7 Questions You Can Ask Yourself To Celebrate This Year's Recovery Wins (Or Any Wins, Really!)

Sometimes in recovery, it's difficult to see the forest for the trees. Today, I would like to invite you to reflect back on your recovery wins over the last twelve months - whether or not you think you should be further ahead, didn't try hard enough, or feel like you have a long way to go. 

Consider asking yourself the following questions instead of engaging in your harmful behaviour the next time you feel an urge, or simply stay in one night, fetch pen and paper and write down your thoughts; I promise this exercise will be even more effective when you jot things down. 

Here we go: 

  1. From ten to zero, where zero represents twelve months ago, where are you in your recovery right now?

  2. How come you are already at that number? 

  3. Which five thoughts or ideas you had or things you did were particularly helpful? 

  4. Suppose you were able to keep up the good work, what would others notice about you twelve months from now?

  5. When you think back over the last year or so, which three situations did you handle particularly well?

  6. How were you able to do so?

  7. What would it take to handle more situations this well?

Considering all of that… You’ve got this, don’t you? :)

The Hidden Benefits of Giving Back In Recovery (On #GivingTuesday and Beyond!)

When we are trapped in problematic behaviours, difficult relationships and otherwise hard situations, chances are we are pretty wrapped up in ourselves. 

That's totally fine and understandable, of course, except for the research that shows that helping others has psychological benefits

Those benefits include, but are not limited to, lower blood pressure, increased happiness and decreased depressive symptoms, a potential reduction in the experience of chronic pain, and improved social connections. 

Needless to say, all of those positives are helpful to recovery, because they activate your brain's pleasure centres in a natural way - even donating money to charity checks all the boxes for this effect! (With the added bonus, of course, that you’re supporting others in need in the process!)

So, if you have been thinking about giving today, but are as yet unsure to whom, here are a couple of ideas for you (U.S.-based organizations in bold): 

  • ASDAH, the Association for Size Diversity and Health, a non-profit organization with an international membership committed to the practice of the Health At Every Size® (HAES®) Principles that envisions a world that celebrates bodies of all shapes and sizes, in which body weight is no longer a source of discrimination and where oppressed communities have equal access to the resources and practices that support health and well being. You can donate through becoming a member. 

  • Body Brave, a boy-inclusive not-for-profit that provides complimentary support services for individuals adults struggling with weight, food and body image issues, including eating disorders. 

  • Jean Tweed, a leading community-based organization that provides a safe and supportive environment for women with substance use, mental health, and/or gambling issues.

  • NAAFA, the National Association to Advance Fat Acceptance is a non-profit, fat acceptance civil-rights organization in the United States dedicated to improving the quality of life for the obese.

  • NEDIC, the National Eating Disorder Information Centre is a Canadian non-profit providing resources on eating disorders and weight preoccupation, including a free of charge helpline and online directory.

  • NIED, the voice for Canadian families, caregivers, and individuals who are affected by eating disorders and other comorbid and concurrent diagnoses.

  • Sheena's Place, a support centre for people affected by eating disorders and their families in Toronto. 

And if you would prefer to be of service in another way, think about a time in the last month or so that you have helped someone: List at least five ways in which helping someone else was helpful to you. 

Then, ask yourself: What would it take to do that again?

Happy #GivingTuesday!

Talk soon,


What Makes A Great Listener? Two Lessons Learned From A 92-Year-Old Woman I Never Met

I attended an event the other night, at the beginning of which each of us was asked what was currently on our minds. As I knew I would be writing this blog post soon, I said that I would like to get peoples' opinions on what makes a good listener. I was hoping for a long list of proven qualities to share here, and had my pen and paper ready to take notes. 

We went around in a circle, and other people were stating what was on their minds, including the horribly othering ideas that the current Government of Ontario is tossing around, or how you could make good ideas at work spread faster. 

About five people down from me, a lady in her fifties that I had never met before turned to me: 

"Your question actually relates to what has been on my mind tonight. I just returned from a visit with my 92 year old mother, who is an excellent listener. She is the best listener I ever met. Every time I see her, she reminds me that she's there for me, and while she might not be able to do many other things anymore, she's here to listen. She says: You go ahead and talk, I'll be your container. She is also genuinely curious. Sometimes I feel bad for unloading all my thoughts on her, but she keeps reconfirming that listening to my story is what she can do to help."

It was a very touching story, and we thanked her profoundly for sharing it with us. 

I knew I had learned what I needed to know: 

The two key takeaway lessons for people who want to make sure they're perceived as good listener are 

(1) deep curiosity about what makes the other person tick and 

(2) an explicit invitation to share in a setting that makes the other person feel accepted and comfortable. 

As a listener, when you can provide those two things, you are golden. 

From personal and professional experience, I can say that developing effective listening skills takes a lot of time and practice, so keep at it - it will change your conversations for the better for the sure. :)

If this article sparked your interest, you can find more detailed, step-by-step instructions on how to be a good listener over at WikiHow. 

What To Say When People Give You Unsolicited Dietary Advice

We've all been there, haven't we? Just about to bite into something really delicious (or scary!), when somebody says: 

"Are you sure about that? I wouldn't eat that!"  

The last time that happened to me, I was about to buy a donut at a railway station, and I was quite surprised to hear the words, as I hadn't expected that particular person to take interest in - or issue with, for that matter - what I ate. 

The last time this happened to my daughter, who is two (!), was when someone asked her whether, along with her Halloween candy, she would also eat plenty of vegetables to offset the damage.

The last time this happened to one of my clients, her mother inquired whether she wouldn't much rather eat carrots. (I am sharing her story with her permission, of course!)   

You get the gist: We're rarely safe from diet culture, sugar fear mongering and carrot advocates, and better come up with helpful strategies around dealing with them.

So, how can we handle these moments?

