Author Archives: Trudi Wyatt

Millennials

Posted by: Trudi Wyatt on janvier 18, 2016 1:29 pm

Increasingly in my practice in Toronto’s Financial District, some of my “baby boomer” clients, roughly defined as individuals aged 51 to 69 years old (1), are noticing and wondering about the possible differences between them and “millennials,” roughly defined as individuals aged 18 to 34 years old (2). For example, do millennials and baby boomers have different perspectives on taking time off work for mental health, and/or on working overtime.

Coincidentally, I have also recently noticed 2 magazine articles related to these questions, so I have created this blog post to explore them a little further.

The first, Millennials at Work (2), suggests that in addition to money, millennials also assign high importance to workplace flexibility, being coached/mentored, and autonomy, as well as to collaboration with rather than competition between colleagues.

The second, Healthy Minds (3), cites an increased demand for mental health services at the University of Toronto (U of T), such as a tripling of mental health presenting as a disability at Accessibility Services, as well as a general increased rate of mental illness among university-aged individuals. Healthy Minds focuses on an October 2015 U of T report that included a list of recommendations to address mental health on campus, and that generally encouraged the whole university community to embrace support of students’ mental health needs. Among the recommendation themes were calls to:

Promote prevention/resilience by promoting sleep, nutrition, exercise, social life, and strengths.
Promote peer support.
Locate counsellors right in day-to-day environments, so as to improve accessibility and confidentiality.
Provide quick access to a psychiatrist if needed.
Tap into community resources outside of the university, though the article points out that “’We do offer health services, but we do not see ourselves as health-care providers… We are an educational institution… We can’t do it all ourselves.”

In conclusion, perhaps the answer is yes, that millennials are different–that they are for example more aware of their mental health and resilience needs than previous generations. If so, then hopefully this translates into a healthier and happier future!!

Sources

https://en.wikipedia.org/wiki/Baby_boomers (accessed 10Jan2016)
http://www.financereference.com/learn/baby-boomer (accessible link)
Millennials at Work (https://www.cultureamp.com/zine/010-millennials.html), in CareerWise 22Dec2015 (https://contactpoint.ca/careerwisesecure/2015/12/employability-vs-employment-millenials-at-work-employment-challenges-for-syrian-refugees/) cited in CERIC (Canadian Education and Research Institute for Counselling) email 22Dec2015.
U of T Magazine, Winter 2016, pp.26-31, Healthy Minds: As U of T responds to a rise in mental health needs on campus, a powerful source of help emerges: students themselves. By Cynthia Macdonald.

Trudi Wyatt, MA, RP, CCC is a Registered Psychotherapist and Canadian Certified Counsellor in Private Practice in downtown Toronto. She has been practising for almost 7 years and currently works with individual adults on a variety of life challenges such as depression, anxiety, anger, trauma issues, and career choices.

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

The Wild West of Psychobiotics

Posted by: Trudi Wyatt on novembre 12, 2015 11:22 am

I’ve been reading a lot lately about the nervous system connection between the gut and the mind—primarily, about the importance of the vagus nerve that connects the GI system to the brain, and whose branches orchestrate whether we respond to changes in the environment via social engagement, fight or flight, or shutting down. This past Saturday however I was reminded of another gut-mind connection when I noticed an emailed Wellness Tip from The Cleveland Clinic that mentioned that “Over time, your microbiome may influence everything from your weight to your risk of chronic illness — including your mental health.”

What is your microbiome? It refers to the genetic material of the vast collection of microbes (bacteria) that line your GI system and that also live on your body. (1) This collection can weigh up to 6 pounds, has 2 million genes (vs. our own humble 23,000), and can be thought of as another organ with potentially diverse functions still to be discovered and confirmed.

I first read about the microbiome in The New York Times Magazine’s June 28, 2015 mental health edition, in an article entitled Gut Feelings, by Peter Andrey Smith. Gut Feelings described a compelling hypothesis currently being investigated that suggests that gut microbes might influence mental states like anxiety and depression, and explored some possible mechanisms of action of this influence. This hypothesis seems plausible to me, as many clients with depressive and anxious (especially anxious) symptoms also report GI symptoms; and, as the article describes, intestinal disorders “coincide with high levels of major depression and anxiety”. So compelling is this hypothesis that the US Taxpayer-funded National Institute of Mental Health in September 2014 offered four grants of $1 million each to support research on the gut microbiome’s role in mental disorders.

