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Gestalt Therapy by Charlene-Ann Kee

The word ‘gestalt’ comes from a German word which literally means ‘whole’. The premise of gestalt is that our behaviours, feelings and thoughts, are what makes us human, whole or complete. When we think back to our childhood days, we were able to express our full selves freely and uninhibitedly until our families told us ‘we can’t behave a certain way’ or that ‘we can’t be angry because it is bad’, or ‘it is not right to think those thoughts’, etc., they tell us what we can or cannot think, do, or feel, based on what is socially acceptable. As a result, we start having restrictions on who we are as we begin losing parts of ourselves as we go through life, so that we can fit into moulds that society has created for us.

Gestalt therapists firmly believe that your life experiences are unique and different from everyone else’s, and are very committed in honouring them as your own. They do not want to change you in any way, or make any suggestions about how you can change your life. Instead, their aim is to try and raise your awareness through the use of various creative experiments that arise out of the moment, so that you are equipped with the tools to make better and more informed life choices. More importantly, they feel that what you or society deem as ‘maladaptive behaviours’ are a result of creative adaptations – the means in which you have developed ways that make you feel safe, and were what enabled you to survive in this world. Again, by spontaneously coming up with experiments, gestalt therapists can help you start gaining access to a fuller range of feeling and expressing your emotions, in the hopes of re-integrating the lost parts of yourself, so that you may once again be complete.

Because gestalt therapists work with your emotions, it is possible for a client to experience many different emotions during an hour long therapy session, so don’t be surprised if one minute you’re crying and the next minute you’re laughing uncontrollably!


Changing Negative Thoughts to Feel Better

By Stephanie McGrath

Thoughts are generated by the mind as a way of giving meaning to and making sense of the world around us. Often, we are unaware that we are interpreting and giving meaning to everything that we see, smell, touch, taste and hear. The thoughts we have about the world is also known as self-talk and is a conversation within our own mind. When faced with an upsetting situation, we are more likely to think negatively about the event and this is known as distorted thinking, also called automatic negative thoughts (ANTS).

When ANTS intrude on our internal conversation repeatedly, thoughts become more believable and happen so fast we may not even realize it. Reality is perceived negatively and this affects our feelings and behavior. ANTS can stem from mental health disorders such as depression and anxiety but ANTS can also play a role in the development of these same disorders and cause unnecessary stress.

Some examples of automatic negative thoughts include:

 

Catastrophizing: When you take a relatively minor event and imagine all sorts of awful situations resulting from it. “Making a mountain out of a molehill”.

All or Nothing Thinking: Also called “black or white” thinking – involves assuming that a situation is entirely good or bad, leaving no grey areas. E.g., all drivers are careless or all people are mean.

Fortune-Telling: You make predictions about the future and firmly believe that your thoughts are correct. E.g., you want to approach your boss about a raise but predict he will say ‘no’.

Mental Filtering: You only let information through that fits with what you already believe about yourself, others, or the world. E.g., if you think of yourself as boring, you only process information that points to you as boring.

Minimization: Overlooking or underplaying the positive aspects of a situation. E.g., someone tells you that you are pretty, but you pass the compliment off because you think the person said it out of pity.

 

What can you do about automatic negative thoughts? Become aware of ANTS and change them.

  • Pay attention to your thoughts (self-talk) and notice how you feel when you think something negative about yourself or others. Notice how these thoughts affect your body, mood and behavior.
  • Write down your thoughts and challenge them with rational and balanced responses. Confronting negative thoughts takes their power away.
  • Don’t believe every thought you have. Not all thoughts are true.
  • Think of this simple RULE to help challenge automatic negative thoughts:

R – realistic: are your thoughts truthful, credible or reasonable?

U – useful: how are these thoughts helping you?

L – logical: does your self-talk make sense? Would you think this thought about a friend in the same situation?

E – evidence: can you prove that this thought is true?

Learning to identify and challenge automatic negative thoughts can help to improve mood, change behavior and reduce stress so that you feel better.

