How to Stop Struggling with Anxiety and Uncertainty

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This year has been, for lack of a better and more polite phrase, one gigantic sh*% show.

New strain of COVID! Lockdowns! Mr. Rogers! When I hear these things, my anxiety can skyrocket. Ok, maybe not with Mr. Rogers.

How are YOU? That’s a loaded question nowadays, isn’t it? I’ve been thinking about you; hoping you’ve had some time to rest and recharge, even if for only half a day.

Over these months, to maintain my sanity (and help my husband’s!), I’ve been practising new and old strategies to support good mental health. Some have helped, some haven’t. I’m going to share with you one of my favorite and most effective strategies that helps with the struggle of stress and anxiety. These tools aren’t overnight fixes. I practice these over and over again. And I’ve made a short video to go with it.

It’s important to note, when I’m extremely overwhelmed with anxiety or emotions, these techniques won’t cut it. However, this e-book describes tools from the same psychological approach that can help with the more extreme “emotional storms.”

First time experiencing anxiety or depression? You’re not alone.

My mental health, like most peoples’, has fluctuated wildly during 2020. With actual diagnosable mental illnesses, I’ve seen my symptoms jump out of the woodwork more intensely and more often. You’re not alone if this has been happening to you.

You’re also not alone if, for the first time, you’re experiencing symptoms of an anxiety disorder or clinical depression. Many people have. Over 50 percent of North Americans have reported their mental health has worsened since the pandemic1,2. More than 1 in 3 Americans are reporting symptoms of anxiety and depressive disorder this year compared to 1 in 10 in 20192. Talk about being in this together.

It’s important to know your experience isn’t an anomaly and somehow, you’re like, the weird one. You’re not. Weird. Unless, of course, you were wonderfully weird to begin with. By the way, weird people are my people.

With practice, these tools work well to lessen my wobbliness in the face of anxiety.

These tools lessen my struggle and wobbliness in the face of anxiety and uncertainty. I hope it will for you too. Note: I didn’t say it necessarily removed my anxiety.

The approach comes from a book, The Happiness Trap by Russ Harris. I recommend it to anyone who wants to find a way to live more easily with the stress, anxiety and uncertainty many of us are experiencing right now. (Oh, and the book title ISN’T backwards like I said it would be in the video!)

Acceptance and Commitment Therapy.

Based on Acceptance and Commitment Therapy (ACT), it’s not about getting rid of uncomfortable feelings and thoughts, but to stop struggling with them; then taking meaningful action based on your values. The beauty of this approach is that it’s not about changing how I feel. Quite the opposite. It’s about having a direct experience of accepting my feelings. As a result, they may decrease, but that’s not the point of the exercises.

Defusion and expansion.

The two components to stop struggling are using “defusion” techniques for thoughts and “expansion” tools for feelings. I explain each in the video. Then, regardless of whether the feelings or thoughts have changed, the next step is to take action based on my values. This way, I don’t get caught up in “the forest of anxiety and fear” but take steps into the life I would like to build based on what I find important (my values).

An example:

I start having anxious thoughts when a client cancels work with me. I become knee-deep in and full-on stuck with these thoughts. The thoughts may go something like:

“All my clients are going to cancel now. I don’t really offer any value to my clients anyway. My business is going to collapse. I know it. I won’t have enough money in the bank for bills. Only for the next two months. That’s not enough… how am I going to survive without work?”

Sound at all familiar? Maybe you have a similar loop but a different topic (i.e.: friends, dating, body image).

What does defusion look like exactly?

“Defusion” involves techniques to help me “un-fuse” from those thoughts; get a little distance from them. Some techniques might seem silly or strange, but you’d be surprised what can work. And that’s what you do — find ones that are effective for you. Some are: singing the thoughts; thanking my mind for sharing; putting a funny voice to the thoughts; labeling the story that the thoughts are attached to. These are just a few. Google “defusion” techniques and you’ll find lots more.

My favourite methods are to sing my thoughts (as you’ll cringingly see in the video) or thanking my mind. As I do that, I usually see that they are just thoughts, a stream of words I don’t have to take so seriously. There becomes breathing room between them and me.

The thoughts sometimes leave or lessen, sometimes they don’t. Doesn’t matter. What matters is that I’m not struggling with them and trying to stop them, argue with them or any other means of trying to control them.

What is this expansion technique, really?

“Expansion” is where I work with the difficult emotions and physical sensations to get “comfortable with the discomfort.” I identify where the uncomfortable feeling is and observe it with curiosity, noting its qualities. Then I breathe into it. Then I open up space around the feeling in order for it to just “be.” It’s more or less allowing it to just be. I may want to push it away or ignore it, but I continue to observe, breathe, expand and allow. It might change, it might not. Change isn’t the goal, allowing it to be is the aim.

The example with the “twitchy” emotions generated by the scenario above would go something like this:

I identify that the anxiety is in my gut, right below my belly button. I observe it: It’s solid, and tight, pulses a bit. I see it as a red, glowing blob moving around my tummy area. I breathe into it and around it, gently sending my breath into my navel area where the sensations are present. Then I, in the way that I understand it, open space around emotion. I keep giving it space and more space if it needs it, doing my best to allow it to be there.

Sometimes the feeling changes, moves on, often it doesn’t.

Take meaningful action tied to values.

Regardless of whether the thoughts and feelings have shifted, I connect with a value or value(s) and choose a meaningful activity. There’s a lot more to action and values than I can write in one post. That’s why I’d suggest reading Russ Harris’s book and exploring his website and videos.

