The Rise of Elder Abuse

Posted by: Asa Don Brown on September 27, 2023 1:39 pm

In recent years, we have witnessed a rise in violence among the elderly. This is not an isolated incident nor is it an issue solely related to the United States or Canada, but rather, this specific demographic has witnessed an upward increase occurring throughout the global community. According to research gathered through the Department of Justice Canada (2023) “About 45 percent of seniors report experiencing some form of abuse from the age of 65 on.” Further research has indicated that “The overall prevalence of elder abuse in Canada is similar to the levels found in the United States, the United Kingdom and Australia.” The rise of abuse amongst any population should garner our attention.

The rise in elder abuse has been well documented, but the number of unreported cases, is astronomical. According to the World Health Organization, “Emerging evidence indicates that the prevalence of abuse of older people in both the community and in institutions have increased during the COVID-19 pandemic. A United States study (conducted by Chang and Levy, 2021), suggests that rates in the community may have increased by as much as 84%.” Let me repeat, this is not an isolated issue within the United States or Canada, rather the rates of abuse are sadly reflected throughout our global community. Elder abuse is on the rise.

Why is it and how is it that such cases continue to occur? Elder abuse, like all forms of abuse, is inexcusable, unpardonable, and unimaginable, but like all other forms of abuse, they are hidden. They are hidden from others in order to conceal one’s misdeeds, wrongdoings, and egregious ways. They may be hidden as a guise, concealing one’s true intent and true nature.  Most commonly, they are hidden because the elder person is either unable, scared, or unwilling to speak up for themselves.

Why is it that victims of abuse refuse to report? Psychologically, there is a term that aptly explains this particular issue and the rationale to hide such abuse, it is called  “trauma bond” (a.k.a. Stockholm Syndrome). A trauma bond occurs when an individual has an emotional attachment or connection with their perpetrator. The bond may have transpired over the discourse of time or it may have been thrusted upon the victim. It is not unusual for the relationship or the bond to be based on need, rather than want or desire. Either way, the bond has an elastic element that brings the perpetrator and victim back together.

The relationship of the abused and perpetrator is one of imbalance. The imbalance is always in the favour of the perpetrator. The elderly person may feel as though they have no sense of personal control or even the ability to control their own lives. The abuser may have convinced the victim that they have no friends, associates or allies. They may have convinced the victim that they are their closest and dearest friend. The

imbalance of power is driven deeply within the core of the mind of the individual. Eventually, through cognitive manipulation and restructuring, the victim develops a belief system that they cannot live without the perpetrator. The perpetrator becomes their sounding board, their support system, and their perceivable ally.

Elder abuse is intentional. It is not uncommon for elder abuse to manifest in a variety of forms, which may include: psychological, physical, sexual, emotional, verbal, financial or medical. The ramifications of elder abuse have been known to cause cognitive impairment, social and emotional withdrawal, and an overall decline in an individual’s perceptions and worldviews. By the way, decline in an individual’s physical and cognitive functioning used to be considered a mere consequence of aging, but we now know that such abuse can have a dire effect upon an individual’s overall well being. Notably, it may not account for all types of cognitive impairment, but it is indeed one of the many elements that can play a major role in an individual’s physical and cognitive impairment.

The abusers are frequently placed in direct care of the victim. The victim may feel as though they are incapable or unable to speak up for themselves. They may feel fearful of the repercussions of speaking up and the possible consequences. It is not uncommon for abusers to utter threats and intimidate the elder person, persuading the individual from seeking help. Ultimately, the elder may feel as though they have limited to no options, leaving them at the will of the perpetrator.

According to the World Health Organization “Globally, the number of cases of elder abuse is projected to increase as many countries have rapidly aging populations. Even if the proportion of victims of abuse of older people remains constant, the global number of victims will increase rapidly due to population aging, growing to some 320 million victims by 2050, as the global population of people aged 60 years and more increases to 2 billion by 2050.”

Who are the abusers? Research has shown that the perpetrators of elder abuse are often intimately associated with the victim. The perpetrators may be a child, grandchild, spouse, or extended family member. In some cases, the perpetrator may have a close relationship with the individual. They may be a lifelong or family friend, religious figure, financial or legal resource, medical personnel or caregiver, or a member of a service organization. It’s important to understand that the most intimate of relationships can lead to someone taking advantage of the elder.

How do I identify a perpetrator or predatory behaviours? In general, predatory personalities are the ultimate chameleon. They are persuasive and capable of convincing others to allow them to take charge. They will morph into whatever disguise that fits your needs, wants, or overall desires. They are charming, intellectual, and reliable. They may insist on overseeing financial matters or the care of another. It is not uncommon for such personalities to lack empathy, personal insight, and an integral sense of the world.

What should I do if I know a victim of elder abuse? Be involved. Be an advocate and a liaison of the elder. Do not hesitate to report any allegations or suspensions of abuse to the authority. Encourage the elder and their family to create a multi-disciplinary team to provide support and advocacy on behalf of the elder. The multi-disciplinary team may be comprised of mental health and healthcare practitioners; adult protective services; legal and criminal justice systems; religious and faith based organizations; and if possible, a team comprised of family and friends.  Please remember that elder abuse is on the rise. Elder abuse is one of the most rapidly growing segments of the population, but one of the least reported.




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Tearing Her Apart, Bone From Bone, Part 1

Posted by: Barry D'Souza on August 25, 2023 1:15 pm

She suddenly looked very uncomfortable, like she might need to be sick. Her breathing was exasperated and she fidgeted in the chair. She shook her head with the reality. Whatever it was, overwhelm had begun to take possession. She asked if she could go there and pointed to the corner of the office.

