Year: 2022

Quantitative Electrophysiology

No lies detected

There’s a scene in a Seinfeld episode where Jerry is interrogated using a lie detector by a police sergeant who doesn’t believe him when he says he’s never watched an episode of Melrose Place. Thanks to some advice from George (“it’s not a lie if you believe it to be true!”) he does fairly well until anxiety gets the better of him and he cracks under the pressure, admitting to being very much into Melrose Place. For an examination of the ‘femmephobia’ present in this scene, see the spotlight on Sexual Orientation and Gender Identity earlier in Psychology Month!

We’ve all seen similar scenes on TV and in movies, where people have electrodes attached to their fingers and hands, and where the machine quantifies their response to the questions being posed. I think most of us know by now that the machine is not actually measuring truthfulness, but rather anxiety. And while it is not very useful in its purported purpose – the detection of lies – this technology is actually very useful in the detection of anxiety! This is the realm of quantitative electrophysiology.

Dr. Mari Swingle is a practicing clinician, a researcher, an author and a presenter. She has a PhD in psychology and an MA in education, and she is certified in neuroelectrophysiology. She is the treasurer of the CPA’s Quantitative Electrophysiology section. She describes the discipline this way:

“We read the electrical activity from the brain, which tells us so many things. We can read from the upper levels of the cortex and get lots of information, and we can also go very deep into structures and circuitry within the brain. You need extremely sophisticated equipment to do this, and you need extremely sophisticated clinicians to read all of it.”

Another of those extremely sophisticated clinicians is Dr. Elizabeth Hartney, the Chair of the Quantitative Electrophysiology Section. Dr. Hartney is a registered psychologist in BC, and is board certified in neurofeedback and biofeedback (two predominant forms of quantitative electrophysiology).

“We’re certified by the BCIA, which stands for the Biofeedback Certification International Alliance. They provide biofeedback certification across the world. Biofeedback includes a few subdisciplines. The one Mari and I most closely work in is EEG (electroencephalogram) neurofeedback – but we also have peripheral biofeedback, which picks up electrical activity from the nervous system through the rest of the body. So we could be applying electrodes to your fingertips, to the palms of your hand, to read your heartrate variability or skin conductance. It’s basically all the stuff you see in the lie detector test on TV – which isn’t really great at detecting lies, but is really good for detecting anxiety. Anxiety is one of the things we work with a lot.”

Biofeedback is about becoming more aware of, and gaining greater control over, the functions of one’s own body. It can be used to help people experiencing anything from irritable bowel syndrome to side effects from chemotherapy. Dr. Hartney continues,

“We work with people to get feedback on their breathing, their heart rate, their blood pressure, all kinds of conditions that can be psychosomatic and involve both the mind and the body. There are specializations that others do in this space around urinary incontinence. The whole approach is about empowering the individual to gain control over their own body and their own brain – and in some cases their own bladder!”

In case the words ‘quantitative electrophysiology’, ‘neurofeedback’ and ‘biofeedback’ weren’t daunting enough, the clinicians who work in this discipline tend to add a few more. Like physiology, which also describes their work! There’s neurophysiology, which deals with the signals from the brain. There’s also general physiology, which deals with the full body, including the brain. Depending on the circumstance, quantitative electrophysiologists might be talking about only the body, or only the brain, or both in tandem. Dr. Swingle talks about two different ways this might look.

“There are huge volumes of research on what we call ‘brain mapping’. So, how do we read the electricity and what does it tell us? We work to either clinical or normative baselines. Normative baselines are measurements taken from brains of individuals who don’t have any overt symptoms or diagnoses. They don’t have ADHD, depression, psychosis, and so on. We look at what the brain looks like in that case, and we can then treat people who are suffering from ADHD, depression, or psychosis and we help them get to normative (or typical). What Elizabeth and I primarily do is the other branch, working from clinical databases. This means we have electrical readings from the brains of individuals who do suffer from anxiety, insomnia, scholastic difficulties, you name it. We then train the brain away from that measurement.”

