Think You Might Have a Case of the Winter Blues?

CFIR Toronto's Clinic Director, Dr. Lila Z. Hakim, C. Psych., offers a few helpful tips below to start feeling good again **:

Nourish Your Body

Many of us experience cravings for certain foods when the winter season blows in and our bodies develop a yen for carbohydrates. Carbohydrates are directly linked to the production of the neurotransmitter serotonin, an emotion regulator that helps you feel emotionally stable, less anxious, calmer, more focused and energetic.

When that 3 p.m. craving for a savoury or sweet snack hits, it’s your body’s way of self-medicating, seeking to improve your mood by boosting your serotonin levels. Listen to your body and give yourself that much-needed serotonin lift.

Instead of calorie-dense, sugary pieces of bread and sweets that offer a quick mood-boost and then a crash, consider healthier alternatives such as fruits, nuts, and yogurt.

Get Active!

Physical activity increases not only the calming neurotransmitter serotonin, but also increases dopamine, the emotion and pleasure neurotransmitter, and endorphins, your pain-relief and pleasure neurotransmitters. Incorporating movement into your day (climbing stairs, going for a walk, etc.) gives your body the activity it needs to keep your mood up throughout the day.

Make Sleep a Priority

Sleeping excessively (or hibernating) is normal in the winter and is often a reaction to the cold, but for some, ongoing insomnia or difficulties falling or staying asleep create difficulties that can lead to the blues. Provide yourself with a space at home that includes comforting objects (such as a warm blanket, beautiful objects, etc.) to calm your stress hormones. Aim to get exactly the amount of sleep you need to feel fully rested and ask a professional if you are unsure about how much rest is the ideal amount.

Do Things that Light You Up

Find activities in your life that give you a sense of pleasure and meaning, that involve curiosity, exploration, and interest­–this could be collecting or building things, researching something you love like traveling, or caring for other people. Artistic endeavours like creating and listening to remarkable music are also great options. Pleasure, curiosity, exploration, and interest all stimulate dopamine, which makes you feel exhilarated and alive!

(**Note: If you or a person you know is experiencing regular symptoms of depression, it is important to seek medical attention from a physician. If you don’t have a family doctor, click here for additional information and options via Ontario.ca.)

Endorsement. It’s Critical for Your Next Job Reference

by: Erin Leslie, Coach, EQ-i Certified - CFIR Toronto


You’ve pretty much landed the job, but now you need to pass the reference check portion. Providing references to a future employer is critical to landing the job and on the right foot.

An endorsement is a natural validation of past job(s) well done.

How do you ensure you’re choosing the right references?

1. Request to meet with your reference so you can go over the job opportunity that you applied to and discuss your expectations of their review of you.
2. Be sure you are approaching the right people who can describe sufficient firsthand knowledge of your work patterns and achievements, to adequately speak on your behalf.
3. Make sure to validate your level of comfort and confidence with their responses on your work ethic and value. Know that they are evaluating their role in your process, their level of confidence to support you, needs to be high.

Ahead of ever needing a reference - know that all references are formed on your ability to build and maintain effective relationships.

If you find yourself having trouble thinking of an adequate reference, it might be time to have a closer inspection of your self-awareness and interpersonal skills.

Performing an EQ-i assessment of your emotional intelligence can help shed some light on potential blinders. Ask a coach to provide this assessment.

For more essential tips on the steps to take to support your reference check phase of the hiring process, click here to review eight mistakes to avoid when engaging your references.

Erin Leslie is an Associate of the Career Coaching and Counselling Service as well as the Career & Vocational Assessment Service at CFIR (Toronto). Erin is certified in emotional intelligence assessment (EQ-i 2.0) and is President of President, EQFootprints. She is a professional who supports clients with professional preparations in leading their careers, breaking down problems in specific projects, teaching team dynamic tools, creating effective professional branding and networking essentials. Erin currently works under the direct supervision of Dr. Dino Zuccarini, C.Psych.

Weathering the Grief Storm Well: What is grief, and when will it pass?

by: Reesa Packard, M.A., Ph.D., R.P.

What is grief? 

Grief is the emotional, bodily, cognitive, spiritual, and/or relational impacts of any important loss. The loss can be obvious, like the death of a loved one, or subtler, like a small or big shift in life circumstances.

Lots of people find grief to be very difficult – if you feel unable to function normally in the aftermath of losing someone or something that you cherish, or are very used to, know that this is a common feeling. Some people react to the intense emotions of grief by trying to ignore them or push them away. This strategy rarely works in the long-term though, since grief is a process that we just cannot run from – like a storm, it cannot be derailed, but instead, has to run its course.

Why is grief so hard? 

Grief can be like a storm also in the sense that it rushes in – sometimes by great surprise – and ravages some or all of what we had previously known as ‘normal’. The grief storm can bring crashing waves of anger, sadness, and guilt. These emotional waves can be big, and frequent, and unpredictable. During and after the storm, it is easy to feel overwhelmed and disoriented.

