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Mental illness, homelessness, and a family’s years-long search for their lost brother.
Wendy Hill-Tout doesn’t like being in the spotlight, but that’s where she finds herself these days. With her new documentary, Insanity, she shines a light on families coping with the severe and persistent mental illness of a loved one lost to homelessness. Sharing the camera’s attention are her siblings, who recount their lives with their brother, Bruce, as he struggled with schizophrenia until his disappearance 25 years ago.
Wherever the Canadian filmmaker’s North American travels take her, she searches the faces of unhoused people, looking for her brother. The photos she carries, bearded and clean-shaven, are shown to anyone who might recognize him. Her quest brings her to the alleys and tent cities that have become points of refuge for those the system has failed. The various homeless encampments the film documents show the scale of the problem and make it clear that Bruce’s face is just one among so many others.
Insanity shares the stories of families caught up in a system that doesn’t support individuals who are either not sick enough to get help or unable to access support while they are housed. In one example, Shirley Chan, a board member for the Pathways Serious Mental Illness Society, has desperately been trying to find the right support for her daughter. After being told that she was “too high functioning” to qualify for housing with the 24-hour support she needed, Chan discovered that the only way to obtain it was to refuse to bring her home the next time she was discharged from the hospital. Her daughter had to be homeless to become a priority.
Another instance shows Tyler, the youngest brother of Kristin Booth, a colleague Hill-Tout met while working on a different film. Tyler had been living on the street in Ontario when he was arrested after suffering a manic episode. Six weeks later, while on probation and living on his mother’s property, Booth recounts the trauma of lying to her brother to keep him on the premises so the Toronto police could collect him. Her voice cracks as she recounts the guilt of having to watch him be cuffed and taken away, breaking down at the impossible situation she found herself in. Even with the support of a lawyer and physician, she still couldn’t get Tyler the help he needed.
“What do other families do?” Karen Booth, Kristin’s mother, asks. Her doctor, who can find no other solution, tells her, “Mrs. Booth, if it wasn’t for you, Tyler would be either be dead or under a bridge — or in prison. That’s just the way it is.” But she refuses to accept that.
Hill-Tout delicately weaves these stories into the film to illustrate how easy it is for someone living with mental illness to end up on the street or get caught up in the criminal justice system. As she says during our Zoom interview while in Calgary, it is unacceptable that so many people are without help in a wealthy nation like Canada.
Wendy Hill-Tout
“Our system needs a major overhaul,” she says. “The first step would be to increase mental health care spending from where it’s at [seven per cent of total health-care spending] to 10 per cent like in European countries. We need to create more community mental health services to help people with mental health concerns before they’re in crisis. Imagine if we had specialized mental health clinics, so people would have somewhere they knew they could go and speak with specially trained doctors and nurses to connect them with appropriate services. Why is it the default to go straight to the hospital or ask someone in crisis to wait six months for services?” she asks.
Other issues to address include the lack of psychologists and psychiatrists, supportive housing, and access to services, Hill-Tout notes, adding that Canada needs to start somewhere, and increasing mental health funding is a good place to get the ball rolling.
What shocked her most during the project was how much more pronounced the problem became in a short time. “When we began filming in 2019, we would go to a city and hope to find someone on the street to show Bruce’s photo to. But before long, we were being confronted with tent cities — and it was happening everywhere — not just in Vancouver’s Downtown Eastside. The number of people on the street increased in both big and smaller cities.
“We need to do something urgently because we can change this,” she says with quiet conviction. “Instead of spending money on policing the problem, we should prevent it. So many people with mental illness are one breakdown from becoming homeless. How do you get back into housing once you’ve lost it? We need more community services along the way to prevent this from happening in the first place.”
She hopes that her documentary reaches the right people in government who have the power to enact the needed change, whether they’re municipal, provincial, or federal officials. This issue impacts more than one in five people who will experience a mental health problem during their life. It also spreads out across friends and families, and they’re the reason she made this film.
“It still surprises me how raw it is to talk about Bruce even after 25 years,” Hill-Tout says, toward the end of our time together. That emotion is also apparent in the film as her siblings share touching stories about their brother. They laugh together, but their memories have an undercurrent of sadness. And through their accounts, we learn that Bruce was the eldest of four children, thoughtful, funny, and warm-hearted, as well as being an artist and a bit of a daredevil at times.
“Bruce was the best person I’ve ever known,” her brother David said, “He was a really great big brother, and he’s worth fighting for.”
As hard as it is to revisit what led to Bruce’s disappearance, it’s important to put a name and face to the problem. Once society sees the people the system has failed as individuals loved and missed by their families, they are more inclined to push for change. Society is more likely to care for them.
