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.

by: Dr. Dino Zuccarini and Tatijana Busic

Finding a path toward recovery from your depression symptoms can be challenging, but is doable! In this third post in our depression blogs, we provide strategies to help you deal with depression symptoms associated with your thinking and how you might be processing your feelings, emotions, and needs.

We’ve offered you some tips to help take the first few steps toward feeling better. We suggest that you start your recovery journey by employing strategies for your self first, and then once you’ve started on those, our fourth blog post offers you strategies for your relationships.

Strategies for Your Self: Develop Structure, Routine, and Self-Care into Your Life

When we are depressed, we tend to become depleted of energy. We move less and feel tired. These circumstances can drain us of important mental and physical stimulation that we need for our well-being.

Put structure and everyday routine back into your life and begin to increase your level of self-care. Create a routine. Make sure to schedule activities that are meaningful or pleasurable to you. Include 20 minutes of physical exercise each day. Prepare healthy meals that will nourish your body and mind. Get good rest. If you are having difficulties sleeping, consult resources that will assist you to develop a soothing nightly ritual that will help you to unwind and relax and ultimately improve your sleep.

Learn How to Regulate and Soothe Stress, Negative Feelings and Emotions

With depression, we can struggle with our feelings and emotions – we feel too much or too little. When we are overwhelmed by strong, intense feelings and emotions, it is important to develop practices and strategies to effectively deal with these internal reactions.

Pause before you act on your thoughts and feelings and try to restore a sense of calm and ease. Learning how to restore calm and ease within ourselves is an important life skill. Make a list of activities that are calming and soothing for you, and engage in these activities when you are emotionally distressed. For example, sipping tea in a peaceful place, going for a walk, engaging in deep body and muscle relaxation, taking a warm bath, learning how to breathe rhythmically and deeply, visualizing peaceful and tranquil settings, quietly reading a book, and listening to calming music are examples of ways to enhance coping.

Try to remember, intense feelings and emotions mellow with time. Try to reassure yourself that these feelings and emotions will pass and you will be okay once again. Once we are calmer, we can begin to think about the thoughts and feelings we are experiencing that are contributing to our depression.

Challenge Negative Thoughts and Feelings about Your Self and Others

Negative views of our ‘self’ and of other people can create a deep sense of hopelessness, as discussed previously. In the midst of feeling depressed, pay attention to the thoughts, interpretations, assumptions, and beliefs you have about yourself or others. Do you notice a negative bias in how you are thinking or feeling about yourself and others?

Try to challenge these negative views and find counter-examples to these negative thoughts. Try to recognize good things about yourself and others at home, work, and in play. Practice noticing positive attributes about you and other people—at least once a day. You can also develop a list of positive things about yourself and other people in your life. Have your list handy and read it whenever you are feeling negative. Do not be surprised if your list of good things begins to grow as you start to engage in this exercise of positive appreciation.

Sometimes our negative thoughts and feelings towards others are grounded in real experiences in which others are behaving inappropriately toward us. If people are behaving toward you in a negative manner that is harmful (i.e., verbal, physical, emotional or sexual abuse), it is important to seek out support and professional help to find a way to address these circumstances.

Develop Self-Compassion in Place of Harsh Self-Criticism and Perfectionism

Sometimes a negative, critical voice toward our ‘self’ and others may be at the root of our depression. When left unchecked, this voice can make life unbearable.

Do you notice a highly critical or perfectionistic inner voice that pervades your life? How do you feel while and after you have berated, attacked, or criticized yourself? Probably not very good. Try to develop a more compassionate and understanding counter-voice at these times. Making mistakes and not meeting expectations and demands are bound to happen throughout our lives. It is part of being human. Remind yourself that no one is perfect nor do we need to be in order to be worthy, lovable, and valuable as human beings. Ask yourself if you would be as harsh toward others, such as a family member, partner or friend if they had not met an expectation? Would you be more understanding of others? Try to develop a kind, gentle, understanding and reassuring voice toward yourself in these moments.

Try to lighten the impact of this oppressive voice by reframing the self-criticism in positive terms. For example, ask yourself what you can learn from the present situation that may help you grow as a person in the future as opposed to harshly attacking yourself. Try to find constructive solutions to your mistakes or problems, rather than senselessly depleting your energy and berating yourself.