To get through the grief storm, we have to actively care for ourselves in it, which takes work. There is a decent payout for this work, though: if we can manage to do this, then those big, crashing waves of emotion can gradually become less intense, less frequent, and more predictable. While the loss itself never goes away, the pain it brings can become easier to tolerate. Over time, we can begin to find ways to re-build a new normal.

So, how can we weather the storm well? 

Striking the right balance between connecting to difficult emotions and also taking regular breaks from them, is key.

To connect with the difficult emotions, you can try any strategy that will help you feel and release the emotions, such as taking in a moment of silence with yourself either in stillness or while moving, journaling or drawing about the feelings, or sharing the feelings by talking to a good friend or a therapist; find ways to let it out.

To take a break from the emotions, you can try any strategy that can re-resource you, remind you of a different perspective, or shift your experience, such as engaging in hobbies or activities that you typically enjoy. This might include social, creative, active, spiritual, or deep experiences; find ways to be a bit more okay, even just for a minute or two.

Remember that everyone grieves differently and that your needs are likely to vary from moment to moment, and situation to situation. The process of learning to weather the grief storm well is less about doing any one specific thing, and more about exploring, and learning about yourself and what you might need. While the balancing of feeling emotions and taking breaks from them can be important, how you go about balancing these will be specific to you. Grief storms can be hard, and anything you do to get through them, that also supports your overall wellness (or doesn’t take too much away from it), can be absolutely okay.

Take good care.

Reesa Packard is an Associate at CFIR. She has a doctoral degree from the Saint Paul School of Psychotherapy & Spirituality and works in private practice as a registered psychotherapist. She works with clients hoping to develop a more integrated sense of self as a means to well-being and meaningful, lasting transformation. Reesa is also involved in the teaching and supervision of psychotherapists-in-training and advanced knowledge through research in her specialty fields.

O, Ladies: Closing the Gap to Sexual Pleasure

by: Sarah G. Bickle, B.A. (Hons.)


For many women, orgasm and sex don’t necessarily go hand in hand. Only one-quarter of women “reliably” orgasm during sex and, on average, say that orgasms are their 15th motivator for sex – following motivators such as an expression of attraction or love, a desire to feel good or have fun, and a desire to please and feel closer to their partner.

No more is orgasm an essential part of a woman’s typical sexual interaction than it is limited to it; in fact, women report having orgasms during all kinds of experiences - such as sleep, meditation, breastfeeding, assault, and medication-induced states. What’s more, not all women experience orgasms the same way. For example, 70% report feeling an orgasm throughout their entire body, 47% are multi-orgasmic, and 77.5% find that sometimes they have orgasms that are better than others.

So, what features are important to a good orgasm? More than half of women agree that spending time to build arousal (77.2%), having a partner who knows what they like (58.6%), and emotional intimacy (55.5%), significantly contribute to a good orgasm. The possibilities of what leads to intense orgasmic experiences, however, are vast and highly detailed. For example, 39% of women find that clitoral stimulation is essential for the quality of their orgasm. The specified preferences for this source of pleasure alone can be highly variable among women with respect to:

location (e.g., mons pubis, hood, left side of the clitoris, direct, etc.),
pressure (e.g., light, firm, consistent, variable, etc.), shape/style (e.g., side to side, circular, tapping, flicking, squeezing, etc.), and
pattern (e.g., rhythm & repetition, alternating between motions, teasing & delaying, consistency, etc.).

The obstacles many women face regarding reaching their full orgasmic potential are undoubtedly affected by the lack of education and shame that has been produced by our cultural history. When research shows that most men and women agree that it is the responsibility of the male to stimulate the female to orgasm, and 43.9% of men cannot locate the clitoris on a diagram, many women inevitably reach an impasse. Fortunately, however, the study of female sexuality and education is growing, and research and clinical work with sexuality are helping many women become more empowered to take on an active role in closing this orgasm gap!

The Relationship and Sex Therapy Service at CFIR offers clients comprehensive assessment, psychotherapy, and counselling to address a wide range of relationship and/or sexual issues for both individuals and couples. Through treatment, we will help you to develop stronger relationships, heal relationship injuries, improve or add new relationship skills, and address sexual issues that interfere with sexual satisfaction and fulfillment, regardless of sexual orientation.

Read more about our Relationship & Sex Therapy Treatment Service. 

Sarah Bickle, B.A., is a counsellor at the Centre for Interpersonal Relationships, working under the supervision of Dr. Dino Zuccarini, C.Psych, and is currently completing a Masters of Clinical Psychology at the Adler Graduate Professional School in Toronto. Sarah works with adults in psychotherapy to support them to increase emotional wellness and resolve depression, trauma-related symptoms, and interpersonal difficulties.

Stigma in Mental Health

Stigma is a negative judgement and stereotype that brings people to feel ashamed, dismissed and dehumanized. People can be stigmatized by family, friends, colleagues, in social media, and sometimes even by health professionals. It changes how people see and feel about themselves, but also how other people see them. People living with mental health and substance use issues can be profoundly affected by stigma. They can isolate themselves for fear of being judged, which can bring them to have low peer support. It can prevent people from disclosing a mental health diagnosis and increase suicide risk.