It’s not all bad, though, as Hill-Tout points out. Some things give her hope for the future. For one, a greater general awareness of mental health and illnesses exists. The press now reports on people experiencing homelessness and how cities are handling the issue. There are also more police officers and first responders taking training on how to handle mental health calls. As well, there are more mobile mental health crisis units like Car 87 in British Columbia (compared to 10 years ago) — although these units cannot keep up with the current demand, so increased funding is still needed.
In the meantime, Hill-Tout and her family remain hopeful that they’ll find Bruce. She continues to search faces for one she’ll recognize after so many years. Maybe an audience member will recognize him after watching the documentary. Either way, her final message to me is the same one repeated in the film.
“Bruce, you are loved.”
Insanity will play at select screens in theatres nationwide starting May 11, 2023, with Q&As from Hill-Tout and other families featured in the documentary. Get more information and find out if it’s coming to a theatre near you at www.insanitydoc.com.
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It’s also around you: storms, fires, catastrophe — the intersections between climate and mental health — and what you can do about it.
In March, a small group gathered along the Rideau Canal in an act of collective mourning. It hadn’t been cold enough to keep the eight kilometre stretch frozen, so the iconic skateway would stay closed for the year. The vigil — organized by the Ecology Ottawa non-profit — gave people a chance to come together and animate discussions on climate change and loss. They would meet on the canal edge, frozen in time on so many postcards and in travelogues, to “be with our uncertainty, not knowing what will happen in the years to come,” as the e-vite put it.
Bringing the global reality of a changing climate close to home — and realizing some of the things we may no longer be able to do — helps us to ground a head-spinning catastrophic concept that can bring up feelings of grief, anxiety, and uncertainty.
But as opinion writer Trish Audette-Longo asked in Canada’s National Observer, could it also be a call to action? “On a scale of climate disasters, in which our collective attention necessarily focuses on the uneven impacts of wildfires, floods, and a range of other losses, one missed season on the Rideau Canal Skateway can register as a footnote for the history books,” she wrote, noting that an apocalyptic focus can eclipse the potential to envision alternative futures.
In other words, instead of imagining far-off idealized or end-of-time scenarios, what can we do right now?
Putting the mental in environmental
The umbrella term eco-anxiety is used to describe a number of emotional and mental states linked to a heightened awareness of climate change and concurrent distress in the face of its threatening implications for the future.
Defined by the American Psychological Association as a “chronic fear of environmental doom,” it manifests as anger, exhaustion, phobia, and despair. It can show up as flash-forwards, nightmares, and even “climate orthorexia,” which Britt Wray describes in Generation Dread: Finding Purpose in an Age of Climate Crisis as “an obsession with eating ‘clean’ for the sake of the environment.”
People in regions plagued by extreme weather usually experience elevated levels of climate-related fear and sadness (as will those living with the consequences for years to come). Two out of three respondents in a landmark Nature survey (10,000 people, ages 16 to 25, across 10 countries) reported having such experiences. Meanwhile, the Intergovernmental Panel on Climate Change included mental health consequences arising out of environmental catastrophes as part of its 2022 assessment report.
While eco-anxiety is not a term listed in the DSM-5, there is plenty of developing research in the field, nicely summarized by the headline in a University of Helsinki article — “Understanding the Mental in Environmental” — featuring the work of Panu Pihkala, an adjunct professor of eco-theology. Pihkala refers to one clinical intervention as “binocular vision;” meaning therapists help clients see that numerous bad and good things can co-exist (instead of black-and-white catastrophizing).
Fostering this sense of inner resilience was among five themes that emerged from a 2021 scoping review by Pauline Baudon and Liza Jachens on the treatment of eco-anxiety. The study appeared in a special issue of the International Journal of Environmental Research and Public Health about the psychological impacts of climate change. Apart from practitioners’ inner work and education, the other themes included encouraging clients to take action, connecting them with nature, and helping them find social connection and emotional support by joining groups.
After looking at various schools of thought, the review found that all approaches emphasized the value of group work as a way to support emotional processing and the ability to connect one’s inner experience of eco-anxiety to that of others and to broader social themes.
Gallows humour?
One form of group therapy involves taking an unfunny topic and giving it a lighter touch. In a March Guardian article called “How Do You Laugh About Death?” for instance, comedians tackle climate change as a gateway to address heavy themes or to try to bridge political polarities or talk to deniers. Participants in the Climate Comedy Cohort, a nine-month fellowship from American University’s Center for Media and Social Impact and the non-profit Generation180, develop shorts and pitch ideas to TV networks on intersecting issues about race and labour. The goal is to talk about climate — even irreverently — to boost civic engagement — something that, for many, can be a more motivating force for change than doom. For those not at the ha-ha stage, Carbon Conversations (in cities around the world) help people face their worries about climate change and stay engaged and ecologically motivated to act and make enduring lifestyle changes.