‘Of course,’ I said in a manner where it seemed the perfectly natural request. She leapt over to the corner, lowered herself to the floor, covered her head with her arms, and shielded me from the sight of her, as if she were protecting me. She started to cry. I looked at her for a moment, then turned away, giving her the moment. She cried and shook her head in paroxsymal release for the next half hour. I looked away into the courtyard, occasionally checking back.

I thought of the ‘political’ ascetics, that great male lineage who once sought a rational religion and to bring fundamental change to Indian society. Ramakrishna Paramhansa, who had put (Bhakti) joy into the life practice of yoga – people need to feel the relationship to the “higher’“ otherwise they won’t switch from idolatry. Vivekenanda, his disciple, who brought yoga and its philosophic message to the World Religions Conference in skyscrapers Chicago. Setting up the East-West dialectic was good globalization. Later the ‘Great Soul’ Gandhi spoke to how Vivekenanda lit the path to his own experiments with the truth. Modernising challenge to the masses, hard act to follow. Awakening to the modern world, they peered into the mirror the British held and saw clear reflection of the inhumanity to women. At least the Imperials didn’t send their widows to their fiery euthanasia, indenture their young girls into future marriages of servitude, or hide away the fully formed adults like some treasure on guard from men without prescribed entitlement. What was this young woman going to add to the story, on behalf of other Indian women, no doubt?

Nothing in my flight of imagination meant a diddle to her, I knew. Nothing of what those spiritual men pointed to in their politics had ever filtered a drip into the lifeworld she inhabited in her village India, seventy years on. She who sobbed in my office, absorbed in painful anguish. She who was hoping that I didn’t see her or was wishing that she’d disappear. This was an early session. This wasn’t ‘Me too’ in India. This was ‘we just don’t count the same’ as I saw it more correctly.

She was a young art student who talked about the violence inside. She described hitting her brother, violence to her father. She spoke to wanting to fight, of wanting to take up kickboxing while she was Paris. But she was ashamed of how she was feeling and kept looking away. She was filled with shame. She had been told that she was crazy all her life, reprimanded for not acting like a proper girl. She was a disappointment to everyone, she confided. The same grandmother, whom she tried to urge off the verandah when the was 6yrs.old, lamented her birth for weeks. She was born a girl!

She hated that grandmother. I could see why. Abuse each in their own way come uncle, come grandfather, come ‘cousin brother’, followed her through life. It was like she was wanting to say ‘fuck them all’, but those were my words. If the discernment was present, she lacked the vocabulary or the experience of speaking and of anyone being interested. If she knew what to say, she lacked the encouragement, the space to say it. I wondered if society back home would ever listen. Would family who really needed to hear it ever listen, give her space and love her at the same time, respect her as human being, no matter what. What would be helpful? We’d take our time. She’d let me know.

I wondered if she’d like to draw Freireian codifications for the next session. For those who might not know, Paolo Freire figured these conceptualisations, the sketched triptych of past structural violence, helped encourage people to talk about the horrific and unspeakable. Such drawings had helped communities in Brazil and beyond talk about their internalised oppression. She was an artist! Maybe they could serve her to get the words. They might serve me in responsible, attuned, enlightened and kind, activist therapy. Of course, careful – no (further) harm where there is trauma. Sure, there was deep and complex trauma. Of course, India is an ancient culture unbudging in its patriarchy. We’d see together what emerges, digest and metabolise slowly, no enzyme, no rush. We’d see together how to proceed against the systemic of south India here in Paris. Prep for an eventual return to the far off homeland. Begin by trying to story the past she carried to the corner of the office. She’d do well in perceiving the violence she had lived in different lights. Therapy is a kaleidoscope, I thought.

“Such powerful depictions!” My turn to shake my head. I took some time to register their effects. “Can you tell me a little about what is happening here in this one?” She looked at me. A determination formed in her face. She nodded knowingly.

“I would like to tear India apart, bone from bone,” she began and let out a pranic generating sigh. I wondered about those male ascetics again and imagined what they’d have to say to what I was hearing.




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

The Complex Nature and Relationship of Stress and Anxiety

Posted by: Asa Don Brown on August 23, 2023 12:04 pm

Have you ever been confused by the difference between stress and anxiety? What exactly is the difference between the two? And how can they be effectively managed?

Let’s begin by clarifying the difference between these similar, but very different coping strategies. Stress and anxiety have a comparable effect on the mind and body. Both can manifest through a number of physical and psychological symptoms. They are both effected by one’s biological, psychological and social environments, or as we say in psychology, biopsychosocial environments. While stress commonly has a short-lived or an acute effect upon an individual; anxiety can have a longterm or chronic effect upon the physical mind and body. Stress itself is a reaction. There is certainly a cause and effect that prompts stress. It may be triggered by an event, circumstance, situation, or an internal or external response to something occurring in one’s life. It can be thought of as an unwarranted tension with adverse effects. Whereas, anxiety often encapsulates an obsessive quality or component that intensifies as one feels an overwhelming sense of being without control. The individual may experience an impeding sense of doom and gloom. They may feel as though they have no ability of overcoming whatever they are

facing. Anxiety is essentially the manifestation of persistent stress. Initially, the anxiety may have been triggered by a stressor, but it may continue to plague an individual long after the stressor has been removed. It is important to recognize that there are anxieties that are known to manifest without a specific cause or reason.

