Originally posted by Ali Goldfield, M.A. on TherapyStew (www.therapystew.com) – August 2013

Lots of kids (and parents) have mixed feelings about the start of the school year. It can be really exciting getting ready for school: getting school supplies, new clothes and looking forward to seeing their friends. However, it can also cause a lot of anxiety for many kids, whether they’re starting a new school or not. Taking the time to talk through their anxieties and fears is the few weeks before school starts could make all the difference. Finding out what they’re nervous about – whether it’s meeting the new teacher, making new friends or finding the bathroom when needed, it’s all important to them.

Try the following tips to further ease back to school anxiety:

Make a Plan

If your child is starting a new school, a tour around the campus can be a simple way to ease the first-day jitters. Make sure they know where their classroom is, their locker and especially the bathroom. If you get a class list before school starts, arrange a get together with one of the kids in the class before school starts — first-day jitters are less jittery if there’s a familiar face in class. Teaching anxious middle-schoolers how to use their lock, talk about whether they will be buying lunches or brown bagging it, even sending your child’s teacher an email introducing yourself and your child can help.

Remind Your Child of the Fun They Had Last Year

Point out the positive aspects of starting school: It will be fun. They will see old friends and meet new ones. Try to refresh their memory about previous years, when they may have returned home after the first day with high spirits because they had a good time,

Address the Anxiety at Home

Talking about the different things that are causing them some worries and even role play out some of the potentially stressful scenarios your child may encounter at a new school — making friends, encountering older kids and encounters with strangers — may help ease their fears.

Get Back Into Routine

Anxious kids can feel soothed by a familiar routine. Prepare kids for a new routine by organizing your house in a back-to-school way. Get their school supplies ready, talk about what they want for lunch on the first day, help them decide what to wear on the first day. If possible, start the back-to-school routine a week or two before school starts. Make sure your back-to-school routine includes plenty of sleep and help your child get back on track with an earlier bedtime and wake-up time.

Read more about our Child, Adolescent & Family Psychology Service.

by: Tatijana Busic, PhD. Candidate

Welcome to our blog on mindfulness. This is the first in a series of upcoming blogs in which we’ll introduce you to the concept of mindfulness and talk about the incredible benefits of this simple, yet, powerful way of living! 

In this first blog, we’ll define mindfulness and talk about some important distinctions between mindfulness and meditation. In our second blog, we’ll explore the psychological and physical benefits of a simple mindfulness practice in everyday life. In our third blog, we’ll talk about how mindfulness can be used to enrich and deepen your relationships at home, school and work. Finally, we’ll tie things up by introducing you to some very basic tools and strategies that you can start practicing, as well as, share some helpful resources. So let’s begin!

To start, lets talk about what mindfulness actually is. Some folks may think of mindfulness as meditation, and this can be scary! Rightly so! We might imagine spiritual gurus spending years of their life practicing and honing the powerful skill of meditation. Although these two concepts are closely related, there are some important differences.

Similarities: The beginning stages of learning mindfulness and meditation are virtually identical. We are learning how to do two very important tasks – How to consciously relax and how to consciously direct our attentional processes. Essentially, we’re learning how to relax our bodies and control where and how our mind wanders.  

Differences: Basically, meditation stems from Buddhist philosophy and spiritualties that derive from ancient monastic traditions. Learning how to meditate involves learning the values, beliefs and traditions that are embedded within various traditions. Mindfulness, on the other hand, emerged from the discipline of psychology, scientific research and modern day language and culture. Learning to be mindful, doesn’t necessarily involve learning the practice or values of monastic traditions. In many ways, mindfulness is far more applicable to our complex, modern society and therefore, a lot easier and faster to learn. 

Some other differences include:

• In meditation we sit still – In mindfulness we can be engaged in any task.

• Meditation takes time. Mindfulness can be switched on at any time.

• In meditation we focus inward on the body. Mindfulness involves thoughts, feelings, actions and any state of mind!

So, what is mindfulness, exactly?

