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Myths of Mental Health/Mental Illness

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“What mental health needs is more sunlight, more candor, more unashamed conversation.”

Glenn Close

Towards the end of May this year, I volunteered to run an online workshop with students from a private school in Mississauga. So there we were, on zoom, about 50 to 60 girls from grades 5 to 12, and teachers, sitting in rapt attention as we discussed mental health, myths, and what we can do about it.


While I was excited at the opportunity to converse with school students about mental health, never had I expected to be able to put together content for such a diverse age group. Post presentation, it was more clearer to me than ever, that I do not need to water down any content for my younger audiences or make things more palatable. They were far more receptive to discussing mental health and brought forth insights with a passion that I definitely lacked at their age. So while the list of mental health/illness myths is in-exhaustive, I will share the ones I discussed with them, but before that, I will discuss the difference between Mental Illness and Mental Health. For the rest of the article, I may use the terms interchangeably.

Mental Health or Mental Illness?
When you think about mental health or mental illness, think about it in terms of physical health. Just like physical health, we all have mental health. This would mean that we have emotions, thoughts, and feelings that help us navigate this world. We all will experience mental health difficulties occasionally. It isn’t a mental illness until it affects us for a long duration and with such a high intensity that it affects our daily functioning. So when you are addressing your mental health-think about it as prevention, and building your resiliency, while with mental illness, you are figuring out skills to heal and get to a place where you can function well. Another easy way to remember the difference is Mental Health = Prevention, Mental Illness = Cure. (This is a very simple way to remember the terms and does not encompass their meanings in their entirety. I would also say that you can be mentally healthy and ill at the same time, but that discussion is for another day when I will discuss dialectics and possibly write a piece on dichotomy versus spectrum.) See below some myths I discussed in the workshop.


Myth 1: Mental illness affects very few people
1 out of 5 Canadians experiences mental illness at some point in any given year. Mental illness is also the leading cause of disability in Canada. My idea behind starting with this number was not to alarm you, but rather emphasize how common and normal this is. It affects us irrespective of factors like age, gender, income, geography, location, race, and culture. Even when we do not experience mental illness, it is likely that someone we know is experiencing mental illness or temporary emotional difficulties. We also rarely pay attention to how physical and mental illnesses are interlinked. People with long term physical illness are more likely to experience mental illness. Alternatively, people with mental illnesses are at a higher risk of developing physical health conditions. So next time you joke about mental illness, think about whether you are discouraging a loved one from sharing their struggles and seeking support.
(*when I say disability, I mean anything that makes it harder for you to live your life to the best of your potential.)

Myth 2: Mental illness is caused by a personal weakness
This, to me, is the most damaging myth that is out there. Mental illness is definitely not a sign of personal weakness or poor choices. What seems to us, as poor decisions or strange behaviors is often rooted in illness. There are a lot of other factors that are not in our control. Like the nutrition we receive, the genetic makeup, the family we live with it, or the financial situation we find ourselves in. All of this may protect against or contribute to mental illnesses. Sometimes even individuals with mental health/illness rather have others believe that they are choosing to make poor decisions or are indifferent than admit that they are struggling because it makes them vulnerable to stigma. It also doesn’t help that the media isn’t representing mental illness properly. I find that the media depictions are often polarized with either glamorizing mental illness and the recovery journey or painting a very dreadful picture with little hope for a positive outcome. The best way to perceive mental health or illness is by thinking of it as a health issue, which is what it is.

Myth 3: Mental illness can’t be treated and you will be ill for life
Research shows that anywhere from 25% to 65% of people with serious mental illness make a full clinical recovery. Notice that we are only talking about serious mental illness. People can and do recover from mental illness provided they receive the right kind of treatment that may include one or more of pharmaceuticals, psychotherapy, peer support, group therapy, psycho-educational workshops, etc. Most research supports a combination of medication and psychotherapy. It is also important to learn the difference between different professionals such as Psychiatrists, Psychologists, Psychotherapists, Guidance Counsellors, Physicians, Social Workers, etc. and their scope of practice. At the end of the day, I think the real focus should be on ‘how we can recover’ and not ‘if we can’.

Myth 4: Mental illnesses aren’t real illnesses
Every time I hear someone tell me that Mental illnesses aren’t real, I boil with rage. It is simply ridiculous that we are in the 20th Century and do not believe it is real. Mental illnesses aren’t your regular ups and downs. Mental Illnesses are far more intense and last way longer. A lot of mental illnesses are diagnosed only after they have persisted for 6 months or more. We have tonnes of evidence and research proving that it affects us even economically! It is estimated that mental illness accounts for $51 billion worth of economic burden each year and in any given week, 500,000 employed Canadians are unable to work due to mental health problems.

Part of the problem lies in the fact that mental illness is subjective, and it is not as visible and obvious as physical disabilities are. This along with media representation, and lack of awareness makes it harder for people to comprehend what mental health/mental illness is unless they have experienced it themselves.

Myth 5: People with mental illnesses are violent
People with mental illnesses are no more violent than people without mental illnesses and that has been statistically proven. People with mental illnesses are also more likely to be victims of violence than be violent. Note that social exclusion from the community is linked to violence and people with mental illnesses are often excluded socially. By no means am I justifying violence by someone who is mentally ill, but I definitely think we need affordable access to mental health treatment.