Perhaps you’ve made yours — say, with reusable bags and portable water bottles. While these have their place, such small lifestyle changes make me think about cruel optimism, a concept coined by University of Chicago cultural theorist Lauren Berlant. It means taking systemic problems with deep-rooted causes, like depression or obesity, and offering people a simplistic individual solution, usually in peppy language. While it sounds lovely because you’re telling them this massive issue can be solved, it is in fact cruel because the solution conceals deeper causes through neoliberal self-control narratives like engaging in healthy lifestyles or taking out gym memberships, which actually direct people’s attention away from the main concern and delay potential answers. To have effective solutions on global warming, we need our conversation and actions to move in time with the ticking climate clock.
Collectivist approaches
While those individual choices can add up — the neoliberal-only view can mean missing the forest for the trees.
As University of Toronto political science professor and Munk School environmental lab co-director Matt Hoffman told the Toronto Star, there needs to be a societal shift to make climate change an issue across party lines. Individuals can take their concerns to elected officials, the ballot box, and the bank (to encourage fossil fuel free investing, for example). These are things that individuals can do to apply pressure upward and achieve more systemic changes.
A way of combining hope and action can be seen in the Solutions section in The Narwhal, a Canadian non-profit environmental news outlet. The series profiles people and communities who are responding in real time to “broken regulatory systems [by] generating ideas for cleaner communities, and re-envisioning natural resource development.” The stories aim to inspire by looking at root problems and what is being done to fix them. Topics include renewable energy, the revitalization of Canada’s environmental laws, and ideas on daily living.
There is also a role for grief as we all face the results of a changing climate. What we choose to grieve can illuminate our fundamental dependency on healthy and thriving ecosystems — as well as the political and ethical responsibilities we have to such systems, to each other, and to our need to act. This was one finding from a 2020 article, called “You Can Never Replace the Caribou: Inuit Experiences of Ecological Grief From Caribou Declines.” In it, lead author Ashlee Cunsolo points to collectivist approaches — a “we-creating capacity” — that recalls our connections to others and our responsibility to mitigate human-induced environmental degradation.
Fateema Sayani
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How compassionate health care can alter the trajectories of people who use substances.
Jes Besharah doesn’t remember how long they’d been living on the street and using opioids by the time they sought medical care, but they remember being in bad shape.
“I was sick, I was hurt, I was crying, I had abscesses and wounds all over my body. I had many needs that needed to be addressed,” they say. But when the nurse came in and looked Besharah up and down, all she saw was a drug user.
“We didn’t take care of anything at all. She told me she would pray for me, and that was the best she could do.”
For Besharah, it was a crushing response. “It just makes it seem like there’s no point in trying when that’s the answer that you’re met with.”
Unfortunately, Besharah isn’t alone. People who use opioids and other substances often encounter stigmatizing attitudes and discrimination, including from the health-care workers they turn to for care.
The Mental Health Commission of Canada (MHCC) invited Besharah to share their experiences of stigma and its impact in a video called Use Your Voice — Reducing Stigma Toward People Who Use Substances.
“For people who use opioids and other substances, stigma can be a powerful barrier to seeking and receiving quality care,” says Julia Armstrong, manager of MHCC’s mental health and substance use health team. “We created this video (and discussion guide) to start important conversations about stigma in health-care settings — the kind of conversations that lead to better understanding and a higher standard of care for these individuals.”
The video also features the nurse that helped change Besharah’s life — Melinda Billett.
As a primary care nurse practitioner, Billett has had years of experience supporting people who use substances. She has also seen first-hand how small choices can have a powerful ripple effect.
“In health care we can make the choice to treat people with respect,” she says, for example in the notes providers make in a patient’s file. “That’s my voice that someone else is going to read. So, I can choose to say that this person is a drug addict, or I can choose to say this is a person who uses substances.”
In making that small change, Billett is drawing on the power of person-first language, which can help distinguish who someone is from the substances they use or the mental illness they live with.
While both describe other changes that health-care workers — and anyone interacting with people who use substances — can make to help curb stigma, every example comes back to one overarching message: treat individuals who use substances as people, not problems.
