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Matthew McKenzie

Matthew McKenzie

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Let’s Be Mindful for New and Expecting Mothers: Lived Experiences and Tips for extended family and friends

Written by: Dr. Matthew McKenzie | Psychologist

This month, I thought about taking a slightly different approach to how I would usually go about generating a blog article. In a conversation with a dear friend who is expecting her second child and another friend who is expecting her very first, I was reminded that psychology is indeed about each person’s unique lived experience and interestingly about the degree to which there is shared experience among several people. As a male psychologist, I have long had an awareness that my capacity for understanding the complete depth of a woman’s experience will always be somewhat limited, simply because it has never been and will never be my lived experience. But part of our growth as human beings should be about learning how to enter into the world of others (whether it be the other gender or some other facet of identity that differentiates us) and make an effort to understand their experience and moreover, respond to it in a helpful way.

Just in time for International Women’s Day 2020, I had the opportunity to sit with 5 new or expecting mothers from different countries and varied cultural backgrounds to ask about some of the things they thought about, perhaps worried about leading up to and just after delivery and what advice they would give to an audience who was interested in hearing their concerns. Most women will agree that bringing a child into the world is hard work – not only because of the physical demands inherent in pregnancy and delivery, but also the often-silent anxiety (amidst the burgeoning excitement of course) that comes from being responsible for a new little human in its most vulnerable period. Surrounded by friends and family who are equally excited about the child that is on its way, mothers can often be concerned about how these individuals show their well-intentioned support. As many of us are frequent members of this pool of extended family and friends – let us hear some of the ways that expecting mothers would like us to be mindful for them.

  1. While families appreciate the show of love, support and excitement to meet the newest member of the family. These mothers wanted others to be mindful of the massive ordeal (the delivery) which mother and child just experienced. Time is needed to allow mother and child to rest and recover. Do not be too quick to visit (home or hospital) and if you are unsure about whether it is the right time, then ask. The timing can be highly variable from one family to the next and from one pregnancy to the next. Every pregnancy and delivery is its own journey, some with more challenges than others, so it is important that we respect that the time of readiness to have visitors will vary as well. Once enough time has passed, if unable to visit then call to check in – having a newborn can feel overwhelming and well-timed breaks can be good for the mother’s mental health.One mother shared an important point, that visitors may want to especially think about how close they are to the mother of the child rather than the father. The new mother may be particularly sensitive and may appreciate more time before having visitors that she may not be particularly close with (e.g., a few weeks rather than a few days).
  2. Read the room, know when it’s time to go and do not overstay your welcome. Many of the mothers (some more than others) expressed that it was challenging to be assertive about this with extended family and friends. Some mothers are not afraid to let visitors know ahead of time what duration they can accommodate, or they may set specific times for visiting – this is a great way to establish a boundary. Other mothers have used the rough 2-3 hour feeding schedule to guide ongoing visits to a polite end with mother and child leaving the visiting space for nursing and napping in private.
  3. Do not visit expecting to be served or entertained, instead, it would be nice if it were the other way around – expressing willingness to help with something or serve in some small way. There can be so many balls in the air to juggle with a newborn in hand – offer to help wherever you think you might be able to (laundry, washing up a few dishes, etc.). Even if the mother declines, she will indeed appreciate knowing the willing support is there.
  4. Many (certainly not all) women may have had a baby shower where friends and family would have brought gifts for the baby in advance of its arrival. This is a tremendous help for many parents. Though this may have been the case, and especially if it was not the case – check to see if there is any little thing that the parents may need for the child before you visit. Once again, even if the mother declines, she will indeed appreciate knowing the willing support is there. Two of the expecting mothers I spoke with smiled and added that sometimes an offer to bring breakfast, lunch, dinner or just some special food or drink the new mother may be longing for would be warmly welcomed.
  5. For very close family members and friends be mindful that sleep and time to self is an expensive and scarce commodity in their first few months of taking care of a newborn. Offer to hold or keep a watchful eye on the baby to allow the mother some time to have a bath or shower, eat or take a nap. Additionally, when the baby develops a routine (in 3 to 6 months) very close friends and family who are willing to babysit when needed, is indeed a priceless gift.
  6. Not only in this current season of serious illness, but ALWAYS – be mindful of your own health and consider whether you are well enough to visit the baby and moreover to hold the child. If you may have a virus/cold/cough, it’s best to stay away and visit another day. Babies’ immune systems are a far cry from our own as adults, so if your health conditions are not appropriate, show your love from afar until you are certain things have changed. Even when you are well, ensure that you wash your hands and sanitise appropriately before coming into contact with the newborn and seek permission from the parents to pick them up/hold them.
  7. In this day and age so many of us are connected to various social media platforms, and there is nothing wrong with that. However, please respect that some parents do not want their children on social media. Asking permission before sharing a photo or post about their child is a common courtesy we should all exercise. Do not be offended – the culture of social media use is varied, and we are all entitled to adopt different stances.

