As we enter the New Year, we are suddenly bombarded with advertisements pushing weight loss products and filling our minds with the idea that, in order to be our “best selves” this year, we must follow some new diet and exercise regimen. For many individuals—especially those struggling with eating disorders (ED)—this time of the year can make us particularly vulnerable to feelings of guilt and shame as we are faced with increased pressure to “undo” the indulgences of the holidays.

For individuals struggling with an ED, food-related guilt and body image shame is often dealt with through self-punishing behaviours; for example, following an overly restrictive diet and excessively exercising. On the other hand, some individuals cope with body image shame by hiding under baggy clothes in an effort to avoid painful feelings of guilt and shame. However, in my practice as a therapist, I’ve found that such self-punishing and avoidance behaviours are unsustainable and ultimately perpetuate the cycle of guilt and shame.

Instead, consider these three more sustainable tips for coping with post-holiday food guilt and body image shame, none of which involve dieting or pursuing weight loss:

1.   Don’t criticize yourself: Practice self-compassion and Radical Acceptance

Instead of beating yourself up, or running away from feelings of shame (literally or figuratively), try working towards greater self-compassion. Be gentle with yourself and be reminded that shame is a fleeting feeling, not an identity; just because you are feeling bad, does not mean you are bad. Another self-compassionate approach to dealing with shame is practicing Radical Acceptance, a skill used in Dialectical Behavioural Therapy (Dimeff & Linehan, 2001). Rather than ignoring, avoiding, or wishing the situation were different, accept things exactly as they are, including the painful emotions of shame and guilt. Radical Acceptance can help you regulate feelings such as anger, guilt, and shame by approaching them with kindness and self-understanding rather than self-judgment.

2.   Ask Yourself: Whose Shame is it Really?

When working with clients who struggle with body image shame, I often ask them to reflect on who their shame really belongs to. This question is meant to facilitate differentiation, the process of recognizing the extent to which one’s body image shame has been taken on as a result of someone else’s shame. This can help you detach from and “disown” feelings of shame by identifying that perhaps your shame does not belong solely to you. Differentiation can protect you from internalizing—and thus negatively reacting to—body shame-inducing comments made by others.

3.   Swap your “Clean Eating” Plan for a Social Media Cleanse

Research shows that exposure to media promoting the “thin ideal” or “athletic/muscular ideal” increases body image dissatisfaction and can also lead to negative emotions, depression, and disordered eating (Huang et al., 2021). We now have the ability to control what shows up on our timelines, so consider unfollowing any accounts that promote diet culture and start following body-positive or body-neutral content online. Doing so will ensure such shame-inducing content no longer appears on your feed or negatively impacts your well-being this year.

Loreana La Civita (B.A.Hons) is a Registered Psychotherapist (Qualifying) at the Centre for Interpersonal Relationships (CFIR) working under the clinical supervision of Dr. Jean Kim (C.Psych). Loreana provides psychological services to adolescents and adults and has a special interest in treating individuals with eating disorders (e.g., Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, ARFID), body image concerns, neurodiversity (e.g., ADHD, ASD, OCD) and trauma. She integrates emotion-focused therapy (EFT), cognitive-behavioural therapy (CBT), and dialectical-behavioural therapy (DBT) informed techniques to support individuals struggling with concerns regarding eating, weight, and body image.  

SOURCES

Dimeff, L., & Linehan, M. M. (2001). Dialectical behavior therapy in a nutshell. The California Psychologist, 34(3), 10-13.

Huang, Q., Peng, W., & Ahn, S. (2021). When media become the mirror: A meta-analysis on media and body image. Media Psychology, 24(4), 437-489.

Blog 2:  Emotional Signaling, Responding And Repairing Ruptures:  Key Interactions in Building Greater Connection

In this 2nd blog in my 3 part series on Emotional Communication, I will be describing 3 of 6 steps that you might want to consider to ensure that your emotions and needs are being clearly communicated and that you are prepared to respond to the other’s expressions.  Emotions signal that you need something.  Learning how to signal in an efficient and effective manner increases the likelihood that your partner can understand your distress and what you are needing from him/her.  Learning how to attend, and attune to your partner’s emotional experience ensures you are accessible to him/her and prepared to be available to respond to whatever need emerges. This allows for co-regulation of your distress to occur— a reduction of distress as a result of the attention and responsiveness to the other.