Besharah credits the compassion they received from Billett and others for the life they lead today, working as a community harm reduction support navigator and peer support worker. “Part of the reason that I do it is because, when I was on the streets, there were people doing outreach that didn’t judge me, that cared about me, that would go out of their way to make sure that I was still around,” they explain. “That made a huge difference in me wanting to take back control of my life.”
Billett emphasizes that people who use substances have a great deal of inner resilience, and it’s up to health-care providers at every level to recognize it. “If we can tap into that, and be kind to them, and care for them and meet them where they’re at . . . then those things together is what can help change the trajectory of someone’s path.”
Amber St. Louis
Estimated reading time: 3 minutes
Discover the voices of lived experience and get access to resources, information, tips, and tools to support your mental health.
UVic Student Mental Health Blog
https://onlineacademiccommunity.uvic.ca/studentmentalhealth/
Dedicated to promoting positive mental health and reducing stigma. UVic students share their personal stories and tips for maintaining wellness. Learn ways to increase your happiness and wellbeing and decrease your stress as you navigate life as a student.
Mind your mind
Mindyourmind exists in the space where mental health, wellness, engagement and technology meet. We work with young people aged 14 to 29 to co-create interactive tools and innovative resources to build capacity and resilience.
Youth Smart
CMHA Calgary’s YouthSMART (Youth Supporting Mental Health and Resiliency Together) integrates collaborative, youth-initiated mental health learning opportunities in local junior and senior high schools.
Generation Mental Health
https://www.generationmentalhealth.org/blog
GenMH is improving the future for those living with mental ill-health through capacity building and
empowering youth with lived experience.
The Student Minds Blog
https://www.studentmindsblog.co.uk/p/explore-blog.html
Students and recent graduates sharing personal experiences with specific mental health difficulties, the actions they are taking to create change and how to tackle different challenges at university and navigate university and graduate life
Black Mental Health Canada
https://blackmentalhealth.ca/fr/blog/
Black Mental Health Canada (BMHC), est un organisme bénévole, sans but lucratif, basé sur la communauté, qui a été fondé en 2019 pour aider à répondre aux besoins en matière de santé mentale des diverses communautés noires du Canada.
Active Minds
https://www.activeminds.org/blog/
Through education, research, advocacy, and a focus on young adults ages 14–25, Active Minds is opening up the conversation about mental health and creating lasting change in the way mental health is talked about, cared for, and valued in the United States.
Francophone mental health blogs
Mindspace
https://www.mindspacewellbeing.com/fr/blogue/
Chez Mindspace, nous pensons que tout le monde gagne à entraîner son esprit, que ce soit pour améliorer sa santé mentale, améliorer son bien-être ou atteindre des objectifs de rendement élevés.
Black Mental Health Canada
https://blackmentalhealth.ca/fr/blog/
Black Mental Health Canada (BMHC), est un organisme bénévole, sans but lucratif, basé sur la communauté, qui a été fondé en 2019 pour aider à répondre aux besoins en matière de santé mentale des diverses communautés noires du Canada.
L’apogée
Nous avons créé un blogue dans le but d’informer, de démystifier et de sensibiliser différents sujets en lien avec la santé mentale.
Mouvement Santé Mentale Québec
https://mouvementsmq.ca/blogue/
Nous sommes le seul regroupement québécois d’organismes communautaires voué spécifiquement à la promotion et la prévention en santé mentale. Nous voulons outiller la population du Québec pour qu’elle développe et renforce sa santé mentale et pour en faire un projet collectif et social.
Mouvement Santé Mentale Québec Rive-Sud
https://www.smqrivesud.ca/blogue
La mission de Santé mentale Québec Rive-Sud est de promouvoir le bien-être des individus et de les aider à prévenir, rétablir et maintenir une bonne santé mentale par la réalisation d’activités de soutien auprès de toute la population.
Estimated reading time: 5 minutes
It seems I’m always trying to forge belonging, or fielding a gulf between myself and the community I grew up with. I feel deeply disconnected from my childhood friends and peers, cultural background, and family. My home base.
My roots.
This past year, I had a plan. I would return to school, find a job, and “settle down.” I would make myself belong.
I guess the way of the world doesn’t cow to our carefully calculated plans. I couldn’t find a job, and I decided to embrace the ether. I began to feel more like myself than I have in a long time.
Growing up was strange
I never felt at home, least of all with my family and our uncompromising codes of hard work and morality, the shame in mediocrity. My parents often said I don’t share their values, which although true, made me feel like more of a pariah in my own home. My parents worked harder than I’ve ever had to, locking down stability to support themselves, their parents, siblings and eventually our family.
