carmanah-counselling

Navigating Midlife, Perimenopause and the Shift in Who You Are

Wed, 09 Sep 2026 05:02:47 GMT

NAVIGATING MIDLIFE, PERIMENOPAUSE, AND THE SHIFT IN WHO YOU ARE

Navigating Midlife, Perimenopause, and the Shift in Who You Are

Perimenopause and menopause are not just hormonal shifts; they trigger massive life transitions. For many women, midlife brings a simultaneous wave of major changes that can leave you feeling disoriented:

● Career shifts: Re-evaluating your job, changing industries, retiring, or burnout.

● Body changes: weight distribution, fatigue, hot flashes, joint pain, and shifting muscle mass.

● Friendship dynamics: Outgrowing old social circles, losing connection, or renegotiating boundaries.

● Parenting transitions: Watching kids grow up, leave home, and step into independent adult lives. Or having young adult children struggle and not knowing how to support them.

● Parental care & grief: Managing the logistics and emotional toll of caring for aging parents, or navigating the grief of losing them.

● Partner relationships: Re-evaluating long-term marriages or partnerships as home life and personal priorities change.

The Identity Crisis and Societal Pressure

Underneath these practical changes sits a core question: Who am I now?

When your daily tasks no longer revolve around active parenting, intense career building, or taking care of everyone else, your old identity breaks down. You are left searching for new meaning, asking what actually matters to you in this next chapter, and trying to figure out your new role.

At the exact same time, society pushes a loud message: hide aging, fix your changing body, stay young, and look a specific way. Trying to meet these impossible standards while your hormone levels shift creates intense daily friction.

Risks and Coping Mechanisms

When life changes hit from every angle, your nervous system gets overloaded. To manage the anxiety, grief, loss of control, or body changes, it is common to slip into coping mechanisms that feel like a quick fix:

● Disordered eating & restriction: Attempting to control a changing body through rigid dieting, overeating, skipping meals, or extreme exercise.

● Increased drinking or drugs: Using alcohol or drugs to numb evening anxiety, cope with grief, fall asleep, or quiet a racing mind.

● Isolating : staying home, not reaching out, spending more time on your phone.

● Working long hours : as a way to avoid emotions or the difficulties.

Recognizing these habits is not about shame. It is a sign that your stress levels have outstripped your current tools.

How Counselling Helps

Midlife is a time to drop expectations that no longer serve you and rebuild your life around what actually matters. Therapy provides a grounded, practical space to:

● Process the grief of lost roles and changing relationships.

● Build healthy, direct strategies for anxiety and body image struggles without relying on alcohol or food restriction.

● Define your personal values and decide what your new chapter looks like on your terms.

You do not have to figure out this transition alone.

If you are interested in learning more about perimenopause/menopause and how to navigate successfully through mid-life please join us for an upcoming workshop.

How to Find a Weight Inclusive Dietitian

Sun, 23 Mar 2025 22:20:15 GMT

Finding a weight inclusive dietitian

How to Find a Weight-Inclusive Registered Dietitian Near You

If you’re looking for a registered dietitian who takes a weight-inclusive approach, you’re prioritizing a compassionate, non-judgmental style of care that emphasizes overall well-being rather than weight loss as the primary marker of health. Weight-inclusive dietitians focus on building healthy behaviors, improving your relationship with food, and supporting your body’s unique needs — regardless of your size.

Here’s how to find a weight-inclusive registered dietitian (RD) near you and what to look for during your search.

1. Understand What “Weight-Inclusive” Means

A weight-inclusive RD practices from a framework that emphasizes health and well-being without focusing on weight loss as the primary goal. Common philosophies they may align with include:

• Health at Every Size® (HAES®)

• Intuitive Eating

• Body Trust®

• Anti-diet approaches

These frameworks focus on promoting sustainable habits, honoring hunger and fullness cues, and cultivating body respect — without restrictive dieting or body-shaming tactics.

2. Ask the Right Questions

During your initial consultation or when reaching out via email, ask these questions to ensure the RD aligns with weight-inclusive care:

• What is your approach to weight and body size?

• Do you practice from a Health at Every Size® (HAES®) framework?

• How do you approach goal-setting for clients in larger bodies?

• Do you focus on behavior-based changes rather than weight loss?

A weight-inclusive RD will emphasize sustainable habits like mindful eating, joyful movement, and emotional well-being — without prescribing restrictive diets or promoting weight loss as the primary focus.

3. Look for Language that Reflects Weight-Inclusive Values

When exploring websites or social media profiles, look for language that emphasizes:

• Body diversity

• Ditching diet culture

• Empowering clients to trust their own bodies

• Nourishment without restriction or shame

Avoid providers who use terms like “weight management,” “fat loss,” or promote before-and-after transformation photos unless they clearly advocate for non-restrictive methods.