Let me tell you how the situations above went down one by one…

Strategy #1: Educate By Offering A New Perspective 

In the first situation, I felt comfortable enough to say: "It's just sugar. We need sugar for our brains to work. This donut won't have lasting effects on me." Their comment also made me understand how much their own recent life experiences informed their thinking. Losing a parent to illness, as well as being surrounded by women who struggle with their body image clearly implanted the message that certain foods are not safe. Because I had trust in the quality of our relationship, I was able to point out that some of the conclusions we draw that we think are causal are really rather arbitrary and unfounded.

Strategy #2: Pick Your Battles

In the second situation with my daughter, I decided not to say anything, because I am a firm believer in picking your battles. In this particular scenario, I was quite certain that my daughter didn't really understand what the person was asking. I think being able to conserve vital energy by avoiding fruitless arguments is a vital skill. Just because we can speak our mind, we don't always have to. 

Strategy #3: Try Something New

The third situation is my favourite of all, because my client managed to set an incredibly boundary for herself. Somehow, in the midst of the moment, she was able to speak up for herself and say to her mother: "I know about carrots. I'm not interested in carrots. I'm trying to heal my relationship with food eating this!" This was a pivotal moment both in my client's relationship with her mother, as she hadn't previously advocated for herself quite this clearly, as well as in our sessions, as the client managed to really put some of the strategies we had mapped out for her to excellent use. We were both so proud! 

One of the concepts we had discussed around aligning your speech and actions with your thoughts and feelings revolved around filtered messages. (If you'd rather watch than read, here's a short clip of me explaining that concept.) If we manage to say what we want in a way that can be heard by others, we are well on our way to recovery. 

Strategy #4: Read Between The Lines

In any case, it might be helpful to remind ourselves that, most certainly, the statement that person makes says much more about their own relationship with food than us or ours. Quite obviously, they are working through something - fear, feelings of inadequacy, body image concerns - that we are not yet fully aware of. With parents in particular, it can be quite shocking to discover how entrenched they are in diet culture. I had to be 34 years old before I realized that my dad was stepping on the scale daily. I immediately advised him to toss it, of course, and he did concede that upon further reflection, he wasn't quite sure what he was hoping to make of the numbers he saw - other than a perpetual inadequate feeling.

Hopefully this article was helpful to you, and if you would like to talk through strategies personally useful to you, feel free to get in touch at any time, I would love to hear from you!



Image by paramoart, via BodyPosiPanda.

Is My Cannabis Use Problematic? Take This Easy Self-Assessment And Find Out

Ask yourself the following six questions to find out whether or not your use of cannabis would be considered problematic by professionals:

  1. Have you ever smoked before noon?

  2. Have you ever smoked when you were alone?

  3. Have you ever had memory issues when you smoked?

  4. Have friends or family ever said you should reduce your use?

  5. Have you tried to cut down or stop smoking unsuccessfully before?

  6. Has your cannabis use ever caused problems, for example bad results at school or work, accidents, fights, being unable to do important things you were hoping to do, etc.)?

If you’ve answered yes to two or more of these questions, you could benefit from counselling.

How To Pace Your Emotional Labour

In times like these, life for women is extra hard. 

As I read somewhere on Twitter: "Most of the women you know are about one conversation away from crying or screaming."

We are exhausted

Exhausted, not because we are too weak, uninspired or sensitive, but because everything we do professionally, politically and in general, we do in addition to providing emotionally for everyone we know

You read that right: Everyone.

This is no overstatement. 

Emotional labour is the labour of caring, organizing, remembering, keeping on top of and regulating, everything that needs to be done in a household and for its inhabitants, or a work environment and its team members. 

As Dr. Judith Moring put it in this article, it's holding someone in mind and thinking about other people's needs:

From doctor's appointments to printer cartridges, from thank you cards to birthday gifts, from meal planning to agenda setting - we're doing it all.

"How much of this labor has a woman got to pay out before dudes will do anything in return?" 

Great question, and I have no clue, honestly!

What I can offer, though, are a few ideas around how to pace emotional labour in a way that will hopefully leave you with more time to recuperate: 

0. Understand that emotional labour is not you being controlling, but rather a systemic issue. That said, you're not the only one supposed to put the work in. Wherever possible, surround yourself with men who are aware of others - even just their presence in space! - and who are willing to coordinate complex tasks and processes for or alongside you.  

1. Choose who you like caring for and prioritize your emotional labour accordingly. Not all dependents are created equal!

2. Identify more balanced relationships: Who are the people that demonstrate an emotional investment in your relationship that is similar to your own? What about those relationships tell you that you're not the only one putting the work in?

3. Document workflows to a T, so that at any time, someone else could take over. And when I say "to a T", that's what I mean: (1) Go to Mailchimp.com. (2) Enter [username] and [password]. (3) Navigate to "Recent" etc. Or (1) Open fridge. (2) Check amount of yogurts. (3) If ≤ 2, refill with yogurt of same brand and flavour. 

4. Delegate workflows. Especially those less important to you as a person. Keep those you enjoy for yourself.     

5. Discuss the issue with friends and colleagues. Particularly with those that seem to have childcare and work distribution  figured out; in our household, for example, my husband takes care of our daughter more often when she's not at daycare, and he is also in charge of keeping the kitchen clean.    
 6. Invest in women. Make time to appreciate and support the women in your life for what they do. 

How does all this relate to substance use and disordered eating? 

Great question, thank you for asking, let me explain:

Problematic behaviours like substance use and disordered eating are generally understood as bio-psycho-social phenomena with an element of oppression

In situations where people are overwhelmed with what they need to be doing or think they should be doing to uphold or increase their societal status or standing with others, the pressures of everyday life turn into oppressive force. 

For women, who in our current political climate struggle to maintain control of their own bodies and are still generally paid less than men for the same work, the playing field is not level to begin with: Women are oppressed on personal, cultural, and structural levels every day, everywhere. 

When we add to this daily oppression the stress of emotional labour that is often not only under-appreciated, but wholly unrecognized, feelings of emotional pain and general worthlessness may take over that often present in behaviours that further increase oppression, such as substance use or disordered eating. We self-medicate and want to disappear. 

