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The Art of Truth-Telling

For most of us honesty is a quality that we value, though when it comes right down to it, telling the truth isn’t always easy. If it were, we would do it all the time, and we don’t. On a large scale, many environmental, political, and economic disasters would be mitigated by speaking and acting from truth. As a young adult I starved myself, but only learned how to speak from truth in recovering from anorexia. For individuals and cultures, it’s an essential skill to cultivate.

Within families and communities, truth shines light on sexual abuse, substance use, extramarital affairs, mental illness – heavy stuff, scary stuff. We go to enormous lengths to deny and conceal truths that we fear. There are many ways that people strive to contain certain truths from emerging.

As someone in a profession where sharing vulnerabilities is par for the course, I’ve given a lot of thought to why honesty can seem so hard. Though it’s not an exhaustive list, there are at least three reasons why people don’t tell the truth:

  1. We are afraid of the consequences.
  2. We don’t trust ourselves.
  3. We don’t know how.

Consequences

Let’s look at the first point. Why would someone be afraid of the consequences of truth-telling? The simple answer is that you may not get congratulated for telling the truth. Perhaps you won’t be believed; maybe you’ll be punished. Some of the greatest pain in people’s lives comes from the fallout of revealing a secret. Whether it’s met with incredulity or outright rejection, the invalidation of one’s truth is an awful – and sometimes costly – thing to bear.

As unattractive as the consequences may be, however, consider the alternative: when you lie, contain, or conceal truths, it creates dissonance in the body, mind, and spirit. It disrupts connection with self and others, and deprives you of being seen as you are. Simply put, it’s exhausting to lie.

Concealing a secret gives it a great deal of power, and if there is another person – an abuser, for example – who also knows, it gives them a certain kind of power over you. Revealing a truth, on the other hand, breaks its spell. Shame researcher Brene Brown says, “If you put shame in a Petri dish, it needs three things to grow exponentially: secrecy, silence and judgment.” When it’s exposed to the light, however, shame can’t survive – it no longer governs a person in the same way. One can breathe more freely and reconnect with life.

Trusting Yourself

One of the things that can make it hard to tell the truth is not trusting yourself. I think at the root of this obstacle is a fear that if you tell the truth and it blows up in your face, you will not be okay. A lack of validation from others does not alter your inner knowing: trusting yourself means that, no matter what, you know you will be okay.

Maybe someone rejects your honesty; maybe you will lose something valuable to you – a partner, a job, your reputation. Those are real fears, with real consequences. But they must be weighed against the cost of concealment – the stress, alienation, and exhaustion of not fully standing in your truth.

There is a difference, however, between an ‘earned’ truth and an ‘owed’ one. With certain aspects of your life, you get to decide who to tell: just because something is true doesn’t mean that you have to share it with everyone. But it’s also not an excuse to conceal the truth from people who have a right to know. For example, there is a big difference between sharing a mental health diagnosis with others (an earned truth) and sharing an extramarital affair (an owed truth).

Of course, there are exceptions to this (not every marriage is built on a cornerstone of this kind of honesty, but you probably know if yours is one of them). And some people share their truths with everyone – power to you! Trusting yourself in this context means attuning to your powers of discernment: is this a truth that I want to share? Do I have an ethical or legal duty to be honest about this? And then building up the courage and self-love to know that you’ll be okay no matter what the consequence.

Telling the Truth

I used to think that honesty was an end in itself, and that it didn’t matter how it comes out. Then I learned that there is certainly an art – a difference between the soft touch and a sledgehammer. As a teacher of mine once said, “Honesty without compassion is abuse.”

So, how do you tell a difficult truth? An important first step is to – again – reassure yourself that you will be okay regardless of whether you’re believed, validated, congratulated, scorned, rejected, or punished. Know your reasons for speaking up, and honour them. Be proud of the courage that it takes. There is a certain kind of freedom that lies beyond the threshold of a binding secret.

If your secret is personal and vulnerable (for example, a mental health diagnosis or surviving sexual abuse), choose the safest and most trustworthy person that you can share with. Ideally this is someone who will hold and honour your truth, and help you find the resources you need. If by some bad luck that person does not hold your truth well, the problem isn’t with what you’ve said; it’s with who you’ve told.

Trust your inner knowing and keep seeking the support you need: it’s out there, I assure you. There is a reason why you have chosen to share, and the right people are out there to celebrate you. The internet is a great place to find supports if you live in an area with limited resources. Keep trying to find the help you need.

If the truth you need to share is of the “owed” variety (for example, abuse of a child or theft of property) it’s still important to trust your inner knowing. Though there’s a higher possibility of legal ramifications (divorce, fine, incarceration), on a fundamental level you will still be okay. Even with a certain loss of freedom, you may in fact feel liberation: there is relief in unburdening heavy secrets. I’ve often thought that when people ‘get away’ with crimes are often not actually free. Sociopathic tendencies aside, people have to live with their secrets and lies.

