that are being thrown into the lives of youth. It seems too often that young people are coming to me with overwhelming feelings of anxiety and worry. So let's take a minute to explore some the major sources of stress encountered by today's youth.

One of the major sources of stress is school. At the academic level, there are the tests and assignments paired with expectations to achieve good grades. When inquiring into where the expectations are coming from, youth feel they are from parents, teachers, and self. They fear disappointing their family with poor marks and are concerned for their futures. Youth appear in my office as young as 13 expressing concern over what career they should pick and fearful that anything less than a B grade on any exam during their entire highschool career will eliminate any opportunity to pursue a post secondary education and ultimately ruin their future. For some, perfectionism becomes an addiction.

Paired with academics are all the extracurricular activities in which youth feel required to partake. Extracurricular activities now serve a purpose of demonstrating to future employers and schools student's level of community involvement. Without them, some youth feel they will be at a disadvantage for getting into the post-secondary institute of their choice. Thus, making it appear even more imperative to load up their schedules with clubs and sports. Youth are also required to participate in work experience programs to assist them in exploring possible future occupations. During their work experience, the expectation to maintain their grades and extracurricular involvement remains.

On top of it all, youth are faced with their peers and comparing themselves to others. I am often amazed at the value of possessions the modern teen holds. Between the designer clothes, bags, phones, and other electronics, I have seen more than a handful teens that, in one outfit, could be valued more than my first car. When a youth does not hold these modern symbols of status, they get an earful of negative comments from peers. What makes it even more difficult is the impossibility to escape being bullied. Not only are youth getting bullied face to face, but they can be bombarded with text messages, voice mails on their cell phones, and wall posts on internet social networking sites.

After a lengthy day of juggling stress at school and after school activities, teens make the trek home. Strife in the home and even parent's expectations can be other sources of stress. In addition, youth encounter chores, part-time jobs, helping with younger siblings, catching up on school work, and finding time to relax and recharge. During these down times, youth may spend time focusing on self stress - stress that others are unaware of, such as self esteem, confidence, expectations, and body image. Self stress also includes the natural desire to discover one's own belief system, values, and identity. Self talk, or internal dialogue, often plays a role with self stress. When feeling overwhelmed, one's internal dialogue has a tendency to turn negative. Common self talk statements I hear include 'Nobody understands me', 'I'm so stupid', and 'I'm not good enough'. It's almost as if youth begin to bully themselves. It's important for youth to learn how to acknowledge and change these statements. They need to know that it is okay to not be perfect and how to appreciate their strengths.

The result of all this stress is a generation of tired and irritable youth who keep hearing that these are going to be the best years of their lives. Perhaps it's time to shift our focus to the potential for the wonderful and exciting futures these young people hold. We can do this by encouraging and supporting our youth by commenting on the things they are doing well. We can acknowledge life can be challenging and that stress can be managed. We can also model healthy coping strategies such as healthy communication, exercise, positive eating habits and time management. Parents, keep the lines of communication open and strong between yourself and your teen. Part of this communication will be to use your listening skills and maintaining a non-judgemental ear. To help build the relationship, plan more time together to chat and have fun. Perhaps start family movie or game nights. Also, include children in making a list of activities the family could do together. Lastly, let them know you are proud of them and that life only gets better.

Workplace Bullying

Mon, 25 May 2009 10:16:24 -0800

Over the past decade, bullying in the workplace has become recognized as an occupational health and safety issue. Most Canadian workers have seen it happen to someone or experienced it themselves.

Bullying is also referred to as harassment or psychological violence. This is any repeated mistreatment of a person that endangers their health or level of functioning. Individuals who are bullied may feel anxiety, humiliation, anger, frustration, de-motivation, stress and shame. They may lose their self-confidence.

Workplace bullying may include such things as verbal abuse; spreading of rumours; issuing threats; criticism; isolating the target; exclusion; humiliation; setting the target up for failure by setting unrealistic goals or deadlines; overloading the employee with work or responsibility and then often removing the authority necessary to get the job done.

Harassing acts of commission or omission are driven by the bully's need to control a person or situation that is perceived as a threat. Bullies are insecure individuals who usually target good employees who are competent, co-operative and efficient .Bullying tends to escalate over time. While the bully is very seldom held accountable, bullied individuals face a 70% chance of losing their jobs.