Mindfulness has become a key focus in psychological and educational research and practice since the 1980’s. Our busy, modern-day lifestyles have steered our minds and bodies toward a constant state of frenzy. We’re always doing – multi-tasking, multi-thinking and multi-moving!

It’s like the autopilot switch in our brain has been turned on permanently. At times this kind of intensity is great! We need it to get a job done while under high pressure. However, when chronically activated, over time, our brains and our bodies become hungry for, addicted to constant stimulation. We may find it hard to switch off or we may become uncomfortable when things are quiet. At other times, we may miss the beauty that surrounds us. Have you ever been on vacation or even just walking through an autumn kissed park and found yourself worrying about other things? Things you have no control over in that moment? Have you found yourself unable to take-in the serenity?  Notice it, feel it and reap the rewards from it? 

Put simply, mindfulness is about slowing down our stimulus-bound attentional processes and taking the time to consciously, with self awareness, choose what we pay attention to vs. automatically responding to whatever is going on around us. 

Like any skill, learning how to live a more mindful life, takes time and practice – about 100-200 repetitions or three months to consolidate this new and wonderful practice in your brain, your mind and your body. 

In the next blog, we’ll talk about the physical and psychological benefits of mindfulness. And explain how and why this practice can help alleviate psychological issues such as anxiety and depression.  How it helps us sleep better, feel better and see our selves and the world around us in a different and healthier way.

Stay tuned!

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

by: Dr. Julie Beaulac, C. Psych.

According to the National Center for Chronic Disease Prevention and Health Promotion, ‘physical activity’ is “any bodily movement produced by skeletal muscles that results in energy expenditure” (National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997).

Regular physical activity is linked to a wide range of important health benefits – from weight management, reduced risk of stroke, cardiovascular disease and cancer, to the prevention and management of anxiety, depression, and stress.

For most people, it’s safe to start slowly and gently increase your activity. If you have a health condition and are not currently active, it’s highly recommended that you talk to a physician before starting a new exercise regimen.

How Much is Enough?

The Canadian Society for Exercise Physiology released guidelines on physical activity that suggest the following standards as a minimum for health benefit:

• Youth (5-17 years): 60 minutes of daily moderate- to vigorous-intensity activity
• Adults (18- 64 years and older adults 65+): 150 minutes of moderate- to vigorous-intensity activity per week

You can also build up activities in periods of at least 10 minutes each. Here are a few examples:

• Low-intensity effort: Light walking, stretching, or easy gardening
• Moderate intensity effort: Brisk walking, raking leaves, or biking
• Vigorous-intensity effort: Aerobics, jogging, or fast swimming or biking

How Do You Know an Effort is Moderate?

If your breathing and heart rate are a bit higher, and you feel a bit sweaty by the end, you are using moderate effort or are being moderately active.

For managing anxiety or depression, research suggests that physical activity should be in bouts of at least 25 minutes 3-5 days a week (Smits & Otto, 2009) and add up to the following amounts weekly:

• Moderate-intensity for minimum of 150 minutes (i.e., 2 hours and 30 minutes) weekly or; 
• Vigorous-intensity for minimum of 75 minutes (i.e., 1 hour and 15 minutes) weekly

In terms of types of physical activity, it is recommended that we aim to include a mix of endurance, flexibility, and strength and balance activities.

• Endurance (4-7 days per week): Continuous activities that make you breath deeper and increase your heart rate

• Flexibility (4-7 days per week): Reaching, bending and stretching

• Strength and Balance (2-4 days per week): Lifting weights or own body, resistance activities.

So, if we know it is so good for us, why is it so hard?

Lots of things keep us from being active – work and family responsibilities, feeling tired, low motivation, pain or health conditions, the weather and low confidence, to name just a few. There are some strategies that we can use to overcome barriers. Some ideas include:

• Fit activity into smaller chunks throughout the day, such as walking 10 to 15 minutes three or four times a day or taking the stairs instead of the elevator.
• Choose activities that you enjoy and are familiar with so that they can be more easily integrated into your life, such as walking to run errands instead of driving, walking the dog, active play with children.
• Invite friends or colleagues for a walk during lunch hour at work.
• Do activities like biking, swimming, or bowling, instead of going out for dinner with your family or friends.

