Dealing With Difficult Family Members During the Holidays

The holiday season often brings up a complex mix of emotions. For some, it represents joy, connection, and celebration with family and friends. For others, especially survivors of childhood trauma, it may bring feelings of sadness, resentment, anxiety, guilt or loneliness. It might bring up a longing for the picture perfect family holiday that you’ve never had. Maybe your family holidays were okay, but there was always some kind of conflict or tension to dampen the mood and shatter your expectations.

This blog post is for you if you’ve decided that despite the tension and walking on egg shells, you are going to tolerate going home for the holidays (How to make this decision could be a whole blog post on its own!)

This blog post will cover tips for navigating family gatherings that go beyond “set boundaries and practice self care”. While important, at times these tips feel not enough to really help you navigate through these tricky family gatherings. Let’s review some of my favourite practical strategies for how to manage these tricky situations.

Imagine yourself at your family’s dinner table, sat beside your great aunt who is notorious for her fat phobia and diet culture commentary. You’ve been working in therapy to accept your body and disentangle yourself from society’s idea of the ideal body. You think you might make it through dinner without any mishaps, when suddenly, your great aunt says to you, “Do you really think you should be eating that?”

Here is where you have a choice. You can allow those few words to take you out and undo all of the hard work that you have been doing. Or, you can hit your aunt with this question.

“What do you mean by that?”

Said in a genuinely curious way, this is one of my favourite strategies for dealing with these sorts of inappropriate, passive aggressive comments. This questions typically takes the asker by surprise and forces them to think about and explain what they really mean. If your aunt’s comment was asked as a way to shame your body, she is now being forced to spell out her intentions to you and everyone at the table in why she asked this. Typically, not wanting to make themselves look badly in this process, you will receive a grumbling “Oh, nothing” in response. Putting her on the spot may stop her from making future passive aggressive comments to you. These types of people like to stay under the radar. Remember, keep yourself calm and composed while openly and politely confronting your relative.

Remember that your great aunt is trying to upset you with these comments. By having a big reaction to them, you are giving her what she wants. Keeping calm, cool and collected is the best way to keep yourself out of the game she is trying to play.

Now, let’s be clear. This strategy is best used for those passive aggressive comments, those backhanded compliments, and those statements that are sly manipulations that might even slide under the radar of your other, less observant family members. If a family member is verbally or emotionally abusing you, I would not suggest this strategy. Speak with your therapist to make a plan to help keep you safe.

If you’re interested in more tips for dealing with difficult family members over the holidays, click the link below where I cover an additional bonus tip in my video on Instagram Reels.

About the Author

Dana Etherington is an Occupational Therapist, Psychotherapist and the Owner of Cedar Tree Therapy, a psychotherapy practice located in Brooklin, Ontario. Dana uses evidence based treatment modalities to treat anxiety, obsessive compulsive disorder and disorder eating and complex family relationships.

Mental Health Tips for Daylight Savings Time

Do you struggle during the winter months?

As the days grow shorter and the chilly winter months approach, many individuals experience a noticeable impact on their mental health. The lack of sunlight, colder temperatures, and limited outdoor activities can take a toll on our mood and overall mental health. However, there are several effective strategies to navigate through the dark winter months and manage your mental health effectively.

Here are some tips that can help:

1. Embrace natural light exposure: Maximize your exposure to natural light as much as possible. Open the curtains during daylight hours, sit near windows, and consider investing in a light therapy lamp that simulates natural sunlight. Light therapy can help regulate your circadian rhythm, boost your mood, and alleviate symptoms of seasonal affective disorder (SAD). The lights used for light therapy, known as Happy Lights or SAD lamps have become much more widely available and can be found easily at Costco or on Amazon.

2. Stay Physically Active: Engaging in regular physical activity has been proven to improve mental health. Exercise releases endorphins and helps combat stress and anxiety. One option is to embrace indoor exercise. There are so many options for indoor exercise, such as home workouts on Youtube or workout apps. Alternatively, don’t let the weather change your habits. Although walking when it is cold and cloudy may not be as enjoyable, it still provides the same mental health benefits. Bundle up and take a brisk walk outside.

3. Maintain a routine: Establish a consistent daily routine that includes regular sleep patterns and structured activities. Structure and routine can alleviate feelings of restlessness and contribute to an overall sense of stability during dark winter months. When the darker months arrive, keep as close to your typical routine as you can.
4. Prioritize self-care: Dedicate time for self-care activities that promote relaxation and stress reduction. Engage in activities you enjoy, such as reading, journaling, taking baths, or practicing mindfulness and meditation. Listening to calming music or engaging in hobbies that bring you joy can also enhance your mood and general well-being. The winter months are difficult. Bring some enjoyment to them through creating a cozy environment to read or journal in.
5. Connect with others: Social support is crucial for mental health, especially during challenging seasons. Reach out to friends, family, or support groups and schedule regular virtual meetups or phone calls. Engaging in meaningful conversations and maintaining social connections can help combat feelings of loneliness and isolation. Join a group activity one day a week to fill up your social cup and keep you busy after dark so you aren’t tempted to isolate.
6. Eat a balanced diet: Nourishing your body with nutritious foods can have a positive impact on your mental health. Take time to cook the foods you enjoy. Savour your favourite treats for enjoyment. Food not only nourishes your body, but your brain too.
7. Practice good sleep hygiene: Adequate sleep is essential for good mental health. It is very difficult to feel mentally well when you haven’t slept well. Establish a nighttime routine that promotes restful sleep, such as avoiding caffeine and screens before bed, creating a calm sleep environment, and practicing relaxation techniques like deep breathing or progressive muscle relaxation.
8. Schedule a therapy session: If the symptoms of dark winter impact your daily life significantly or persist for an extended period, consider scheduling a therapy session. We can provide support and guidance tailored to your specific needs.

