Within the past few weeks, so many of our realities have entirely changed. With the COVID-19 pandemic, many of us are working from home and choosing to practice social distancing. This new realm may have interfered with your weekly or biweekly therapy sessions. For others, you may be finding yourself struggling with new or familiar troublesome thoughts, feelings, and memories. 

Right now may be a time when you are looking for support.

Right now is when video and telephone therapy are great options to explore. 

Some of the benefits of video and telephone therapy include:

Accessibility

ideo and telephone therapy is easily accessible to everyone that has a phone, computer, or tablet and an internet connection.  

Comfort

You can have sessions from the comfort of your own home which may make you feel more comfortable because you will be in a familiar setting

Flexibility

There is more flexibility in terms of scheduling your sessions

Consistency

These sessions work much in the same way that face-to-face meetings do. If you are used to coming into your therapist’s office, there will be minimal difference when switching to video or telephone sessions. 

Clinicians at CFIR are offering secure video and teletherapy sessions during this time, to ensure continuity of care. Reach out if you would like to have safe, confidential therapy sessions from the comfort of your own home.

Natalie Alexov, B.Sc. is a counsellor at the Centre for Interpersonal Relationships (CFIR) under the supervision of Dr. Aleks Milosevic, C.Psych., and a Masters of Education with a concentration in Counselling Psychology at the University of Ottawa. She supports individual clients to overcome a broad range of difficulties, including depression, anxiety and stress, the impact of traumatic experiences, and relationship problems.

During this unparalleled novel coronavirus pandemic, the majority of the global population has been instructed to practice social distancing and stay at home. However, front line workers have no choice but to continue serving the public during this critical time. These workers include, but are not limited to, hospital staff, nurses, physicians, police officers, firefighters, paramedics, and many more. Under normal circumstances, society relies on these individuals for our wellbeing and understands the importance of protecting their mental health. However, in the context of COVID-19, our collective reliance on and heartfelt gratitude for this population is highlighted. Thus, it is incumbent upon us as mental health professionals and as a society to care for the specific mental health struggles these individuals will face during this devastating time. These individuals are knowingly exposing themselves and their loves ones to the virus to serve the public. Taking this risk comes with its own set of mental health challenges that I will speak about, drawing from a psychological understanding of how chronic exposure to trauma affects individuals.

Isolation 

Front line workers understand that their job requires them to be exposed to events outside of the average person’s experience, including having to work to protect the public in a state of global crisis. At the same time, the rest of the world is social distancing. This exposure creates isolation as many front line workers live with a sense that others do not understand what they go through and that people around them are concerned with “more trivial” issues. This sense of isolation can lead to further disconnection from loved ones during a time when front line workers need support. Additionally, feeling isolated can result in their apprehension to raise their challenges with loved ones, operating under the assumption that they will not be understood. Thus, a deep sense of shame and alienation about one’s internal struggles can ensue, furthering isolation, and helplessness.

Disconnecting from Difficult Emotions 

As front line workers are taking risks to their own (and loved ones’) safety and security, they must adopt coping strategies to manage their own painful emotions of fear, powerlessness, sadness, and more. These strategies may include suppression, dissociation, and avoidance and are, to a certain extent, standard in response to trauma and crises to maintain functioning. While these mechanisms are necessary to allow front line workers to perform heroic acts of bravery, there are detrimental effects to chronic use of these coping strategies. These damaging effects involve operating on “autopilot,” as if one’s survival is continuously threatened, lack of engagement in the present moment, being indifferent, withdrawn, or cutoff. Moreover, the complex emotions engendered during times of crisis do not get processed in a healthy way that allows for constructive meaning to be made. Further, enduring chronic trauma increases the risk of substance use and other forms of self-destructive behaviour.