Thanks again to all the expecting mothers who contributed to these thoughts – we hear you; we are listening. Let us take this on board and be mindful for family members and friends who are expecting. For more information on navigating adjustments and the inherent challenges of parenting, please feel free to contact us at Drop of Life Psychology Clinic.

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On regulating your emotions: A key ingredient for enhancing psychological well-being

Emotions are a central part of the human experience, and when individuals are challenged by the stressors of life and attend therapy for support emotions are also a key component of the work that is done in therapy. In my clinical work with individuals across the lifespan, one of the most common issues I have observed is the challenge individuals may have with regulating their emotions. Interestingly, this challenge with regulating emotions seems to manifest in several different mental health concerns, with some concerns being more commonly associated with specific emotion regulation difficulties. But, what is Emotion Regulation?

Well, to keep it as simple as possible, think about emotion regulation as a process whereby individuals influence which emotions they have, when they have them and how they experience and express them (Gross, 1998). These efforts at modifying emotional experiences and expressions typically have, as a part of their goal, the individual trying to respond to their environment in a healthy and acceptable way. Therefore, one’s ability to regulate their emotions impacts on their ability to adapt successfully to their environment and maintain a sense of psychological well-being.

On the other hand, when individuals are not able to do so effectively, they may be more vulnerable to challenges with their mental health. Moreover, it may not be surprising that there are several different strategies that people use to regulate their emotions – and while it’s tricky to say that a strategy is “good” or “bad” (since it really depends on the situation), there are some strategies that are more adaptive/healthy and others that are regarded as maladaptive/unhealthy. While there are probably too many different strategies for me to cover in this blog, I thought I would highlight some of the more helpful and less helpful ones that I speak about most frequently in my work with clients.

Less Helpful Emotion Regulation Strategies

Suppression – At times, individuals may engage in suppression of their thoughts and emotions, this means that they try to hide how they are feeling internally or push the thoughts and feelings as far out of their awareness as possible. But does out of sight really mean out of mind? Unfortunately, not in this case. What decades of research tells us is that when individuals suppress their emotions their experience of the difficult emotion is more intense than if they had not suppressed at all. This means that it might be more effective for us to develop pathways to working through an emotion rather than trying to “get over it” or otherwise push it aside.

Rumination – Many people may become trapped in a cycle of rumination, whereby the individual may engage in repetitive thinking about a situation and its causes which fuels the negative emotions that have arisen. This regulatory strategy is probably the individual’s best effort to try to analyse or solve a problem that is causing them a great deal of distress, except no solution emerges – especially in cases where the problem is “unsolvable”. To understand this strategy, I often use the metaphor of watching a washing machine – where all the thoughts and emotions just continuously go around and around and around and…well you get the idea.

More Helpful Emotion Regulation Strategies

Cognitive reappraisal - refers to changing the meaning or interpretation of an experience to manage the emotional response. The reappraisal is typically centred on the situation itself or the individual’s capacity to manage its demands. In other words, HOW we think about the situation and our ability to manage it can very much change the emotional experience we have while going through it or change the way we feel about what has already happened.

Acceptance - The individual is aware of the thoughts and emotions they are experiencing, and they remain open to these internal experiences without feeling the need to change the thoughts or emotions that are present. There is a recognition here that neither thoughts nor emotions are dangerous, and we have control over how we respond to them. Developing acceptance as a strategy can be challenging, especially when we are so used to wrestling with thoughts and emotions that come up in response to life’s challenges. However, we can indeed develop a more accepting style of coping. When individuals view thoughts and emotions as inherently negative, they are more likely to engage in problematic behaviours like avoidance and withdrawal.