Using the work-related example above, taking value-driven action would look something like this:

Two of my values are responsibility (according to Harris’s list of values: “to be responsible and accountable for my actions”) and persistence (“to continue resolutely, despite problems or difficulties”).

Despite whether the difficult feelings and thoughts are there, I choose to do a meaningful work task. It could be writing a blog post that I’ve been procrastinating (like this one), or following up with a client that mentioned an interest in having me speak at a virtual conference. It’s important I do something that is significant to me because it offers a chance to have a sense of accomplishment and pride (and perhaps with those feelings of worry).

The ACT approach helps me “be with life” and get on with life at the same time. That’s valuable to me. I hope it is to you too.

Comment below about your thoughts about this or your experience with expansion and defusion if you’ve used it. It’s important for me to know if I’m writing about relevant topics.

If you like this approach, take a look at Russ Harris’s free resources, click here or for The Happiness Trap book.

If you’d like to reach me or inquire about my mental health coaching email me at [email protected] You can book a free consultation to see if it’s right for you. For more info: www.victoriamaxwell.com

References

1. Angus Reid, 2020 Institute http://www.camh.ca/-/media/files/pdfs—public-policy-submissions/covid-and-mh-policy-paper-pdf.pdf   Retrieved Dec 30, 2020 from The Centre for Addiction and Mental Health

2. Kaiser Family Foundation https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/ Retrieved Dec 30, 2020

© Victoria Maxwell

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6 Ways to Increase Tolerance for Uncertainty

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Anxiety Canada is presenting town hall meetings each week on guess what topic? Anxiety! And boy, the one I recently watched titled “Uncertainty during COVID-19” was so helpful! 

Knowledge is power they say. Getting accurate information about anxiety, how it works, and the tips to increase ‘uncertainty tolerance’ was anxiety reducing in itself. 

Most people are feeling more anxious than usual. A pretty natural response to a global pandemic, I’d say. For those of us with generalized anxiety disorder (GAD), like myself, or other anxiety disorders, these times can be even more challenging. I know they have been for me.

Psychology Today describes generalized anxiety disorder (GAD) as a “chronic state of severe worry and tension, often without provocation. Those with GAD regularly anticipate disaster, often worrying excessively about health, money, family, or work. Merely getting through the day brings on anxiety.” Sounds comfy huh? Not.

Research tells us that people with GAD have difficulty tolerating uncertainty.1 In Anxiety Canada’s video, psychologist Dr. Melisa Robichaud, explains “intolerance of uncertainty means the person with GAD will worry about an imagined feared event as long as there is even the slightest risk of it happening.”

Most people are a little uncomfortable with uncertainty. There’s nothing wrong with that. But being VERY uncomfortable with it, is problematic. It can lead to extreme levels of stress, anxiety and worry and time-consuming behaviors.

Increasing our ability to tolerate uncertainty can go a long way to helping us feel more at ease when things are stressful. This is the case whether you have an anxiety disorder or not. 

Robichaud continues, “uncertainty is a component of a situation where you can’t predict the outcome which is great fodder for anxiety and worry.” 

It’s important to differentiate. Worry is of the mind (those negative ‘what if’s’ that roll around in our heads). Anxiety is of the body (racing heart, shortness of breath, the physical feelings we get). 

In my personal experience of GAD, difficulty tolerating uncertainty drives my worry. 

In general, this is how it works for most people. Dr. Robichaud says “worry is a mental attempt to reduce the unknown and feel more certain by thinking through anything that could possibly happen.” Unfortunately, complete certainty is always out of reach and this feeds the relentless cycle of anxiety and worry. 

Recognize any of these behaviours? To feel more certain, do you:

  • ask for reassurance from others a lot?
  • get 2nd, 3rd, 9th opinions on things? 
  • do unending research and information-gathering? 
  • worry about negative events happening even if the likelihood is very low? 
  • make lists upon lists, maybe making multiple ones in a day?

On my ‘not-so-good-filled-with-worry’ days, yes I do. These and other thoughts and behaviors indicate an intolerance of uncertainty.2

There’s actually an assessment to measure it. It’s called, what else? The Intolerance of Uncertainty Scale (the IUS)!

Even though we will always live with uncertainty, there is good news. There are ways we can improve our ability to tolerate it and thus increase our everyday sense of ease.

6 Ways to increase tolerance for uncertainty:

1. Acknowledge and accept – First, it’s ok to be anxious about the current uncertain times. It’s not just ok, it’s understandable. Even without the pandemic, anxiety is ok. Yes – it’s uncomfortable, but it is also acceptable. Accept and acknowledge it’s natural to feel anxious – you’re not alone. This in and of itself can create space to relax.

In the video above, clinical psychologist Dr. Anne Marie Albano suggests we recognize and accept that “we can’t (ever) be completely certain, but we can do the best we can, for who we are. You do what you can to take care of yourself and to make (positive) outcomes more likely.” 

2. Knowledge – Education is powerful. Learning about uncertainty tolerance, understanding how anxiety works etc. can improve our ability to tolerate uncertainty. Watching the video and reading this blog can increase our understanding and decrease our anxiety. 

3. Flexible thinking – As Dr. Anne Marie Albano describes, it is learning to “roll with things when you can’t control them. The ability to make good use of accurate information”. Shifting our thinking when we get new information and allowing that to positively influence our behavior is what developing flexibility in our thinking is all about.

