by: Dr. Lila Z. Hakim, C.Psych.

Dealing with fertility-related problems can be extremely distressing for individuals and couples. Anxiety, depression, fears, doubts, guilt, shame, and despair may be experienced when there are biological barriers to conception. The stress of a fertility problem can affect one’s sense of emotional and sexual intimacy in relationships. Sometimes a negative self-concept and a sense of failure and anger can spill over into other areas of life, exacerbating couple conflicts and leaving partners feeling emotionally distressed. Partners may become emotionally disconnected, which deepens the sense of loneliness, isolation, and helplessness that can already be experienced as a result of dealing with a fertility issue. The stress associated with fertility-related issues can undermine an individual’s and couple’s emotional health, which can result in anxiety and depression, and negatively affect intimacy and sexual interactions in the relationship. 

Exploration of the deeper meanings associated with infertility or fertility is also an important aspect of the healing process. With couples, reconnecting emotionally can help to counteract feelings of isolation and loneliness. Strengthening the couple relationship ensures that each partner can turn to the other for support in moments of vulnerability to lessen distress and restore a sense of calm and comfort in their lives. Partners become a stronger team in facing fertility challenges and the difficult emotional experiences involved. 

Psychologists and clinicians at CFIR support individuals and couples dealing with fertility-related issues in coping and dealing with the negative thoughts, distressing feelings, and emotional reactions, and any relationship issues that may have emerged as a result of fertility problems. We also provide clients with education to deal with infertility so they are empowered throughout this journey.

Psychologists and clinicians at CFIR are active in research in the area of fertility. We have published scientific articles in the area of fertility counselling and are involved in ongoing research in this area.

Read more about our Fertility Counselling Treatment Service.

by: Dr. Dino Zuccarini, C.Psych.

Life can be a symphony of losses. Many of us struggle to cope with unresolved losses from either the past or present day. We can experience loss as we transition through various life stages (i.e., childhood onward toward the end of life). Some individuals will experience loss as a result of unmet needs, separation, divorce, or death of loved ones, or unfulfilled goals and potentials. Some of us will experience a deep sense of loss as we inevitably experience changes in our physical and mental abilities, health status, and roles and identity. The emotional residue and grief associated with these losses, when left unaddressed and unprocessed, can evolve into anxiety and depression.

In terms of overcoming your grief, we help you to understand the meanings of your losses, and to process the unresolved or complicated emotional residue from these losses. Unprocessed grief and loss can affect our emotional well-being, our functioning in everyday life, and our interpersonal relationships. We support you throughout your grieving process so that you may move forward with your life with a renewed sense of meaning, purpose, and hope. Psychologists and clinicians at CFIR employ psychodynamic and experiential approaches to support you through the process of dealing with past and present-day losses.

Read more about our Depression, Mood & Grief Treatment Service.

by: Dr. Lila Z. Hakim, C.Psych. & Dr. Dino Zuccarini, C.Psych.

Many of us will experience a self or existential crisis during our lifetime. These crises are usually precipitated by life transitions. Life transitions that can trigger a crisis include: aging, changes in relationship status (i.e., marriage, separation and divorce), betrayals and loss of loved ones (e.g., death of parent, partner or child), changes in our identity (e.g., children leaving home, loss of youth, and perceived attractiveness), and recognition of our own mortality and the end of our life. Such moments may spawn a search for meaning, purpose, and connection to others and the world around us, or result in a downward spiral and deepening crisis involving hopelessness, despair and anxiety, and suicidal ideation.
Some individuals struggling with such crises have spent numerous years disconnected from their own selves by virtue of not pursuing their authentic feelings, needs, and desires in the world. Instead, these individuals may have surrendered to the expectations and demands of others. Recognition of the freedom to create one’s entire world may be daunting for some individuals in these circumstances, but is key to the recovery from such a crisis. 
Some individuals experience a mid-life crisis brought upon by specific concerns about mid-life transitions and an impending sense that a decline is imminent. Mid-life can involve a reframing of life and deep reflection on life in terms of years left to live. With parents passing away, children moving out of the family home, and dissatisfaction with self (i.e., physical and bodily changes related to aging, dissatisfaction with relationship, career and accomplishments), some individuals will experience despair and hopelessness. A crisis can ensue upon realization of the passing of time with very few opportunities to change life’s course. This realization may precipitate intense emotions, a desperate search and effort to change one’s life. Seeking out younger partners, drastic changes to physical appearance, or career may ensue.
The Self-Growth and Self-Esteem Service at CFIR supports clients to deal with particular life issues that involve one’s questioning of the purpose, meaning, and value of one’s life, and difficult feelings associated with being alone and isolated. Such moments can leave us questioning past and current decisions related to our choices in occupation, residence, and relationship partners.
Read more about our Self-Growth & Self-Esteem Treatment Service.