Many surveys have been conducted in regard to this issue and their results are quite surprising. In a 2003 survey, the Workplace Bullying and Trauma Institute found the following results concerning individuals who had been bullied at work.

76% exhibited symptoms of stress and severe anxiety.

71% had disturbed sleep patterns.

39% had symptoms of post-traumatic stress disorder.

In 70% of the cases, the victims quit their jobs or were let go.

17% of the victims transferred to other departments within the same company.

Only 13% of the perpetrators ever suffered any consequences.

In 71% of the cases the bully had higher rank than the victim.

17% were bullied by peers.

12% of the victims were bullied by someone lower than them on the workplace ladder.

What can you do if you find yourself the target of a bully? The Canada Safety council has some advice. They recommend that the first step you take is talking to the bully face to face. Explain why you think you are being targeted and how you feel. Be calm and never retaliate with disrespect or threats as these may be used against you.

Check the company policy. Many companies have procedures to follow. Avoid being alone with the bully. Discuss the problem with your manager, Human Resources personnel or a trade union representative. You may want to talk to your co-workers to see if anyone else has been subjected to the same treatment.

Document all incidents. Record the date, what happened, any witnesses that were present, how it affected your feelings and your work, and any medical help you sought. With the exception of Quebec, unless harassment involves sexual harassment or discrimination along the lines of sex, race, age, or religion, Canadian labour laws do not address bullying. You may decide to bring the issue to the attention of the Human Rights Commission.

Educate yourself about this issue. There is a wealth of information on this topic in self-help books and on-line. If possible, be active in your workplace. Try to influence company policy and guidelines regarding harassment, bullying and psychological violence. Repeatedly remind yourself that you are not the problem. The bully is the problem. The bully's view and opinion of you is incorrect and intrue. Encourage yourself to be strong.

Medically, psychologically and socially, society pays a high cost for bullying. Employers and employees suffer because bullying can lead to illness, resignation, high staff turn over, severance packages and costly litigation. A workplace atmosphere can become poisoned with low morale, high absenteeism, loss of efficiency, fear, anger and depression. A target's marriage, family and friendships may suffer. Bullying costs the health care system in terms of visits to doctors, prescription medicine and long term counselling.

Many individuals have had to leave the work they love because of bullying. This is very unfair and most unfortunate. However, in the long run, it is not worth allowing bullying to permanently damage your health and your future. If there is no solution within a reasonable time, consider moving on to a new work environment. Move on but don't go quietly. Make sure that the highest ranking person in your company or trade union is aware of your situation. If you have difficulty letting go and moving on, you may need to seek help from a counsellor.

Communicating With Teens

Mon, 25 May 2009 09:48:37 -0800

Is it possible to communicate with a teenager? Yes... we are always communicating with our teens. However, the issue has more to do with quality than quantity and often the quality is not that great.

Effective communication with teens can be enhanced by focusing on a few ground rules:

Keep it short: Most teens dislike "lectures." Keep to the point with brevity and you will be more likely to have an impact. Your teen may not acknowledge this impact though, so don't be surprised if their response to your short life lesson is the word "whatever."
Influence over direction: When our children are young we are the "boss" and make all the decisions related to their care. As they become older they take over more and more control of their lives; there are only a few areas of life in which we still have "control" as parents. For instance we do not have control over who their friends are; this is an area in which we "influence" decisions. Giving an opinion in a brief manner carries more weight than trying to tell a teen who his friends should be. Some parents, however, pull back from being the boss to saying nothing at all. Teens, though, are open to influence and might question our commitment and love if we do not offer our opinions from time to time.
Review your own life as a teen: It can be useful to think back on our lives as teens and remember how we got along with our own parents. There was a father who was very strict with his sixteen year old daughter. He had been a rebel as a teen and much more adventurous than his daughter. He was worried that his daughter would go down the path he had followed and she was beginning to do so as a response to his controlling style of parenting. In another instance a mother had clashed with her own mother who had been very directive towards her. As a parent of a teen she was using the same approach her mother had used on her and it was working just as poorly. It was as if these two parents had forgotten what it was like to be a teenager.
Be aware of the "tasks of adolescence": Teenagers are in the process of making the transition from childhood to adulthood and in this journey there are themes which tend to surface. Most teens will experiment with ideas and lifestyle decisions, including friendships. Sometimes these choices are very different than those they would have made in the past. You will have a young person who has always gone to church with his family; now he no longer wishes to attend or if he does, he sits off by himself. You will have another teen whose family rarely if ever attended a church service and she will begin to go to a church with a friend. Teens are very peer conscious and will seem to make friends their major priority; they are also hypersensitive to authority and being "bossed around."
It becomes important to teens to be unique. The teen is in the process of "individuating" or of becoming an independent adult. Once the transition is made, many of the decisions about lifestyle are similar to those embraced as a child and yet the young adult is living this lifestyle because it is her choice to do so, not that of her parents.