If you want to increase your physical activity, the top five tips for success are to:

1. Plan ahead
2. Start slow & gradually increase
3. Do something you enjoy
4. Build it into your life
5. Get family and friends involved

When working to make changes to your activity level, it is important to set goals that are:

• Behaviourally-anchored (“I will walk for 15 minutes 3x/week is a behavioural goal”; “I will lose weight” is not a behavioural goal)
• Realistic – Ask yourself, “Is this goal doable?”
• Important – Set goals that are important to you right now.
• Specific – The most useful goals are specific and concrete (e.g., “I will walk for 15 minutes 3 times per week” as opposed to, “I will walk more”)
• Scheduled – Schedule your goals. Write them goals down. Post them somewhere you can see them and tell others about them.
• Reviewed – Goals change. Review your goals often.

For more information, see the following resources:

• Canadian Society for Exercise Physiology Guidelines on Physical Activity
• Exercise for Mood and Anxiety Disorders by Michael W. Otto & Jasper A.J. Smits (2009). New York: Oxford University Press

The psychologists of CFIR’s Health Psychology Treatment Service can help you create a strategy for increasing physical activity and improving your overall wellbeing.

Read more about our Health Psychology Treatment Service.

Do you have an anxious child?

Childhood fears are a part of normal growing up. Fears of the dark, monsters under the bed, starting at a new daycare or school – all of these may be part of typical child development. Anxiety is also a signal to help all of us protect ourselves from situations that are dangerous- a warning signal about a lack of safety in your child’s world. Under normal circumstances, anxiety diminishes when a child’s sense of security and safety is restored—anxious thoughts and feelings subside.

When is your child’s anxiety something you should be concerned about?

Anxiety is considered a disorder not based on what a child is worrying about, but rather how that worry is impacting a child’s functioning. The content may be ‘normal’ but reach out for help for your child under the following circumstances:

1. when your child is experiencing too much worry or suffering immensely over what may appear to be insignificant situations;
2. when worry and avoidance become your child’s automatic response to many situations;
3. when your child feels continuously keyed up, or,
4. when coaxing or reassurance is ineffective in helping your child through his or her anxious thoughts and feelings.

Under these circumstances, anxiety is not a signal that tells them to protect themselves but instead prevents them from fully participating in typical activities of daily life-school, friendships, and academic performance.

What to look for:

If your child is showing any of the following it may be time to seek help from a qualified professional:

• Anticipatory anxiety, worrying hours, days, weeks ahead
• Asking repetitive reassurance questions, “what if” concerns, inconsolable, won’t respond to logical arguments
• Headaches, stomachaches, regularly too sick to go to school
• Disruptions of sleep with difficulty falling asleep, frequent nightmares, trouble sleeping alone
• Perfectionism, self-critical, very high standards that make nothing good enough
• Overly-responsible, people pleasing, an excessive concern that others are upset with him or her, unnecessary apologizing
• Easily distressed, or agitated when in a stressful situation

A child, adolescent and family psychologist at CFIR can help you and your child to diminish unhealthy anxiety. A thorough assessment of your child will provide you and your child with valuable information about the sources of your child’s anxiety, and evidence-based psychological treatment will be employed to help your child deal with his or her anxiety symptoms.

(This post was originally written by Dr. Rebecca Moore C.Psych.)

by: Dr. Rana Karam, C. Psych.

In our previous blog, we discussed immigration and the concept of “culture shock” which is a common product of immigration. In this blog we will discuss the cultural adaptation process and offer some strategies to help you cope with difficulties stemming from immigration and culture shock.

Adaptation process

• The first stage, just before or shortly after immigrating, is often described as the “honeymoon” stage. It is filled with high hopes, great expectations, confidence, happiness, fascination and excitement towards the new culture.
• The second stage, the “culture shock” described in our previous blog on immigration, is a period of destabilization that can last between 3 to 18 months.
•  During the third stage, often referred to as the “adjustment” stage, stress and anxiety recede. The individual starts to accept their new surroundings, feels more in control of their life and gains a better understanding of their host country.