Remember, managing your mental health during the dark winter months requires a proactive and well rounded approach. Implementing these tips can help alleviate symptoms of seasonal affective disorder, boost your mood, and enhance your overall well-being. With proper self-care and support, you can navigate the winter season with resilience and maintain optimal mental health.

About the Author

Dana Etherington is an Occupational Therapist, Psychotherapist and the Owner of Cedar Tree Therapy, a group psychotherapy practice located in Brooklin, Ontario. Dana uses evidence based treatment modalities to treat anxiety, depression, obsessive compulsive disorder and disorder eating.

Therapy For Anxiety

Should I get help for my anxiety?

Anxiety can significantly impact your daily life, affecting relationships, work, and overall well-being. Seeking help for anxiety is beneficial for several reasons. One of the biggest issues with anxiety is the avoidance behaviours that it leads to.

Cycle of Avoidance and Anxiety

The cycle of avoidance and anxiety is a common pattern that many individuals experience. It begins with an initial feeling of anxiety triggered by a particular situation, thought, or event.

As anxiety intensifies, the individual may engage in avoidance behaviours. Avoidance acts as a temporary relief strategy, allowing the person to escape the anxiety-provoking situation. For example, someone might skip social gatherings to avoid feelings of panic or embarrassment. While avoidance can provide immediate respite from anxiety, it ultimately reinforces the original anxiety and leads to long term anxiety growth.

Each time an individual avoids a situation, their belief that the situation is indeed threatening becomes strengthened. This reinforcement creates a feedback loop: anxiety leads to avoidance, which in turn increases anxiety over time. As a result, individuals may find their world shrinking, limiting opportunities for social engagement or personal growth.

Breaking this cycle often requires intentional therapy interventions. Cognitive Behavioural Therapy (CBT) is particularly effective, as it helps individuals confront their fears gradually. By recognizing and challenging irrational thoughts, individuals can reduce their anxiety levels. Additionally, exposure therapy techniques can be employed, where a person is gradually exposed to their fears in a controlled manner, with the support of a therapist.

It's crucial to acknowledge that while the cycle of avoidance and anxiety can feel overwhelming, there are effective therapeutic strategies available to help individuals regain control. By taking proactive steps towards facing their fears, individuals can begin to disrupt the cycle and foster resilience.

Anxiety and avoidance are often best friends. Living with anxiety typically means avoiding many of the things that make us anxious, leading to our world shrinking over time. Going to therapy can help can facilitate a deeper understanding of your anxiety, allowing you to manage symptoms more effectively and enhance your overall quality of life.

Going to therapy for your anxiety can help you develop effective coping strategies. Therapists at Cedar Tree Therapy are experts in arming you with various coping mechanisms, including cognitive behavioural therapy (CBT) strategies and dialectical behavioural therapy (DBT) strategies to name a few. These strategies can assist you in navigating challenging situations, no longer avoid what makes you anxious, and helps to reduce your anxiety levels over time.

Engaging in therapy for your anxiety can help you to get to know yourself on a deeper level. Therapy provides a safe space to explore the specific triggers of your anxiety. This exploration helps you develop personalized strategies to address and mitigate these triggers' impact.

Therapy offers a judgment-free zone where you can express your feelings and experiences openly. This supportive environment fosters a sense of understanding and connection. The relationship you develop with your therapist can be an incredibly corrective and healing experience, and can allow you to learn that it is safe to trust others again. By understanding and managing your anxiety, you can improve your interactions with others, leading to healthier and more fulfilling relationships.

When left untreated, anxiety can escalate into more severe mental health issues. Early intervention is crucial to prevent these potential complications.

Many individuals experience anxiety, yet many people struggle to reach out for help. You don’t have to go it alone. Recognizing that we all experience mental health challenges from time to time can empower you to take proactive steps towards your well-being.

Treatment For Anxiety

Seeking therapy for anxiety is a proactive step towards reclaiming control over your life. Engaging with a therapist can be a transformative experience, providing the tools needed to manage anxiety effectively and lead a fulfilling life. At Cedar Tree Therapy, treatment for anxiety typically involves a combination of therapeutic approaches tailored to the individual's needs. Common methods include:

1. Cognitive Behavioural Therapy (CBT): CBT is considered the gold standard treatment for anxiety at this time. This approach focuses on identifying and changing negative thought patterns and behaviours that contribute to anxiety. CBT operates on the principle that our thoughts, feelings, and behaviours are interconnected, and by altering negative thought patterns, we can decrease anxiety and improve our emotional well-being.

2. Acceptance and Commitment Therapy (ACT): Acceptance and Commitment Therapy (ACT) is a therapeutic approach that is increasingly used for treating anxiety. ACT aims to help individuals build psychological flexibility, which is the ability to remain open to experiences, including negative emotions, while actively pursuing valued actions. This shift from avoidance to acceptance can significantly improve one’s ability to cope with anxiety, enabling clients to lead more fulfilling lives.

3. Dialectical Behavioural Therapy (DBT): Originally designed for the treatment of borderline personality disorder, DBT is effective for anxiety as well. DBT offers mindfulness skills, distress tolerance, emotion regulation and interpersonal effectiveness skills. DBT has been shown to significantly reduce symptoms of anxiety, improve emotional regulation, and enhance overall functioning in clients. By incorporating mindfulness and distress tolerance techniques, individuals can develop resilience against anxiety, allowing them to face challenges with greater confidence.

