Author Archives: Farah Lodi

Thanks to a Culture of Gratitude

Posted by: Farah Lodi on octobre 22, 2015 5:00

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Tons of research has been done on the psychological benefits of gratitude. Reading studies is one thing, but coming face to face with grateful clients in my practice is a joy to see and I find that gratitude is uplifting and contagious.

But have you noticed how sometimes, when you pay someone a compliment, rather than saying “thank you”, their spontaneous reaction is to negate what you are saying? “Oh I could have done better”, “it was nothing”, or “well I just got lucky”. This kind of response can be based on the cultural view that accepting praise is egotistical, and in certain cultures there may be other indirect ways to show appreciation rather than giving thanks. But in many cases people who feel unworthy of praise lack gratitude. A mindset that focuses on “should, have to and must” is unappreciative of the way things are, and looking for what’s perceived as missing. Some people have been conditioned to think this way because of demanding parents, a tendency to compare with others, an overdeveloped drive to achieve, or cultural training that stresses putting oneself down in public – but whatever the cause, lack of gratitude leads to feelings of dissatisfaction. A client of mine, who disregards all the positive factors that are present in her life and instead dwells on what “should” be, is emotionally exhausted by her quest for perfection and can’t identify a single thing she’s genuinely grateful for. This is the root cause of her dysthemia. I have several other cases where cognitive errors such as disqualifying the positive, maximizing and minimizing or mental filtering lead to an alarming and disabling lack of gratitude.

On the other hand, I’ve worked with people from cultures where the practice of gratitude is an essential aspect of daily life. Some of these clients embrace gratitude as part of cultural, religious or spiritual practice, while others just embody this virtue as part of healthy psychological resiliency. The self-talk which is generated by a verbal “thanks” or “how kind of you”, is usually self-soothing, self-accepting and self-reassuring. Positivity over-rides negativity in their interpretations of life events. I have even seen extreme gratitude where a young grieving mother whose toddler had drowned in the family swimming pool said “I really really miss him, but thank God I was lucky to have had two years with him, and I am blessed with two other children”. At a deeper level she was expressing her way of finding meaning in this most difficult life situation. While the grief was overwhelming, it was cushioned by gratitude. Not only is gratitude a culturally expected characteristic of leading a good life, but it’s a powerful coping mechanism.

Like any habit, developing a culture of gratitude takes practice. Daily journaling of good things that happened and things you are looking forward to is an excellent ritual. Charity work where you help those less fortunate than yourself helps you see things through a more grateful lens. Slowing down and consciously savoring good moments will help train your thoughts to be grateful. Being grateful……ahh, what a beautiful feeling that is!




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

 In-laws or Out-laws?

Posted by: Farah Lodi on septembre 18, 2015 2:15

selfie-801226_1280             All too often I see multi-cultural couples in therapy who’ve been together for a year or so; the novelty of marriage has worn off, and now they are realizing things that usually only surface after you’ve been living together for a while. While the foundation of a good marriage can depend on things like friendship, commitment and a shared meaning in life, each of these factors varies significantly according to cultural norms. It can be hard enough for a homogenous couple to adapt to marriage. A multi-cultural couple has to adapt at a whole different level.

For example, a common problem I see in multi -cultural marriages is differing expectations regarding the rights and responsibilities towards the in-laws. The saying goes that in-laws can make or break a marriage. The collectivist mind-set takes it for granted that in-laws are part of the immediate family, they must be respected, involved and prioritized. It’s expected that in-laws will participate in all aspects of family life, and sometimes even be key decision makers. This view is not shared by those with an individualistic orientation, who may interact with in-laws on a « by invitation only » basis, and who value privacy, autonomy and independence. Another old adage is that you marry a family – this is so true for many cultures where joint living is the norm. In most of the cases that I’ve worked with, the adjustment has to be done by the young couple – rarely does the family system change to accommodate new blood. Just like in the movie « My Big Fat Greek Wedding » where the influence of the girl’s traditional family was all-powerful, and her husband adapted to it. Continue reading




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

A New Online Support Group

Posted by: Farah Lodi on juin 12, 2015 2:59

My last post was about the importance of emotional support, especially for those who leave their country of origin (http://www.ccpa-accp.ca/blog/?p=4188). Usually family and close friends are the first people we lean on or turn to for advice. Anxiety and depression can be soothed by talking to loved ones, but when people have geographic distance from their support networks, life problems can be hard to manage and anxiety and depression can spiral.