Myth 6: Children do not have mental health problems
Here are some statistics worth noting.
●70% of mental health problems have their onset during childhood or adolescent ●Young children aged 15 to 24 are more likely to experience mental illness
●34% of high-school students show symptoms of psychological distress
●14% of high-school students indicate a serious level of psychological distress
Again, these statistics are not meant to scare you, but to talk about how commonplace this is. So if you are struggling, that is okay, and if you think someone is struggling, then just be kind to them and find ways to support them. We have evidenced-based interventions, we have medications, and we also have access to far more information about mental health than we did before. I definitely believe that mental health literacy programs should be a part of the school curriculum.

Myth 7: People who experience mental illnesses cannot work
Well, one of the reasons why people do not know how common mental illnesses are, is because a lot of us can function, hold down steady jobs, and act according to the norm despite struggling with illnesses. Many others learn to mask their illness from others. Mental illness also does not look like it does in the movies. It can look like loss of interest in what were once fun activities, changes in appetite, sleeping too much or too little, being irritated often, avoiding social connections, and so on. It is also easy to function well when you have tonnes of protective factors like family support, education, community support, access to healthcare, financial stability, and so on. Work environments that have additional health insurance benefits, wellness programs, mental health sick leaves, and other initiatives are also beneficial.

Please note that the purpose of this article is to simply share information and not replace therapy or other health interventions. If you are experiencing significant distress and it is an emergency, call 911. For community resources click here.

To book a free 30 minute consultation with me, click here.

References
Challenging the Myths of Mental Illness . (2017, June). Retrieved May 1, 2020, from https://www.camhs.ca/wp-content/uploads/2017/06/myths-of-mental-illness-brochure.pdf

McGinty, B. (n.d.). Myths and Misconceptions About Mental Illness and Addictions. Retrieved May 1, 2020, from https://www.hopkinsmedicine.org/news/newsroom/events/science-writers-boot-camp/_docs/myths-and-misconceptions-about-mental-health-and-addiction.pdf

Mental Health Myths and Facts . (2017, August 29). Retrieved May 2, 2020, from https://www.mentalhealth.gov/basics/mental-health-myths-facts

Mental Illness and Addiction: Facts and Statistics . (n.d.). Retrieved May 2, 2020, from https://www.camh.ca/en/driving-change/the-crisis-is-real/mental-health-statistics

Mythbusters: using evidence to debunk common misconceptions in Canadian Healthcare. (201AD, December 3). Retrieved May 1, 2020, from https://www.cfhi-fcass.ca/sf-docs/default-source/mythbusters/myth-mental-health-recover-e.pdf?sfvrsn=dd082440_0

MYTHS & FACTS: The Stigma of Mental Illness and Resulting Discrimination. (n.d.). Retrieved May 1, 2020, from http://www.eachmindmatters.org/wp-content/uploads/Stigma-Myths-Facts-English.pdf

Myths About Mental Illness. (n.d.). Retrieved May 1, 2020, from https://cmha.ca/documents/myths-about-mental-illness

Myths about Mental Illness. (2016, February 27). Retrieved May 2, 2020, from https://cmha.ca/documents/myths-about-mental-illness

Stigma, Discrimination, and Mental Illness . (n.d.). Retrieved May 1, 2020, from http://www.health.wa.gov.au/docreg/Education/Population/Health_Problems/Mental_Illness/Mentalhealth_stigma_fact.pdf

What’s the difference between Mental Health and Mental Illness? . (n.d.). Retrieved May 2, 2020, from https://www.heretohelp.bc.ca/q-and-a/whats-the-difference-between-mental-health-and-mental-illness

Featured

Being a Culturally Competent Psychotherapist

The murder of George Flyod and the surging Black Lives Matter Movement has got therapists around the world actively talking about being more culturally competent in their practice. I wish, from the depths of my heart, that this is not a just a momentary, performative decision, but a lifelong commitment to be more culturally inclusive. I hope that we recognize that being culturally competent is not expected to be just an overnight change, a one time seminar or a series of workshop fix but instead is a willingness to take a hard look at our own stereotypes, perceptions, our personal flaws and our willingness to be be more vulnerable to better serve others who are re-traumatized by institutions, policies, and approaches to therapy.

My experiences with a few mental health professionals, as a person of colour, left me frozen in shock and gasping for words as I was not fully equipped to respond to certain questions. While most people are genuinely curious, respectfully clarify their doubts about my ethnicity, some of them have openly asked me questions or passed comments that were straight up offensive. This includes a social worker asking me if I moved to Canada because my dad did not want me (assuming that all women are treated badly in India), to somebody asking me to explain why people don’t protest in India against the government, to others asking me if I am being pressurized to get married. This made me extremely uncomfortable and I refused to pursue conversation with those people on that matter or otherwise. It makes me reluctant to openly be myself, express my thoughts, and live in the fear of being gas-lighted and/or my experience minimized if I choose to vocalize an unpopular opinion or confront others.

This also got me thinking about the experience that a person of colour might find themselves in, in therapeutic settings? What could I be doing that could ruin someone’s experience in therapy? Does the focus on the ‘here and now’ and ‘living in the present’ work against people, when what they really need is an acknowledgment of their multi generational trauma, impact of colonialism, systemic discrimination that requires a visit to the past? Does the focus on ‘power of rational thinking’ add insult to the injury? Isn’t it possible that a person is not perceiving things irrationally, or negatively, and that their situation is indeed working against them? If you are wondering what I am talking about, I am directly addressing a significant portion of self help books and philosophies that share the notion that ‘the power lies within you’, ‘a simple change in your approach can make a difference’, or ‘you can do it’.

