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  • Mental Health Matters 4

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    The Necessity of Communication for Healthy Relationships


    Love and Relationships

    To love is universal; we all love someone, at some point in our lives.  For many of us, our first experience of love begins in the home, from a parent or caregiver.  For others, love may be realized from a role model or from a very close friend.  Our early experiences of love give us the strength and support we need to develop into the individuals we are today.  Our early experiences of love teach us that love is good – it is something we yearn for.


    As we grow older, we learn that love can take on many forms.  Robert Sternberg’s Triangular Theory of Love provides us the basis for understanding love in light of this realization.  According to Sternberg, love consists of three components:  INTIMACY, PASSION, and COMMITMENT.  The intimacy component refers to feelings of closeness and connectedness in your relationship with another.  The passion component refers to the drives that lead to romance and physical attraction.  Lastly, the commitment component refers to both the decision to love someone and the decision to maintain that love.  Different relationships can consist of different quantities of each component.  For example, the relationships we had with our parents as children likely contained a balance between intimacy and commitment, whereas the romantic relationships we form with our future spouses likely contains a balance between all three components. 


    While forming new relationships in the context of young adulthood, it goes without saying that we will experience roadblocks in our quest for love.   While we grew up watching Prince Charming dedicate his life to wooing the Princess, we later realize that, in reality, this will not be our experience of love.  While there will be moments of utter joy and pure bliss, there will also be times when you feel like firing your shoe across the room at your partner (but please refrain).  Love is not always a fairytale.  Love is hard work. 


    Conflict is inevitable in the context of a romantic relationship.  Fortunately, we can develop skills that will aid in the resolution of such conflict.  Time and time again, marriage therapists identify a primary source of conflict within the romantic relationship to be a deficit in successful communication between two partners.  Sounds minor, doesn’t it?  While communication skills sound very simplistic in nature, the next time you feel an overwhelming desire to throw a shoe at your partner, you may be surprised when you take a second to realize how many basic communication skills you failed to employ. 


    Communication Skills for a Healthy Relationship

    Many studies have identified the correlation between successful communication and relationship satisfaction.  I have compiled a list of important actions one must take to promote healthy communication within a relationship. 

    1. 1)    Look around you!  Successful communication cannot occur in an atmosphere of chaos.  Find a quiet room.  Turn off the TV.  Put your phones on silence.
    2. 2)    Check yourself!  Is your speaking sounding more like screaming?  Are you making proper eye contact so that your partner feels heard?  What is your posture communicating? 
    3. 3)    REFRAIN!  NEVER, under any circumstance, blame, accuse, call names, make hurtful remarks, or get defensive.
    4. 4)     Identify what the problem is.  It is difficult to communicate successfully unless you both are in agreement as to what it is you are discussing. 
    5. 5)    Listen.  You cannot appreciate what you do not hear. 
    6. 6)    Empathise.  Chances are, if you don’t feel understood, your partner may not feel understood. 
    7. 7)    “I” vs. “You”:  When communicating, communicate using “I feel” vs. “You make me feel”.  Using “You” statements automatically puts the other person on the defensive.  Plus, when you use “I”, you maintain control over how you feel. 
    8. 8)    Focus on appreciation.  As a general rule of thumb, say five nice things for every one complaint. 
    9. 9)    Be honest.  Your partner is not a mind reader.  Maybe you assume that he/she should know that your feelings were hurt when he/she said your casserole tasted like dog food.  It does not mean that they necessarily do!
    10. 10)  Regardless of how angry you are, respect the other person. 

      Quote of the Month: 

    Bad human communication leaves us less room to grow. 
    ~Rowan D. Williams 

    References:

    Sternberg, R. & Weis, K. (2006).  The new psychology of love.  New York: Vail-Ballou Press. 

    http://www.psychologytoday.com/blog/building-great-marriages/200911/how-talk-serious-your-spouse

    Related Website: Signs of abusive relationships.

    http://helpguide.org/mental/domestic_violence_abuse_types_signs_causes_effects.htm

  • Mental Health Matters 5

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    Entry 5: ARE YOU A STRESSED-OUT SALLY?