Stress is the internal catalyst informing the mind and body to react now. It is a survival mechanism that informs us of potential threats or danger. You may not only lean upon stress when encountering the probability of a threat, but the possibility of losing out on something. Stress can come in a variety of forms including: a baseball player who sees a ball flying across centerfield; a student who is taking an academic exam; a speaker who’s addressing a large audience for the first time; a couple sharing marriage vows; a physician who’s treating an unfamiliar illness. Please note that a healthy balance of stress is a normal attribute of the human condition.

Another way of looking at the difference is, stress often manifests in relationship to something or because of something. Whereas, anxiety may occur whether or not there is a real-life threat or obstacle to overcome. Anxieties may have been related to a stressful situation, but the event continues to plague the mind and body of the individual long after the event has passed.

Generally speaking, stress is the body’s way of coping and managing events occurring in the moment. While anxiety is commonly an overwhelming sensation that does not dispensate following a stress induced occurrence. Notably, stress and anxiety can both have a profound effect upon the mind and body. The symptoms can exacerbate or be the catalyst of other physical and psychological conditions. These issues may lead to

a generalized feeling of being unwell, a lack of sleep or disrupted sleep patterns,  excessive worry, increased blood pressure, chronic fatigue, irritability, tension, bruxism (TMJ), and headaches. It may also have a systemic effect upon one’s overall immune, digestive, cardiovascular, or reproductive systems, and a barrage of physical and psychological manifestations.

By the way, you are not alone with your health concerns. There are others facing the same and similar challenges. It is not too late to reach out for help.

The good news is, both stress and anxiety can be effectively treated. You can learn to cope, manage and possibly overcome these issues. Please understand that it is not uncommon to experience some level of stress and anxiety throughout one’s life. It’s how we cope and manage these issues that makes all the difference.

The following are strategies that may help you with your personal stress and anxieties:

  • Regular exercise can have a profound effect on an individual’s mood, concentration, alertness and overall cognition. Furthermore, just 30 minutes of regular exercise has been shown to have a positive effect on self-esteem and cognitive function.
  • Be certain to eat a well-balanced diet and stay hydrated.
  • Consider the possibility of seeking the care of a mental health practitioner.
  • Journaling is an excellent way for you to pen your thoughts, perceptions, and any personal challenges. It’s an excellent opportunity to practice positive self-talk and another way to focus on behaviours, attitudes and perceptions that you might like to improve.
  • Scientific research has shown that controlled and concentrated breathing is a beneficial way for managing stress and anxiety.
  • Meditation can provide you a place of balance and an overall sense of control.

There are many methods with which one can eliminate, manage, and cope with stress and anxiety. It’s important to recognize that you are ultimately in control. Do not allow your mind to convince you otherwise. Adapt the skills mentioned above to your own personal routine. Do not feel afraid to adapt skills or to manipulate skills to fit your own life. At the end of the day, it’s all about your mental health and wellbeing.

[email protected]
www.asadonbrown.com




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

The 3 Agendas of the Triangle Model of Animal Assisted Therapy (AAT)

Posted by: Eileen Bona on May 29, 2023 10:00 am

I recently read an article entitled: “What Horses Teach Us About Systemic Oppression” by Julia Alexander and it resonated with me because I was working on this article.

Funnily enough, I was going to write the article yesterday, but it was a freezing cold -26 degrees here and so my own agenda morphed into blanketing the equines rather than writing about them. It was after I chased them around trying to convince them that the blanket was a good thing that I came back to write the article and had to laugh out loud. Here, I was going to write about the need for being fully aware in AAT of the fact that the animals have their own agenda which is not our agenda or our client’s agenda. I was going to write about the ethics of ensuring we are considering all 3 agendas in the work and to not allow our human agendas to lead the session against the animal’s will. And then I chased my mini donkey around and half lassoed him to get his blanket on. I gave up on my pony because he refused to be caught and so I allowed him to make the choice to not wear a blanket although it was going to be steep -30’s overnight – so who did I do the right thing by?

Did I do the right thing by the donkey I forced to wear his blanket or by the pony I allowed to refuse because I gave up trying? It can be argued that systemic oppression does not apply to forcing someone to do something that is for his own good if he is in your care.

When I think of this in the context of AAT, I think of it on two levels: One level includes the need to ‘force’ an animal to undergo things s/he may not want to ensure his/her wellness and the other level is regarding the agendas that we have as therapists and clients in the medium of AAT. When we bring animals into our AAT practices, we become their ambassadors and are responsible for all tenets of their welfare. We must complete their wellness checks or give first aid when needed or we are not meeting our ethical obligation to care for them. They may not want these treatments, but what if they just don’t want to work the day your client chooses them in your AAT practice? Are they allowed to say no?

This is where the 3 agendas come in and also possibly animal oppression. Let’s do this through an example:

Josh is attending therapy because his mother has died. Josh has attended traditional counselling but it has not been effective. Josh is an animal lover and his father is hoping that by working with animals and an AAT mental health therapist, Josh will get the help he needs.

You are that therapist and you have a horse who is very gentle by nature. Josh has no experience working with horses and is excited to brush this horse. When you and Josh go toward the horse, it turns away to graze. Here are 3 possible agendas at play: 1. Your agenda is to build rapport with Josh, 2. Josh’s agenda is to brush the horse, 3. The horse’s agenda is to eat. What is the best ethical approach to helping Josh in this moment?