4. Create a healthy relationship to threat – Dr. Robichaud explains “a healthy relationship to threat (or uncertainty) is based on probability not possibility.” That is, I use my rational mind, not my anxious mind, to determine the likelihood of an event occurring. If it’s a low probability that it will happen, then, in Dr. Robichaud’s words, “I will not act as if it is a threat.”

5. Strategically gather information – Determine if the information gathering is helping and actually informing or is it another sneaky form of seeking reassurance? If it’s an attempt to find reassurance, then choose to stop. Intentionally choose when to gather information, and where to get it. That is healthy control. 

6. Problem solve from the rational mind – When there is a concrete issue (for example, job uncertainty) problem solve. Create a healthy plan using your rational mind not anxious mind. 

Dr. Robichaud describes a ‘wait and see’ approach. If you make a plan when you’re anxious, wait until the next day and review it. If it really is a good idea, it will still be a good one the following day when you’re less anxious. 

One of my favorite psychiatrists said to me “life is learning to live with uncertainty without being paralyzed by fear”. Uncertainty in life is unavoidable. The pandemic highlights this in neon. There are a lot of things in life that are out of our control. Fortunately, the way we choose to respond and relate to the unknown isn’t one of them.

© Victoria Maxwell

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1 Boswell JF, Thompson-Hollands J, Farchione TJ, Barlw DH. Intolerance of uncertainty: a common factor in the treatment of emotional disorders. J Clin Psychol. 2013;69(6):630-645. doi:10.1002/jclp.21965).2 Lee JK, Orsillo SM, Roemer L, Allen LB. Distress and avoidance in generalized anxiety disorder: exploring the relationships with intolerance of uncertainty and worry. Cogn Behav Ther. 2010;39(2):126-136. doi:10.1080/16506070902966918

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20 Ways to Help Your Adult Child if They Have Mental Illness

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As a speaker who shares her story of mental illness and recovery, I’m often asked what helped me most when I didn’t want help. What benefited me most when I was struggling and pushing people (and their assistance) away? What worked I call the “Crazy Naked Truths” (CNT).

CNT are principles healthcare providers, savvy friends, and my parents, in particular, embodied. They are strategies they utilized which facilitated my wellness journey. Eventually, I lived into these tenets– allowing me to flourish on my own. 

I was learning to manage bipolar disorder, anxiety, psychosis and the aftermath of a spiritual emergency. But these pointers encourage wellness in general. They’re applicable to many situations where someone is in distress or for anyone wanting to increase their ‘contentment quotient’. The guidelines transcend condition and illness, gender, age, ethnic background, socio-economic status, sexual orientation, religious affiliation, even political persuasion. Darkness knows no bounds. Neither does light. 

The 20 Crazy Naked Truths 

1. You can’t get well for me. You can’t change or control my behavior, reactions or choices. You can create conditions and options to help me accept my illness and make positive choices.

2. Acceptance is my greatest liberator; denial my greatest barrier.

3. Who you are and how you show up, matter as much as what you do and how much you know.

4. Find support and skills for yourself so you have the strength to say ‘no’ to me and offer me alternatives I may not welcome.

5. Learn to set boundaries with me so I can learn to set boundaries for myself.

6. Stay calm in conversations. Practice responding rather than reacting. Before you get to your “wits’ end”, walk away. Take a time out.

7. Show me how to use my anger not lose my temper.

8. If conversations always escalate into arguments, consider family therapy.

9. Learn to empower, not enable. As consistently as you can, offer me choices that work for YOU. Incorporate your needs and wants. IE: In exchange for living with you (the parent), I (your adult child) needs to get up by 9am and do a chore everyday. If I don’t want to do that, then you can still be there to help me and explore ways to find subsidized housing. 

10. Slowly, in small steps, create a reciprocal relationship with me. A relationship that is based on respecting the needs of others. Julie Fast has two excellent articles about this: The Hijacked House  and Reciprocal Relationships: Parenting your Adult Child with Mental Illness While Meeting your Needs

11. Sometimes I need a kick in the butt more than a pat on the back. Sometimes, the opposite.

12. Don’t protect me from the privilege of failure. 

13. You may never know which of your words created my tipping point into wellness; but know our conversations matter. 

14. I will rise to your expectations.

15. Hold a vision for me until I can hold it myself.

16. Explore what helped me in the past and focus on those strengths and tools to help me in the present.

17. Help me discover what I yearn for most deeply, and you will have helped me find the intrinsic motivation I need to participate in my wellness journey.

18. Push back indicates that fear is afoot. Model and teach me tools to manage and articulate my anxiety and needs, and I will move forward.

19. Respect my timetable. It is likely different (and slower) than yours. 

20. Once I’m well, support me to make ‘a good thing better’.

What do you think? In the comments section, let me know which one you’d like further information on. Who knows, it might appear as a future blog post.

© Victoria Maxwell

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Finding a way to be spiritual and crazy.

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As my husband and I move past the 40-day mark of staying at home due to COVID-19 (egad!), I thought another excerpt from my ‘work-in-progress’ memoir might be a nice diversion. Not much context is needed for this. Gentle feedback welcome. Email me at [email protected] or leave a comment. Happy reading!

For years I tried to manage without help from the medical system. I put up all the clichéd roadblocks: I don’t trust big pharma. Doctors just want to push their agenda, their pills. I don’t have mental illness. I didn’t have psychotic episodes. I had spiritual awakenings. I don’t like the labels. I don’t want the drugs. I want to treat it, heal it the ‘natural’ way. Read: the ‘healthy’, morally superior, spiritually evolved way.