Coping strategies

Despite the lack of a quick fix to culture shock, it can be very relieving to recognize that it forms part of a “normal” adaptation process to a new culture. Often, the best remedies are time and prolonged contact with the new culture. Consequently, resisting the temptation to withdraw and avoid any painful and stressful contact with the new culture and making a conscious effort to adjust to it are key coping steps. Moreover, stress management strategies, self-care, social support from compatriots, creating new relationships with people from the host culture are also important. The following is a number of more specific suggestions on how to cope with difficulties related to immigration:

• Acknowledging that these impacts/challenges exist and are not signs of weakness.
•  Learning the rules of living in the host country (how and why people act the way they do and their behaviours and customs).
• Getting involved in some aspect of the new culture (study art or music, learn a new sport, volunteer in your community).
• Taking care of yourself (eat well, exercise and get a good night’s sleep).
• Sightseeing in your new country.
• Making friends and developing relationships.
• Maintaining contact with old friends and family back home.
• Keeping a journal of feelings, reflections and experiences or sharing them with others to help you sort through them.
• Doing something that reminds you of home (listen to your favourite music or practice a familiar hobb

Cultural adaptation: a lifetime process! 

In general, the process of adaptation is a slow and lengthy one. It often continues throughout the person’s stay in their new culture. Building a new cultural identity is the product of a personal integration of values from both cultures (new and existing culture). Such integration can aid in forming an integrated identity from the two cultures, absorbing the culture shock and supporting the individual in their exploration of the new culture.

More often than not, cultural interactions enrich our life and enable us to identify and better appreciate some aspects of our own culture.

Psychologists and psychotherapists at CFIR can help you navigate through such challenges and cope with the various intercultural difficulties and struggles that may come your way. 

Read more about our Multicultural Treatment Service.

by: Dr. Rana Karam, C. Psych.

Welcome to our blog on immigration! In this blog, we will discuss the immigration process and its impact on the immigrant. In our next blog, we will discuss the adaptation process and offer strategies for coping with the various challenges of immigration.

Starting a new job, going to a new school, moving to another city are common experiences that resemble immigrating to another country. The individual leaves a familiar milieu and dives into a new and unknown environment. This, inevitably, implies a period of adaptation. Such a period can be filled with excitement and hope for success and growth but it can also bring stress and anxiety. Most notably, for people who are changing countries, these difficulties are amplified because the difference between the familiar and the unknown environment is greater. 

What are the underlying experiences of migration? Migration means departing from (emigrating) the people, places, sounds, and scents upon which ones internal and external world was built. Migration also means arriving in a new country (immigrating) and rebuilding, in a short period of time, ones life. Immigrating entails recreating for oneself essential and basic things that were once established in their native country. For instance, rebuilding a work environment, forging new relationships, establishing a new home, and the like.

The experience of immigration is unique to each person and varies according to ones personal history, the reason for, and context of, immigration (whether it was voluntary or an obligation, temporary or permanent, etc.). However, some challenges and impacts are common to that experience.

In general, immigration leads to a period of disorganization that varies in length for each individual. For example, struggling with contradicting desires is very common. Two distinct types of desire are usually manifested, these are: 

• The desire to blend in with others in order not to feel different or ostracized; and

• The desire to distinguish oneself from others in order to remain the same person as before immigrating.

In general, this period of disorganization is sometimes referred to as “Culture shock”.

The concept of culture shock describes a common reaction to a new culture and is one of the phases of the adaptation process to that culture. It is a period of stress, anxiety, tension, nervousness as well as sadness, confusion, surprise, disgust, rejection, and helplessness vis-à-vis the host society.

During this stage, one may undergo a broad range of experiences and behaviours such as:

• Feeling angry, uncomfortable, disappointed, confused, frustrated or irritable;
• Eating and drinking compulsively or needing excessive sleep;
• Having difficulty going to work or looking for a job;
• Avoiding contact with people from the host country and spending time alone or only with people from ones own culture;
• Having negative feelings about the people and the culture of the host country;
• Focusing on the differences between oneself and people from the host country;
• Missing ones family and feeling no connection to the host country; or
• Feeling guilty about leaving family members behind.