There are many ethical options. First, you could help Josh understand that the horse is a sentient being with her own feelings and wants. You can ask Josh what he thinks you both should do. This would give you a good indication of Josh’s awareness, depth of empathy and many more important social skills. In doing this, you would be meeting your agenda, which is to get to know Josh and you would be meeting the horse’s agenda, which is to eat but you wouldn’t be meeting Josh’s agenda as he wanted to brush the horse. Second, you could catch the horse and bring her back to brush her, meeting both yours and Josh’s agendas but not the horse’s.

So how can you meet the 3 agendas? Perhaps Josh can get some food to offer your horse. When she comes to him, she gets to eat while you teach Josh to brush her and build rapport. All 3 agendas will have been met!

As a psychologist who has been practicing AAT for 20 years as well as offering certification in AAT to professionals, it is my opinion that we should work to meet the 3 agendas when working with animals in practice. Our therapy animal partners have their own wants and needs and it is our duty to respect them. It is not ethical to not consider our animal’s preferences or to drop our agenda or convince our client to drop theirs if our agendas are disrespecting the agendas of our animals.

I might go so far as to say, now that I read Ms. Alexander’s article, that we may be ‘oppressing’ our therapy animals if we ‘force’ them to do what we want them to do in AAT for our personal agenda or that of our client.

It often takes more work to meet our agendas when working with and respecting our animals. Many practitioners have pre-knowledge of working with animals before partnering with them in professional AAT practice. It is our due diligence to ensure that we are checking in on our beliefs and values about animals before we practice with them and during every single AAT session. There is a very good chance that our pre-lived experiences will influence the agenda of the session. If in fact, we are moving ahead with our human agendas without consideration for our therapy animals’ agendas, then we are very most likely practicing animal oppression rather than animal assisted therapy.

Eileen Bona

Registered Psychologist

Dreamcatcher Nature Assisted Therapy

www.dreamcatcherassociation.com




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Being Empathic: An Empath’s Journey

Posted by: Asa Don Brown on May 26, 2023 4:40 pm

It’s another day and you’ve continued the journey down life’s precarious highway. Those who know you best, know how much you deeply care about each and every individual that you encounter. Knowing you, is to know an individual with tremendous empathy, compassion, and unconditional love. It’s the passion, within compassion, that is often the common thread that weaves throughout such a personality. Your empathy often knows no limits, but this can prove as a hinderance to your own maturation and ability to thrive. Individuals with this type of personality are often at odds with their own needs versus the needs of others.

Please understand that empathy is not an exclusive attribute of empathic individuals. Rather, empathic individuals often have a core mechanism within them that accelerates this feature of the human condition. So what is empathy? It’s the cognitive ability of immersing yourself into an event, situation, circumstance or the life of another. Plainly speaking, it’s about having unrequested compassion for someone else. Ultimately, empathy is about meeting someone where they are at.

How does someone cultivate or refine their own level of empathy? Dr. Jamil Zaki of Stanford University describes empathy as “our ability to share and understand one another’s feelings—a psychological ‘superglue’ that connects people and undergirds cooperation and kindness.” (The Economist, 2019). It’s the ability of understanding that we need to be more engaged and showing more unrestricted care to those around us. As a clinician, I have met individuals who sincerely believe that empathy is predetermined, hardwired, and decided at birth. Fortunately, empathy is not predetermined, hardwired or decided at the moment of your birth. In fact, research suggests that you are not restricted to the level of empathy that you currently retain within your person. Empathy is pliable, amenable, and capable of being changed.

As a natural empath, I have had to learn the careful balance of giving versus depleting your own natural reservoir. It’s the ability of knowing when you are offering of yourself versus sacrificing yourself. Please understand me that it is not always easy for someone who genuinely yearns to serve others. It’s not natural for those who have a deeply woven spirit that thrives to serve. To deny this aspect of oneself feels like a rejection of thy inner-self, but the truth is, we must all learn the necessity of balance and personal selfcare.

As a clinical psychologist, I have worked with other empaths on managing and bringing balance to their own lives. Again, it’s not easy when we have a heart to serve and be of service. While empathy is a gateway of service, we must also lead by example. For after all, how good is someone’s service if they are no longer capable of serving? It’s not about the rejection of others or their personal needs, but rather, it’s about balance of the preservation of one’s own life, health and overall wellbeing. It’s about recognizing that you have your own limits and personal needs.

Self-care is essential! It is of the utmost importance that we practice self-care in our home and in our daily lives. What good are we if we sacrifice our own life, personal health and wellbeing? Attending to your personal needs is exemplifying the best attributes and role modeling unto others. It’s ultimately about being an example unto others. Self-care is not self-centered or selfish, it’s about offering aid to yourself when you are feeling depleted. It’s about ensuring that your reservoir is full and that you have an adequate supply when serving others.

What is self-care? Self-care is the practice of being consciously aware of your needs and taking the necessary steps to preserve or improve your overall personal health. It is the ability of recognizing your essential needs. It’s the ability of recognizing when you have had enough. Fundamentally, it’s about knowing what you require to rejuvenate and feel refreshed. Research suggests that those who experience burnout, or report burnout, have had many signs and symptoms developing long before they are recognized. What does this suggests? It suggests that we must be better stewards of our own health and personal wellbeing. Remember that whether as a practitioner or a patient we must be diligent not only to look after the needs and wellbeing of others, but we should be looking after our own needs as well.

Self-awareness is one of the greatest instruments that an empath has on hand. It is through our self-awareness that we are constantly observing, interacting and experiencing life. We must understand that self-awareness begins by being cognitively aware, attentive and knowing our own person. It is through self-awareness that we are capable of understanding the essential needs and issues of others, as well as, our own.