I tried everything from colour therapy, primal therapy, aromatherapy, psychotherapy (you gotta wonder why they call it “psycho”-therapy – pretty insulting if you ask me), astrology, numerology, reiki and pranic healing. I saw channelers, tarot card readers, psychics. I studied A Course in Miracles, the Alcoholics Anonymous’ big book. I went to halfway houses, support groups, 1-day workshops, weekend retreats. Did muscle testing, moving meditation, insight meditation. Got acupuncture, shiatsu, massage. Took flower remedies, Chinese herbs; did affirmations, journaling, morning pages, automatic writing, body work, dream work, aura cleansing, aura reading, chakra balancing, chakra clearing. Joined AA, OA, OY-VEY.

 You name it. If it was New Age, Self-“Yelp” or somewhere on the shelves of Banyan Books (Vancouver’s oldest new-age bookstore), I had read it, paid for it, trained in it, practiced it, meditated over it, ingested it, sniffed it, got fleeced by it. And none of it, not really, super down deep, was enough to keep me well.

 My last resort? Enlightenment. See, I thought if I got enlightened, I wouldn’t feel depressed anymore. I wouldn’t feel anything anymore.

I have more trouble telling you I went to India to visit a guru to get enlightened than I do admitting I ran down the street naked in a euphoric psychotic episode and ended up in the psych ward. 4 times.

I don’t know why. Maybe because the perfectionistic overachiever that I am, is ashamed I failed to reach my goal. I am definitely not enlightened. Maybe because mental illness is common. Enlightenment not so much, and what’s the point of it, really? It’s not like being enlightened is practical or even attainable. Mental illness however, now THAT’S attainable. Though mental illness isn’t all that practical either. Practically fatal, perhaps.

Spiritual searching (more like lurching in my case) is…embarrassing.  My fervent hunt for enlightenment revealed my desperation. Granted, it kept hope alive and as a result, it kept me alive.

Depression led me to question everything. Like paint thinner, depression denatures our lives of purpose and point. Living with dramatic despair and mangy meaninglessness, I spiraled into an existential crisis. Over and over and OVER again, I was caught in an Escher-like maze of questions: “What is God? Why are we here? What’s the meaning of it all?”

On a cloudy North Vancouver day, my dad sat beside me on my springy mattress in my bedroom. Both of us looking at the floor, him shaking his head as I rattled off those questions that ricocheted between my temples. With that furrowed brow of his, he sighed and grunted “Man has been asking those questions from the beginning of time. If you keep that up, you’ll go crazy.” More prophetic than either of us knew.

Instead of focusing on a traditional way of combating my malaise by going to my doctor, treating the symptoms or continuing with counseling, I assumed if I discovered the meaning of life, I’d be fine! Enlightenment, the end of suffering, the Buddha said. What’s not to love? Those contemporary gurus seem pretty chill too, right?  The Dalai Lama is pretty much always giggling. Eckhart Tolle – though a bit creepy in an elfish kind of way – seems fairly content. Thich Nhat Hanh – now that dude is laid back. Pema Chodron? My rock star. She exudes equanimity while also readily embracing her messy humanity. I put all my energy into seeking the answers to life. Because that was the real root cause of my suffering. Not this thing called mental illness.

The new age movement says the psychoses I experienced were spiritual emergencies and awakenings. I didn’t need to ‘resort to’ medication or medical treatment to heal. The medical system has one perspective: mental illness is a disease; a complex interplay of genes and environment. I hadn’t experienced God. 

It’s a blessing OR a curse. I was caught in a psychiatric “Sophie’s Choice”. Choose the spiritual perspective: suffer. Choose the medical perspective: suffer. But over the course of 25 years since I’ve been diagnosed, I’ve discovered, it’s not that clear cut. It never is.

Maybe I have a hard time telling you I went to India to sit with a guru and “wake up” because I think my seeking actually led me into the foul spiral of mental collapse. Maybe. Just maybe – I feel like I’m to blame for bringing my mental illness on myself. Or that I failed myself. If I had just been more grounded, more prepared, that massive burst of energy that coursed through my body on that particular evening in a meditation room wouldn’t have resulted in me believing that I saw my own grave and that I could drive my car with my thoughts. Maybe just maybe I’m disappointed in myself. That somehow, I could have harnessed that moment into permanent liberation, instead of plummeting me into a fight for my vision of spirituality and for my mental health.

Does mental illness and spiritual experiences have to be mutually exclusive? That’s what I felt the medical system was telling me. That’s what I thought my spiritual community was telling me. It was one or the other. But I needed it to be both. Both. For me to stay alive, I needed to find a way to be spiritual and crazy.

To be continued…

© Victoria Maxwell

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Dudes & Dogs ‘Walk & Talk’ Helps Men’s Mental Health

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I love this initiative. Rob Osman from Bristol in the UK, who has struggled with social anxiety and depression, created a dog walking group for guys to gab about their feelings and struggles (if they so choose). He did so after he found walking his dog, Mali, was such a huge help for his own mental health. 

For anyone, but for men especially, ‘let’s go for a walk’ is so much more appealing than ‘let’s have a talk’. 

Dudes & Dogs Walk & Talk he calls it. Don’t you just love that? 

The program is there to make it easier for men to talk or, even just to join in and go for a walk with another dude and a dog. No pressure or requirement to say a thing.

In a Somerset Live interview, Rob Osman says “”It [walking a dog] is a good way (for people to relax and drop their barriers) because you do not have to look at each other in the eye and are in an open space.”