4. Exposure & Response Prevention Therapy (ERP): A subset of CBT, exposure therapy involves gradual exposure to feared situations or stimuli in a controlled manner. Gradual exposure to anxiety-provoking situations is a critical element of CBT. Clients confront these situations in a controlled manner, allowing them to build tolerance and reduce fear over time. This helps reduce avoidance behaviors and desensitize individuals to their anxiety triggers. This form of therapy is the gold standard in treatment for Obsessive Compulsive Disorder (OCD).

5. Mindfulness and Relaxation Techniques: A wonderful addition to the therapy models above, these include practices such as meditation, deep breathing exercises, and progressive muscle relaxation. They help promote relaxation and reduce the physiological symptoms of anxiety.

6. Medication: In some cases, medication may be prescribed alongside therapy. Common options include antidepressants like selective serotonin reuptake inhibitors (SSRIs) or anti-anxiety medications like benzodiazepines, depending on the severity and duration of anxiety symptoms.

7. Lifestyle Modifications: Encouraging lifestyle choices that support your mental health, such as regular exercise, a balanced diet, adequate sleep, and reducing caffeine and alcohol intake, can significantly impact anxiety management.

Each client’s treatment plan is personalized, taking into account the individual’s specific experiences and preferences, ensuring the most effective approach to manage anxiety. If you think you might benefit from having more control over your anxiety, do not hesitate to reach out to Cedar Tree Therapy and book a free 15 minute consultation.

About the Author

Dana Etherington is an Occupational Therapist, Psychotherapist and the Owner of Cedar Tree Therapy, a group psychotherapy practice located in Brooklin, Ontario. Dana uses cognitive behavioural therapy along with other evidence based treatment modalities to treat anxiety, depression, obsessive compulsive disorder and disorder eating.

The Vicious Cycles of Depression

Depression is a common mental illness that can severely impact a person’s ability to complete the tasks they need and want to do. It is characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities that were once enjoyable. It can affect how a person thinks, feels, impacting one’s ability to engage in their usual daily tasks. These devastating symptoms of depression can lead to significant impairment in functioning at work, school, at home and in their relationships.

Depression can vary in its intensity and duration, from a short episode to a chronic illness that requires ongoing management. Depression is caused by a combination of genetic, biological, environmental, and psychological factors. Understanding these complexities is essential for effective treatment, which involves psychotherapy, medication, or a combination of both. Early intervention and support are crucial in helping individuals navigate their experiences with depression and interrupt the negative cycles that depression can cause.

Low motivation is a common symptom of depression that can significantly impact daily functioning and overall quality of life. Individuals may experience extreme low energy and motivation, making even simple tasks feel overwhelming or impossible. This lack of motivation often leads to disengagement from activities that were once enjoyable to the person, contributing to a cycle of isolation and worsening mood. People may struggle to initiate or complete everyday responsibilities, such as tasks at work or school, engaging in basic social interactions, or struggle with completing simple self-care and hygiene tasks, which can make feelings of worthlessness or guilt worse.

One of the most impactful symptoms of depression is that change that occurs in a person’s behaviour. With low mood, comes decreases to one’s activity level. These changes can have profound impacts and change the person who was once active, engaged and upbeat to someone who is isolated, withdrawn and struggles to take care of themselves.

A vicious cycle is created when these feelings of low motivation and fatigue are paired with decreased activity levels. As your activity level decreases, you start to stop doing the things you once loved and enjoyed, leading to fewer opportunities to experience positive emotions. This, in turn, perpetuates the feelings of depression, allowing the depression to persist and be maintained.

Physical symptoms of depression, such as fatigue and disrupted sleep patterns, also play a significant role. Lack of energy can reduce motivation to engage in self-care or seek help, while poor sleep can worsen mood and clear thinking ability. As a result, individuals may find it increasingly difficult to break out of the cycle. Additionally, people with depression may experience difficulty concentrating or making decisions, leading to decreased productivity at work or school. This decline can trigger feelings of inadequacy or failure, reinforcing negative thought patterns and perpetuating the cycle.

Depression often creates vicious cycles of inactivity that make the person’s mood worse and prolong recovery. One aspect of the treatment of depression that is critical is addressing and interrupting this cycle through increasing activity levels. This evidence based treatment for depression is called Behaviour Activation and comes from the Cognitive Behavioural Therapy model. When we engage in activities that are pleasurable, it increases our chances of experiencing positive emotions, allowing for increased motivation, confidence and energy. This is one of the ways to break out of the vicious cycle of depression.

Understanding these vicious cycles is crucial for addressing depression effectively. Therapy interventions for depression, such as cognitive behavioural therapy (CBT), can help individuals identify and challenge negative thoughts, interrupt the vicious cycles of depression, and gradually re-engage in life again.

About the Author

Dana Etherington is an Occupational Therapist, Psychotherapist and the Owner of Cedar Tree Therapy, a group psychotherapy practice located in Brooklin, Ontario. Dana used cognitive behavioural therapy along with other evidence based treatment modalities to treat anxiety, depression, obsessive compulsive disorder and disorder eating.

Flora's Walk Durham Region 2024

My Why

Discussing perinatal mental health is so important to me as this period can be the most difficult time in a new mother or mother to be’s life. By shedding light on this topic, we can promote awareness, provide support, and ultimately foster healthier outcomes for families during this critical stage. It is my passion to advocate for mental well-being during the perinatal period, recognizing the profound influence it has on the overall health and wellbeing of both parents and their children.