STEP 1: Expressing Partner—Expression of a Feeling/Emotion: Stay in a reflective place (e.g.., thinking about your feelings and emotions as opposed to reactively, intensely, and loudly expressing whatever thought and feeling you are having); otherwise, your partner will not be able to pay attention to you as loud and intense emotions can be disorganizing for the listener. When expressing your feelings and emotions, speak from the “I” position, and refrain from language that is judgemental, and blaming.  Starting with “You” may incite defensiveness.  Reflect on the emotions you are aware of, label the emotion and link it to the incident or context (e.g., “I feel angry/sad/scared/hurt/shame/guilt/excited/

joyful/proud about ….the situation in which…”).  Remember to only talk about one feeling/emotion at a time, and start your sentences with words like “From my perspective, or my experience”.  Here’s some examples:  “I feel angry about our discussion we had last night and would like to talk about my feelings”, or “I am sad about your working too much and I would like to talk to you about this”. 

Also, try not to speak in concrete ways about your partner or the circumstances and make sure you communicate that your emotions are coming from your experience and perspective. Using words like “it seemed to me” allows your partner to understand how you have experienced him/her (e.g., “you seemed/seem to be ignoring me” as opposed to “you were/are ignoring me”) and allows you to remain open and curious to the possibility that your partner had different intentions, beliefs, thoughts or feelings than you had originally considered.  Also, stating openly that you are sharing from “your perspective” or “from your own experience of the situation” allows for open dialogue and mutual understanding of each partner’s feelings and emotions about situations (e.g., “from my perspective, it seemed like you were ignoring me”).

STEP 2: Responding Partner—-Acknowledgment and Interest in Understanding What the Feelings/Emotions May be About: When responding, it’s important to acknowledge what your partner is feeling and demonstrate an interest in his/her experience.  Listen carefully, and fully to what your partner is expressing and make sure not to interrupt until they are finished.  Stay curious, calm, present and open to understanding what the emotional distress is about. Monitor your body language (i.e., do not lean away, but toward). Make eye contact, if possible. Try to empathize with your partner’s feelings (i.e., imagine what they are going through and how this is distressing for him/her).  Your partner’s emotional distress is a signal that they are in need of something—try to listen for what they might be needing from you to help them along with this distress.

Responding lowers your partner’s emotional arousal and intensity.  It reduces their emotional isolation as you join them in his/her experience. Acknowledgement and interest in your partner’s feelings and emotions can allow your partner to feel more at ease.  Being seen, and understood is very soothing and connecting. Before acknowledging your partner’s emotions or asking questions, ask whether he/she have completed sharing with you (i.e., “Is there anything more you want to share? Or “Is now the time that I might say something?”).  You can acknowledge feelings/emotions by simply reflecting back something like “I can see that you are (e.g., sad/angry/scared/)….I sense that you are (sad/angry/scared/upset etc…)”. You can demonstrate your interest by asking “What’s making you sad/angry/scared/nervous…help me understand what’s going on for you now…or tell me more so I understand how you are (sad/angry/hurt/frightened/stressed) right now”. Reflecting back the feeling and what is it about provides your partner with a sense of presence that further reduces distress.

Step 3:  Repair Ruptures in Emotional Communication—-Checking in with each other about whether your efforts to express your feeling and emotions and your responses to the other are being understood:  Trying to express and respond to someone’s emotions with your words can create misunderstandings.  Human communication can be filled with assumptions, and misinterpretations.  We might use inappropriate language in expressing ourselves or use words unintentionally that are not capturing what we are trying to express.  We may also in listening not have heard something or misinterpreted what our partners was trying to communicate.  

Repair requires lower emotional arousal and intensity. Do not react strongly to these miscommunications, and instead, you and your partner have to initiate a repair process. If you become too emotionally reactive due to miscommunications, your capacity to reflect and think about your experience and empathize with the other will be greatly diminished.  Take a breath, relax, and try once again to work clarify what you were trying to convey to the other.  An expressing partner may say to a responding partner, “You got part of it, the part about A, but I don’t feel as though you’ve gotten this part about B. I’ll try again to express me to you and find words that might help you better understand me if I can.”  This step requires patience to ensure clarifications and corrections are made so understanding is achieved. If you are struggling to express yourself or understand, you might both want to express your intentions and willingness to try to understand (e.g., “Maybe I’m saying too much here and it’s hard“, “I really want to make sure I see you here”, or “I’m willing to keep at this until you get the sense I’m getting you here”). 

In my next blog, Figuring Out Needs and Responsiveness to Needs:  What Ultimately Brings Our Distress to An End, I’ll be looking at the importance of identifying the needs that are at the root of your distress.  I’ll be providing the last 3 steps of 6 steps in emotional communication. Learning how to zero in on what you’re feeling and what you’re needing, and being able to clearly figure out what you need and then communicating this to the other person.