The truth is, change and growth is not a simple matter of motivation or making choices. Choices are a luxury, and so is power. We all do not have equal access to either. The first step is recognizing that this is true. The second step is acknowledging privilege and/or lack of it. I definitely recognize that I have some privileges in terms of education, location, finances and at the same time seem to lack other privileges. But this is not about my personal life. This is me taking steps to ensure that I can cater, to the best of my ability, to my clients who may not have the same privilege as I do.

I also recognize that me being a person of colour does not mean that I cannot be ignorant and unknowingly make inappropriate judgments. I, like all of us, definitely have blind spots, and am fully aware that my own perceptions can be biased. I don’t believe I will be perfect, but I am going to spend significant time educating myself. I will share what I learn, in the hopes that this will contribute to everyone’s well being. At the same time, I invite you to share resources, ideas, and suggestions that you have that will help me become more culturally competent. This is not meant to replace therapy or supervision, but simply an attempt to share what I learn, and learn from you as well.

Below, we will take a look at a few ways to know we are culturally encapsulated, and signs that we need to change as well as a very useful model that can help us keep track of all factors that affect an individual’s well being. The source of my information has been listed below for your reference.

In the first article I read, I come across Gilbert Wrenn who explains that counselors can run the risk of being culturally encapsulated. Here are some signs, us counselors can know that we are culturally encapsulated

1. we hold the same standards of behaviour for everyone
2. individualism is deemed more appropriate than collectivism
3. narrow professional boundaries are sort & interdisciplinary interaction is discouraged
4. contextual influences are not taken into account
5. dependency is considered undesirable or neurotic
6. a person’s support system is not considered relevant to mental health
7. linear, cause-effect thinking is considered sufficient
8. expect individual to adapt to the system
9. historical roots are disregarded or minimized
10. counselors assuming they are free of racism or cultural bias

The second article I read, is simply fantastic. It spoke about RESPECTFUL Model developed by Michael D’ Andrea & Judy Daniels. The model lists 10 things that influence an individual’s psychological well being. I believe having an acronym at hand would definitely be useful for me to check myself and see if there is something I fail to acknowledge/address in therapy.


1. Religious-Spiritual Identity: It could be religion a person chose, or a religion someone was born into. A person can even choose to be spiritual, agnostic, or atheist.
2. Economic: Different economic situations have different impacts. Poverty is definitely associated with many ACES (Adverse Childhood Experiences).
3. Sexual Identity: Historically, people have been oppressed because of their sexual identity, gender identity, partner preference, and it is important to learn and educate ourselves on their experiences and the risk to their mental health. Centre for Suicide Prevention has a very useful fact sheet about sexual minorities and suicide which can be found here
4. Psychological Maturity: focusing on individual’s ability to adapt to the environment based on their psychological strengths
5. Ethnic Cultural Racial Identity: some ‘within’ group experiences would be important to note. I would also focus on asking clients’ their perception of their experience, to ensure my stereotypes is not influencing therapy
6. Chronological Developmental Challenges: any developmental delays or challenges may affect individual experiences. This makes me think especially of individuals with medical conditions, invisible disabilities that are likely to experience significant challenges early on, especially in school settings
7. Trauma and other threats: To me, learning more about ACES as well educating myself about Trauma Informed Approach led to a huge shift in the way I perceive people in general and I would recommend Trauma Informed Approach to everyone. More information about ACES can be found here. One of the best resources I have used for Trauma Informed Approach is the toolkit by Manitoba Trauma Information and Education Centre which can be found here.
8. Family History and Dynamics: there are so many things to consider here. There are many different types of families, blended families, diverse families, nuclear or joint families, etc. How they view themselves and how they are viewed in by society can play a huge role in the mental health. Different generational experiences, especially in migrant families are also noteworthy.
9. Unique Physical Characteristics: people who are physically different, in terms of height, weight, physical limitations, colour of their skin, age, may have experiences different from those of the norms. It also becomes important to check our own negative stereotypes about appearances.
10. Location of Residence and Language Differences: Each location brings with a lot of influence in terms of climate, terrain, diet, job market, access to resources, media influence or lack of it, finances, cultural influences, colonial and/or migration history, stereotypes, cultural strengths, among others. It would be important to understand the client in this larger context and their experience of it to help check any biases or stereotypes we may have. I remember working with a child who lived in a slum. While I complained to him about child labour and thought it wasn’t fair, he on the other hand, saw it as an opportunity to pull his family out of poverty rather than a social evil. Which was my first lesson in how my idea of the what the client experiences, need not be accurate all the time.

Therapists, this is not written with judgement, but more an attempt to share and learn from one another. 

Clients, your therapist wants to know how they are doing. Communicate with them, call them out, and collaborate with them as no therapy is successful without collaboration. 

I would love to know what you think about this blog. If there are more resources, ideas, or topics that you would like me to explore, comment below or write to me at krishnavora8@gmail.com.

If you are experiencing significant distress call 911 for emergency or click here for resources in Ontario.