As a mother of two, I deeply understand the challenges that the perinatal period can bring. My wish is that other women feel that that can open up and talk to others about their struggles, without having to wear the mask of being the “perfect mother” all of the time.

Motherhood can be a complex journey filled with a range of emotions including comparison to others, experiences of shaming, overwhelming guilt, the constant flux of change, disruptions to familiar routines, and the persistent sense of not meeting one's own expectations or standards. If we can have more open conversations about the challenges of the perinatal period and normalize seeking support when we need it, we can prevent tragic outcomes such as Flora’s from occurring.

This year is the 3rd annual Flora’s Walk for Perinatal Mental Health in support of the Canadian Perinatal Mental Health Collaborative (cpmhc.ca) a non profit organization working to improve perinatal mental health care in Canada.

The Why Behind the Walk - About Flora

Flora’s lifelong dream was to be a mother. At 44 years old, after years of fertility treatments, Flora, a single mom by choice of Toronto, Ontario, finally and happily became pregnant. Flora experienced anxiety throughout her pregnancy. Her family noticed her calling the hospital weekly requesting extra ultrasounds to make sure that her baby was okay.

After the birth of her daughter, Flora experienced physical health complications that required her to be hospitalized and separated from her baby.

Flora’s family recalls noticing extreme changes in her mood. They worked hard to get Flora help. They tried enrolling her in a perinatal mental health program but Flora didn’t want to see a health care professional because she was afraid Amber would be taken away from her. Flora’s family managed to speak with a doctor over the phone on Thursday and made an appointment for Flora to see the doctor in person on Monday. 

Tragically, on the Friday, the next day after her family spoke with the doctor, Flora passed away. As a result of undiagnosed and untreated postpartum psychosis, Flora tragically died by suicide two months after baby Amber was born.

Team Durham Region

In lieu of a walk, Team Durham Region has chosen to host Flora’s Flow, a yoga event on May 5th 12:30 -2:30, located at 351 Frankcom Street, Ajax (HER Fit Camp).

Your donation of $35 or more will provide you 1 ticket to Floras Flow on May 5. Please contact herfitcampdurham@gmail.com for your ticket to the event once you have made your donation

Click Here to DONATE HERE & Join us at Flora’s Flow

Hope to see you there!

How To Make the Most of Your Therapy Session

Do you ever attend your weekly therapy session, eager to have a safe space to express your emotions, only to find that once you're seated across from your therapist, your mind inexplicably goes blank? The weight of the previous week's experiences sits heavily on your shoulders, yet it all feels like a distant blur. Frustration and uncertainty wash over you as you desperately search for the right words to bring up what's truly important to you, in the hopes of making the most of this therapy session. In this blog post, we will explore effective strategies to help you make the most of your therapy session, ensuring that your therapy sessions become a sanctuary of self-expression and genuine progress.

Attending therapy sessions can be a valuable and transformative experience for individuals seeking support for their mental health. Optimizing every therapy session helps to ensure you get the most out of your experience. Whether you're new to therapy or have been attending sessions for a while, the therapists at Cedar Tree Therapy have compiled a list of valuable tips to help you maximize the effectiveness of each session. From preparing yourself mentally to setting goals and actively engaging during the session, these strategies will guide you towards a fulfilling therapeutic journey. So, let's dive in and discover how you can make the most of your therapy sessions.

1. Be Open and Honest: One of the most important factors in therapy is creating a safe and trusting environment. To establish this foundation, it is crucial to be open and honest with your therapist. Being vulnerable is so hard. There is no better place to be vulnerable than in therapy. Share your thoughts, feelings, and experiences without holding back. Remember, therapy is a judgment-free zone where you can freely express yourself.

2. Set Goals: Prior to each session, take some time to reflect on what you hope to achieve or discuss. Setting goals will help you stay focused and make the most of your therapy session. Whether it's working on specific coping techniques or addressing a particular issue, having clear objectives can guide the conversation and make the session more productive. Maybe it’s making sense of childhood trauma. Maybe it’s having a better relationship with your mom. Maybe it’s being able to express yourself and communicate more assertively in your relationship. Have these goals written down so that you’re able to come back to them often. Sharing these with your therapist is really important so that your therapist can be directing your session back to these goals as well. If you’re not sure what your goals might be, this is something that you and your therapist can discuss and work towards together, as well.

3. Come Prepared: It can be helpful to come prepared with any relevant information or topics you want to discuss during the session. Jot down your thoughts, questions, or concerns in advance, so you don't forget anything important. This will ensure that you maximize your time in therapy and address the areas that matter most to you.

4. Be Active and Engaged: Therapy is a collaborative process, and your active participation is key to its success. Engage in the conversation, ask questions, and seek clarification when needed. Remember that therapy is not a passive experience but an opportunity for growth, self-discovery, and skill-building. The more engaged you are, the more you will benefit from the session.

5. Take Notes: Consider bringing a notebook or using a note-taking app during your therapy session. Jotting down important insights, strategies, or homework assignments can help you remember and implement what you've learned outside of therapy. Notes can serve as a reference and reminder of the progress you've made throughout your therapeutic journey.

Keep a journal throughout the week of emotional highs and lows, things that were really exciting or not so great that happened to you. Take note between sessions of things that felt really good and also things that didn’t feel so good like difficult conversations and other emotional lows.