 

Stephanie McGrath, M.Ed, CCC


Sleep

By Colleen Bingham, M.Ed.

How can something so basic be so problematic for so many people?  Statistics tell us that on any given night, one in three people have a problem falling, or staying, asleep.  Technically, insomnia is a lack of sleep so severe that it interferes with a person’s ability to function normally during the day.

There are three basic kinds of insomnia:  sleep onset problems; night waking problems; and early morning waking problems.  People may experience any or all of these issues.  People with stress or anxiety commonly experience onset issues and/or night waking, and people with major depression often experience early morning waking as well as trouble falling asleep.  Insomnia can be a symptom that something else is wrong such as stress, physical pain, illness or another sleep disorder.  Lifestyle habits such as keeping irregular hours, or the anticipation, either positive or negative, of a particular event, can cause insomnia.  Sometimes sleep problems that emerge when people are apprehensive about a specific event, or upset by a crisis, cam turn into chronic sleep issues.  In these cases, each night of poor sleep reinforces their worries about not sleeping, which leaves them anxious and exhausted and set up for more insomnia.  This is often called ‘learned insomnia’.

Although the treatment for insomnia is very individualized, keeping good sleep habits, often known as ‘sleep hygiene’, usually forms a basis for treatment.  Good sleep hygiene includes having a consistent pre-bedtime routine to signal your body to begin to prepare for sleep.

Other helpful guidelines include:

  1.  No food or alcohol after about 7p.m. (digestion can contribute to night waking).
  2. No caffeine of any sort (coffee, tea, hot chocolate, chocolate) from mid-afternoon to bedtime.
  3. Finish any exercise at least one hour before bedtime.
  4. No napping during the day.
  5. Keep a strict bedtime and waking time.  This must be the same for weekends as it is for weekdays to avoid “catching up” on sleep.  Lights must go out at exactly the same time every night and you must get out of bed at exactly the same time each morning.
  6. Turn around any bedside clocks so they are not easily visible.
  7. Use your bed for sleep and sex only.

For further information, please contact our office.


A Successful Life – Should You Leave Your Relationship?

How do you know when it’s time to say goodbye to a relationship? In any intimate relationship—especially in a marriage—it’s not a good idea to let a doomed partnership drag on, simply to avoid the pain of a breakup.

Signs of Trouble

There are some warning signs that your relationship is in trouble. If you recognize any of these signals in your own partnership, you may have some work to do to get things back on track.

1. Your life priorities have changed significantly. Major life changes often force people to reconsider what’s important, and this can make a once-healthy partnership lose its bearings. A near-death experience such as a serious accident or illness, being unexpectedly fired from a job, or losing a family member can cause anyone to reevaluate his or her life and decide to make some changes. Everything looks different after such an experience, and some things lose their meaning. When this happens, these new ways of seeing things must be addressed, since it’s unlikely that such changes will just disappear.

2. The arrangement still works, but the passion is missing. Lots of doomed relationships manage to work—for a while. But when neither partner has any genuine enthusiasm for the relationship, it may be in trouble.

3. You no longer trust your partner. After a partner has broken the bond of trust, it can be difficult to get it back. If your partner has had an affair or was irresponsible with a large amount of money, it is understandable that you feel angry and hurt. Over time, these wounds may not heal. Broken trust can cause serious harm to a relationship, and, if it is not healed, the relationship may not recover.

4. Your partner’s lifestyle or values clash with yours. It is difficult to sustain a long-term relationship when you and your partner do not agree on some of life’s most basic things. If you want to make and save a lot of money, but your partner seeks a simple life and would be happy living in a small house with few luxuries, this is a potential problem. If your partner seeks excitement and wants to be around people most of the time but you are basically a loner who prefers solitude, you may find yourselves growing apart. You may have been attracted to each other in the beginning because you brought each other some balance, but, over the long term, the very things that drew you to each other may doom your relationship.

Deciding to end a relationship can have enormous implications. If you are married, have children, own a home, and share finances, leaving your partner can be very complicated and will affect everyone in the family. It is important to make such a decision thoughtfully and for the right reasons.