Whether or not you identify as an empath, it’s important that each individual practice a balanced life. A balanced life may appear different in each life that it encounters. Yet, there is a common and consistent truth, life is about centeredness and balance. It’s about consuming as much good, as the negative, that will assuredly come our way. We must constantly monitor our own needs and our overall welfare, while serving others. Even if, our work does not allow us to work directly with others, we must strive to maintain a balanced life. So what does it mean to have a balanced life? A balanced life is about achieving a particular synergy in life. It’s about equipping your life with the proper support mechanisms that will enable you to live a healthy, productive and fulfilled life. It’s about recognizing those areas of your life that deplete your reserves and those that replenish them. It’s about utilizing tools that will enrich your life like daily breathing,
meditation, journaling, exercise, and a healthy diet. Ultimately, life is about living, thinking, and feeling healthy.




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

The Power of a Healthy Friendship

Posted by: Asa Don Brown on April 21, 2023 3:43 pm

There is something rather unique about the bonding that takes place between two individuals. As we develop as infants and toddlers, we learn many of our social, moral and ethical cues from our parents or primary caregivers. We learn the difference between right and wrong, our likes and dislikes, and the ability to trust or distrust another. It is the quality of this relationship that reinforces our sense of self. The parental relationship has a distinct bearing upon our overall psychological makeup and the way with which we see the world. Yet, research has shown that while parents or caregivers play a significant role in the development of a child; there remains something rather striking about an authentic friendship.

We know that friendships have had a significant role in the development of the human consciousness. It has been debated whether or not the urge for friendship is stimulated by a collective consciousness or an individual consciousness. Research has indicated that friendships are a unique blend of the individual and the collective. It is this unique weaving of the individual and the collective consciousness that appears to be the foundations for friendship.

Why are we drawn towards total strangers? What is it about friendship that we crave as a species? Friendships are not unique to homo sapiens, rather there are many examples throughout the animal kingdom of such binding relationships. Until recently, researchers often refrained from describing the bond that occurs between animals as “friendship.” Dr. Lauren Brent who is a primatologist and professor at Duke University, is conducting research on rhesus macaques. She is looking specifically at the quality and development of relationships and friendships amongst the rhesus macaques. According to the National Geographic, “Rhesus macaques are familiar brown primates with red faces and rears. They have close-cropped hair on their heads, which accentuates their very expressive
faces. Rhesus macaques are Asian, Old World monkeys… These intelligent animals can adapt to many habitats, and some can even become accustomed to living in human communities.” Dr. Brent’s research suggests that the rhesus macaques do indeed develop lifelong friendships. It is this research and others that lends one to think that just maybe we are innately predisposed to friendship. Furthermore, science has revealed that friendship was an evolutionary response to ensuring that the human species would thrive and survive. Without the contribution of others, our species may not have survived.

Friendships are a fascinating aspect of the human experience. It is not uncommon for childhood friendships to develop through social constructs, such as attending the same school, religious venues, extracurricular activities or living in the same neighbourhood. Similarly, adults continue this trend by connecting with work colleagues, neighbours, and through a variety of other social constructs.

Friendships play a significant role in this thing called life. It is commonly expected that friendships will naturally take a backseat to familial events, circumstances and decisions. After all, we have no familial loyalty or structure to those that we call friends. We also know that as adults that there may be extended periods of time that we do not engage with our friends. For most individuals, this is an acceptable behavior for this particular construct. Likewise, there is something intrinsically special about choosing a friend. Often times, we develop friendships out of thin air. Think about it for a moment. Friendships are unlike family, in that, there are no familial obligations or considerations bonding you together. Consider the following: the next time you are walking in a park, pay close attention to how young children and youth engage. It is not uncommon for a child to befriend a virtual stranger. Again, friendships often occur out of thin air. There is something dynamic about friendships.

There is something uniquely special about choosing a friend. I have heard patients declare that they can choose their friends, but they are stuck with their families. What is it about having an ability to choose a friend? Are friendships that much different from other relationships? If so, why are they different from other relationships?

Friendships are an evolving aspect of the relationship paradigm. As children, we might knock on our neighbour’s door begging for their child to come out and play. As youth, we continue this cycle, but with more independence and freedom to make such a request. Of course, technology has had its clutches on the ever-evolving changes that is occurring within friendships. The likelihood of knocking may sadly be a thing of the past, but the truth is, children still rely upon the permission of the parents or caregiver. As we enter adulthood, many find themselves spending less and less quality time with their friends and more and more time with their families, work colleagues and other associates.

While social media has made it possible to keep in touch with mass groups of individuals, research is discovering that many of these “so-called” friendships are shallower than before. It may be because we tend to embrace friendships that may have otherwise fizzled with time. Social media has violated this natural function of relationships. Whereas,before the relationship would go through a variety of stages including the loss of the relationship; rather, we now tend to clasp on to these individuals collecting them like
bottle caps.

Social media has a damning effect. For many individuals seem to be incapable of moving beyond their own mistakes. We have all known someone who reminds us of our past. We have all known someone who is more than willing to share our mistakes, our mishaps, and our misunderstandings. Unfortunately, social media does not allow for the individual to grow and move beyond what has occurred in his or her past. Let’s return to what is friendship? Friendship is the ability to connect with another. It is this ability to share in common interest, desires, and achievements. It is also having an ability to connect when times are not so rosy. It is in these particular times that we tend to grow together, bonding over the situation, circumstance or event. Friendships are naturally woven together by these experiences.