Dr. Dino Zuccarini, C.Psych. is CEO and co-founder of the CFIR. He has published book chapters and peer-reviewed journal articles on the subject of attachment, attachment injuries in couples, and attachment and sexuality. He has taught courses at the University of Ottawa in Interpersonal Relationships, Family Psychology, and Human Sexual Behaviour. He has a thriving clinical practice in which he treats individuals suffering from complex attachment-related trauma, difficult family of origin issues that have affected self and relationship development, depression and anxiety, personality disorders, sex and sexuality-related issues, and couple relationships. At CFIR, he also supports the professional development of counsellors, psychotherapists, and supervised practice psychologists by providing clinical supervision.

Blog 3:  Figuring Out Needs, Responsiveness to Needs: What Ultimately Brings Our Distress to an End

In this 3^rd blog in this 3-part series of blogs on emotional communication, I’ll be sharing with you information about the importance of delineating the needs that are at the root of your emotional distress and how responsiveness to these needs is core to bring about change to the feelings and emotions you are experiencing.  After you have expressed, or responded to your partner’s feelings and emotions, and you’ve repaired any ruptures, it’s very important to make that next leap to understand the needs that gave rise to the emotions.  The concerns, goals and needs underlying your emotions have to be stated clearly, directly and be realistic (e.g.., doable by the other).  

Step 4: Expressing Partner- Expression of Concerns, Goals and Needs: Upon completion of the acknowledgement and understanding phase and any repairs in communication, there has to be some type of dialogue related to the needs that underlie the emotions.  Figuring out our needs can be difficult and not within our awareness immediately.  Try to figure out what you need to reduce the distress and from your partner or for your self to shift your feelings (e.g…, “I really need to just go out for a walk and take a break”…or “I need to be alone momentarily”…or “I need for you to just listen to what’s been going on”, or “tell me everything is going to be okay”).  Do you need to just share your feelings? Have someone listen and validate you? Do you need reassurances? 

Make the need concrete, doable and realistic.  If you say something like “I need for you to love me” or I need for you to care more”—this might be too vague without clear examples of behaviours, or actions or words that you might require.  Be specific (e.g. “I need more affection” or “I need more support from you around the home and with the children, such as making sure you are present at dinner to help me cook and feed our child”.  Your partner will not be able to meet all of your needs.  Partners can meet many needs, but sometimes maybe only partially, and so be prepared to negotiate and compromise.

Step 5: Responding Partner- Responsiveness to Needs: Be prepared to respond to the expressed need as described by your partner, after ensuring you understand what is needed in concrete, clear terms. Do not provide any responses until you are clear about what your partner needs from you (e.g., “what I am understanding is that you need me to be more present and helpful by ….”).  Needs for emotional connection, contact, support, affection and sexuality have to be taken seriously as an emotional connection, care, affection and sexuality are cornerstones for the relationship. 

Make sure you clearly let your partner know that you plan to take steps to address these needs.  If you are unable to meet the needs, it’s important that you be prepared to let them know what is possible, and try to compromise and negotiate what’s possible.  

Step 6:  Both Partners -Clarifications and the Understanding the Responding Partner’s Emotions and Needs: It’s important that the responding partner’s feelings and needs are also shared about any situation that has caused distress.   Turn-taking is important.  Your partner might have their own feelings and needs related to what you are expressing.  The responding partner can then take his or her turn in becoming the expressing partner related to any situation or incident that was difficult for him or her (e.g., “I would like to share my feelings about the affection in our relationship and what I am needing here”).  Clarifying the responding partners feelings and needs related to the topic will help in the process of trying to figure out what they are able to offer as a response and can be used in trying to negotiate and find a compromise between both partners. 

Dr. Dino Zuccarini, C.Psych. is CEO and co-founder of the CFIR. He has published book chapters and peer-reviewed journal articles on the subject of attachment, attachment injuries in couples, and attachment and sexuality. He has taught courses at the University of Ottawa in Interpersonal Relationships, Family Psychology, and Human Sexual Behaviour. He has a thriving clinical practice in which he treats individuals suffering from complex attachment-related trauma, difficult family of origin issues that have affected self and relationship development, depression and anxiety, personality disorders, sex and sexuality-related issues, and couple relationships. At CFIR, he also supports the professional development of counsellors, psychotherapists, and supervised practice psychologists by providing clinical supervision.