To book a free 30-minute consultation with me click here

References/Credits
-Photo Credits: Nathan Dumlao https://unsplash.com/@nate_dumlao & nathandumlaophotos.com
-Emeritus, P. B. (2002, August 1). The Making of a Culturally Competent Counsellor, International Association for Cross Cultural Psychology. Retrieved June 16, 2020, from https://scholarworks.gvsu.edu/cgi/viewcontent.cgi?article=1093&context=orpc
-10 Multicultural Factors to Consider in Counseling. (2017, April 5). Retrieved June 16, 2020, from https://onlinecounselingprograms.com/blog/multicultural-counseling-model/

Book Review: Small Things by Mel Tregonning

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“Anxiety was born in the very same moment as mankind. And since we will never be able to master it, we will have to learn to live with it—just as we have learned to live with storms.”

Paulo Coelho, Manuscrito encontrado em Accra

(Trigger Warning: Mental Health, Anxiety, Depression, Suicide)

So I am usually not someone who tends to read picture books. While I am very visual, I also like reading books that are language-based as I personally enjoy them a lot. However, my experience working with neuro-diverse individuals got me thinking about their experience of consuming content. Not everyone is verbal and not everyone enjoys listening to audio-books. What are their options then? Also, what happens to people who don’t have the energy to read. Reading can be exhausting, so is communicating. What if we had a solution to this problem?

My online search led us to this book about anxiety and little did I know that it would be a picture book and a beautiful one at that. The book was authored by Mel Tregonning in the final year of her life. You can find out more about her here. When I browsed through the author’s website I realized that she had her own personal struggles with mental health and the book published by her family after losing her. I value this book a lot and I think it is a wonderful picture book for any child or their caregiver to learn more about their experience with mental illness.

Here are some of my favourite things about this book

  • I might have said this before, and I will say this again. We need to hear directly from individuals who have experienced mental health illness and hear them voice their stories more so than that of the experts. I appreciate narratives from someone with a lived experience as they are easy to relate. (A lot of mental health professionals have mental health struggles and they openly talk about it. More about that later).
  • This book is completely visual!! Not a single word is included in it.
  • Can you imagine being able to relate without hearing or uttering a single word? I believe this can be such an easy and a powerful way to start communication about mental health struggles without the overwhelming need for us to find the right words to express our experiences.
  • One of the struggles with explaining mental health problems is that people cannot understand what they don’t see. And this book helps us with just that- it helps us see what anxiety looks like and feels like to the person experiencing it.
  • I do not want to give away the plot therefore I am holding back on sharing the themes of the books. What I definitely want to share is that the book beautifully depicts what ‘the child is feeling on the inside’ on the outside and how his anxiety manifests itself in the different aspects of the daily life. (There are so many wonderful things I would like to say but I really don’t want to cloud your interpretation with mine.)

I think this is a great read for

  • Parents, who have young children who struggle with anxiety or other mental health issues. This might be a very useful resource for parents of children who are non-verbal or struggle with verbal comprehension.
  • Children, especially children who do not know how to communicate the way they feel. A picture book could be a great start for them to understand their own experience, be able to pinpoint parts or whole of their experience without scrambling for the right words to narrate their experience.
  • Educators & Librarians who wish to include mental health literacy as a part of their curriculum and/or programs and want to find ways to address every child in the class.
  • Mental health professionals who work with children can also include this in their toolbox along with other sensory items to help children comprehend and articulate their experiences. I am aware of many children who are cannot be assessed due to lack of participation on their end and I wonder if books such as these could be a way to bridge the gap? Cause can a child communicate what they are thinking or feeling if they do not understand or know how to verbalize it or are nonverbal to begin with?

Things to consider when you read this book

  • I am trying to be mindful of diverse learners here and I think for individuals who struggle with nonverbal comprehension or have difficulty comprehending abstract ideas this may not be the right resource.
  • Since it is completely nonverbal, everyone would have their own interpretations of it. When I read it, my interpretation was very far from those that other people have expressed (I read a lot of reviews on Goodreads). So if you are using this to support someone, be open to their interpretation of it.
  • I am not recommending this book as a miraculous solution to someone who is nonverbal or not communicating their anxious thoughts. There really need not be an outcome that we can ‘see’ or ‘hear’. If it helps a parent understand their child’s experience, if a child feels understood, or if any reader just gets a better insight into an individual’s experience of anxiety, it is worth it.

Have you had a chance to read this book? I would love to know what your thoughts are! If you do read the book after reading the review, let me know if this was helpful.

Please note that the purpose of this article is to simply share information and not replace psychotherapy or other health interventions. If you are experiencing significant distress and it is an emergency, call 911. For community resources click here.

I try my best to learn new skills and update myself with the latest developments in the field, but I definitely do not know it all. I would love to learn what you think about my content and if you have any concerns. Feel free to write to me if you wish to start a dialogue about a certain topic.

I provide individual psychotherapy to youth and adults for a variety of mental health issues, create and facilitate workshops, and consult. To learn more, book a free 30-minute consultation with me, click here

Myths of Anxiety

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My anxiety is silent. You wouldn’t even notice a change on the outside but I’m honestly so stressed I can’t even manage simple tasks. People call me lazy when, in reality, I’m just overwhelmed.

Unknown

In this article, I will simply focus on the myths of anxiety. There is so much information about anxiety out there that sometimes even I find myself taken aback with someone of the content I come across. I find a lot of it extremely invalidating to be honest. Especially the content that implies that anxiety can be easily fixed and that people are simply not trying hard enough! So not cool.