“Somehow” the article describes, “micro-organisms in the gut tickle a sensory nerve ending in the… intestine and carry that electrical impulse up the vagus nerve and into the deep-brain structures thought to be responsible for elemental emotions like anxiety.” The article explains that neurotransmitters like dopamine, serotonin, and GABA—the same ones that are thought to communicate and regulate mood in the brain, and that are often targeted with antidepressant and anti-anxiety medications—are actually also secreted by these microbes in the intestinal tract. Thus, much of our supply of neurochemicals may originate in the gut; and thus, these bacteria might affect the brain and mental health. And hence, neuroscientists John Cryan and Ted Dinan have named these potentially mind-altering microbes ‘psychobiotics’.

What are the implications? Will changing someone’s bacteria one day be a treatment option for mental health issues? For example, in one experiment by Cryan and Dinan, mice fed bacteria kept swimming longer when placed in water than their counterparts, who gave up sooner and just floated in “behavioural despair” (or “immobilized woe”).

This treatment application is perhaps plausible, but still very far from supported, as the research is still in its infancy. But, certainly food for thought!

Trudi Wyatt, MA, RP, CCC is a Registered Psychotherapist and Canadian Certified Counsellor in Private Practice in downtown Toronto. She has been practising for over six years and currently works with individual adults on a variety of life challenges such as depression, anxiety, anger, trauma issues, and career choices.

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

Where is the Father in Attachment Theory?

Posted by: Trudi Wyatt on octobre 1, 2015 7:00 am

“Attachment theory” is very popular in the field of mental health. In the context of infants, it suggests that some are “secure,” certain that the primary attachment figure (usually conceptualized as the mother) will be there following exploration of the external environment, and that some are “insecure” (sometimes described as anxious, avoidant, resistant, disorganized, or disoriented), uncertain of this, and displaying unresponsive, clinging, or confused behaviours towards the primary caregiver.(1) Continue reading →

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

Dealing with Difficult People

Posted by: Trudi Wyatt on juillet 23, 2015 12:24 pm

Many people come to psychotherapy due to frustrations in dealing with “difficult people” in their day-to-day lives – family and extended family members, colleagues, fellow TTC passengers, etc. On this topic of dealing with difficult people, I recently listened to Louisa Jewell, President of the Canadian Positive Psychology Association, interview David J. Pollay, MAPP and author of “The Law of the Garbage Truck: How to Stop People from Dumping on You”(1). Some of the content of that interview is shared here.

Mr. Pollay explains that while we sometimes allow other people to “dump their emotional garbage” on us, allowing this – taking it personally, giving meaning to what they say, absorbing the words – can weigh us down and make us unhappy. He points out that even seemingly small/insignificant garbage – everyday “hassles” such as criticisms and complaints – can have a negative impact on our health, and lure us away from focusing on what is truly meaningful to us in our lives.

Mr. Pollay was inspired to write this book when he encountered a New York City Taxi driver who, having been cut off and then yelled at by the very driver who cut him off, just smiled and waved at this other driver, and moved on. In turn, Mr. Pollay now suggests that people remind themselves that, “I am not a garbage truck. I do not accept negative emotional garbage I can’t control and dump it on others.”

Of course choosing not to engage in others’ garbage offloads is not as easy as 1-2-3! But with practice, and in time, it can potentially save a lot of energy.

Other strategies provided by Mr. Pollay for this sort of challenge include: Asking the person dumping his garbage on you if he would like a chance to vent, as this question tends to slow the person down; reducing your interactions with this person; and/or, when you catch someone who often dumps her garbage on you acting kindly towards you, notice it, point it out, and mention how much you appreciate this behaviour over when she’s picking on you.

Trudi Wyatt, MA, RP, CCC is a Registered Psychotherapist and Canadian Certified Counsellor in Private Practice in downtown Toronto. She has been practising for six years and currently works with individual adults on a variety of life challenges such as depression, anger management, post-traumatic stress disorder, relationships, and career direction.

References:
1. 14 May 2015 Louisa Jewell interview with David J. Pollay: Dealing with Difficult People.

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

On Accessing Psychotherapy

Posted by: Trudi Wyatt on juin 17, 2015 8:26 am

Open Minds is a recent Globe and Mail series exploring mental health in Canada. One topic is paying for psychotherapy, and one of the articles under this umbrella, “The case for publicly funded therapy”, by Erin Anderssen, is explored and reviewed in this post.

Ms. Anderssen’s case is built on two premises: that psychotherapy is an effective intervention for mental health issues — especially depression and anxiety; and, that because not everyone has the resources to pay for it, it should be paid for with tax dollars.

