<![CDATA[Christina Crowe & Associates, Psychotherapy, Counselling & Coaching - The Blog]]>Sun, 11 Feb 2018 18:58:11 -0500Weebly<![CDATA[6 Tips to keep your sanity over the holidays]]>Sun, 19 Nov 2017 21:16:08 GMThttp://christinacrowe.ca/the-blog/6-tips-to-keep-your-sanity-over-the-holidays

The holidays bring up many powerful emotions for many of us. We have joyful, precious moments we intuitively know we should both be present for, and lock into memory, and then we have those moments where we can’t help it – the (adult!) meltdown is coming and its coming hard! 

How do we set ourselves up for having holidays that leave us feeling refreshed and reconnected, rather than exhausted and depressed?
So much about having optimized mental health is about being real about who we are and what our limitations are. Once we have had that gut check, it becomes about planning, planning, planning. And if you’re not a planner, don’t despair! I’m not talking about spreadsheets and family meetings. I’m talking about taking moments for yourself, every day, to check in and reflect on what went right, what could have been better and what might you do next time opinionated Cousin Eddie comes over, to set up a better buffer for yourself. 

Sometimes the holidays bring you face to face with people in your family whose political beliefs turn your stomach. People who have not been there for you, when you were down. People who have disappointed you time and time again. Last holiday season, maybe their presence made you feel worse about yourself and your situation and maybe you were determined to put your foot down about seeing them again. And now the holidays are approaching and mom is pressuring you to just ‘let it go.’ And that old familiar twist is forming in your stomach.
First and foremost, you are a grownup. That means that you can choose whom to spend your time with, who you let into your inner circle, and you get to decide who you expose yourself to. However, the holidays are tricky because often, some of the most toxic people in your life happen to come with others whom you do love and cherish. What is any reasonable grown up-recovering-from-their-childhood to do?

Here are my top 6 tips for maintaining your sanity this holiday season: 


  1. Boundaries. Take some time to reflect on your boundaries, and perhaps how they need to change now that you are said grown-up. Notice if there is someone who overwhelms you pretty quickly. Move away from them. As a grown up, you are the one who has the final say in your choice of partner, religion, sex life, job, how you spend your money or social activities. You also don’t have to accept gifts, touch, sexual advances or food from anyone that you do not want to. 
  2. Build in down time. Especially if you have kids. Sometimes we are so overwhelmed with needing to see everybody that we either are on the road the whole season, or so busy entertaining ourselves that the whole season passes us by. Maybe 3 nights out in a row isn’t such a hot idea (it’s basically a game plan for many meltdowns, kids and grownups alike).   
  3. Reflect on personalities. This is for you extroverts. Here is a newsflash: not everyone is an extrovert (shocking, I know). And just because someone wants to stay in, not go to the party, not see everybody, doesn’t mean that they are depressed or anything at all is wrong with them. It just means They.Are.Not.You. Everyone should get to celebrate the holidays the way they want. Maybe ask the introverts in your life what they like best about the holidays, and accommodate them too.   
  4. Outsource. This is exactly the time of year to change an annual gathering into a pot luck, try that new meal or grocery delivery service you’ve heard about, do all the Christmas shopping online (one for you, one for them?) and plan in some date nights for you and that other adult you live with (what’s their name again?).   
  5. If you are missing someone. This holiday season you might be alone, and not by choice; perhaps you have suffered a loss, and you can see all of the triggers that lay ahead of you. Try to volunteer somewhere, in a soup kitchen, with children in group homes, or the elderly in various facilities. People will so appreciate you, you may feel better about yourself, but most of all, you’ll have company. Staying connected to people will ease the feeling of loneliness.   
  6. Self-care. Self-care isn’t about locking yourself in the bathroom for an uninterrupted hot bath once a week (although I highly recommend it). It’s about structuring your life and your days in such a way that you are also on your To Do list. You absolutely Cannot.Pour.From.An.Empty.Cup. Mom, dad or stepparents having a nervous breakdown one day, totally losing their shit (see Clark Griswold), losing control about anything in particular is just human. It’s also a sign that someone isn’t taking care of himself or herself emotionally. My number one question for people is, while you are running around taking care of everyone else, who is taking care of you? If the answer is “no one” (which it often is), you have a problem that needs to be addressed. And, while I’m at it, you also need to average 7 hours of sleep a night, eat well, move your body a bit everyday and take it easy on the booze. 

I hope this post gives you some pause to reflect for a few moments and think ahead to how you want to feel this holiday season (rather than what you want to do).  Plan your life around the things that bring you joy. And if you have to encounter situations, people or scenarios that are taxing for you, build in the supports you need to make it through, and then build in a reward for yourself that gives you a pat on the back. And as always, reach out for support when you need it. We humans are social animals, and we weren’t meant to get through things alone, but connected to people we feel emotionally safe with.
Best wishes for a safe, joyful, peaceful and not insane holiday season. 

<![CDATA[Back to School Anxiety and 5 Tips to try at home]]>Wed, 30 Aug 2017 19:57:50 GMThttp://christinacrowe.ca/the-blog/back-to-school-anxiety-and-5-tips-to-try-at-home
It’s a week before school starts in Ontario and back to school prep is in full swing! Teachers are setting up classrooms, kids are finding out who their teachers and classmates are, clothes are being picked out, snacks are being stocked up and backpacks are getting packed. While for many It’s the Most Wonderful Time of the Year, its strikes paralyzing fear into the hearts of many of our students. Whether it’s a school specific anxiety, excessive worry about what other kids think, worry about fitting in or about teachers, the sore tummies and headaches might start ramping up for some of our kids. What is a parent to do?
Here are my top 5 tips for parents, stepparents and caregivers to consider while supporting their kids:

  1. Get back onto the school year schedule: regular bedtimes, regular wake times and regular mealtimes.
  1. Power down the devices at least an hour before bedtime. Our phones and tablets emit this super bright “blue light” that enables us to see the screen well during the day, but at night it messes with our levels of the hormone melatonin in our brains. It tells our brain its still daytime, and can lead to insomnia and night awakening in all of us. Charge those suckers in the kitchen, not in kid’s bedrooms. Kids need to sleep.
  1. Creating bedtime routines that tell our body, ‘the day is slowing down, let’s prepare to sleep’, is an important step for the whole family. Depending on the age of your kids, it might be everything from the old ‘bath, book, bed’ routine, to spending special cuddle time with a parent, or a pet, getting ready for school the next day, or practicing some kid-friendly mindfulness meditation techniques.
  1. Nutrition: Sit down the kids and allow them to be collaborators in their own meal plans. Eating more healthfully is a lifelong pursuit, but let each kid tell you what his or her favorite nutritious snacks are. Are you a mom or dad on Instagram? Follow Instagrammers who create nutritious, safe, school snacks that are kid tested! I like a local: @Wifeofagrocer. Homemade, low sugar and real ingredients are always good bets.
  1. Supports for your child: If you have a child that you have to work harder to support emotionally than your other kids, a ‘strong willed’ child, or a child who has a diagnosed disorder or learning disability, take the time to set your kid up for success. This might mean sending a letter to your child’s teacher (“All about Sally” with her strengths, challenges and tips from your perspective), going in to meet the teacher before school starts (call the principal), visiting school before the hustle and bustle begins, and perhaps most importantly, teaching your child how to calm their body down (mindfulness breathing) when they get anxious/stressed/worried. 
Symptoms of anxiety in school-aged children can be varied but might look like this:

  • Persistent, irrational fear or worry
  • It interferes with daily life
  • Irritability, jitteriness, sleeplessness, weepiness, headaches, stomach aches, chest pain, dizziness
  • Can occur with other diagnoses (Ex: ADHD; depression)
  • School refusal, avoidance
If you think your child is suffering from undiagnosed anxiety, there is a lot of support available, from self-help sources like Anxiety BC (see below), as well as locally from regional children’s services, private therapists or school-based supports. Many practical things can also be done at home to support kids.
Parents and caregivers can:
  • Pay attention to your child’s feelings (don’t minimize their feelings and suffering). Stop and listen.
  • Parents need to stay calm when children become anxious.
  • Recognize and praise small accomplishments toward improved coping.
  • Be flexible and try to maintain a normal routine.
  • Modify expectations during stressful periods – this isn’t a new time to throw in something new.
  • Plan for transitions (Ex. allow/plan for more time if getting to school is difficult).
  • Teach kids how to do mindful breathing to calm their bodies.
My favourite resources for families are these:
  1. https://www.anxietybc.com/parenting/creating-a-map - A free guide to creating My Anxiety Plan (MAP) for you and your child.
  2. Region of Peel: http://cmhapeeldufferin.ca/mental-health-information/find-help/
  3. CAMH Info for Parents: http://www.camh.ca/en/hospital/about_camh/newsroom/understanding/Pages/mentalillness.aspx
  4. For Tweens & teens: http://youth.anxietybc.com/faq
Good luck next week!