    “Oh my gosh, I have like five exams, I am so stressed!”...  Sounds familiar?  In December, we easily succumb to the joy and cheer of the holidays, thinking to ourselves, “I will worry about finals in January… that is a whole month away!”  Then, after the turkey is eaten, the presents are opened, and the waking up at noon draws to a close, we find ourselves rubbing our eyes in disbelief, wondering where December went and thinking, “Oh no! It is January and I have not even cracked a book!”  Your heart starts beating quickly, you might start to sweat a little, and you get that sick, twisted feeling in your stomach. 

    It is going to be a long month.

    First of all, let me reassure you, this response is not abnormal, nor is it a bad thing!  I want to talk to you a bit about the wretched experience of stress and what you can do to ease yourself through the treachery that is January.

    First, let’s define stress.  Stress is generally a state caused by bodily or mental tension that disrupts existing equilibrium.  There are three stages of stress:

    Stage 1:  Your body releases adrenaline, your heart beats faster, you begin to breathe harder. Other physiological changes occur that allow you to deal with the situation that is causing the stress in order to return to equilibrium.  We call this the Fight-or-Flight Response.

    Stage 2:
      This stage occurs if the stress is prolonged.  Your body becomes tired and begins to release stored sugars and fats from its reserves.  This is when you start to feel pressured and tired.  You experience anxiety, poor memory, and due to your compromised physical health, you may easily attract colds and the flu.

    Stage 3:  This stage occurs in response to chronic stress.  Your body has nothing left to give.  You experience insomnia, errors in judgment, and even personality changes.  You are at an increased risk for developing a serious illness, such as heart disease, ulcers, or mental illness.

    Stress can appear in many forms.  It can be acute or chronic.  It can be good or bad.  It can be environmental, physical, social, or psychological in nature.  One interesting component of stress that forms that basis of what I want to discuss today is that stress is a subjective experience.  What does this mean?  It means that your experience of stress – triggers, reactions, coping mechanisms – is unique to you.  No two people experience stress the same way and in response to the same situations. 

    Take Stressed Sally, for example.  Sally has five exams this month.  To Sally, a lot is riding on these exams.  I mean, the outcome of these exams could very well determine THE REST OF HER LIFE!  If she doesn’t get an A in all of her classes, it will be catastrophic.  I mean, she will never be able to show her face in school again.  If she doesn’t get an A in every class, she won’t get a scholarship, she won’t get into university, she won’t get a good paying job, she won’t attract a partner, she will never have kids, and she will die alone.  The thought of studying makes her sick.  She cannot sleep, she does not eat, and she cries a lot. 

    Needless to say, Sally is stressed. 

    Then we have Calm Carrie.  Carrie, too, has five exams.  In fact, Carrie sits next to Sally in all five of the same classes.  Carrie, too, wants to do well, but she does not experience any of the same symptoms as Stressed Sally.  Carrie tells herself that, while it is important that she puts forth her best effort, a mark that is less than an A will be ok.  She tells herself that her life will not be determined by the results of these exams.  She wants to do well, and will surely study, but at the end of the day, a test is a test. 

    Can you identify the difference between Carrie and Sally?

    The difference between Carrie and Sally is in their perspectives.  Sally is engaging in a whole collection of cognitive distortions (see blog entry two) that are influencing her experience of stress:  Overgeneralization, All-or-None Thinking, Jumping to Conclusions, and Magnification are a few of the obvious ones.  Carrie, on the other hand, is a different story.  While she still experiences stress, the stress she experiences is good stress; it will motivate her to study.

    What is the difference between good stress and bad stress?  Bad stress is debilitating; good stress is motivating.  Bad stress is long-lasting and is detrimental to our physical well-being; good stress is short-term and does not affect our physical health.  Bad stress leads to decreased performance; good stress leads to increased performance.  We need good stress; it gives us the motivation to get out lazy butts out of bed in the morning and be productive citizens.  Bad stress, on the other hand, we can do without.


    How we react to stress is also unique to us as individuals.  Coping mechanisms are strategies we mobilize in times of high stress.  Coping strategies can be negative (i.e. smoking, yelling, hitting others) or they can be positive.  Below is a list of positive coping strategies you may want to employ in response to the stress that January will inevitably cause you. 

    RELAX!  Take deep breaths.  Massage tense muscles.  Stretch.

    TAKE CARE OF YOUR BODY!  Never underestimate the power of adequate sleep, exercise, and healthy eating.

    BE REALISTIC!  You are not a super hero and you can not do it all.  Set limits.

