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, 
Annina 

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,
Annina

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,

Annina

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 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,
Annina

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,
Annina

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.

Warmly, 
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. 

Warmly,
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
416-864-3082
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.

New FREE Webinar: Intro To Intuitive Eating

You guys, I cannot even contain my excitement for this FREE webinar that Sarah Berneche (Anti-Diet RHN and certified Intuitive Eating Counsellor) and I have recorded yesterday!

I am not kidding when I say this should be mandatory viewing for absolutely everyone who has ever thought twice about food - I promise you will not be disappointed.

What we talk about here is exactly what we talk about in session with clients (minus, of course, the individualized care and support).

If you are willing to dedicate about an hour of your time anytime after September 3rd, this is an excellent way to spend it.

Simply register your name and email address here and wait for the thing to be delivered to your inbox on Monday, September 3rd, at 12pm EST. (Feel free to share this email or link with your friends and colleagues, too!) 

This is the first of a few upcoming webinars this Fall, and I will keep you posted about all of them, of course. <3

The Recovery Benefits Of Filtered Messages

Aligning our actions and speech with our true feelings and thoughts will work wonders in recovery. 

In today's blog post, I want to focus on a difficult scenario - such as an argument with someone we like - and how we could handle that in recovery.

Most likely, when we're in a bad place with ourselves, we tend to accuse and blame others in arguments. 

Or maybe we're the type of person who chooses to walk away from unpleasant exchanges. 

Whether we argue or take off, though, there will come a moment after the fact when we will be alone with our feelings.

Most probably, we won't feel too great about how we handled ourselves. 

We might feel extra bad, because we were being hurtful on purpose.

Enraged, we might have said exactly what came to our minds, unfiltered and fuelled by disappointment or resentment.

Or, if we chose to walk away, we might feel worse, because the problem at hand is still unresolved. 

 

Another Approach: The Filtered Message

As a third option, aside from sharing unfiltered opinions and walking away from discomfort, I would like to introduce the filtered message.

Filtering our messages is often helpful to our own peace of mind, and with that especially important in recovery.

Here are the basics of a filtered message, as explained in the following example: 

Tom has an argument with his partner Tim, during which Tim makes unfair assumptions. Tom is getting angrier and angrier, as Tim's comments hurt his feelings. Instead of leaving the situation without comment, which is the other idea that comes to Tom's mind, he decides to give Tim a piece of his mind: 

"You have no proof for any of this! Why do you keep making things up? You're an a*hole, Tim!" 

These are the thoughts that came to Tom's mind, exactly how he heard them in his head. Without thinking much, and because he was hurt, Tom attacks Tim back. The argument continues for a little while, with both of them cussing each other out and Tom leaving to get a drink at the bar in the end.

Had Tom chosen to send a filtered message instead, it could have read something like this: 

"I don't like listening to your accusations. They're untrue, but I don't have the energy to fight them at the moment. I will go home now, because I need space."  

Tom would have left the scene, upset, but proud of the fact that he was able to speak his truth in a way that did not perpetuate the argument.  

Think about a recent scenario where you said something unfiltered, and try to think of a filtered way to state how you felt, and how you could handle a similar situation going forward. 

It's important that your filtered statement focuses only on you and your experience of the moment; without casting blame on your partner, and also without passive-aggressive undertones.


Why are filtered messages helpful to your recovery? 

Filtered messages are helpful to your recovery, because: 

  • You won't have to "get rid of" bad feelings through problem behaviours, as there will be fewer or even no bad feelings at all after making a filtered statement
  • You will learn how to speak your truth in a way that is the least hurtful to people while staying true to yourself
  • You will get more comfortable with speaking your truth

Hope this was helpful! 

What Type Of Person Makes You Feel Most Comfortable?

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One thing I love about facilitating online groups is that so many interesting thoughts and view points are expressed by participants that lead to new insights for everyone. 

Most recently, the issue of going out for dinner came up, and how that can make those of us struggling with disordered eating or body image issues very uncomfortable.

(You could easily make up a similar scenario for someone trying to stay sober when all their friends are still drinking - navigating going out is *hard* in the beginning!) 

In our group discussion yesterday, we came to see that there tend to be two types of people:

Those who make us feel comfortable around food (or are okay with us not drinking) and those who don't or do so less (or aren't). 

My question for you tonight is:

What type of person does it take to make you feel relaxed?