The Effects of Chronic Stress Response 

Unfortunately, front line workers will also suffer from the chronic activation of anxiety associated with always being in “fight or flight” mode. The persistent activation of this kind of psychological stress also has harmful physical and mental effects. Such effects include: 

• destabilization of mood, 
• distorted perceptions of events, 
• hyperarousal of the nervous system, (resulting in elevated blood pressure, heart rate, physical tension, and stress hormone production) 

Moreover, nervous system dysregulation results in increased difficulties with primary bodily rhythms, such as sleep, appetite, digestion, body temperature, sexual desire/arousal, and energy levels. These detrimental psychological and physical effects of chronic stress levels make it even more difficult for front line workers to cope and less capable of accessing their baseline levels of resilience.

Supporting Front Line Workers During the Pandemic 

At CFIR and in the broader community, we are enormously grateful for the sacrifices front line workers are consistently making daily during this global crisis. CFIR clinicians are skilled in providing trauma related-care and assisting family members of front line workers. Collectively, we can support front line workers by increasing our awareness of the specific challenges they have and will endure and letting them know that mental health support is available to them. We also recognize that, particularly at a time like this, front line workers need to be confident that the world around them is ready and able to provide much-needed care and support. If you are a front line worker during the COVID-19 pandemic, you are not alone—we see you, we value you, and there is support for you!  

Tracie Lee, M.A. (Ed)., R.P. is an Associate at CFIR (Ottawa).  She provides psychotherapy to adults and couples who are experiencing issues related, but not limited to, anxiety and depression, self-esteem, interpersonal and couple relationship functioning (e.g., divorce/separation, infidelity, intimacy issues, family issues), sexuality, body image concerns, personality disorders, identity issues (e.g., professional, gender, sexual), suicidal ideation or self-harming, trauma and domestic abuse, and workplace and school functioning (e.g., burnout, workplace stress, performance). She recently spoke with CBC News Ottawa co-host, Adrian Harewood, about the psychological effects of COVID-19.

Over the past week of the #COVID-19 pandemic, many of my colleagues have written wonderfully helpful articles on how to cope (https://cfir.ca/2020/03/18/a-psychologists-tips-to-mentally-cope-with-covid-19/) and connect without physical contact (https://cfir.ca/2020/03/23/5-ways-to-connect-socially-during-covid-19-self-isolation/). I’d like to do something a little different, so I’m going to talk about power. So, take a (virtual) walk with me, and we’ll find out a bit more about power in the time of the COVID-19 pandemic; who has it, who needs it, and what to do with it if you’ve got it.

Power relations (i.e., social power) can also play a role in helping or hindering any attempt to your attempt to sway others into adopting, implementing, and adhering to COVID-19 social distancing policies. Social power, though difficult to define, can be understood as the capacity to influence others, even when they attempt to resist influence (Forsyth, 2009). In an early analysis of the roots of power that still holds today, French and Raven (1959) identified six critical bases of power: reward, coercive, legitimate, referent, expert, and informational power. Group members who control these bases of power are more influential than those who do not (Forsyth, 2009). Let’s focus on a few that might be most useful for getting your friends, family, and loved ones to #socialdistance.

One kind of power that you might possess is referent power – influence based on group member’s identification with, attraction to, and respect of others. Someone who commands referent power is a person meriting respect, is admired by others in the group, and is a nice, likeable person. For example, a person may achieve high levels of referent power by being a social leader (i.e., the one that plans the Skype parties), or someone who others look up to for any number of reasons. The person who is attempting to influence people around them to #socialdistance can do so by simply asking them to socially distance. When individuals with referent power ask for compliance, their followers are often happy to oblige (Weber, 1921/1946). Put simply, people like you, they hear what you say, and they’re open to it.

Another base of power is expert power. This one refers to an influence that is based on others’ beliefs that the individual possesses superior skills and abilities in some relevant dimension. Here, we’re looking at you if you’re a medical doctor, a nurse, a public health professor, or any other person working in a field where other people assume that you have relevant knowledge on the merits of social distancing. If you’ve got that kind of power (like so many ER doctors we’ve seen in recent days on social media), merely suggesting that social distancing occurs, many people are likely to comply, as they might assume that “the expert knows best.” This could be one reason so many of these posts have been made. 