An authentic friend does not need to receive a daily, weekly, monthly, or even a yearly call. An authentic friend remains loyal during the difficult times. An authentic friend is willing to be assertive and accountable when the times call for it. An authentic friend understands that friendship is an ever-evolving relationship bound to be complicated, but commonly comprised of mutual respect.

Throughout our lives, we will encounter many individuals. We may have the privilege of developing lifelong friends. We may elect to develop different sets of friendships throughout the many stages of our lives. We may even elect to move beyond a friendship for reasons related to our own mental health and wellbeing. Remember that friendships are never perfect, but authentic friends should always look at empowering you.

Most of all, what does it take to develop a healthy friendship? Healthy friendships and relationships occur through mutual respect and understanding. You cannot simply “click” a healthy friend into being. Healthy friendships and relationships transpire over time with trust, dignity and active communication. It is these types of relationships that are fortified by the individual loyalties that create a unique bond. Likewise, such relationships are based on a mutual admiration and ambition towards a particular outcome. At the end of the day, authentic friends have chosen to be friends. They are well aware of one another’s flaws, attributes, compliments and personalities. It is this type of friendship that we should all strive for, but such friendships can only evolve over time with dedication unto one-another. The ultimate power of a healthy friendship occurs through the ability of having an authentic friend.




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Sometimes I Just Want to Cry Out

Posted by: Barry D'Souza on April 14, 2023 3:24 pm

The pit in her stomach began to appear April 2, 2020.  She spoke of all that she was tending to.  The stress of preparation and anticipation anxiety of the ‘death do they part’.  What is that pit saying, trying to say, I wondered.  I wondered if she had been listening to her body.  I guess maybe in her own way. My wondering out loud became her own wondering check-in loop.  Trying to put words to the pit.  Months later when she returned, the pit had become something more real for her when it manifested as an acid reflex.

Sometimes I want to just cry out,” she had pumped her arms anxiously in the moment, to show me.  It wasn’t triumph, I saw the human in her.  There was the ‘what will I do?  How will I live without him? The summer and fall came and went.  It was nice to hear from her again.

« I have heard that yogis can control their heart rate and blood pressure. It feels like I can feel the acid swelling within.”  What the yogis do is like biofeedback.  It is said in yogic terms, control your breath, live life with full awareness agency.  We can all practice that feedbacking awareness.  Imagine that you offer a gentle rub to the gurgling acid just as it might seem to be popping the herniated membrane.  It might be calming.  She nodded, “but who really knows”. 

Who really knows.  She was fascinated and importantly, all caught up on the possible research on his behalf, including a second opinion with one of the leading oncologists in the field, so why not turn to the acid reflux pit in her stomach and hear what it is saying!  There’d be time for her.  Not in the final sense, just in the sense, there wasn’t anything else she could do!  She was grateful that their lives had been as normal as they had been.  She’d been able to do all that keeps her happy, while looking after him.

Now, the eve of a trip back home, not knowing what it might hold, he was losing weight, he had lost a lot of weight and we sat in silence a moment and I think, I sighed.  She took the cue.

The pit in my stomach is not so much the ‘this is getting to me’” as it is ‘how will I do? and how will life be on her own?’.  It could be an experiment reading her body signs.  She is seeing that engaging a mind-body dialogue and awareness could be helpful towards self-knowledge.  She could count her blessings.  She could feel a terror.  The arms pumped in the air again.  This time there was an inaudible shrieking.




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Our Words, What Is Said and How They Ring Home

Posted by: Barry D'Souza on April 5, 2023 12:14 pm

“So the harmony is hard to come by this past week?” I said to client #1. The next week, he came back quite upset as he had upset his wife – he had taken home the question and spoke to the ‘harmony’ with his wife !  Sessions later, he reported his wife was upset with me.  He didn’t say it as such, but I presumed that she felt I was putting ideas about harmony into his head.

“Just now, when you said you wish for the strength to not cower, I had this picture of you pulling out and cracking open a can of spinach!” I shared with client #2.  He laughed and motioned to do the emptying of the can and gulping like Popeye.  Needing some strength at the right moment, a confidence booster.  Within a few sessions he was more at ease with the fact that he was “working up to it”, building his courage, wanting to confront his fear so that he could be in contact with her.

The things that pass through the mind.  The things we say to our clients!  The things we say – part of our presence and engagement; part of our “countertransference” in the lexicon of some; part of our appreciation of what is seeming to be the case, the reality.  The things we say – part of the imaginal effort to connect that which in the layering of experience are potentially useful ways clients might see the things.  And how do we know when it is skillful use of ourselves, when we share back with clients?

These two clients I reference, male, both in the ‘young old’ of early retirement, were both similarly confronting themselves as partners, similarly experiencing their wives as “scary”, both for valid, but different reasons.  Both clients were taking therapy in the good stride of personal exploration and open to insights on how to make shifts in how they are and what they want to live or are not wanting to live in their relationships anymore.  Both had a sense of humour and seemingly feeling humour helpful to ease toward the not so easy of themselves or of life situations at home. Both were open to seeing the relevance of the ‘not-so’ adaptive child, in Terry Real perspectives, at work in themselves or in their partners, in their couple dynamic.  This background I hope is a little helpful to what I want to say about the things we say to clients, how we say them and when we say them.