This mostly involves taking existing processes in certain areas of the brain and either enhancing or diminishing their strength. This can be an effective way to treat depression, anxiety, ADHD and other conditions. When it comes to situations that involve actual damage to the brain itself, the treatment looks much different. Says Dr. Swingle,

“When we’re dealing with very severe strokes, or structural brain differences, then we’re looking for different pathways [what is often referred to as neuroplasticity – the ability of the brain to overcome damaged parts by learning how to use other parts to perform the same functions]. The majority of the work we’re doing is working toward making existing pathways more efficient. Some are underpowered and some are overpowered. A good example is the foundational work of Davidson. He looked at the balance of the frontal lobes, left vs right. He found that if the cortical electricity was more than 15% higher on one lobe than on the other, that was almost always indicative of emotional deregulation.”

Showing the brain an easier way

The field of quantitative electrophysiology has changed a great deal in the last twenty years, most notably because of the advent of the personal computer and greater technological power. For a discipline that relies enormously on technology, this has been a boon – but has also made disorders, and the treatment of them, much more complex. Dr. Hartney reflects on this change.

“It has actually become easier – but also much more complicated – with the rise of personal computers. They’ve made the process of getting and giving feedback from and to the brain much more entertaining. Therein lies a problem. Before we had computers, psychologists like us used lights and sounds that would light up or ding when our brain was doing what we were training it to do. That would be the ‘feedback’ part of the ‘neurofeedback’ or ‘biofeedback’. That actually worked really well! What we have now is fancy computer games and puzzles and videos that go on and off according to what your brain is doing and we have fantastic arrays that we can observe that show the frequencies of peoples’ brainwaves in several different sites at once.”

Dr Swingle provides a specific example of the kind of work she and Dr. Hartney might do for a client.

“We might want to augment a brainwave at one location on the brain for a specific purpose. For example, we want to augment theta [a type of brainwave] at the back of the brain because when theta is higher at the back of the brain you have greater stress tolerance. We can use that to help with insomnia, anxiety, addictions, all these types of ailments that would benefit from the brain being quieter. We attach an electrode to a very specific site, and ask an individual to interact with a computer. A really simple way of doing this is when the theta moves in minutia, a cricket jumps on the screen. Let’s say we have a young person who is having trouble with extreme anxiety and they need help with calming. All we do is ask them to make the cricket jump. Little ones don’t ask how do you do that, why do you do that – they just say okay. So it’s really easy to work with munchkins! We’re behind the scenes watching the pure wave forms and the amplitudes and ratios so we can see the frequency of theta come up, and manipulating thresholds to make it easier or harder to make the cricket jump. What we’re doing is giving that child the control to augment the theta wave on their own. When we show the brain an easier way to do something, it will take it.”

Boing boing boing boring

As I’m writing this spotlight right now, there is a TV on mute in the background. Team Canada is playing for the gold medal against the United States in the Olympics on the screen. My phone sits next to me and is constantly issuing notifications – Dr. Jonathan Stea just liked my tweet, CTV Ottawa has started a live video on Instagram from the protests in downtown Ottawa. I haven’t played Words With Friends in three weeks, and they want me to know they miss me. I have to stop typing every now and then because email notifications obstruct the screen, and I’ve received 14 since I started writing. Dr. Swingle has written a book called i-Minds: How Cell Phones, Computers, Gaming, and Social Media are Changing our Brains, our Behavior, and the Evolution of our Species about just this sort of thing. She says,

“An issue in our discipline is that things have become so fancy that they’re not as efficient. A cricket jumping for five minutes is fun. A cricket jumping for forty minutes is boring! And the kids go back to these incredibly involved amazing-looking video games. So what happens is we’ll get really good data in session, but the brain doesn’t change on any permanent level. When working with children, especially those with attention difficulties, screens have to be a little bit boring to work. That’s become something of an inner conflict within our discipline.”

So how has that changed in the past decades? Do kids find the cricket boring today because they are used to a much higher level of interactive screen time with more stimulation? If they had been exposed to this in 1988, would they have found the cricket to be entertaining for a longer time? Dr. Swingle says yes – and no.

“You could sustain the attention longer with lesser stimuli 20 years ago, but it was still boring! It’s a larger problem now because a lot of interactions with technology are affecting the development of childrens’ brains. A lot of children don’t know how to ‘sustain the mundane’ because everything in their lives is going at such a high pace. If you do one hour of neurotherapy a week, but 20 hours of gaming a week, the gaming is likely to win. And it does the exact opposite of neurotherapy, it trains the brain to respond only to excitement.”