I talk about how to create an encouraging space for folks to talk in my most recently developed “keyshop” (combo of a keynote and workshop) Creating Comfortable Mental Health Conversations at Work. 

When you’re talking to someone about a potentially delicate issue (like mental health, or simply feelings), you want the individual to feel safe. You don’t want them to feel cornered (as in a hallway) or too exposed (in view of co-workers in the break room) or threatened or defensive (like sitting across a table or a desk even).

I suggest the very initial ‘how are you doing?’ questions happen while casually walking through the parking lot away from others. Strolling from one job site to another is another good place to start a conversation. 

Osman continues: “It is at their pace and there is no expectation for them to have to talk – it could be that they just listen the first few times.” 

Men and women relate and express their feelings in very different ways and environments. We women sit across from each other, looking supportively into each other’s eyes, drinking tea or coffee and talk, and talk and TALK. 

I can call a girlfriend who I will be seeing that same night, talk on the phone for an hour or more during the day, and still have things to say to her in the evening. My husband just shakes his head and wonders how on earth could we have so much to say to each other. That’s women for ya.

Men on the other hand, so I’ve been told, open up when they are side-by-side doing things together. None of this eye contact kind of stuff. They watch ‘the game’, sit around a fire, go for a hike, or as Osman knows, go walking with a dog. Then talking flows from the activity.

We need our men to talk. The stoic ‘I-can-tough-anything-out’ is killing them. 11 people die every day by suicide In Canada. Most of them are males. That doesn’t even capture the individuals who attempt it. 

We need to normalize talking and explore ways of sharing that’re comfortable so men are willing to participate. Having women suggest ways ain’t gonna fly too far. Role models are the best way to create change. Rob Osman is one of those who is pioneering new methods to get his brothers in arms to stop suffering in silence and instead get into nature, with dude and dog, and share some of the tough stuff. 

When men find healthy ways to express themselves and their struggles it positively impacts their families, their workplaces, and their communities. And THAT is something definitely worth talking about! 

© Victoria Maxwell

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Not Another Bipolar Memoir: an Excerpt

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I’m writing a book. There, I said it. Not quite sure if it’s going to be a straight-up memoir. Perhaps titled, as someone joked, “Not Another Bipolar Memoir”. Or, the book might be a combination ‘memoir/personal-essay-with-action-tips” kinda book. Either way, as I write it, I’m going to, from time to time, share excerpts with you. I love the idea of having a friend like you (‘cause that’s how I think of you) getting a peek into what I’m thinking and what I’m writing. 

I don’t have a date set for the final draft, or a publisher (if I go that direction) in place. But as a valued reader, I value sharing these pieces with you. If you have thoughts about them, resources that might be helpful as I get closer to publication, people you think I should contact or just general cheerleading comments and encouragement – email them my way! 

This piece is pretty self-explanatory. If it’s not, then I need to do a major rewrite! Read on and hope you enjoy it.

Cute Guy in the Psych Ward

One month in on A2 at Lion’s Gate hospital – A2: the acute psychiatric ward. By the way, there is nothin’ cute about a psych ward.  I’m following this blue line down the middle of the hospital hallway. It leads to the smoke ‘garden’. That’s where all the chain smokers hang out. I never smoked before until I got here, but the cute guy from room 17 lights up every 35 minutes. I won’t see him otherwise. I don’t think he knows I’m alive. I must be invisible. Oh, don’t ever say that to your doctor: ‘IN-VISIBLE’. Red flag phrase for psychiatrists.

Anyway, I’m in the smoke ‘garden’ wearing those regulation blue hospital PJs, sitting on one of those flimsy white plastic patio chairs.  One leg is shorter than the others, so I’m trying to find my balance and at the same time trying to be all flirty while I look at Sam. That’s his name, Sam, the cute guy (red hair, pulsing biceps) who undoubtedly has a girlfriend. I know his name because we’re all assigned orderlies for the day and it’s posted on a white board with our names listed under them. Wednesdays I’m with Liam. So is Sam. Isn’t that cute? We’re a couple without even trying. This is my manic hypersexual ‘super’ logic. 

“Can I have a light?”  I lean towards him, careful not to topple over. A silky hand carries his Bic lighter close to my mouth. I inhale, the flame flares and cigarette ignites. I cough. “Thanks.” And I cough again. Not quite the impression I wanted to make. 

Despite the giant hedge of fir trees running the circumference of the unit, the grass of the smoke garden and beyond is scorched. Rays of late afternoon summer sun lasers through the foliage onto the top of Sam’s head. His red hair lights up like sparkles in a snow globe. 

And then? Out of his mouth comes poetry, snippets from his therapy journal. His words make me think of tangerines and the smell of sandalwood. He says these things and I just laugh. Like a lunatic. NO. I mean really like a lunatic. And he looks at me like I’m crazy or something “‘cause,” as he tells me “it wasn’t supposed to be funny”. And there I am with my burning butt of a cigarette feeling like an idiot, a crazy woman, thinking about the tie-dyed sunsets of India. And then, guess what Sam does? He leans back, takes a drag of his cigarette and smiles.  For the next 5 minutes, we sit in comfortable quiet, staring at each other, waiting ‘til our smokes die.

© Victoria Maxwell

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Strategies for Business Leaders to Make their Workplace Psychologically Safe and Mentally Healthy

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I’m excited to pass along this new workplace mental health resource I’ve discovered: the evidence-based Workplace Mental Health Playbook for Business Leaders. 

The economic burden of mental illness in Canada is a whopping $51 billion annually1. That’s billion with a ‘B’, every single year. Even more striking is that the cost of a disability claim due to a mental illness is almost double the cost of a claim due to physical illness2. 