Blog 1:  Setting The Conditions for Emotional Communication

Welcome to my series of blogs about emotional communication.  In this 3 part series, I will be outlining basic emotional communication steps that you can use in your most intimate friendships and love relationships to help learn how to express your feelings, emotions and needs and respond to the others’ emotions. Attachment bonds are emotional bonds— your capacity to be able to both express your emotions in a modulated, non-threatening way, and to be responsive to these emotional signals in others plays an important role in creating emotional closeness and connection.  We are not designed to be left alone and isolated with difficult emotional experiences without reaching for a loving other. In these blogs, you’ll be provided with some simple steps to consider.  You’re on your way to greater emotional intimacy!  

In my first blog, I’ll be sharing with you various items to consider in setting up the conditions for emotional communication.  Emotional communication and intimacy takes time, patience, and your full attention and presence to your self.  Paying attention to these conditions might support you in your effort to provide your full attention and presence.

The conditions presented here are to help you set up the appropriate space to have emotionally laden dialogues.  We are most effective in being able to experience, reflect upon, and make sense of our own feelings and empathize and hold a compassionate space for others when our nervous systems are in a calmer and more restful state.  If we are overly stressed and distressed, and in a sympathetic nervous system response, also known as a ‘fight and flight response’, or in a dorsal polyvagal nervous system response, which involves a ‘shutting down’, we are unable to truly connect to our self and others and are  most likely to be defensive or self-protective.  We are more likely to block engagement, escalate conflicts, and only see our perspective, or disengage altogether.

To improve the possibility of not activating a ‘flight and fight’ or ‘shut down’ response during your dialogue, I suggest you consider establishing the following 4 conditions for your dialogues:   Dr. Dino Zuccarini, C.Psych. is CEO and co-founder of the CFIR. He has published book chapters and peer-reviewed journal articles on the subject of attachment, attachment injuries in couples, and attachment and sexuality. He has taught courses at the University of Ottawa in Interpersonal Relationships, Family Psychology, and Human Sexual Behaviour. He has a thriving clinical practice in which he treats individuals suffering from complex attachment-related trauma, difficult family of origin issues that have affected self and relationship development, depression and anxiety, personality disorders, sex and sexuality-related issues, and couple relationships. At CFIR, he also supports the professional development of counsellors, psychotherapists, and supervised practice psychologists by providing clinical supervision.

1. Pick an appropriate time and place for both of you to discuss your feelings, emotions and needs about any topic or incident. Make sure you and your partner are not distracted when having emotionally-laden discussions.  Do not have these types of discussions while doing any other tasks, such as driving, the laundry, cooking or watching TV–. You will need sufficient time to process. If you are in the midst of a discussion and cannot complete it, make sure to both commit to another time to complete the discussion.  Also, try to have these dialogues at a time and  place in your home that you both agree too—setting a regular time or processing space will ensure that these discussions are contained by a regular time and space in your home. 
2. Ensure that you are not overly emotionally aroused, tense or stressed or shutting down before, during and after the dialogue. Over arousal increases defensive responding, and blocks your ability to figure out and attend to your own and partner’s feelings and needs. If either of you are feeling too emotionally aroused or stressed, or shutting down, it is important that you engage in breathing, relaxation exercises, and possibly taking a break from your dialogue until you are both able to be more present to your self and the other. Monitor your body prior to and during the conversation to ensure that you are breathing rhythmically and are sufficiently relaxed (e.g, body scan to ensure that you are not holding tension throughout your body). Intimate emotional communication requires that you are both present and attentive, and calm and relaxed.  This contributes to the experience of connectedness and safety.
3. Deal with only one or two feelings, emotions or needs at any one time. Do not bring up other feelings, emotions from past incidents during your dialogue. Discuss one situation and/or event as processing multiple events and feelings intensifies emotional arousal and disrupts processing as a result of overarousal. Partners can quite quickly become flooded by negative emotions if too many past incidents are raised during one discussion. 
4. Recognize that at any one time you and the other may have different experiences of events and situations. You are a separate psychological being in body and mind from the other. Remembering that you might experience situations or understand them differently is important in helping you maintain an openness and curiosity to the other’s self.   Be prepared to be patient to give your partner the necessary time to FULLY describe his/her experience. Start as many statements as you can with words such as “In my experience” or “From my perspective”. These statements will help each of you to recognize that your experience of an incident is uniquely your own, and acknowledges the reality of how you may have different thoughts, feelings, emotions, preferences, desires and needs at any time and in any situation. Feeling seen and heard in regards to your unique experience by the other will lessen distressing emotional arousal.  