Your truth is one of the only things you own: no one can take it away from you. Secrets bind, and truths really do set you free. Work to trust, love, and forgive yourself if need be, so that no matter what happens you have refuge in your being. Seek support and guidance from people you can trust, and please be in touch if you need any extra help. In health and wellness, Deirdre.

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Three DBT Skills To Help a Suicidal Teen

Living in the Kootenays, we are isolated from acute care facilities that help teenagers who struggle with serious mental health issues. The closest adolescent psychiatric hospital is in Kelowna; the closest eating disorder hospital is on the coast. If a teenager struggles profoundly with a mental health issues like suicidality or anorexia, they must leave their home community in order to receive the help they need.

We need more resources closer to home for rural teenagers. Not only is it less disruptive, if we’re talking dollars and cents it is also less expensive. With better supports in local settings, communities can gather and help teens further upstream. Dialectical Behaviour Therapy, or DBT, is one such resource.

Dialectical Behaviour Therapy was originally designed to help profoundly suicidal patients within hospital settings. As the name suggests, at its outset DBT was a behaviour therapy, meaning that its approach was to change ‘problematic’ behaviours. However, the pioneering patients of the therapy felt that they were being moved too fast into changing their behaviours. As a result, DBT was modified to be based on acceptance and change. A key tenet of DBT is that one must first accept reality as it is – totally and completely – before even beginning to contemplate change.

I sometimes get calls from concerned parents, psychiatrists, and other helpers looking for DBT support specifically for teens. It’s a good fit: teens often struggle with regulating emotions, relating with parents, impulsive behaviours and so forth – all of which DBT addresses. While it is often delivered in a group setting, there is no such resource for teens in the West Kootenays. The good news is, DBT skills can also be utilized on a one-to-one basis. There’s even a great DBT book for adolescents. It’s full of skills and activities to work through alone or with another. Below are three skills that can help teens who struggle with suicidal ideation. The last one – TIPP – is specifically for when crisis feelings are high.

Validation

Many of us know how it feels when our truth is not validated from the outside. On the emotional level, it doesn’t matter very much whether other people’s intentions are kind or hurtful: a feeling of invalidation leads to isolation. If the pain is too great to bear, it can turn to suicidal thoughts and behaviours. The founder of DBT, Marsha Linehan, outlines some of experiences that lead to painful invalidation:

1. Being ignored.
2. Being repeatedly misunderstood.
3. Being misread.
4. Being misinterpreted.
5. Having important facts in your life ignored or denied.
6. Receiving unequal treatment.
7. Being disbelieved when being truthful.
8. Having private experiences trivialized or denied.

For many teenagers, being misunderstood is quite common. Feelings of injustice can arise when perspectives are ignored, or when teens differ from their caregivers on the best way to guide them. It is a difficult time of life. Power dynamics shift and they often see things differently than the adults in their lives. Whether or not teenagers find support and validation on the outside, there are skills by which they can self-validate. These include:

1. Being non-defensive and checking the facts of a situation. Are your responses valid, or have you misunderstood another’s intentions? If you have someone in your life that you trust, check your responses with them.
2. Acknowledge when your responses don’t make sense, and drop blame – it rarely helps.
3. Be kind to yourself. Remind yourself that you are doing your best (just getting through the day can be a heroic accomplishment).
4. Admit that it hurts to be invalidated by others.
5. Grieve traumatic invalidation and the harm it creates. If you have a trusted person in your life, share it with them.

Radical Acceptance
Radical acceptance is a superstar of the DBT world. In a nutshell, what it means is this:

It is what it is.
Oftentimes, the pain we experience is exacerbated by the idea that if we could only make it different somehow, things would be better. We don’t like the present moment. We hate the way things are. As unpleasant as things may be, however, if we rail against the reality of it we only increase our suffering.

The word radical has its origin in the Latin word radix, or ‘root’. What it means in this context is to go all the way to the root of acceptance – totally and completely. In radical acceptance there’s no “Yeah, but…” It’s complete acceptance, all the way, even if the situation sucks.

Sometimes people think that acceptance means saying that something is okay, even if it is intolerable. That’s not what is meant here. It means is that even if the situation is unacceptable – say, sexual abuse for example – radical acceptance simply states that it is what it is. It doesn’t cancel out problem solving or change. It just means that we have to allow that the bad/uncomfortable/painful thing happened/is happening/might happen.

TIPP Skills

When a person is in crisis, these are the skills to use. The human nervous system consists of both the sympathetic and parasympathetic nervous systems. The first stimulates arousal; the second calms us down. All of the TIPP skills work to stimulate the parasympathetic nervous system. These skills don’t replace the problem solving; they calm us down enough to begin to think of solutions.