More Warning Signs

If your partner regularly does one or more of the following things, you have good reason to be concerned.

1.  Behaves abusively with your friends and family

2.  Betrays your trust

3.  Breaks promises

4.  Cheats on you

5.  Does not challenge you mentally

6.  Does not support your goals in life

7.  Is extremely jealous without cause

8.  Is not financially self-supporting

9.  Opposes or ignores your thoughts, feelings, or concerns

10.  Physically abuses you

11.  Pressures you to have sex when you are not interested

12.  Resists your attempts to improve the relationship

13.  Shares your secrets with others

14.  Tells lies regularly

15.  Threatens violence

16.  Tries to isolate you from your friends and family

17.  Verbally abuses you or puts you down

These behaviors are very serious and potentially dangerous to you. If you are in a relationship with someone who treats you in any of these ways, you should seriously consider seeking the assistance of a mental health professional.

The Impact of Stress

Stress can make it harder to decide what to do. If you are questioning your relationship and have problems with money, are stressed at work, or the kids are acting up, deciding what to do becomes even more difficult. It’s important to take your time and resist the temptation to make a fast decision that may later turn out to be the wrong thing for you.

Tips for Making Good Relationship Decisions

1. Take your time making any important decision such as whether to end an important relationship. Even though you may feel confused and indecisive, it is important to recognize that this situation requires a deliberate and careful decision-making process.

2. Making a relationship decision calls for both instinct and logic. It’s important to trust your gut, but don’t lose track of reason.

3. Look at the issues from different points of view.

4. Consider the immediate and long-term implications of each option (staying or leaving), including the impact of each on other people in your life.

5. Consider the worst- and best-case scenarios, as well as the possibilities in between.

6. Give your relationship every chance to get back on track before you call it quits. Ask yourself if you have really tried everything. If you have, and it still isn’t working, it may be time to move on.

Seeking Advice and Support

Involving a few trusted friends in your decision-making process can help you avoid the tendency to rush into a decision and hurry to get it over with. Consulting others helps you step back from the situation and see it in a broader context. While it is more difficult and time-consuming, getting the advice and support of others can help you reach a better decision about whether to end the relationship. This is true for relationships or any other kind of decision.

You may decide to work with a professional counselor or therapist during this process. This is strongly advised if you are in an abusive relationship. A licensed, experienced professional can help you sort out the issues, help you see things you may not be aware of, and give you feedback on how you are seeing things. Involving an objective outsider can be a smart move because you can feel free to say everything that is on your mind without worrying about offending someone you care about or being judged for your thoughts and feelings.

Finally, if you decide that the relationship should end, minimize the chances for emotional fallout by planning how, where, and when you will deliver the news. When making such an important change in your life, it is better to set aside spontaneity in favor of being slow, deliberate, and certain.

Suggested Reading

Hammond, John, Keeney, Ralph and Raiffa, Howard, Smart Choices: A Practical Guide to Making Better Decisions. Harvard Business School Press, 1998.

Heller, Robert and Hindle, Tim, Essential Manager’s Manual. New York, NY: DK Publishing, 1998.


Marriage Issues for Seniors

By Ann Smutylo, M.S.W., R.S.W.

Many of us are caregivers for our parents and senior relatives.  And many of us are seniors ourselves, facing retirement, and the later stages of our lives.  If we are fortunate to have our spouse at our side, there are still marriage issues that arise, that we need to understand and manage, whether it is regarding our parents’ marriage or our own.

Marriage is a journey, one of the most complex and rewarding of human journeys.  Survive a marriage through the various developmental stages and you think you can coast into years of harmonious bliss.  But life never fails to keep us on our toes and keep us interested.

In past generations, many things were taken for granted, such as gender roles and the very permanence of the marriage.  Today, when so many marriages end in divorce, experts have tried to analyze and understand the dynamics of marriage and relationships, in order to help couples.