The role of parents in developing a child’s capacity to regulate their emotions

From the very beginning of life, parents have a crucial role to play in children’s development of healthy emotion regulation. Early aspects of a child’s emotional life are guided by their parents’ selection of situations for them, especially while they are infants. Parents take the lead on deciding what children can and cannot manage emotionally, simply because at this stage children do not know enough about the world to make such determinations for themselves.

Parents generate routines that are comfortable for the child. Such practices are a normal part of the early parent-child dynamic. However, as children get older and mature, and their pool of life experiences expand, they are expected to take more responsibility for such regulatory processes and parents are expected to oversee and guide this self-regulation. Therefore, as children mature, they learn which situations to avoid or approach, when they can modify situations externally, and when they may need to make internal modifications in order to cope. Parents ideally model healthy emotion regulation as well, by way of their responses to situations which children observe and learn from overtime.

If you would like support with developing more healthy strategies for regulating your emotions and reducing the tendency to use unhelpful strategies contact us at Drop of Life Psychology Clinic.

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“Don’t Worry About a Thing”

As my home country, Jamaica, recently celebrated 57 years of Independence I celebrated with them – putting on some Bob Marley music that the whole world knows and loves. One of the songs (Three Little Birds) had lines therein that inspired the title of this post. He sang, “don’t worry about a thing, because every little thing is going to be alright”. For so many of the clients I see who experience high levels of anxiety (the emotion), there is often the accompanying experience of worry (the thoughts). The combination of the two often leads to the individual’s experience of significant levels of distress and can result in a number of serious mental health concerns.

In psychology, there are different ways in which we understand the nature of anxiety and worry thoughts and there are as many varying viewpoints on how we treat with them. Anxiety is most simply defined as an internal experience of stress, which may involve feelings of nervousness, fear, worry and apprehension. It is also important to know that Anxiety is a future-based emotion – meaning that the focus is always on something that has not happened yet. You may reflect, for a moment, on an experience of anxiety (it can be recent or one further in the past) and notice that while it may have been triggered by something in that moment it was really about something that you believed was going to happen or that you believed could happen.Anxiety is an emotional experience created and made stronger by the nature of the thoughts that we have and usually these thoughts are negative.

But, is all anxiety BAD?

The truth is, some amount of anxiety can be useful in that it gives us information about things in the future that are important to us. Take a job interview, for example, and the anxious feelings about that which may arise. First, we acknowledge that the anxiety is present in this situation because of our thoughts about the future (we might be concerned about whether we will get the job). Secondly, it is giving us some information, which is that this is a job you really want, or it is important to you. Some anxiety can help us to perform well, but too much anxiety can get in the way of us being our best selves in the present.

Worry takes a toll!

Worry tends to go hand in hand with anxiety and it is the thought process, the self-talk that keeps running on a loop in our mind when we are anxious. Anxiety can also result in physical symptoms and these tend to vary across different people. Noticing what happens in your body is an important first step in coping with anxiety, because you can be alerted to the warning signs of when you are becoming anxious.

 

Get out of your worry loop and back into your body

To get out of the mind, sit or lie down in a quiet place. Close your eyes and feel your body – focus on where the sensations are and bring awareness to them (you do not have to do anything about them, all you have to do is notice them). Even though these sensations are not pleasant, rest assured, they want to go out. Take deep breaths. Draw the air down into the pit of your stomach, then easily and slowly release it again.

Dealing with anxiety and worry can be a challenging experience and there are different approaches and tools that can support you towards living a better quality of life. If you believe you could use support in terms of managing your own experience of anxiety and worry, contact our team at Drop of Life Psychology Clinic.

 

By: Matthew McKenzie, B.Sc. (Hon.), M.Sc. (Dist.)