Try to find ways to challenge harsh self-criticism. Ask yourself, “How realistic are the expectations and demands that I hold of myself and others?”. Remember that human beings are limited in terms of what we can achieve. We can’t always meet all of our or others’ expectations or needs. In addition to negotiating our needs with those of other people in our lives, we also have to balance a lot of competing needs in different contexts, including work, family, and play.

Find counter-examples that contradict the extreme and global way you are putting yourself down. Create a more balanced and accurate view of yourself. Think about what is good enough and possible in your current life situation rather than how things should be in order to be perfect.

Be Mindful, Build Awareness of the Present Moment

When we are depressed our thoughts are often focused on worrying about the future or ruminating about the past. Depression impedes on our ability to live in the present moment, which often further aggravates the cycle of worry and negative rumination.

Try to notice these moments as they are happening without any judgment. Simply notice your ‘self’ thinking or feeling something that is connected to worry about the future or rumination about something that happened in the past. As you notice what is happening, try to gently shift your attention to your body. For example, if you are walking notice how the soles of your feet feel with every step you take. Practice using your senses to notice how things look, feel, taste and smell around you.

By gently shifting your attention to the present moment, you rest your awareness in the here and now of being alive. This mindful practice can help you to build an inner sense of refuge from the stresses of life. Also, this practice can occur under any circumstances and over time, will help you to develop greater resilience and freedom from the negative thought and emotional patterns associated with depression.

Identify, Label, and Access Emotions and Needs and Make a Plan of Action

Emotions provide us with important information about what our concerns, goals, and needs are for ourselves and in our relationships with others in the world around us. Depression is a signal, calling for us to listen to what our feelings are telling us about what concerns or goals have gone unmet, or what we might want or need for ourselves or in our relationships with others.

Being able to identify, label, and express these feelings in words is important if we are to appreciate what our concerns are and what we might need as individuals and from our relationships. When we figure out what our emotions are telling us, we can then develop a plan of action toward taking care of ourselves more effectively. We can develop strategies to address our goals and concerns, and meet our wants and needs in a manner that does not create further difficulties for us.

Try to identify and label your emotions. Pay close attention to the feelings that underlie what you are experiencing. For example, you may be feeling numb, but masked underneath resides hurt and sadness. Or you may feel outwardly sad, but are also angry deep down. This may not be easy to do at first and takes practice.

Also, try to tune into what the concerns, unmet goals or needs are that come with these feelings and emotions. What do you need for yourself in your sadness or anger? Write about your feelings in a journal with a particular focus on what these feelings are telling you about what you might need for yourself or in your relationships with others.

Begin to plan and create strategies of how you can go about meeting your goals, wants, needs, or desires in a manner that is constructive for you and for those around you. You may require support from others to help you organize your thoughts and to develop plans to have your goals, wants, or needs met.

Seek out Professional Support: Consulting with your Physician and a Registered Clinical Psychologist

Consulting with a physician may also be an important first step to assess your current mental health status. Depression can be associated with many biological and medical causes that require medical interventions.

Seeking the professional support of a registered clinical psychologist may be important to help you address the negative thoughts and feelings you are having about yourself, or others. Learning how to address perfectionism, self-criticalness, and process your emotions and clarify wants, needs, and goals can be challenging. Contact a registered clinical psychologist if you find that dealing with your thoughts and feelings on your own has become unmanageable.

Read more additional posts from the ‘Depression’ series:

• Depression: How Your Thinking Can Lead to the ‘Blues’ (Part One)
• Depression: The Role of Unprocessed Feelings and Emotions (Part Two)
• Combatting Depression: Strategies for Your Relationships (Part Four)

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

by: Dr. Dino Zuccarini and Tatijana Busic

Do you find yourself struggling to cope with the intense feelings and emotions associated with depression?

In this second post of our four-part series about depression, we’ll provide you with a few of many psychological views of how unprocessed feelings and emotions might lead to depressed feelings. In the following post, we’ll provide you with various strategies you can use to deal with depression on your own, or in your relationships with others.