I gave voice to those two passing thoughts and as such they became interventions with a powerful impact.  I don’t see client #1 anymore and my guess is because I might have helped bring out that which was there, that which he couldn’t quite get out himself, and perhaps he as regards to his couple, was not wanting to topple the balance.  I think as a therapist that sometimes we are performing a “conversational analysis”, something linguistic anthropologists do as they aim to understand semantic meaning.  Reading between the lines, a practice that one can do responsibly, checking-in for resonance.  As therapists, we help clients hear themselves, their feelings and put words towards a fuller awareness.  Typically, and humbly I should say, I feel good about the ease, comfort and safety of the space that I construct with clients.  I have come to trust how I am with clients, what I want to try to say, how I might come out with it, the “relational” sharing of my experience of the client.  But how do I know sometimes?

‘I really enjoyed that ‘trying to build up my faith in myself’ from last time, client #2 said and he had softened his view from the high-pressured one, where he was “pathetic” and “frozen”, and kept having secondary emotion states of being upset at himself for not being able to do what his wife wanted him to, that is to stay in contact with her, no matter what, ‘til death do us part’.

I finish this blog reflection by sharing some ancient wisdom about “right speech”, coming from my life practice as Buddhist.  I note what I say in my clinical notes! I note what I found myself wanting to say, but, didn’t!  I read over my notes in prep for the next session and submit what I “did” or “didn’t say” to the following reflective self-query:

  1. Is it Factual and True?
    -This is 1st person client, 2nd person therapist, 3rd person ‘objective’ to get at the factual/true axis
  2.  Is it Divisive? Or Will it be Connecting?
    -Can our speaking promote harmony, good feeling of connection or understandin
  3. Is it Harsh? Or is it Gentle?
    -Want ‘kindness’ to be intention-orientation and to abandon speech that isn’t ‘heartful
  4. Is it Beneficial?
    -The acronym WAIT or ‘Why Am I Talking?
  5. Is it the Right Time to Speak?
    -The proper time is linked to compassion for the “other” and where the client is at and could take in what we would want to say.

By: Barry D’Souza




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Recognizing the Subtle Nuances of Domestic Violence

Posted by: Asa Don Brown on February 28, 2023 5:20 pm

Domestic violence is never acceptable. What comes to mind when you hear the words domestic violence? Have you ever experienced any form of domestic violence? Have you been vicariously effected by domestic violence? For you, how would you describe domestic violence? In your own words, what would account for domestic violence?

Perhaps, you were the perpetrator of domestic violence. What erupted your emotional fuel-line? Do you believe that domestic violence is ever excusable? If so, what forms of domestic violence do you believe are acceptable?

If you were given an opportunity to describe domestic violence, you might have your own personal slant on what is, and what is not. For majority of our society, domestic violence are “extreme” and “intolerable” violent acts. Ultimately causing physical harm or the possibility of physical harm. Yet, we often draw the line at the physical manifestation of violence. We seldom take into account many other forms of violence. When was the last time you considered economic abuse, cyberstalking, stalking, or verbal or emotional abuse as potential threats? Even the very threat of harm, may be considered a form of domestic violence. Nevertheless, we slough off certain categories as mere side effects of being with a particular individual.


• “You don’t understand them, like I do.”
• “I shouldn’t have pushed their buttons. — I know better.”
• “They’re under a lot of pressure these days.”
• “If I had only stopped, then they wouldn’t have become so enraged.”
• “I’ve should have respected their quiet time.”
• “It was my fault.”


The abused is often familiar with iStatements. “I should’ve, could’ve, would’ve,”
becomes their poetic song. It is always about justifying the intolerable behaviours of their
partner. Reminder, there is never an excuse in abuse!

For many abusers, they rarely accept personal responsibility. It’s about feeding their own ego, desires and identity. Notably, not all abusers are narcissistic, but narcissism is often a common feature amongst abusive personalities. The abuser is often an expert of the word “you.”


• “You should’ve listened to me.”
• “If you had only done what I had asked.”
• “I wouldn’t have become so enraged, if you had just listened.”
• “Today wasn’t a good day for you to grow a backbone.”
• “I became so angry when my food wasn’t ready.”
• “You make me so angry.”

Why do we dismiss acts of violence? Why is it that we have created categories and subcategories of what is excusable and what is inexcusable? As a clinical psychologist, I have often felt like asking, haven’t you read the fine-print? There is never an excuse for violence!


What is it within the human condition that creates excuses? Why does the abused accept responsibility for their victimization? Research has indicated that victims of abuse are often preprogrammed to think this way from early childhood. What prevents a victim from leaving their abuser? Individuals who are abused, are not unlike hostages. It is not uncommon for victims of abuse to feel particular loyalty and strong feelings for their abuser. After all, many relationships start out seemingly positive. The abuser may have wined-and-dined their victims. The victim may have felt safe and secure in the relationship. Likewise, the abuser may not have been outwardly displaying such characteristics either. Research has indicated that elevated stress and other life challenges are frequently the catalyst driving this type of personality.

The abuser is seldom born an abuser, rather they are nurtured into abuse. Just like victims often seek out victimhood, so do abusers seek out victims to abuse. Publicly, it’s not uncommon for the abuser to wear several different masks; pretending to be one individual for one group, while conveying a different personality for the next. The victim may be unaware of the abusers deep-ingrained personality.

What changes? The abuser may not have intentionally turned that leaf over, but one day, out of nowhere, the abuse begins. The relationship is no longer filled with charm, kindness, love, and affection, rather it becomes filled with envy, jealousy, violence, intolerance, and dogma. For many victims, they know their victimizer intimately. They have witnessed a different side to their victimizer. Was it a facade? Who knows, but they, the victims continue to believe in the way things were and that the abuser will surely return to their more vulnerable side. It is the victims relentless belief in the way things were, that prolongs their victimization.