Reach out regularly: When relationships become tense, it can be easy to ignore each other and to not initiate contact. We used to go on Sunday outings as a family and our 16 year old daughter would stay behind. One day we made our plans and did not invite her to join us and she was upset. My excuse was that she always said no to the invitations and she responded that "she wanted to be invited anyway." It was important to her that we still thought about her and wanted her to be part of our excursion. When she still said no to the invitation we suggested that she bring a friend and this pleased her; she came along with a friend in tow. Her friends would usually exclaim to us how great it was that we "did things as a family."

It is also important to be friendly. This can be challenging if things are tense between a parent and teen and yet it can be a simple way, over time, to warm things up. Teens can be reactionary and will play "tit for tat." If we are negative they will respond in kind. If we are nice they may do the same, but not right away necessarily.

Choices and consequences work: Being influential rather than directive is fine but there are some aspects of life which require direction; it is important however to avoid "power struggles." Let's say that you as a parent want help with chores around the home. You can create a list of five items and ask your teen to choose three. One of the items may not be negotiable, such as cleaning his room once a week. When the decisions have been made, deadlines are given which allow the teen freedom to complete the task at his convenience but by a deadline so that you as the parent have some assurance the job will eventually get done. If the deadline is met, all is well and it's business as usual. If the deadline is not met there is a consequence which would have been spelled out before hand. If the room is not clean by five o'clock on Friday, no use of "media" (i.e. computer and phone) will be allowed until the job is done. If the agreement was that the teen be in by a certain time and she is late, the consequence might be a loss of media for 24 hours. If there is debate or argument about the consequence, this can be discouraged by offering a further consequence which is a doubling of the 24 to 48 hours. This second consequence often shortens the argument. Many teens prefer this approach to the hassling which can result from chores being ignored. They dislike "nagging" as much as they dislike "lectures."

Feelings first: When talking with a teen, or anyone for that matter, it can be useful to tune into his or her feelings. Keep in mind that when people say rude or outrageous things, the challenge for you is to focus on the feelings before reacting to the way they were shared. "You must be tired to be saying that" or "You sound really angry right now. Why don't we talk later."

Collaborate with your spouse: Parents usually have very different parenting strategies and can easily become locked in a debate as to whose approach is the best. One person is usually strict and the other more easy going. The truth lies somewhere between the two approaches and can be best accessed by the parents listening to each other's feelings and then trying to move to a collaborative position. Collaborative or "team parenting" can be very effective and can enhance the marital relationship at the same time.

Brooke Lewis

Tue, 28 Apr 2009 18:52:29 -0800

Brooke Lewis, MA
Registered Clinical Counsellor, 3332

Brooke, a registered clinical counsellor, offers counselling to individuals thirteen years and older who are experiencing a variety of concerns, including depression, anxiety, self-esteem, transition, stress management, personal growth, and substance abuse.

Brooke incorporates a range of therapy orientations into her practice. She provides a safe, supportive environment in which clients can explore their personal challenges and difficulties.

Brooke has worked in high school settings in addition to day and residential addiction programs. Brooke has also provided workshops on a variety of topics including stress management, addiction, suicide, and sexual exploitation. She received her M.A. degree from the Adler School of Professional Psychology and is registered with the BC Association of Clinical Counsellors.

Living With a Chronic Illness: Why You Should Maintain Hope

Tue, 17 Feb 2009 16:10:14 -0800

Part 1 - What to expect

Kathy vividly remembers her "life turning upside down" after her car accident ten years ago. She has struggled with chronic pain ever since. Despite being a "high achiever," she has not been able to work since this time and has had difficulty accomplishing her usual household tasks. Martin has had multiple sclerosis for eight years and had to leave an upper management position, after 20 years with the company. Both Kathy and Martin experience ongoing low mood, feelings of uselessness, and an overall decrease in their self esteem. Both feel isolated from others, as they are no longer able to participate in activities with friends or family to the same degree. They frequently feel that significant people in their lives don't understand what they are going through and at times feel rejected or blamed for their illnesses. Both feel defined by their respective illnesses and are no longer the "Kathy" and "Martin" that they previously were.