The good news is: a little bit of feminist education will go a long way: 

It's okay to not do it all. 
It's okay to ask for help. 
It's okay to take up space. 

We deserve better!


As always, I hope this blog post was useful to you, and I'd like to ask one last question: 

Suppose you were able to reduce your amount of emotional labour, what would you use your energy for instead?

The Must-Knows About Legal Weed In Canada

Effective October 17th, 2018, cannabis will be legal in Canada under the Cannabis Act.

Here's what you need to know: 

  • To buy, possess or use cannabis, you must be of legal age (that's 19 in Ontario). Selling to or sharing with people under the legal age is strictly forbidden. 

  • The only place to buy legal cannabis for now is online, via the Ontario Cannabis Store. This means that street dispensaries will remain illegal. 

  • You can possess up to 30 grams of legal cannabis.  

  • Legal cannabis can be distinguished from illegal cannabis, because it has an excise stamp. 

  • Medical marijuana will continue to be provided by health care practitioners. 

  • Your weed needs to be stored away from children, youth and pets. 

  • Driving high and working high remain illegal. This is because cannabis can impair your ability to operate vehicles and equipment safely. 

  • You won't be able to take any weed across the border. This applies to all countries, irrespective if cannabis is legal there or not. You might want to be extra cautious when travelling to the US. 

If you are worried that legalization will negatively impact your frequency or amount of use of cannabis, consider the following suggestions: 

  • Try to identify the feeling that makes you want to use. Many people use cannabis to self-medicate symptoms of depression and anxiety. It might be a good time to look into treatment options and support groups. 

  • Reach out for support. Everything is easier when loved ones are able to assist you. Try it - people love being asked for help, whether they are family members, friends, or professionals. I'm always happy to speak with you, too, and might be able to point you in the direction of additional support. 

  • Reducing or stopping your cannabis use usually takes more than one attempt. It's especially hard when you surround yourself with other users.

  • Seek out sober environments and make non-cannabis related activities and people a priority. 

When The Going Gets Rough In Recovery

I can say with certainty that there will come times when this sh*t is difficult:

Habits will change, relationships will be re-evaluated, and emotions will surface that we weren't sure we had. 

It's all part of the process, and that is a good thing. 

Don't think that recovery is not worth pursuing, because it causes trouble.

It is the opposite, really:

Your problem behaviours impaired your ability to make smart decisions and set appropriate boundaries, and recovery will help you backtrack.

If relationships change in the process, remember that healthy relationships grow stronger from conflict, while unhealthy relationships further deteriorate because of it. 

Setting boundaries around personal needs will, over time, help distinguish one from the other.  
If you want to get better, embrace the lifestyle changes that recovery brings. 

Nothing will change unless you do. <3

Talk soon, 

How I Quit Drinking

I came across an article recently that I wanted to share with you. 

The article is titled How I Quit Drinking In A World That Wants Me Drunk and inspired me to recap how I quit drinking myself - and tell you about it.

I quit drinking slowly over the course of several years, and then once and almost for all when I got pregnant.  

I say almost, because I went on a one week long vacation to Germany this July, where I met with old friends and during which I drank frequently, but little.

(With the exception of a wedding reception, where I drank a little more, but still responsibly and hangover-free!) 

After I came back to Toronto, I had one last beer over dinner with friends, and that was it. 

In spite of this handful of exceptions, I consider myself sober since January 1st, 2016. Indeed: I consider myself sober, even though I had a few drinks on six out of those 1013 days, because the way I drank before January 1st, 2016, and the way I drank this summer are entirely incomparable, and because I believe that some of us can be in recovery and still have a few responsible drinks.

That said, I don't believe that I could have kept drinking responsibly over time had I stayed in Germany longer, but with a clear distinction between my old lifestyle there and my new lifestyle here, the switch back to zero was surprisingly easy overall; it goes to show, too, that our drinking habits really are often dependent on who we spend time with, and that there are circumstantial triggers like weddings and old drinking settings that make abstaining harder.  

But anyway, you are probably most interested in how I managed to put my sanity first and stop partying in the unhealthy ways that I used to. 

Here is my very abbreviated personal recipe for sobriety:

This recipe worked for me, and while I am not saying that the following pieces will seal the deal for everyone, I do think there is something to be said for their effectiveness in recovery - hence the way that I work.

I will list my "steps", if you want to call them that, in order of chronological appearance: 

1. Feminism
2. Yoga 
3. Realizing that nonalcoholic beer and tea are drink menu items
4. Asking: "Why am I doing this to myself?"
5. Understanding that meaningful connections only happen sober
6. Planning a future (dropping dead any minute seemed likely before)
7. Getting pregnant and understanding my role in that context

That was it in a nutshell, and I am happy to elaborate on any of these steps in my small and exclusive upcoming relapse prevention workshop in Toronto this Saturday, or in the upcoming Relapse Prevention 101 online support group starting at the end of the month, if you are interested.  

And if you are wondering what all they did for me, here are just the first few of the benefits that sobriety delivered for me:

Fewer mood swings, improved mood, making less of an ass of myself in public, less anger, fewer arguments, better friendships, better connections, less injuries, better choices in life overall, more in control of my fate, less waste of time, better decision making, no hangovers ever, more in touch with my emotions, better health, ... 

I could go on for a while, but I'll let you get back to doing your thing. 

And if you want to talk about that thing, you know where to find me. ;) 

Talk soon,

Daily Self-Compassion

Have you considered incorporating a daily practice of self-compassion into your routine? 

More than anything, I have a moment of quiet in mind, where you practice self-acceptance and kindness.

A moment to remind yourself that you are doing the best that you can, given the circumstances, and in which you express compassion toward yourself in light of your present suffering.

In this moment, you may choose to say kind words to yourself, place a hand on your heart, or give yourself a hug. You might direct energy to where it hurts. Whatever works for you and feels loving will do just fine. 

