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.

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.

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.

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.