by: Dr. Lila Z. Hakim, C.Psych.

“Mood and anxiety disorders are among the most common types of mental disorders in Canada and have been shown to have a major impact on the daily lives of those affected.“

SOURCE: Mood and anxiety disorders in Canada | canada.ca

Anxiety tends to be accompanied by a wide range of physical and psychological symptoms. Individuals experiencing anxiety may have physical complaints such as shortness of breath, heart palpitations, sweating profusely, or feeling dizzy. Chronic fearful arousal can interfere with sleep, concentration, and attention, and affect overall functioning. These physical symptoms are often accompanied by negative and self-critical thoughts about oneself, catastrophic fears, and thoughts of terrible things happening to oneself or loved ones. Some individuals will engage in certain behaviours (e.g., checking, counting, handwashing), or avoid certain places or social situations to deal with their anxiety.  Anxiety can manifest in different ways — individuals can struggle with different types of anxiety, including agoraphobia, generalized anxiety, panic, social anxiety, and specific phobias.

Anxiety may be rooted in difficult early or present-day life situations. For some of us, early childhood experiences in which we lacked appropriate and sufficient nurturance and support may have resulted in a vulnerable sense of self that is prone to anxiety in everyday life. For others, challenging, negative life experiences with family, friends, peers, and relationship partners may have undermined our safety and security in such a way that our confidence in our selves and others has been drastically altered.

Deep self-vulnerability may emerge when the unprocessed emotions and unmet needs associated with these past and present-day life events are not addressed. As a result of these experiences, we begin to think about, or emotionally react to our selves, others, and the world, in ways that constrict us from being able to move freely in the world or create relationships with others. We can begin to overly anticipate danger, or bad things happening to us, and engage in behaviours to cope with the anxiety. These behaviours then stop us from participating fully in life and become a further source of distress.
Sometimes stress, particularly when long-lasting, can overwhelm us and result in us feeling anxious. Some individuals have stress for days before tests, public speaking, or appointments, which impairs their ability to cope with life’s daily tasks. Their functioning becomes significantly diminished and our anxiety response to life increases. Being able to manage stress increases our sense of confidence, and improves the quality of our lives, and reduces our anxiety.

Work stress can also undermine our sense of emotional and physical well-being, and as a result, bring about chronic anxious feelings. Burnout can result from long-term stressors that are unresolved. Being able to cope with work stress is essential to prevent burnout. Work stress and exhaustion are caused by multiple factors that require attention to ensure we are creating a good quality of life in our work lives. Work stress and burnout can have a long-lasting impact on our sense of selves and our relationships when not addressed. When we are overly stressed and experiencing burnout, life’s smallest tasks can bring about anxious feelings. 

The Anxiety, Stress & Obsessive-Compulsive Service at CFIR offers clients a comprehensive assessment and diagnosis of your anxiety issues to facilitate appropriate treatment planning. We employ short-term and long-term, scientifically-validated interventions to address the specific type of anxiety you are experiencing. Cognitive-behavioural, psychodynamic, and experiential approaches are employed to help you resolve issues related to anxiety or stress.

Read more about our Anxiety, Stress & Obsessive-Compulsive Treatment Service.

by: Dr. Dino Zuccarini, C.Psych. & Dr. Lila Z. Hakim, C.Psych.

Being able to communicate in an efficient and effective manner in a relationship is important. Each individual in a relationship will have his or her own feelings, needs, wants, desires, opinions, and values to share on a wide range of topics from intimacy needs, children and parenting issues, relationship to in-laws, household roles, duties and tasks, finances, and balancing life-work and family demands. Inevitably partners will have different expectations about how to address these topics. Effective communication strategies allow individuals or couple partners to be able to navigate life’s issues in a manner in which both partners feel valued, seen, and heard. Individuals or couple partners who are also equipped with conflict resolution, problem-solving, and negotiation skills are able to deal with difficult relationship moments in which there is disagreement and when problem resolution seems impossible.