The most important result this exercise will produce is that it will give you the strength to keep on keeping on while at the same time opening your mind to what is beautiful in life (you, for example!). 

Talk soon,


On Holding Space In A Space That People Appreciate

What is it like to spend time with you?

What atmosphere are you striving to create in the space that you hold? 

Let's explore the topic! 

Holding space begins with being present.

I'm probably stating the obvious here, but absent minds don't foster healing environments. With busy schedules divvying up our attention, connections are often fleeting. And yet, the less time we have, the more important it is to tune in: Getting to know our community, showing genuine interest in our clients, colleagues and teams, and marvelling at the ease with which investing presence transforms relationships.   

It continues with compassion.


Rather than trying to fix things or people, we must learn to trust that our clients are the experts on their situation, always. When we are holding space for someone, we are caring for them instead of controlling them. Withholding judgment. Through practicing humility, empathy and gentle guidance, and through fostering a culture of curiosity and lifelong learning, we empower and build confidence. In solution-focused dialogue, this is called taking a position of not knowing and leading from one step behind

Give the least amount of advice possible.
(And that's... advice - you got me!)

This can be hard for anyone, especially those of us working in roles that are expected to give advice often. The more people are willing to listen to us, the harder it becomes to "read the room" and honour others in their needs. If you are influential, white, or male, you might be interested in reading Heather Plett's piece Holding Space When There Is An Imbalance In Power Or Privilege

Tidy up!

Just kidding.

The physical space we share with others can make all the (positive) difference, though! Here'a a brief list of features of a safe space, borrowed and adapted from a great infographic on the topic published by The519, an LGBTQ organization in Toronto:

* Inclusive symbols, images and artwork
* Use of inclusive language
* Communication that goes both ways, not just top-down
* Thoughtfully chosen reading materials in waiting rooms
* Organizational policies that reflect the protection of human rights including gender identity and expression

You can find a few more general guidelines for welcoming spaces over at the American Planning Association, which has compiled a list of Characteristics of Great Public Spaces.

And if you are more interested in the visual aspects of interior design, you might find @OfficeWithCouch interesting, a little Instagram project I started on the side while decorating my own new counselling office at 1409 Yonge Street.  

How To Set Professional Boundaries

Have you ever asked yourself how to best set professional boundaries?

I can relate. 

Beyond the most obvious and most commonly agreed on boundaries - sexual relations with clients, dual relationships, acceptance of expensive gifts - the lines are blurry. 

Being a warm and empathetic human being while putting your foot down at the same time can pose a challenge, and different relationships warrant different rules. 

The following are few typical scenarios that fellow helping professionals struggle with:

Examples of Common Boundary Twilight Zones 

  • Starting and ending sessions on time

  • Scheduling appointments that work for the client, but not the helper

  • Sliding scale fees

  • Feeling energetically drained after sessions

  • Taking vacation days

  • Taking sick days

  • Taking on extra shifts

  • Taking phone calls away from the desk

  • Answering emails after hours

  • Spending too much time on your smartphone 

  • Weekend work

  • Handing out private contact information

Before going into my personal strategies around how to handle each of those sample scenarios, I wanted to share this excellent piece on how to best protect our emotional energy by boundary specialist and feminist therapist Nicole Perry; you might remember her from our free webinar on setting clear boundaries. Nicole created this piece especially for today's newsletter. Thank you so much for generously sharing your expertise with us, Nicole!  

How To Protect Your Emotional Energy

In a nutshell, the three strategies to protect your emotional energy when working with clients as suggested by Nicole are:

  1. Conscious noticing

  2. Reconnecting and grounding

  3. Understanding how we stay in tune with ourselves in session

My Personal Strategies 

As promised above, here is how I personally handle each of the sample scenarios in my own practice:

  • Starting and ending sessions on time

My sessions are 50 minutes long, and while I can't always land the 50 precisely, I do make a point of never, ever going over 55 minutes. My favourite strategy to keep track of time is to check my wristwatch about two thirds into the session and say something like: "We have about fifteen minutes left together today, what else would be helpful for you to talk about?"

  • Scheduling appointments that work for the client, but not the helper

I use Acuity Scheduling, an online scheduling tool that lets clients self-schedule their appointments on my homepage within an availability range that makes sense for me. My availability generally is the same every week, but if I need to take some time off or change things up because of an important event, Acuity Scheduling lets me adjust my work windows flexibly as needed. As I understand that some clients need evening and weekend appointments, I stay at the office later on Tuesdays and offer Saturday afternoon appointments, too. However, I don't veer outside of those regular time brackets to accommodate clients further.  

  • Sliding scale fees

Personally, I charge one non-adjustable fee for everyone, which is currently CAD $95 per 50mins. I set this particular price point last year, when I was about halfway through my Addictions Careworker Diploma training at McMaster University. As soon as I'll finish the program (my last paper is due in June), I will raise my rate to CAD $125 per session for new clients as well as returning clients who have been inactive. I have found that sticking with my pricing has been easier than expected, and it hasn't seemed to deter clients, either.  

  • Feeling energetically drained after sessions

This is an interesting one, as I usually feel energized by my work. However, in the rare cases I don't, I very much understand why people would charge two hundred and fifty dollars per hour. In any case, if your work environment is more draining than inspiring on the regular, perhaps adjustments need to be made?

  • Taking vacation

I'm not great with this one, but I think that is because I work part time hours. That said, for this summer I have already set aside one week of cottage time, one week of professional training time, and one week for reconnecting with friends in Europe. 

  • Taking sick days

I have come to understand that I can only be helpful to others when I take time to recuperate. Rather than prolonging an illness unnecessarily, I now know that I heal faster when I take rest when I need to. While I hate cancelling client sessions, I am looking at it as modelling self-care to them. 