4. Prioritize Lived Experience and Compassion

While credentials are important, finding someone who fosters trust and empathy is equally valuable. Seek an RD who creates a safe, non-judgmental space — especially if you’ve experienced weight stigma or struggled with disordered eating.

5. Consider Virtual Care

Many weight-inclusive RDs offer virtual sessions, giving you access to specialized support even if no local providers align with your needs. This expands your options and allows you to prioritize finding someone who truly resonates with you.

6. Seek Community Recommendations

Online communities focused on intuitive eating, HAES®, or body positivity often share recommendations for trusted providers. Facebook groups, Reddit forums, and Instagram communities can be helpful resources for referrals.

Final Thoughts

Finding a weight-inclusive registered dietitian can be transformative for your relationship with food and your body. By focusing on behavior change, nourishment, and self-care — rather than weight loss — these professionals offer compassionate guidance that supports your long-term well-being.

Taking the time to find a provider who respects your body and honors your individual needs can empower you to build a healthier, more positive relationship with food and yourself.

What is Neurodiversity?

Mon, 09 Sep 2024 04:25:33 GMT

understanding our differences

Understanding Neurodiversity: Embracing Differences in the Human Brain

In recent years, the term "neurodiversity" has gained significant attention, particularly in discussions about mental health, education, and workplace inclusion. But what exactly is neurodiversity, and why is it important?

What is Neurodiversity?

Neurodiversity is the concept that differences in the human brain and its functioning are a natural and valuable part of human diversity. Just as we celebrate diversity in race, gender, and culture, neurodiversity encourages us to acknowledge and respect the different ways in which people think, learn, and experience the world.

The term was first coined in the late 1990s by sociologist Judy Singer, who sought to challenge the medical view that neurological differences like autism, ADHD, dyslexia, and other cognitive variations should be "cured" or "fixed." Instead, neurodiversity advocates argue that these differences should be embraced as unique ways of being.

Neurodiversity includes individuals who have cognitive variations that affect how they process information. Some of the most commonly discussed conditions include:

1. Autism Spectrum Disorder (ASD)
Individuals on the autism spectrum may experience differences in communication, social interaction, and sensory processing. The "spectrum" aspect highlights the wide variety of ways autism can manifest.

2. Attention Deficit Hyperactivity Disorder (ADHD): People with ADHD often struggle with attention regulation, impulsivity, and hyperactivity. However, they may also exhibit strengths in creativity, problem-solving, and enthusiasm.

3. Dyslexia: Dyslexia affects how individuals process written language, often making reading and writing challenging. Many people with dyslexia are highly creative and excel in visual and spatial reasoning.

4. Dyspraxia: Dyspraxia affects motor coordination, making tasks that require physical coordination more difficult. However, individuals with dyspraxia often have strong skills in other areas, such as verbal communication or creative thinking.

5. Tourette Syndrome: Characterized by involuntary movements or vocalizations known as tics, Tourette Syndrome can vary widely in intensity and presentation. Many individuals with Tourette’s have typical or above-average intelligence.

The neurodiversity movement challenges the idea that there is one "right" way for the brain to function. It emphasizes that people with different cognitive abilities bring unique perspectives and strengths to society. Here’s why it’s important to embrace neurodiversity:

1. Breaking Down Stigmas: Historically, individuals with neurological differences were often marginalized, misdiagnosed, or subjected to harsh treatments. By recognizing neurodiversity, we move toward a society where differences are accepted, and individuals are treated with dignity.

2. Educational Inclusion: Neurodiversity encourages a more inclusive education system where students with diverse learning needs are supported. It advocates for personalized learning approaches that accommodate different ways of processing information.

3. Workplace Innovation: Neurodiverse individuals often bring fresh, creative solutions to problems, thanks to their unique ways of thinking. Companies that value neurodiversity can benefit from enhanced creativity, innovation, and problem-solving capabilities.

4. Promoting Self-Acceptance: For individuals who are neurodiverse, understanding and accepting their cognitive differences can be empowering. It shifts the focus from trying to "fit in" to embracing who they are and recognizing their unique talents.

If we are to embrace neurodiversity fully, we must actively work to create inclusive environments in schools, workplaces, and communities. Here are some ways to support neurodiversity:

Education and Awareness: Raising awareness about neurodiversity and educating people on different neurological conditions helps break down misunderstandings and prejudices.