You will learn about several different therapy skills during your time in therapy. Write them down as you learn them and throughout the week record how you used each skill. Share with your therapist how you used each skill. This is important so that you can ensure that you’re using the skills as they’re meant to be used and getting the full understanding of them. Additionally, keeping track of the therapy skills you have learned is really helpful to have as a reference for when you graduate from therapy. You can revisit your journal of skills and refresh your memory to integrate the skills into your life if you feel like you could use a refresher. You can also ask your therapist for a “skill summary” if you have been in therapy for a while already and you’re not sure exactly what skills you have learned.

6. Practice Self-Care: Therapy sessions can sometimes bring up challenging emotions or topics. To support yourself during this process, practice self-care after your sessions. Develop a post-therapy self care ritual, perhaps a post therapy shower, or making and drinking a post therapy tea as you reflect on the session. Taking care of yourself will enhance your resilience and ability to engage fully in therapy.

7. Reflect After Your Sessions: After each session with your therapist, spend some time immediately following session where you write down important things that stuck out to your during the session. Maybe it’s something that your therapist said. Maybe it’s a realization that you came to during session. Take a second after your session with your therapist to write down feelings, thoughts, or anything that comes to mind. This can be really helpful because you can bring these things back to your next session and say, “This really stuck with me from last session, I’d like to explore it further.”

8. Communicate Your Expectations: If you have specific expectations or preferences regarding your therapy sessions, don't hesitate to communicate them to your therapist. Whether it's the frequency of sessions, the therapeutic approach, or any other concern, open and honest communication will help ensure that your needs are met effectively. Your feedback is so valuable and is always welcomed by your therapist.

9. Attend Therapy Consistently: It is crucial to attend therapy consistently in order to maximize its effectiveness. Research has consistently shown that therapy tends to decrease in its efficacy when individuals do not go regularly. Therefore, it is highly recommended to be consistent with your appointments and scheduling to ensure that you are receiving the full benefits of the therapy process. By maintaining a regular attendance, you create a sense of continuity and allow your therapist to properly assess your progress and provide you with the necessary support. So, make it a priority to attend your therapy sessions consistently and reap the maximum benefits from your therapy journey.

Remember, therapy is a gradual and individualized process that requires patience, dedication, and perseverance. It's important to understand that true transformation takes time, and there are no quick fixes when it comes to improving your mental health. By incorporating these practical tips into your daily life and fully engaging in your therapy sessions, you will be able to unlock the full potential therapy has to offer. Remember, each person's mental health journey is unique, so it is essential to approach your therapy with an open mind and a willingness to do the work necessary for lasting change. Through consistent effort and commitment, you will be able to make significant strides in your personal growth and experience an enhanced sense of well-being. So, embrace the process, and believe in yourself, as only you have the power to create positive change and lead a more fulfilling life.

About the Author

Dana Etherington is an Occupational Therapist, Psychotherapist and the Owner of Cedar Tree Therapy, a group psychotherapy practice located in Brooklin, Ontario.

Occupational Therapists Apply Psychotherapy to Real Life

October is Occupational Therapy (OT) month! This blog post will cover the role of Occupational Therapists in mental health treatment and why they are the best person to have on your treatment team when seeking support for your mental health challenges. With our unique expertise in promoting independence, Occupational Therapists provide valuable insights and interventions to help you manage and overcome your mental health challenges. Occupational Therapists play a crucial role in supporting individuals with mental health conditions. Read on to learn more.

An OT brings something different to the table than standard therapist. OTs believe that healing comes from doing, so we are naturally drawn to concrete, actionable goals. Whether it be engaging in an activity you really used to enjoy again, or working up the courage to order a coffee. Our therapy is based in doing.
One of the primary goals of occupational therapy in mental health treatment is to enhance your ability to engage in meaningful activities and participate in daily life. By focusing on a person's occupations (the things you do every day), occupational therapists can address the physical, cognitive, emotional, and social dimensions of mental health conditions.

An Occupational Therapist will frame your treatment around how your problem is getting in the way of the things you want and/or need to do. The things you want and need to do could be anything, from the little tasks such as getting dressed in the morning, to the bigger tasks of having family over for a dinner party. 

Occupational Therapists are unique practitioners in that goals are set collaboratively with the client and they tend to be concrete and action oriented. Although action orientated goals may sound intimidating, like jumping off the deep end into something you are scared to do, the tasks are always scaled to be just the right challenge. Not too hard and not too easy. We focus on the building up small successes to attain the client’s larger goal. 
To begin the treatment process, Occupational Therapists conduct comprehensive assessments to understand the unique needs and abilities of each individual. These assessments may involve evaluating cognitive and executive functions, analyzing daily routines, and assessing social interaction skills within various contexts.