Let’s look at some common myths of anxiety here. Try to contest them yourself before you read what I have to share.

Myth #1 Anxiety isn’t a real Illness

It is definitely a real illness! The reason why we often think that is is not, is because we sometimes experience symptoms similar to those who have anxiety. With anxiety, the severity, intensity is much more higher and impacts everything in your life. Things impacted could include, ability to go to work, socialize, do job interviews, manage relationships, among others. In Canada, we know that approximately 5% of the people will experience anxiety disorders at some time. If you don’t believe in mental health disorders to begin with, know that 1 out of 5 people will experience mental health difficulties at some point in their life.

Myth #2 People with anxiety should avoid things that make them anxious

The thing about avoiding anxiety is, the more you avoid it, the more your anxiety is reinforced to continue avoiding it. A better way is to deal with the situation. Now one way to go about it is directly facing anxious situations head-on or take small steps towards it. How one goes about it is really dependent on the client’s comfort levels. (So please don’t go about forcing your friend to do something that makes them anxious.) There is no one way to fix it. There are also biological influences that need to be taken into account, whether it is diet, medications, mood-altering substances, other existing medical conditions, etc. There are also often things out of control such as discrimination, financial status, which may contribute to anxiety. So each would need a different approach, and/or many professionals (physician, psychiatrist, social worker, policymakers, school counselors, psychotherapists, nutritionists, etc.) to support the management of anxiety.

Myth #3 Anxiety cannot be treated

This cannot further away from the truth. Anxiety can be treated. Therapies like Cognitive Behaviour Therapy could take anything from a single session to up to 10-12 sessions. Therapy requires a lot of work on the client’s part. It is all about getting the tools and strategies you need to improve your anxiety rather than simply showing up to a therapist with the hope that therapist will fix it. Additionally, there is no shame if it does take many years. Sometimes the wounds are deeper than meets the eyes and for someone with absolutely no support system in their lives and/or complex issues, more than few sessions may be needed.

Myth #4 Anxiety can go away by thinking positive thoughts

If we could all do away with anxiety by thinking positive thoughts if it were really that simple, would we not have a world full of confident, happy, anxiety-free people? Also, asking someone to think positive thoughts is straight-up toxic positivity. I personally think this is invalidating and one of the worst things to say to someone who is experiencing anxiety. I will do another piece on validation later on, but in the meantime, if you aren’t sure what you are saying or doing is helping or hurting, simply hold space for the person. Be honest and tell them you do not understand their experience but you choose to be with them. Really, that’s all you need to do.

Myth #5 It is either due to hereditary or life experiences

Really, it is a complex combination of both. The question now is no longer nature versus nurture, but more so nature + nurture = ??

Myth #6 People with anxiety can stop being anxious spontaneously

I mean, are you going to make me say this again. If people could stop being anxious spontaneously, they would. Just like one cannot spontaneously stop any physical ailment, you can’t do the same with mental health issues. Can you stop diarrhea at will? (If you can, please tell me how.) No one, trust me when I say this, absolutely no one derives any pleasure from being anxious. So, just as they are not choosing to be anxious, they cannot choose to stop being anxious spontaneously at your command.

Myth #7 Medication is the only treatment for anxiety

It is one of the treatments for anxiety. Research supports a combination of medication and Cognitive Behaviour Therapy. There are many other therapies out there to choose too. I know there are tonnes of stigma around medication. But that conversation deserves another blog post. Also, I am not sure if I can do justice to it as I do not have any medical training. (Psychotherapists are different from Psychiatrists!)

Myth #8 Medications are addictive so they should only be taken if necessary

As said before, medications are one form of treatment. Just like any medication, consult with your physician/psychiatrist about the medication that you or they are considering and closely monitor your dosage, side effects, and how you are responding to it. Do not hesitate to ask questions as many times as you want!

Myth #9 The causes of anxiety are rooted in childhood

We do not really have an exact number/percentage with regard to it. Anxiety, like all other mental health disorders, is due to a combination of many factors. The statement above does not account for countless other factors. It would be more appropriate to say that childhood problems can be one of the many reasons that cause anxiety.

Myth #10 Anxiety Disorders are rare

Not true. 1 in 4 Canadian is likely to have at least one anxiety disorder in their life. As of 2017, about 284 million people experienced an anxiety disorder. See statistics here. This definitely gives me something to think about. Do we think anxiety disorders are rare because people are less likely to talk about it? What do you think?

Myth #11 Alcohol, drugs, cigarettes, marijuana, or self medication can help with anxiety

This does give a temporary relief and may seem helpful in the short term but there is always a concern about dependency issues in the long term.

Myth #12 Therapy will take years

This used to true when we had lesser options when it came to therapeutic approaches and people believed that it would take many years to heal in therapy. We now know that is not true. There is a lot of evidence for short term counseling and recent evidence even supports a single session therapy.

Myth #13 If you eliminate stress, you can eliminate anxiety

The thing about anxiety is, it will persist even after the threat has passed. Anxiety is also about the anticipation of future threats. I am not denying the impact of actual threats, let’s say, for example, the fear of losing your job amidst Covid19 is understandable. It is when your anxiety is unfounded, and your reaction is intense and out of proportion that is warranted.

Of course this is not an exhaustive list. I am sure there are many more.

I would love to know what you think about this blog. If there are more resources, ideas, or topics that you would like me to explore, comment below or write to me at krishnavora8@gmail.com.