To help people who have no help, I’ve created a new online support website: Supportseekers.info. This is an interactive forum where members can post any mental or emotional health problem, and get feedback from other members who may have faced a similar situation. Maybe you’ve been struggling with a situation for some time, and need advice, encouragement or clarity? Maybe you are stressed and overwhelmed? This website is especially useful for people who lack an emotional support network. There are two separate forums, one for adolescents and ansupportseekerother for adults. Sometimes youngsters respond better to their peers, and of course all members use anonymous user- ids. The most useful part is that each day a moderator who is a professional psychologist will go online and offer guidance to each poster – so in effect it’s free counselling therapy. The psychologist moderators are all trained in cross-cultural sensitivity with a solution-focused CBT approach. So no matter what your ethnicity or background, you will get balanced feedback from a non-judgmental professional (as well as from other members who may have life-experience to share). In addition there’s a « support library » which will give members the latest information on mental health awareness issues.

This community service doesn’t replace face-to-face therapy, and it’s not a forum for crisis situations, but it’s an option for those out there who (for whatever reason) don’t have access to emotional support. It’s completely free. All you have to do is join. I invite everyone who reads this, to log onto supportseekers.info, and become a member. You can post your problem anonymously and get same-day advice from your peers, as well as a free professional opinion. And you can help another member by offering your support. Who doesn’t need a bit of emotional help and support these days?




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

There’s No Place Like Home

Posted by: Farah Lodi on mai 15, 2015 12:27

In my counselling practice I see a lot of clients who have moved away from their home countries, usually because of job transfers. This means a nuclear family is uprooted from their home, and re-located to a place where they have no family, friends or support network. Many people enjoy the novelty, excitement, and adventure of international relocation, but the clients who walk through my door struggle with that often over-generalized diagnosis: adjustment disorder. It’s a condition that many insurance companies won’t cover, but it accurately describes a lot of my cases.

mobile-home-417578_640Relocation can take its toll on a family’s resiliency. For example, one common problem that I see is when children have underlying feelings of resentment: they were not part of the decision to move, it was forced upon them by adults, and they feel a lack of control and heightened helplessness. Youngsters can become depressed after a big move – I’ve seen this manifest in girls as young as 10 years old who develop eating disorders and boys with anger and even raging episodes – triggered by the move. Previously well-adapted adolescents can develop oppositional behaviors, making the adjustment process for the whole family much more complicated. Erik Erickson identified peer approval and group identity as the psycho-social crisis at this age, and relocation to a new country, new school, new neighborhood upsets this already challenging task. Many children describe feeling lonely and unaccepted as they struggle to adjust, whilst pining away for their old life. As they try to deal with their kids, parents can feel frustrated and helpless (missing their support network at home), and also guilty for uprooting and causing their kids distress. They may also feel guilty for leaving aging parents or other responsibilities behind in their home country.

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

Compassion Based CBT and Spirituality Work Well Together

Posted by: Farah Lodi on mars 20, 2015 12:00

Compassion-based CBT, as described by Paul Weber, could be straight out of a manual of Buddhist teachings, or from Holy Scriptures. I use a lot of CBT with my clients, but in cases where the monk-555391_640client is overly focused on self-criticism and shame, actually believing the « alternative healthy thoughts » is a struggle. Conceptually they understand the logic of Socratic dialogue, but they don’t integrate the rational thoughts, maybe because they lack a key ingredient crucial to recovery: self-compassion. This is when I use more compassion-based interventions. Finding and developing self-compassion is a lot easier with religious clients. Here’s why:

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

When Family Ties Are Too Tight

Posted by: Farah Lodi on mars 13, 2015 8:23

These days I’m working with several clients from collectivist family -oriented cultures. For them, the importance of family values translates into extended family having the same power, influence, rights and responsibilities as nuclear family. When family ties are harmonious then kinship is an excellent source of support and security. But when there’s conflict in the clan, then inter-personal relationships can be harder to navigate because of demanding relatives. Usually these are enmeshed relationships in a very large family unit. It’s like there’s a fire burning in your living room, where everyone congregates. You can’t escape it, you are trapped, and you feel the heat no matter what.