In this blog, I provided you with some ideas about creating conditions for your emotionally-laden dialogue to ensure that overarousal doesn’t result in escalations of conflict or shut downs and withdrawals.  In my 2^nd and 3^rd blogs, I will set out steps to help you in your emotional communication with others through 6 steps. I will be providing practical advice on how to emotionally cue and respond to your partner as they are expressing their emotions and needs.  These steps will allow for more efficient and effective emotional communication

Dr. Dino Zuccarini, C.Psych. is CEO and co-founder of the CFIR. He has published book chapters and peer-reviewed journal articles on the subject of attachment, attachment injuries in couples, and attachment and sexuality. He has taught courses at the University of Ottawa in Interpersonal Relationships, Family Psychology, and Human Sexual Behaviour. He has a thriving clinical practice in which he treats individuals suffering from complex attachment-related trauma, difficult family of origin issues that have affected self and relationship development, depression and anxiety, personality disorders, sex and sexuality-related issues, and couple relationships. At CFIR, he also supports the professional development of counsellors, psychotherapists, and supervised practice psychologists by providing clinical supervision.

For many in the BIPOC community, finding the right fit with a therapist can be a difficult and arduous endeavor. There are a myriad of experiences that racialized people face and endure that may be unbeknownst to a therapist outside of their community. So often, many BIPOC-identified people struggle with being seen, heard and validated in society, so it is essential that when they do seek mental health services, that they are paired with a therapist who can support them in a safe-space where their lived racialized experiences are taken into account during treatment.  

Here are two questions to assist in your search for a therapist: 

1)   Do you operate within an Anti-Oppressive framework?

By asking a therapist if they have received additional training in an anti-oppressive framework  is important in serving some of the needs for BIPOC-identified clients that differ from other populations served.  A therapist who incorporates an anti-oppressive framework is educated on the racial and oppressive inequities that can pre-dispose a client to experiencing mental health difficulties. 

2)   What professional development have you done to work with the BIPOC community?

While it is okay to ask a therapist for their educational and professional experience in general, it is important to obtain a sense of how a therapist works with people from different cultures and/or marginalized people. For many BIPOC-identified clients, it is important that their therapist demonstrate an openness and inclusive approach to working with clients of diversity. Obtaining clarity on how a therapist works with the BIPOC community can directly inform your selection of therapist in this respect. For the BIPOC community, seeking therapy may be difficult in general; however, knowing that your therapist has received further education in working with diverse populations with an anti-oppressive approach may create less of a barrier to seeking and engaging in therapy.

Teisha Gunness, PsyD. is a therapist at the Centre for Interpersonal Relationships (CFIR) in Ottawa. Ms. Gunness provides psychological services to individuals and couples using an integrative approach by using therapeutic techniques comprising of Adlerian Psychology, Cognitive-Behavioural Therapy (CBT), Attachment informed therapies, Multicultural Therapy, Feminist Therapy and Emotionally Focused Therapy (EFT) for couples. She has received additional training in Anti-Oppressive Psychotherapy™, Emotionally Focused Individual Therapy (EFIT Level 1 and 2), Relational Life Therapy (RLT Level 1) and is an EMDR certified practitioner. Please note that she is not currently accepting referrals for EMDR therapy  

Self-awareness is one of those topics in which Western and Eastern teachings meet. It is a concept that has gained a lot of attention although there are still variations in the names used to refer to it, the concept of it and the applications of this term in different contexts. 

Since the 1970’s there had been efforts to define self-awareness including the idea that this is about individuals’ ability to focus on the self and/or focus on others or the external world. Self-focus could involve the attention in the present moment to emotions, thoughts and thinking, behaviors and physical sensations. Others had referred to it as the “observing self”. Although there are different factors that can affect people’s ability to develop or maintain self-awareness, individuals can still learn to become more self-aware. In daily life, self-awareness could support self-regulation in the interaction with others and could contribute to self-reliance and the ability to sooth and calm oneself when triggered by events or people, the possibility to shift states. It can also help in identifying what is happening internally, recognizing and naming the emotions, accepting them, understanding how the body carries the emotion making it real. The development of self-awareness skills could be supported by mindfulness exercises including breathing, body scans, mindful walks, mindful eating and by openness and curiosity to enquire about individuals’ experiences to make sense of what is happening internally. 