Accommodations: Whether in school or the workplace, providing reasonable accommodations—like flexible work hours, assistive technology, or sensory-friendly environments—can help neurodiverse individuals thrive.

Strength-Based Approaches: Rather than focusing on deficits, a strength-based approach emphasizes the unique skills and abilities of neurodiverse individuals.

Advocacy and Policy: Continued advocacy for policies that protect the rights of neurodiverse individuals is critical to ensuring equal access to education, employment, and healthcare.

Neurodiversity encourages us to see neurological differences not as deficits, but as part of the broad spectrum of human diversity. By fostering environments that embrace these differences, we can create a more inclusive, innovative, and compassionate society where everyone has the opportunity to reach their full potential.

Local Autism Assessments: Helpful Website and Providers List

Mon, 29 Apr 2024 23:46:46 GMT

Autism Assessments: Helpful Website and Lists of Providers

Navigating autism assessments providers in the Vancouver, BC area can feel confusing, and the Vancouver Pathways website is an excellent resource. This site simplifies the search process by directing you to relevant information and nearby providers: visit here .

Also, see the attached lists (pdf's):

PRIVATE ADULT ASSESSMENTS CLINICIAN LIST

PRIVATE ASSESSMENTS - CHILDREN

How can Occupational Therapy help?

Sun, 23 Apr 2023 23:15:38 GMT

An Occupational Therapist is a helpful addition to mental health & neurodiversity support, eating disorders, life-altering injuries, and more:

A n occupational therapist can help individuals of all ages who are experiencing difficulties with performing meaningful activities or occupations due to physical, cognitive, or psychological impairments. Here are some ways occupational therapists can help:

1. Evaluating and assessing a person's ability to perform daily activities and occupational tasks, identifying any barriers in their environment, and developing a customized treatment plan to improve their independence and quality of life.

2. Providing assistive technology or adaptive equipment to help individuals compensate for physical or cognitive impairments, allowing them to perform daily activities more easily.

3. Working with individuals to improve fine motor skills, such as handwriting or buttoning clothes, or gross motor skills, such as walking or using stairs.

4. Developing strategies to address sensory processing issues, which can impact a person's ability to engage in daily activities and interact with their environment.

5. Providing psychological support to facilitate emotional and mental well-being, and supporting individuals with disabilities in coping with the social and emotional challenges associated with their condition.

Overall, occupational therapists help individuals lead more fulfilling and independent lives by maximizing their potential to engage in daily activities, work, and leisur e.

What is EMDR and how can it help me?

Sun, 26 Mar 2023 06:06:18 GMT

An excellent therapy for processing trauma and more!

E ye Movement Desensitization Reprogramming (EMDR) for Trauma & Anxiety

While cognitive- based or top-down therapies are excellent modalities for treating certain mental health challenges, somatic- based or bottom-up approaches are helpful for chronic or trauma- based concerns. The book “The body keeps the score” by Bessel Van Der Kolk explains why somatic treatments are helpful for trauma that is trapped in the body’s nervous system.

Briefly, the emotions and bodily reactions created at the time of a traumatic event are associated with chemicals in the nervous system and these cause the brain to store or encode the traumatic experience in a manner different from an everyday event which doesn’t carry a strong emotional charge.

EMDR uses bilateral stimulation via rapid eye movements (or tapping) to reprocess the memory by having the client bring it into consciousness during the eye-movements which are guided by the therapist. Some people may experience the memory becoming less vivid or intense but the memory itself is still in tact. Unlike strategy based modalities, talking in length or describing the traumatic event is not necessary for treatment to be effective. The memories must be recalled by the client while also acknowledging body sensation location.

Alongside reprocessing, we target negative core beliefs associated with the traumatic memory and integrate a more adaptive belief. When the more adaptive belief feels more true, and memory is not associated with distress, the EMDR goal is complete. There are often several experiences which underlie the client’s traumatic episode, and therefore several sessions of EMDR may be warranted.

Before any traumatic reprocessing, we have at least two sessions learning stabilization/ self- care techniques to use both during s essions and between sessions. Before any treatment takes place, the therapist conducts a thorough psychosocial assessment to determine whether EMDR is a good fit for you.

At Carmanah Counselling & Integrated Health, we currently have two therapists who are trained & experienced in delivering EMD R therapy.

Please inquire for more information!

What is ARFID? aka: Avoidant Restrictive Food Intake Disorder

carmanahcounselling@gmail.com (Krista Blatchford) — Tue, 22 Nov 2022 19:57:21 GMT

Beyond Picky Eating:

What is ARFID? aka Avoidant Restrictive Food Intake Disorder

ARFID is an eating disorder characterized by a person’s limited food intake- either in quantity, or type of food, or both, and that this restrictive eating pattern interferes with quality of life and/ or physical health. If body image concerns are present, an individual would not qualify for an ARFID diagnosis.