I’ve never had to worry about those things because it was all done for me, out of devotion from parents who didn’t know me yet. Still, why am I so different? My siblings share similar goals as our parents and greater community. Why am I the way I am despite sharing DNA?
DNA isn’t the only thing that binds people. I grew up in the small microcosm that is the Pakistani community in Ottawa, which is emblematic of other Pakistani communities throughout the diaspora. We seek professions in stereotypical fields like science and engineering. Even law was considered too soft in my mom’s time (the 70s), and she opted for medicine instead.
I do have academic accomplishments that I am proud of, but it’s not enough. I went to college, I did liberal arts. I blog and draw as a side-hustle. I take photos for a living.
There’s always been something missing inside of me that alienates me from my community. I lack that desire to hunker down, sacrifice my time and freedom for a rewarding profession. Both of my parents had their own aspirations that were hacked at the heart by their parents. My dad was sent to Canada at 17 so he wouldn’t join the Pakistani air force, and my mom is a writer at heart, but her dreams have taken a backseat for decades as she fulfilled her parents’ dreams instead.
Why am I so selfish?
When I graduated from university I resolved that I was done studying for some elusive career on the horizon. Before long the realities of life crept unto me, and I felt the pressure. At some blurry point in time, I became obsessed with mirroring those around me, and felt inadequate because I hadn’t been seeking “more.”
The clarity that I once had about my life grew hazy, and soon it was entirely obscured by the desire to be someone I’m just not. I returned to school last fall to land myself a job that would render me established in the bubble that enclosed me and my world.
The truth is that I grew up surrounded by people I don’t fit in with, and I’ve always tried to mould myself into someone that does. I’ve tried to bury shame and un-belonging by forcing myself to exist harmoniously inside that bubble. Only recently I’ve realised that all this does is trap myself in a perpetual cycle of discomfort and alienation.
Sacred moments in nature
So, I reverted back to old habits. Jobless and jaded, I drove around Ontario for a few weeks. I followed the Group of Seven route from Toronto to Thunder Bay, retracing the hundred-and-some year old steps of the legendary Canadian artists’ along the highway, stopping at creeks and waterfalls and vistas that inspired the paintings that line the walls of Canadian galleries.
Nature has a profound effect on me. Taking in the sights surrounding me is almost transcendental. There’s nothing sacred about these moments, yet to me they are powerful moments in time that are intensely grounding. I sit on a rock mid-river, watching the water swirl around my feet, transfixed. I come to a sudden stop as a big brown owl swoops low over my car on a winding country road in broad daylight. A thousand kilometres away from home I stare into the blending of blues between Lake Superior and the sky as my rickety SUV teeters up the hills on the edge of Ontario.
My vision sharpened as I drove, the endless unfolding of scenery filling my cup which had been dry for so long I hadn’t even realised I was choking on the dregs. That clarity began to return.
I know a lot of the shame I feel is self-inflicted. Comparing yourself to others, while insidious, is a pretty human thing to do. I want my core circle to know that I can fit, even if the raw truth of it is that I don’t even want to. Letting go of the need to prove something to others is harder than I thought. I don’t want to cower anymore, haunted by shame, steeping in self-hatred. I want to grow and be the person I’m supposed to be.
It’s myself I need to win over, I see that now. And it’s hard to do when I stay rooted to a place that doesn’t nourish me, but deflates me as I am faced with displays of happiness that have never resonated with me.
So, this is what they mean when they say happiness is a choice. Spread your wings. Don’t be afraid of growth. Follow your heart. All those tacky cliches have been pretty meaningless to me until now, when I finally have enough perspective to understand them.
Either choice will bring hardship and happiness, but I owe it to myself to see my own dreams through.
Author: Aishah Khan
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Putting substance use on a spectrum creates a space for more open conversations about safer, healthier, more manageable consumption.
Part of the Mental Health Commission of Canada’s work involves education on the distinction between mental health and mental illness. Mental health — an aspect of overall health — exists on a spectrum we all share. One end of the spectrum reflects optimal mental health, while the other shows where mental illness or mental health problems occur. A spectrum model is also helpful when we talk about substance use.
What it means
Toward one end of the substance use health spectrum, a person might abstain entirely or engage in sporadic use without any adverse consequences. At the other end are substance use disorders with far-reaching effects on overall health and well-being. Depending on the circumstances and a multitude of factors, anyone can move along the spectrum at any time.
Why it matters
Due in part to a long history of criminalization and secrecy around drugs and alcohol, a negative undertone persists. This way of thinking may lead people to see all substance use as problematic. On the other hand, putting substance use on a sliding scale helps create a space for more open conversations about safer, healthier, more manageable consumption — whatever that looks like for each individual.