  • Taking on extra shifts

I can't really speak to this one, as I have never worked in shifts. Hypothetically, I think I would be agreeable to taking on extra shifts in a reciprocal system, for extra income, or for a colleague in a dire situation. Ideally, I wouldn't want to take on extra shifts over a longer period of time, though. 

  • Taking phone calls and answering emails after hours

I don't take business phone calls after hours, but I do answer emails on those nights I am on my computer anyway. When I am on vacation, I will set up an auto-responder and record a related intro on my voice mailbox. Generally, I am trying to return messages within 24 hours. 

  • Spending too much time on your smartphone or social media 

As I used to be in digital media, this is a hard one for me. My previous career required being online all the time, and while I have managed to cut down my screen time considerably, I acknowledge that I still spend a lot of time in digital environments. A strategy that has worked for me in this regard has been to be mindful of when my daughter is around and to curb my screen time around her. 

  • Evening and weekend work

As mentioned above, I am at the office every Saturday afternoon and on Tuesday evenings. Beyond that, I will only act on bursts of work energy when my child is asleep and my husband is busy otherwise. 

  • Handing out private contact information

For my own convenience, I use only one mobile phone for work and private matters alike, and I used to use only one email address for both until recently, too. Now that I do have a separate work email address - this one! - I made sure that work emails are *not* pushed through to my phone. With the exception of appointment booking notifications (which I set up to go to my private address for ease of planning) I only check my work email at my desk. 

How do you maintain appropriate professional boundaries?

Here are a couple more strategies that might be helpful in this respect: 

Ideas For Improved Boundary Setting 

  1. Reassess your boundaries weekly

  2. Stay true to yourself by honouring your personal needs

  3. Put everything in your calendar and do as it says  

  4. Use positive self-talk

  5. Consult around these issues with a colleague, supervisor, mentor or coach - sometimes it's just easier to talk things through

As per usual, I hope this email was useful to you. 

The Problem With The Nightly Glass Of Wine

What are your thoughts on a nightly glass of wine? 

I am asking, because sentences I hear often include:

"My doctor says a glass of wine a day is fine."
"I read that red wine is good for the heart." 
"My husband doesn't think my drinking is a problem."

Here are my thoughts on the issue:

Whether a nightly glass of wine is a problem depends:

Most of all, it depends on the actual amount consumed. Quite casually, a glass of wine at home turns into two, or three, or a whole bottle, and before we know it, we have lost track of how many glasses we really drank - and who measures them in millilitres, anyway?

If this happens occasionally, there is likely nothing to worry about, but if we frequently drink more than a glass or have less than two alcohol free days per week on the regular, we might start feeling ashamed and choose to ignore both the true quantities and underlying reasons for our drinking. 

The problem with the nightly glass begins when it turns into two. Or three. Or four.

In order to determine whether a glass of wine at the end of the day is ok, becoming mindful of how much we really drink is key. 

For those of us open to an experiment, a weekly log might help; even if in the morning all we remember to note is "lost count". 

"Mommy juice"?

Pre-existing health conditions and gender specific factors play a role as well when we are trying to determine if a daily drink is fine.

As you likely know, alcohol affects women more negatively than men in many ways. 

Age, genetics, and life circumstances often further complicate the situation and add vulnerability.

Research advises women who are pregnant or breastfeeding, taking medications or restricting their food intake to avoid alcohol entirely.

Keep in mind that alcohol dependency often looks much less dramatic than the media make us believe: 

Not everyone who drinks problematically is homeless, economically disadvantaged and single. 

Quite the contrary is the case: Many upper and middle class mothers struggle, but suffer in silence because of expectations regarding their role in society and fears around what might happen to their children if a problem were to be admitted.

What to listen for in conversations with your patients or clients:

As a rule, problematic drinking creates problematic situations.

Those who have experienced feelings of guilt or shame after drinking know what it's like: a fun evening somehow turned into a series of painful or embarrassing mishaps.

When drinking affects our clients' self-worth and impacts those around them negatively, our alarm bells should go off. Clients might like themselves less and less and become more quiet and withdrawn, because they understand that their behavior didn't help the situation, but they are unable to initiate change on their own.

Make sure to take their symptoms and concerns seriously, even when no direct negative health consequences are apparent or they "don't look like" they might have a problem. This goes for eating disorders, too, by the way - most often, they are invisible illnesses!

By the time attempts at cutting down regular drinking are unsuccessful, or when family members voice their concern, seeking professional help is recommended - if only for a second opinion.

Use your professional leverage to advise patients or clients that there is no shame in letting a counsellor know that it's all a bit much at the moment. In fact, the sooner problematic behavior can be addressed, the easier it will be to establish new nightly habits and rituals.


What to do when you suspect that someone you care for (or about) abuses alcohol
If you suspect that a client, patient, friend or family member abuses alcohol, gently inquire if she would like to talk about your observation
 Try to withhold judgment and attempt to find out what would help her in her current situation.

If you can truthfully alleviate fears around the possible apprehension of her children by child protection services, do so. (Many women are scared to discuss the true extent of their substance use due to legitimate concerns around losing custody of their kids.) 

Normalize the use of substances to deal with stress. 

Help her get in touch with a counsellor, if that would make her feel supported.

Keep in mind that change is difficult; not everybody who we feel needs help will agree with our assessment.

If they are not receptive to help, respect their autonomy and let them know that you are ready to support them whenever the time is right for them to move in a different direction.

What To Do When Adult Children "Fail To Launch"

I might not have mentioned it yet, but my other speciality aside from working with women who struggle with disordered eating and binge drinking are young adults who just can't seem to get started in life. 

"Failure to Launch" 

The phenomenon is sometimes called "Failure To Launch".

In spite of supportive parents and economic security, the young adults I am referring to often highly depend on their parents, have no or very dissatisfying careers and are insecure about how to live a meaningful, fulfilling life.

Many are highly intelligent, but socially challenged, school or university dropouts who spend their days surfing the Internet, playing video games, or smoking cannabis.