The final base of power, informational power, is influence based on the potential use of informational resources such as factual data and rational arguments. For example, the early adopter of social distancing can increase adherence to social distancing by showing others the data regarding its efficacy (e.g., anyone who has shared #FlattenTheCurve information). This will help some people adopt social distancing who might otherwise not have done so.

So, think about which of those sources of power might apply to you or people you know. Getting people into the social distancing mindset might not be easy, but it sure is essential. These power tactics might just save a life.

Finally, it’s completely normal to be concerned or experience stress and anxiety from the growing challenges we are facing from COVID-19, but it’s essential to stay calm, be prepared, and stay informed. Right now, our clinicians at CFIR are offering secure video and teletherapy sessions to new and existing clients. Please reach out if you would like to have a safe, confidential therapy session from the comfort of your own home. 

For additional information and important updates related to COVID-19, please refer to the following links:

• https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid19.html

• https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

• https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Brent Mulrooney, M.A.S.P. is a therapist at CFIR (Toronto). He works with individuals and families to improve family functioning and relationships, work and school success, as well as anxiety, depression, and anger problems. He also work to alleviate problems associated with substance use, learning difficulties (including ADHD and Learning Disabilities), bullying, trauma, violence, grief and loss, transitions in life, self-esteem, gender identity, sexuality, and intimate relationships. 

Children are often more perceptive than most adults may give them credit for; they may be wondering why their mom and/or dad are home more, why they aren’t in school or why their routine has changed, or why they can’t go see their friends or even leave the house. It’s essential to tackle these questions head-on and in a manner that satisfies their curiosity and helps to put their mind at ease. 

Self-Reflect

Talking to your children may require that you self-reflect about your concerns and feelings. Be aware that you also may be projecting your insecurities or anxieties on to your children and recognize that you may also need additional support or guidance during this time. Also, make sure that you do your research first so that you can adequately answer any questions that may come up. 

Listen and Teach

Ask your child what they already know or have heard about the virus. Be sure to dispel any myths and elaborate on critical pieces of information like the importance of handwashing. It’s also important to talk to your children in a manner that is appropriate for their age/ level of development. Also, try putting things in terms that they can relate to or understand. It’s important to teach but not to overwhelm. 

Validate Their Feelings

Your child may be confused, scared, or anxious about the changes they are experiencing. It’s important not to dismiss their feelings and to reassure them during this time that what they are feeling is very reasonable. Don’t overcommit or overpromise on things that you may not have control over to solely help them feel better – it’s important to be reassuring but also realistic. 

Create a New Routine, and then keep it Consistent 

Children thrive on stability and knowing what to expect. Help give them that consistency by developing a new routine for them. For example, create a daily schedule that outlines their activities for the day. Setting up a plan in case things suddenly change or take longer than expected can also help provide them with further assurance moving forward. Have your child get involved in the planning process so they can feel empowered and confident moving forward. 

Many people are feeling stress and anxiety during this uncertain time, and children are no exception. The mental health experts at CFIR can help you navigate how to have these meaningful discussions with your children. Clinicians at CFIR are offering secure video and teletherapy sessions during this time to ensure continuity of care. Please reach out if you would like to have a safe, confidential session from the comfort of your own home.

Dr. Brianna Jaris, C.Psych. is a clinical psychologist at CFIR. She has extensive experience in psychological assessment and diagnosis and the treatment of a wide range of psychological issues, including trauma, depression, anxiety. She is currently the head of CFIR’s Trauma and PTSD service. 

Opportunities for ‘Distant Socializing’ in the Time of Social Distancing

With the state of emergency declared in Ontario because of COVID-19, many are self-isolating to protect themselves and others. While isolating or ‘socially distancing’ ourselves can limit the spread of the virus, it can also lead to feelings of loneliness. Humans are inherently social creatures. In a time where most of our basic needs are met with the click of a button or a trip to the store, we continue to strive for comfort, reassurance, self-esteem needs, and to feel worthwhile. Research shows that social support from valued others increases our life satisfaction, self-confidence, ability to cope with distress, and mitigates stress and negative mental health symptoms.