Remember, we’re all human and we need each other for support, especially our students. 
<![CDATA[When you have anxiety, but don’t know it.]]>Wed, 18 Jan 2017 16:46:33 GMThttp://christinacrowe.ca/the-blog/when-you-have-anxiety-but-dont-know-it
(Brief disclaimer: This article isn't meant to be used as a diagnostic tool. You should seek out your family doc or a psychologist for a formal diagnosis. If you want.)

Anxiety is the number one mental health reason Canadians seek out psychotherapy. 

Low levels of anxiety can persist for years – and many people just get used to it. People tend to start to wonder if they need to see a therapist when it starts to interfere with their work, romantic, family relationships and friendships. 

One of the reasons anxiety can be hard to understand, or identify with at first, is because anxiety is normal! Yes, you read that right. It’s a normal human response to a stressor or stimuli. Anxiety is an adaptive response that all human beings have, telling us when we are in danger. When our primitive ancestors were faced with the saber-toothed tiger, their bodies were immediately flooded with hormones and chemical messengers released from their brains enabling them either run, or fight. That physiological response enabled us to survive - to physically fight, or to run away, from danger – the famous ‘fight or flight’ response.

This makes good sense, right? 

Anxiety starts to become a problem when you react as if there is danger, when there in fact is no danger
The perceived ‘danger’ can be emotional or physical (for example, excessive and distressing worry about a loved one you cannot reach). Basically, your body is acting like its seen a sabre-toothed tiger, when there in fact is no tiger about to devour you. The problem is by the time your brain realizes there is no danger, your body systems are revved up to go! You are deep in ‘fight or flight’, and it can take a while to calm down. However, the thing that has triggered that response in you is very real, and it deserves your attention. 

So what are some of the signs that you actually suffer from too much anxiety?

  • Overreactions to Stress – perhaps a lot of time over preparing for an early morning, bad weather or some other negative event in the near future. People don’t consider their ability to cope and focus on what might go wrong instead.
  • Difficulty Relaxing - An inability to relax, ease your mind of worry and constantly carrying around stress could be a sign of an anxiety disorder.
  • Easily Startled – research cites an “exaggerated” startle response as a sign of anxiety. Frequently feeling on edge and startled by even the slightest, unexpected event could mean you have an exaggerated startle response.
  • Difficulty Concentrating - A primary symptom of several mental health disorders, staying focused and concentrating on a task can be difficult for people living with anxiety disorders.
  • Trouble Falling or Staying Asleep - Sleeping problems and anxiety often go hand in hand. Not only can a lack of sleep worsen anxiety symptoms, but also difficulty sleeping can be a sign of anxiety disorders.
  • Physical symptoms - muscle aches and tension, throat/swallowing problems, trembling, nausea, excessive sweating, urge incontinence - People with anxiety can commonly experience chronic pain, including diseases like arthritis and fibromyalgia. These symptoms by themselves don’t indicate anxiety, but over time, they might be indicative of the consequences of the flood of hormones and other physiological signals that overtake our body when anxiety hits.
If some of this list resonates with you, thats actually good news. You have to be aware, before you can do anything about it. 

​There are many tools and exercises you can learn to help manage anxiety. 

Anxiety has a very physical, as well as thinking, or cognitive, component, so it’s important to address both.  

Remember, when our ancestors were running from the saber-toothed tiger, they didn’t have time to stop and think about counting to ten! That is why we have this response – it’s built-in, to ensure our survival and safety. Breathing and body relaxation exercises are important to help bring your body out of ‘fight or flight’ mode and return to a more relaxed state.

There are many different physical exercises to try to find the right one for you. In addition, some of the cognitive, or thinking, skills a person can learn include,
  1. Getting more comfortable with uncertainty,
  2. Exploring your thoughts about the usefulness of worry,
  3. Improving problem solving and communication skills, and
  4. Finding new ways to gain support from loved ones.
For people with more severe forms of anxiety, with whom psychotherapy has either not worked or is not appropriate, or if you just want the extra support, your family physician can provide you with information about the medication options available to you. Finding a therapist trained and registered to delivery psychotherapy is as important in finding someone you trust and 'click' with. If it didn't work with one therapist, it might very well work with another. 

Life can get complicated! Everyone encounters challenges from time to time they need help with, and that is a normal part of a well-lived life. Being able to name your struggle and connect the dots is an important part in owning it and enacting the thinking and behavioural changes you need to in order to reclaim your life.
<![CDATA[On Depression: The Why, The Beginning and the Recovery.]]>Wed, 07 Dec 2016 14:28:10 GMThttp://christinacrowe.ca/the-blog/on-depression-the-why-the-beginning-and-the-recovery
There are a lot of things that can be difficult about having a condition that isn’t seen as much as felt.  If you have suffered from depression in the past, or are living with it now, you might have questions at some point like,

  • why has this happened to me,
  • how do I get better,
  • how will I know when I’m better?
When someone breaks their leg, we all know when they are better – they are walking again.  When an asthmatic has an attack, we all know they need their puffer, and then they feel relief within minutes.  When you have a cold, you know you are better when the fog lifts and you’ve stopped sneezing or coughing.  But when you suffer from depression, what is the sign for everyone, including yourself, that it’s over?  For a lot of other conditions, there can seem to be a more finite treatment and recovery endpoint. 

Understanding how you were susceptible to depression in the first place is a good place to start, because it’s related to your recovery. 

Why do some people suffer from depression and not others?
The ‘diathesis-stress model’ of depression suggests people have, to different degrees, vulnerabilities, or predispositions, for developing depression. The model attempts to explain how biological or genetic traits - ‘diatheses’ - interact with environmental stressors to produce depression. In other words, your genetic predispositions must be crossed with stressful life events (of a social, psychological or biological nature) in order to develop depression. And further, one person’s definition of stress, is not necessarily another’s. [1] So, the greater genetic background, the less of a stressor it will take to trigger depression, and vice versa.
In your life, what are the stressors that triggered depression? Turns out, life! The death of a loved one, other losses such as a job layoffs, relationship difficulties like divorce, or even ‘normal’ milestones such as puberty, marriage, or retirement. For some, it's alcoholism or drug abuse, neurochemical and hormonal imbalances, and even infections can all be powerful enough to cause depressive symptoms in someone with a 'diathesis' for this condition. A significant loss may be enough to trigger depression in one person, while a similar loss experienced by another person might not bother them much at all.
The natural course of major depression is that the average adult can potentially experience 4 to 5 more episodes after the initial one.  A depressive episode can last anywhere from 3 to 24 months, and may varyin severity person by person. There are different ranges studied and cited, because there are different definitions of “recovery”. [2]

​In a very basic nutshell, you have recovered from depression when you feel better,
​mentally and physically

In general the question is, are you functioning again in a manner similar to a time when you can identify that you weren’t depressed?  But it can be complicated.  What if things have changed in your life and not only can you not resume normal activities, but for your own health, you shouldn’t? For example, you were injured, and in the aftermath of your physical recovery, you became depressed.  In order to not reinjure yourself, you’ve been instructed to modify your physical activity, or your lifestyle in some major way.  You’re left feeling like even though your mind is in a better place (after psychotherapy and potentially medication), you still can’t do what you once did. You don’t quite feel normal again.  Are you still depressed?
Treatment is the best way out. The best evidence for depression treatment involves psychotherapy, “talk therapy” (CBT – ‘cognitive behaviour therapy’ has the most evidence behind it) and if necessary, medication. [4] In Ontario, one can get the medication much more easily than they can get the psychotherapy (psychotherapy is as effective and sometimes more effective that medication alone, and psychotherapy combined with medication has been shown to provide the best outcomes).  The main reason is that once you have experienced depression, a majority of people, even those who have had medication, will suffer a relapse if they have not had any skills training to teach them how to prevent relapse. And that is where therapy involving CBT comes in. 
In the scenario above, there is a new perspective (the C in CBT) that can make all the difference. There is a “new normal” to adjust to (the B in CBT).  And slowly, you begin to understand (the T in BCT) how to manage your own condition, within the new context of your own life.