The reaction to a new culture is a “shock” primarily because of massive and unexpected changes in ones life and overwhelming exposure to new things. Moreover, exposure to cultural differences can lead a person to question their cultural values. Culture shock is also caused by the anxiety provoked by the loss of our cultural references and familiar symbols in social interactions (e.g., whether to shake hands, hug, or kiss when meeting someone; when and how to tip a service provider; gift exchange; dress codes and customs). Other contributing factors to culture shock include language barriers, experiences of discrimination (prejudice and racism from the host culture), getting recognition for ones education, and qualifications in the host country.

Psychologists and psychotherapists at CFIR can support you and your family members to better cope with these immigration-related difficulties. 

Read more about our Multicultural Treatment Service.

by: Darcy Minick, M.A. and Dr. Dino Zuccarini, C.Psych.

Welcome to our blog on Relationships and Sex. In this blog, we will be sharing information about building a more fulfilling sexual relationship.

In a previous blog on Sex and Attachment, we explained how sex can be viewed as an attachment behaviour, and how our attachment style can affect how we engage emotionally and sexually with others. How we are attached to our partners has an impact on how we experience sex in our relationships. Our physical desire for our partners increases when we feel safe, secure and connected. An emotional connection is often viewed as an aphrodisiac. So first things first – a rich and fulfilling erotic life starts well before we hit the sheets! Our sexual relationship can also deepen our sense of connection to our partner, and allow us to feel better about ourselves and our relationship. Sex
can be a place of connection and healing as well. We have to be securely connected to our partners, both inside and outside the bedroom.

When we are securely attached to our partners outside and inside the bedroom, we are freer to talk about ourselves – our thoughts, feelings, needs, desires, and preferences. We can talk about our sexual ‘self’ in a more open and candid manner without feeling fear, discomfort, shame or guilt. Secure attachment also allows us to be able to bear witness to our partner’s emotional and sexual world – and to celebrate and cherish our partner’s sexual being. We are better able to process negative emotions experienced and/or associated with all aspects of emotional, physical and sexual intimacy, and to join our partners in more positive emotional experiences of joy and excitement involved in exploring
ourselves, and each other, and engage in sexual exploration and play. Being able to connect to our partner’s emotional and sexual experience inside and outside the bedroom leads to more connected interactions and improves our chances of having more “better sex”! The more “better sex” – the more connected – the more you desire sex.

Here are a few factors that you need to consider to create a more secure, richer, erotic life with your partner: 

• Emotional Connection and Better Sex:The relationship must be a safe haven. With a safe, secure connection, partners can risk exploring their own, and their partner’s sexual world … we are close enough and safe enough, to attune to our partner’s feelings and experience, as opposed to being focused on sex as a performance and task simply to relieve tension, please our partners, or gain their reassurance and approval. When our connection is not secure, attachment fears and general negative emotional distress in a relationship can dampen sexual passion, and hamper sexual curiosity and exploration.

• Accessing Erotic Potentials: Learning about ourselves and our partners sexual “hot spots”, and risking sharing and exploring these hot spots requires an environment of trust and respect. Many of us long to discover our true selves – to go inward and come in touch with deeper passions and erotic interests – to be courageous enough to diminish anxiety by reducing shame and guilt about finding our desires, passions and owning our sexual selves; ultimately integrating these deeper sexual interests into the fabric of our sexual relationships. Eroticism is about finding our own hot spots and stimulating our partners psychologically – meeting them in their hot spots during sex – joining them in their sexual world of play.

• Exotic is Erotic: Less exploration of our sexual selves, less novelty – the less desire we have for sex. Sexual routine, or sex that is offered from a place of duty, dampens sexual desire. Again, we need to feel safe to have fun, and safe to explore ourselves, find something new in or selves, to be able to then try something new with our partners. Novelty is important as it increases dopamine, which increases androgen levels … as Marvin Gaye said, Sex “is good for us”. Fun, interesting sex may be even better. Novelty creates that excitement and desire, and keeps everyone interested. For some of us, our partners sexual differences – what’s exotic to us – can be exciting places of exploration.

