Natalie Guenette, M.A., R.P.

What does it mean to be in a healthy relationship? Many elements are important in a relationship, such as open communication and reciprocity. The Ontario Psychological Association suggests that “when our relationships are strong, we’re more resilient in the face of stress and hardship. But when our relationships are fraught, we are more likely to experience anxiety, depression and maladaptive coping behaviours” (The psychology of relationships: Connections for better well-being, 2023). 

The Crisis and Trauma Research Institute (CTRI) identifies 5 elements to a healthy relationship. Let’s explore them.

1. Respect
2. Boundaries
3. Sharing of power
4. Guidelines on conflict management
5. Adaptability and flexibility

Respect

In relationships, respect is about allowing each member to be as they are. It is about accepting their personality, individuality, unique opinions, thoughts and feelings and recognizing that everyone has a right to express themselves. Respect is about holding space for differences to exist; despite the discomfort this can create in you. 

Boundaries

Boundaries in relationships are about identifying your limits in order to have your needs met. Individual boundaries are set and communicated with one another. In relationships where children are involved, their needs are prioritized and boundaries are set to protect them from adult challenges and conflicts. 

Sharing of power

This means that everyone involved in the relationship can co-exist and that there is space for everyone to openly and freely share their thoughts, feelings, and opinions without fear of consequences. It is important to consider individuals’ ages in relationships (i.e.: it is OK and normal that parents/adults make more decisions and have more responsibilities than children. This does not mean, however, that children’s wants and needs are not considered). The risks for relationships to become unhealthy are increased when there is an imbalance of power.

Guidelines on conflict management

The fourth element is about having rules on how conflicts will be managed. Conflicts are stressful and can trigger uncomfortable emotions. For this reason, having a structure for conflict management can help navigate the discomfort that conflicts may elicit in you and other member(s) of the relationship. In addition, because we all respond differently to stressful situations, it is important to discuss openly about the best ways to handle conflicts for everyone involved (e.g.: having a code word that reminds you to take a step back; taking a 10-minute break when the conversation is escalating before going back to it; etc.). 

Adaptability and flexibility

The fifth and final element to a healthy relationship is about being adaptable and flexible to trying new ways of working through stressful situations together. It is also about wanting to work as a team towards a collective goal, such as having a healthy relationship.

If you or someone you know is experiencing challenges in their relationships, know that CFIR-CPRI has many clinicians available to help you reinforce your skills to improve your relationships. 

References: 

Coburn, S.C. (2021). Family Violence [Workshop]. Crisis and Trauma Research Institute.

The psychology of relationships: Connections for better well-being. Ontario Psychological Association – The Psychology of Relationships: Connections for Better Well-Being. (2023, December 21). https://www.psych.on.ca/Public/Blog/2023/the-psychology-of-relationships

Natalie Guenette, M.A., R.P. is a Registered Psychotherapist at the Centre for Interpersonal Relationships (CFIR). She provides online and in-person individual psychotherapy services to adults in both French and English. Natalie offers services to individuals experiencing a wide range of difficulties related to interpersonal relationships, anxiety, depression, self-esteem, trauma, and substance use. She works from humanistic and psychodynamic approaches and integrates a variety of therapeutic interventions from emotion-focused therapy (EFT) and cognitive-behavioral therapy (CBT). 

When we get angry or are in heightened conflict, we lose the ability to think complexly. This process is commonly referred to as the fight-flight-freeze response, which is the body’s automatic, built-in system designed to protect us from threat or danger. The fight-flight-freeze response developed early in human evolution and continues to impact our psychology today. While this response was helpful when we were running away from predators as early human beings, it’s less helpful when we are having complex interactions with our partner. It’s important for all couples to recognize when they are angry, as this can trigger their flight-fight-freeze response. Taking a break is one-way couples can reduce this response and be better able to navigate complex discussions.

Remember: Breaks will not solve every problem, but they should help you think more clearly about the ones that do occur.

Try your best!