Registered Psychologist, Drop of Life Psychology Clinic

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Don’t be Cruel, Be Kind: Developing Self-Compassion

In reflecting on my own experience growing up, and also reflecting on the personal histories that many of my clients have shared with me, I have noticed a common thread – a shared experience for many of us. I have noticed that for many of us the development of virtues such as being responsible individuals, being goal-oriented, hardworking and motivated towards success, came with the indirect message that we needed to be hard on ourselves to establish these virtues and keep them alive. We confuse the good practice of holding ourselves accountable with punishing ourselves for our inherent imperfections. We lose compassion for ourselves, though we maintain compassion for others. For many of us, our suffering is a result of the poorly developed relationship we have with ourselves; we have either forgotten or we never learned to be kind to who we are. In my own life’s journey and with the clients I see for psychotherapy, I often integrate the good practice of developing self-compassion.

Self-compassion is the act of being kind and understanding toward yourself. Rather than being highly critical of yourself because of shortcomings and mistakes made, Self-compassion encourages you to accept that you are human and imperfect. It seems strange that we would struggle to be kind to ourselves, but part of the reason for this struggle may be our misunderstanding of kindness to self as a code phrase for self-pity; which many of us are understandably averse to. But self-pity is, what self-compassion is not! When individuals feel self-pity, they become immersed in their own problems and forget that others have similar problems. They ignore their connections with others, and instead feel that they are the only ones in the world who are suffering. This takes the “normal-ness” out of the experience you are having, and this tends to make the suffering worse.

Many people say they are reluctant to be self-compassionate because they are afraid they would let themselves get away with anything; being overly indulgent. Being kind to yourself also means holding yourself accountable and doing what is healthy for your present and your future self! Remember that being compassionate to oneself means that you want to be happy and healthy in the long-term. In many cases, just giving oneself pleasure may harm well-being (so we definitely would not want to confuse having an entire tub of ice cream with the process of self-compassion).

The truth is many of us already know how to be compassionate, because we are to others. With others, we are able to see their suffering and then respond to it with kindness and help. This is the process we must engage in with ourselves – noticing our suffering, identifying where it is coming from and then helping ourselves as we would a good friend.

These things I leave for you to contemplate, and until next time – Be kind to yourself and look out for your neighbour. If you would like further support on your journey to self-compassion, contact our team at Drop of Life Psychology Clinic.

 

By: Matthew McKenzie, B.Sc. (Hon.), M.Sc. (Dist.)

Psychologist, Drop of Life Psychology Clinic

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Changing Challenging Behaviours in Children: How Do We Respond?

A good friend of mine recently told me a story from his childhood of being a youngster with challenging behaviour at school. He was, and still is, one of the brightest minds I know, nevertheless teachers found him difficult to manage at times. In reflecting on his experience, he shared that being “good” consistently got him nowhere and nothing, whereas when he behaved poorly and then improved on his behaviour for a day he would be rewarded immensely. As a young boy he figured out how his environment would respond to different patterns of behaviour and his behaviour became influenced by that.

As I listened to his story I thought of many families I had seen wherein parents seemed to miss opportunities to consistently notice, praise and reward good behaviour. In many instances, this occurs because we are programmed to expect good behaviour naturally and actively respond to undesirable behaviour. However, if we step back we might ask ourselves: What motivation would a child have to demonstrate good behaviour consistently if that behaviour is seldom noticed and reinforced by those around them? Additionally, we should also recognise that even when parents respond to undesirable behaviours with anger, this negative response represents some form of attention, which they have been eager for and not in receipt of when they have behaved well. It seems then that balancing the scales in terms of paying more attention to desirable behaviours and reinforcing those behaviours is a key element for parents to consider taking on board.

Does Punishment have a place?

While punishment may not be the primary disciplinary strategy that we suggest to our parents, we are certainly not saying that it does not have its place. However, to be effective it has to be delivered in a particular way – otherwise, it could do more harm than good to the child’s psychological well being. For example, in some families I have worked with, parents may have allowed inappropriate behaviours to go unchecked for extended periods and then at their breaking point of frustration they crack down all at once with often excessive forms of punishment that may not have been proportionate to the most recent display of challenging behaviours. It is as though the parents were saving up the punishment and then made the decision to spend it all at once.

Parents, of course, have the best of intentions even when life seems to get in the way – however, the key to developing greater consistency in the child’s behaviours is by increasing the consistency in the parental response as well. In fact, the research tells us that inconsistent parenting may place children with oppositional tendencies at risk of greater anti-social behaviours in the teenage years and later in life.