Reducing stigma around substance use is also an important part of fostering recovery. The less negatively we judge substance use, the more comfortable a person might be about disclosing a concern about their own or someone else’s situation. For someone struggling with substance use, understanding that they can achieve safer, healthier consumption without (or before) complete abstention can help instil hope when they need it most.
How you can use it
Adopting the term substance use health can challenge personal biases and binary thinking. Substance use isn’t black and white. It’s not about being addicted or abstaining entirely. There’s a wide, grey area of movement, nuance, and individual circumstances in between. As with all mental health, the way we think and talk about substance use matters. The better we understand the substance use health spectrum, the better we can support people through every stage of recovery.
Amber St. Louis
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What makes a funeral great? The good, the bad, and the gaudy of saying goodbye.
Perhaps it’s a sign of age, but I find myself at more funerals lately — and I’ve started to rate them. No, I’m not evaluating how much money was spent on the spread, flowers, casket, or urn. Let’s be honest, whether you had it catered or cajoled your friends into helping, egg salad sandwiches are egg salad sandwiches. I’ve never attended a funeral for the food. The thing I’m rating is whether the event gives me and those closest to the departed the opportunity to grieve.
I’m not looking for a maudlin affair, nor am I trying to make myself sadder. I just want to feel like I can say goodbye and perhaps learn a thing or two about the person who passed.
I expect funerals to be as diverse as the dead. Some are formal affairs with participants sharing whispered conversation in church pews. Others are more casual gatherings held in a pub while images of the departed run in a loop meant to recall happier times. Still others change locations, churches, gravesides, or pubs as the rituals of death are played out according to the desires of the departed or those left behind.
Ire and brimstone
I don’t have a preference, really. The activity just needs to do what it should to help people grieve. What doesn’t impress me is when things unrelated to the process of saying goodbye take centre stage. I’ve lost count of the number of times I’ve showed up for a funeral service only to find myself in the middle of sales pitch on the benefits of going to church. (The word “eternal” is used a lot.)
Don’t get me wrong. We’re a captive audience and I can see the appeal of making such an appeal. I also have no objections to a religious service. But I am repulsed when the official takes the opportunity to dominate the moment, make a political pitch, heap guilt on the unfaithful, chastise the living for their lack of attendance or, in one instance, silence family members who wanted to say a few words of farewell.
Low scores also happen when the business of funerals becomes too apparent. A good example is when the officiant hasn’t taken the time to learn the name of the departed and either mispronounces or forgets it all together. Those are jarring experiences that pull mourners out of the moment and force them to consider the transactional nature of the event.
Sometimes, of course, things go horribly wrong, like when the dearly departed gets misplaced or the wrong body is cremated. In one funeral I heard about, instead of the usual photos of the loved one running in the background, mourners were accidentally shown four minutes of porn. Give that funeral a zero.
An out-of-the-box affair
If I’m being fair, the failure is not always the down to the officials. Quite often, the mourners or attendees make the event one to remember for all the wrong reasons. I’ve yet to take a selfie at a funeral, but apparently that’s an increasingly popular activity. Then there are the brawlers and catcallers who see the funeral as a great place to start a fight or settle a score, because who doesn’t go to a funeral to catch a boxing match — the end point in some decades-long petty pileup of grievances between estranged family members?
In China, exotic dancers at funerals became so problematic that some cities had to intervene. If you’re wondering how this came about, it’s based on the idea that large crowds at funerals are a sign of good luck for the deceased in the afterlife. So, to draw more people, some organizers started to bring in dancers. Since children also attend these funerals, the whole thing is just hard to justify.
Sometimes I want to ask if they could take that somewhere else or save it for after the funeral. Unlike weddings, there is no dress rehearsal. That means people are often emotionally raw, numb, or overwhelmed. Grief is also very personal and has different outlets for different people. Some cry, some don’t. Some yell, and some sink into themselves. People grieve for a few weeks, months, or years, and different cultures, personalities, loved ones, or stages in life will also affect how and how long we grieve.
No matter what your grief “tenure” is, the funeral is often the start, and it’s frequently where people remind themselves of their social safety net. While a 2022 mixed methods review of the effect funeral practices have on bereaved relatives’ mental health and bereavement outcomes was inconclusive, qualitative research provides additional insight: the benefit of after-death rituals, including funerals, depends on the ability of the bereaved to shape those rituals and say goodbye in a way that is meaningful for them. Findings also highlight the important role of funeral officiants during the pandemic.