When partners are distressed, they tend to fall into negative communication patterns that escalate into negative displays of emotion or withdrawals. Couples who are ill-equipped to resolve problems and are unable to negotiate, stay stuck in conflict and eventually engage in high-conflict interactions or distancing.

Psychologists and clinicians at CFIR are skilled in supporting you to develop solid relationship communication skills. We help you to learn how to resolve your problems, express and assert yourself, and negotiate with others on topics of great concern to you.

The Relationship and Sex Therapy Service at CFIR offers clients comprehensive assessment, psychotherapy, and counselling to address a wide range of relationship and/or sexual issues for both individuals and couples. In terms of treatment, we offer individual, couple, and group therapy to help you to develop stronger relationships, heal relationship injuries, improve or add new relationship skills (e.g., communication, problem-solving and negotiation skills), and address sexual issues that interfere with sexual satisfaction and fulfilment, regardless of sexual orientation.

Read more about our Relationship & Sex Therapy Treatment Service.

by: Dr. Dino Zuccarini, C.Psych. & Dr. Lila Z. Hakim, C.Psych.

Our ability to trust another person is core to our being able to create and sustain close intimate relationships. When we are able to trust another, we reap the emotional rewards of feeling connected to others. Trust is an antidote against any sense of isolation and non-belonging as it allows us to develop relationships in which others can be experienced in a manner that feels emotionally safe and secure. We initially learn to trust others in our relationship with our parents, then our peers, and eventually our relationship partners. Sometimes when we have difficult early relationship experiences we lose our bearings in terms of whom to trust and how to trust another person.

Trust can be eroded when we are hurt, frightened, or angered by the behaviour of those to whom we are most attached. Emotional, sexual, or physical abuse or neglect in our early years, or past and current relationships can breakdown our capacity to trust another, particularly when abuse or neglect occurred by someone who we expected to be a source of safety and security for us. At other times, betrayals and emotional injuries arising from a perceived lack of support from our relationship can also alter our sense of the other person’s reliability, dependability, and trustworthiness. Sexual and emotional affairs, betrayals, and emotional injuries in close couple relationships also erode and create serious ruptures to the attachment bond between partners. These types of emotional injuries in our family of origin and our relationships with friends and partners can leave emotional residue. These injuries then become triggers that are activated in our relationships and that block us from feeling safe and secure with others.

We help you to learn how to trust again in the aftermath of different types of incidents that have eroded your trust in relationships. 

The Couples Therapy Service at CFIR offers clients comprehensive assessment, psychotherapy, and counselling to address a wide range of relationship and/or sexual issues for both individuals and couples. In terms of treatment, we offer individual, couple, and group therapy to help you to develop stronger relationships, heal relationship injuries, improve or add new relationship skills (e.g., communication, problem-solving and negotiation skills), and address sexual issues that interfere with sexual satisfaction and fulfilment, regardless of sexual orientation.

Read more about our Couples Therapy Service.

by: Dr. Lila Z. Hakim, C.Psych. & Dr. Dino Zuccarini, C.Psych.

Sexuality is an essential part of who we are. At CFIR, we promote healthy sexuality. A crucial first step is to ensure that individuals and couples have access to accurate information about sex and how our bodies work, and an understanding of the physical (e.g., contraception, sexually-transmitted infections) and emotional risks involved in expressing ourselves sexually. Healthy sexuality also suggests being comfortable with ourselves (i.e., liking our bodies, finding ourselves attractive, being aware of and accepting our desires and fantasies, feeling capable sexually, knowing our sexual boundaries and asserting our limits), being able to experience sexually arousing feelings, communicating our sexual desires, and engaging in satisfying intimate-sexual relations with others. 

Sexuality, however, can also be a source of great distress. Distress can occur when we do not have accurate knowledge or information or are experiencing sexual functioning problems or sexual and pornography addictions. Some of our sexual issues flow from a lack of, or inaccurate, learning about how our bodies actually function, or distress over fears of pregnancy or sexually transmitted infections. A lack of knowledge can create anxiety about decisions and choices and sexual expressions. 