As many of us take shelter in our homes during this unexpected period in history, we can find solace in the fact that we are in an unprecedented age of social connection. Social media has allowed us the ability to connect in new and creative ways. At the same time, it can be a tiring and limiting way to socialize, especially when we find ourselves scrolling mindlessly on Instagram for hours. Here are some new, old, and forgotten methods of socializing from a distance.  

Seeking Innovative Interactions Online

Perhaps one of the consolations in the face of the COVID-19 pandemic is the knowledge that everybody is experiencing the same variations of loneliness, isolation, and boredom. A lot of your self-isolated friends are likely desperate for interaction! If you’re a gamer, multiplayer games that allow voice-chatting are a great way to amuse yourselves, work towards a shared goal and connect with others all at once. If you are less of a gamer and more of a Netflix fan, bond over your shared love of content-consumption using websites like Netflix Party. This site allows friends to chat while watching Netflix content together online, and is becoming a popular platform to socialize from a distance.

Normalize the Video Call

When people think of video calling, they often think of one of two scenarios: either they’re enrapt in an urgent conference call, or they’re talking to their parents, who are usually sitting much too close to the camera. We often forget that video calling can be useful for everyday check-ins. Your distant family members aren’t the only ones who enjoy seeing your face! Try replacing your 10 a.m. coffee chat with your coworker with an informal video call. If you have switched to at-home workouts, try video-chatting your gym buddy as you sweat through a cardio routine in your living room. Don’t be afraid to normalize video-calling by reaching out to those in your life you typically wouldn’t think to Facetime. 

Revive the Pen Pal

Letter-writing may seem like an outdated means of communication, but it can foster deep and meaningful connections with your loved ones. Unlike the average text message, writing a letter involves considerably more time and reflection, and the topics you discuss are usually more deliberate. It can thus be a profoundly introspective activity, much like writing in a journal. Sending mail is a thoughtful way of showing someone they’re on your mind while providing you with the opportunity to organize ideas and understand your experience. Older individuals who are more at risk of COVID19 and are likely also bored at home may appreciate your reaching out. 

Engage with Pets

Those of us self-isolating with a pet are in good company! The presence of an animal can be very therapeutic during times of fear and uncertainty. Cuddling your pet is a great way to release endorphins and oxytocin, which foster feelings of happiness and connection. 

In this period of social distancing, some pets can provide a great excuse to momentarily get outside from time to time. Walking your dog can become a healthy routine that allows you to check-in with yourself, get some fresh air, and catch up with neighbours (from a safe distance).

Connect with a Therapist Online

Self-isolating without family or roommates can be a lonely and emotionally-taxing experience. Self-isolating with panicked family and friends can be just as anxiety-inducing and draining. Virtual psychotherapy can allow individuals who are distressed, struggling, or who need someone to talk to, to connect with therapists from the comfort of their home. Reach out to CFIR online for secure video and teletherapy sessions. 

Nisha Mohan, B.A. is a counsellor at CFIR (Ottawa) and is currently in her final year of a Master of Arts program in Counselling Psychology at the University of Ottawa, pursuing research on the intersecting experiences of biculturalism and emerging adulthood. At the time of this publication, she is under the supervision of Dr. Aleks Milosevic, C.Psych. Nisha provides therapy and assessment to adults for difficulties related to anxiety and stress, depression and mood, anger and emotion regulation, grief and loss, learning challenges, life transitions, personal growth, existential meaning and purpose, and relationship struggles. 

 

Last week there were crowds of people amassed at grocery stores; carts full of bottled water and toilet paper, and shelves left barren. Now, businesses are closing their doors, while many are near empty as people begin to self-isolate and avoid crowds. Some people are now out of work, and they’re worried about how to make ends meet. It’s hard to ignore the impact that COVID-19 has had on Canada, and around the world. Amid so much panic and uncertainty, what can we do, and how can we cope? 

Some of the most important things we need to remember are to stay calm, be prepared, and stay informed. It’s entirely understandable for everyone to have concerns or anxiety surrounding a growing global pandemic. In particular, individuals with pre-existing mental health conditions may be more prone to experiencing these symptoms. While stress and anxiety are seemingly at an all-time high, there are some strategies and techniques that can help as we navigate through this period. 