Based on the assessment findings, occupational therapists collaborate with you to develop personalized treatment plans. These plans may include a variety of interventions, such as:
1. Activity Analysis: Occupational therapists break down daily activities into smaller components to identify potential barriers and develop strategies to overcome them. By modifying activities or adapting the environment, you can build confidence, enhance your coping skills, and restore a sense of accomplishment. This may look like analyzing food related activities such as grocery shopping, meal planning, eating, cooking in order to help manage the anxiety surrounding them for someone with an eating disorder.
2. Skill Training: Occupational therapists provide guidance and support in developing new skills or relearning lost ones. This may involve focusing on self-care activities like dressing, grooming, or cooking, as well as leisure pursuits or work-related tasks. Through skill training, individuals can regain independence and improve their overall well-being. Regaining skills or learning new ones helps in the process of self discovery and exploring self outside of mental illness. An important part in the recovery process is engaging in meaningful activities. 
3. Coping Strategies: Occupational therapists teach you practical techniques to manage stress, anxiety, and other emotional challenges. These may include relaxation exercises, guided imagery, deep breathing techniques, and time management strategies. This could also involve learning cognitive behavioural therapy (CBT), dialectical behavioural therapy (DBT) or other psychotherapy based tools. By equipping you with effective coping mechanisms, occupational therapists empower you to navigate your mental health journey more effectively.
4. Environmental Modifications: Occupational therapists assist you in creating supportive environments that foster positive mental health outcomes. This may involve rearranging living spaces or workstations to optimize functionality, promoting safety, and reducing potential triggers for anxiety or depression.
5. Social Skills Training: Occupational therapists facilitate social skills development teaching assertiveness skills, anger management skills, and boundary setting to name a few. By nurturing healthy relationships and enhancing communication skills, you can increase your social support network, which is vital for mental well-being.

Occupational Therapists in mental health treatment also collaborate closely with other healthcare professionals, such as psychologists, psychiatrists, and social workers, to ensure comprehensive care. This interdisciplinary approach fosters a holistic understanding of your mental health needs and enables a more integrated treatment plan.
Throughout the treatment process, Occupational Therapists regularly evaluate progress and adjust interventions as needed. By providing ongoing support, education, and empowerment, occupational therapists empower you to take an active role in your mental health recovery.
In summary, Occupational Therapists play a fundamental role in mental health treatment by using our expertise in enhancing the functional independence and overall well-being of individuals. Through a range of interventions, we help individuals overcome challenges related to daily activities, develop coping strategies, and create supportive environments, all with the aim of promoting positive mental health outcomes.

ABOUT THE AUTHOR

Dana Etherington OT Reg. (Ont.), Psychotherapist is the owner of Cedar Tree Therapy, a psychotherapy practice for young adults that is located in Whitby, Ontario.

Unhelpful Thinking Styles

Unhelpful thinking styles are ways that our brain processes information that can contribute to feeling badly about ourselves, and add fuel to our shame and anxiety. These styles of thinking are automatic and often occur without our awareness. They filter our thoughts, beliefs, and experiences, leading to biased interpretations and judgments. Unhelpful thinking styles (otherwise known as cognitive distortions) can manifest in various ways, such as black-and-white thinking, overgeneralization, mental filtering, jumping to conclusions, personalization, and catastrophizing to name a few. We will explore each of these in more detail in this blog post. It is important to recognize and challenge these distortions in order to cultivate healthier thought patterns and promote emotional well-being. By understanding our unhelpful thinking styles and discovering ways to address them, we can gain a clearer understanding of ourselves, our emotions, and the world around us. our shame and anxiety.

Learning to name our unhelpful thinking patterns can be a helpful skill that we learn throughout therapy. Naming our thought patterns that are keeping us down is very helpful , we need to notice and name our problematic thinking styles in order to address them . Now, we all experience some of these unhelpful thinking styles from time to time. However if one or more of these ways of thinking are causing problems in your relationships, at school or work, or keeping your mood down , it’s time to address them with a therapist. 

As you read through, notice which unhelpful thinking styles you find yourself getting stuck in. Make a note of it and bring it up with your therapist next session to be able to dive deeper into this.

Black and White Thinking

Seeing things as all or nothing, with no room in between for possibilities.

For example: if I don’t give 100%, I’ve failed.

Mental filter

Only seeing and paying attention to certain types of evidence, mostly negative.

For example: Only seeing the dirty laundry your partner leaves on the ground and not that they emptied the dishwasher. 

Disqualifying the positive

Not taking into consideration any positives of the situation or saying the positives don’t count. 

For example: Receiving lots of positive feedback on a presentation you did but only remembering one critical comment.

Jumping to conclusions

Making assumptions without evidence that they are true. Assuming things are worse than they actually are.

For example: Meeting a new person and thinking they’re going to think i’m weird.

Catastrophizing

Blowing things out of proportion, seeing small problems as a “catastrophe.” 

For example: If I don’t get an A in the course, my life will be over.

Minimization

Shrinking something to seem less important . 

For example: Receiving a compliment on a shirt and saying, “Oh, it’s just a hand me down.”

Emotional reasoning

Using our emotions as facts. 

For example: I feel anxious so something bad must be about to happen.

Shoulding & musting

Using judgemental words (I should, I must) that make us feel guilty or like a failure. 

For example: I should be married with kids at my age. 

Labelling

Assigning labels to ourselves that put us in a box.

For example: I’m lazy because I don’t get up early. 

Personalization

Believing things are your fault for something that wasn’t. 

For example: My boss is in a bad mood, I must have done something to make them mad.

As you go throughout your day, if you find yourself thinking in a way that’s not helpful, see if your thought might fit into any one of the above categories. Notice what story you are telling yourself that might not be true . Changing your thinking patterns IS possible. It takes practice, persistence and a deep dive into it with your therapist. You  spend a lot of time in your mind, let’s make it a nice place to be. 

About the Author

Dana Etherington is the owner of Cedar Tree Therapy, a psychotherapy practice for young adults that is located in Whitby, Ontario.

Taylor's Pregnancy & Postpartum Story

Taylor is a summer student with Cedar Tree Therapy, currently in the Social Service Worker Program at Durham College. She graciously offered to share her story of becoming a new mother in the hopes that it may help someone. A step mom to two children and new mom to her own baby in her early 20’s, Taylor shares her thoughts on seeking out therapy, the overwhelm of motherhood, and postpartum body image struggles.