Just like an asthmatic has to constantly monitor themselves for constricted airways, a person who once experienced depression needs to reflect and monitor themselves for signs of relapse.

There is a heap of self-exploration that goes along with optimal treatment for depression, and the more support you can get from your family, friends and people you trust, the better.  The trick is, it sometimes requires you to be the one to educate people about what you are going through (even people whom you think should know), despite the fact that when you are depressed you don’t have the energy or motivation to advocate for yourself. Catch-22! This is why reaching out for help is critical. There are a LOT of people who don’t understand what depression is or what it feels like. And it can be hard to acknowledge even to ourselves that our depression exists, let alone have a grasp ourselves on what treatment and recovery are like.
In summary, depression is a condition that can be thought of as caused by both genetic and environmental factors, and It.Is.Not.Your.FaultThere is treatment available, support for families and caregivers, and lots of free information available online. Once you dig down deep enough, there IS a start and end point, and with the support of a properly trained mental health professional (read: those who have been specifically trained to provide psychotherapy) you can get there.
For more resources, check out the links on the Resources page. 

If you think you might be a little, or a lot, depressed, here is an online screening tool. It is not a diagnosis, but can give you a little direction about whether you should seek more support. Click here

[1] Scott B Patten: Major depression epidemiology from a diathesis-stress conceptualization. BMC Psychiatry 2013 13:19.
[2] Klein, Daniel N.; Kotov, Roman. Course of depression in a 10-year prospective study: Evidence for qualitatively distinct subgroups. Journal of Abnormal Psychology, 125(3), Apr 2016, 337-348.
[3] Trujols J, Portella MJ, Pérez V. Toward a Genuinely Patient-Centered Metric of Depression RecoveryOne Step Further. JAMA Psychiatry. 2013;70(12):1375. doi:10.1001/jamapsychiatry.2013.2187
[4] Cuijpers, et al. A Meta-Analysis of Cognitive-Behavioural Therapy for Adult Depression, Alone and in Comparison with other Treatments. Can J Psychiatry July 2013 vol. 58 no. 7 376-385

<![CDATA[Learning to Repair: otherwise known as ‘healing’]]>Fri, 30 Sep 2016 21:32:36 GMThttp://christinacrowe.ca/the-blog/-learning-to-repair-otherwise-known-as-getting-over-it
We all have those things in our relationships … That Thing we can’t get over.  Maybe it’s a part of your partners past, or a fight that keeps coming up over and over.  Or maybe its that time when things got out of hand, that neither of you are quite over.  Maybe it’s that parenting moment you are sure has ruined your kid forever.  Maybe you are living with something that is compromising your values, and you don’t know what to do about it.
Once you understand something, it’s hard to stay mad at it. 
I do a lot of work with couples, and I have also done a lot of work with individual partners who have been involved in everything from infidelity to domestic violence against their partner.  And sometimes in the case of domestic violence for example, the partner who got arrested is the partner who was finally fighting back after many, many years of being the victim.  Or, they were defending themselves, but the cops didn’t care and arrested them anyway.  Or, it was the “first time” things ever got out of hand, or the “first time” someone cheated.
I also support parents who are struggling in their relationship with their kids, from primary school-aged, all the way through to young adulthood.  Raising kids is hard. Full stop.  However, there are right and wrongs in this journey.  Perhaps the wrong you did is less the point, than the amends that are required to make up for it.  And some parents aren’t sure how to make amends, or even acknowledge that they should.
The point is, our journeys with ourselves, and in our relationships with others, are made up of many imperfect moments.  We are not perfect beings, and therefore the very act of being in relationships means you are going to hurt people, and people are going to hurt you.  For some, these can be benign, small things that cause hurt feelings of varying levels.  For others, these moments are physical or sexual in nature and cause much deeper and long lasting pain.  When you come to terms with the fact that the Incident happened in your relationship, how do you move forward?
There are three main things to focus your attention on:
  1. the Incident itself,
  2. the consequences of the Incident, and
  3. how to start moving forward.
The Incident
How did this happen?  Can you say out loud, or listen to someone else say out loud, the thing you did, or the thing you said, that hurt someone you love.   What about if you are the victim?  Have you been able to acknowledge that what happened to you, or was said to you, was not appropriate? What were the circumstances?  Were you angry?  Were you in an emotional state that you could have managed differently? What were the circumstances in your lives?  Once you have a broader view of the context of your lives, or as some like to say, the view from 30,000 feet, you can start to consider how far reaching the consequences have been.  And maybe you will not be moving on as part of a couple.  But whichever path you chose, you must have an understanding of what was happening for you in the moments leading up to this impassable place.
The Consequences
Consequences range, depending on what it is you are trying to get over.  Sometimes consequences stretch this period of time out for a long time, for example, if you are dealing with the legal system as a result of a domestic violence charge.  Perhaps you are with an unforgiving partner, child or colleague.  Consequences can be far reaching, from judgment from your family and friends, to job suspension or loss.  Coming to terms with the natural consequences of your choices can be difficult, especially if you feel misjudged, mistreated or a victim of circumstances yourself.  Sitting with all of these unresolved feelings is difficult, especially if you haven’t been able to lean on your partner for support.  You might be able to move forward with your partner, or you might be starting to face the possibility that you will be moving forward without that significant person in your life.
Moving Forward
Moving forward is one general step, but the biggest one. Moving forward involves deep reflection and self-education. Reflection on the nature and state of your relationship, from the beginning, and everything leading up to the Incident. Understanding how you got to this place in the first place.  Educating yourself on where your experience falls with other people who are in similar circumstances.  You might feel alone, however the depth of the emotional pain felt by people who are emotionally disconnected from themselves, from their loved ones and from their sources of pain who are struggling in relationships, is universal. 
Focusing on the 'Incident' is where most people get stuck. 
But the reality is, there were 100 things that happened in your life, in your relationship (and in your past relationships), that led you to be in that place at that moment, when the incident occurred. Whether it was a marital argument, losing your cool with your child, being intoxicated at a work function and getting fired, saying something hurtful or hateful you immediately regret but can’t take back, or compromising your values and putting yourself at future emotional risk. Once you have a deeper understanding of how you found yourself in the situation where this Incident occurred, you can acknowledge the very fact that you are there.  You probably did the best you could, with what you knew.  Looking back, it might also be reasonable to think there might have been some other things you could have done that could have changed the path you were on.  However, you didn’t.  And here you are.  Acceptance for this very simple fact is one step that is necessary to move forward.
You are Here.
Once you have accepted that You Are Here, you can look out ahead of you in life and start to figure out where you want to be.  Notice I didn’t say, ‘where you are going’ because now you are driving now with a clear windshield.  You can see some signs that you didn’t see before. You can make a decision ahead of time, whether you want to get off that highway or continue on.  Our society does a great job of encouraging us to ‘stay the course’, ‘never quit’ or ‘never give up’ which sends the message that you just have to keep plowing forward no matter what is blocking your path. But the truth is, you can exit at the next town anytime you want.  There are new and different people living there, with new shops, new restaurants and new schools.  There are ALWAYS options.  You can learn to insert a pause and breathe, where previously, there was no consideration to making that exit.  Once you allow yourself to consider the fact that you do in fact have a choice, you can start to consider your options.
Educating yourself
Collectively, we know so much more about health, science, the development of disease and the choices we make in life, than anyone has ever known throughout humanity. No doubt, some of our more ancient cultures have known these things intuitively a lot longer than popular culture acknowledges, but now we have science to prove it.  For decades, mental health and medical professionals have understood that emotional, physical or sexual abuse of children impacts long-term health, both physical and emotional, outcomes for those children as the move into adulthood. [1] Thinking about making amends to people we have hurt, should also include making amends to ourselves. Relationship science now tells us that it takes five positive interactions to overcome one negative one! [2] You can start to think about the changes you can make in your life moving forward to bring less judgment, and more self-compassion forward. To bring more emotional safety in your relationships and less hurt. 
What comes before, impacts the future. 
The same principle holds true in our daily lives, and in our daily interactions with our loved ones.  As we have reviewed, when something, that Thing, is bothering you, or repeatedly comes up, in your relationships, your first step is to own it as your problem, and the second step is to reflect on how you got this problem.  Its important here to unpack this problem with someone you trust, someone who will not just tell you what you want to hear, and someone who you also feel safe with and you feel will not judge you.
Once you have a clearer picture of why you keep making the choices you are making, including the ones that are causing you pain or turmoil in your life, it makes sense doesn’t it?  Of course that’s why things have happened this way, because of X, Y and Z. A-ha.  Now, what do we do now?
Envision your future.
Your life is yours to live and to create.  If you’ve got stuff tripping you up, its time to take the blinders off.  Your experience of your life is what holds the answers to the questions that keep coming up for you, not what anyone else thinks your life should be.  Acknowledging how you got here, reflecting on what all of your options are (even the ones you don’t like), and doing a totally free brainstorm of what your future could possibly look like are worthwhile pursuits that could totally change your life for the better.  Move away from being someone bogged down by a once debilitating incident that unleashed undesirable consequences in your life, to someone who can own that a negative but understandable problem is now something that is positive, empowering and life affirming.
Learning to repair in relationships is a fundamental life skill, one we have not done a great job of teaching our ourselves, or our kids, in the past.   However greater awareness of the critical importance of healthy relationships – both with ourselves and with our loves ones, their impact on our physical and emotional health – is what allows us to thrive once again.  Yes, you can move past whatever it is that you feel is holding you back.  There is a process and you aren’t the only one who feels this way.  Each new, positive and emotionally safe interaction with the ones you love (partner, children or extended family) can help heal the wounds of the past, should you chose to move forward in that direction.