1. Temperature
The ‘T’ stands for changing your facial temperature with cold water, while holding your breath. This activates the dive reflex, which reduces physiological and emotional arousal. For those who are unfamiliar, the dive reflex causes the heart rate to slow down to below resting heart rate in mammals when they are immersed in very cold water without oxygen. A great way to do this is to fill a sink with very cold water and ice if it’s available, and then immerse your face for as long as you can hold your breath.
Caution: please avoid if you have heart problems. There are other skills you can use in a crisis.

2. Intense Exercise
The ‘I’ stands for intense aerobic exercise for at least 20 minutes. Not only does intense exercise increase positive emotions, it also helps to shake off unpleasant ones. According to DBT, emotions help to organize the body for action. For example, anger cues the body to fight, while fear cues us to run. Sometimes emotional reactions are not useful and can even make a situation worse. Exercise can help us discharge the energy of the emotion without causing any harm.

3. Paced Breathing
The last two TIPP skills are less vigorous and better for people who, for whatever reason, should avoid extreme physical states. Paced breathing includes slowing the breath down to 5 or 6 breath cycles per minute, and breathing deeply from the abdomen. The outbreath should be longer than the inbreath. This longer outbreath stimulates the parasympathetic nervous system, which in turn calms the body down.

4. Paired Muscle Relaxation
With this skill, the strategy is to tense muscle groups while breathing in, and then to relax the muscles on the outbreath while silently saying “Relax”. This skill teaches a person to notice the sensations of tensing and relaxing, and also allows for greater muscle release by tensing first. Pairing it with a word (the word can be anything calming) also brings a different level of awareness to the calming intention.

This is a “quick and dirty” rundown of some DBT skills to help teens work through suicidal thoughts and behaviours. It is by no means exhaustive, and is meant to complement rather than replace a safety plan. If you know (or are) a teen who is suicidal, make sure that there is a trusted someone to reach out to – be it a friend, a caregiver, or a counsellor. There is a 24/7 crisis line to access, and you should know where the nearest emergency room is as well. If all other supports fail, this is the place to go, any time of the day or night.

It is sometimes said that suicide is a permanent solution to a temporary problem, and I really do believe this to be true. It can be hard to believe that things will get better – especially when you have relatively little life experience with which to compare your current situation. The beautiful thing about getting help young is that the earlier someone gets help, the better the outcome – even going into adulthood. So don’t be afraid to reach out – there is help, hope, and healing available. Feel free to be in touch if you have any questions. In health and wellness, Deirdre.

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Anorexia, Bulimia, and the Starving of Saints

There is an idiom about the canary in the coal mine, dating back to when miners brought caged canaries underground with them. If the canary died, signalling toxic levels of methane or carbon monoxide which were undetectable by smell, the miners knew to get out. I’ve heard those with eating disorders likened to canaries in coal mines – delicate, small beings heralding some imperceptible danger. Sometimes, too, they pay with their lives.

A compelling parallel can be drawn between the canary and those with eating disorders (often young, usually female): underestimated, ornamental, expendable – their deaths indicative of a problem beyond themselves.

But what might eating disorders say about our culture at large? For although narrow body image standards extend ever farther with the impact of globalization, eating disorders are a particularly Western problem.

Tracing Western thought back a ways, the influence of Judeo Christian values on our culture is undeniable. Not long ago, the Lord’s Prayer was recited in the classrooms of public schools, and – needless to say – what are you doing for the holidays? How we organize our time, many of our statutory holidays, the very year we are in, orbit around the Christian calendar.

Here’s something to ponder: a great number of Christian saints died of anorexia. The literature does not define it as anorexia nervosa mind you, but really, how can we know? To explain the difference: anorexia is simply a medical term meaning “a lack or loss of appetite for food.” Anorexia nervosa, on the other hand “is an emotional disorder characterized by an obsessive desire to lose weight by refusing to eat.” This starving of the saints has been called “holy anorexia” – the melting away of flesh to be closer to God.

Compare this, on the other hand, with the seven deadly sins, of which gluttony is one. In this context, to hunger, to desire, to eat and not stop is sin – a deep taboo. In Latin, bulimia literally means “ox-hunger” (bous=ox, limos=hunger). In modern times, we intersperse saintliness and sinfulness into how we describe food and desire. There are ‘pure’ and ‘clean’ foods; angel and devil’s food cakes; temptation and denial; ‘sinful’ indulgence; good or bad foods – the list goes on. Control over our physical nature is both implicitly and explicitly reinforced as desirable, even morally superior.

Which brings me to another point: in the 1600s, when Rene Descartes said, “I think, therefore I am” he ushered in a new mode of thought that we now call Cartesian dualism. It runs like a silent, underground river – or noxious substance, depending on your politics – through our culture to this day. Dualism separates the mind from the body, and – as his famous statement suggests – elevates the former.