Please note that the purpose of this article is to simply share information and not replace therapy or other health interventions. If you are experiencing significant distress and it is an emergency, call 911. For community resources click here.

To book a free 30 minute consultation with me, click here.

References/Credits
-When Panic Attacks, The New, Drug Free Anxiety Therapy That Can Change Your Life by David D. Burns, M.D.
-Anxiety Canada Website www.anxietycanada.com 
-Anxiety and Depression Association of America www.adaa.org
-The Cognitive Behavioural Workbook for Anxiety, A Step by Step Approach by William J. Knaus
-Myths about Anxiety, Webinar on ADAA https://adaa.org/webinar/consumer/common-myths-about-anxiety-disorders
-Anxiety Versus Depression: Symptoms and Treatment https://www.verywellmind.com/am-i-anxious-4045683
-Anxiety and Panic Attacks https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/anxiety-symptoms/#.Xdr5UuhKjIU
-10 Anxiety Myths Debunked https://www.everydayhealth.com/anxiety/10-anxiety-myths-debunked.aspx
-Myths and Misconceptions about Anxiety https://adaa.org/understanding-anxiety/myth-conceptions

Book Review: Aspergers On the Job by Rudy Simone

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Asperger’s On The Job by Rudy Simone

What I love about Toronto Public Libraries is that I can access a large volume of books. So when I found out that they had quite a few books on Aspergers I ordered all of them. So far, this is the only one I have managed to finish and I quite like it. Here are some of my thoughts on it.

What I absolutely love about this book is, that it is written by a woman on the spectrum. I genuinely believe that any information is more valuable when it is narrated from a person with a lived experience. We need to hear their experiences more often so we (both professionals and non-professionals) better understand what we need to do more of or do things differently to best support them as none of us, even with the best intention, and qualifications, can truly understand how a person’s neuro-diversity plays out in real life.

*Please note that while Aspergers as a diagnostic condition was removed in DSM-V and the correct terminology is Autism Spectrum now, there are still individuals who were previously diagnosed as Aspergers and continue to use this term for themselves. I will use the term Autism and Aspergers interchangeably for this article.

So here are my favourite things about this book.

  • It is authored by a woman on the spectrum herself -Judy Simone. We definitely need more neuro-diverse voices!!
  • She interviewed 50 adults with Asperger’s and their voices are also included in this.
  • This book gives many practical tips on how to sustain a job, and address many issues unique to high functioning individuals on the spectrum such as importance of small talk, dealing with a jealous coworker, asperger arrogance, sensory issues, over/under stimulation, strength based approach, having rituals and routines, figuring out attire among others (I obviously don’t want to share everything but I especially love the part at the end of each chapter she has advice for employers & advocates as well as for employees).

I think this is a great read for

  • teachers who work with youth and/or adults on the spectrum who are also high functioning. I believe parts of this book will definitely provide a better insight into certain behaviors and help us avoid us falling for the easy, and what seem obvious labels such as ‘lazy, arrogant, obnoxious, aloof, anti-social, etc.’ and replace them with more positive and appropriate labels such as struggles to interpret social cues, sensory environment not a great fit for them, troubles with transitions, and so on.
  • employers who wish to understand their employees and figure out accommodations (involving the said employee of course!)
  • parents who are concerned about helping their adult children on the spectrum find and sustain jobs. While this book does not cover the challenges of finding a job on the spectrum, it does touch on many helpful points otherwise.
  • adults on the spectrum who are struggling at work and can benefit from learning from the author’s experience and research. I also think this would help them feel less alone in their experience. This could also help them articulate their struggles better. I find quite a few of my clients don’t have the exact words to communicate how they are thinking and feeling and am wondering if this may help with that.

Things to consider when you read this book.

  • If you are looking for a one-size fits all approach you will be disappointed. I read a lot of reviews online where people were upset about the practicality of the solutions or the solutions not being effective for them. But of course, how can they be? Each individual on the spectrum is different and add to that other layers of the location they are in, community resources, awareness/stigma about the spectrum, family support or lack of it, educational and employment laws, political systems, climate, and so on. It is hardly ever possible to take a solution from one book and simply use it. The right approach is to always look for ‘customized solutions.’ Just cause one thing works for a person on the spectrum doesn’t mean it works for others. Having said that, I understand that when a person grabs a book, they are looking for definite solutions to apply right away. Being neuro-diverse or being a caregiver for one may leave less time and energy to pursue creative solutions, so the need for ready to go choices are justified.
  • There are personal anecdotes share throughout this book that provide insight into the real struggles people with Asperger. This can be very insightful, inspirational, but may also crush your hopes to know how much you or your loved on spectrum will struggle on a daily basis at work. A good example is- imagine being stuck in a country where you don’t speak the language, don’t understand the customs, and cannot read any signs-I wonder if that is what it is like for them to navigate the subtleties of nonverbal communication that most of us take for granted.

Have you had a chance to read this book? I would love to know what your thoughts are! If you do read the book after reading the review, let me know if this was helpful.

Please note that the purpose of this article is to simply share information and not replace psychotherapy or other health interventions. If you are experiencing significant distress and it is an emergency, call 911. For community resources click here.

I try my best to learn new skills and update myself with the latest developments in the field, but I am definitely do not know it all. I would love to learn what you think about my content and if you have any concerns. Feel free to write to me if you wish to start a dialogue about a certain topic.