In therapy, the self-awareness of the client and the therapist are critical for an effective therapeutic process. In this context, being self-aware could facilitate clients in a deeper exploration of their internal experiences, gaining more insight about reactions, beliefs and patterns. Self-awareness has been also considered a key attribute of therapists. In this context, self-awareness has been referred as the knowledge and insight that therapists have of themselves, of their own issues, their strengthens and weakness as well as their biases. Self-awareness can be developed and it is a skill that can facilitate both the therapeutic alliance and therapeutic outcomes.

Although there have been efforts to define its attributes, self-awareness can be experienced differently since it is a very personal way to relate to oneself, to others and to the world. Self-awareness would be hardly a state individuals reached and preserve for long. It could be more an instant, a moment of mindful attention involving body, mind and emotions, here and now, that can be expanded with practice. The presence in the present moment gives a unique quality to the way life can be experienced. It could provide a sense of control because it is not about the past or the future; it is only about here and now. It could help individuals anchor themselves in a place in which they could challenge beliefs and re-write life narratives. It may help in breaking patterns developed in the past as a way to cope with distress, even if it is for just a moment. It is a skill or ability that could open opportunities to continue to know one self in a process of self-actualization.

Myriam Hernandez is a Registered Psychotherapist at the Centre for Interpersonal Relationships (CFIR). Myriam provides services to individual adults, couples, LGBTQ2 experiencing a wide range of difficulties related to mood and anxiety disorders, trauma, interpersonal relationships, grieve, identity, gender, sex and sexuality, existential and meaning making issues. She works from a humanistic approach and integrates therapeutic techniques from Psychodynamic, Attachment, Object Relations, Emotion-Focused, Mindfulness, Cognitive-Behavioral and Parts theories. Myriam began her meditation practice since her teen-age years. She works with her clients in developing self-awareness skills to support the therapeutic process and outcomes. 

Winters are a hard time for so many of us – we can get stuck in routines, retreat more within the comfort of our homes, and perhaps most challenging, we find ourselves reflecting on ourselves and our relative contexts. In fact, this particular time of year is synonymous with seasonal affective disorder (SAD), an experience that is so common it has become a (uninvited) household name and guest. 

Mental health challenges tend to be more acutely challenging this time of year, as it becomes more difficult for us to maintain self-care routines, try to get adequate sleep, and feel well balanced – we tend to slip back into old habits, enter into more relational struggles with our loved ones, and generally feel less satisfied and resilient. Small stresses can take us down, and we find ourselves stuck with distressing thoughts, and uncomfortable emotions. What if it didn’t have to be that way?

Cognitive-Behavioural Therapy (CBT) is an evidence-based and often gold-standard approach anchored to client needs to address the unhelpful thinking and behavioural patterns that underly the challenging emotions that hold us back. 

How does it work? 

Work with a cognitive-behavioural therapist involves developing a treatment plan that is tailored to address a number of client goals. It is a short-term treatment that generally lasts between 8-24 sessions. CBT focuses on finding solutions, providing strategies and techniques to improve coping and reduce distress, designed to help clients challenge difficult thoughts and beliefs, and change problematic behaviours. A number of specific interventions have been developed stemming from a cognitive-behavioural perspective: Dialectical Behavioural Therapy (DBT), Exposure and Response Prevention (ERP), Mindfulness-Based Cognitive Therapy (MBCT), and Acceptance and Commitment Therapy (ACT). 

The CBT Clinic

On January 16^th, 2023, the Centre for Interpersonal Relationships (CFIR) opened its doors to The CBT Clinic. CFIR is poised to provide cognitive-behavioural therapy in a client-centered fashion, tailored to your specific needs. The CBT Clinic includes a large number of empathic and caring mental health professionals that can see clients virtually, and in-person at our sites in Ottawa and Toronto. 

Dr. Marc Bedard, C.Psych. is a psychologist and neuropsychologist at the Centre for Interpersonal Relationships (CFIR). Dr. Bedard provides psychological services to individual adults experiencing a wide range of psychological and relationship difficulties related to mood and anxiety disorders, trauma, eating disorders, sleep disruptions, and interpersonal betrayal. He works from a client-centered approach and integrates therapeutic techniques from object relations, ego, and self-psychology psychotherapies, emotion-focused therapy (EFT), and cognitive-behavioral therapy (CBT). He also provides neuropsychological assessment services to individuals with acquired brain injury, post-concussive difficulties, and to diagnose issues related to neurodivergence (e.g., Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder). Dr. Bedard is the Director of the Cognitive Behavioural Therapy Clinic (CBT-C) at CFIR. 