Reason over emotion dominates some of our most respected institutions, from law to ‘higher’ learning. Feminist scholars have done an admirable job of tracing how this dualism prizes the masculine over the feminine, as well. After all, women are inextricably bound to their physical nature – at the very least, every month. As a quality, emotion is considered more feminine, ration more masculine. Again, the list goes on.

At the intersection of the Western body, these associations have been grave. As women have been subjugated, so have their bodies – indeed, subjugated because of their bodies.

Eating disorders are a new(er) spin on an old story: that the avenue to worthiness, goodness – ‘perfection’ – is through denial of the physical self.

There is no room for the deep wisdom of bodily hunger, or for the sensual joy that comes from loving life. There is no room for that to be form of worship, devotion.

And this worthiness we seek: of what, to whom? The old answer would be God; the new answer is open to interpretation. Certainly, media is a modern day god, and a punishing one at that. The beauty industry alone is a multi-billion dollar enterprise, keeping us spending with little regard for cost to the individual. By design, it constantly shifts the goal posts beyond reach while it sells the fantasy of perfection.

In the midst of my own eating disorder decades ago, a new thought occurred to me:

What would I be doing with my life if I weren’t so obsessed with this impossible pursuit?

And the answer was: pretty much anything. Using my voice, that’s what. Taking up space, that’s what. Asking that question was my first awakening to a life outside of the Matrix.

And there’s another message here about freedom. The canary in the coal mine was caged. Do you think she so loved the miners that she volunteered for her mission? Doubtful. Throughout history and even today, women have been caged, corseted, covered, concealed. The peculiar success of the eating disorder is that a person comes to confine themselves, and that it appears to be an individual – rather than cultural – problem.

As feminists of the 1960s said, the personal is the political. To believe that eating disorders are unique to the individual is to not question the institutions that shape our thought. If eating disorder sufferers are canaries in coal mines, it leads one to wonder a few things:

· Who has the right to confine another ideologically?

· Who benefits from that confinement?

· What if, instead of disappearing, individuals broke free and took up space?

And a word about the miners in all of this: the same system that sacrifices canaries is the very one that sends men underground to work for wages at the cost of their lives. Guaranteed, someone profits from that sacrifice. This narrow focus on body image that occupies our culture is a red herring of sorts. It keeps us from remembering to ask whatever was wrong with our body in the first place. And who got to set that standard?

Perhaps the greatest cost incurred is that eating disorders inhibit exploration; taking up space; and being of service to some cause greater than perfection. The actual answer that emerged for what I would be doing with my life if I weren’t so preoccupied with an eating disorder was this: digging waters wells in Africa. I haven’t done it – yet. But now that I’ve said it aloud, I have to. And because I’m alive, I can. It is the privilege of living in this human body.

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What’s the Difference Between Borderline and Bipolar?

That’s the question that begat this article, but it mushroomed into more than that. You see, to talk about how borderline and bipolar are different, we also need to talk about how they’re similar. And to talk about how they’re similar, we need to talk about how they’re both diagnoses in the Diagnostic and Statistical Manual, or DSM. And to talk about the DSM, we need to talk about how language shapes our understanding of a thing.

On Language and the DSM

If you’re unfamiliar with the DSM, it’s the manual that contains all the current psychiatric presentations. A new one is published roughly every 10 years or so; the fifth one has been out for about 5 years. Everything in the DSM – from anxiety to adjustment to tobacco use – is classified as a disorder.

Classifications and definitions change: for example, the DSM listed homosexuality as a mental disorder until 1987. One can see how this paralleled our cultural treatment of homosexuality as somehow ‘unnatural’. Gender dysphoria is still a classification in the DSM-V, parceled out with goal posts such as “a marked incongruence between one’s experienced…and assigned gender, of at least 6 months’ duration, as manifested by at least six of the following symptoms”. The medicalized language, with its precise delineation of symptoms, suggests that gender – already a cultural construct – can be quantified in this way. It also implies, in what is perhaps the oddest feature of all, that the American Psychiatric Association is the premiere authority on this matter.

The point I’m trying to make here is that what we collectively decide is a disorder – and what the parameters of that ’disorder’ are – is a human construct, not necessarily fact. It would be dishonest, however, to say that certain presentations do not share recurring constellations of symptoms, because they do. What we call bipolar has existed for as long as humans have recorded symptoms. The Traditional Chinese Medical text the Spiritual Axis, which dates back to 475 BCE, describes it thusly:

When Dian [Depression] first appears, there is lack of joy, heavy and painful head, red eyes, eyes looking up. When Kuang [Mania] first appears, there is little sleep, no hunger, glorification of the self as if one were the most knowledgeable person, shouting at people, no rest in day or night.