Feelings and Emotions Associated with Depression

Depression involves different types of difficult emotional experiences, including chronic negative feelings and emotions (e.g., fear, sadness, anger, worthlessness, guilt, shame, irritability, restlessness or lethargy, detachment and numbing). Depression is, of course, a broader mental health diagnosis that consists of many different features, as outlined in this series’ first post in which we addressed what is depression. Depression is different than normal grief in which we feel sadness for a prolonged period of time in the aftermath of the loss of a loved one (i.e., loss of a parent, child, sibling or friend).

Unprocessed Feelings and Emotions as Signals of Need in Depression

Our feelings and emotions provide us with important information about our self, others and the world around us. Depression is a signal to us—a calling for us to listen to our feelings, emotions, desires, and needs.

Some of us are unable to clearly identify, label or express our feelings and assert our needs. Being able to figure out our feelings, emotions, and needs is, however, critically important. It is important because our feelings and emotions guide us by providing us with a sense of what is significant to us in our environment both at home and work. Emotions signal to us that we have concerns, goals, and needs and that some type of action may be required by us to deal with these concerns, goals, and needs in our environment. When we do not attend to our feelings, emotions, and needs, we can create a world that feels false to us. We can become disconnected from what’s really important to us and in our relationships, which can result in hopelessness, anger, or detachment and withdrawn feelings.

In our relationships, it’s important to process our feelings, emotions, wants, and needs. Depressed individuals may have difficulties managing their emotions and figuring out what they need from others. If we can’t figure out our feelings, emotions, wants and needs, we won’t be able to approach our friends, family members, partners, or even employers with our concerns or needs. Some individuals become out of touch with how others can sometimes provide us with responses that can be valuable to us—-only if we actually know what it is that we need from others, feel entitled to ask for support, and risk expressing our vulnerabilities and needs to others (i.e., to listen to us, help us sort out our feelings, verbal reassurance or physical reassurance through a hug etc.) can we realize how others can be a source of contact-comfort, and soothing to assuage the distress in our everyday world.
When we can’t sort out our feelings, emotions, and needs, we can’t get in touch with ourselves and how others might be able to respond to us in ways that can make life better for us. Depression sets in as hopelessness grows—with depression, it becomes more and more difficult to reach for support and increasingly we withdraw, detach, or are irritable and angry, which pushes people further away from us.

Loss and Grief, Meaninglessness and Purposelessness

Life can be a symphony of losses. Many of us struggle to cope with unresolved losses that are accompanied by grief, and possibly a sense of meaninglessness and purposelessness. We can experience loss in many ways—loss of loved ones in our close relationships (i.e., death, separation), and the loss of self and identity as we transition through various life stages or as a result of unexpected changes to our mental or physical health.

We may experience the loss of a parent, partner, child or friend through death, separation or divorce—and experience normal grief. Some individuals will grieve these types of losses and eventually return to feeling better—albeit life is never the same with the loss of a loved one. Some individuals, however, will not recover as well. The loss may create a deep sense of loss and grief about the relationship with the loved one—this loss may also remind you of various other past losses in life in which your emotional needs were unmet—increasing a sense of loneliness, pain, guilt, shame, and isolation. When we have not appropriately grieved our losses, the pain and sadness of previous losses can accumulate and surface unexpectedly—prolonging your recovery time.

Loss of a loved one might also leave you with a shattered sense of your self, identity, and future—if so many of your life plans were associated with the lost loved one. Re-discovering who you are separate from your lost one can take time. Hopeless despair, sadness, and anger can also emerge when it is difficult to reconnect with others, and re-create a renewed sense of meaning and purpose after these types of losses.

We also experience loss and grief as a result of changes caused by normal lifespan changes (i.e., change in roles and identity), changes in our physical and mental abilities, and health status. When these changes occur, some individuals have to face loss related to unmet expectations and unachieved goals—the lost hopes of what we thought our lives would be. Changes in our life circumstances (i.e., children leaving home, loss of employment etc.), health status (i.e., mental and physical changes associated with illness or aging), alter our capacities and possibilities of functioning in ‘old’ ways. When we experience loss or a lot of change, we can lose our bearings and struggle to find meaning and purpose in life again. Over time, we can begin to feel hopeless about ourselves. You can lose a sense of vitality as you try to re-define what’s of importance to you in the aftermath of all of these changes.