Key Points:

1. Tangible Goals System
2. Internal Motivation
3. Self-Compassion

Have you ever set a New Year’s resolution filled with determination and ambition, followed by a shattering crash? I have! 

Setting a resolution is a big deal and can surely contribute to our sense of ambition and fulfillment. However, we tend to set goals that are completely doomed for failure. Read more for tangible tips to help your resolutions actually stick.

Tangible Goals System

Think of a goal you want in your life. Now, take that goal and break it into smaller goals (the more the merrier!). It is crucial to differentiate between what is and what is NOT in your control. These simple but mighty tips help our goals to become realistic, attainable, and practical. The more specific and distinct your system is, the greater the probability of following through with your goals. 

Internal Motivation

Consistent momentum’s best friend is internal or intrinsic motivation. Odds are, when we’re preoccupied on what the world thinks we “should” be doing, our motivation comes in spurts. Meaning, we are likely to experience that crash. If your motivation is coming from a place inside of you, it’s intrinsic and its lasting. Learning how to access that place inside of us can be easier said than done. Psychotherapy can be a great tool to help us strengthen our sense of self, improve our identity resilience, and learn how to differentiate between internal and external motivators. CFIR professionals are here to help you do just that, and more.

Self-Compassion

Don’t let a lapse turn into a relapse. Allow the setbacks to happen and then get back on track. Prioritizing self-compassion leaves us with the realistic wiggle room we need when it comes to attaining a goal. It can also help us to manage our expectations, eagerness, and feelings of guilt. Self-compassion is not based on positive judgements or evaluations, it is a way of relating to ourselves. The motivational power of self-compassion is the difference between working hard to grow and to learn vs. needing to impress ourselves and/or the world.

Natasha Vujovic, RP (Q). is a Registered Psychotherapist (Qualifying) at CFIR. She works with individuals and couples experiencing a wide range of psychological and relational difficulties including anxiety and stress, depression, mood and grief, relational conflict, trauma, life transitions, personality, body-image, marital and pre-marital, internal conflicts, family dynamics and self-esteem. Natasha is an integrative therapist pulling from psychodynamic/analytic theories and takes a collaborative and honest approach to session.

By: Katherine Van Meyl, M.A.

“We keep having the same fight over and over again.” 

“I feel so angry when he doesn’t listen to me, I feel out of control!” 

“Sometimes when we are talking, I just zone out and think of other things.”

“When I feel this way, I actually hate her, which is crazy, because I love her!”

I’ve noticed that people attend relationship therapy when they feel “stuck,” and are having the “same fight” repeatedly with their partner(s), leaving them feeling angry, resentful, hopeless, sad, and alone. I have seen people experience this regardless of their relationship structure (monogamous, non-monogamous, kinky), gender identity, and/or sexual orientation. You’re not alone! This is more common than you might realize.

Usually, something real is happening in the moment. For example, you might feel rejected and/or angry because your partner “cut you off” during a conversation. When you try to address this with your partner, your partner becomes defensive (“that wasn’t my intent!”), which further angers you. As a result of this experience, maybe you feel the need to “escape,” shut down, or get so angry you threaten to end the relationship. The depth of your emotions, how much you feel whatever you’re feeling, is often an indication that something deeper is going on. 

This is the work of therapy, figuring out all the textures and layers of what is happening “beneath the surface” in our relationships and learning to differentiate our past experiences from our present.

If you and/or your partner(s) identify with some of what is written here, you may benefit from Developmental Couple Therapy for Complex Trauma (DCTCT). This treatment was developed by Dr. Heather MacIntosh, C. Psych., to help couples cope with the long-term impacts of childhood trauma, including emotional, physical, and sexual trauma. Many clinicians at CFIR-CPRI have been trained in this approach.

The goal of DCTCT is to help couples learn how to tolerate, understand, and manage their own and their partner’s emotions, how to understand each other’s perspectives, and how to be present and engaged to meet one another’s emotional and attachment needs. 

The treatment involves four stages. In Stage One, the focus is on establishing a relationship with your therapist and understanding how trauma impacts relationships, attachment styles, sexuality, and shame. In Stage Two, the focus is on skill building, particularly mentalizing capacities and emotion regulation capacities. In Stage Three, the therapy moves towards understanding how you and your partner may be re-creating certain traumatic “scenes” from childhood (the vignettes above likely have elements that can be traced back to early childhood experiences). Without the ability to mentalize and regulate our emotions, stage three would be too triggering for couples. Finally, in Stage Four, learning is consolidated and treatment ends. I will expand more on this in a future blog post! Keep an eye out for it in early 2023.