In the initial “honeymoon phase” of marriage, we focus on our similarities, often savouring our partner’s differences as endearing.  However, the “settling in phase” or “power struggle phase” of marriage follows, which highlights these differences.  Our differences are obvious when we are making decisions about life together: when and how often do we see our families; how do we deal with conflict; when is the right time to have children; how do we raise them; how involved should the extended family be; how do we work out the balance of power and the roles we play; how do we resolve our differences.  By the time the more mature “reconciliation” or “acceptance phase” is reached, the partners acknowledge the other as a unique individual, with strengths and limitations.  Now differences in interests can enhance the relationship without threatening the love for each other.  With self-knowledge and appreciation of the other, and with experience in solving problems and making decisions together, conflict can be handled in a less threatening way.

The Journey Continues….

As we get into the senior years, and indeed enjoy longer lives than our forbearers, the challenges of marriage can change.  It may be that the roles have reversed due to illness or due to the fact that you have remarried after losing a spouse.  Stresses and strains can come from unexpected areas.  Some examples may serve to illustrate.

  • Mr. Jones has become the main caregiver of his wife since her health problems began last year.  He did little housework or cooking during their marriage, so he has taken over all the household responsibilities, feeling he owes it to his wife who has looked after him.  He is a hardworking man with an independent spirit; asking for help would mean that he is not capable.
  • Mr. Smith and Mrs. Smith married 15 years ago, the second marriage for both, after being widowed.  Mrs. Smith is caring for her husband since his health problems started, but is having little cooperation from his children from the first marriage.  They make decision without consulting with her and criticize many things she does.  This is affecting the quality of care she can provide because she needs their help and support.

What to do to Make it Work…..

You may recognize these scenarios, or have some others in mind.  Many people feel alone and isolated and are not aware that there are helpful options available.  It is still necessary to pay attention to the quality of the marriage, and to the comfort and enjoyment each person can give to the other.  Getting the help needed to do this is possible.  Try to use resources and ideas to keep the stress from your relationship, to smooth out the bumps and sharp turns along the journey.  The valuable emotional marital support is what you and your spouse can offer each other.  This is something you have worked hard to attain over the years, and something unique to the two of you.

For more information, or to refer a client (patient), please contact us.


Biofeedback

By Colleen Bingham, M.Ed.

We are now able to offer clients biofeedback for stress and anxiety reduction.  For over 30 years biofeedback has been a valuable (invaluable) tool for teaching relaxation, an essential skill in dealing with stress related symptoms (disorders) as well as panic attacks, performance anxiety and phobias.

Although we are born with the ability to calm down and deeply relax the widespread stress and tension evident in our society today means that deep relaxation is something we have to re-learn.

Biofeedback enables us to detect and amplify internal signal of stress in our body.  When we are able to detect even subtle changes in physiology then we can begin to modify our responses.  Biofeedback allows us to know immediately if those modifications have had the desired effect of increased relaxation.

Mastery of deep relaxation can lead to reduction of generalized anxiety; prevention of stress build up and prevention and reduction of stress-related disorders such as hypertension, migraines, headaches, asthma, ulcers and so on; increased energy level and productivity; improved concentration and memory; reduction of insomnia and fatigue; establishing greater control over mind-body interaction – promotes a sense of wellness; decrease dependence on medication.

Learning to control arousal levels can be a critical step in facilitating ongoing cognitive behavioural therapy.  For more information, or to refer a client (patient), please contact us.

Colleen Bingham is a clinical psychotherapist with Goldstein, Moncion, Greenbaum and Associates.  She works with families, individuals and groups with such issues as stress management, time management and achieving balance in life.  She is an effective and enthusiastic speaker and workshop organizer and has facilitated stress management groups.  Colleen has worked with the schools and school boards, government, and local organization and has attended advanced workshops on Post-Traumatic Stress Disorder.


EMDR (Eye Movement Desensitization Processing)

By Yaffa Greenbaum, M.S.W., R.S.W.