Whether in a professional or personal context, if you know a family who has a highly dependent adult child, you might have gotten a sense of how taxing the situation can be - and how hard it is to find expert help.  

There is hope, even for parents who tried everything!

With all the best intentions, and with seemingly endless love, good will and energy, parents of young adults who failed to launch often go to extreme lengths to put their children in the best possible position:

They pay their children's rent and other living expenses, use their own professional connections to secure them employment, and turn into part-time career counsellors and human resource managers who are intimately familiar with the educational landscape in their region.

And yet, no solution seems to stick and no real progress is made: 

The child remains unhappy and unable to cover their expenses, and the parents keep worrying, blaming themselves and each other and wondering what else they could possibly do to fix the problem.   

I recorded a free webinar for those parents.

Over the span of fifteen minutes, the webinar will go over: 

  • How to finally stop worrying about a dependent adult child

  • Why the status quo is not the parents' fault

  • What their child really needs from them

  • How parents can approach their child in an effective, helpful manner 

  • The five exact steps a family needs to take to move forward

If you want to access it or forward it to someone, the webinar can be accessed here simply by signing up with an email address.

For a limited time, I am also giving away a free, full-length 50mins consultation pertaining to this matter to anyone who books an appointment through the booking button provided below the webinar. 

In the hopes that you, your patients, clients, or friends will find this free support for parents as helpful as my previous clients have found it, I will leave you with the reassurance that hope is always worth it and that it is never too late. In my experience, there are no “hopeless” cases.

In any case, please feel free to get in touch if there is ever any way that I may be helpful to you, your friends, your patients or your clients.

On Dieting As Religion

Tanja Hoch completed her Master of Arts in Religious Studies and Media Studies. Besides her interest in detecting religious behavior in contemporary cultural practices that appear rather secular, she is happiest when moving her body in a playful, yet focused way through bouldering, calisthenics and yoga. Tanja lives in Basel, Switzerland, publishes on Academia, and can be contacted via email for further questions.

Tanja, your recent work explores the religious aspects of dieting, and particularly the role that Western social media influencers play in how we eat. What would you say have been your most important findings so far? 

Annina, thank you so much for having me!

First off, it’s important to say that my thesis was one of the first in religious studies delving into this specific field, and that my findings are really just scraping the surface.

Very briefly put, though, I would say that following dietary advice released or reproduced by social media influencers can make people feel like they are on the road to salvation - even if they wouldn’t describe themselves as being particularly religious or spiritual. Eating like other people in our peer group also gives us a sense of community and belonging. At the same time, following a very different set of dietary rules or “food logic” compared to our “offline” peers can be a source of alienation.

In essence, “food logics” and dietary rules advertised by social media influencers provide us with a set of instructions for part of our life and therefore provide a sense of security.

This is very similar to the popular religions we have known: They instruct believers on how to live their lives in every aspect, not just in relation to food consumption.

Even in a society where an increasing number of people don’t follow rules set by religious institutions anymore, or follow them only partly, we might feel that we can reap spiritual benefits that a set of instructions and morale relating to food can offer by following the advice of certain social media influencers.

Wow! I am particularly interested in two expressions you used: “salvation” and “food logic”. What do you mean when you say “salvation”, and what exactly are “food logics”? 

Salvation is to be understood very broadly here: It could be in relation to something that transcends existence on this earth or in this life, such as salvation for the soul. But it could also be seen as salvation for the body and mind in the very “secular” sense of physical and mental health during one’s life, or as working towards salvation for non-human animals, the ecosystem, and so forth.

Someone’s “food logic” is their belief system regarding which foods are allowed, which are forbidden and how you should prepare and consume them to find salvation. These systems are very diverse and the rationale behind them is often quite arbitrary, drawing from theological dogma to scientific studies - which themselves very often have other studies opposing them, stating the exact opposite.

In relation to current food trends, salvation is usually connected to physical and mental health or the protection of nonhuman animals and planet earth.

What do you think is it about these mostly arbitrary food rules advertised online that appeals to people?

Well, in order to live, all of us have to figure out what food to consume and how. Especially since the industrialization of food production resulted in drawbacks like health concerns and environmental problems, people are looking for guidance as to what to eat. Some people do so mostly unconsciously, while others are extremely conscious of these things. Most of us stand between these two extremes.

Having someone tell us how to live and eat provides us with the understanding that we are doing what is considered “good” or “correct” - if only by social media influencers.

This is such an important point, because one big message of the Health At Every Size and Intuitive Eating philosophies that I myself subscribe to personally and professionally is the idea that there are no “good” or “bad” foods, but that all foods can and must fit into a balanced diet. Do you have any further insight into the morality or moral values we ascribe to foods? 

I didn’t assess which “food logics” are better or worse for an individual in my work, so from the perspective of a researcher, this philosophy, too, is just one among many.

That said, what I did find is that the separation between “good” and “bad” foods is, in most cases, synonymous to “clean” and “unclean” foods. Consuming something deemed “unclean” can make us feel like a failure and as if we are self-sabotaging: for example sabotaging our progress in building muscle, or sabotaging our self-image of someone who does the morally right thing by refraining from drinking milk.

Those of us trying to free ourselves from eating disorders in particular have to learn how to comfortably be around food and consume it. Your philosophy of not judging foods as “good” or “bad” could most certainly be helpful to people in this situation.

I see. Science aside, what’s your personal view on these matters? 

As long as neither physical nor psychological suffering results from following a certain “food logic”, I think we are doing fine. I think the more diverse the spectrum of foods one eats, the less one is prone to suffering.

However, there are certainly differences between “food logics” that lead to suffering very easily and those that usually won’t (except, obviously, to the suffering of nonhuman animals).

Personally, I’ve dabbled in veganism and vegetarianism, but I’ve always tried to balance my desire to help animals with caring for my own mental health and physical well-being. These days, I do my best to keep the consumption of animal products low, but I don’t believe I am “bad” whenever I do choose to eat cheese, for example.