Grounding

Grounding is a technique that can help to focus on the present and pull away from challenging emotions. One method to practice grounding is to follow the 5-4-3-2-1 rule – identify five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. Helping your mind to focus on the present is an excellent way to calm down quickly. 

Positive Self-Talk

Positive self-dialogue helps identify negative thoughts and attitudes and works to turn them into positive ones. A positive mindset or outlook is better able to take on and tackle life’s challenges and help to mitigate stress and anxiety. 

Journaling

Writing in a journal is a great technique to help you collect and organize your thoughts. When things are so chaotic and uncertain, journaling can be a means of self-reflection, and a means to provide more clarity. Additionally, keeping a gratitude journal can be a great way of focusing on the positives and silver linings of this situation.

Exercise

The benefits of exercise extend beyond that of just physical. Physiologically, exercise helps to address your body’s stress responses by releasing “feel-good” endorphins, while, psychologically, it can boost self-confidence and take your mind off your worries. Some numerous programs and organizations are offering free video sessions for yoga and physical exercises so that you can stay healthy at home. 

Reach Out for Support

Don’t be afraid to reach out to friends or family to help provide comfort or support, however possible. Also, be sure to take advantage of community or government resources as available and as necessary. 

Meditation

Through meditation, we learn about our internal thoughts and emotions, safely explore them, and work to better cope and manage them. Meditation is a great technique to help regulate stress and anxiety. The Calm app is currently offering several free resources, from guided meditation to relaxation techniques, to music and sleep stories. 

Deep Breathing

Breathing exercises can offer simple techniques that can help overcome emotional strain. It can be used on its own or in tandem with other methods like grounding or meditation.

Stay Busy

By focusing on our behaviors and things we can accomplish during this time, we can stay productive and mindful. Making effective use of this time by learning a new skill or hobby, spending quality time with loved ones, getting our spaces organized, and focusing on self-improvement (all the things that we don’t normally have time for). When we get productive, we can increase our moods and decrease our stress and anxiety. Staying healthy by controlling what you can when things feel out of control. 

Make Our Spaces Cozy and Peaceful

During this time when we are all cooped up in our homes, it can begin to feel as though we are trapped in our environments. When we don’t want to spend times in our physical environments (e.g. messy, cramped, chaotic), we can increase negative thought patterns and turn to potentially unhealthy coping mechanisms (e.g. isolation, lashing out at others). Make your space inviting by keeping it clean and organized. Having a cozy place to curl up and watch a movie or read a book is essential. By making a relaxing environment, you will want to enjoy your time at home. You can use essential oils and diffusers, as well as calm lighting and soft blankets (or weighted blankets) to slow down your arousal response and reduce your stress levels. 

In addition to the anxiety-reducing techniques mentioned above, the Government of Canada website offer ways to help reduce and contain viruses like COVID-19 such as:

• Practice proper hand hygiene and coughing/sneezing etiquette

• Stay home if you are sick

• Reduce exposure to crowded places, whenever possible

• Avoid direct contact with individuals

• Stock up on essentials, but avoid panic buying

• Disinfect frequently touched objects like doorknobs or toys

• Get reliable information

• Communicate and make a plan

It’s completely normal to be concerned or experience stress and anxiety from the growing challenges we are facing from COVID-19, but it’s essential to stay calm, be prepared, and stay informed. Mental health professionals can work with you and develop ways to manage the stress and anxiety surrounding this global pandemic – it’s never too late to start. 

Clinicians at CFIR are offering secure video and teletherapy sessions during this time, to ensure continuity of care. Please reach out if you would like to have a safe, confidential therapy session from the comfort of your own home. 

For additional information and important updates related to COVID-19, please refer to the following links:

• https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html

• https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

• https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Dr. Brianna Jaris, C.Psych. is a clinical psychologist at CFIR.  She has extensive experience in psychological assessment and diagnosis and the treatment of a wide range of psychological issues, including trauma, depression, anxiety.  She is currently the head of CFIR’s Trauma and PTSD service. You can visit www.cfir.ca to find out more about Dr. Jaris.