puzzle-210786_640For clients with this world view, a family feud centered around a distant uncle can have the same distressing effect as conflict with a spouse or brother. These clients may rely on external validation from family, have weak personal boundary strength, and easily « catch » emotions from others. The rights that one accords to parents, spouse and siblings are linked to a much wider circle of people. Stressful situations with an aunt, sister-in-law or even cousin who culturally qualify as near and dear- can lead to psychological issues for whoever is at the receiving end of demands, criticism or complaints. Hyper- arousal and elevated cortisol levels can be as easily triggered by distant relatives, as by immediate family. This can activate automatic negative thoughts of « I’m not good enough » with core beliefs emphasizing that « family should come first ». When there’s a lot of trouble the realization that « my family is not happy or normal » can result in unhealthy comparisons, feelings of helplessness and insecurity. In many cultures, when there’s strife in the family, this is a source of shame. These clients then have to deal with guilt and self-worth issues.

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

Family Tree: an Oak Tree or a Cactus?

Posted by: Farah Lodi on février 11, 2015 12:10

There are many things that influence our well-being, but family culture is one of the most important factors determining mental and emotional health. The protective factor of having close family nearby to help you, to give advice, to guide or even to set you right, can be like an oak tree: solid, comforting and shady with deep roots that help keep you anchored. Sometimes it can be grandma’s understanding nod or smile, a sibling’s moral support or a parent’s quiet presence that helps you stay psychologically hardy. Turning towards loving family can be a buffer when facing difficult life situations and sometimes an effective enough alternative to psychotropic medications. The latest research on addictions treatment also points to strong family support as an indicator for successful rehab therapy, over-riding the significance of chemical hooks. People who enjoy this extra cushioning stay resilient and don’t need counselling.

On the other hand, sometimes living close to family can be emotionally taxing as boundaries are crossed (or never even established), and autonomy and independence may be hard to uphold. Relationships can become rigid and dry; managing family interactions can be like scaling the thorny, hollow limbs of a cactus tree. The sting of a perfectionist parent’s demanding expectations or a narcissistic spouse can result in feelings of low self-worth, unmanageable stress, anxiety and depression. Childhood emotional neglect causes long-term feelings of emptiness, an inability to prioritize one’s own needs, and shallow relationships. Many of my counselling clients present with these symptoms, and more than half the time they have to deal with deeply rooted family issues. When family values are embedded in a client’s worldview, internal feelings of self-loathing, blame and shame add layers to the problem, while clients from an individualistic culture often find it easier to detach and move on when faced with family conflict.

Family can be a stabilizing or a destructive factor. When clients talk about their oak tree, I invite family members to the session and involve them in counselling strategies – this usually helps. And when the client’s problem is aggravated by a cactus, we look for alternative positive relationships and activities, with more emphasis on problem- solving and self-soothing skills. The course of therapy and treatment planning is determined by whether the family is protective like an oak tree or thorny like a cactus.




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

The Culture of Happiness

Posted by: Farah Lodi on janvier 23, 2015 1:01

I recently had an interesting conversation with a young client from Bhutan, which is a small country in the Himalayan mountains bordering India and China. In Bhutan the government measures prosperity- not through the GDP (gross domestic product) like most of the world, but through GNP: Gross National Happiness. 33 indicators which are classified under 9 main domains, are used to come up with a single number which measures the peoples’ gross national happiness. Data is gathered through questionnaires. These domains are: psychological wellbeing, use of time, health, cultural diversity, education, good governance, ecological balance, community vitality and living standards. To sum it up, a combination of these factors measures life satisfaction. Each year the government, non-governmental organizations and businesses strive to increase the measure of a good life, through policy changes and new initiatives. One such simple initiative is a common road sign seen on the many beautiful mountainous roads – no it’s not about speed limit but rather: « life is a journey……complete it! »

Interestingly, but not surprisingly, the GNP index in Bhutan started dropping sharply in 1999 – the year when TV was first introduced in this country. More recently, the use of technologies such as smart phones and computers has also been linked to a drop in the national happiness index. People who for centuries followed traditional, collectivist and spiritual Buddhist values (such as nurturing real relationships, modeling respect, and actively practicing patience and gratitude) were now plugged in like the rest of the world – to influences that very often degrade the above mentioned core values. The result has been people reprogramming themselves to needing instant gratification and stimulation, leading to a state of being that is not in harmony with nature, but rather disconnected from it.