[1] For more info, check out the CDC website and all the interesting information on The ACE study. https://www.cdc.gov/violenceprevention/acestudy/

<![CDATA[What is a Registered Psychotherapist anyway? ]]>Tue, 19 Jan 2016 03:43:47 GMThttp://christinacrowe.ca/the-blog/what-is-a-registered-psychotherapist-anywayPicture

I am so pleased to share the news that I have received my acceptance as a Registered Psychotherapist (qualifying) to the new College of Registered Psychotherapists in Ontario (CRPO). After a grueling graduate degree while balancing work, family, school and clinical work, it’s gratifying to take this next step. 

What is the new College and what does it mean for the average Ontarian? 

Mental health has received unprecedented coverage and heightened awareness within the public sphere, which is very exciting for mental health professionals.  More and more, we see people feeling safe to come forward as they consider being more proactive about their own mental health, as well as seeking treatment for existing disorders.  In Ontario, we have to take our health care into our own hands.  And when it comes to mental health care, our system is unfortunately, not universal. 

Why did we need a College in Ontario?

College’s are created to regulate health care professionals for the protection of the public. On March 31, 2015, the transitional Council was advised by the Ministry of Health and Long-Term Care (MOHLTC) that the Psychotherapy Act, 2007 would come into force on April 1, 2015, thereby creating the new College of Registered Psychotherapists and Registered Mental Health Therapists of Ontario (CRPO). What this means is that ‘psychotherapy’ will soon be a controlled act (like medicine, dentistry, social work). The use of the title ‘Psychotherapist” or “Mental Health Professional” is restricted and only those practitioners registered with the CRPO or other approved users.

Besides Registered Psychotherapists – who are Members of this College – the members of five other regulated professions practice psychotherapy: nurses, occupational therapists, physicians, psychologists and psychological associates, and social workers and social service workers.

What’s the difference between a psychotherapist, a counsellor or a coach?

Coaching is unregulated. If you seek a life coach, you will want to ensure they have undergone a training certification. Coaches are not trained to treat or work with mental illness of any kind. They do have life experience, which is the foundation from where they work. 

(see footnote) distinguishes between psychotherapy & counselling as follows: “The practice of psychotherapy is distinct from both counselling, where the focus is on the provision of information, advice-giving, encouragement and instruction, and spiritual counselling, which is counselling related to religion or faith-based beliefs.”

The Ministry of Health and Long Term Care defines psychotherapy as,

The assessment and treatment of cognitive, emotional or behavioural disturbances by psychotherapeutic means, delivered through a therapeutic relationship based primarily on verbal or non-verbal communication…. to treat, by means of psychotherapy technique delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgment, insight, behaviour, communication or social functioning (2007, c. 10, Sched. R, s. 3). 

That’s a mouthful! 

In much simpler terms, generally speaking, psychotherapy is a collaborative wellness and treatment strategy based on the relationship between an individual, or couple/family and the therapist.  Based on this definition of what psychotherapy is, it might be easy to see then how the qualifications and experience of your chosen therapist are critically important. 

There are important questions you should ask a potential therapist. These are:
  1. What is your academic and training been to prepare you to practice as a therapist? 
  2. What specialized training and/or experience have you had in working with the issue I am dealing with? 
  3. What professional associations do you belong to? 
  4. What are your fees? 
  5. How will my insurance claim be handled? (preferably fees and potential insurance coverage should be discussed on the phone prior to making the first appointment) 
  6. What type of therapy do you do? (mostly talking, role-playing, visualizing, CBT, Rogerian, person-centered, “body-work”) 
  7. What are your office protocols? (booking appointments, payment for missed appointments, emergencies, building access after-hours, etc.) I would like a brief explanation as to what I can expect to happen in my sessions. 
  8. How long will each session last? 
  9. How many sessions will it take to resolve my issue? 
  10. How will my confidentiality be assured? 

How do I access services?

In Ontario, psychotherapy can be accessed both publically with your OHIP card, as well as privately, either through your third party insurance or by paying yourself.  Publically, you can start with your family doctor, and some family physicians are specially trained in providing psychotherapy, although all physicians can technically provide it.  You might be further referred to a psychiatrist, a hospital out or in patient program or a local public agency.  Some public agencies will provide free counselling services, and most will provide some free short term (1 or 2 sessions) or up to 5 sessions on a sliding scale based on income.  You can also confidentially access your employers EAP program.

Privately, you have a lot more options and of course, shorter wait times.  You can see your clergy (generally free of charge), access extended services at a public agency (like Catholic Family Services of Peel), see a registered social worker, a registered psychologist and now, a registered psychotherapist.  Each of these specialties has training in how they might help you – in Ontario, historically it was up to the consumer/client to sort that out on their own (anyone could claim to be a therapist).  Now, with the existence of the CRPO, you can be assured of a minimum standard of education and training, and ongoing education and regulation of your chosen therapist. 

Given all of this information, the good news is, the government of Ontario is recognizing the need for more mental health care. They are paying attention to who is delivering care, and hopefully, this will lead to making access more universal. 

You can learn more about these topics through the Ontario association of psychotherapists here and through the CRPO here

All the very best in your search for support! 

​HPRAC note: HPRAC advises the Minister on whether unregulated health professions should be regulated, whether regulated professions should no longer be regulated, amendments to the Regulated Health Professions Act, a health profession act or a regulation under those acts, quality assurance and patient relations programs of Ontario's health regulatory Colleges, and on other matters referred to it by the Minister. 
<![CDATA[The Last Taboo: Screening for Childhood Trauma]]>Thu, 29 Oct 2015 17:29:12 GMThttp://christinacrowe.ca/the-blog/the-last-taboo-screening-for-childhood-trauma
Has someone figured out a way to get therapy with out talking about our childhoods yet? 