Relying too heavily on punishment tends to create more challenges than it solves problems. When parents overuse punishment, children are less inclined to be honest about their behaviours and their motivation shifts from striving towards more desirable behaviours to avoiding punishment at all costs. What I find most unfortunate about an overreliance on punishment is that it also has negative long-term implications for the parent-child relationship whereby fear becomes a feature of that relationship, which in many instances is not what parents intend.

For punishment to be effective it has to be used as little as possible; occur immediately after the child displays unwanted behaviour; be carried out in a similar manner each time; be handled in a calm business-like way (making it about the behaviour and not the child being “bad”); and be of short duration.

The take home message here is that focusing on children’s positive behaviours and consistently reinforcing those efforts goes a long way to increase the frequency of those desired behaviours. Often times within this process, undesirable behaviours lose their strength and the frequency of such behaviours decreases. Changing our parenting perspective can go a long way in helping us win greater cooperation from children. If you believe you could use support in improving your parenting response or would like support in managing your child’s challenging behaviours, contact our team at Drop of Life Psychology Clinic.

By: Matthew McKenzie B. Psych. (Hons.), M. Psych. (Clinical) (Dist.)

Psychologist, Drop of Life Psychology Clinic

 

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Overcoming Childhood OCD: The Family Facing and Fighting Together

Obsessive-Compulsive Disorder (OCD)is a common and debilitating disorder that affects many children and adolescents (roughly 1-4%). The disorder usually involves the child’s experience of obsessions which are intrusive thoughts, images or impulses that are quite distressing and for some children this leads to compulsions which are rituals that are performed repeatedly in an effort to alleviate the distress that comes from the obsessions. Both obsessions and compulsions can take up a significant amount of the child’s time and often gets in the way of daily functioning at home, school and in their peer relationships. 

OCD, even more so than other anxiety-based disorders, tends to impact significantly on families and this is particularly because so many of the obsessions and compulsions often take place within the home environment. Parents often get pulled into the OCD experience with the child, whereby they begin to perform rituals with the child or for the child. This process is called Family Accommodation. Parents and other family members do not accommodate because they believe the OCD rules are true, however in an effort to prevent high levels of distress and an often chaotic response from the child suffering with OCD, they make massive adjustments to the way the family would typically function. Family accommodation increases the experience of stress within the family and unfortunately makes the child’s OCD more severe over time. 

Fortunately, there have been significant advances over the last decade in our understanding of OCD, the factors that maintain it and how best to approach treatment. In working with children with OCD I take an evidence-based approach which is Cognitive-Behavioural Therapythat specifically involves Exposure and Response Prevention. In this form of therapy, I work with the child to take small gradual steps towards facing their OCD fears (the Exposure), while not engaging in the rituals which OCD tells them is necessary to alleviate the distress (the Response Prevention). In the process of treatment, children learn to tolerate distress and they also learn to let go of beliefs they may have about their responsibilityfor things that in reality are not within their control. For example, through treatment a child may learn that engaging in a 1-hour bedtime routine will not prevent something bad happening to a beloved parent, the child will also learn to tolerate the anxiety that comes from such a thought, and they will learn that the anxiety will pass on its own without any need for rituals. 

Because OCD impacts so much on family functioning, I get the whole family on board from the very start, providing good education about OCD and how it works, then getting the whole family to make a commitment to work together as a team to fight the OCD. This treatment approach is dynamic and flexible and very often can be incredibly fun for the young person even while they face some of their most challenging fears. At times, I may do sessions in the child’s home since for many children the OCD is centred around the home environment. We want to make the treatment experience as similar to the child’s daily experience with the OCD as possible.

The role of parents and other family members in treatment is just as important as the role I play as a therapist. It can be challenging for parents to decrease accommodation, especially when it has become an automatic part of the way the family works. However, even making small changes every day makes a big difference in the long run. It is often an incredible experience for children with OCD and their families to re-discover aspects of life which they had been missing out on for so long because of OCD. OCD is challenging, but there is solid evidence that a good dose of treatment can go a long way and overtime it is possible for a child with OCD to be OCD free! For more information about OCD and treatment options please feel free to contact us at Drop of Life Psychology Clinic.

 

By: Matthew McKenzie, B.Sc. (Hon.), M.Sc. (Dist.)

Provisional Psychologist, Drop of Life Psychology Clinic

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