The scenarios described above are indicative of what someone with a chronic illness might experience. Unlike more acute illnesses, chronic illnesses are often poorly understood, both by the patient, their family members, and, at times, even by the physicians involved in their care. Well meaning friends or family members may tell them that "it is all in their head," "they are using their illness as an excuse" or that they just need to "pull up their bootstraps and get on with their lives." And "getting on with their lives" is essential; however, it is often a long and difficult struggle, with little clarity regarding how to do this.

So what does "getting on with one's life" mean? Getting on with one's life involves finding a way to slowly adjust to and cope with the illness, and to ultimately regain a sense of meaning and value in one's life. However, people need to actively go through a number of stages of dealing with their illness before they can get to this point. The typical stages are as follows:

Initially, the person experiences challenging symptoms that are new to them. They may feel confused, overwhelmed, and fearful about their symptoms. They may begin to experience a sense of loss regarding the impact of their symptoms on their lives and the consequent limitations that they are facing. Some experience a sense of denial and even try to ignore their symptoms. In this stage, the person may see a number of health care professionals, who offer conflicting diagnoses and treatment methods.

During the second stage, a diagnosis may be provided. This can provide relief in explaining what has been happening to them. However, there may be increased uncertainty about their future and how much improvement can be hoped for. The reality of having a chronic illness has sunk in and is very difficult to accept. Many will not accept it and will push themselves past their physical limits, resulting in increased symptom severity. Others may experience an increased sense of despair regarding their illness. Typically, there are ongoing attempts to find the "magic cure." Many wind up isolating from others who don't appear supportive, although they may desperately yearn for their support and understanding.

In the third stage, the person has accepted the fact that they have a chronic illness. At this point, they may experience deep grief about the loss of their former "self" and other illness-related losses. They may question why this has happened to them. Consequently, they may question their religious or spiritual beliefs, as well.

During the fourth stage, the person has found a way to integrate the illness into their life. They understand their symptom patterns (i.e., from relapse to plateau) and have learned how to structure their lives accordingly. At this stage, the person has developed new interests that are compatible with their physical challenges. Although some relationships may have been lost, others have been strengthened and new relationships are likely to have been developed. The person has developed a sense of meaning and purpose to their life, despite the physical challenges that they continue to endure. They are no longer defined by their illness; rather, the illness is viewed as one aspect of who they are.

Part 2 - How to move forward

The following psychological strategies can help you move through the four stages, so that, ultimately, you can "get on with your life."

It is essential to let go of blaming yourself - your illness is truly not your fault. It could happen to anyone. It is important to slowly develop compassion for yourself with what you are facing. It takes enormous strength to deal with a chronic illness and being able to validate this can be extremely helpful.

It is necessary that you slowly modify your expectations for what you need to accomplish each day. Unfortunately, compared with your earlier days, having a chronic condition necessitates using a different "yard stick" to evaluate your accomplishments. This can be hard to face. However, it is very important to learn to give yourself credit for the "small accomplishments" of each day. Pacing yourself, so that you do small chunks at a time, with breaks in between, is essential, so that you do not "crash" the next day.

In the initial stages of the illness, you may experience various emotional changes (e.g. outbursts of sadness or anger) in response to your illness. This is not unusual as you are dealing with significant changes in your life.

You may have to slowly learn when you need to ask others for help. Significant people in your life may truly not know how to support you. You may need to educate them with what you need. Finding helpful supports, through friends, family, or a therapist is essential for navigating through these phases. Seeking a support group of others who are facing a chronic condition can also be helpful.

At some point, it will be essential to go through a grief stage. This entails actively mourning the losses/changes in your life and the loss of your former self. Taking time in your day to allow feelings of sadness and anger, as well as journaling about your feelings is very important.

Writing a narrative about your "journey" with your illness can be valuable. This can assist you with developing new insights about yourself, others, and life. In this process, you can discover your true values and what is truly important and meaningful to you. Surprisingly, you will find a number of qualities that still remain true of you, even with the illness (e.g. empathy, creative side, sense of humor, keen interest in learning new things, etc.)

