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.

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.