As with most treatment models that have “stages,” people in relationships weave in and out of these stages at different times throughout treatment. That’s normal! This treatment model is a guide, but every relationship is different and therefore, may need more time in certain stages than others.

If you and/or your partner(s) are interested in learning more about trauma, how it impacts our relationships and how it can be treated, please get in touch. 

With guidance, it’s possible to start shifting these patterns in our relationships.

Katherine Van Meyl, M.A., is a trauma-focused psychodynamic therapist at the Centre for Interpersonal Relationships. Katherine works with individuals, couples and families with a specific focus on relational distress, trauma and PTSD. Katherine is supervised by Dr. Dino Zuccarini, C. Psych., for adults & couples and Dr. Lila Hakim, R.P., C. Psych., for families. 

By: Dr. Sara Antunes-Alves, C.Psych.

Human beings are hardwired for connection. Unlike other mammals, we rely absolutely on our attachment figures for survival, for an extended period of time, from birth. Without secure connection, our health is at risk. 

When we experience trauma, the wiring for connection is disrupted and we develop adaptations in order to feel safe. It is important to note here that trauma needn’t necessarily be a “Big T” trauma, which include disturbing experiences that happened to you, such as sexual abuse, loss of a loved one, and violent crimes, but also “little t” traumas, especially ones that repeat throughout our development. “Little t” traumas are ones that cause us distress and uncertainty and can also include experiences that didn’t happen to you but should have. A lack of emotional availability from an attachment figure – even if they had the best of intentions – can be traumatic. 

Our attachment style refers to the behaviours we engage in to feel safe with others. Attachment exists on a spectrum, and we may be a mix of different attachment styles, and with different people. Disruptions in attachment tend to originate from our early developmental years, within our families, but can also be affected by harmful experiences later on, such as with a painful romantic relationship or being bullied in school.

There are four attachment styles, and they are briefly described below:

Secure Attachment:This is the “ideal” attachment leaning, manifesting as a healthy level of interdependence with another and comfort expressing emotions openly; relationships are a place of thriving, but being alone is also not necessarily a distressing place. You feel comfortable relying on another for support and having them rely on you.Avoidance and anxiety are low.

There are three forms of insecure attachment:

Dismissive-Avoidant:This attachment leaning manifests as (emotional) distance from others, valuing a high level of self-sufficiency and independence; closeness feels threatening and efforts to push another away can be prevalent; emotions are generally suppressed and denied. You feel triggered by closeness and intimacy. Avoidance is high and anxiety is low. 

Anxious/Preoccupied:This attachment leaning is characterized by high needs for intimacy and a fear of abandonment and rejection. These are managed by high attunement to another’s emotions and pronounced efforts to meet the other’s needs, often at the expense of their own. Eventually, protest behaviours to feel reassured may occur. You feel triggered by distance and uncertainty. Avoidance is low and anxiety is high. 

Fearful-Avoidant/Disorganized:This attachment leaning manifests in a push-pull dynamic. The individual desires connection with another and simultaneously fears it, leading to inconsistent and ambiguous behaviours in social bonds. Emotions are not regulated well and a sense of shame is prevalent; both closeness and distance can feel triggering. Here, anxiety and avoidance are both high.

The above insecure attachment styles represent clever adjustments as a result of important developmental needs not being met. They reflect humanity’s impressive propensity for survival through adaptation. However, at some point, you may find that these adaptations are no longer useful to you and may in fact be causing you or your relationships harm. 

The good news is, attachment styles are not fixed; they can change. 

If you find yourself identifying with an insecure attachment style, there is hope. It is not a life sentence. With greater awareness of your attachment style with another, what makes you feel threatened and how you find safety, you can learn to pause and choose to respond in more adaptive and secure ways. It is an effortful and sometimes lengthy process of re-learning, but it is never too late to choose. 

Dr. Sara Antunes-Alves, C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). Sara provides therapy to individuals experiencing a range of psychological difficulties, and especially enjoys helping others understand their relationship to self and others, and how attachment (trauma), especially in formative years of development, affects adults in their current functioning. Her approach to therapy begins with building self-awareness, which she believes is necessary for meaningful change. Sara makes efforts to highlight the importance of having a more integrated perspective of one’s functioning, including one’s intellectual, emotional, and physiological states of being. She incorporates interpersonal and psychodynamic psychotherapies, emotion-focused therapy (EFT), and cognitive-behavioural therapy (CBT) to help clients achieve their therapeutic goals.