Joshua Peters is a Clinical Psychology Doctoral Resident and Registered Psychotherapist (RP) with the Centre for Interpersonal Relationships, Ottawa. Over the past decade, he has presented at several notable conferences, including the Guelph Sexuality Conference, the National 2SLGBTQ+ Service Providers Summit, and the Community-Based Research Centre’s Atlantic Regional Forum. Joshua also regularly contributes to online, radio, and television news stories for the CBC, Global News, the Toronto Star, and other organizations. In his clinical practice, he is particularly interested in providing psychotherapy, mental health research, and advocacy for the 2SLGBTQ+ community — especially for those from rural and other marginalized backgrounds. Joshua has obtained a specialization in Psychology at the University of Ottawa, a Master of Arts in Counselling at Saint Paul University, and is currently completing his final year in the Doctorate in Clinical Psychology at the University of Prince Edward Island under the supervision of Dr. Aleks Milosevic and Dr. Lila Hakim. 

Complex post-traumatic stress disorder (C-PTSD) is a relatively new diagnosis for understanding how past events can impact our mental health in the present. If you’re struggling with difficult symptoms, you might have wondered if they could be due to complex trauma. 

Complex trauma involves experiencing a series of events of a threatening or horrific nature, where escape is difficult or impossible. These events overwhelm an individual’s capacity to control or cope with the stressor. They can occur in childhood or adulthood, and could include (but aren’t limited to):

• Domestic violence
• Physical abuse
• Sexual abuse, harassment, or assault
• Neglect or abandonment
• Racial, cultural, religious, gender, or sexual identity-based oppression and violence
• Bullying
• Kidnapping
• Torture
• Human trafficking
• Genocide and other forms of organized violence

Those with complex trauma develop post-traumatic symptoms such as flashbacks, avoiding reminders of the events, and feeling constantly “on edge” or hypervigilant. But due to the prolonged and pervasive nature of the trauma, those with complex trauma develop additional symptoms that are important to recognize.

The first is trouble with affect regulation. This means they might have trouble calming down after a stressor or have strong emotional reactions. On the other end of the scale, they may often feel emotionally numb, or not able to experience positive emotions such as joy. 

Secondly, individuals with complex trauma struggle with negative self-concept. This means they often have strong beliefs that they are worthless, or a failure. They might feel intense guilt or shame in relation to these beliefs.

Finally, individuals with complex trauma often have issues in relationships with others. They might have trouble sustaining relationships and feeling closeness to other people. They might have short, intense relationships, or avoid relationships altogether.

Complex trauma often occurs across generations (sometimes referred to as intergenerational trauma), due to a lack of resolution of previous traumas and prejudice and discrimination that results in the oppression of entire families and groups.

Always consult with an experienced mental health professional if you believe that you may have complex trauma or another condition. Regardless of the cause of your symptoms, there are many treatment options available that can help you achieve your goals and feel better. 

Camille Labelle, BSci, is a therapist working at the Centre for Interpersonal Relationships (CFIR) under the supervision of Dr. Lila Hakim, C.Psych. They provide individual therapy to adults who have experienced single-incident or complex trauma or are seeking support for other mental health conditions such as anxiety or depression. They use an integrated approach including emotion-focused therapy (EFT) and cognitive behavioural therapy (CBT) to empower people to process their experiences, understand their reactions, and change their lives. 

References

Ford, J. D. & Courtois, C. A. (2020). Treating Complex Post-Traumatic Stress Disorders in Adults, 2nd ed: Scientific Foundations and Therapeutic Models. New York, NY: The Guilford Press. 