ARFID can affect folks of all ages, and the restrictive eating patterns could have been present for most of their life, or precipitated by an averse life event. Usually the interference in functioning is related to eating in non-home environments. Individuals with ARFID feel immense social pressure to eat more flexibly when visiting friends or relatives, at celebrations, at restaurants, when traveling. Many children and adults with ARFID may avoid these environments or activities to avoid the associated stress, and in this way their social network is constrained.

A higher incidence of ARFID is seen in neurodivergent folks who have existing diagnoses of Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Sensory Processing Disorder (SPD). However, ARFID diagnoses are present in a majority of folks without these concurrent issues. The restrictive food repertoire may be related to taste or smell sensitivities, or increased or decreased interoceptive awareness- which is akin to internal sensation awareness. Some people feel strong sensations of their internal physiological and emotional systems, whereas others do not. For example, some people may not notice hunger cues like others, or feel very quickly full or uncomfortable when nearing stomach fullness. In addition, those with sensitive sensory systems, may experience tastes, textures and smells much more intensely than the average person, making eating much more intense.

Depending on the nature of the development & expression of ARFID symptoms, there are different treatment options available. A few evidence-based modalities include Cognitive Behavioural Therapy (CBT) and Exposure and Response Prevention (ERP), Responsive Feeding Therapy, and Ellyn Satter’s Division of Responsibility Model. If fear of choking or difficulty chewing or swallowing is a concern, an assessment from a speech-language pathologist or occupational therapist may be informative. It is important to note that the treatment goal for ARFID is to help the individual feel more functional around food, however this may look, and to ensure physical wellbeing.

It is prudent to seek medical assessment from your GP, and baseline lab-work and heart rate function (ECG) may be warranted. It is important to monitor weight and nutritional deficiencies. A registered dietitian can be a valuable addition to the treatment team. Our RD, Ally Choo, works alongside families and therapists to monitor growth and nutrition, and she has many creative ideas for making meals and snacks more calorie and nutrient dense. Two of our mental health therapists- Susanne Leach and Krista Blatchford, have experience and training treating eating disorders, including ARFID.

It is important to note that as with all eating disorders, ARFID has the potential to be life threatening. If safe foods have diminished, weight has been affected, or there are any physical symptoms present, such as dizziness, syncopal episodes (nearing fainting), chest pain or irregular heart beat, fatigue, etc, it is very important to seek regular appointments with a physician.

Dietitian Assessment & Counselling as Recommended Addition to Therapy Sessions

Thu, 10 Nov 2022 22:01:07 GMT

Dietitians, Therapists, and Eating Disorder Recovery go Together!

M any folks who seek therapy for disordered eating and body image concerns may not be aware that adding registered dietitian support alongside therapy, is shown to increase efficacy of treatment and improve prognosis.

While therapy helps clients to understand the mechanism of the disordered eating: how it may be functional to regulating emotional states, as well as distracting from lack of control over other environmental problems; nutritional assessment helps to address specific areas of nutritional deficiencies, as well as meal planning & ideas for reintegrating feared foods.

Eating disorder therapists generally recommend dietitian consults and medical assessments, including updated labwork and snapshot of heart function, also known as ECG. These help your treatment team determine how your body has been affected by the disordered eating/ malnutrition.

Some of the specific ways registered dietitians can help manage disordered eating, and healthy/ intuitive eating:

• The first area of focus in nutrition recovery is learning how much your body needs and establishing regular eating patterns (i.e. regular meals and snacks) to nourish our brain and body. A nourished brain allows us to better engage in psychological treatment of the ED. This can be done through use of a structured eating plan, meal support, and for some individuals may involve weight restoration and/or stabilization.

• Dietitians can help to evaluate Nutritional deficiencies/Electrolyte abnormalities: to reduce immediate risks and health consequences

• Assess the the efficiency of Hunger/fullness cues: often when folks are engaging in disordered eating, these cues are unreliable or lacking altogether if we have been constantly overriding them. By eating enough and often enough our hunger/fullness cues do return and we can begin to turn in to them and later, you may wish to work on not only recognizing these cues, but eating in response to them.

And finally,

• Working toward having a neutral mindset towards food: begin to detach our moral value based on the types of foods we eat. The more we detach from “good vs bad” mentalities towards food, the more healthy we can be in our relationship with food.

We have an amaz ing dietitian at our clinic who specializes in all of the above areas. Please reach out to Ally Choo, RD, on our website, to book an initial appointment!