Although no one can say for sure how or why this method works, it is a well- researched method that has proven effective in helping individuals see disturbing events in a new way.  When a traumatic event happens to an individual, certain smells, feelings, sounds and images associated with the trauma can bring back the traumatic memories and cause the individual to relive the event.  Recalling and reliving these events can severely disrupt people’s lives, impact negatively on how they see the world around them, and create difficulties in relationships.  EMDR ”reprocesses” the brain functions so that these stimuli do not have such an impact on the individual.  The event is still remembered but is not so traumatic.  EMDR may also help with phobias, posttraumatic stress, anxiety disorders and many other difficulties when used with ongoing therapy.


Making Time: A Look at Time Management

By Colleen Bingham, M.Ed.

Do you experience any or all of the following symptoms?

  • Rushing;
  • Chronic vacillation between unpleasant alternatives;
  • Fatigue or listlessness with many slack hours of non-productive activity;
  • Constantly missed deadlines;
  • In sufficient time for rest or personal relationships;
  • A sense of being overwhelmed by demands and details, and having to do what you don’t want to do most of the time.

The solution may be improved time management practices.  Good time management practices are often compared to a compass, which shows us direction and helps us to make decisions, rather than a stopwatch, which just divides up our day.  Many people avoid looking at how they use their time because they are afraid that any solutions will be rigid and restrictive, and so they instead continue to be apathetic and feel out of control.  Another way to look at good time management is to picture an active hand with lots of muscle control getting things done, neither of which accomplish nearly as much.

The central question in good time management practice is “What is important to you?”  It is very helpful to identify our goals on a daily, short-term and long-term (or life goal) basis.  Many people feel ongoing dissatisfaction because the lives they are living are not in keeping with their long-term goals.  These goals can aid in the prioritizing and decision-making that we have to do on a daily basis.

A handy tool for time management decision-making is to use our goals to help us decide if an activity fits in the top, middle or bottom drawer of the chest that represents our life.  Top-drawer activities are those that are the most essential and most desired.  Middle drawer activities can be put off but are still important, and bottom drawer activities can be put off indefinitely with no harm done.  Here are four basic rules, and nice optional rules, for making time.  The four basic rules are as follow.

  1. Learn to say, “no”.  Unless it’s your boss who asks, keep away from commitments that force you to spend time on bottom drawer items.  Be prepared to say, “I don’t have the time”.  If you have trouble saying no, look into assertiveness training.
  2. Banish bottom drawer items, unless you have completed all higher priority items for the day.  The definition of bottom drawer items is that they can wait.
  3. Build time into your schedule for interruptions, unforeseen problems, unscheduled events, etc.  You can avoid rushing by making reasonable time estimates for activities, and then adding on a little extra time for the inevitable snafus.
  4. Set aside several periods each day for quiet time.  Arrange it so that you will only be interrupted in an emergency.  Focus on deep relaxation.

These are the nice “optional” rules for making time.  Check three of them that would be most helpful to you.  Begin the habit of following the rules you have marked right now.

  1. Keep a list of short five minute tasks that you can do any time you are waiting or are “between things”.
  2. Learn to do two things at once:  Organize an important letter in your mind while driving to work, plan dinner while vacuuming.
  3. Delegate bottom drawer tasks.  Give them to your children, your secretary, your housecleaner, your mother-in-law.
  4. Get up half an hour or an hour earlier.
  5. Television is a huge time killer.  If you watch, make an agreement with yourself to write a one-sentence summary of each commercial.
  6. When you have a top drawer item to do, block off your escape routes:  Schedule daydreaming for a later time; stop socializing; put away the books; put away tiny, unimportant tasks; don’t run out for ice cream or other sudden indulgences; forget the errands you could probably do more efficiently later.
  7. Cut off non-productive activities as soon  as possible (eg. Socializing on the phone when top drawer items are begging to be done).
  8. Throw away all the mail you possibly can.  Scan it once and toss it.
  9. Stop perfectionism.  Just get it done.  Everyone makes mistakes.

For information on goal-setting, decision-making, prioritizing or any other time management practices, please contact our office.