• Mindful Sexual Presence and Embodiment: When we are emotionally safe – peaceful and relaxed inside – we can become present – really present – to sensation, touch, and the moment. When we are embodied (“of the body”), we are aware of sensations, sexual desires, feelings and wants, and are able to follow the flow of these sensations and strivings, the essence of a good sexual experience.

At the Centre for Interpersonal Relationships, a therapist can help you find and create a more fulfilling sex life by working with you individually and/or as a couple. A therapist can help you understand your sexual desires, emotional reactions and needs, and help you communicate these to your partner more effectively. A therapist can also help you learn how to respond to your partner’s desires, feelings and wants to help you build a more secure and satisfying sexual relationship. A therapist can help you to create greater security in your relationship – and then facilitate sexual growth and intimacy.

Read more about our Relationship & Sex Therapy Treatment Service.

by: Dr. Marie-Pierre Fontaine-Paquet, Psy.D., C.Psych.

In this post, we will define perfectionism vs. healthy striving, describe when perfectionism is a problem, and we’ll offer strategies for overcoming perfectionism. 

Defining Perfectionism 

Wishing to do things well and having high standards is often adaptive and can help you to pursue and achieve your goals in life. This healthy striving can be contrasted with perfectionism, which is a felt need to do things perfectly and to regard anything short of perfection as unacceptable. To help clarify the distinction between healthy striving and perfectionism, here are some characteristics of each one.

Characteristics of Healthy Striving:

• Striving for high but achievable standards that result in feelings of satisfaction and increased self-esteem
• Motivated by enjoyment of the process, enthusiasm, enjoyment of what you do, and desire for success and mastery
• Efforts (not just results) give you satisfaction and a feeling of accomplishment
• Self-esteem is not based on accomplishments and performance
• Rewarding self or others for good performance
• Seeing mistakes as opportunities for growth and learning
• Bouncing back quickly from failure or disappointment

Characteristics of Perfectionism:

• Repeatedly setting goals for yourself that are beyond reach and reason and not being satisfied by anything less than perfection
• Motivated by fear of failure, obligation or duty
• Driven to be the best, but unable to enjoy accomplishments
• Feeling that your sense of self-worth and acceptance is based on accomplishments and performance
• Criticism and judgment of self or others
• Seeing mistakes as evidence of unworthiness
• Becoming depressed when faced with failure or disappointment

When is Perfectionism a Problem?

Like many things, perfectionism can be viewed as a problem when it interferes with a person’s wellbeing and happiness, relationships, or functioning at school or work. This is not always easy to know. If you struggle with perfectionism, the high standards you hold for yourself or others may be so long-standing and ingrained that they may even be unconscious and outside of your awareness. You may have a self-critical internal voice that constantly judges and berates you for not being “______” enough (fill in the blank: smart, hardworking, rational, strong, attractive, thin, sexy… and the list goes on), but you may be more aware of ensuing feelings of guilt, shame, sadness, inadequacy, anxiety, helplessness and hopelessness. You may also be aware of feelings of anger, frustration and resentment when others fail to live up to your expectations, and perhaps this has caused difficulties in your relationships.

Perfectionistic thoughts and behaviours can place an individual at higher risk for depression (see blog ‘Depression: How Your Thinking Can Lead to the ‘Blues’’) and anxiety. Research shows that perfectionism is associated with several psychological problems, such as depression, anxiety, worry about being judged by other people, excessive anger, body image and eating disorder problems, and obsessive-compulsive behaviours.

Strategies for Overcoming Perfectionism

Building Awareness:

The first step to change is to first build awareness of what it is that you want to change. Since perfectionistic thoughts and behaviours can be automatic and unconscious, this may not be an easy task! One way of identifying perfectionistic thoughts is to notice situations in which you experience emotions such as anxiety, sadness, anger, frustration or shame, and to reflect on thoughts and interpretations that may be contributing to these feelings. You can also pay attention to situations in which you find yourself engaging in  perfectionistic behaviours (e.g., checking and rechecking your work, spending too much time cleaning, excessive organizing and list making, difficulty making decisions, procrastinating, exercising excessively to stay thin, etc.), and notice what you may be thinking and feeling in these situations.