If you hop on a treadmill or a rowing machine for 30 minutes a day, that’s likely very good for you – but if you spend the rest of your day eating nothing but poutine and peanut butter cups, the effects of that rowing machine will likely be greatly diminished, and you are unlikely to see the results you desire.

At the same time, if you go to the gym every day for three months, working with a personal trainer to figure out an ideal workout regimen, you might be able to maintain the fitness level you desire afterward by going only once a week. This is the goal of electrophysiology – that the changes you make in your brain become part of you, and they stay after the process. Says Dr. Hartney,

“The ultimate goal is that you want your client to learn how to change state without the help of the feedback. One of the things we’re dealing with is that young people in particular see this as a form of entertainment, and don’t necessarily understand that it’s an educational process. We’re trying to teach them to change state, but because they’re overloaded with the bells and whistles and animations it’s much harder for them to generalize what they’ve learned in a session outside that environment.”

On the value of boredom

Every Friday night, my family does a Games Night with friends over Zoom. We play a game using our phones as we all share a screen. The rapid advancement of technology over the last several years has made such incredible things possible, and it’s great that we’re able to connect this way, especially during a pandemic where other methods of connection might not be available to us. But I notice the kids approach it a little differently than the adults. While we’re waiting for a game to load, they’re playing a different game on their phone. Or, while it’s not their turn they’re dealing out cards on the table here in the house so there’s another game to play during the 90 second gaps in action. Dr. Hartney explains why this is becoming more common.

“We’re of an age where being bored was a normal part of childhood. If you went to your parents and complained about being bored they’d give you a chore, or suggest you figure it out on your own. We grew up expecting things to be a bit boring and seeking out our own entertainment. This generation just don’t have that same kind of baseline.”

Like Dr. Hartney, Dr. Swingle is also a big fan of boredom!

“All creativity and all innovation comes from boredom. If you don’t have boredom, you don’t have curiosity. You don’t have time to assimilate things and see patterns, and so on. We’re going far beyond our work in quantitative electrophysiology to the bigger picture now, but they are intrinsically linked.”

Before we go too far beyond quantitative electrophysiology, we’ll leave it here.

Stay bored, folks!

Family Psychology

“No healthy person is totally independent.”

At the end of The Godfather Part III, Michael Corleone (Al Pacino) dies alone in a courtyard, having apparently cut all ties with his family and the family business. On closer examination however, he can never have fully cut ties with his family – they made him who he is, and they shaped the path of his entire life. In fact, even the courtyard where he is sitting as he slumps over and dies is in the villa belonging to Corleone family friend Don Tommasino.

In our culture we tend to think about people as individuals much of the time. In this way, we think of a good health individual separately from their family, and rarely think about them in that larger context. Family psychologists, on the other hand, think about that context all the time. Dr. Jen Theule is an Associate Professor at the University of Manitoba in the school and clinical psychology programs, and the Chair of the Family Psychology Section of the CPA. She says many things we experience in our daily lives come about as a result of family psychology.

“Rooming in at the hospital instead of the baby going to a nursery as they once did – that’s a family psychology thing. Inviting family members into medical appointments and discussions. Parent-teacher meetings. Anything where we involve your family context, and involve more people in the discussion, those are the kinds of things family psychologists push for.”

When Amerigo Bonasera comes to visit Don Corleone on the day of his daughter’s wedding to ask for a favour, it is not just him and the Godfather in the room. There are others, among them the family consigliere Tom Hagen (Robert Duvall). These decisions are not made by the Godfather alone – he values input from those closest to him.

There are the discoveries brought about by science and the study of families, and then there are the applications of those innovations in dealing with family dynamics, often but not always in a therapy scenario. Says Dr. Theule,

“I think of family psychology as two things. One, it’s the study of ‘the family’ – parent-child relationships, romantic relationships, multigenerational families, close friendship groups, that kind of thing. Learning about how families operate, both the larger family units and all the subsystems within them. And two, it’s the application of that research to interventions. Family therapy, couples counselling, those kinds of things.”

Dr. Cathy Costigan is a Professor in the psychology department at the University of Victoria.

“I teach about what we call ‘developmental psychopathology’, or the mental health challenges of children and youth. I teach that from a strong family lens, all about how we understand childrens’ normal and abnormal development. I also teach family therapy to graduate students, which involves ways to intervene at a ‘systems level’. We see problems not as ‘there’s something broken within a child that we need to fix’ but rather by looking at the relationships among the different family members and their communication patterns. It is these broader ‘systems’ issues that might be creating or maintaining some stresses in a family where the child might be the one expressing the stress in the family by say, acting out in school or having meltdowns at home.”