I will say two problematic things about the DSM. First, the language we use shapes our experience. Whether we use strengths- or deficit-based language is a choice that will influence how we connect with another, and whether that person feels safe with us. When we use the word disorder it de facto becomes pathology, and sometimes by extension we pathologize the individual. I personally avoid using the word disorder when I can, and try to honour how a person defines themselves. For some, a label puts them in a box; for others, it sets them free.

The second thing I want to highlight is that the DSM carries a great deal of power: for better or worse, it shapes the dominant discourse around mental health. You know the saying, “If all you have is a hammer, everything looks like a nail?” Well, if all you have is the DSM, everything looks like a disorder. Boiled down to its simplest element, what I’m trying to say is this: think critically about all information, including this article. No one has an absolute window on the truth.

Back to the Original Question

An important distinction between borderline and bipolar is that bipolar has a strong physiological/genetic component. One of the screening questions for bipolar is whether any family members have had it. Borderline can also run in families, but that tends to be more a product of environment than genetics. Moreover, people often outgrow a borderline presentation with maturity, treatment, and time, whereas for most people, bipolar is a sidekick for life.

Impulsivity and extreme highs and lows can make the two look similar, though in borderline the behaviours can shift many times within the same day and are usually caused by external factors. With bipolar, on the other hand, the factors generally have a physiological basis and episodes last longer. There are some hallmarks of mania that you wouldn’t find with borderline, such as not sleeping yet not being tired; a rapid rate of speech; an elevated expression of righteousness. Bipolar depression is unique, as well. In the absence of mania it can look like regular depression; however, with bipolar antidepressants often trigger mania.

Also, there are some things that make borderline unique. Some people experience an inconsistent sense of themselves. Suicidal or self-harming behaviours are quite common. Intense relationships can form quickly but then fall apart, intensifying a person’s feelings of unworthiness. Sometimes because of boundary violations in the past, a person has difficulty making or honoring boundaries in the present. The good news is: sense of self, effective ways of expressing distress, and boundaries are all teachable skills. With time and effort, a person doesn’t need to feel dominated by their emotions.

Treatments for Bipolar and Borderline

For both borderline and bipolar, stress can make things worse, so skills in this area are very helpful. The ‘usual suspects’ apply here: how is the person sleeping? Eating? Moving? What substances are they putting in the body? Tending to sleep is particularly important with bipolar, as lack of sleep often precipitates an episode of mania or depression, and is itself a symptom of mania. Food is our original medicine. Having awareness of the effects sugar and caffeine, for example, can take a person a long way in regulating their own mood naturally. Ditto with exercise: move your body and chances are you’ll feel better. Even the act of getting outside and feeling the air on your skin is a powerful step in the direction of mental health.

Because borderline is influenced so much by environment, it’s helpful for individuals to gain skills that allow them respond to the events and people in their lives. Dialectical Behaviour Therapy, or DBT, is a go-to treatment for borderline. Based on acceptance and change, DBT teaches mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. As someone who has taught DBT groups for years, I can say that it teaches great life skills for anyone – you don’t have to have any sort of ‘diagnosis’ to reap the benefits. And also, people in DBT groups are always changing their hair colour, their piercings, their style. There’s never a dull moment and I love it!

On Social Justice and Mental Health

I’m including here some of the excellent work done by the Icarus Project, which is a “media and activist endeavour broadly aligned to a Recovery approach, arguing that mental illness should be understood as an issue of social justice”. For those of you who don’t know, Icarus is the figure from Greek mythology who was warned by his father but nevertheless flew too close to the sun with wings made from feathers and wax. The wax melted and he plummeted into what is now known as the Icarian Sea. The myth is often used as a metaphor for bipolar.

However, as a person whose own namesake from Irish mythology, Deirdre, suffers a similarly tragic ending, I’d like to offer a different interpretation. What if Icarus did touch the sun, and made it, and everything was okay? John Lennon asked, “Who in the world do you think you are: a superstar? Well, right you are!” What if, as he wrote, we all shine on, like the moon and the stars and the sun?

The Icarus Project goes on to state that “a person’s mental state can improve through greater social support and collective liberation.” That is my stance as a counsellor as well:

The more we attend to social justice as an aspect of mental health, and hold one another in community rather than isolation, the closer we all are to liberation.

Just because you have a mental health diagnosis doesn’t mean it defines you, but it doesn’t mean you need to ignore it either. Know yourself and the terrain of your symptoms, and create a care plan that works for you. Reach out if you have any questions and, as always, in health and wellness, Deirdre.

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Standing on the Shore of a Loved One’s Addiction

Not infrequently, I will receive a call from someone who is looking for help with addiction. In these calls I’m thinking about, it’s not the person suffering the addiction who calls – it’s a loved one. They want to know a few things:

What can I do to help?

What am I doing that harms?