I provide individual psychotherapy to youth and adults for a variety of mental health issues, create and facilitate workshops, and consult. To learn more, book a free 30 minute consultation with me, click here.

Being a Culturally Competent Psychotherapist #2

Over the last few weeks, I have been listening to podcasts and watching videos which has helped me to explore my blind spots and make an effort towards being more trauma-informed, and sensitive to the needs of BIPOC clients. My experience with educating myself has shaken quite a few notions, and confirmed others. More importantly, I know a few things I can do differently moving forward.

Below, I will share the content that I viewed and list what I believe were important takeaways. All the resources I share below are currently being offered free of cost, so if it is of interest, I recommend you go ahead and pursue it.

1] Lifting Black Voices: Therapy, Trust, and Racial Trauma (Podcast)(1 hour)
by http://www.clearlyclinical.com
This is a panel interview facilitated by Elizabeth Irias, LMFT and includes expert clinicians La Shanda Sugg, LPC, Dr. Tiffany Crayton, LPC-S, and LJ Lumpkin
You can find the link to this course here.

For me, some of the key takeaways were
Mental health stigma in the culture: Some reasons why BIPOCs do not seek therapy is because people had to suppress their pain, ‘hold it in’ to survive, which is a response that has been carried through generations. Also, the system is untrustworthy which does not validate and/or acknowledge the experience of BIPOCs thereby re-traumatizing instead of helping them manage their mental health. Therapy can also be another place where a client’s ‘internalized racism’ is reinforced especially when the therapist does not have cultural humility.
-To me, it was important to learn the difference between cultural competence and cultural humility. I learned that I cannot truly become a culturally competent psychotherapist if I do not have lived experiences, or when I am never likely to have the lived experiences that my client does. But having cultural humility, and openly acknowledging that ‘there is so much I do not know’ can create an honest, safe space for my clients to talk about their experiences.
-The idea behind this conversation is not to get an “apology” about what happened in the past (though it wouldn’t hurt), but to take responsibility at present to fix the system and help bridge the existing gap!
-other key ideas include impact of microaggressions, fear of success for BIPOCs, and the negative impact of the ‘I conversations’ when clients come with a systemic issue.

While this podcast focused on blacks, it was helpful for me on a personal level because I now understand some reasons why there is so much stigma to seek therapy among South Asians. For reasons unknown to me, I blamed our community without acknowledging the colonial burden we share and how current mental health approaches that do not acknowledge the impact of the current context and racial history that can be invalidating. My next focus will definitely be on colonization and its impact on mental health as well as a look at my own privilege and/or lack of it, while growing up in India.

2] Hey, White Therapist, Here’s Where We Start (Podcast)(1 hour)
by http://www.clearlyclinical.com
This is an interview with Frank Baird, LMFT, LPCC which was facilitated by Elizabeth Irias, LMFT. I absolutely love that this course was produced with the consultancy of compensated non-white clinicians!
You can find the link to this course here.

This is a fantastic podcast for any healthcare professionals working with BIPOCs and I believe every therapist, not just a white therapist, should hear this out. I will try to summarize concepts that really grabbed my attention and that I will be taking with me to my practice.

I learned to be more aware of the difference between
‘intent’ versus ‘impact’
(It is important to note that unintentional harm does not minimize negative impact. I also think that using the word ‘impact’ instead of ‘intent’ forces us to take more responsibility for your words and actions instead of putting blame on intent.)
‘safe spaces’ versus ‘courageous spaces’
(Safe spaces tend to avoid difficult conversations. We need spaces that value difficult, necessary conversations, and they don’t even have to be confrontational.)
‘riots’ versus ‘uprising’
(what is framed as riots by a dominant culture, is often an uprising for the minority culture).
Instead of asking, ‘Do you have any questions? ask ‘What questions do you have?’
Instead of asking, ‘Did it affect you? ask ‘How did it affect you?’
(Of course, the context matters a lot in this case, but I believe it is important that our clients know that we will hold space for them, no matter what they want to talk about.)

Other important takeaways include
-our training in mental health does not talk about addressing politics in the consultation room and the unspoken assumption is that you do not touch that topic. But for people who are the victims of systemic discrimination, it is invalidating when we see them isolated from their experience.
-to listen to my client’s stories and believe when they tell me their stories instead of undermining their experience. In short, respect their voice!
-BIPOCs are not your Encyclopedias or Google. They do not have to carry the weight of speaking on the behalf of their people or carry the weight of educating you. I have often felt I was someone’s Netflix special when they thought I owed it to them to address their racial curiosity. Honestly, I don’t owe that to anyone. I can choose to share what I want on my own time, and at my own comfort.
-‘white saviour complex’-this essentially means a person who helps a non-white person, but in a self serving manner. Why do you think this would matter in a therapeutic setting? Well, this increases the power imbalance and fosters a belief in the client that they do, in fact, need the therapist to get anywhere. We all know that is not true. Therapy is all about collaboration. It always has been.
-when someone says that they ‘don’t see colour’, that isn’t helpful. It is like erasing the experiences that come with being coloured.
-being a beneficiary of white privilege is not wrong, it is what you choose to do with that privilege after educating yourself about racism and its impact

3] Racial Injustice And Trauma: How Therapists Can Respond (Panel Discussions)(Two parts, 1 hour each)
by http://www.pesi.com
I highly recommend this as it includes a honest narration of lived experiences of people of colour both as a therapist and as a client. And this is what we truly need right now, unfiltered, honest, conversations about the experience of BIPOCs in therapy, both as therapists, and as clients.