When I speak to executives and managers, I hear they want to do something; they know they need to do something. But often they’re unclear as to the best path to take to make the biggest difference. 

If you are one of those of leaders, this guide might offer some welcomed clarity.

The Centre for Addiction and Mental Health (CAMH), in partnership with BMO, launched the playbook at the end of January.

I was sceptical when I first heard about it. But when I looked at it more closely, I was encouraged. It includes feedback from Canadian corporate leaders and case studies of top companies that are implementing mental health strategies. 

It includes research-informed recommendations to help leaders and organizations successfully put into action a mental health strategy that enhances employee wellness and performance, and increases company profits. The guide states that “Organizations with comprehensive mental health strategies perform better on average in all areas – from health and safety to shareholder returns.3,4

Some suggestions you will have already read about, some you may not have. A key idea is that any mental health strategy must be integrated into the overall long-term business strategy. Equally important is to create a work environment that is safe for everyone to discuss mental health. How a company goes about that will differ depending on various factors in their workplace. 

One concrete way is to have senior leaders share their own journeys with mental health. I for one, would love to see more individuals ‘from the top’ champion and role model what they would like to happen in their workplace. When CEO’s step up and discuss their mental health experiences, that person is walking the talk. Honest and vulnerable communication from leadership helps reduce stigma and discrimination. 5,6

In my new keynote workshop called ‘Creating Comfortable Mental Health Conversations at Work’, I emphasize the power of simple but regular ‘how are you doing’ check-ins to help people feel free to discuss any issues and help managers and supervisors to prevent serious issues from occurring early on. 

At least every other day I hear on the radio or I read in a magazine, a piece on a psychiatric disorder, an individual telling of their experience, or an initiative to help those suffering. That’s a big change since I started sharing my story back in 2002. And that, my friend, is a good thing. A very good thing.

However, businesses are still learning how to really make their workplaces psychologically safe and mentally healthy. I’m hoping this new playbook can help. What mental health initiatives is your organization putting in place? Email me to let me know.

© Victoria Maxwell

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References

1 Lim, K.L., Jacobs, P., Ohinmaa, A., Schopflocher, D. and Dewa, C.S. (2008). A new population-based measure of the economic burden of mental Illness in Canada. Chronic Diseases in Canada, 28(3), 92-98.

2 Dewa C.S., Chau N. and Dermer S. (2010). Examining the comparative incidence and costs of physical and mental health-related disabilities in an employed population. Journal of Occupational and Environmental Medicine, 52(7), 758-62.

3 Deloitte. (2019). The ROI in workplace mental health programs: Good for people, good for business – A blueprint for workplace mental health programs. Deloitte Insights.

4 CSA Group. (Reaffirmed 2018). Psychological health and safety in the workplace —Prevention, promotion, and guidance to staged implementation CAN/CSA-Z1003-13/BNQ 9700-803/2013 National Standard of Canada. CSA Group.

5 Howatt, B. and Palvetzian, S. (2018). How leadership can impact workplace mental health. Globe and Mail. Retrieved from: https://www.theglobeandmail.com/business/careers/workplace-award/article-how-leadership-can-impact-workplace-mental-health/

6 LaMontagne, A.D., Martin, A., Page, K.M., Reavley, N.J., Noblet, A.J., Milner, A.J., Keegel, T. & Smith, P.M. (2014). Workplace mental health: Developing an integrated intervention approach, BMC Psychiatry 14. Retrieved from: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-14-131


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My Strategy for Honoring Work Responsibilities When I Need a ‘Mental Health Day’

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I took several mental health days off this past week and will take one today, too. 

I didn’t even lie to my boss and say something like, “I think I’m coming down with a cold”. My boss is pretty understanding. I work for myself.

After a nudge from my lovely husband and gentle curiosity from my new psychiatrist, I gradually recognized what they already saw. That, yes, I’ve been depressed and I needed a bit of a break. I’m usually pretty good at knowing my warning signs, but this occasion, not so much. Sneaky little *bleep* — this depression beast. It still can do a doozie on me.

Taking time off and practicing self-care made me think. How can I take care of myself, but still honor my work responsibilities? I have emails to return; this blog post and a newsletter to write; clients to follow up with. I also need to keep it simple for myself and keep the pressure off.

Solution: pare down to only the essentials. There’s only one pressing email I need to return. Even while experiencing this brain fog and insecurity, I can manage one email. My client follow-ups aren’t set in stone. Waiting a day and a half won’t collapse my business. Refusing to rest and practice self-compassion just might. For my newsletter, missing my deadline will make me more anxious, meeting it will create some relief. I’ll make it easy and share a piece I wrote a while ago but never published. I won’t, on the other hand, set myself up for failure and attempt what currently feels like the herculean task of writing completely new content. It’s about kindness today.

To boot, this post I’m using is meant to bring some laughter. Another self-care tool I use.

If you’re feeling good, well this will hopefully just make your day that much brighter.

If you’re fighting the dynamite of depression like I am right now — I’m about two-thirds of the way out of the woods — well, I hope it does at least one of three things. It might, a) make you smile a teensy weensy bit, or b) distract you from any negative self-talk if only for a couple minutes (depending on how fast you read), and/or c) help to read something positive in nature as opposed to all the crap the news has to bring.

Side note: I want to make my opinion known. It shouldn’t be called ‘news’. It should be called ‘BAD news’. That would be accurate. Then it would also make it clearer what we’re actually feeding our minds when we peruse it. But, I digress.