In therapy, there are a few different approaches, and sometimes you can deal with an immediate problem at hand without a huge delve into the past. But when you want to more permanently solve a problem, typically, unearthing the cause is necessary. (Disclaimer: it should be said that as a client, you should only undertake to do so with someone you trust and feel completely safe with). 

Do the trauma's we experience in childhood actually follow us through adulthood? What qualifies as trauma? What one person of one generation would call a "tough" childhood, we might now call "traumatic". And when it comes to preventative health care - including mental AND physical health - that is a pretty significant distinction. 

Education is everything. Knowledge is power. There can be so much freedom and progress in understanding why

This TED talk reviews the original ACE's Study, its groundbreaking results and encourages all health care practitioners to screen for childhood trauma and how to name those events that shape our length of our lives. Nadine Burke Harris does a great job describing the study, why its important for health care practitioners in particular to think about changing their practices. 
Stories of childhood abuse are all around us. 

I just finished reading Breaking Away, a memoir of NHL player Patrick O'Sullivan's devastating childhood experience at the hands of his abusive father. I could not put in down. Patrick tells his story in a way that any person who has experienced childhood abuse will instantly recognize: extreme isolation from community, not understanding why others did not help him, being emotionally isolated, being ashamed of the abuse and intuitively knowing to limit the amount you tell others for fear they would be too overwhelmed. Patrick's experience goes one step further in that he also went back to confront the bystanders. I would recommend it to anyone who has experienced childhood abuse, if only to crack the isolation of that experience. 

And today, the deeply sad story of harrowing abuse unfolds in Toronto courtrooms as Melonie Biddersingh's father stands accused of extreme abuse and ultimately her murder. Journalist Rosie DiManno's statement in this story, "To the death roll of Randal Dooley and Jeffrey Baldwin, children starved to death and grotesquely mistreated while alive, right in our midst, add now the name of this 17-year-old who lived and died with nobody taking notice" demands that we start paying attention to each other.

The more we understand about what constitutes "trauma", the better choices we'll make, the more we'll know about what to call it when we see it, when to tell someone, when to ask for help, and how to move forward. 

For more information, check out Ontario's Association of Children's Aid Societieshttp://www.oacas.org, or speak to a trusted friend, counsellor, therapist, clergy person. 

<![CDATA[Burnout in healthcare: what you can do to protect yourself]]>Fri, 03 Jul 2015 13:07:31 GMThttp://christinacrowe.ca/the-blog/burnout-in-healthcare-what-you-can-do-to-protect-yourself
Every now and then, I’m really struck by the enormous task our health care providers take on, in the service of the general public, adjudicator’s of sorts, of the physical and emotional lives of their patients and their families.  

Patient after patient, day after day, and often with no time to eat, let alone to take ten minutes to reflect on how tough cases are affecting them.  I work amongst doctors, nurses and pharmacists, and I also grew up with doctors (my mother is a family physician).  Watching my mother totally and completely dedicate her life to her chosen profession was pretty educational; I know from living my childhood that “work-life balance” wasn’t a concept that actually existed for physicians or nurses back when she went to medical school (class of '73).  I have witnessed first hand the toll its taken on her, and I’ve seen doctors I work with now, everywhere from being on the verge of tears to the other end of the spectrum, on total emotional lockdown, no doubt a difficult and unfortunately learned skill.  

About 7 of my 15 years working in the healthcare system in Ontario, have been in oncology.  Sometimes people would say to me, isn't it depressing, working in cancer? For me, it has never been depressing, but incredibly hopeful; however, I know that for many of the oncology professionals I know, it can be in fact, really, really hard a lot of the days. 

How exactly are you supposed to do your job efficiently, accurately and with as much compassion as you can if you fall apart every time you lose a patient to cancer? 
Studies have shown caregivers (both family and professionals) supporting cancer patients feel they can’t show negative emotions as frequently, yet at the same time, they are expected to show understanding and express sympathy to the patient [1].  This is incredibly tough.  Further, no one gets to go home after a tough loss (especially if you are already at home as a caregiver).  And for our oncology care givers, there are always more patients to see.

There’s no doubt, being a doctor is emotionally challenging, and oncology physicians have been shown to be at a higher risk for burnout than other health care specialties.  Some of the issues they face include serious work overload (large patient volumes, insufficient resources, or poorly managed centres) and a lack of control over their work environment.  Women physicians have a tougher time, and working alone and being young are also risk factors. Some of the things that help to buffer against burnout include being married and having children, which likely point to the importance of having healthy, supportive relationships.

Oncologists and oncology nurses are at higher risk for burnout due to the nature and intensity of the clinical challenges they encounter, as well as facing a higher frequency of patient death. End-of-life concerns often require confronting resistance from patients and their families, colleagues, and also their own institutional culture. 

Traditionally, medical and popular culture views a patient’s death as the physician failure.

In Ontario, 20 oncologists were interviewed at three hospitals exploring what coping strategies they used to deal with burnout and grief.  The results showed they engaged in various rituals, including meeting with families, participating in bereavement rituals in their centre, making a phone call, or sending a condolence card to the family.  Specific coping strategies that they reported using included social support, activity-oriented coping (exercise), turning to faith, compartmentalization, and also withdrawing from patients and families. There is no question that these oncologists grieved for patients; however, the ability to demonstrate that grief or find good coping strategies may still be needed [2].  More often than not, a busy day might get in the way, and at least a third of medical, radiation and surgical oncologists surveyed in Canada never participate in these practices [3].

Oncology nurses of course also suffer from burnout, high levels of job dissatisfaction and distress from their clinical work.  Oncology nurses deal with multiple deaths, providing close care for patients, as well as families/caregivers.  After a patient death, a nurse is also expected to continue working.  However, being able to talk about one’s feelings really does help: one study found many benefits when nurses got together though a support group, including,

·      a reduction in end-of-life care stress,

·      an increase in self-care, and

·      improved patient and team care [4].

Another study confirmed the validity and benefits of bereavement programs for oncology health care professionals [5].  Some of the types of activates health care professionals can engage in include: attending funerals, holding alternative rituals, calling families, posting photographs and/or sending cards.  Staff can take turns each month leading the signing of the sympathy cards, enabling all to personally sign their names and express condolences. These programs tend to garner positive feedback from participants as well as from patients’ families.

How can you tell if you have burnout?

In studies with oncology professionals, burnout syndrome was described by three main dimensions (also called Maslach's dimensions): emotional exhaustion (EE), depersonalization (DP) and low personal accomplishment (PS) [6].  Maslach describes components of these further as:

·      Exhaustion: Feeling overextended, both emotionally and physically.

·      Cynicism: Taking a cold, cynical attitude toward responsibilities.

·      Ineffectiveness: When people feel ineffective, they feel a growing sense of inadequacy.

Its also important to note that if a clinician has burnout, its not that the person is necessarily the problem, but likely it could be because of the social work environment they are in. Maybe they would like to engage in more productive self-care strategies, but they are not in an environment that is supportive.

So, beyond ‘coping’ what exactly is self-care within the context of a cancer care provider?

“Self-care is a spectrum of knowledge, skills, and attitudes including self-reflection and self-awareness, identification and prevention of burnout, appropriate professional boundaries, and grief and bereavement.” [7]

Unfortunately, there aren’t any courses on self-care or wellness management in our medical or graduate schools. 

However, there are validated strategies that can be used and sometimes stating the obvious is important. 

There are many ways to live a healthy, well-balanced life, including recognizing our inner lives, families, work, community, and spirituality.  A widely available tool called the Wellness Wheel refers to 6 types of wellness – physical, intellectual, emotional, spiritual, social and occupational – and allows individuals to reflect on current life balance and self-care.  Health care providers can use the Wellness Wheel to improve job satisfaction and overall well being, reducing the likelihood of stress and burnout (you can click the image below for more detailed information). 
Strategies for personal self-care include:

·      prioritizing close relationships such as those with family;

·      ensuring adequate sleep,

·      regular exercise,

·      time for vacations;

·      fostering recreational activities and hobbies;

·      practicing mindfulness and meditation;

·      and pursuing spiritual development.