Evaluating Your Standards

Here are some questions to consider when evaluating whether your standards are serving you well or whether you might benefit from challenging or altering them:

1. The excessiveness of the standard (e.g., Can this goal be met?)
2. The accuracy of the belief (e.g., Is it true that this standard must be met?)
3. The costs and benefits of imposing the standard (e.g., Does it help me to have the belief or standard?)
4. The flexibility of the standard or belief (e.g., Am I able to adjust my standards and change my beliefs when necessary?).

If you determine that a particular standard cannot be met or that the costs of having a particular standard or rule outweighs the benefits, you may want to consider loosening your standards for that particular issue. If you are unsure, you may consider asking the opinion of a friend or loved one whom you trust.

Making Changes to Perfectionism:

Rather than being unwilling to accept anything less than perfection, remind yourself that no one is perfect nor do we need to be in order to be worthy, lovable and valuable as human beings. Think about what is good enough and possible in your current life situation rather than how things should be in order to be perfect. Work on developing self-compassion in place of harsh self-criticism and perfectionism, and more compassion for others. Coping statements like “It’s okay to make mistakes” and “Nobody’s perfect” can be helpful in challenging perfectionistic thinking. People who struggle with perfectionism tend to go to great pains to control many different aspects of their lives, including their own behavior, the behavior of other people, and the environment in which they live. Because you often cannot control or predict things that occur, it can be helpful to find ways to tolerate some degree of uncertainty and ambiguity in your life.

If perfectionism is a problem for you, chances are that the high standards you hold for yourself or others are long-standing and ingrained. The thought of giving up these standards may be very frightening for a number of reasons, and changing these long-standing patterns can be difficult. You may find that it is too difficult to overcome your perfectionism alone or with the help of your family and friends. A psychologist can help you better understand your perfectionism and the role it plays in your life, and support you in changing these long-standing patterns. A psychologist can also support you in addressing problems often associated with perfectionism, including anxiety, depression, anger, eating disorders and relationship problems.

This blog is based on some parts of the book: “When Perfect Isn’t Good Enough: Strategies for Coping with Perfectionism” by Antony & Swinson (1998)

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

There are many reasons people use substances such as alcohol or recreational drugs. Some of us drink wine with dinner, or meet friends at a bar or pub for drinks; some people use recreational drugs, like marijuana and cocaine, at some point in their lives to enhance their mood when they’re feeling down. When life feels tough, we may rely on substances to alter how we see reality or to help us feel more comfortable around other people. 

Although substances can increase positive mood or enhance social experiences, for some people substance use can lead to significant negative consequences at school or work, with physical and emotional health, as well as in important relationships. For individuals experiencing negative consequences from their substance use, changing their relationship with alcohol or drugs can be difficult and repeated, unsuccessful attempts to change can leave them feeling hopeless. 

What is a substance use “problem”?

The first step in changing a substance addiction involves identifying whether you or someone you care about has a problem. Although this may feel like a daunting task, it is an important first step. Addiction psychologists recommend asking the following questions:

1. Is the substance taken in larger amounts or over a longer period of time than was intended?

2. Has the individual persistently wanted, or struggled to, cut down or control their substance use?

3. Is a great deal of time spent trying to obtain the substance and recover from its effects?

4. Is there a strong desire or urge to use the substance?

5. Has recurrent use resulted in a failure to fulfill major obligations at work, school, or home?

6. Is there continued use despite having relationship problems caused or worsened by the effects? 

7. Are important social or work activities given up or reduced because of substance use?

8. Is there recurrent substance use in situations in which it is dangerous (e.g., drinking and driving)?

9.  Does substance use continue despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or worsened by the substance?

10. Has tolerance of the substance occurred (i.e., a need for more of the substance to achieve the desired effect or diminished effect with continued use of the same amount)?