If you’re feeling the twinges of any mental health issues, this is my wish: that you take care of yourself like you would if you had the flu. Take it easy on yourself; adjust your expectations for a bit; celebrate the little wins; see a doctor if you’re really ill and reach out and connect with a friend or partner. Let yourself be helped. And, read this post to feed your mind and soul with something that’s on the lighter side as you pass through this tough patch. Because, as the cliché goes: this too will pass. And it will. Meet you on the other side.article continues after advertisement

If you know someone who might need a boost, please forward this to them.

© Victoria Maxwell

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Other People’s Trauma is Way Worse Than Mine – Or Is It?

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Until recently, I never identified as someone who went through childhood trauma. Dysfunctional family dynamics – oh yeah. But trauma? No. Until I started learning about it and talking to my counsellor, Andi. 

She knows my psychiatric diagnoses but also all the juicy details of my childhood to adult history. “What you experienced is called complex or relational trauma.” She told me. 

“But trauma is,” I piped in, “physical, emotional or sexual abuse or neglect, right? Like I need to be the recipient of it to ‘qualify’.” 

“Not exactly. What you described are examples of trauma, but trauma encompasses more than those.” Huh? This was news to me. 

What is Complex Trauma?

Andrea Schneider MSW, LCSW quotes Dr. Ron Doctor, psychologist: “complex or relational trauma can arise from prolonged periods of aversive stress usually involving entrapment (psychological or physical), repeated violations of boundaries, betrayal, rejection and confusion marked by a lack of control and helplessness.”1

Oooh-kay…maybe I’ve been wrong. 

Still, I tend to dismiss what I experienced. Sure, as a child I witnessed daily rage and emotional abuse between my parents. But I wasn’t the target of it. 

Both had mental illness, but my dad was ‘only’ depressed and anxious. Yes, my mom had bipolar disorder and talked to me about wanting to die. But she never attempted suicide. 

My parents lived in a pretty much loveless marriage, but I felt loved, in a precarious kind of way. I felt scared most days, but loved at the same time. 

Ok, that does sound pretty uncomfortable and confusing even to me.

But it’s been years since all this happened. I’ve done lots of therapy.  It can’t be running my life STILL? 

Others had real abuse. You know like getting hit, sexually molested, living in poverty. Others had it way worse.

Ron Doctor’s definition describes trauma in a new light. One that makes sense to me. One that validates why I still feel haunted by the basement cobwebs of my past. 

It’s true, others suffered abuse I can’t even imagine, but that doesn’t mean what I underwent was any less significant or painful to me.

I’m cautious though. There’s a danger of overidentifying with being a victim of trauma. It can unintentionally perpetuate the learned helplessness I want to escape. 

Regardless, to create a calmer, healthier life and more positive relationships I’ve discovered I need to face the pain without clinging to it and find new behavior patterns.

Attachment and Healing

As a result of trauma, wounding to secure attachment can occur. PsychAlive explains that attachment is “the particular way in which (we) relate to other people. (It’s) formed at the very beginning of life, during the first two years.”2

Though I felt loved, and I was taken care of in a haphazard manner, this didn’t protect me from developing what is called an insecure attachment style. Oh, gawd. I know, more labels. But it has actually helped me create a coherent narrative.

There are different types of insecure attachment, and often we are a combination. I discovered, I have a mainly avoidant style. There’s also what’s called disorganized attachment. Though I don’t fall into this form, I relate to how this kind of attachment originates. 

Dr. Lisa Firestone, Director of Research and Education at The Glendon Association explains “Disorganized attachment arises from fright without solutions. A child may experience repeated abuse, neglect or scary behaviour from a parent or caregiver as life-threatening. 

The child is stuck in an awful dilemma: her survival instincts tell her to flee to safety, but safety may be in the very person who is frightening her. The attachment figure is thus the source of the child’s distress. In these conditions, children often disassociate from their selves. They may feel detached from what’s happening to them. What they’re experiencing may be blocked from their consciousness.  A child in this conflicted state develops a disorganized attachment with their parental figures.” 3

As an adult, at times I feel overwhelmed, swallowed up by my feelings (no wonder I was diagnosed with bipolar disorder). I disassociate easily. Terror comes up when I face anger or even disagreement. 

It can trigger me and render myself and my needs invisible. In order to find some semblance of internal safety and relief from the tsunami of fear, I’ll capitulate to others needs and wants (whether they are asking me to or not). 

But this is changing. And the good news is it CAN be changed. 

I’ve healed some of the behaviors and continue to transform the ones still hanging around. It doesn’t serve me or those around me to stay stuck in patterns of unresolved trauma and unhealthy coping tools. Is it messy, hard and painful work? Yup. But it also feels essential to free myself from what has unconsciously been driving me. 

I get impatient though. Do you? I’ve been doing this thing called ‘talk therapy’ for years now. I’ve been fortunate to be able to do it. Shouldn’t I be further ahead? Shouldn’t these patterns have dissolved already? But I know the answer. 

Clichéd but accurate: it’s like a snake shedding its skin or peeling layers of an onion. Though I’d rather have less slithery, stinky metaphors. How about…a rose bush? Stay with me. 

Healing trauma or recovering from mental illness, or both, is like caring for a rose bush year after year. Each season, buds bloom. Then the plant is pruned (parts no longer needed are removed) so that next year’s flowers are even more lush. 

In the tending of the roses, the thorns may still prick but over time both the flowers and the plant get healthier and more lovely. That’s what I hope anyway. That’s what I’ve been told. That’s what I’m beginning to experience. So I keep the faith and continue gardening.  