It will be essential to find new interests/hobbies that fit with the limitations imposed by your illness. Reading, writing, creating art work, playing a musical instrument, attending classical music performances in small venues, and having meaningful conversations with others are examples of the many possibilities.

You may also have to examine some tough existential questions regarding the unfairness of why the illness happened to you. Reconnecting with a religious faith or a spiritual belief system is enormously helpful in this regard. In the process of answering these questions, you can actually discover a greater sense of meaning from what you have experienced. Ironically, your life may take on a greater sense of depth and purpose, despite your illness.

Reading true stories about others who have used adversity to transform their lives in a meaningful way can also assist in developing greater meaning and purpose.

Reframing some of your losses and seeing them from a more positive perspective is also essential. For example, perhaps, you are no longer able to do weekly walks/hikes with your closest friend; however, you can attend monthly lectures on art history; or, you can engage in deep conversations about life, over coffee. In fact, despite your losses, your newly developed insights may, in turn be a "gift," You may have developed a compassion for the struggles of others, as well as a certain "wisdom" about life. Your insights might even inspire others or help them, in turn, create more meaningful lives.

Note: During all these stages, it is essential to continue to see your physician for ongoing monitoring of your condition. Additionally, the strategies described above take time and effort to implement. If you feel that you are not able to move forward through these stages, it is essential to get counseling from a licensed psychologist or counselor.

When Partners Start Forgetting

Tue, 17 Feb 2009 16:07:03 -0800

Allison is rushing to get ready for a theatre engagement with her sister. Frank notices the commotion and asks what's going on. "What are you talking about?" says Allison angrily, "I told you yesterday that I was going to the theatre with Marion. Don't you ever listen?" "You never told me that" says Frank. Allison now thinks that Frank is either playing games or he didn't care enough to listen to her in the first place.

Occasionally, one of us will forget something that the other has told us recently.

As couples age there may come a time when one or both partners has an occasional lapse in memory or maybe even more regular and noticable memory difficulties. This can be both irritating and concerning for the partner of the one who has become memory challenged.

Allison is definitely frustrated and annoyed but since this has happened before she is also getting worried. She wonders if their relationship is weakening or if Frank is becoming depressed or worse. Her frustrated response is just her knee-jerk reaction but she has noticed that since Frank retired they have more time and interactions together which might explain the greater number of incidents like this occurring.

Getting into a "Yes I did - No you didn't" type of argument only deteriorates into fault finding and harms the relationship. Allison has to admit that she occasionally forgets details that Frank tells her as well. Allison realizes she could have chosen to give Frank the benefit of the doubt and she vows that if this happens again she will clearly and kindly (and not condescendingly) repeat the forgotten detail. She wishes now that she had responded more caringly; something like "Sorry Frank, I meant to remind you that I'm going out to the theatre tonight with my sister. I know you wanted to stay home and watch the game anyway".

At other times, one of us will forget that we have already told a story or some non-critically important detail to the other.

"Frank, wait until I tell you about the piece of property that Marion and Stan bought" says Allison. "You already told me that three times" retorts Frank as he shakes his head. "What on earth is wrong with you?" Allison looks shocked and hurt and a bit frightened. "Did I really?" she asks softly. "Maybe there really is something wrong with me."

If Allison honestly doesn't remember having told the story before, how loving is it to blurt out a bruising statement like, "What's wrong with you?" or "You tell that same joke every Christmas."

When someone repeats the same story a second, third, or fourth time within a matter of days or weeks or even months, consider it a gift that they want to include you in their life! Rather than abruptly stopping the story, a wise and more loving choice may be to value the presence of the story-teller in your life and listen patiently and kindly. There are times when we all forget that we told a particular person a certain story or joke. Frank could have asked himself the question: "Has it really been helpful for Allison's memory functioning to remind her that she's already told me this story before?" And he can remind himself that Allison is simply sharing her excitement and in doing so is making a loving connection.

Young children often like to be told the same story over and over again, and they often like to repeat the same story. Rather than cut them off, most adults are very patient with their young children and grandchildren at these times. Maybe we can apply the same adult wisdom to our relationship with adults as well. And we should remember that we are all children in many ways and still learning.

Recent memory for non-life-threatening details should become less important than patience and wisdom in strengthening the relationship of a loving, aging couple.