Ultimately, it is very important to question moral statements surrounding food and doubt “food logics” you encounter. Definitely don’t just follow a set of food rules because influencer X has 80k followers.

One finding of my thesis was that influencers are mainly this successful, because they symbolize conscious or subconscious desires of their followers. One important question we can ask ourselves, therefore, is why one “food logic” is more appealing or more sensible to us than another.

How did you get into researching the connection between dieting and religious behaviour?

I was initially interested in looking at the religious aspects of dietary phenomena, because I noticed how people who follow dietary concepts or rules very strictly, for example vegans or those with an extreme interest in “healthy” eating, were often described as being “religious” or “extremist”. I really wanted to get to the roots of why people see how someone eats as their religion.

And why do you think that is? 

Complex religious systems such as Christianity or Islam (used to) regulate and guide almost every single aspect of human life; they have specific dietary rules and restrictions: Which foods are good for consumption and clean? Which foods are dirty and thereby deemed unfit for consumption? When should one fast, for how long?

Those believers who follow these rules very strictly are typically viewed as very religious or firm believers. Further, food is and has been used to symbolize body parts of deities, it has been and it is still being sacrificed.

Most certainly, food has always meant more than mere sustentation:

It is a means to regulate time by marking certain points in a day, a month, a week or a year. It plays a big role in constituting who belongs to a social group and who doesn’t. And, in most cases, its correct preparation, consumption or sacrifice is meant to lead a single person or community to salvation.

For all of these reasons, I think it is no wonder that people use food and diets as tools or instruments to tackle the big questions of life.

How To React When Someone Gets Angry At You

Dealing with someone else's irrational or over-the-top anger can be incredibly exhausting, frustrating, and even dangerous.

Whether it is your highly dependent adult child who is angry at you for doing something that inconveniences them, or your partner who might get angry at you for taking a different approach with your highly dependent adult child than they would have, here are five steps to take when the situation is heating up beyond your comfort level:

1. Remain calm. Your stress levels and anxiety might be rising, but if you manage to counterbalance their negative emotions, the situation is less likely to escalate. You can use gestures such as stepping back and lifting both hands to signal that you aren't interested in a fight. 

2. Make sure you are safe. As soon as you sense that things could get out of hand and become physically dangerous, leave immediately if you can. If you can handle the situation or are unable to leave, proceed to step three. 

3. Clarify why they are angry. If you know why they got mad, you can say something like: "Wow, you're really mad at me." Or: "I hear you, you're really upset about this change in routine." If you don't know what triggered their outburst, try to establish what exactly they are angry about, for example by saying something like: “I hear what you’re saying. Let me see if I got it right. You’re upset because ____.” It is important to let them finish their explanation without interrupting them or talking over them. Do not try to punish or correct their behaviour, and try to consider what your dependent adult child is trying to tell you instead. Think bottom of the iceberg (unmet need) instead of tip (audible accusation).

4. Postpone the conversation. Tell them that you are not interested in getting into a fight and reassure them that the situation they are unhappy about can be resolved. If possible, create some physical distance between you two, for example by suggesting one of you go for a walk. 

5. Get help. If you can at all, reach out for help about this. Ask your family or friends to support you, consult with a counsellor like myself, and certainly call the police or a local domestic violence helpline for ideas if you are being verbally or physically abused on the regular. 

What have you tried in the past when you were exposed to someone's anger? Was it helpful?

I'd love to know - message me, if you want! 

Talk soon,

PSA: Smoking Weed Legally In Canada Will Earn You A U.S. Travel Ban

It's hard to believe, but this piece of news was just released a couple of days ago: 

Canadians who smoke marijuana legally, or work or invest in the industry, will be barred from entering the United States

Say what?!

Obviously, you still won't be able to bring cannabis across the border after October 17th, but policing who can enter the country based on what legal choices they make elsewhere seems a little harsh, no?

No matter where you live, if you are currently using cannabis or planning on doing so in the future, you might be interested in taking a look at these lower risk use guidelines.

In essence, they say that not using cannabis is healthier than using it, that no one under 23 years of age should use it, that very infrequent use is best (and pregnant and breastfeeding women shouldn't use it), and that you shouldn't be driving under the influence. And, of course, that if you have a family history of substance use or mental illness, you're at a higher risk of negative consequences from using cannabis.

In other news, I have restructured my website so that...

  • all the freebies are now easier to find (the webinars, my email mini course, and my substance use workbook

  • my forms can be accessed hassle-free and 

  • my services are updated and easy to find and 

  • the book now button is finally in the top right corner, where it should have been from the beginning! 

That's all for now, I think? 

Have a nice weekend and let's talk soon,

How To Redefine Health In Recovery

Today I wanted to ask you the following question: 

What would it take to redefine "health" in a way that is helpful to your recovery?

Rather than focusing on the purely physiological aspects of the word, I suggest the following: 

Try to think of health as a state of overall wellbeing.

Personally, when I am thinking of a state of wellbeing, I am thinking of a state of joy and presence in the moment that allows for meaningful interaction with others; a state that allows for room for thoughts aside from food, alcohol and substances.

What does a state of wholesome wellbeing mean to you?

And, with that definition in mind:

What small action could you take today that will improve your overall wellbeing? 

If you have a few minutes, try to list five or ten doable action steps, and then see if any of those sound appealing right now. 

After tonight, keep the list for the coming weeks and and add to it whenever inspiration strikes.

And before you're getting too hard on yourself, remember:

Whatever works in the short term that isn't causing problems in the long term is a good strategy!  

The Co-Dependency Myth

Over the past month, I have heard "co-dependency" way too often. 

Somehow, the idea that supportive family and friends of people who struggle with substance use "enable" them and are "co-dependent" just won't go away. 

What is wrong with the C-word?

Firstly, it is informed by the idea that addiction is a disease, which is flat out untrue. Addiction is a bio-psycho-social phenomenon with elements of oppression.