If you are an oncology care provider and you are struggling to incorporate these types of self-care activities in your life, get yourself to a therapist or seek support from your colleagues.  These are skills that everyone can learn, and have had proven benefits for a lot of years.  In fact, you may be practicing some of these skills and not even knowing it.

The bottom line is, oncology care professionals are all people too. 

Doctors and nurses, pharmacists, social workers, care navigators are all also deeply affected by the nature of the work in cancer care.  The system is perpetually stressed, and that isn’t changing anytime soon.  All you can do is make sure you set yourself up for success – you’ve got a tough job.  Getting support for it is a no-brainer, whether it’s within your own cancer centre, your religious/faith community, your social community or with a professional therapist. 

1.     Kovács, M. K. (2010). Is emotional dissonance more prevalent in oncology care? Emotion work, burnout and coping. Psycho-Oncology, 19(8), 855-862.
2.     Granek, L. K. (2013). Oncologists’ Protocol and Coping Strategies in Dealing with Patient Loss. Death Studies, 37(10), 937-952.
3.     Chau, N. G., Zimmermann, C., Ma, C., Taback, N., & Krzyzanowska, M. K. (2009). Bereavement Practices of Physicians in Oncology and Palliative Care. Archives Of Internal Medicine, 169(10), 963-971.
4.     Wittenberg-Lyles, E., Goldsmith, J., & Reno, J. (2014). Perceived Benefits and Challenges of an Oncology Nurse Support Group. Clinical Journal Of Oncology Nursing, 18E71-E76. doi:10.1188/14.CJON.E71-E76
5.     Marshall, G. (2007). Bringing a bereavement program back to life. Oncology Nursing Forum, 34(2), 506.
6.     Trufelli, D., Bensi, C., Garcia, J., Narahara, J., Abrao, M., Diniz, R., & ... Del Giglio, A. (2008). Burnout in cancer professionals: a systematic review and meta-analysis. European Journal Of Cancer Care, 17(6), 524-531. doi:10.1111/j.1365-2354.2008.00927.
7.     Richards, K. C., Campenni, C. E., & Muse-Burke, J. L. (2010). Self-care and Well-being in Mental Health Professionals: The Mediating Effects of Self- awareness and Mindfulness. Journal Of Mental Health Counseling, 32(3), 247-264.

<![CDATA[Pixar’s Inside Out – Neuroscience for the Whole Family!]]>Wed, 24 Jun 2015 02:37:10 GMThttp://christinacrowe.ca/the-blog/pixars-inside-out-neuroscience-for-the-whole-family
(potential spoiler alerts!)

I took my family to see the new Pixar movie Inside Out this evening, wishing and hoping that it would live up to all of the rave reviews I’ve heard since its release.  Sometimes I’m totally swept up in a kids/family movie, sometimes I’m left really cranky as I fume about sexist stereotypes or standardized fairytale endings.  As a therapist, our household is no stranger to talk about feelings, emotions, how to regulate, mindfulness and so on. So much so, that my family is just used to it …. we forget from time to time that other people don’t live with a constant stream of neuroscience talk happening in the background.  I was thrilled to see a jam-packed theatre on a school night in our small town!  Way to go families!

I’m not sure I can even yet appreciate just how innovative and exciting this movie is for kids and adults alike. 

 There is finally a movie that tries to explain to all of us how emotion, memory, cognition and behaviour are all related.  Kids will get it at their level, and adults will appreciate this movie on a whole other level.  There are some pretty big concepts addressed … how we make memories, how they are stored, how they can be changed over time.  The characters that play out in the minds of the family (11 year old Riley and her mom and dad) are Joy, Sadness, Anger, Disgust and Fear, and we get an intimate view of how these emotions interact with each other and how they can even change who we are and the memories we have.  

We each talked about our favorite parts of the movie, and when I said mine, my husband triumphantly announced he knew that would be what I would say.  I won’t spoil it ... but will say that there are a few interactions between Sadness and Joy that I see over and over and over, in myself, in my kids, in my clients, in everyone around me, and I’m SO happy to see them portrayed in a movie so that kids might understand them.  I will say that for the most part, many of the concepts in the movie are bang on.  Being able to acknowledge and make space in one’s mind for our emotions is a huge part of how we can teach our kids emotional regulation.  Too often I see people working incredibly hard at denying some of these basic emotions that we all have as human beings and the results are usually pretty unfortunate. 

Of course, I also loved that the protagonist was a hockey playing girl, who ultimately saves herself, and she isn't a princess waiting for a prince to save her (see sexist stereotypes or standardized fairytale endings, above).  The movie reminds us that sometimes the answers to our problems often seem far away (Minnesota) and the only path to them can seem rather dramatic. However, those are the options (external and dramatic) when we aren’t in touch with our feelings.  If we do have the courage to tap into what is going on inside, suddenly the options shift, and our whole world can change.  Inside Out provides so many great lessons to talk about as a family, and sheds light on so many opportunities where we can notice our kids and peek into their inner worlds.  

I hope you will enjoy it as much as we did! 

<![CDATA[Understanding Anger - Part II]]>Sun, 14 Jun 2015 17:52:38 GMThttp://christinacrowe.ca/the-blog/understanding-anger-part-ii
In Part I of Understanding Anger, we talked about anger as a healthy and normal emotion (at times).  We also reviewed how anger unchecked can do a lot of damage in your life: on your physical health, your family and romantic relationships and on the job.  We all get angry for different reasons – because we are all very different people, who have different life circumstances.  

There is no one size fits all solution, but there are many strategies you can try until you find the one that works for you. 

One of the first things to try and figure out, is what is your anger trying to tell you?  Is your anger covering up for other feelings such as embarrassment, insecurity, hurt, shame, or vulnerability?  It’s hard to have those feelings come to the surface.  However, I would invite you to consider one thing:  when you let yourself admit that you aren’t perfect, that you are in fact human, you begin to let the walls down that keep people from truly connecting to you.  Shame is a loss of connection to people, and specifically, the people you love.

How do we repair this?

When you can reconnect to people, shame can disappear.  We know a lot about shame, thanks to shame researcher Brene Brown, and her work has influenced and supported a massive movement forward in understanding the difference between people who we recognize as living life “wholeheartedly” with “joy” and connection to their community and families and those who do not (and of course both groups of people have had the same range of tough things happen in their lives).  If you decide you would like to work on your relationships, you might find you’ve got some work to do if anger has consistently been present there. 
We also talked about slowing our thought process down, trying to understand where the negative thinking spirals out of control.  Cognitive distortions are errors that we all make in our thinking, and they can be a real source of pain for many people.  Here are some examples of common cognitive distortions:

  • Overgeneralizing. This is happening anytime you say “always” or “never”. “You always interrupt me.  You never consider my needs.  Nobody respects me.  I never get the credit I deserve for what I do around here.”
  • Obsessing on “should’s” and “musts.”  Having a rigid view of the way things should or must be and getting angry when reality doesn’t line up.  I like to say you need to stop “should-ing” all over yourself. 
  • Mind reading and jumping to conclusions.  Assuming you know what someone else is thinking or feeling—that he or she intentionally upset you, ignored your wishes, or disrespected you.
  • “Collecting straws”.  Looking for things to get upset about, usually while overlooking or blowing past anything positive.  Letting these small irritations build and build until you reach the “final straw” and explode, often over something relatively minor.
  • Blaming.  When anything bad happens or something goes wrong, it’s always someone else’s fault.  You blame others for the things that happen to you rather than taking responsibility for your own life.

There are more …. but do you recognize any of these in yourself?  The important point here is that it isn’t the thing that made you angry, but your interpretation of it, is what you can work on.

Stopping the spiral

Once you have spent some time identifying the things that trigger your anger, you can have a little bit of insight into where your thinking might be leading you down an unhelpful path.  Next, you can work on changing your reaction.  The overriding principle is to get out of your head, into your body and into the present moment.

  1. Focus on what is happening in your body: that racing heart, jumbled thoughts, stomach in knots, muscles tensed.  Doing a “body scan” from the tips of your toes – slowly – to the top of your head will highlight to your where your tension is manifesting in your body.
  2. Start taking some slow deep breaths.  It’s important to actually focus your mind on your breath (not let your mind wander while you just breath slower).  Think about how the air going in your nostrils is slightly cooler than the air coming out. Take 10. 
  3. Exercise.  Run up and down the stairs; take a walk around the block.  Give yourself a chance to burn off the tension and allow a cooler head to prevail.  You can also focus on some stretching exercises, or massaging your head and scalp. 
  4. Repeat this list as much as you need to.  If you really practice, it will get easier with time. 

Time for a reality check

Another technique we counsellors like to use that can be very effective is referred to as conducting a “thought record”.  This essentially helps you slow your thought process down, on paper.  You write down what the triggering event is (my spouse has not done X again, even though they KNOW how much it bothers me).  Then you assess how emotionally wound up you are over this, on a scale from 1-100 (I’m at 80%).  Then you think of all the reasons you are right (They just don’t care, I’m not a priority, etc).  THEN you write down all the reasons you could be wrong – I like to call this “poking holes in your theory” (They had other things to focus on, there was something more pressing, I know they love me, they aren’t perfect).  And then your rate your emotional feeling on the same scale again (Now, I’m at 50%).  The idea here is that you are giving yourself your own reality check.  How important is this thing you’re angry about?  Is it worth ruing your day over?  Do other people react to you this way?  How would that make you feel?  Is there another way to approach this?

Moving onto healthier relationships

It’s not always so simple, but sometimes even the smallest awareness of these issues is what it takes to crack the window of personal growth open.  And for some people, this is enough – you are the expert of your own life.  You know what you need to do to move forward and have more authentic / real connections to people.  Believing you are worthy is part of the hurdle.  But when you look at all the work that is listed above – that’s a lot of work!  Taking the time to reflect on all the work you are doing helps that worthy feeling become more present in your life.  Hopefully this post has given you a few things to consider that might end up being helpful for you. 

<![CDATA[Understanding Anger (Part I)]]>Fri, 12 Jun 2015 17:05:46 GMThttp://christinacrowe.ca/the-blog/understanding-anger-part-i
An issue I come across more frequently than not these days is anger.  Turns out, there are a lot of misconceptions, old wives tales and armchair ‘experts’ talking about anger, and it really confuses people.

To be transparent, there is also disagreement within the world of psychology about anger and it’s role as an emotion.  Some consider anger to be a “secondary” emotion – meaning the thing that triggered your angry emotions is not real culprit, but something else entirely.  In this sense, anger is indicative of some other unmet emotional need you have buried deeper within.  And some argue it’s not quite accurate to say its ‘secondary’, because anger has a healthy purpose and is part of our human evolutionary design.  It’s there to alert us to something going wrong in our world.

Anger itself is a normal emotion.  How you show your anger, and how long it takes to recover from a trigger are really where the heart of the conversation lies.  In women, anger can be triggered by our hormonal cycles.  Our fuses are shorter, we might be more argumentative, we might be more prone to making a “mountain out of a molehill”.  Hormones also influence men and testosterone is known to play havoc with young men’s lives.  Some cultures or communities in our society tell us that for the most part, it’s wrong to express our anger outwardly, so we work hard to suppress these emotions.   However, when we suppress our feelings, rather than process and feel comfortable to talk about them, we can run into trouble.  Its also important to remember, our hormones have a natural function – perhaps they give us the courage to let these emotions come to the surface – in essence saying – “hey, pay attention to me, I need your help.”

Is it really that harmful to get angry?

We know that out of control anger hurts our mental and physical health, it hurts our romantic and family relationships and it can definitely hurt our careers.  If you feel like you have to use anger, or the threat of anger, to control the people in your life, this strategy will ultimately disappoint you.  If you find yourself angry a lot of the time, continually frustrated, find it hard to compromise, and take other’s opinions as a challenge to your authority or position, there might be more to your anger than you think. 

Specifically, it can be hard to manage our feelings of anger when,
  • We are under a lot of ongoing stress,
  • If we are resentful when we realize we didn’t get as children the things we really needed,
  • When old traumas or disappointments are triggered, or unresolved situations keep resurfacing. 

What can you do?
Take some time to get to know your inner self.  Be aware of your anger warning signs and your triggers.  Many of these include the physical changes in your body when you are ‘triggered’ (clenching of hands, jaw or back muscles, stomach pains/knots, feeling flushed, confused, racing heart, pacing around).  

Talk to someone about, or start to write down, where your negative thinking starts to spiral out of control.  There are many errors in thinking we all make as humans (called cognitive distortions), and only when you start to slow this process down, can you begin to pinpoint exactly where you can make a meaningful change in your relationships, and ultimately your life. 

As we become more aware of all of our “fight or flight” physical responses, we can also start to use proven strategies to cool down in the moment.  Then the work of understanding how our thoughts got us into this mess in the first place can start to really take shape.  Finally, finding new, more effective strategies for making yourself heard, and resolving some of these lifelong issues can start to help you move forward in a new healthier way.  Learning to focus on the present moment is not easy.  It takes dedication, practice and a lot of self-compassion. 

The good news is, there is a way out of the anger spiral.  The even better news is, you’re human, and its normal to get overwhelmed with your emotions from time to time. Learning to connect the dots in your emotional world can help provide the clarity you may be seeking or needing, in order to move forward.  In the next post (Part II), I will address some proven strategies for recognizing your triggers and learning new ways to both manage your emotions and contribute in a positive way to the relationships in your life. 
<![CDATA[Overcoming your childhood trauma]]>Tue, 21 Apr 2015 14:10:44 GMThttp://christinacrowe.ca/the-blog/overcoming-your-childhood-trauma
The popularity of Top Ten lists for everything from parenting to couples relationships to career success seems to have skyrocketed in the last few years.  An increasing awareness of mental wellness and personal responsibility has grown in our collective consciousness, and that is a great thing.  But why do we need so many tip lists?  

Why are initiating and maintaining healthy relationships such a challenge? 

In addition to the public health campaigns aimed at reducing the stigma associated with mental illnesses, as well coping with normal challenges in life, there is much more awareness about how trauma from our childhoods follows us into adulthood.  While we all instinctively know that a traumatic childhood can take a long time to “get over”, did you know its been scientifically proven that said crappy childhood actually increases your overall risk for a whole host of chronic physical and mental illnesses?  Yikes!

The groundbreaking ACE Study (adverse childhood experiences) studied over 17,000 people about their childhood experiences of abuse, neglect, and family dysfunction ( and more than 50 scientific articles have been published and more than 100 conference and workshop presentations have followed).  Researchers in the ACE study assigned participants an ‘ACE score’ based on the various types of household dysfunction they encountered before the age of 18; basically, the higher your score, the higher your risk of some of the following health conditions:

  • Alcoholism and alcohol abuse
  • Chronic obstructive pulmonary disease (COPD)
  • Depression
  • Fetal death
  • Health-related quality of life
  • Illicit drug use
  • Ischemic heart disease (IHD)
  • Liver disease
  • Risk for intimate partner violence
  • Sexually transmitted diseases (STDs)
  • Smoking
  • Suicide attempts
  • Unintended pregnancies
  • Early initiation of smoking
  • Early initiation of sexual activity
  • Adolescent pregnancy

Well now that's a bit depressing isn't it?

What hasn’t been studied as much, is how do people with really high ACE scores overcome this (inevitable?) legacy?

There are protective factors we intuitively understand, such as that teacher that went the extra mile, that adult that took an interest, that surrogate ‘parent’ who stepped up when yours where nowhere to be found.  There is also the ability to see your family of origin for who they really are – imperfect human beings, who despite their terrible choices and traits, might have had a few redeeming qualities (or maybe not).  Potentially similar traits that you - the more highly evolved lifeform - have been able to make some better choices with.  Other studies have found that there are in fact people who do really well in life, despite having experienced some serious trauma as kids.  Developing resiliency and working as hard as you possibly can to cultivate and sustain close relationships with the people around you are two things you can do to protect yourself.  

While it might be fairly obvious to you that your childhood sucked, hopefully this data provides you with some reassurance that it’s perfectly reasonable that as a result, there are some things you struggle with, either from time to time, or chronically.  In other words, it’s normal.  You can stop feeling like there is something wrong with you, and join the rest of your community in our collective struggle to get our s**t together.  

Curious? You can check your own ACE score here.  A while lotta stuff might start to make sense.  Sometimes it really helps knowing that it isn’t just you.  Most of these Top Ten lists all really say some version of the same thing over and over:  eat well, get good sleep, participate in your community, practice mindfulness, work on your relationships, practice self-care and live in the moment. If you are struggling with depression or anxiety, it’s worth mentioning that it isn’t uncommon for people who had escaped traumatic or abusive homes to suffer from posttraumatic stress disorder for an unspecified amount of time.  You can seek some help to support you in your healing process.  It can take a village and a lifetime (and that’s okay). 


<![CDATA[Is This Why You Are Stuck?]]>Sun, 22 Mar 2015 02:45:55 GMThttp://christinacrowe.ca/the-blog/is-this-why-you-are-stuck
More often than not, clients come to me for support because they know deep down inside, something is a bit off, but aren’t sure exactly what is wrong. It could be a nagging feeling. A reoccurring fight with a loved one. A feeling of frustration at work or in a personal relationship. Sometimes, it’s to ask the question, “Am I normal?” or “Is it okay that I do that or think this?” Other times, people talk themselves out of reaching out for support, thinking, well I have a great family/spouse/healthy kids/job … I shouldn’t be complaining.

All of those frustrating moments, reoccurring fights and nagging feelings are trying to tell you something. That is your subconscious trying to break through to you. An executive coach I know uses the analogy of trying to drive a car when the alignment is off. If you take your hands off the wheel for only a moment, your car will pull to one side or the other. You have to really steer hard to keep going straight. The minute you start to relax your grip on the wheel, the alignment error starts messing with your lane choice.

This is what its like when your conscious life (job, family, day to day activities) isn’t lined up with what you really want, in your subconscious. The alignment is your subconscious and the car/wheel is your conscious mind. Where does your mind go when you daydream? When you get frustrated, where do you wish you were? You might start to fleetingly question things ... Gee, should I be drinking this much? Or, am I an emotional eater? Wait, did I pick that fight, or did he?

There are some distinct phases of change, and being aware of where you might be with a certain issue can be a real advantage. When you have those fleeting thoughts, second-guessing yourself, or the first inkling, or gut feeling, that something is a bit out of whack, it is referred to as the pre-contemplation stage of change. There is a 6-stage model called the Transtheoretical Model of Change, which was originally developed by J. O. Prochaska as a framework for understanding behaviour in addictions such as smoking, food or drinking (Malotte et al., 2000).  It has been and continues to be the subject of much research.

The 6 stages are:

1.     Pre-contemplation (not ready)
2.     Contemplation (getting ready)
3.     Preparation (ready)
4.     Action (doing it)
5.     Maintenance (active and have strategies against relapse)
6.     Termination

As a personal counsellor and coach, I often see how contemplation is the stage where a lot of people get stuck. They sort of know where they want to go and can visualize themselves achieving their goals. They sometimes even already know the steps they need to take to get there. But it just isn’t happening.

Why is this?

Interestingly, there is a growing body of research that blames the growing ‘positive psychology’ movement … if we think happy thoughts, change our negative self-talk, then we can think ourselves into a better life, right? Apparently not. A game plan, and someone to hold you accountable, is in fact necessary (Oettingen, 2014).  It’s critical to plan for all the obstacles that might potentially spring up in your path, and know how you might overcome them. There are recent studies demonstrating different techniques proven useful in moving people past contemplation to action – achieving the goals they want to achieve (Houssais, 2013).

Positive psychology is important and can contribute to a sense of positive well-being and self-efficacy. But if you are stuck, and wondering what more you can do to make it happen, reach out! You might do well with the support of family and friends. If you’ve already tried that and it hasn’t worked, reach out again. You can definitely get there and it might be time to set up your own personal Dream Team. Think about it. 

Malotte, C. K., Jarvis, B., Fishbein, M., Kamb, M., Iatesta, M., Hoxworth, T., & ... Bolan, G. (2000). Stage of change versus an integrated psychosocial theory as a basis for developing. AIDS Care, 12(3), 357.

Oettingen, G. (24 Oct, 2014). The Problem with Positive Thinking. NY Times. Retrieved from http://www.nytimes.com/2014/10/26/opinion/sunday/the-problem-with-positive-thinking.html?_r=0

Houssais, S. D. (2013). Using mental contrasting with implementation intentions to self-regulate insecurity-based behaviors in relationships. Motivation & Emotion, 37(2), 224-233.

<![CDATA[Soul Satisfying Summer Reading]]>Thu, 12 Mar 2015 13:45:22 GMThttp://christinacrowe.ca/the-blog/soul-satisfying-summer-reading
There are times in the past, when I was too close to something difficult to be able to view it with any kind of clarity. I would try really hard to think rationally, be reasonable, all to no avail. I started to find that losing myself in a really good book satisfied my craving for emotional connection.

People often ask me what I’m reading, or ask for book recommendations. There are those books that my soul has just devoured. I found them at the right time, and they hit exactly the right spot. There are lots of others – my favorite relationship books, business books or lifestyle books. 

Here is my list of soul satisfying books, that I turn to over and over, and they never let me down. 
 Only number 4, 6, 10 and 11 can be classed as “self-help” books, the rest are gorgeously written novels or short stories.

1.     Beach Music by Pat Conroy - set in two of the places I romanticize the most – Italy and the deep South, it has provided “food” for a ravenous soul many times over.

2.     The Prince of Tides by Pat Conroy – again set in the South and New York City, this beautiful novel explores the depths of sibling relationships and romantic love. Movie is also great.

3.     The Art of Hearing Heartbeats by Jan-Philipp Sendker – translated from its initial German, this novel explores the depths of a family’s past and an unbroken and lifelong love story, reaching from NYC to Burma. Beautiful.

4.     The Untethered Soul by Michael Singer – if you are searching for inner peace and emotional freedom, this is THE book for you. Before you even get into mindfulness, understanding your mind and how to consider your thoughts is a good first step.

5.     When Nietzsche Wept by Irvin Yalom – muses over the birth of “talk therapy” in a novel in the late 1800’s, filled with love, affairs, despair and a deep friendship.

6.     The Book of Secrets by Deepak Chopra – 15 ‘secrets’ to consider as you deepen your self-awareness and begin a journey of understanding who you are and why you think the way you do. I didn’t get it the first time I read this book, but I knew it was important, so I hung on. When I was ready, it blew my mind.

7.     Tis by Frank McCourt – a beautiful memoir about a poor Irish immigrant in America, trying to make a new life for himself. I have a thing for Irish and American history, so this is a perfect mix.

8.     Nine Stories by J.D. Salinger – a great collection of short stories with so many interesting life lessons. “He was rather like a Christmas tree whose lights, wired in series, must all go out if even one bulb is defective.” - J.D. Salinger, Nine Stories

9.     A Little Princess by Frances Hodgson Burnett – one of those books that is so beautifully descriptive that you feel every emotion the protagonist does, right down to your mouth watering and your heart aching.

10.  The Gifts of Imperfection by Brene Brown – If you ever think “what will people think” and you want to get to that place where it really doesn’t matter? This is the book for you.

11.  Daring Greatly by Brene Brown – How to embrace vulnerability, the only path to emotional wellness, connectedness and belonging.

If any of these are your favorites, you’ve read them, or you have a comment, please let me know! I’d love to engage with you on these.