Sexual functioning problems related to desire, arousal, and orgasm are also a source of emotional distress for individuals and couples. The causes of such issues are vast. Sexual functioning is affected by a wide range of organic, biological, and medical issues, as well as social, cultural, and psychological factors. Some of us become overly consumed by negative thoughts and emotional reactions about oneself (e.g., our bodies, genitalia, sexual performance), or our sexual partner. We may also engage in relationship or sexual patterns that diminish arousal and the desire or interest in sex. Some individuals experience sexual pain or other difficulties during sexual intercourse due to a complex blend of physical or psychological factors. 

Some individuals will struggle with sexual or pornography addictions, including the use of internet porn, massage parlours, or risky sexual encounters. In these situations, individuals and their relationship partners may experience significant distress. Sexual functioning issues, regardless of their origins, can block an individual and couples from experiencing positive feelings, such as joy and pleasure, within the sexual aspect of the relationship. Sexual issues can also spill over into other aspects of the relationship, including emotional and physical intimacy. 

Psychologists and clinicians at CFIR have published research and theoretical articles in peer-reviewed journals, and written book chapters in the area of couple and sex therapy. We help you by providing a comprehensive psychological assessment to help you understand the causes of your sexual difficulties and then develop the most appropriate treatment plan to address underlying causes. We are well-informed about contraception, sexually transmitted infections, and the physical aspects of sexual functioning, and the psycho-social issues associated with these topics. We also support clients to develop sexual authenticity by helping them to clarify desires and remove blocks to the expression and assertion of their sexual needs in relationships. We also help to resolve sexual functioning issues to restore one’s sexuality as a source of joy, sensuous pleasure, and connection. 

The Sex Therapy Treatment Service at CFIR offers clients comprehensive assessment, psychotherapy, and counselling to address a wide range of relationship and/or sexual issues for both individuals and couples. Regarding treatment, we offer individual, couple, and group therapy to help you to develop stronger relationships, heal relationship injuries, improve or add new relationship skills (e.g., communication, problem-solving and negotiation skills), and address sexual issues that interfere with sexual satisfaction and fulfillment, regardless of sexual orientation. 

Read more about our Sex Therapy Treatment Service. 

by: Dr. Aleks Milosevic, C. Psych.

Our deepest sense of our own worth or value is an important part of our self-esteem. Having a positive sense of self-esteem involves being able to hold a solid sense of being a good person, making life decisions that are respectful toward ourselves, and having a sense of worth and competency. Our early childhood experience in our family of origin has a significant impact on how our self-esteem develops. Peer relations and then relationship partners also have an impact on our self-concept. Our relationships to others will play a role in how we view ourselves, the confidence we have in our selves, and our deepest sense that we are good and competent individuals; in short, we are more likely to have a good sense of our own value and worth. This good sense of our own value and worth affects how we talk to ourselves, the choices and decisions we make for ourselves in everyday life, and how we will experience and manage our relationships with others. Healthy self-esteem adds to our sense of resilience.

Individuals with low self-esteem often struggle to come in touch, or maintain, a sense of being a good and competent person. Typically, individuals with low self-esteem experienced challenging early life environments that may have involved harsh criticalness about appearance, intelligence, or clothing by family members or peers, bullying and teasing, emotional, physical, and sexual abuse and neglect, obstacles that blocked achievement, or mistreatment based on social identity (e.g., gender, sexuality, race) or on a learning or physical disability. As a result of these experiences, one might be more self-critical, preoccupied by doubt and uncertainty, overly driven by perfectionistic standards and ideals, have less belief in one’s ability to achieve or accomplish, or experience an increased sense of anxiety, loneliness, and shame that block them from building relationships with others.

When we did not develop a positive sense of self-esteem, we are less able to tolerate challenging life moments and sudden life changes, to cope with adversity and perceived failure, or to deal with work and relationship issues. Lower self-esteem diminishes our ability to deal with these moments. Life challenges and financial, relationship, and career difficulties or failures can also have an impact on our self-esteem.