How Psychotherapists at CFIR Can Help

Psychotherapists at CFIR can support you to deal with your emotions, including helping you to get to know your feelings and emotions, label them and figure out what they might mean to you. Some of us of have strong emotions that need to be dimmed somewhat but still understood. Sometimes strong emotional reactions come from unprocessed feelings, emotions and needs from our past relationships, and losses, or from losses in present-day life. Psychologists at CFIR provide cognitive-behaviors, existential-humanistic, emotionally-focused and psychodynamic therapy strategies to support you to deal with your emotions, understand what these important signals mean to you, and to help you to take action in the world that will promote self-growth and recovery from your losses.

In the next blog post of the series, we will be providing you with strategies on how to deal with your feelings of depression. We’ll be outlining strategies for ‘yourself’ and strategies for ‘your relationships’. Aside from seeking psychological services to help you with your symptoms, there are many things you can do to feel better on your own.

Read more additional posts from the ‘Depression’ series:

• Depression: How Your Thinking Can Lead to the ‘Blues’ (Part One)
• Combatting Depression: Strategies for Your Self (Part Three)
• Combatting Depression: Strategies for Your Relationships (Part Four)

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

by Dr. Dino Zuccarini and Tatijana Busic

Are you tired of struggling with low energy, negative thoughts, and feelings that seem to absorb so much of your day? You may be suffering from the debilitating symptoms of depression.

This is part one of four in our blog series about depression. These posts have been created to help you consider what might be at the root of your feelings of depression. In the first two blogs, we write about some common causes of depression; particularly, about how you’re thinking and how the way you deal with your emotions might be causing or contributing to your feelings of depression. Finally, in the last blog, we provide you with strategies you can use to deal with depression on your own, or in your relationships with others.

What is Depression?

Depression has many different symptoms. When we’re depressed, we experience symptoms, such as, chronic negative feelings and emotions (e.g., sadness, worthlessness, guilt, irritability, restlessness or lethargy), loss of interest or pleasure in previously enjoyed activities, difficulties with attention, concentration and decision-making, changes in appetite or weight, fatigue, bodily aches and pain. Individuals suffering from depression are also typically bombarded by a chorus of negative thoughts about themselves, others and the world around them. These negative thoughts and feelings may be at the root of your depression.

How Our Thinking Paves the Road to Depression

There are several biological and psychological causes of depression. Let’s review a few ideas about how your thinking can contribute to depressed feelings.

1.  Negative Views of Our Self and Others

Your depression may be linked to negative thoughts and feelings you are having about yourself, others or the world around you. These negative thoughts and feelings can emerge from difficult life experiences at any time in our life—from childhood onward to present-day challenges we are facing in our lives. These difficult life experiences can affect how we might think and feel about our self and others (i.e., thoughts and feelings of inadequacy, worthlessness, incompetence, a sense of being unlovable and insignificant). When you think and feel negatively toward yourself and others for a long period of time, you can become hopeless. You can begin to attribute negative situations and events in your life to negative thoughts you have about your self. A sense of hopelessness about our self further blocks us from being able to achieve our goals and get our needs met. You might also believe that others think and feel the same way about you, which further deepens the hopeless feelings.

As a result of childhood or present-day challenging life experiences, we may have also developed a negative view of others. Others may have been harsh, inaccessible or unsupportive to us during some difficult life moments—and now, it may seem to us that all others are unreliable, undependable and untrustworthy, or potentially harsh and judging. These views of others may diminish the likelihood that we’ll be able to connect with friends or family for support when we are facing challenges and need others the most.

When we hold a negative view of ourselves and others as a result of past or present-day life experiences, we can begin to feel hopeless and less capable of meeting our goals, concerns, and needs, and unable to reach out during times when we are in need of others support and care. These negative views of ‘self ‘and ‘other’ cascade into feelings of depression over time.

2.  Unrealistic Standards, Ideals and Expectations Fuel Perfectionism and Self-Criticism

We all have standards and ideals that create expectations that then guide our thinking, behaviours and emotional reactions toward others. From childhood onwards, the outside world through our parents, teachers, and employers place expectations and demands on us. We also develop our own expectations about our own and other people’s behaviour (i.e., how we and others ‘should,’ ‘ought to,’ or ‘must’ think, feel, and behave). Our expectations can sometimes be unrealistic and unachievable, which can create a great deal of pressure and stress in our lives. Unrealistic expectations of others may also create difficulties in our relationships with others. When we are too overly driven by our own and other’s unrealistic expectations, we can become hopeless trying to keep up with all of these demands. We can also lose touch with what we are really feeling, preferring, desiring, wanting or needing for ourselves.