Both Dr. Theule and Dr. Costigan speak a lot about ‘systems’. It’s a way to be a little more broad and inclusive when speaking about families. It’s not just a nuclear family of two moms and two kids – it could also refer to the extended family of grandparents and cousins, or a close-knit friend group, or a large hippie commune in California that has been running continuously since the 70s. Dr. Theule explains,

“Everyone’s impacted by various systems. Whether that’s who you work with, or who you live with, or are related to, or your friend group. All of those things operate quite similarly to families. Most people would consider a foster family to be a family unit of a sort, but the larger world might struggle with things like ‘is my roommate my family?’ By and large, society still considers ‘family’ to be a nuclear family – a mom and a dad and 1-4 children. But in some communities families are more broadly defined, and are larger. So when I use the term ‘system’ people might be more okay with the idea that the family can include Auntie or Grandma – or even roommates.”

How big, exactly, is the Corleone ‘family’ in the Godfather movies? Is it limited to just the immediate family members – Vito, Michael, Fredo, Sonny, and Connie? Does it extend to spouses? Children? Is Tom Hagen, informally adopted by the Corleones at a young age, truly a family member? What about all the ‘made’ guys – is that official induction into the organization, or into the family itself? In fact, where does the ‘family’ end and the ‘criminal enterprise’ begin?

Every community, and every culture, defines ‘family’ a little bit differently. For Dr. Costigan, it is these definitions of family, and the cultural differences in what constitutes a healthy family, that interests her.

“These days my research is predominantly focused on immigrant and refugee families. Looking at ways in which families under stress and cultural adjustment harness the resources and strengths within them as they go through changes from one country to another, along with the various traumas that might have accompanied that journey to come to Canada. How do they maintain strong family ties against this backdrop of many cultural differences, where each individual family member might be adjusting to Canadian culture in different ways and at different rates that might create tensions within the family?”

One of the ways these tensions manifest themselves might be for parents who are here in Canada, but whose own parents and extended families are still living back home. With today’s global technology, they are more connected to those remote family members than they could ever have been before. Sometimes that connection puts parents in a tough situation. The expectations of their own parents as to the proper way to raise children might now contrast greatly with the expectations of their own children who are growing up in Canada. It’s this kind of tension Dr. Costigan deals with often within the families with whom she works.

Family Psychology, as a discipline, has been moving this way for some time. An increased emphasis has been placed on cultural variation in families. It’s moving away from an implicit assumption that the Canadian context (the white family with Western values) is the way a family should function. Instead, the focus is more on what good and effective parenting looks like, or good communication within a family. This, of course, varies greatly by culture. Healthy family functioning doesn’t look the same for everyone, and acknowledging this has been a big step forward for family psychology over the past few decades. Dr. Costigan gives an example:

“In White Western culture, we have the primacy of the marital relationship between partners, whether that’s same-sex or opposite-sex. The partners play a leadership role in the family and there should be good boundaries around the decision-making in the family, where kids aren’t really a part of that. We might consider it problematic if kids are too privy to adult issues or too involved in adult decision-making. In some cultures, however, the primary relationship is parent-child. It can be desirable for children to contribute to the family at a much higher level than we expect in Canadian culture. Fulfilling those family obligations is really a strength, and it’s part of a healthy adaptation for that child from that cultural lens.”

For psychologists who specialize in working with families, their work can involve every moment of the lifespan, from dealing with a newborn arrival into the family to planning for end-of-life care for a parent or grandparent. Dr. Costigan says that in all those situations, although the approach might be vastly different, the fundamental principles remain the same.

“The core family functioning systems principles around communication and problem-solving have relevance at every phase of the lifespan. How do you get families to share what they’re thinking in respectful and helpful ways, how do you get them to solve problems in ways where everyone feels heard? Adult children can live their own lives fairly independently. Then when their parents start to decline they have to interact with one another and deal with each other much more, in a really emotional context. Some of those old wounds of childhood interaction can really rear their heads and disrupt that process. That’s an example of a prime time when psychologists might want to get involved, to help a family navigate that difficult phase of the lifespan.”