Stigma is one of the greatest barriers to help-seeking and treatment, which can delay diagnoses and treatment options for people affected by stigma, however, there are ways to change this.

1. Educate yourself and others around you by asking questions and doing research: you can visit http://www.camh.ca/or https://www.canada.ca/en/public-health/topics/improving-your-mental-health.html for informative resources;
2. Be mindful of the language you use to talk about mental health and substance use (i.e. non-judgmental, inclusive and respectful language);
3. Be aware of your attitudes and opinions: upbringing and society can influence your views on mental health and substance use; and
4. Speak up when you hear or see something that is stigmatizing: people do not always realize the impact they have on others and it is sometimes a question of not knowing all the facts about certain topics.

Clinicians at CFIR provide evidence-based treatments to individuals from an array of backgrounds based on their needs and personal differences. We continue to stay informed about leading-edge research related to the presenting issues of the clients who come to our offices.

Natalie Guenette, M.A., is a counsellor at the Centre for Interpersonal Relationships (CFIR) in Ottawa. She employs treatments that include aspects from Cognitive-Behaviour Therapy, Mindfulness-based Therapy, Motivational Interviewing, and Psychodynamic Theory, and she has an interest in working with adults experiencing a diversity of psychological and relationship issues. Natalie is currently completing a Master of Arts in Counselling Psychology at Yorkville University. At CFIR, she is under the supervision of Dr. Karine Côté, C.Psych.


References

Canadian Mental Health Association. (n.d.). Stigma and Discrimination. [online] Available at: https://ontario.cmha.ca/documents/stigma-and-discrimination/ [Accessed 29 Nov. 2019].

Centre for Addiction and Mental Health. (n.d.). Addressing Stigma. [online] Available at: https://www.camh.ca/en/driving-change/addressing-stigma [Accessed 29 Nov. 2019].

Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare management forum, 30(2), 111–116. doi:10.1177/0840470416679413

Mental Health Commission of Canada. (2019). Stigma and Discrimination. [online] Available at: https://www.mentalhealthcommission.ca/English/what-we-do/stigma-and-discrimination [Accessed 29 Nov. 2019].

The Challenges of Being Assertive and Setting Boundaries for Pleasers and Self-Sacrificers

Many people struggle with being assertive or setting boundaries. The prospect of setting limits or asserting that your needs be met can provoke anxiety as this may require some form of aggression or expression of anger on your behalf. Aggression and anger – in proper measure – can help clearly signal to others what you’re willing to tolerate and is implicated in your capacity to take up space when it’s appropriate.

Some people disavow their aggressive drives – because of conditioning within the family or the broader cultural surround - as they fear that it may negatively affect how others see them or even how they see themselves. However, disclaiming anger or aggressive drives when it may be needed doesn’t mean that these parts of you vanish; instead, it accumulates within, and it may eventually be experienced as resentment and bitterness toward others and the world. Indeed, many clients I see who attempt to preserve relationships by disavowing their need to set boundaries or assert themselves, swiftly cut people out of their lives. Or they displace their anger onto “safe” relationships that are ultimately not the source of their frustration. Others may direct their anger inward, which mutates into a nasty self-critic that sometimes ends in them physically hitting themselves in frustration.

Another common outcome for people-pleasers or non-asserters is burnout. Habitually prioritizing others’ needs over one’s own is untenable and may lead to exhaustion and symptoms of depression. During burnout, their identity as someone useful and helpful is compromised, making their dominant ways of maintaining closeness and connection unavailable to them. This experience can further exacerbate distress, as people in this situation often feel unable to communicate their needs to others – the language to do so may elude them.

Therapy can help people like the ones described above to understand the context of their people-pleasing habits. Everyone is born ready to assert their needs in the world. But, in a global sense, your experiences will shape your attitudes regarding whether being assertive is perceived as negative. Understanding how you went from being an infant who only knew how to need to someone who disavowed your needs can help reorient you to a more moderate space where you can set appropriate boundaries, and where a reciprocal exchange of needs with others is possible.

Mental health professionals at CFIR can also support you in addressing problems often associated with perfectionism, including anxiety, depression, anger, eating disorders and relationship problems.  Contact us to inquire more and to begin or continue on your journey toward making yourself and your mental health a priority.

Dr. Sela Kleiman, C.Psych. (Supervised Practice) is a psychologist in supervised practice at CFIR’s Toronto office. He has provided clinical and assessment services in a variety of settings such as the Centre for Addiction and Mental Health, the McGill Psychoeducational and Counselling Clinic, and the Health and Wellness Centre within the University of Toronto. He has alsoI completed his Ph.D. in clinical and counselling psychology at the University of Toronto. In individual therapy, he help adults struggling with depression, anxiety, grief, as well as those trying to cope with the effects of past and/or current verbal, emotional, physical, and sexual abuse.