Where can I find support for myself?

It’s an apt analogy to say that loving someone in addiction is like standing on the shore and watching your beloved thrash about in the waves. It’s painful. It’s scary. You don’t know if they’ll survive.

Addiction is an interesting area of mental health. Though it’s often grouped with mental health (as in, mental health and substance use treatment centres), it’s also distinguished from it. One we treat as an affliction, the other as a choice. It’s a curious thing that they are treated as separate issues, and the outcome can mean the difference between compassion and criminality.

When someone with any other mental health issue – from bipolar to anorexia to schizophrenia – becomes ill to the extent that they are gravely harmful to themselves or others, they can be hospitalized involuntarily until the risk is no longer critical. Not so with addiction. Unless incarcerated, which brings a host of other problems, a person in addiction must voluntarily seek treatment in order to get help. This can take years, for those who are lucky enough to make it.

And where does this leave loved ones? The answer is, feeling pretty helpless much of the time. Grieving someone who is still alive. Wading in the muck of uncertainty, teetering between anger and despair. So, let’s begin to unpack some of the more common questions that loved ones ask.

What can I do to help?

When someone lives with chronic pain, the pain never really goes away. The trick is to live with it mindfully, appreciating subtle differences in sensation and noting how the pain changes from one moment to the next. When you love someone with addiction the pain is always there…but life still needs to go on. There are birthdays to celebrate; love still wants to love. Rather than letting it stop you from enjoying life, invite the pain to come with you. Allow it as a guest, whether welcome or not. To resist it is to increase its hold.

Another way to help is to tend to your own wellbeing. Find a counsellor or support group if that is helpful. Eat well, sleep well, move your body. Recognize that there are other areas of your life to attend to; other people to love; events, holidays, and hobbies to enjoy. I will include resources on extra support at the bottom of the article.

What Am I Doing That Harms?

The most important thing you can do for someone in addiction is continue to hold that person in love. It’s an affliction that is easy to vilify: often the person’s behaviour is unattractive. Sometimes it is actually abusive.

So, what does loving someone with an addiction look like? Sometimes it means making a boundary. This can be anything from telling the person you will talk with them when they are sober, to calling the police if the behaviour is abusive.

In the 12 Step Tradition there is a saying: You can have boundaries or you can have resentments, but you can’t have both.

Even though boundaries can seem harsh, when done in the spirit of love they are anything but. Enabling a person to continue on a destructive path by ‘protecting’ them, however, can be inadvertently cruel. Sometimes the most loving thing you can do is stop protecting them and get out of their way so that they can crash.

Another way you can reduce harm is with your language. You may have noticed that throughout this article I don’t use the word addict. I do this intentionally to create distance between the person and the problem. While I will say that someone struggles with addiction, I won’t call them an addict. Your perspective may differ on this: whatever your choice, I invite you to bring awareness to the power of language to both harm and heal.

Where Can I Find Support For Myself?

Certainly, loved ones are the silent sufferers of addiction. There are treatment centres, support groups, and counselling for those in addiction, but far less for those on the periphery. Below are links to a few supports for loved ones:

1) To date, no one in the recovery community has mobilized or organized quite as successfully as the 12 Step Tradition. Al-anon (and Alateen) “are people, just like you, who are worried about someone with a drinking problem.”

https://al-anon.org

2) SMART Recovery Family and Friends is “a science-based, secular alternative to Al-Anon”. They have lots of great resources on their website for loved ones of people struggling with any addiction, not just alcohol.

https://www.smartrecovery.org/family/

3) Emotion Focused Family Therapy (EFFT) “support[s] caregivers to increase their role in their loved one’s recovery from mental health issues”. This support is mainly geared towards parents of children in their care, though it is useful for parents to children of all ages.

http://www.emotionfocusedfamilytherapy.org

4) For people supporting those with addiction in Nelson and surrounding areas, the Addictions Day Treatment Program (ADTP) out of Castlegar holds family and friend support groups on occasion. To find out when the next one is being offered, call 250-304-1215.

It is my heart wish that this article makes you feel more empowered and less alone. If you find yourself standing on the shore of a loved one’s addiction, you can still appreciate the beauty of the landscape. Send love and assistance to your loved one when you can, and also tend to the other areas of your life with care. If you would like more support or have any further questions, please feel free to get in touch with me.

In health and wellness, Deirdre.

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How To Find The Right Counsellor

When I began my master’s degree in counselling, the first thing that struck me was how genuinely warm and kind my classmates were. In a roomful of people that supportive, I thought to myself, “I’m home!” It’s pretty true that, by and large, counsellors are a caring bunch of people.

That said, when you’re looking for a counsellor of your own, it can be hard to choose the right one. How do you know who will be a good fit – what should you look for? Choosing the right counsellor is an important decision, and there are a few guidelines that will help you make the right decision for yourself.