The 9 domains used to measure happiness in Bhutan remind me of positive psychologist Martin Seligman’s model of wellbeing: PERMA. His five factors for happiness were positive emotions, engagement in life, relationships that are authentic, meaning in life, and accomplishment. If we have a balance of these going on in our lives, then chances are we will be happier. My client wholeheartedly embraces this. After finishing grad school he plans to return to Bhutan (along with a high percentage of his peers), even though salaries are considerably lower there. Why? Simply because psychological wellbeing is more valuable than material wealth.




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

Grief Matters

Posted by: Farah Lodi on décembre 5, 2014 4:01

Although different cultures react to grief and loss differently, humans express sadness in a universally similar way – through tears. Tears are known to contain stress hormones, so crying is a healthy and natural release of stress caused by grief.
The Kubler – Ross Cycle was originally formulated to describe the phases one goes through when faced with the prospect of death: denial, anger, bargaining, depression, acceptance. Now, many psychologists use these stages to help explain how we cope with any type of grief and loss, not just death.
When working with people who identify strongly and consistently with a belief in God, I’ve found that my clients who experience loss find it a lot easier to accept the loss. Most of them still experience depression, but skip the stages of denial, anger and bargaining. Acceptance of destiny, belief in a « bigger picture », and this life as a temporary journey towards a more meaningful after-life are the beliefs that help them cope with grief, loss and death. For spiritual people, death is not final, though it can still be devastating. The deep sadness and yearning for what has been lost is still there, but again, those whose spiritual faith is strong and consistent find it easier to accept. I am sometimes amazed at the way some of my grieving clients can express feelings of gratitude, even in the midst of sadness. Gratitude to the Higher Power who knows best. Another group of clients identify as spiritual, but their faith is not always consistently solid – more people fall into this category. They may go through denial, bargaining and anger. Acceptance, that deep inner state of patience, is harder to reach, but eventually they do reach it. For some, achieving acceptance is part of their spiritual journey.
How last rites are performed varies from culture to culture as well. For some, a wake is an opportunity to celebrate the life of a loved one. It’s a time for remembering good memories and being thankful for them. Clients who pay their last respects in this positive manner feel less traumatized. For others, funerals are a time of loud crying and lamenting. This type of « goodbye » is distressing and makes the process of recovery from grief longer and harder, especially for children.
Regardless of cultural background and belief systems, it’s important to accept loss. Unresolved grief can manifest as emotional instability, affecting a person physically, socially and across all areas of life. Acceptance of loss, especially when combined with gratitude, manifests in an amazing capacity for resiliency.




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

Cross-Cultural Cognitive Behaviour Therapy

Posted by: Farah Lodi on novembre 17, 2014 1:23

There are some amazing similarities between some modern psychotherapeutic interventions, and coping strategies taught through religious philosophies. For example, Rogerian- style empathic listening reminds me of the Golden Rule: do unto others as you’d have them do unto you. We all want to be understood and accepted non-judgmentally, right? A CBT counseling intervention for low self -worth is practicing positive affirmations at the beginning of each day, such as « I love and respect myself ». This reminds me of the Quranic blessing that is said at the beginning of important actions « I begin in the name of God, the most merciful and kind ». In order to feel whole we must be kind and compassionate to ourselves, which reflects the attributes of God as ultimately the most merciful and kind. Loving kindness meditation, used to dissolve anger and hostility, is akin to the Biblical injunction « Love thy Neighbor ». By deliberately sending out feelings of love to those we are angry at, we are « turning the other cheek », another Christian way. Mindfulness keeps us focused with deliberate concentration, as does the act of prayer.

When I explain the rationale of Cognitive Behavior Therapy to Christian, Muslim and Jewish clients, they often say it resonates with them because it reminds them of their spiritual teachings. Identify a negative thought, challenge and dispute it, and come up with alternative balanced ways of thinking. This is the same process of reasoning that people of faith go through when practicing acceptance of what God has destined for them. Socratically questioning difficult thoughts results in helping to manage frustration. In others words this is the practice of patience, which is a virtue repeatedly mentioned in Divine scriptures. Journaling about what’s good about you, your world and your future is an expression of gratitude – another commendable virtue emphasized in the Holy books. Behavioral activation, or forcing oneself to act in certain positive ways, is similar to adhering to the routine of structured prayers and fasting – both serving a similar purpose of staying active and engaged in something purposeful and meaningful.

Freud would probably disagree with me, but I see God in psychology and psychology in religion. For my clients who appreciate this, therapy is deeper, longer lasting, and life-enhancing.

 

 




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