Research indicates that victims often fit a specific profile. It is not uncommon for a victim of abuse to have been abused per childhood. In fact, studies have indicated that the victim may not have been the direct target of the abuse per childhood, rather having witnessed violence appears to be enough to leave a deep impact on the life of the child. The victim is not always raised in an abusive home, but this increases the odds that they will be preyed upon. Furthermore, abusers are not always raised in homes filled with violence and abusive personalities, but this too increases the possibilities that they will develop into abusers. Why does the victimizer seek out a specific prey? It stems from the knowledge that individuals with weakened self-images and self-esteems are more apt to cling to such a personality. Just like the animal kingdom, victimizers often seek out those who are the most vulnerable. It is at that optimum time that they pounce.

The research on the victimizer is quite stunning. Abusers are seldom without many skeletons. It is not uncommon for abusers to have been neglected and abused per childhood. They may have been directly abused or vicariously witnesses of abuse in their childhood home. While the childhood home is sometimes the catalyst, we must not blame an abuser’s choices on their childhood. For at the end of the day, we all have an ability of making choices between right and wrong.

Recognizing the Signs and Symptoms of Domestic Violence and Abuse
• avoidance of personal responsibility
• regular and frequent swearing and yelling
• withholding affection as a form of punishment
• abusive rhetoric and language
• gaslighting
• controlling and demanding personalities
• punitive actions
• restrictions on who someone can see and not see
• an inability to accept wrongdoings
• belittling and humiliating another
• threats of harm or the potential of harm
• the intentional degrading of a person’s self worth
• an inability to show compassion or empathy
• an overinflated sense of self
• indications of excessive jealously or possessiveness
• obsessive and stalking qualities
• sexual demands or threats
• withholding access to financial accounts
• withholding access to transportation
• suicidality
• homicidality

Please understand that you are not alone. Research has clearly indicated that in North America, that there are approximately 12 million victims of domestic violence each year. It is not uncommon for victims of abuse to feel isolated and alone. You are not alone. Physical and sexual abuse are not the only forms of domestic violence. Abuse occurs in a variety of forms including: physical, sexual, emotional, psychological and verbal abuse. Abuse is never excusable!

2520 Vestal Parkway East, PMB #177, Vestal, New York 13850 (206) 430-2611
Email: [email protected]

asadonbrown.com




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

How to choose a niche for your Canadian private practice

Posted by: Julia Smith on October 29, 2020 10:25 am

It can be tempting to advertise as a generalist in private practice. The fear that you won’t get enough clients if you niche (specialize) in one area of counselling can trick you into believing that you must generalize in order to fill up your private practice. If you give in to this scarcity fallacy, you may make decisions about your Canadian private practice that could in fact reduce the number of clients who choose you.

Why It’s Important to Niche

When there are many options, you need to stand out from the crowd. From my experience niching is an excellent way to do this. Though it’s not the only factor, niching showcases your passion and expertise so that your ideal clientele will have an easier time finding and selecting you over other therapists.

How to select a niche in private practice

Questions to ask yourself:

  • What type of cases do you look forward to?
  • What type of cases energize you?
  • What counselling outcomes bring you satisfaction?

I believe that you should go into private practice to do work that you are passionate about and that you find fulfilling. Do not let the fear of not getting enough clients push you into selecting a niche that you don’t like but that you think will get you more clients. Make sure that when you start your private practice you can support yourself financially without any clients so that you will not make decisions based on desperation. If you feel that you are not skilled in the area that you are most passionate about, get more training and find a supervisor that is an expert in that area before advertising.

Types of Niches

Choosing a niche usually involves a:

  • Certain age group
  • Certain problem
  • Certain outcome

A therapeutic approach could also be included in your niche, but from my experience, people choose therapists from the criteria above and are less concerned about your approach. Niches can be very specific or more general. Deciding how specific your niche should be (or if you should have multiple niches) usually depends on how big of a population there is in your town or city. The bigger the city the more specific and focused the niche should be so that you stand out. For example, when I started my private practice in Halifax in 2016, my niche was:

“I help teens who feel weighed down by anxiety and depression build confidence, gain insight, and find happiness.”

This niche fit well for me at the time because I was (and still am) passionate about helping teens. Through previous experiences before starting private practice, I realized that I enjoyed helping teens who were struggling with mental health issues and I loved to see teenagers become confident and happy through therapy with me. I also had experience working for the BC government as a Child and Youth Mental Health Clinician.

However, if I was in a larger city like Toronto, I would have focused my niche even further. Such as:

“I help teens who feel weighed down by depression find happiness”

Or if I was in a small town, I would have added a couple of niches such as:

“I help teens who feel weighed down by depression build confidence and young adults who feel lost find direction”

It can be scary to limit your advertising to one area of counselling. Bur when you niche, more clients will choose you because you’ll stand out as an expert. And don’t fear that niching means you can only counsel a certain population. Just because you niche does not mean that you only have to accept clients who fit your specialization. I have many clients that seek me out who do not fit into my niche(s). They choose me for other reasons. But the main part of my private practice has been built through niching.

Until next time,

Julia

About Julia

Julia Smith, MEd, RCT, CCC, is the owner of Fearless Practice. She specializes in consulting with Canadian counsellors and therapists who want support and guidance with starting an online private practice. She also owns a virtual private practice in Halifax, Nova Scotia.

Learn more about her consulting services at www.fearlesspractice.ca!

Disclaimer: The information provided on this blog is for informational purposes only. It is not clinical or consulting advice. E-subscribers and website visitors are receiving general advertising and information about starting a private practice and should not act upon this information without seeking professional consultation.

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA