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I am sitting in a make-shift auditorium and am choking back tears. Although I have sat through similar ceremonies numerous times, they invariably move me this way. 8 men and 3 women sit proudly at the front of the room – two of them with their young children on their laps. 3 short weeks ago these 11 souls ran, walked or crawled into this inpatient treatment program – most of them dishevelled, beaten down and/or spiritually wounded. This morning they are graduating from what is commonly referred to as ‘Rehab’. It is a symbolic graduation of course, but the pride, renewed hope and healthy fear in each of their voices as they speak is palpable and incredibly moving as is their clear connection to one another. They are a victorious troop – forever connected by their mutual struggle.

There are many misconceptions about what ‘Rehab’ actually is. Many people think of it as a mysterious place where celebrities go when they hit ‘rock bottom’. The idea of ‘Rehab’ is more of an American term and here in Southern Ontario, similar treatment programs are referred to as Inpatient Addiction programs or Residential treatment programs. While the dramatic depictions of ‘Rehab’ in American television and movies involve a good deal of confrontation and ‘drama’ between counsellors and those in the facility, the clinical approach in the vast majority of inpatient programs in Southern Ontario more client-centred, respecting the importance of building a supportive relationship between addiction counsellors and the people they work with. Most programs are 21-days long and most of them are covered by OHIP. Although most programs support either long-term abstinence or moderate use goals, people attending inpatient programs are typically required to abstain while in the program as well as for at least a week prior to entering (so they are not going through intense withdrawal symptoms while in the program).

Most inpatient programs are designed in a way that requires the people in the program to be very busy for much of the day. Some of the day will usually be spent in ‘psycho-education’ groups, which focus on teaching about concepts relevant to overcoming addiction. There are often daily group therapy sessions, physical activity based sessions and art or music therapy sessions as well. People in the program will often have a counsellor assigned to them to help them to successfully navigate personal challenges they are encountering while in the program and to start to make plans for the important changes they will make in their lives after they leave the program.


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Inpatient programs have been primarily designed to help provide a type of jump-start or model for the type of healthy lifestyle which is most likely to allow graduates to maintain their treatment goals. The days are very structured – people eat regular meals and develop regular sleep routines, they engage in regular physical activity, spend most of their time engaging in positive social interactions and try to develop practices which help them to manage their emotions in less destructive ways. These lifestyle-related habits have been well researched and the evidence shows they lead to positive treatment outcomes. This is why these strategies are the focus of most treatment programs, including outpatient follow-up therapy.

The biggest change I usually observed in people after they have completed a 21-day inpatient program was in their ability to have faith in people again – including themselves. While most people seemed to come in with their guard up and their head down, the vast majority of graduates left the program more open to others and with more faith in themselves. I have often said to both my colleagues and graduates of 21-day programs that if we were all required to complete a 21-day inpatient program every few years – addiction issues or not – we would all be more grounded people and our society would probably be a much happier and healthier place.

If you are interested in exploring options for addressing addictive behaviours, either in your own or a loved one’s life, please contact us today.

 

 


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Welcome, Bienvenido, 欢迎, आपका स्वागत है, Fogadtatás

  • Canadian Birth Rate Low, Immigration To Thank For Growth
  • Canada’s birth rate is currently hovering around 1.67 children per woman, well below the minimum of 2.0 needed for natural population replacement.
  • For Canada, expanding our numbers means depending on immigration, which accounts for two-thirds of population expansion. About 250,000 immigrants, most of them from China, India, Pakistan and the Philippines, are accepted into the country each year.
  • “Some come from countries where economic, cultural and religious traditions have made larger families common”, said Jeffrey Reitz, a professor of ethnic and immigration studies at the Munk School of Global Affairs at the University of Toronto.
  • At the current rate, if nothing changes, immigration — currently responsible for 67 per cent of Canada’s population growth — could account for 80 per cent of growth within the next 20 years, and nearly 100 per cent by the year 2061, Statistics Canada says.
  • I don’t see it really looking a lot different in the future than what it looks now,” McDaniel said. As older immigrants age and die, they will be replaced by new immigrants, changing and enriching the threads that make up the country’s multicultural fabric.

Between 2006 and 2011, around 1,162,900 foreign-born people immigrated to Canada.

Coming to a new country can be an overwhelming and challenging experience.

Why is it so stressful?

  • Feelings of loss
  • Parting from family
  • Language difficulties
  • Finding employment, housing, and education
  • Culture Shock
  • Enduring abuse, domestic violence and discrimination
  • Lack of understanding of healthcare system

Acculturative stress: My daughter is becoming too “Canadian”! I can no
longer relate to her!
Trauma: “I left my country at a time of war. Some of those thoughts still
haunt me” (Reena Hamid)
Discrimination: “My father left a great job back home. He now drives a taxi
in Toronto. I see how badly people treat him because his English is poor”
(Vivek Pratak)

Adjusting to a new culture and language is difficult as it is. Discrimination and multiple traumas (such as war and other types of violence in countries of origin) makes it even tougher. These challenges can weaken and challenge immigrants’ mental well-being. As a result, immigrants and their children can profit greatly from suitable psychological and social understanding and support.

Incorporating one’s culture of origin into one’s culture of new home is known as successful acculturation.

Our professional therapeutic approaches can help you and your children achieve successful acculturation by working with you on the following:

Learning to live with change

Understanding Canadian family law 

Separation from family

PTSD – post traumatic stress disorder or “reaction”

Solving issues within the family

Communicating with partners and children as well as coworkers 

Disciplining styles with children

Handling stress and burdens 

Welcome! At Jeff Packer MSW & Associates Inc., we use effective and culturally valid diagnostic tools sensitive and inclusive enough to account for cultural variability. If you’re looking for confidential and non-judgmental counselling services, book an appointment today.

Social Connections Reduce Stress


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Stress is an inevitable occurrence in our lives. Sometimes we can manage easily. We may remain focused with our daily tasks, take a couple extra work breaks, exercise, joke around or eat a few more snacks to help us through the day.

However stress can also be, at times, too overwhelming to push aside with our usual coping strategies. We may have so many stressors we may not see a way out or can’t find enough outlets so our stress levels can subside. We may feel like the walls of stress we are surrounded by are narrowing in on us.

Then we get a phone call from a friend who would love to spend some time together. We may, at first, want to respond; “No, now is not a good time.”, however, what better time than to escape this reality for an hour or two? So we agree to meet up with our friend, and after five minutes of small talk, we take in a breath of relief.

When we push aside relationships because we are “too stressed out,” we may feel more stress and even a little anxious. Thoughts of being unsupported can fuel feelings of loneliness and isolation leading to even less motivation to seek friendships.  Limited social support has been associated with depression and cognitive decline (Harvard Women’s Health Watch).

Social relationships:

  • Provide support, encouragement, empathy, and humour
  • Encourage our physical health. “Social connections help relieve harm to the heart’s arteries, gut function, insulin regulation, and the immune system (Harvard Health Publications).
  • Help us feel a sense of belonging, that we can relate and share similar life stressors (work, school, family, spouses, and/or children).
  • Build opportunities to engage in the same activities of interests (sport, music, artistic, etc.)
  • Provide stress-relief, financial aid at times and helpful advice

Professional counselling can assist you to better manage stress and develop improved interpersonal skills.  We can also help strengthen existing social skills and strengths helping you overcome challenges with friends and build up satisfying social connections. Contact us today.


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Some may read the title of this blog appalled by the assumption that everyone is an addict. So let’s consider this statement from Christopher Kennedy Lawford, author of “What Addicts Know.”

As a culture we’ve become addicted not only to gambling, drugs, alcohol, sex, and other suspects, but also technology and the acquisition of material possessions and every conceivable promise of instant gratification: More is better has become society’s mantra. We eat more, spend more, take more risks, abuse more substances…only to feel more depressed, unsatisfied, discontented, and unhappy. You may know these symptoms firsthand, or recognize them in the lives of people you care about,” (www.Today.com, January 16, 2014).

Given the statement above, we may all be able to identify that we have, or have had at some point, some addictive behaviours. Merriam-Webster’s definition states: Addiction: a strong and harmful need to regularly have something (such as a drug) or do something (such as gamble). The key word is harmful. In this light, one could even postulate (and we have) people can be addicted to arguing and fighting, thus, also to the chemicals released from the adrenal gland?

Did you know the actual term “addiction” was originally used in the slave trade? (see Drugs, Morality and the Law). When a slave was sold to the “owner”, they were said to be addicted to their master which meant “tied to”. Well, if you and I can be tied to something… yes… we can also be untied! 

When asked in counselling; What is an addiction?, we often respond anything (thoughts, emotions and behaviours) that significantly interrupts or gets in the way of an important area of your life. Harmful may mean persistent thoughts and behaviours “threatening” to healthy functioning in our vocational (work/school), social, emotional, physical, spiritual, financial, family, marital spheres. Of course, we may all have a different definition of what “threatening” is as well and the threat may not be immediately evident, recognized or acknowledged.


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Admitting our personal areas that are unhealthy can be difficult enough to do and others generally see the problem before we do.  Owning hurtful behaviour exposes the “dark side” of being human, something few of us are comfortable letting out about ourselves. Many who do admit openly and acknowledge their addictive behaviour, report feeling liberated, relieved and energized with a renewed sense of hope and joy.

This is most evident for those with addictions who go through the recovery process (a clearly defined step-by-step program with accountability measures built in). Those who were once showing characteristics those around them would call deviant, deceptive, manipulative, self-absorbed, and disrespectful can come out of recovery having rediscovered long lost gifts of self-awareness, honesty, integrity, grace and forgiveness. In addition, when we overcome a particular challenge, we gain greater understanding into human behaviour and change processes, also gaining an acquired skill set to become the greatest role models and teachers.

So do we all need to be in recovery?

Consider these questions, also suggested from Lawford:

  • Am I generally content with the way things are?
  • Are my emotions mostly on an even keel?
  • Are my personal relationships strong and supportive?
  • Is there enough joy in my life?

Careful before you answer: Those in self-absorbed, manipulative and deceptive modes of functioning even “swindle” themselves to believe they are content and happy with their lives. So another question may also be considered when this is the case:

  • If there is content and joy in your life, why do you have feelings of being depressed, unsatisfied, and empty? (What is fueling this is not always “biochemistry”)

Instant gratification, the main ingredient and greatest influence of our addictive behaviours refuses to remind us of the fact that the satisfaction we experience is only temporary. Short-term gain, long-term pain! If we can consider those questions on a grand scheme of our lives, we may come to realize that we are not truly happy. We have lost sincere human connections with others through a series of poor thoughts and choices. We have been selfish and have neglected the true meaning of love, trust and support for others and for ourselves. We do need help.


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Changing ourselves without input from others doesn’t work. This is the profession of counselling: assisting others to bring out their inherent skills and qualities and develop new ones to effectively improve their quality of life, overcome challenges faced and, thus, develop satisfying and caring relationships with others. We can also get good coaching advice from books and web resources to be used in concert with evidence-based therapeutic counselling.

We can all benefit from quality counselling to improve our lives. Contact us today.

 


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How can one decide between a treatment plan that is strict on abstinent behaviours and one that offers stages of reducing addictive behaviours (“harm-reduction”). Some may prefer the latter because, to them, complete abstinence seems unrealistic, overwhelming, and destined for failure. Families may encourage abstinence programs because of the impact that addictive behaviour has made on family members’ lives. Nonetheless, the difficulty in choosing the right treatment program is not made any easier from simple internet research.

Studies have shown that regardless of the method employed to become sober/clean, the number one factor for sobriety success is a permanent commitment to discontinue use permanently; a commitment to abstinence. It actually is much easier to just give it up entirely than punish yourself trying to moderate or control your addictive behaviour (SMART Recovery).  That said, the more times you work on quitting an addiction, the better your chances of reaching the goal of quitting permanently.

Data from several countries shows that treatment policies that insist on abstinence lead to a greater number of deaths than those that allow some kind of substitution therapy, with safer opioids such as methadone or buprenorphine (Subutrex) for heroin use. Although less well studied, the same is likely to be true for alcohol, where substitution therapies such as oxybate and baclofen exist but are less widely used (The Guardian).

Many recovery program staff and professionals espouse that abstinence is the only viable approach, and they reject any program that does not demand abstinence. This is such an obvious truth for these disciples that further thought is pointless. (Canadian Harm Reduction Network)

Despite their popularity, abstinence programs have come increasingly under pressure from research. Scholarly studies based on motivation theory, pharmacotherapy, and cognitive-behavioural therapy have shown that abstinence is not the sole route to recovery from addiction. Although proponents of the abstinence approach have argued that drug use is the defining feature between recovery and addiction, most experts believe that recovery is more accurately represented as a process in which clients move through a series of distinct stages, including relapse (Prochaska, Norcross, & DiClemente, 1995).

The different forms of information out there are not providing much ease in choosing the right treatment program. The choice should not be made according to majority votes or majority statistics. The choice should be made based on the addicted individual’s (1) willingness to recover, (2) individual goals, and (3) understanding of the impact the addictive behaviour has on his/her life and the life of others. When these are established, treatment programs can effectively address the person’s specific needs as well as those in their family.

Contact us today for more information and to start an individual assessment and to explore your addiction treatment program options.


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It almost goes without saying that media has a major impact on our perspective on many issues: mental illness, love and relationships, as well as body image, health and wealth. Here is one way in which the media can do some good for young girls and teenagers who are coming into their own bodies, adapting to hormone changes, and who are exposed to peer pressure.

The following link shares Lupita Nyongo’s acceptance speech at the Essence Magazine awards.

We are too often exposed to extremely thin waistlines, airbrushed faces, flawless skin, and long and flowing hair.  Little girls are growing up watching cosmetic commercials and teenagers are reading fashion magazines. As a result, their perception of beauty can become easily skewed by the media’s “acceptable” ideologies and portrayals of beauty.

This can, unfortunately, create inner turmoil in a preteen or teenager who does not resemble the bodies and faces seen on screen. Females, and even some males, may excessively strive to adjust their behaviours in hopes to eventually become the “beauties” they idolize in magazines and on television. These behaviours may include: restrictive eating, binge eating, vomiting, disordered eating, excessive dieting, manipulating medications (e.g. lower insulin dosing) and excessive exercising. These behaviours, when prolonged, have a severe impact on overall health (social, psychological and biological).

Fortunately, once in a while, we are able to hear celebrities comment on real beauty like Lupita did in her speech. However, is everyone listening to this message? Sometimes family support, well-intentioned comments and repeated requests just don’t seem to be enough. In fact, many common statements and approaches can actually, unintentionally, add to the problem. And it takes much effort and professional help to change disordered eating behaviours. Contact us today to get professional help!


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Narrative Approaches Help Conquer Disordered Eating

The approaches found most effective to recover from eating disorders and “disordered eating” behaviours include (but are not limited to) cognitive-behavioural, narrative, family systems and developmental theories. These knowledge bases help those struggling with body image issues and eating disorders to work alongside mental health therapists, dietitians and doctors to improve health outcomes. Today’s blog post provides a sample of the approach in one homework assignment completed by a teen girl. She was asked to first write from her perspective and then, second, re-write the story from the perspective of a five year old.

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1-      “Stinkin Thinkin”

Once there was a girl named Rae. She went into the front doors of the school and walked up the stairs alone. When she got to the hallway of her locker, she stared down it and looked behind her. ALONE, she thought. She turned the combination key until it was open, and began organizing her locker and getting the books that she needed.

People started filling into the halls, some would say hi but they would still leave. They don’t really want to be with me anyways, she thought. The halls were now crowded and she just wandered until the bell rang, When it did, she walked into class and sat down. She acted happy and engaged in conversation; meanwhile she was feeling like complete crap.

At lunch time she debated on eating. DON’T EAT, you’ll lose weight, she thought. But she was hungry, so she ate anyways. Don’t eat when you get home, she thought. But she did, and became into a binging session, which lead to purging. PurgepurgepurgepurgepurgepurgepurgePURGE. The voice inside her head was loud enough to make her listen. She didn’t eat for the rest of the night.

After her shower, she regretted glancing in the mirror because now she was sad and angry. She grabbed the fat on her stomach and began to cry. I hate my body, she thought. She looked away, put some pj’s on and cried herself to sleep. I can’t wait until the day that I can love myself, she thought.

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You can see here a small sample of how pervasive the thoughts can become underlying disordered eating patterns. Of course, the feelings of disgust, loneliness, anger, confusion, worry, anxiety, sadness and isolation will drive and increase the negative behaviours of over exercise, laxative use, food restriction, binging and purging. With these thoughts, feelings and behaviours the person’s story about themselves, their bodies and their options  for recovery, worsens.

When taking a narrative approach, combined with cognitive-behavioural strategies to change, people suffering are asked to consider the perspective from a five year old’s vantage point. In order to contemplate change and re-writing of the negative story, clients are to ask themselves; What would a five year old me say about eating, body, exercise, food etc.? The following is the second part of the teen girl’s homework; narrative “re-writing” of disordered eating from the five year old’s view;

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2-      “Five year old”

Once there was a girl named Rae. She went into the front doors of the school and walked up the stairs alone. When she got to the school, she looked around her and thought, people will be here soon, I’m just early. She played and waited for people to arrive.

People started arriving, some would say hi but they kept walking past her. They’re just busy, she thought. The halls were now crowded and she just wandered until the bell rang. When it did, she walked to class and sat down. She acted happy and engaged herself in conversation, meanwhile she was feeling pretty badly.

At lunch, she debated on eating, if you’re hungry eat, she thought. So she did. You can always have a snack when you get home too, she thought. She felt guilty for eating and was contemplating purging. Ew don’t do that, that’s gross, she thought, so she didn’t.

After her shower, she looked in the mirror and felt confused about her body. Every body is different and unique, she thought. She looked away, found some pj’s and went to sleep.

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Thanks to this courageous teen author for sharing her narrative homework above in her efforts toward a healthier and happier future.

For experienced, professional guidance in this area, book your appointment today.