    CONNECT WITH OTHERS!  While it may seem like you don’t have the time to chat on the phone, support from loved ones is a crucial component of effectively managing stress. 

    MAKE TIME FOR YOU!  Give yourself an allotted period of time to engage in activities that you enjoy.  Let’s be realistic… studying is not a good time.  If you give yourself intermittent breaks, you will return to the material renewed, refreshed, and better able to retain information. 

    Let’s sum this up.

    Stress is inevitable.  Everyone experiences stress differently.  Perceptions/thought patterns influence the experience of stress.  Stress can be good or it can be bad.  Good stress is short-term and motivational; bad stress is prolonged and is detrimental to our health.  How we react to stress can be either good or bad.  Attending to your well-being is crucial in times of high stress. 

    Quote of the Day

    Stress is an ignorant state.  It believes that everything is an emergency. 

    ~Natalie Goldberg

    REFERENCES:

    http://www.cmha.ca/bins/content_page.asp?cid=2-28

    http://www.womenshealth.gov/publications/our-publications/fact-sheet/stress-your-health.cfm

  • Mental Health Matters 6

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    Entry 4:  "Don't beat yourself up over the holidays - Awareness of Fat Talk" 
    We live in a society brimming with Fat Talk.  “Do I look fat in this?”… “Look at this gut!”… “Ugh, I hate my thighs!”  These are all comments you have likely heard too many times, whether it be from your mother, father, a teacher, a friend, a sister, a brother, or that evil internal voice that likes to bring you down a notch the moment you start feeling good about yourself. We all engage in Fat Talk, in some form.  Many of us engage in Fat Talk as part of our daily routine.  And, not surprisingly, it leaves us feeling pretty bad about not just what we look like, but who we are. 

    Where does this Language of Fat come from?  Go stand in line at the grocery store and you will be bombarded with a major perpetuator of society’s beauty obsession: the media.  I took a break from writing this entry for you just to Google today’s latest news headlines in the entertainment world.  Here we have it:  “Kris Humphries Called Kim Kardashian Fat;” “Jessica Simpson in for 4 Million Dollar Weight Watcher’s Deal;” “Kate Gosselin Gets a Facelift” … like, seriously?  The media bombards us with messages everyday that translate to this:  if you are not beautiful, you are not worthy.  Sadly, as a society, we have internalized this message. 

    Sandra Friedman, in her book entitled Nurturing Girlpower, has coined the term “grungie” to describe the negative voice that we have developed in response to our overwhelming desire, as a society, to be beautiful.  “Grungies” are the negative things we tell ourselves about ourselves.  They commonly appear in the form of “you are fat” or “you are stupid” or “you are ugly.”  Underneath these statements are real feelings; when we do not know how to express ourselves or are too frightened to do so, we shift our focus from our internal needs to our external image.  We turn to our Language of Fat.
     

    Take, for example, the simple phrase, “I feel fat.”  Feeling fat is quite different from being fat.  Thin people feel fat and fat people feel fat.  Nobody feels fat all the time. If someone felt fine at 5:00 pm and felt fat at 6:15 pm, that change that occurred was not physical; it was emotional (Friedman, p. 50).

    Why do we do it?  There are many motivations behind this tendency and individual answers may vary.  One commonality, however, exists amongst Fat Talkers and it is related to our natural tendency as human beings to fear the unknown.  Feelings are deep, unseen, and can be pretty difficult to figure out.  Our appearance, however, is superficial, quite visible, and is rather easily manipulated.  Why make yourself feel better by dragging yourself through emotional wreckage when you can simply book a hair appointment, buy a new shirt, and band-aid it all up?

    I have a good reason:  band-aids fall off.

    Through ignoring our internal needs and focusing our efforts on our appearance, while we do achieve temporary relief, it is just that – temporary.  Our internal needs will resurface, our external fix will wear off (or out), and we will find ourselves right back at (minus) square one… now adding frustration and a sense of hopelessness to the mix. 

    So here are the two messages that I am hoping you are interpreting from my rant.

    First, it is crucial that we learn to challenge media messages that promote not only an unrealistic beauty ideal but self-depreciation and self-hatred.  Secondly, it is absolutely necessary that, on a personal level, you learn to identify your tendency towards Fat Talk and refrain from covering your emotional experience with expensive clothing and bronzer. 

    Quote of the Day

    What you do, the way you think, makes you beautiful.

