Practical Tips to Address Mental Health and Wellness Challenges in Families: Psychotherapist POV

Welcome to Where Parents Talk TV. My name is Lianne Castelino.

Our guest today is a mom of one, a social worker, and a psychotherapist whose vast resume spans counseling services, and crisis intervention for individuals and families, as well as healthcare organizations. She has worked extensively in the fields of pediatric and adult oncology, eating disorders, end of life care and mental health. We are delighted to be joined today by Deborah Berlin. Hi, Debbie.

Hey, Lianne. Thanks so much for having me.

And thanks so much for taking time out of your very busy calendar to join us. And I wanted to start by talking about that busy schedule of yours. How would you go about describing what it has been like to do what you do in your field during a global pandemic?

That’s a very interesting question. You know, when everything on that auspicious day, March 13, I remember thinking, I’m wondering what is going to happen to the world of online counseling as we know it. And things in my practice, went a little quiet, because I think people were absolutely terrified about their finances, their coverage at work, their benefits, coverage, and just protecting their own and protecting themselves. And then I would say, Come April, May of this year, my practice went from being less than, you know, 50%. Full to now it’s, I’m at capacity. Because I think people are really quite desperate for a sounding board. Another perspective, another person to talk to someone to help them with their parenting concerns, their own mental health concerns, or even their aging parents. There’s just a, you know, an array and a variety of issues, I think, that are bringing people to counseling, especially now, as we’re even more isolated from each other during this pandemic.

Let’s delve a bit deeper into some of what you just spoke about as it relates to families and parents who have really seen their entire lives turned upside down in various ways over the course of this pandemic. What would you say are the top issues that you are helping people with that they really need to drill down into with your professional help?

One of the first things that people are needing support with, it’s managing to find this work life balance. Really, when everyone is working from home, people are also doing online school from home, trying to find the balance of having so many people at home all at once. I think we saw in the early days of the pandemic, that the Kids Help Phone, those crisis lines went up 300% and lcbo, sales went up over 100%. So those are two great indicators for me as a clinical social worker, and a therapist who does a lot of crisis intervention, that people are really in trouble. And schools, especially in those early months are safe places for kids to go to when things are not great at home. So I was truly starting to wonder and worry about how people just were coping from a safety perspective. So those are some of the issues just the family, in the house, in the apartment. wherever they’re living, how are they doing? The other I would say, which hits a little close to home. Anyone who has an autoimmune illness or any underlying issue like diabetes, or lupus or you’re a cancer survivor, and trying to feel safe in this world of contagion, because the health risks for those people become increasingly higher as our numbers continue to go up. And while we certainly are hearing about the promise in the hope of a vaccine, people are scared. So that would be the second issue I’m really seeing a lot of in my practice.

The third is financial. And please know that there’s no order in which I’m presenting these issues as you know, as for everyone, it’s different. People are struggling financially, people are losing their jobs, people are feeling despondent about making ends meet, if you’re in the entertainment industry, the food industry, I don’t have to tell you. And I certainly hear stories from my daughter about her friends and her friend’s parents, and how some people are struggling in that domain. So I think socioeconomically even though you hear in the paper about the savings of billions of dollars that people have made, that doesn’t represent everyone, or all people. And I think we still haven’t seen the worst of it. In terms of we haven’t heard the stories yet of people losing their homes, or having to move in with other family members. I think the struggle is real. And again, you know, whether it’s media or social media, there’s only going to be a certain representation of certain narratives and stories that you’re hearing.

So the enormity of the challenge in terms of being a source of support, and of counsel for people reaching out to your clients must be immense. During this time, Deborah, I’m just wondering, what strategies do you offer families, in terms of providing them hope, and actually, tactical potential tips and solutions that they can use to try to get through this?

And I’m always very clear, when I start working with any client in my practice, that I am very directive. So if I see that their ship, their life, their self is, is not going on a good course. And I have alarm bells going off, I tell them I’m not in the business of hand holding meaning. You’ve come to me because of my knowledge and my expertise. And so I am going to tell you that there are certain things that I think you will need to start incorporating in your life, to really help alleviate some of the stress, the burden, the mental health challenges that you’re having. And, and as I spoke to you about earlier, we need routine. We need purpose, even whether or not we’re working from home, we need to get up at the same time every day, we need to go to bed at the same time every day. We need to put monitors on how much social media, how much scrolling are we doing through our phones, that has a huge impact on our mental health, especially when people are in situations where they find they’re comparing or contrasting their lives to other people’s, even now, during the pandemic.

I’m talking to people about eating regularly, moving your body, getting outside, going for walks, staying connected, and trying not to live too far in the past, but also at the same time not to future-trip. So don’t move too far into the future, right? Because that also helps manage feelings of disappointment and loss. Because we want given that there’s such unpredictability, right now, I’m really trying to help people manage what’s on their plate. And we look at it very openly. And we talk about all the different parts of their plate that is making up their life. And then I tried to provide true suggestions, alternatives for either managing a really hard situation, or dealing with a tricky situation, whether it’s revolving around their kids schooling, or their elderly parents care, it’s very task oriented, but it’s also very focused into finding remedies and solutions.