My journey as a first-time young mom is probably not very conventional. Firstly, it was completely planned with my partner with whom I had only been with for a few months at the time and secondly, I was lucky enough to have it happen so fast I didn’t even have much time to prepare mentally for the journey I was about to undertake.

Not only was I about to be a mother, but I was already playing the role of stepmom to my partner’s two children at 24 years old, “0 to 3” as I like to say! I wasn’t prepared for any of it if I’m being completely honest. All I knew was that I was going to spend the rest of my life with my partner and everything that came with it.

The hormones took me by surprise at first, being that I was the first in my family and first of all of my friends to have a baby, my mom was the only one that could give me any real advice. My moods were so unpredictable, and my anxiety became increasingly worse during the second trimester. With both my partner and I working shift work and having no set schedule with my step-children things were starting to weigh heavy on my mind. What would we do for day-care?Would we have any time left for our relationship? Our off-days with the kids will turn to on-days all the time!

Once our beautiful “ours baby” came into the world my anxiety took a back seat for a little while. Although it was the toughest thing I had ever done in my life, it was so incredibly empowering, rewarding and my favourite experience I’ve ever had with my partner. Arriving back home however, I think that’s where a lot of the anxiety starts for most new mothers. I was very lucky to have my partner, he was the primary caregiver when it came to his own children and had far more experience than most dads. He’d laugh when I’d say “Ok what do I do now!” when it was something that came like second nature to him. It seemed crazy to me that for most new parents they were just expected to take this tiny little human home with them and figure it all out as they went.

When it came to my anxiety, a lot of it stemmed from wanting to be back to my old self so quickly. I was lucky enough to be very active my entire pregnancy my partner often commented that it didn’t even seem like I was pregnant if it weren’t for the beachball on my belly. Waddling around the house in a diaper, however was not something that I had planned on. Whether it’s my age, or just on the society we live in as a whole I felt the pressures of the “snap back” culture. My belly was squashy, and instead of being proud of what my body had just done I was way too concerned with getting back to the way it was before. I was learning to breastfeed around the clock and was completely sleep deprived. There’s a saying “sleep when the baby sleeps!” but it was a little unrealistic as I had a two- and eight-year-old running around the house as well as foolishly trying to complete 6 college courses with a new-born. I was in over my head.

Although I never struggled with postpartum myself, it quickly became apparent to me why so many mothers suffer with their mental health during the months following giving birth. You wake up, someone needs you. Didn’t snap back fast enough? They’re judging you. Bath time. Dinner time. Laundry, again. It never actually ends.

Is it really a surprise we as new mothers are struggling with our mental health? We’re completely neglecting our own needs and feel we just do not have time to make ourselves a priority anymore! Some mothers feel they need to dedicate 100% of their time to their family, but if we’re not taking care of ourselves, we’re not being the best versions of ourselves and therefore not showing up for our family in the best way we’re capable of. My advice? ASK FOR HELP! I enjoy getting my hair and nails done, and just because I’m a mom now, doesn’t mean that has to become a thing of the past. I plan time for myself in advance and ask my partner or family for help. Sometimes even just having a mommy day on the calendar that month reminds me that I am just as important as all of our other 100 to-do’s on there too!

For me, the hardest part was learning to be a new mother while learning to be a stepmother. Basically, when you’re a stepmom, you’re damned if you do, and damned if you don’t. If you’re acting like their mom, you’re over-stepping, and if you’re not, you don’t care enough. Now try to juggle the complexities of parenting with your partners ex, when you and your partner would like to raise the kids a certain way but have no control over what the kids are doing or not doing half of the time. When you’re a new mom you have hopes and dreams about the person your child will become and what kind of household you want your baby to grow up in. A blended family means that your child cannot be promised to spend Christmas morning with their siblings or have regular Thanksgiving traditions because half the family is not home for it. This is something I am struggling with and quite honestly, I can’t confidently say I’ve come to terms with the idea of it. In one breath, all I want is a normal family that can have these things but in the other, I would not have this beautiful family if that was the case.

The thought of going back to work gave me severe anxiety. I was losing sleep worrying about who I was going to leave my perfect baby boy in the hands of. Due to the custody arrangement between my stepchildren and their mother, my partner and I do not get to choose where we live. This means we do not get to live close to my family and ultimately do not get those benefits of having their help for things like child-care. Not only did I move away from my family, but ultimately, I moved away from all of my friends and my life as I once knew it. There were so many changes taking place at once. How was this fair? Why does my baby have to go to daycare because of where your ex chooses to live? These thoughts would keep me up at night and I knew something needed to be done about it before this resentment carried onto my partner.

I once thought that therapy was reserved for those who have been through some type of trauma. It wasn’t until I was completely overwhelmed and in over my head that I thought to myself, ok what have I got to lose? I started looking for resources to help me and stumbled upon a couple podcasts and blogs that led me to a really awesome stepmom community. What a lot of these women had in common was their advocacy on therapy and seeking mental health support. After my first session, my body felt lighter. The relief I felt was so intense, I’d actually have to take a shower following my sessions because of how badly my body was sweating! I had realized that talking about my emotions instead of keeping them to myself felt invigorating. By saying things out loud, I was making connections to feelings and behaviours and relating it back to how I had been living my life. I learned that therapy is not only for those who have suffered trauma, it’s for those who want to be the best versions of themselves.