Talk with them first

The first thing you want to do is find one that offers a free consultation. You can do this either by phone or in person, and an ideal amount of time is 20-30 minutes. The idea is that you get to ask them some questions and get a sense of their style. Just like any other important relationship, there are some people you will naturally feel more comfortable with, and that’s the sort of feel you want to go for.

I find that when someone is new to therapy, they are often unsure of how this initial conversation should go. I encourage you to have a few questions prepared – after all, you’re interviewing them for an important position in your life. A counsellor should be approachable, professional, and prepared. A few examples of questions to ask include:

1. What is your style of therapy?

2. What is the structure of your sessions?

3. What do you love about your profession?

Choose a registered counsellor

There are some exceptions to this and the designation doesn’t matter to everybody. Generally speaking, however, a counsellor having some kind designation is a good idea. Here’s why:

First, it shows that they have put in the time, dedication, and commitment to educating themselves well for this most trusted profession. For me personally, my ongoing dedication to education is an ethical stance that says I can hold the space for someone and I know what I’m doing. It also says that if something is beyond my scope of practice and I don’t know what I’m doing, I have the ethics and education to know that, and to guide a person elsewhere.

Another reason why choosing a registered counsellor (or social worker, psychologist, etc.) is important is for the purpose of benefit plans. If you have a benefit plan through work and it covers counselling of some sort, your plan will require you to engage in services with a registered provider. An important caveat: check with your plan to see what it covers. Some plans cover services with a registered counsellor, and others cover services with a registered social worker or psychologist. This will guide you in your choosing.

Go with what feels right to you

After attending to some of these checklist items, there really is no substitute for just knowing what and who feels right to you. Many factors may influence that decision:

1. Do you have a style of therapy that you either prefer or feel curious about? Maybe you’ve heard of Dialectical Behaviour Therapy and want to try it out, or you’ve done Narrative Therapy before and really like that approach. When a third party is paying for the sessions (for example, a graduated return to work after injury), they may require you to engage in the evidence-based Cognitive Behavioural Therapy. In that case, you might want to ask a counsellor about that. I will add here that research shows that the therapeutic relationship, more than any other factor, determines the success of therapy. In other words, if you have a good bond with your counsellor and you trust them, you’re more likely to reap the benefits of counselling.

2. Are you looking for someone with particular training in a certain area? For example, above and beyond offering anxiety and depression therapy, I have specialized experience with body image, self-esteem, and eating disorders. I also have training in issues pertaining to gender and sexuality: my ethical stance is to be an advocate and ally for gender-affirming health care. Other people have special designations in art therapy or somatic therapy – the list is broad and varied. Think about what is important or interesting to you, and try to find a counsellor who fits that description.

3. Money may be a factor and if so, don’t be afraid to ask a counsellor if they have a sliding scale. Even if they don’t explicitly say it on their website, many counsellors offer sliding scales based on financial need. In fact, if you have any questions that aren’t answered on their website, be sure to ask. You may be pleasantly surprised if you do.

I hope this article helps you in your pursuit to find a counsellor who is right for you. Please feel free to reach out if there’s anything I can help you with. In health and wellness, Deirdre.

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Curious Questions

“There’s no such thing as a stupid question.”

Or, as one of my teachers said, “Yes there are, but those are outliers and they don’t count.” The simple truth is that we often don’t know where an encounter will take us, and that’s the good news: this is where magic can happen. Professionally and in life, the courage to be curiously questioning opens us up to worlds of possibilities.

It requires vulnerability to ask a question for which you have no answer. You risk exposing yourself as a non-expert, or looking ignorant. Yet, as Brent Atkinson states:

“The way our brains our wired, the most effective way to solicit cooperation is by exposing vulnerability.”

Many of us can identify with the feeling of relief when someone else asks a question we are too afraid to pose. “Thank goodness,” we think. People trust sincerity, and it puts others at ease when we reveal vulnerability. It’s honest; it’s human.

When you wonder in the spirit of open-ended enquiry, seeking to learn rather than to prove, you expand your horizons and minimize the chance for bias in your thinking. On the other hand, asking leading or close-ended questions can promote a false sense of certainty and garner premature conclusions.

Assuming we already know the answer before we ask a question puts us in the same quandary as bad science: we risk making the facts fit our theories rather than the other way around.

It’s okay to begin with an idea – we often do. But from that point, try to see where the enquiry takes you. Your destination may come as a surprise and perhaps (hopefully) you will learn something along the way. Asking, rather than knowing, is really at the heart of intelligent enquiry. Einstein himself stated, “Imagination is more important than knowledge.” The poet e.e. cummings put it this way: “even if it’s sunday may i be wrong/for whenever men are right they are not young.” Not knowing can be a great thing!