Some important takeaways include..

-One of the most important takeaways for me from these panel discussions is that when a client shares their stories with us, believe they are true and sit with it and not divert attention away from it. We do not need them to prove to us that they are speaking the truth.
-It is important for each of us to examine our relationship to race. We cannot pretend racial issues do not exist.
-Calling out on racism is not easy, not even safe, but if we are waiting for it to be safe and easy, change is never happening.
-Do we ask clients directly about racial stress and trauma? Just like we don’t ask about trauma directly, we don’t ask about racial stress directly. We can, at best, create an environment that is safe for the client to truly express themselves. I think this is where we need to examine both our implicit and explicit bias, as well as keep track of micro-aggressive choices.
You can find the link to these panel discussions here

Once again, I invite you to share your thoughts, suggestions, and resources that you think I should explore. As I have said before, the idea is not to shame or take anyone on a guilt trip but to open a dialogue that helps all of us change. If there is something you would like to say, leave a comment here or write to me at krishnavora8@gmail.com

If you are experiencing significant distress call 911 for emergency or click here for resources in Ontario.

To book a free 30-minute consultation with me click here

Perfectionism

Photo by Ksenia Makagonova on Unsplash

“At its root, perfectionism isn’t really about a deep love of being meticulous. It’s about fear. Fear of making a mistake. Fear of disappointing others. Fear of failure. Fear of success.”

Michael Law

As a recovering Perfectionist, I thought it would be best to start with this topic. I use the word ‘recovering’ as I personally see it as an ongoing process and not an easy fix. Our world has changed a lot in the last few decades, at a very fast pace. If we are to keep up with the slew of information thrown at us from all angles, keep up with economic and socio-political changes, AND deal with the images that we see in social media on a daily basis-then we really need to start and sustain a conversation about perfectionism.

What is perfectionism?
Perfectionism, in simple terms, is a need to strive for high and flawless standards. Perfectionism can be either adaptive or maladaptive. When adaptive, it can help drive you to achieve higher standards by putting in the hard work that is required and at the same time enjoying the success that comes with it. Maladaptive perfectionism, is extremely unhealthy, whether it is turned inward or outward leading to disappointment, discouragement, frustration, anxiety and/or depression. A harmful combination, if left unchecked.

Perfectionism can take three major forms
1. Self oriented, where you put unrealistic expectations on yourself to be either the prettiest, most successful, most organized person. This would be akin to putting yourself in a drowning boat. You are so busy trying to row, that you do not notice that you are drowning in the sea of despair.

2. Other oriented, where you impose those unrealistic standards on significant others which could be a parent, partner, sibling, child, friend, coworker, employee, or a boss. It is a doom we set for all our relationships, both personal and professional. At work, you will see a steep drop in performance and on the personal front, you will see your relationships suffer. Continuing on with the drowning boat analogy, here it isn’t just you, but you are taking someone along with you.

3. Socially prescribed, where you think others are imposing unrealistic standards on you. Going back to the drowning boat analogy, think of this as you being in the drowning boat, and thinking that you are expected to stay there and you continue to stay there even when people try to throw a lifebuoy at you.

Perfectionism has been a growing concern in recent times. We have only now begun to move from a product orientation to a process orientation, only now beginning to recognize that romanticizing perfectionism has dire consequences. And honestly, there isn’t any one particular person or a thing, but a large accumulation of consumerism, social media, Instagram filters, and an availability of products that promise quick luxurious fixes.

On a personal front, I was a perfectionist even as a kid. I read novels that idolized relationships, gave me a set idea of how things should be. My inclination towards art didn’t help it either as I found myself in extremely competitive environment where beauty and perfection (art pieces) were applauded all the time. While no one ever gave me direct negative feedback, it led me to assume that perfection was all that was appreciated.

Think about it. How often do we acknowledge, much less appreciate, less than awesome products? Even if we did, we do not take out the time to acknowledge small gestures. I was lucky to have one such teacher who did. He noticed that I erased everything I drew before starting all over again. He seemed really angry about this, looked at me in this eyes and said, ‘You do not use an eraser ever. What you have done, stays as is. It is a proof of what you are capable of now and helps you see how far you have come.’

I did not realize this till much later in life, that this would be my first lesson in acceptance of my imperfections, being okay with who I am. I have taught Mandala and Zentangle to a lot of different age groups and this lesson stays with me. The ‘no eraser’ rule is both mind-boggling and liberating at the same time. As suddenly, people find themselves free to make mistakes, free to attempt art without judgement and still take pride in it.

I hope to share more articles on Perfectionism that will cover its impact on Mental Health and strategies to deal with perfectionism. If you like any other topics to be covered, let me know in the comment section. Till then, look around for an imperfect object that you find beautiful!

This article is not meant to be a substitute for medical intervention or psychotherapy. Kindly seek professional services if you are looking for mental health support.

If you are experiencing significant distress call 911 for emergency or click here for resources in Ontario.

To book a free 30-minute consultation with me click here

References
https://en.wikipedia.org/wiki/Perfectionism_(psychology)
https://www.psychologytoday.com/ca/basics/perfectionism
-Image by Ksenia Makagonova

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