Secondly, it implies that family members and partners actively work towards keeping the user in their addiction, which, if you ask anyone who has ever had a loved one struggle with alcohol, substance abuse or an eating disorder, is very, very far from true. 

Thirdly, it thereby stigmatizes not only the user, but also their support system as defective, when really, the opposite is true.  Time and time again, stigmatizing people and calling them names has proven to be harmful and produce adverse effects.

Someone who is working hard at keeping their loved one safe deserves praise, not contempt. 

What is, unfortunately, typically called "enabling behaviour" - providing people with love and attention, a place to live, perhaps Naltrexone and an opportunity to safely use drugs, for example - are really evidence-based strategies that we know to use in publicly funded harm reduction efforts: They significantly reduce the number of overdose deaths and actually help people who struggle with problematic substance use cope better in life. 

Whether we are talking about people in recovery from eating disorders or substance use - the tough love approach doesn't work. Instead, family-based treatment is recommended wherever possible. In fact, it doesn't matter which or how many family members show up, as long as they do, even if the person who is struggling is the only one NOT attending counselling.

Why? Because it has been shown that there is a ripple effect of positive change within social systems.  

And here is another important aspect of the debate:

Most often, caregivers are women. Labelling them as cognitively defective for fulfilling the role that society forces on them is devaluing and anti-feminist.

Expecting wives, lovers, mothers, sisters, aunts, and best friends to detach from from their partners and children in distress, while at the same time being "good" and "respectable" women is asking the impossible.

Of course, family members are not typically trained in addictions counselling, and even when they are, they are ill-equipped to counsel loved ones.

Rather than casting blame, we should utilize the knowledge and support loved ones can offer for the benefit of treatment. 

Just like people who display what we would consider problematic behaviours, their family members already feel bad enough. Labelling and stigmatizing them will not help, but rather perpetuate the problem. 

As practitioners, we are in the best possible position to talk with people rather than about them.

Annina Schmid

Cannabis Use In Pregnancy Isn't Safe

I recently attended an excellent presentation on substance use in pregnancy, which was held by Dr. Erin Lurie, addiction medicine fellow at the University of Toronto and staff member at the Substance Use in Pregnancy Clinic (SUP) at St Michael’s Hospital.

Dr. Lurie's presentation was part of a series of educational events called Addiction Rounds facilitated by CAMH.

If you are interested, you can find out more about these and similar events through the EEnet connect  events calendar.

Of the issues that Dr. Lurie discussed, I personally found her research update on cannabis use in pregnancy most fascinating. 

With the pending legalization of Cannabis in Ontario, I thought it could be helpful to share some of her findings in this newsletter.  

Below, please find an interview with Dr. Lurie on substance use in pregnancy and while breastfeeding:

Dr. Lurie, as someone who is directly involved in medical work with women who use alcohol, cannabis or heroin in pregnancy and while breastfeeding, what is the most important thing you would like us to know about your area of expertise?

The most important thing to know is that any active substance use in breastfeeding has the potential to be harmful. It sounds like a bit of a hard line, but the risk is really both with the exposure of the specific substance through the breastmilk as well as the risk of caring for a young newborn and infant while intoxicated. While we do not have great Canadian guidelines on substance exposure and breastfeeding, the American Academy of Breastfeeding Medicine has excellent guidelines on the issue.

Thank you for pointing that out. In my experience, most people focus on substance use during pregnancy and hardly ever talk about substance use when breastfeeding - other than, perhaps, when they try to play down the risk of alcohol consumption during that time. Specifically with regards to cannabis use, what is it that people need to be aware of in this context?

With the upcoming legalization of cannabis it’s important to point out that there is NO safe timeline after use for exposure with breastfeeding.

Meaning that even if we were to smoke at the end of the day, it would not be safe to breastfeed the next morning?

Correct. THC is the psychoactive component of cannabis. It stays in the body for a very long time: up to 48 hours in infrequent users, and in chronic users or people who use nearly daily even up to four days. THC also likes to store in fatty tissue, and breast milk, especially early on, is very very fatty. THC has been shown to be concentrated in breast milk and be up to eight times the amount that would be in the same person’s bloodstream.

Wow! And with regard to cannabis use in pregnancy - what would you tell those that advertise cannabis as anti-nauseant?

Well, we know that both the Society of Obstetricians and Gynaecologists of Canada, as well as the American College of Obstetricians and Gynaecologists recommend to abstain from cannabis use during pregnancy in their 2017 guidelines. This is because it has been shown that some of the risks of prenatal exposure to cannabis include decreased fetal growth, preterm birth, miscarriage, stillbirth, and significant long-term neurobehavioural changes. The latter have been documented by the Canadian Centre on Substance Use and Addiction [see infographic below] and can impact children and young adults up to 22 years of age.  

So, when we compare all of this to the effects of opiate replacement therapies during pregnancy and while breastfeeding, is it safe to say that the negative effects of alcohol or cannabis use are actually much worse for the child, both long-term and short-term, than, say of Methadone?

Correct. In the absence of any other substance use, opiate replacement therapy - including Methadone and Suboxone - is very safe, and even protective to prevent neonatal abstinence syndrome (the withdrawal a baby experiences when they are no longer exposed to opiates from the mom after delivery). For women who are stable in their recovery from opiates, breastfeeding is encouraged.

Thank you so much for taking the time to answer these questions, Dr. Lurie. 

As always, I hope this article has been helpful to you. 

Annina Schmid

The Substance Use in Pregnancy Clinic (SUP)
at St Michael’s Hospital is open to referrals:

St. James Town Health Centre
410 Sherbourne St., 1st Floor
Open Wednesdays 12:00 – 4:00

Using a multidisciplinary health care model, the clinic helps to support women with previous or active substance use throughout their pregnancy

Patients can be seen within the week and can drop in for their first appointment.
Please email either Dr Lurie (luriee@smh.ca) or Dr Turner (turnersu@smh.ca) for referrals of pregnant patients only.