Some individuals maintain unrelenting, rigid standards and ideals about how they or others should perform in the world. In these circumstances, some individuals may have unyielding and high expectations about their performances. They may strive for perfection in their endeavours, and be self-critical and harsh toward themselves when they do not meet these expectations. A self-critical internal voice may emerge that continuously judges or berates the individual (e.g., ‘you dummy’, ‘you’re lazy’, ‘you’re weak’, ‘you screw things up all the time’). Research affirms that self-criticism and perfectionism are often cornerstones of depression.

Perfectionism and self-criticalness may initially work together inside of you to ensure that you perform well. You may criticize yourself to improve your performance so that you will see your self or others will see you in a more positive manner. The more we drive ourselves in this manner, the more we wind up feeling overwhelmed and stressed. We start living an unbalanced life that can feel overwhelming and stressful. Over time, perfectionism and a self-critical voice can create a sense of guilt for not performing adequately, and hopelessness about our self (i.e., global, negative view of your own self as inadequate, not good enough, and worthless). Some individuals can also be critical and harsh toward others for failure to live up to their demands. This can create difficulties when you are engaged in either constant conflict with others or others decide to disconnect from you and you becoming increasingly isolated over time.
CFIR psychotherapists can support you to deal with your negative views of self and other, and the unrelenting self-criticism and perfectionism that might be at the root of your depression. We integrate cognitive-behavioral, mindfulness and acceptance and commitment, and psychodynamic-based approaches to help you deal with the thinking that might be contributing to your depressed feelings.

Read more additional posts from the ‘Depression’ series:

• Depression: The Role of Unprocessed Feelings and Emotions (Part Two)
• Combatting Depression: Strategies for Your Self (Part Three)
• Combatting Depression: Strategies for Your Relationships (Part Four)

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

by: Dr. Melissa Calhoun, C.Psych.

Are you tired of having a poor night’s sleep?

You’re not alone. People experience insomnia when they have persistent difficulty falling asleep or staying asleep through the night. We all have sleepless nights from time to time, especially when we’re under stress.

Chronic insomnia affects many people (about 10%) and often leads to daytime fatigue, decreased energy, problems with attention and memory, and irritability that can interfere with your home, work and social life. Chronic insomnia can also be a risk factor for depression, anxiety and substance use disorders. 

Psychological treatment for insomnia will involve helping you change the behaviours, thoughts and emotions that can get in the way of you having a good night’s sleep. 

One of the main ways to improve your sleep is to practice good sleep hygiene on a regular basis. Here are five tips for getting a good night’s sleep:

1. Keep a regular sleep-wake schedule – go to sleep and get up at about the same time every day, including weekends. The time you wake up resets your biological clock for the day.
2. Avoid taking daytime naps because they can disrupt your nighttime sleep.
3. Set aside some time every evening as your “problem solving” or “worry time.” Use this time to reflect on your day and problem solve. When the “worry time” is up, remind yourself that you can continue to address your problems the next day. Sleep time is not worry time! Bringing your stressors with you to bed gets in the way of becoming relaxed – a necessary part of falling asleep.
4. Limit the bedroom to sleep and sexual activities – do not read, watch TV or use your electronic devices in bed.
5. Turn the clock away from you so that you cannot see it. “Clock watching” simply reminds you that you are not sleeping; this awareness can increase your anxiety about the effects of not sleeping (e.g., fatigue the next day) and decrease the likelihood that you will fall back asleep. No peeking! 

Insomnia is a common condition, yet few people seek professional help to manage symptoms. Research has shown that psychological treatment for insomnia is highly effective and has longer lasting positive outcomes than medication treatment alone.

Psychologists at CFIR can support you to address your insomnia symptoms and to get you back to having ‘sleepful’ nights! 

For more information about sleep and insomnia, check out the ‘Psychology Works’ Fact Sheet: Insomnia.

Read more about our Neuropsychology, Rehabilitation & Health Psychology Treatment Service.