No matter whether around food or in other anxiety-provoking social situations.

What are their qualities, behaviours and attitudes? 

List at least three features of the person that puts you most at ease. If you don't have such a person in your life at the moment, make one up: What would they need to say or do so you could feel calmer?

Lastly, if you can at all, surround yourself with those helpful actions and attitudes more often. <3

Talk soon,
Annina

Self-Compassion vs. Self-Criticism

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Today I wanted to provide you with two little thought experiments to try at home:

One revolves around your needs, the other around your thoughts.

Both are easy to try whenever you remember to do so. 


Choose your choice!


The first one goes like this: 

When someone asks you what you would like to do, see, try, etc., try not to respond with "I'm easy", "You choose", or "I don't care either way." 

Instead, take the question seriously and try to really think about which option you would prefer. 

Then, state your preference and see what happens

  
Self-Criticism vs. Self-Compassion


The second experiment is a little more subtle, but even more important. 

Pick literally any event, instance, or situation that happened to you today or yesterday, and compare and contrast two reactions to it: 

The self-critical response vs. the self-compassionate response.

Try it:

Let's say you missed the bus. 

The self-critical way of thinking would go something like:

"Why am I always late?! This is the third time in the last couple of weeks that I took too long to get out of bed in the morning. Everybody else has their act together and I'm the only one who can't even leave the house at the right time!"

Not so nice, is it? 

Now try the self-compassionate response instead: 

"Ok, I missed the bus again. I guess I must be really exhausted, considering how hard it is for me to get out of bed at the moment. I really deserve a break. Perhaps I could take some days off?"

So much kinder! 

And the best part is:

This works with literally any situation. 

Have a kind day and talk soon, 
Annina

How To Help A Family Member In Recovery

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What to do when one of your family members, a partner or close friend is struggling with an addiction or eating disorder? 

You might be surprised to hear that about one third of my clients are not personally in recovery, but coming to see me because they want to learn more about, for example, how growing up with a person who drank problematically impacts them every day as an adult.

Or why it is so hard to see a sibling smoke too much weed.

Or why their sister's eating disorder just won't go away.

I touched briefly on this topic in one of my last emails to you, The Role of Siblings.

What I didn't mention in that email is how important family support is in recovery. It is very, very important.

In fact, the importance of family support in recovery cannot be stressed enough.

Treatment outcomes are much better when even just one family member other than the person struggling agrees to seeing a counsellor, too.

They could see a different counsellor, or the same one, and could come to sessions together or separately - any involvement has proven to be more effective than no involvement. 

And the more family members participate, the better!

Ok, so aside from joining the family member in recovery in seeing a counsellor, what can we do when a loved one is struggling?  


Try the following six steps: 
 

  1. Before all else, make self-care a priority.
  2. Learn about the substances and mental health problems your loved one struggles with.
  3. Don't let them abuse or hurt you or put you in danger. Ever. (If this is difficult for you, consider attending my boundaries workshop on November 14th in Toronto.)
  4. Help your affected family member become as independent as possiblein everyday life.
  5. Guide them towards appropriate community resources and treatment options and help them make use of those as best as you can - for example by becoming an accountability partner.
  6. When disagreement arises about which next step to take, work towards a compromise and find a way forward that all family members can agree with - including the member who struggles.

 

Let me know if you have any questions about these steps, I would be happy to answer them.

And if you have a friend who could find this information helpful, please feel free to forward it to them, too.

Webinar Replay Now Available!

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This is just a quick note to let you know that the replay of the free webinar I recorded last week is now available - all you need to do to watch is click the link. 

I know it says that it's for parents, but that's really not true - any woman who has struggled with emotional eating or binge eating will be able to relate to the content of our discussion and hopefully also gain some new insights around not only why diets don't work, but why they are flat out harmful.

At the beginning, Olivia - whom I would hire as postpartum therapist any day, by the way - talks a little bit about her own traumatic experience with dieting (it literally almost killed her... consider this your trigger warning!). 

Then, we dive right into the mindfuck that is living in a culture that wants to make money off our fear of being or becoming fat.

The struggle is real!

If you're interested in how Olivia and I approach those subjects, feel free to watch us in action here

And if our talk raises further questions for you, do let me know, I'm always happy to help.

Talk soon,
Annina

P.S. Do you know another woman/ mom/ caregiver who might be interested in this webinar? Please feel free to share the feminist love and forward them this email. <3