The thought of being selfish is often a fear most new mothers have when it comes to the idea of making their mental health a priority. I want to tell you that it’s ok to be “selfish” sometimes if that means taking care of yourself. I’m not a professional, I’m honestly not even that experienced but what I am, is real. I’m a real mom, who falls short from being perfect every single day. I’m going to keep getting disappointed when it comes to my co-parenting dynamic with my partners ex, and I’m going to get too overwhelmed with being a mom, a stepmom and a wife from time to time, but that’s ok. Working on ourselves is not a job that can be completed because we’re constantly evolving, changing and hopefully growing! When you make a mistake, learn from it instead of beating yourself up. Recognize your own triggers and work on being proactive instead of being reactive. Lean on your support system when you need them and celebrate the small victory’s when you can. You’re doing great mama, you got this.

Body Shame Keeps Us Anxious & Distracted

We aren’t born hating our bodies, however most of us can find something we don’t like about ours.  Toddlers don’t hate their chunky thighs or chubby cheeks. This critical eye in which we view our bodies is something we learn to do. We learn it through small moments. We hear our grandmother compliment our sister’s recent weight loss. Our friend makes a comment while the two of you are out for lunch about how she must order a salad to stick to her diet. In these moments, we are subtly receiving the message that our body needs to live up to the thin ideal, thinner is better, and we must be in constant pursuit to be shrinking our bodies in order to be accepted, or to be viewed as successful or worthy.

We see and hear this type of messaging constantly, more than we might even consciously realize. We start to internalize the message of “your body isn’t good enough” until we think it’s our own voice in our head. It’s not. It's the voice of the body shaming society that we live in. 

Body shame is the intense feeling that there is something wrong with our body the way it is. This can lead to the relentless pursuit to change it or hide it. Body shame causes us to shrink the full expression of ourselves and tells us that our bodies are wrong because we don’t look how we “should”. Body shame can cause isolation, and can cause us to be distrusting of others. We don’t want to get close to others because we are scared of being judged, assessed, evaluated or hurt.

Where Does My Body Shame Come From? 

Your grandmother that compliments other’s weight loss or your friend that talks about their diet, they are not the root cause of your body shame. They are a small part of a much larger picture of generational dieting and diet culture disguised as promoting health that we have absorbed and understood as rules and expectations for how we should look. They haven’t yet begun to challenge and think critically about the systems that contribute to body shame. 

What Can We Do About It? 

We can ditch external rules about food and exercise. When you are hungry, check in with yourself and not a calorie counting app. Move your body because it feels good and lifts your mood, not to close rings. We can let go of external expectations and turn towards internal cues and what feels good to you.

We can have body shame free friends and role models that live in their body without apology, that live with food freedom and don’t let body shame get in their the way. 

When others make comments that perpetuate body shaming, gently explain why it is harmful. We are the people that make up society, so if we would like to change the body shaming ways of society we have to start at the individual level. 

The problem is not your body, the problem is your thoughts about it and the societal messaging we have received that maintains those thoughts. Body shame and living in diet culture keeps you busy, anxious and distracted. Worrying about how you look is a distraction from discovering true self and living freely. If you’d like to explore who you would be and what your life would be like without diet culture and body shame, get in touch with Dana for a 1:1 session.

Author Bio 

Dana Etherington is an Occupational Therapist, Psychotherapist and owner of Cedar Tree Therapy in Whitby, Ontario. Cedar Tree Therapy specializes in treating teens and young adults with anxiety, perfectionism and body image issues. 

www.cedartreetherapy.com

IG: @cedartreetherapy 

Fostering healthy body image

Perhaps you’ve noticed that you teen is overly critical of their body, and is making attempts to hide how they look. Bringing up your concerns with your teen’s body image can be a tense topic. This post is aimed at helping parents discuss the challenging topic of body image with their teens. This conversation can be important for all young people who are learning how to love their bodies as they change and grow. It is especially important if you suspect that your teen is struggling with body image and self esteem. 

Start the conversation with validation. Create an atmosphere of safety and openness by telling them they are not alone in what they are feeling. 

You could say something like:

“ It’s normal to have some bad body image days, some days where you don't feel so comfortable in your body.” 

Go on to say: 

“It's important that you know that your worth isn’t determined by your appearance. Regardless of how you look, you are still worthy of people’s time, attention and respect. I hear that you would like to have the “perfect” body. What I think you might mean is that you would like to feel comfortable in your body. We can feel comfortable in our bodies regardless of their shape or size. Your body is not something to feel shame or guilt about, your body does so much for you and serves you in so many ways.” 

The conversation can be concluded by reinforcing the teen’s own unique qualities and strengths that are not related to appearance. 

You can encourage your teen to try out the following practical strategies if they are struggling with body image. 

• Stop comparing. As hard as it may be, resist the urge to compare yourself to others.

• Unfollow social media accounts that lead you to not feel good about your body. Any accounts promoting potentially harmful behaviours or products don't need your attention.

There are some do’s and don’ts for promoting positive body image with our teenage children. As a parent, don’t comment on a stranger's body, your own body or your teen’s body. Even if you are making a compliment, remain neutral about bodies.
Lastly, the most important tip of all — model positive body image. Teens absorb so much about how they feel about their body from how parents feel about theirs. Remove all “diet” language from the family conversations. Modelling acceptance of your own body will help your teen with acceptance of theirs.

 Author Bio

Dana Etherington is an Occupational Therapist, Psychotherapist and is the owner of Cedar Tree Therapy.  Cedar Tree Therapy is a psychotherapy practice that serves clients 13 and up all across Ontario with anxiety and body image challenges. Dana’s eating disorder experience comes from working in adolescent residential eating disorders treatment centres.