The journey to embracing wonder and curiosity is fundamentally one of humility.

The very act of asking invites feedback, allowing for connection and attunement with others. In essence, we are saying, “Are we on the same page – have I understood you?” or, posed in the language of richer enquiry: “How may I understand you better, and what would you like me to know?”

What adventures await when we follow the path of openhearted questioning?

* * * * *
6 Steps to Asking Curious Questions:

1. Don’t be afraid to ask questions! Welcome the quality of wonder.

2. Recognize that enquiry is a form of intelligence. From the ignorance of ‘not knowing that you don’t know,’ move to ‘knowing that you don’t know’ and from there, take steps toward discovery.

3. Be aware and self-reflective. Search for hidden biases and assumptions you may have.

4. See asking as a form of humility. It is gracious to share your vulnerability with others, and fosters understanding and connection.

5. Ask open-ended questions that cannot be answered with ‘yes’ or ‘no.’

6. Be prepared to be surprised! Be prepared to be wrong! Celebrate this.

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How to Say No

When my daughter was little, I posted some affirmations up around her room. On heart-shaped post-it notes were statements like, “I am funny” and “I am kind.” In return, she made some affirmations for me.

I walked into my bedroom to find the walls plastered with pink hearts. Every last one of them read, “Say NO.” Out of the mouths of babes, hey?

I used to have a problem with saying no. I was afraid that people’s feelings would be hurt, or that they wouldn’t ask me to do things again if I declined. As a result, I constantly overcommitted myself and – to be honest – was a bit of a flake. I forgot engagements. I hurt people’s feelings. Sometimes, my inability to say no even compromised my safety.

It’s ironic that the one thing I was most afraid of – hurting people’s feelings – is the very thing I ended up doing by spreading myself too thin.

Since learning to say no, my life has gotten easier. I’m less busy, and a lot more sane. I’m truer to my word, and commit to activities that I really value. Two little letters, N-O, constitute a complete sentence. No need to complain or explain.

For those of you still on the hand-wringing side of saying no, here are some tips to make it easier:

Be simple, direct, and kind. No need for lengthy explanations.

Buy some time by saying, “Can I get back to you on that?” This gives you a chance to check in with yourself and formulate what you really want to say, and how to say it.

Remember that saying yes when you mean no invites stress into your life. As they say in the 12 Step traditions: you can have boundaries or you can have resentments, but you can’t have both.

What would you say no to if you had the courage?

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The Wonder of Wonder

I love the quality of wonder. It evokes curiosity, exploration, and the humility to simply not have all the answers. When we wonder, we ask questions. We open our hearts and minds. We are as children.

Clinically, wonder is a very useful tool. When first learning mindfulness skills in therapy, clients often judge themselves quite harshly. For example, they might become aware that they feel anxious, or that their mind is racing, or alternatively that they feel nothing at all. Almost without fail, their inner dialogue will then run something like this:

“I’m doing this wrong. I’m such an idiot. I’ll never get it right. Nothing will help me. I hate mindfulness.”

Interestingly, this is the opposite of what mindfulness is meant to teach us, and where wonder comes in handy. Imagine simply noticing your feeling state, and exploring it without judgement. The inner dialogue might sound quite different:

“I notice that I’m feeling shame/boredom/anxiety/frustration.”

And that’s it. No judgement – just awareness, with a mild curiosity. No need to have the answers; no need to do anything at all. When we explore with open-hearted wonder, we can befriend ourselves with kindness. Of course, it takes practice to unlearn our adult ways. The poet e.e. cummings once wrote,

may my mind stroll about hungry
and fearless and thirsty and supple
and even if it’s sunday may i be wrong
for whenever men are right they are not young

What small thing can you do today to cultivate the quality of wonder?

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Healing Sexual Shame

When a client shares some sexual shame that they’re struggling with, I’m always filled with such awe at their strength. Maybe they’re using porn more than they want to, or they fear intimacy. Maybe they’ve just received a diagnosis of a sexually transmitted infection. Whatever it is, telling another person takes courage.

As much as it’s everywhere and all around us, we live in a strange culture when it comes to having honest conversations about sex. The well-respected shame researcher Brene Brown said, “If you put shame in a petri dish, it needs three things to grow exponentially: secrecy, silence, and judgment.” Clinically, I have found this to be truer with sex than with any other topic.

By the time people risk divulging an embarrassing, humiliating, terrifying, or painful truth about their sexuality, they’ve often been carrying it alone in the dark for too long.

We all need to know that it’s okay to share: everyone has a right to be authentically seen. Sexuality is a joyful, wonderful, essential part of life – like a plant, it deserves to be in the light. When we integrate our shadow with our light, we stand in a place of unshakeable power. We can stop running from ourselves and make peace with our truths; there is nothing left to hide and shame cannot bind us.

How would you live if shame held no power over you?

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