It’s the week after the “spring forward” time change for daylight saving time (DST). How are you feeling? Many people feel slight groggy the first Monday after DST starts, due to losing an hour of sleep, but the adverse effects can linger for days or even weeks! Circadian rhythms can affect sleep. Are you looking for proof? One sobering statistic shares that fatal car accidents increase by 6% the week after DST begins.

Circadian Rhythms 

The term circadian means ‘about a day.’ The circadian clock, located deep in the brain in the suprachiasmatic nucleus (SCN), coordinates systems throughout the body, including sleep and hormones. Exposure to light keeps our circadian rhythm tightly linked to the local 24-hour environment. 

Circadian Influence on Sleep 

In normal sleep, two processes interact to keep people awake for approximately 16 hours and asleep for around eight hours. One process keeps track of the need to sleep, while the other method (controlled by the circadian clock), provides strong signals favoring sleep or waking at specific times. 

Sleep disorders can be caused by a mismatch between sleep needs and the timing of the signals from the circadian clock. The result can be fatigue, poor work performance, and sleep disturbances, particularly difficulty falling asleep or waking up at desired times. 

Night shift work 

People who work at night often experience reduced alertness and job performance during their shift, as well as inadequate daytime sleep ( one to three hours less) when they return home. They may also have trouble staying awake while driving home. 

Advanced Sleep Phase Syndrome (ASPS) 

ASPS folks are “early birds” with bedtimes around 6:00- 9:00 pm, and early morning awakening around 1:00- 3:00 am. Sleep quality is generally normal if they can go to bed early, but poor if trying to stay up late. 

Delayed Sleep Phase Syndrome (DSPS) 

DSPS people are extreme “night owls,” with bedtimes around 3:00-6:00 am and wake times around 12:00-3:00 pm. Sleep quality and duration are normal when they are allowed to sleep at their preferred biological times, but DSPS symptoms appear when trying to sleep earlier because of work or school demands. 

Conclusion 

Conflicts between the circadian clock and work/social demands can lead to poor sleep. Careful control of exposure to light and sleep timing can help people adjust their clocks to the requirements of their jobs and social lives. 

Suggested readings 

Boivin, D.B. & Boudreau, P. (2013). Circadian rhythms and insomnia: Approaching the time barrier.  Insomnia Rounds, 2(4), 1-8. https://css-scs.ca/files/resources/insomnia-rounds/150-010_Eng.pdf

Fritz, J., Vopham, T., Wright, K., Vetter, C., & Fritz, J. (2020). A chronobiological evaluation of the acute effects of Daylight Saving Time on traffic accident risk. Current Biology, 30(4), 729–735.e2. https://doi.org/10.1016/j.cub.2019.12.045

Walker, M. (2018).  Why We Sleep: Unlocking the Power of Sleep and Dreams. Scribner. 

Elaine Waddington Lamont, Ph.D., M.S.W., R.S.W. is a clinician at CFIR (Ottawa) with experience in helping people to rediscover and harness their inner resources. Elaine has spent the past 15 years doing neuroscience research aimed at better understanding how the environment influences biological rhythms like sleep, hormones, and metabolism, which, in turn, affects our mental health. 

Friendships tend to bring people a lot of fulfillment and joy. From vulnerable self-disclosures to inside jokes, there are many benefits to acquiring a confidant. But, similar to some romantic relationships, not all friendships were meant to thrive. Being aware of the roles we play in our connections and how they, in turn, affect our mental wellbeing can be crucial information. Listed below are signs to take notice of to analyze your friendships a bit closer.

You’re always there for them, but you feel like they’re never there for you.

“What ways would I like to be supported in my friendship?”

“I always put the needs of others before my own?”  

• You’re there for every phone call, there to support when they’re not feeling their best, you even check-in, to see if they are doing okay. But you never feel as if your friend is as concerned about you as you are about them. Assess your needs for connection in the friendship, and whether or not they are being met.
• Use this opportunity to notice whether you tend to over-extend yourself within your friendships.