11. Is there withdrawal from the substance when use is reduced or stopped?

Individuals experiencing some or many of these consequences as a result of their substance use may want to consider seeking assistance to help them reduce, control, or stop their substance use. Psychologists and psychotherapists at CFIR can support you to address your substance use, whether you want to reduce your use or abstain completely.

Read more about our Substance Use Treatment Service.

Dr. Aleks Milosevic, C.Psych. is a Clinical Psychologist, Director of Clinical Training, and the Centre Director at CFIR’s Ottawa location.  He has a specific interest and extensive clinical experience in the treatment of substance use-related difficulties and sexual addiction. Dr. Aleks Milosevic, C.Psych. provides psychological services to individuals experiencing difficulties related to the use of all types of substances (alcohol, recreational drugs, prescription medications, anabolic steroids).

by: Dr. Dino Zuccarini, C.Psych and Dr. Marie-Pierre Fontaine-Paquet, Psy.D., C.Psych.

Are you struggling with sex in your relationships

How you relate to your partners sexually is affected by how you relate to each other outside of sex.

In the CFIR blog post ‘Anxiety and Your Relationships’, we describe how attachment theory may help you to understand your experience of your self and others in your relationships. We also talk about the concept of attachment style, which includes ways of seeing your self (“Am I worthy of love and care?”) and others (“Are you there for me, will you respond when I need you?”) in your close relationships. Sex can be viewed as an attachment behavior, and thus your attachment style affects how you engage in sex. Attachment anxiety and avoidance can interfere with enjoying sex and creating an enriching and fulfilling erotic life.

If you are anxiously attached, you might have doubts about your self-worth and attractiveness, and about your partner’s availability to meet your feelings and needs. Sex can be a way to obtain reassurance about these things – about whether your partner finds you beautiful or sexy, and about whether your partner loves you, cares about you and wants to be close to you. When sex is a way for you to obtain reassurance and to soothe your deep fears about your self or your relationship, you may become demanding and critical of partners when they do not respond to you sexually in the ways that you hoped.

If you are avoidantly attached, you might find it difficult to be close to your partner during sex because you fear rejection by your partner. You might tend to keep more distance during sex and be more focused on tasks and duties, and on performing in such a way that is pleasing to your partner. It might be difficult for you to access your true desires, feelings, and needs and to share these with your partner. You might also struggle with understanding and being attuned to your partner’s feelings and needs when you are so focused on performance and tasks during sex.

When sex becomes a place filled with fear, it may be difficult for both partners to be in touch with, explore and share their erotic potentials and all that sex has to offer.

Here are some tips on how to deal with attachment anxiety and avoidance during sex:

For the anxiously attached:

• If you have doubts about your self-worth and attractiveness, start working on nurturing a more positive relationship with yourself and your body – as opposed to overly relying on your partner’s responses to reassure you. Try to explore what makes you feel sexy and nurture these parts of yourself.
• Try not to over-interpret your partner’s cues as being related to you, how much they care about you and your relationship. Learn to calm yourself and to take a step back to notice all of the other factors that may be influencing your partner’s responses to you.

For the avoidantly attached:

• Develop more awareness of your true desires, feelings, and needs. Try to take a risk to share these with your partner and talk about what interests and excites you in sex – instead of avoiding taking risks by distancing yourself during sex or even avoiding sex altogether.
• Learn to be more present to your own and your partner’s desires, feelings, and needs during sex. Recognize when you are distancing from yourself and your partner, and remember that the more you distance, the more you can create distress in your relationship.

A psychologist can:

• help you find and create a more fulfilling sex life by working with you individually and/or as a couple.
• assess your attachment style and its impact on your sex life, help you understand your sexual desires, emotional reactions, and needs, and help you communicate these to your partner more effectively.
• help you learn how to respond to your partner’s desires, feelings and needs to help you build a more secure and satisfying sexual relationship.

Especially when couples feel stuck in constant negative interactions as a result of fears that block sexual fulfillment and erotic exploration, a psychologist can help you better understand these moments and help you create more security in your relationship. Over time, sex can feel less dangerous and become a space to explore and connect in movement, touch and shared emotions of excitement and joy.

Read more about our Relationship & Sex Therapy Treatment Service.