Or, maybe, psychologists might want to get involved right after the death of a family patriarch. This could potentially avoid future disagreements and betrayals, and ensure that Fredo never sealed his fate by taking sides against the family. I mean, maybe. The Godfather had some pretty difficult family dynamics and precious few psychologists.

Over the past two years, a new test has been placed on families and, by extension, the family psychologists who help them. Not only has the pandemic increased mental health difficulties, it has made it harder to reach out for the supports that could once have alleviated some of those issues. Says Dr. Theule,

“I think the last two years have put a lot of pressure on families who live together. The pandemic has taken away a lot of the larger system, and the supports that come with it like grandparents. We have a lot of great technological innovations, but those innovations aren’t going to come over and take care of your kids when they’re sick, or change a diaper for you. They don’t solve instrumental needs. In my estimation, a lot of research in the last two years has opened a lot of eyes outside the field of family psychology. Psychologists all sort of anticipated this, but to see the stress that children, people with disabilities, and older individuals – people who rely on the family system a little bit more – how impacted those individuals were by stresses to caregivers. It made people realize that maybe focusing on the adults who help those who need the extra care is one of the best ways to help those people who need extra care. For anyone who’s relying on others, a caregiver is really important and I think that may have been a shift in the larger community.”

Again, Dr. Theule is talking about systems. The future of family psychology is an integration of what the experts know now into a much larger, and more complex system that we can call a ‘family’.

“Family psychology is just starting to scratch the surface of the whole system. We’re really good at examining the parts of the system – what happens between a couple, what are the dynamics between one parent and one child, and so on – but a family isn’t just all these little parts added together, it’s greater than the sum of its parts. So how do you look at, and measure, something as complex as a family system? They vary in size, in culture, in dynamics in every single family. That’s where we’re trying to go – to look at the larger systems. Some research is being done now into triad dynamics, like one parent and two children, or two parents and one child. But the amount of complexity it adds to go from two people to three is so large that this is a huge shift already.”

Picture a diagram that you draw on a piece of paper. If you have two people (two dots on the diagram), there is only one line that can be drawn between them. Add a third person (third dot), and there are now three lines that can be drawn between individuals. One more person – three times as complex. Add a fourth, and there are now five possible lines. And so on – so you can imagine how difficult it must be when you’re dealing with a whole family system, where there can be upward of nine, ten, or even thirty people involved. Making sense of those systems might be the monumental task facing family psychology over the next several years.

Dr. Theule and Dr. Costigan will be a part of that – making sense of the incredible complexity of family systems, and coming up with more effective interventions and treatments as a result. There may, however, be one question they will not be able to answer. What, exactly, convinced Francis Ford Coppola and Al Pacino that making that third Godfather movie was a good idea?

Clinical Psychology

Early in his career, Sigmund Freud specialized in hypnosis. He would hypnotize patients in order to get them to open up about their symptoms, which would then presumably reduce their severity. He was quite new to it, and not very skilled, so he needed his patients to be as relaxed as possible – so he had them lie on a couch while he smoked his cigar and told them they were getting very sleepy.

Eventually, he discovered that simply having patients talk about their symptoms in a relaxed atmosphere might be even more effective. He ditched the hypnosis, but kept the couch (and the cigar). Other psychoanalysts who followed in Freud’s footsteps adopted the couch themselves – to the point where the Imperial Leather Furniture Company in New York City became a very wealthy corporation thanks to the sales of ‘analytic couches’ in the 1940s. The psychoanalyst with the cigar and the austere couch became a ‘meme’ of sorts more than seventy years ago. One that persists to this day.

Where would the New Yorker cartoons be without the psychologist couch? Bob Mankoff, himself a former experimental psychologist, is the cartoon editor of the New Yorker. He says the analysis couch in cartoons is a useful shorthand, one that immediately conveys a power dynamic. In The Sopranos, when Tony sees his therapist, he sits in a regular comfortable armchair – but the couch is there in the background, lest we forget what kind of office this is.

Of course, the field of psychoanalysis has progressed a great deal since the heyday of the Imperial Leather Furniture Company, and sitting behind a patient’s head while they talk on your couch is a thing of the past. But powerful images, engrained in popular culture, can hold a certain amount of sway long past their expiry date. As the image of the cigar-couch-psychologist fades, so too does the stigma around seeking help for one’s mental health.