    ~ Scott Westerfeld

    References

    Friedman, S. (2003).  Nurturing Girlpower.  Vancouver, B.C.:  Salal Books. 

  • Mental Health Matters 7

    Entry 3:  It Is Okay to Hurt

    I think you can agree that we all live in a society that adores speed and ease.  In other words, let’s get things done quickly and let’s do so in the simplest way we know how.  Seems like a good idea… right?  I mean, why read the novel when you can buy the Coles notes?  Why exercise when you can get liposuction?  Why prepare a healthy meal when you can stop at McDonalds?  When faced with life’s obstacles, we, as a society, prefer simple answers that require as little effort as possible on our part.  As it turns out, we approach our emotions in a similar manner.

    Here are a couple of interesting facts for you: 

    • In Canada, between 1981 and 2000, the percentage of antidepressant medication prescriptions increased 353%. 
    • That is right – in 19 years, the number of prescriptions written by Canadian doctors for antidepressant medications increased from 3.2 million per year to an astonishing14.5 million. 

    Now I hope all of you critical thinkers out there acknowledge that many confounding variables may have played a role in this increase – population growth, revisions of diagnostic criteria, etc.  Nonetheless, it is a staggering statistic and one must wonder if our tendency, as a society, towards the “quick fix” may have been a contributing factor to the sky-rocketing statistic. 

    What we are observing here is a concept that has been termed the medicalization of sadness – pathologizing emotions that are within the healthy range of human experience. Wakefield and Horwitz, in their book entitled, The Loss of Sadness, proposed three essential components of normal sadness:  context-specificity, intensity proportionate to loss, and the tendency for the sadness to end once the situation resolves.  These authors have argued that, historically, pathological sadness was separated from normal sadness based on these three criteria.  Since then, with the focus of the diagnostic manual emphasizing symptomology over context, we are seeing what Wakefield and Horwitz identify as a “bogus” epidemic of pseudo-depression.  Because being sad is rather unpleasant and we, as a society, prefer simple solutions to our problems, is it possible that we are becoming quick to jump on the medication band-wagon as opposed to accepting emotions for what they really are – healthy expressions of our day-to-day experiences?  

    What I am trying to say here is this:  It is okay to be sad.  It is okay to hurt sometimes.

    There are many positive coping mechanisms that can be implemented in times of sadness that may help you begin the process of healing.  Interact with others; isolation promotes depression.  Go for a walk; release some of that negative energy.  Talk to someone; social support is a necessary pre-requisite for a healthy mind.  Journal; writing is therapeutic.  Punch something (like a pillow – not your brother); release your unpleasant feelings!  

    I have adopted an evolutionary perspective on the emotional experience; emotions are functional adaptations that exist because they were of benefit to our ancestors. If certain emotions were not functional, natural selection would have weeded them out many generations ago.  We feel unpleasant emotions at times because they are providing us information about our surroundings and allow us to act accordingly. 

    With this being said, depression is a very real disorder that exists due to a combination of biological, psychological, and social factors.  If your sadness is prolonged and you are experiencing any of the following symptoms, you should schedule an appointment with your school counsellor or family physician:

    • Significant weight gain or loss
    • Loss of interest in activities you once enjoyed
    • Withdrawal from social interactions
    • Feeling of hopelessness
    • Decrease in concentration
    • Fatigue or loss of energy
    • Feelings of worthlessness or excessive guilt
    • Change in sleep pattern:  excessive sleeping or inability to sleep
    • Agitation or irritability
    • **Thoughts of suicide

    **If you have had thoughts of suicide, it is important that you seek help IMMEDIATELY.  While feelings of sadness are within the range of normal human experience, thoughts of death or suicide are not and are indicative of a Major Depressive Disorder. 

    Contact number for Children and Adolescent Crisis Line:  780-427-3390

    Quote of the Week: 

    Feelings are not supposed to be logical.  Dangerous is the man who has rationalized his emotions.

    ~ David Borenstein

    References:

    1. 1)    http://www.magazine.utoronto.ca/leading-edge/increasing-use-of-antidepressants-in-canada/
    2. 2)    Wakefield & Horwitz (2007). The Loss of Sadness.  New York:  Oxford University Press. 
  • Mental Health Matters 8

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    Entry 2:  Changing Distorted Thoughts

     I know you are all patiently awaiting the answer to the cliff-hanging question I left you with last time.  I am going to keep you waiting only a few moments longer so I can quickly review what we discussed. 