© Victoria Maxwell

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References:

1 Schneider, Andrea  (2018, January 22) “What Is Relational Trauma?: An Overview” retrieved November 29, 2019 from https://blogs.psychcentral.com/savvy-shrink/2018/01/what-is-relational-trauma-an-overview/ 
2 PsychAlive “What’s Your Attachment Style?” retrieved November 29, 2019 from https://www.psychalive.org/what-is-your-attachment-style/

3 PsychAlive “Disorganized Attachment: How Disorganized Attachments Form & How They Can Be Healed” Retrieved September 7, 2019 from https://www.psychalive.org/disorganized-attachment/

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Curb Your Perfectionism: 9 Tips to Rewire Perfectionistic Patterns

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December is almost here and the pressure to have the perfect holiday experience can come along with it.

Not only that, but we live in an aspirational, Instagram-curated world. Maybe we always have (minus the social media bit). The “great American dream”, “the pursuit of happiness”. Capitalist culture is based on the quest of bigger, better, MORE. 

Because of this, I didn’t recognize the part perfectionism is still playing in my life. I thought I was a rather “recovered perfectionist”. Oh, our blind spots! I thought I had left most of those tendencies behind or at least were aware of them when they popped up. Afterall, one of my most popular posts on Psychology Today is “How To Escape the Vicious Triangle of Depression, Anxiety and Perfectionism”.

My favourite quote is: Good enough really IS good enough.

I actively use it to remind me to send that email after revising it only twice – instead of 11 times; to finish that (or this) blog post even when I have the urge to do just one more rewrite; to NOT research 15 different types of dog beds before choosing one.

Perhaps because I got some distance from my perfectionistic patterns, I started to think of perfectionism as harmless, like an annoying party guest. “Oh, yeah, I’m such a perfectionist – I have to have everything just so or I just can’t relax.”

But in his TEDMed talk “Our dangerous obsession with perfectionism is getting worse”, social psychologist Thomas Curran explains perfectionism has been on “an astronomical rise over the past few years.” It conceals, he goes on to say “a host of psychological issues that can lead to depression, anxiety and suicidal ideation”.

It erodes good relationships by setting unattainable standards. It cuts accomplishments, never allowing any celebration or feelings of gratitude. The very feeling of which in fact supports good mental health.

Far from being merely an annoying party guest, if left unfettered, perfectionism can become a destructive live-in monster.

Interestingly, perfectionism kept me sane and safe when my world as child wasn’t even close to that. When things around me were exploding, it was easier and less terrifying to (unconsciously and erroneously) believe it was my fault.

The belief gave me hope. If I could just behave better, be better, do whatever it was more perfectly then maybe I could stop the chaos around me. In essence, my striving for perfection as a child and youth gave me a sense of control, even if it never worked.

As an adult now, my drive for the ideal, works against me. Knowing that, however, doesn’t mean it’s a simple decision to let it go.

There’s some hardwiring that needs to get well, rewired. The good news is our brain is like a neurological Gumby, flexible and malleable. Rewiring our thinking and re-routing past patterns of behaviour is possible.

Slowly (and I mean very slowly) I have started that rewiring and begun to embrace the perfectly imperfect.

 How? Here are 9 Strategies I use:

1.  Take it seriously. That’s actually the biggest one.  Realize perfectionism, as much as I scoff at it, dismiss it or even laud it as a motivating force in my life, has a corrosive and potentially devastating nature. That way it’s on my radar and I’ll attend to it as part of my self-care.

 2. I choose to recognize that perfectionism, NOT me is the problem. It’s a learned habit that served me when I was young, not a sign of irreparable damage. Note, I use the power of choice (over and over again) to see this problematic habit is not who I am. 

3. I bring my awareness to my patterns of perfection, particularly the negative self-talk that accompanies – or more likely precedes and drives – my perfectionistic actions. Notice when this type of behaviour is triggered and what activities are most involved with it. Examples for me are: writing blogs, emails, even texts sometimes! Decision making about my simple steps in my career, resistance to celebrate accomplishments.

4. Honour process and progress over impeccable outcomes. Yeah – sort of a bumper sticker ‘the journey is the destination’ kind of thing. But it’s a good mantra and reminder.

 5. Make choices that feed my soul, instead of fuel the ‘flawless’. I don’t use Instagram much. I watch “The Ellen Show” because she celebrates being human and laughs a lot. I go for runs in the rain and splash in puddles so I get muddy.

 6. Allow myself a temper tantrum when it’s not perfect. Paradoxically, it helps me realize it doesn’t need to be.

 7. Make my own decisions when normally I’d ask for help and see what happens. It builds trust that I can depend on myself even when I’m uncertain I’m making the ‘right’ choice.

 8. Similar to #6, take small, safe imperfect risks to prove the sky won’t fall. My friend, Leah Goard, calls it taking “inspired imperfect action”.

9. Finally, I repeat my mantra “good enough, really IS good enough” when I’m stuck in perfectionistic procrastination paralysis.

 These steps build my tolerance for perfectly imperfect imperfection, for uncertainty, and eventually cultivate more and more acceptance for myself, just as I am. Because like the quote I have on my vision board says “We were born to be real, not perfect.”What do you do when you notice you’re caught in perfectionism? I’d love you to send me your tips. Put them in the comments or email me at [email protected]. I’ll put them in a future post so we can all live more comfortably and compassionately with imperfection.

© Victoria Maxwell

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