World Health Organization. (2019). International Statistical Classification of Diseases and Related Health Problems (11th ed). https://www.icd.who.int/  

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. Ashwin Mehra, C.Psych

It is a well-known adage that good communication is a central component of healthy relationships. Whether we communicate as a partner, parent, family member, or employee, the quality of the communication drives the outcome of that interpersonal interaction. We know this to be true through scientific research, as well as from our personal experiences. However,  it should be emphasized that negative communication can be just as detrimental to interpersonal outcomes as positive communication can be beneficial to them. We can understand negative communication using the framework of Polyvagal Theory, which is based on the activation status of the autonomic nervous system mediated by the action of the vagus nerve. This theory posits that our mind and body can be in a positive  (social engagement) state or in a distressed negative (fight/flight/freeze) state. The resultant communication from each state invariably influences the quality of the communication made from the respective positive or negative state. An interesting observation is that the neural pathways linking to empathy, mentalization and long-term thinking are disengaged during the fight/flight/freeze mind-body states. Engaging in communication with a partner, child or co-worker from this state is obviously counter-productive. Most people, in hindsight, usually wish to take back the things that they have communicated from this negative mind-body state.

In therapy, we can learn to better manage these negative mind-body states so that we can effectively navigate towards the positive mind-body states before communicating, rather than after. This helps us to be in the best possible position to communicate our emotional and other needs and to stay open to other viewpoints during the discussion. This allows us to stay engaged with empathy, mentalization and long-term thinking and the quality of our communication reflects this increased mental capacity. We can use our communication to emotionally self-regulate and strive to co-regulate with others, leading to desired interpersonal outcomes. Therapy becomes an exploratory process to help understand the pathways towards negative communication as well as a structured process to help remove blocks and build capacities towards positive communication. In summary, good communication is built on the foundation of also learning how not to communicate, and therapy can help with achieving that capability.

Conflict, arguments, discussions, fights — whatever you’d like to call them –are entirely normal in all relationships. No matter how hard you might try to avoid them, chances are you are going to encounter conflict at some point within your personal relationships. What if, instead of trying to avoid conflict, we became better at it?

‘Good’ communication is said to be the secret to all conflict resolution. Although ‘good’ communication is essential, you should also consider some logistics when resolving conflict. Here are five tips to improve the logistics of your arguments:

1. Schedule your conflict. It sounds odd at first, but take a moment to think about it: Have you ever said something you did not mean during an argument? Most of us have. Emotional flare-ups at times stop us from engaging the “rational” part of our brains. Taking some time apart and preparing to “argue” at a specific time will allow both of you to settle your emotions and give you some time to reflect on what is important to you.
2. Take care of your body first. You would not go into an important business meeting or school presentation hungry, sleep-deprived, or in an unpleasant physical state, would you? Of course not. Doing so would alter your ability to think and perform in those situations effectively. The same applies here. If possible, make sure all your physical needs are met before engaging in a potentially conflictual discussion. Not only will this improve your mood, but it also allows you to think more clearly.
3. Neutral environment. Our environment makes a huge difference! Try to find a neutral place where you both feel comfortable discussing the issue(s) (and try to keep conflict out of your bedroom!) Ideally, bedrooms are for sleeping or sex; do not bring your arguments into that space.
4. Limit distractions. Put your mobile devices away, turn off the television, and give each other full and undivided attention. No one likes to feel like they are being ignored or not listened to; inattentiveness may make the argument much harder than it already is. The fewer distractions, the quicker you can focus on the discussion and (hopefully) come to a resolution.
5. No interruptions. If you have children in the house, make a conscious effort to watch your voice’s volume and tone. Finding healthy ways to resolve conflicts is vital because children and adolescents can absorb discord energy between parents. You also want to make sure you are in an environment where you will not be interrupted or cut-off. It is vital to mutually dedicate this time to focus on each other and the issue at-hand without fearing interruptions.

Rebeca Fernandez Bosanac, B.A. is a counsellor at CFIR working under the supervision of Dr. Reesa Packard, M.A., Ph.D., R.P. Rebeca is currently studying to complete her Master of Arts in Counselling Psychology at Yorkville University. Her professional experience includes working with at-risk youth struggling with extensive trauma, dual-diagnoses, and behavioural issues and working in harm-reduction programs with individuals who struggle with substance abuse, trauma, homelessness, and mental health disorders.