For a lot of families, a lot of parents, it starts and stops with maybe struggling to be self motivated, you know, despondence, despondency can just overwhelm and it just kind of becomes the foundation for how you look at everything during a time like this. How about just, you know, some tips around that too? How do you motivate yourself every day to see the glass half full instead of half empty, during something as unprecedented as the history that we’re currently living through?

You know, some of this is taken from good old fashioned Buddhist philosophy, but if you look at the original tenets of Buddhism, they will tell you that life is suffering that we are going to suffer in our lives. The pandemic is an example of that. So then, what we’re encouraged to do is to, in order to step outside of our feelings of grief, loss and suffering? How can we actually be in the service of somebody else, whether it’s our child, or our elderly parent, to make ourselves feel better about where we’re at. And I have to tell you, that perspective was always my mantra at sickkids. It didn’t. It didn’t dismiss the challenges I was having in my personal life. But I always knew that there was someone out there who may need more. And so a walk to the ward, where I saw very sick children and their parents was just yet a reminder for me about Okay, Debbie, right, everyone has something. So, over the holidays, I was encouraging people to give to a food bank, to get together with their kids to build a project where they were donating to a shelter, to a group home. Because this time, this year, more than ever, volunteers weren’t able to help with any causes because of COVID. And it was a project, it was a task that could bring people together to work on something where they could feel good about the outcome.

But when you talk about the day to day, I can’t overemphasize the word routine enough. And it almost has to feel mechanical. And there’s days where you’re gonna feel like you’re just kind of going through the motions. When I think about having a baby, right? And getting into that routine of eat, activity, sleep, even when you feel like you’re gonna fall off your feet. And look, we know why some women develop postpartum depression, okay? It’s not to say that it’s not one of the happiest times in a person’s life. But there are challenges that go with it. If you think about the pandemic, okay, this is forcing everyone to have to kind of internally drill down and draw upon resources that some of us many of us never imagined that we would have.

And lack of motivation. It’s not uncommon, you have to expect that in the planning and the in the doing of a routine in the executing of a routine, you’re going to have good days, you’re going to have not great days, but that in order to keep the momentum going, you need to be able to make sure that you have someone to offload with. Because sometimes in the midst of the business of your life with kids and parents, you might not be emotionally or psychologically connecting with your partner. So who are you talking to, about what’s going on inside your heart, inside your head, and an uncensored way for you to share so that then you’re not feeling like you’re burdening anybody or bothering anybody.

Because I think a lot of people right now Lianne have reluctance around reaching out to people, because they think well, so-and-so has got it worse. Well, so-and-so is struggling more. The reality is everyone is struggling right now. So, you know, if people are new to therapy, and this is something that I’m seeing in my practice, especially now, people in their 20s 30s 40s 50s 60s and 70s, are reaching out, because they realize now more than ever, the supports that were once there are no longer and they realize that we’re in for a bit of a long way, a long winter.
As a mom to a teenage daughter yourself, what would you say are some of the strategies that you have intentionally, you know, asserted in your own home, to help you navigate this, knowing that you have a role as a parent, as well as what you do professionally, and sort of the weight of both of those roles against the backdrop of a global health emergency.

So this is me and this is happening in my home with my daughter. So I’m certainly not saying that this would work in everybody’s home, but during school, I have very strict limits on my daughter’s phone. There are hours where she does not have access to any social media. In fact, I have her phone when she is doing online school at home. The reason for this is because her brain is developing and you know There’s a writer in the New York Times Her name is Lisa D’amour. And she talks about the lives of teenage girls. She wrote an incredible book called ‘Entangled’. And she talks about how, just like we need to intervene when kids are having a difficult time with a fight.

We can’t leave our kids to their own resources, thinking that they’re making the best decisions on their own behalf because they just don’t have the benefits from life experience yet, or age or wisdom to know. I need to make sure that my daughter is staying focused on her schoolwork. So I put the limits on her phone, I also make sure she’s getting up at the same time every morning, and I’m making sure she’s going to bed at the same time every night, these kids need their sleep. That said, outdoors, she has to get out of the house. Now my daughter doesn’t have siblings. So that means that there are a few of her girlfriends who I know quite well, and parents and I, she’s actually unbelievably great with all the COVID precautions around social distancing masking, very careful, super respectful. In fact, some of my neighbors have commented on seeing is a out and about in our neighborhood of leslieville. And they said she’s walking everywhere with a mask. So it’s also saying to my kid, I can trust you to make good decisions, as long as I know that you’re getting all the information. Because in our home, we speak very openly about health care about people getting sick, what that looks like, in a non fearful way, and in a non panicked way. So that she sees that we are just kind of moving as we go and not freaking out. And so she understands that, okay, I’m safe. And my mom is making good decisions based on the information she has.

You alluded to having worked at SickKids. And we talked briefly at the top about the varied range of roles and responsibilities that you’ve had in your professional career. Debbie, I’m wondering if you could take us through the fact is is that you’ve kind of had a front row seat in terms of trauma and the different roles that you’ve experienced. How have each of those experiences further informed or has it in this current pandemic and and sort of the support that you’re providing clients.