Some individuals have overly-inflated self-esteem or fluctuating self-esteem. In cases of overly-inflated self-esteem, an individual may be compensating for low self-esteem. Typically, this includes over-working, or over-achieving at the expense of mental, physical health, and relationships. They may also overestimate what they are able to achieve or accomplish, and set unrealistic goals with the intention of improving their sense of value and worth. Sometimes individuals oscillate between periods marked by anxiety and depression as they shift from experiencing low to overly high self-esteem.  

There are many dimensions to self-esteem. Psychologists and clinicians at CFIR in our Self-Growth & Self-Esteem Service are skilled in being able to understand how your self-esteem developed, and the necessary steps to foster a positive and healthy sense of self-esteem in the ‘here and now’.

Read more about our Self-Growth & Self-Esteem Treatment Service.

by: Dr. Dino Zuccarini, C.Psych. & Dr. Lila Z. Hakim, C.Psych.

“When communication breaks down, unprocessed negative emotions accumulate.” 

Emotional, physical, and sexual intimacy can be considered essential components of adult attachment bonds. Our capacity to engage in an intimate manner contributes to our ability to form and maintain mutually satisfying, long-term relationships. Emotional intimacy allows partners to feel seen, heard, and understood. Emotional closeness is core to developing satisfying couple physical and sexual intimacy.

When partners feel emotionally close, physical touch and sexual contact seem less threatening and more rewarding. A solid emotional connection allows individuals to be present and engage moment-by-moment in encounters involving intimate physical and sexual contact. Within this context, more intimate, arousing, pleasurable, and erotic encounters are then possible. On the other hand, when partners lack emotional closeness, they feel distanced or engage in circular, escalating conflicts as they strive to be understood and have their needs met by the other. Negative feelings and emotions begin to accumulate when partners are unable to intimately engage.

In some cases, a partner may fear intimacy, or lack the skills to engage in an intimate manner about their feelings, needs or desires, or lack knowledge about how to respond to the other’s feelings. When communication breaks down, unprocessed negative emotions accumulate. Unable to process their feelings and needs, partners engage in rigid, negative patterns with one another. They begin to distance from each other, experience separation fears, and engage in high-conflict exchanges in their effort to protect themselves from the growing sense of disconnection in the relationship.

Psychologists and clinicians at CFIR help individuals and couple partners learn how to identify, express, and assert their selves in their relationships to others. We also support individuals and partners on how to exit from difficult relationship patterns and become more accessible and responsive to one another. Healthy relationship and sexual functioning are important in maintaining a good sense of ourselves. Both our physical and mental well-being is improved when we have the ability to create and sustain intimate relationships with others both outside and inside the bedroom. In fact, research affirms that many individuals struggle in their efforts to maintain relationship and sexual satisfaction throughout their lives, and that dissatisfaction in these areas of life can have an impact on our mental and physical health.

Read more about our Relationship & Sex Therapy Treatment Service.

by: Dr. Lila Z. Hakim, C. Psych.

Upon birth, many couples will require some time to get used to their new home circumstances. Learning how to create and adapt to sleep and feeding schedules that suit the reality of the couple can be challenging. Numerous issues related to sleep and feeding emerge that can create distress, particularly in the context of a lack of sleep and the novelty of figuring out and managing the newborn’s needs. The relationship will transition during this period to adjust to these new circumstances. 

For some women, this period becomes complicated by depression caused by numerous physical and psychological factors, including a growing sense of isolation, emotional residues of birthing problems, sleep difficulties, and a change in sense of self and identity. Feelings of depression during this period may also be accompanied by self-criticalness and identity challenges that can then increasingly spiral into hopelessness and despair. Partners may also struggle and find themselves slipping into states of anxiety and depression. They may experience similar challenges during this transition period. 

Psychologists and clinicians at CFIR are able to diagnose and guide the treatment of postpartum depression. We provide support individuals and couples to adjust to their initial challenges upon return to home with their newborn. We help individuals and couples establish solid networks of physical and emotional care and support to ensure that isolation is reduced. We support new parents by providing them with resources to connect to the outside community. We also provide specific psychological treatment for postpartum depression, involving both individual and couple sessions to support women to emerge from the cascading negative emotions and biological turmoil that may occur during this period.

Read more about our Fertility Counselling Treatment Service.