    We learned that the individual who says, “He made me so mad!” is plain wrong.  While we are not denying his anger, we are arguing against the assertion that someone made him angry.  No person or event makes us feel any specific way.   It is the thoughts we have (our self-talk) that causes us to feel one way or another.  In other words, the only person that is responsible for how you feel is YOU.  

    So, how do you change how you think?  I have met many clients that, when faced with the daunting task of altering maladaptive thought patterns, slump to the back of their chair, cross their arms, and claim, “I cannot possibly change how I think.  This is how I am.  This is how I have always been.”  Well guess what?  These people, too, are wrong!  While I will acknowledge that their distorted thought patterns have likely plagued their lives for an extended period of time, the pervasiveness of these thoughts speaks not at all to their permanency.  Distorted thinking is a learned process; similarly, it can be unlearned. 


    The first and CRUCIAL step is to BE AWARE OF IT.  You may have heard the saying, “You cannot change what you choose not to acknowledge.”  When you stop attempting to attribute the cause of your unpleasant feelings to an external source, you take back the control over these feelings.  You now have the power to change them!


    So, where to begin?  You can start by creating a mood log.  When you are feeling upset, write down how you feel.  Write down the upsetting event and then write down the thoughts that were going through your head immediately following the event.  You will, over time, begin to notice a pattern in how you think.  You will begin to notice how this pattern directly results in how you feel on a daily basis. 


    As I have mentioned before, we all practice self-talk continuously throughout our day.  These voices are automatic and tell us about our world.  Things happen in our lives that affect what our voices tell us about our surroundings.  It might be a negative experience, it might be the result of the way you were raised, it might be due to physiological mechanisms that are beyond your control.  Many factors alter our stories in ways that can be both negative and positive. 


    When factors affect our thinking in a negative manner and we continue to employ these negative thought patterns, they begin to replace our previously existing automatic thoughts.  We call these Cognitive Distortions.  David Burns, in his book entitled “The Feeling Good Handbook” (1989), identified 10 common cognitive distortions that individuals most often employ in their daily lives.  I encourage you to have a look over them.  I have a feeling you may be able to identify more than one distorted thought pattern that you have fallen victim to at one time or another:

    1. All-or-nothing thinking: You see things in black and white categories. If your performance falls short of perfect, you see yourself as a total failure.
    1. Overgeneralization: You see a single negative event as a never-ending pattern of defeat.
    1. Mental filter: You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolors the entire beaker of water.
    1. Disqualifying the positive: You reject positive experiences by insisting they "don't count" for some reason or other. You maintain a negative belief that is contradicted by your everyday experiences.
    1. Jumping to conclusions: You make a negative interpretation even though there are no definite facts that convincingly support your conclusion.
    1. Mind reading: You arbitrarily conclude that someone is reacting negatively to you and don't bother to check it out.
    2. The Fortune Teller Error: You anticipate that things will turn out badly and feel convinced that your prediction is an already-established fact.
    1. Magnification (catastrophizing) or minimization: You exaggerate the importance of things (such as your goof-up or someone else's achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow's imperfections). This is also called the "binocular trick."
    1. Emotional reasoning: You assume that your negative emotions necessarily reflect the way things really are: "I feel it, therefore it must be true."
    1. Should statements: You try to motivate yourself with shoulds and shouldn'ts, as if you had to be whipped and punished before you could be expected to do anything. "Musts" and "oughts" are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment.
    1. Labeling and mislabeling: This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself: "I'm a loser." When someone else's behavior rubs you the wrong way, you attach a negative label to him, "He's a louse." Mislabeling involves describing an event with language that is highly colored and emotionally loaded.
    1. Personalization: You see yourself as the cause of some negative external event for which, in fact, you were not primarily responsible.

    Your homework for this week:  When you are feeling upset, ask yourself what is going on in your head to make you feel this way.  Then, take this thought and see if you are able to place it into anyone of the categories of negative thoughts.  Lastly, try to re-write that thought in a way that is both realistic and more positive.  Please, do not give up!  You did not learn distorted thought patterns overnight and you will not learn to untwist these thought patterns overnight, either!

    Best of luck!

    Quote of the Week:

    “A man is but the product of his thoughts.  What he thinks, he becomes.”

    -  Mahatma Gandhi