Funerals can be a tangible way to show support for the living. They may provide companionship during a difficult time and can be a fundamental part of how we mourn. But they should help us to process the loss and actualize a person’s death. If the thing I’m discussing as I drive away is the officiant’s fail or the fight out front, then the funeral is a flop. I don’t go for dinner and a show. I’m not trying to be converted. I go to get and give support.
Debra Yearwood
Illustration: Holly Craib
Estimated reading time: 3 minutes
Physical activity is not just beneficial for maintaining a healthy body, but also for improving mental health. In fact, research shows that exercise is one of the most effective tools to manage mental health issues like anxiety and depression. Even modest levels of physical activity or low-intensity exercise are beneficial.
Key benefits of physical activity for mental health:
Reduces stress and anxiety
Physical activity is a natural stress reliever. When you exercise, your body releases endorphins, which are feel-good chemicals that help reduce stress and anxiety. Regular exercise can also help reduce the levels of cortisol, the hormone that is released during stress. By reducing cortisol levels, exercise can help calm the mind and reduce feelings of anxiety.
Improves mood
Exercise can improve mood almost immediately by increasing the production of serotonin and dopamine, two chemicals in the brain that are associated with feelings of happiness and well-being. Regular exercise can also help reduce feelings of fatigue and improve energy levels, which can have a positive impact on mood.
Boosts self-esteem
Regular physical activity can help improve self-esteem and self-confidence. When you exercise, you are setting goals and achieving them, which can give you a sense of accomplishment and pride. Exercise can also help improve body image, which can lead to a more positive self-image.
Enhances cognitive function
Exercise has been shown to improve cognitive function, including memory, attention, and processing speed. Exercise increases blood flow to the brain, which helps supply oxygen and nutrients to the brain cells. Regular exercise can also increase the production of brain-derived neurotrophic factor (BDNF), a protein that is important for the growth and maintenance of brain cells.
Reduces symptoms of depression
Regular exercise has been shown to be as effective as medication for treating mild to moderate depression. Exercise increases the production of endorphins and serotonin, which can help improve mood and reduce feelings of depression. Engaging in exercise can also help increase social interaction, and reduce feelings of isolation which can have a positive impact on mental health.
Physical activity is an important aspect of maintaining good mental health. Regular exercise can help reduce stress and anxiety, improve mood, boost self-esteem, enhance cognitive function, and reduce symptoms of depression. Also, exercise is less costly and is free of the negative side effects that are common in drug therapies. So, whether it’s a daily walk, a yoga class, or even just moving more, incorporating physical activity into your routine can have a positive impact on your mental health.
Author: Caelie Townsend
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We ask practitioners for a reality check on the TV series about therapy, grief, and getting by.
With season one of the popular series wrapping soon, we’ve been following along as the main character Jimmy (Jason Segel) — in all his human fallibility — crosses boundaries with his clients, tries to process his grief, and leans on his fellow therapists, Gaby (Jessica Williams) and Paul (Harrison Ford), as they stumble through life’s ups, downs, and sideways trajectories. How does it end? Is everyone fully self-actualized? Does this kind of stuff happen in real life? We surveyed a few experts to get their take.
The three principal characters often debrief with each other after managing challenging client situations — a kind of rapport-building that happens in many workplaces. In this instance, it seems like the therapists have therapists. Is this a regular dynamic?
In short, absolutely. As a consultant, being in community is necessary to the human healing process.
A lot of therapists have naturally been drawn to this work because, just like our clients, we too are actively riding the ebbs and flows of the human experience: the joys and the pains. Part of what serves the authenticity of the therapeutic relationship is your therapist’s ability to hold space for all of you — both the pleasant and unpleasant experiences.
The truth is, it’s very difficult to hold space and support clients in compassionately witnessing their emotional injuries if we haven’t been willing to do the same for ourselves. This must be an embodied practice, a lifestyle that encourages our clients to show up for themselves while we actively engage in practices that also support us as practitioners. Doing that helps us develop and strengthen our emotional boundaries and promote safety, so that by taking care of our “stuff” it doesn’t interrupt or intrude on our client’s process.
This dynamic was often shown in different scenes with Jimmy, who “presented” as frustrated with his client’s pace of change. As the show progresses, we learn that he has been “numbing” (or shutting down) his emotions since the loss of his wife while struggling to connect with his grief.
Sara Smith is a registered psychotherapist with the Live Free Black Therapist Collective.
As a therapist, having a space where you are supported in seeing the most vulnerable parts of yourself allows you to show up for your clients as a human with lived experience who is ready and willing to walk alongside them on their healing journey.
I regularly access support from my peers and connect with my own therapist. An accessible connection with other colleagues while supporting clients who face challenges is integral to how we as therapists compassionately care for ourselves and others, including other therapists. When Jimmy lost his connection to Paul after a conflict, he really struggled.