They don’t want to hear about what is troubling you. 

“Do I feel about the lack of support I am experiencing?”

• When you need a shoulder to cry on, or someone to vent to, are your friends there for you? You call them, but they don’t pick up. Whenever you text, but they consistently reply hours later. You start to wonder whether you are a priority for them or not. You almost begin to feel alone, within your friendship. Tune into your experience and assess how you feel about the situation.

They criticize you or shame you.

“What ways does this person make me feel as if I am not good enough?”

• You feel like your friend always has something negative to say something about how you look, how you’re acting, your lifestyle (if not harmful), and more. You feel tense, and like you always have to maintain a false persona. You perceive judgment when you share something personal with them and are often met with unsolicited and/or subtle criticisms. Reflect on your experiences as they pertain to feeling shame within your friendship.

They don’t celebrate your successes.

“Do I feel uncomfortable sharing my success stories with my friend?”

• You achieve something significant to you, and share the news with your friend, hoping they will be as happy as you. But they’re not. They either dismiss or minimize your successes. You feel uncomfortable sharing your accomplishments and gains because you anticipate an expression of disapproval from your friend. In this case, it’s essential to assess how this makes you feel.

They only communicate with you when they need something. 

“How do I feel about only being important to this friend when they need something?”

• Your friend reaches out, and you immediately sense that they’re going to ask you for a favour or some tangible assistance.
• It seems like they no longer want to invest time in getting to know you better. You feel like a resource that serves one purpose. In this case, it’s essential to evaluate how you think about your role in the friendship.

If anything noted above resonates with your experiences, it may be helpful to evaluate how your friendship makes you feel—assessing your cognitive, emotional, and physiological states when you’re around this person or when you think about your relationship with them. It may also be necessary to initiate a conversation with the friend you’re thinking of surrounding your concerns. Doing so may help open a new, insightful dialogue or help you re-assess your boundaries, expectations, and understanding of friendships.

Clinicians at CFIR can support you to find and build relationships by enriching your interpersonal skills. Book an appointment today and start your journey to learning how to communicate and connect emotionally!

Nereah Felix, B.A. is a counsellor at Centre for Interpersonal Relationships (CFIR) in Ottawa and is under the supervision of Dr. Aleks Milosevic, C.Psych. The clients who come to see her are provided with an authentic, non-judgmental, safe, and supportive environment to share their experiences and improve their wellbeing. Nereah is currently enrolled in the Master of Arts in Counselling Psychology at the University of Ottawa.

In an earlier post, my colleague Mathilde Theriault, B.A. Hons., Clinical Psychology Resident, wrote about the paradoxical effect of social media. Despite its potential to connect us, reducing the usage of social media has the paradoxical effect of helping people feel less lonely and depressed. This perspective got me thinking about other ways in which we engage in online activities and their impact on wellbeing. 

The Entertainment Software Association’s Annual Report 2019 revealed that 65% of Americans surveyed played video games every day. Video games are ofte viewed as a pass time for adolescent boys. However, this popular stereotype contradicts actual trends. The vast majority of people who play video games are age 18 or older, and nearly half of them (45%) are women. 

In 2018, the term “Gaming Disorder” was introduced in the 11th Revision of the International Classification of Diseases (ICD-11) as a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by:

• impaired control over gaming, 
• increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and
• continuation or escalation of gaming despite the occurrence of negative consequences. 

For gaming disorder to be diagnosed, the behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. It would typically have been evident for at least 12 months.

Despite how widespread video gaming is, research reveals that gaming disorder only impacts a small proportion of those who play them. However, many people are likely to engage in a pattern of video gaming that, while sub-clinical, could negatively impact wellbeing. I would encourage you to remain alert to the amount of time spent gaming, especially when this behavior becomes repetitive, routine, and at the exclusion of other activities. 