When you’re working at SickKids and pediatric oncology, so kids who are being diagnosed with cancer, you learn the saddest lesson in life, that how precious Our lives are the lives of our children, and that things can change like that. And, you know, even sometimes, as I’m reading the very sad stories about people dying in long term care homes, I just feel such sadness because whether a death is preventable or not, there are certain well constraints and things that are happening right now in society that is creating such distance between us and people who are really requiring care.

So lots of families are needing that crisis intervention now more than ever before, whether it’s about mental health support, or just concrete information. There are many people who read the news or listen to the meat, the news, but may not fully understand the impact of COVID. I’m having to do a lot of psychoeducation with people about the vaccine, there are some people saying, Well, if they haven’t found a cure for cancer, or for HIV AIDS, how can I trust this, that this vaccine is safe? So we need to really give accurate, concise, consistent, reliable information. And I find that people love that. And that was something that really carried through when I was working with families that SickKids is in the not knowing. I’m waiting for the biopsy. I’m waiting for the surgery. I’m waiting for the results. Okay, we just finished the first round of chemo. Now we have to wait, the lumbar puncture? Is he going to be in remission? And in those periods of waiting and not knowing what are the things that we can do to take care of ourselves so that we can shift and focus on our other children. Our work is self care. So, you know, and, and as a social worker, you have to tease out what those priorities are day-to-day because they shift. And even now I see that in my private practice, what might be a burning issue one week, might then take a backseat to something much more urgent the following week. So, even when I was working with interns, you try to really work with people in terms of where they’re at. And try to slip in the compassionate messages as best you can. Without having people thinking like you’re trying to fix them or change them, because there is this term known in dialectical behavioral therapy called radical acceptance. How do I practice radical acceptance, given my life in a pandemic, where things are right now? And learn to just be at peace with myself? Because we often have, you know, if you think about life before the pandemic, Lianne, if we didn’t like something, change it.
Okay, oh, Idon’t like this outfit, or I don’t like where I’m living or, like, everything was just about a lot of immediate gratification. But when you think about emotional intelligence, and one of the things I’m trying to teach my daughter is we delay gratification. No, we’re not taking trips right now. No, we’re not thinking about making those purchases right now. What are the priorities right now. And that can be a grounding exercise for people. What matters, just reevaluating what matters?

On that note, I’m wondering, in what ways has the pandemic been of benefit to you and your family?

Would you say, I can’t wait to hug my mom. So my mom, my dad died, it’ll be two years ago, February. And just as my mother was coming out of the one year Jewish mourning period, COVID hit. And so she has bubbled with my brother’s family. My brother has an autoimmune mewn illness, and they’re not sending their son to school. So since March, I’ve had some social distancing visits with my mom dropping off groceries, seeing her but really not being able to hug her and spend time with her. And that has made me realize how fragile life is. She’s at. And I, I think about many elderly people, right now, I’m working with a few in my practice, who just feel so scared and isolated from their kids and their grandchildren. So that’s made me really think about how precious family is, and I know of people who’ve actually contracted COVID in my family, and also just out in the health care world, and I don’t think I’ve ever appreciated my health as much before as I do now. Because often, the people who are underestimating COVID and not taking the precautions, you know, I’ve been pretty firm with them to say, this can be a potentially life-threatening virus. This is life threatening to people. This is not a joke. And when it when one when one family or when one group of people doesn’t pay attention to the rules can have a ripple effect. Right. And so trying to really appreciate the responsibility that we all have in trying to make this better. Right.

That leads perfectly into my next question, Debbie, and that is what gives you hope?

My daughter gives me hope. My daughter gives me hope because I think about how you know Lianne they’re going to be writing PhD dissertations about this stuff. This is one for the books, the research and the writing and the thinking that is going to be coming out of this pandemic, when the dust finally does settle. I just think trusting that this will make my kid even more resilient, more tenacious, that this will teach her that we can do hard things. That’s what gives me hope. And 17 years of watching families, do the unthinkable, gives me renewed hope and makes me remember that. Okay. It’s okay to struggle. It’s okay to struggle, because then it can really remind us of what’s important.

Finally, is there anything that I haven’t asked you, Debbie that you’d like to add to this topic about? Mental wellness, mental health during the pandemic, and specifically within families?

Yes, and to anyone, anyone out there who might be listening to this, who might be struggling in silence, there are people out there to help you.

Psychology Today has an incredible website and a roster of hundreds of therapists, you can ask your family GP for referral. Unfortunately, we know that psychiatry is quite filled up these days. So not a lot of OHIP covered services when it comes to mental health. But there are people with sliding scales and affordable practices, where it’s just a phone call or an email away and I just can’t, you know, say this enough to people that it’s so it’s okay to not be in a good place. And just to let people know that it’ll pass and that it’s really, that help is out there if you need it. And if you want it.

Debbie Berlin, thank you so much for your time. There’s so many tips and, you know, incredible nuggets of wisdom shared there as a parent as a psychotherapist, as a social worker. Counselor, thank you so much for your time today.

Lianne. Thank you for having me. It’s a pleasure.