In truth, I think this is a metaphor for life. We need each other, and we thrive when we have access to deep and meaningful connections with others where we can be seen, heard, and accepted. Viewing these interactions on screen was an important reminder of that.
Sara Smith is a registered psychotherapist with the Live Free Black Therapist Collective based in Toronto. She specializes in supporting adults in working through the far-reaching impacts of trauma on the mind and body. Sara’s approach is rooted in building embodied awareness, education, empowerment, and validating your experiences while working together to develop effective coping strategies to support your healing journey.
Those are nice offices with Architectural Digest-level ambitions and calming neutral tones. Are your offices that nice? What makes for a good therapeutic environment?
The offices that are depicted in Shrinking are very spacious and nicely decorated in neutral colours. The style they show is one school of thought for therapy offices: a blank canvas that leaves space for the client to think and imagine.
It is similar to the therapy offices shown in The Falcon and Winter Soldier, which is supposed to be a neutral space where the hand of the therapist is not seen at all. The goal of this style is to not reveal anything about the therapist to the client. In this case, the therapist is supposed to be a neutral party, almost not a person in the eyes of the client — they are a therapist, not a person in their own right.
While plenty of therapists follow such design choices — and might even go so far as to take off personal jewelry, such as a wedding ring or a “Best Dad” tie clip — others do the opposite. These therapists choose to show their style in how they decorate. They might stick up posters of favourite movies or show off collectible items. The idea here is to be a human to your clients and be on a journey with them.
This is the decor style I personally use. My goal is to have my clients know a bit about who I am when they look around the office and to start considering whether they’ll get along with me.
It will be interesting to see if Jimmy starts to change up the decor of his office to reflect his more open approach with his clients. Paul is very stoic and distant from those he works with, and keeping out personal elements makes sense for him. Gaby seems to be in the middle. Her overall office decor is quite neutral, although she has several personal touches that make it more hers than what we find with either Paul or Jimmy. Perhaps these changes will be shown in season two.
Dr. Megan Connell is a board-certified licenced psychologist, practising virtually in more than twenty states. She lives in Charlotte, North Carolina, is an avid geek and gamer, and is passionate about teaching others how to use role-playing games such as Dungeons & Dragons in therapy. Watch for her forthcoming book: Tabletop Role-Playing Therapy: A Guide for the Clinician Game Master (Norton, March 2023).
Compassion fatigue seems to be a through-line for each story. How do you manage this in your own life?
The show highlights our humanness and how we tend to put therapists on the “all knowing” pedestal. I remain aware that I am human, too. I’m not a guru and, with humility, I’m mindful of my own tendencies toward self-proclaimed pedestals. I guide as best I can and (frequently) remind myself that I can’t control the outcomes.
I have my own team of professionals and friends that I can debrief with and be in care of my own mental, physical, and emotional health. I’m also in tune with the times I need support, and I’m careful not to judge myself for sometimes feeling less-than. On the show, we witness Paul’s challenges in accepting support from his daughter, and this reminds us that sometimes the helper needs the help.
Boundaries are key, and we see this with Paul many times. When he says he’s not going to do something, there is no waffling or justifying. He knows his limits and honours them.
I have my own go-to’s when I find myself feeling overwhelmed, including routines. Like Liz (played by Christa Miller), who collects and polishes stones as a form of meditation, I blast calming music in my house and stare out the window at the beauty of nature, and this helps ground me. In the shower, I will visualize all the thoughts that don’t serve me going down the drain as the water runs off my body.
Choosing to eat what I like to call feel-good foods is another — blueberries are a favourite. They nurture my health (body and mind) and are full of vitamin C to help with stress.
Having a good laugh, even at myself — not taking myself so seriously — and letting my hair down puts things in perspective and reminds me of the beauty of what we call life.
Author: Yvette Murray lives in Tiny Beaches on Georgian Bay, which she considers her sanctuary. She believes that being surrounded by nature does wonders for her mental health. Yvette is the author of The Mental Health Contagion: Navigating Yourself Through a Loved One’s Mental Well-Being Decline (forthcoming). She is a mental health advocate, influencer, and keynote speaker; a psychotherapist; and a facilitator for the MHCC’s Mental Health First Aid (MHFA) virtual certification program. MHFA is available for those who are supporting adults, youth, and/or older adults. It trains participants on how to recognize a loved one’s mental health problem, have that conversation, and get the best help.
Inset: Sara Smith is a registered psychotherapist with the Live Free Black Therapist Collective.