I have often heard from people who play video games that they do so routinely because it’s accessible, and they don’t have to overthink it. If that is the case for you, I challenge you to experiment and become more intentional in what games you play and how you play them. If you mainly play online games, try single-player games. Instead of competing against others online, try competing against yourself. Conversely, if you mostly play single-player games, try an online multiplayer game with your group of friends. It can be fun and more engaging to play as a team, and a lot of them are free. Another fun way to experiment would be to take video games (like table-top role-playing games) and bring it to the real world. Get together with your friends, gather around a table, and roll some dice to go on an imagined adventure together that rivals and surpasses even the best video games available today!

Dr. Miguel Robichaud, C.Psych. is a psychologist in Supervised Practice at Centre for Interpersonal Relationships (CFIR) in Toronto. In therapy, he specializes in helping individuals understand and change long-standing personality patterns and process unresolved issues stemming from family relations and upbringing (i.e., attachment issues, past or ongoing emotional deprivation, traumatic experiences). His work is currently supervised by Dr. Rylie Moore, C.Psych. and Dr. Dino Zuccarini, C.Psych.

For many of us, work represents a significant part of our lives. Not only do we spend half of our time at work, but we also tend to invest personal resources and efforts to accomplish our professional responsibilities, develop meaningful relationships with colleagues, and construct our sense of identity on what we do.

In the past few decades, organizational and management research has focused on the impacts of absenteeism and implement measures to prevent it, such as rewarding satisfactory attendance and reinforcing policies to justify absences. Combined with a social context that values performance and being seen positively by peers, these measures can influence employees’ decisions to go to work or not. In return, another attendance behavior has been a subject of interest more recently: presenteeism. 

Defined as going to work while being sick, presenteeism is now known to be a widespread phenomenon among workers. It is estimated that more than 60% of employees report having worked while their health was not optimal, having different impacts for organizations and their members. 

Impacts of presenteeism for organizations

By reducing employees’ efficiency, presenteeism also generates productivity losses for organizations, which are estimated to be higher than those produced by absenteeism. It is estimated that presenteeism costs, on average, $255 annually per employee of a single organization, and its productivity losses can cost between $150 – $180 billion dollars per year (Goetzel et al., 2004; Hemp, 2004). Some authors argue that organizational culture and policies that promote presence at work can then have the impact of developing presenteeism, and therefore, is very costly.

Impacts of presenteeism for employees

Presenteeism represents a risk factor for workers’ physical and mental health. 

• Going to work while being sick can put others at risk by contributing to the transmission of infectious diseases. 
• This attendance behavior has been associated with different health difficulties, such as burnout, depression, anxiety, and chronic pain.
• Presenteeism is also associated with the worsening of physical and psychological symptoms, and by delaying the recovery process, it can eventually lead to more absences.
• Not respecting our need to stay at home and to take care of our health can also impact our productivity or sense of accomplishment at work, and therefore leading to a diminished sense of work engagement and job satisfaction.

In summary, even though absences from work can hurt an organization, going to work while being ill also can provoke real consequences for both the organization and its employees. It is, therefore, important to recognize signs of suboptimal health and to promote self-care in and outside the workplace. Psychotherapy can be a great place to start to learn how to identify our warning signs, how to assert our needs, and develop acceptance of our limits – and then optimize your health!

Dr. Karine Côté, D.Psy., C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). Dr. Côté provides psychological services to individual adults and couples experiencing a wide range of psychological and relationship difficulties related to mood and anxiety disorders, trauma, eating disorders, sleep disruptions, and interpersonal betrayal. She works from a humanistic approach and integrates therapeutic techniques from gestalt and object relations psychotherapies, emotion-focused therapy (EFT), and cognitive-behavioral therapy (CBT).

References

Goetzel, R. Z., Long, S. R., Ozminkowski, R. J., Hawkins, K., Wang, S., & Lynch, W. (2004). Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers. Journal of Occupational and Environmental Medicine, 46(4), 398-412. https://doi.org/10.1097/01.jom.0000121151.40413.bd

Going to work while being sick – not always the best policy (part 1)Hemp, P. (2004). Presenteeism: At work—But out of it. Harvard Business Review, 82, 49-58. Retrieved on https://hbr.org/2004/10/presenteeism-at-work-but-out-of-it