The first premise is obvious to me, though I admit my bias! As a Psychotherapist, I see on an almost daily basis how helpful this intervention can be. More broadly, as Ms. Anderssen points out, “Research has found that psychotherapy is as effective as medication – and in some cases works better,” “In randomly controlled trials, drugs often perform only marginally better than sugar pills”, and “we have 100 clinical trials [in support of talk therapy] and no one believes us”.

In building the second premise, Ms. Anderssen points out that not everyone is able to afford psychotherapy, or enough psychotherapy. She illustrates a range of scenarios: from people who can’t pay and are on public wait lists, to people with some but limited private insurance coverage, to people with ample coverage (including federal public servants, paid with tax payers’ money).

She also indicates where dollars (about $2-billion annually) are being spent on psychotherapy in Canada: About half are tax-collected dollars and go to physicians, including about $350-million to family physicians who may not be well-trained in psychotherapy, and about $650-million to psychiatrists who may maintain small practices that serve higher-functioning, higher-income patients, perhaps for years. Contrast this with Australia, Britain, and the United States, where publicly-funded psychiatrists serve more as consultants on severe cases (as other specialists do) than as psychotherapy providers.

The other $1-billion is spent by private insurance / workers’ compensation, and individuals directly (“out-of-pocket”). But despite $2-billion being spent ($272 per Canadian if one in five suffers from mental illness) (1,3), not everyone in need is receiving treatment.
Continue reading →

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

A Narrative Psychoeducational Introductory Tool for Trauma Work

Posted by: Trudi Wyatt on juin 5, 2015 2:08 pm

Following emotional trauma, people may develop symptoms of post-traumatic stress disorder (PTSD) such as flashbacks, avoidance of reminders of the event, negative cognitions or mood, and hypervigilance (1). Observing that some clients with these symptoms seek an understanding of why they experience them, David Leong, MA, LMFT, created and often starts off therapy with a “story” about the neurological effects of trauma on the brain (2). While David notes that his story (based on work by Dr. Dan Siegel) might be over-simplified, he finds his clients find it helpful. This post is a summary of the story:

The brain can be thought of as a fist: Your forearm leading up to it is the spinal cord, and the base of your palm is your “lizard” primitive brain, that manages such automatic body functions as heartbeat and sweating. Next, if you fold your thumb sideways across your palm, this is your mid-brain—your “limbic system.” It houses emotion, memory formation, and the “fight or flight” response. Two important structures within it are the amygdala, thought to be a key player in emotional/fear/implicit memories (3,4), and the hippocampus, thought to be a key player in converting information into memory codes (4). The “language” of the limbic system is emotions. Finally, if you fold your fingers over your thumb, you have your cerebral cortex, which speaks in words, and houses sense of time and explicit memory—a more abstract, gist-based, structural recording of episodes than implicit memory (3). Continue reading →

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

Quality Assurance in Psychotherapy

Posted by: Trudi Wyatt on mai 8, 2015 2:00 pm

Perhaps you have noticed the many ads lining Toronto’s TTC subways recently, asking “Do you know a psychotherapist?”? (1)

Indeed, there has been much ado about psychotherapy in Ontario lately, especially related to the province’s new College of Registered Psychotherapists of Ontario (CRPO), established on April 1, 2015, under two provincial Acts (2). CRPO’s mandate is “to regulate Registered Psychotherapists in the public interest, striving to ensure that practitioners are competent, ethical and accountable” (3).

At this time, over 1,700 practitioners — including many Canadian Certified Counsellors (CCCs) — in Ontario have already become registered with this regulatory College (4).

What do these developments mean for someone seeking psychotherapy or counselling? For one thing, because one of the Regulations under these Acts requires having a Quality Assurance (QA) program (5), if you choose to pursue therapy with a Registered Psychotherapist (RP), you will know that his or her regulatory College requires him or her to participate in the type of rigorous QA program described below (6).

Specifically, CRPO’s QA program encourages “the continuing competence and quality improvement of Members”(7). It includes professional development, and “professional self” assessment for all Members, as well as Peer & Practice Assessments in some cases.

The professional development component of the program requires Members to create a “Learning Plan” (6) with goals for professional development, and to record and describe which acceptable activities were pursued to meet those goals. My understating is that the specific details of these requirements have not yet been finalized, but I imagine that a goal example might be “maintain and sharpen competence in providing Cognitive Behavioural Therapy (CBT)” and that an acceptable supporting activity example might then be “attend a CBT seminar.”
Continue reading →

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