Dr. Nicholas Carleton is a Professor of psychology at the University of Regina, a registered clinical psychologist in Saskatchewan, and is currently the scientific director of the Canadian Institute for Public Safety Research and Treatment. He is encouraged by the progress of the field in debunking and breaking down stigma in seeking help for mental health concerns.

“I think we’re watching stigma fall, and I think it’s largely because psychologists are increasingly out in the community. The notion that it will look like a Mad Men episode when you walk into a psychologist’s office, with a big old leather couch and someone smoking a cigar, all of which could feel very ominous, I imagine is pretty much gone from what actually happens. I also think we’ve started to diffuse that now mythical notion of what happens a little bit.”

Dr. Brigitte Sabourin is an Assistant Professor at the University of Manitoba in the clinical health psychology department, and a practicing clinical psychologist in Winnipeg. She is the Chair of the Clinical Psychology Section at the CPA, and says the field has come a long way but the core goals remain the same.

“We can define ourselves as a field of practice where we deal with human functioning. Clinical Psychology runs the gamut from identifying human problems and solutions to promoting general physical, social, and mental wellbeing. This involves assessment, treatment, consultation, program development, program evaluation, research, mentoring, teaching…”

Dr. Sabourin specializes in clinical health psychology, at the intersection between health psychology and clinical psychology. She does her work in a tertiary care clinic dealing with people who have chronic pain. This means looking at the biopsychosocial aspects of living with a chronic health condition, and applying clinical psychology skills and behavioural health principles to try to support them. Most clinical psychologists have a specialization like this, whether it’s in a hospital setting or in dealing with specific mood disorders. This is not the only way the field has changed over the past few decades. Says Dr. Sabourin,

“I think for one thing, the field has become more diverse. Historically it was dominated by white men, and that continues to change. Our commitment to evidence-based practice is continuing to evolve in bringing together all our knowledge in terms of what we know about anything from mental disorders to human flourishing. We’re now using that knowledge a lot more in terms of improving our services and being accountable to the people we serve. I think also the settings in which we practice have evolved. You see clinical psychologists in settings anywhere from primary care to very specialized services, which means the settings and the populations we deal with are much more diverse than they used to be. I also think the acknowledgement of how helpful it can be to access services has progressed. It’s not about there being something wrong with you, or that you’re crazy – that stigma has started to go away and people are realizing that we can help anyone from an elite athlete to someone who’s really having trouble with basic day-to-day tasks.”

Bringing together that knowledge and using it in clinical practice is something both Dr. Sabourin and Dr. Carleton know well. Both are researchers in addition to clinicians. Dr. Carleton sees, and treats, a lot of first responders in Regina – particularly RCMP, as the academy is there in the city. He also does a lot of research with the RCMP and other public safety personnel (PSP). Recently he and his team created an anonymous online tool where PSP could assess their own mental health and then reach out for support should they need it. He says,

“I think we’re seeing a better integration of science and practice. We’re doing a better job of connecting with one another, and having reflexive relationships between those psychologists who are doing research and those who are doing practice. We’re seeing how science informs practice and vice versa in a more dynamic way. For example, there have been significant changes when it comes to PTSD. Thanks to clinical practice interacting very closely with research, there are now four symptom clusters instead of only three. PTSD diagnoses can now happen without having a singular event, considering the aggregate of compounding events. Certainly for our first responders and other public safety personnel, those were two huge steps forward. Public safety personnel were having difficulty specifying which event was causing them the most trouble because they would have experienced hundreds or maybe thousands of them within a single calendar year. Previously, they would go to see a psychologist and say ‘I’m in trouble’, and the psychologist might have said ‘so am I because I’m struggling to diagnose you unless you pick one event’. We’ve fixed those things, and we’re making sequential improvements and important advancements.”

Another advancement, one with which we’re all familiar by now, is technological. I am conducting this interview with Dr. Sabourin and Dr. Carleton via Zoom, and there are dozens of other virtual platforms available for meetings – and even therapy sessions. Dr. Sabourin says,

“I think something else that’s really taken off, especially since the pandemic, is the role of technology and innovation in terms of accessing psychological services. The idea that you have to go into a psychologist’s office for even a fifteen-minute session somewhere in a forbidding building is no longer how we think about clinical psychology. Now we can access video conferencing platforms, phone apps, and so on. For example, we’re doing a lot of our group-based programming where participants can be in the comfort of their own home, and not have to drive to the hospital and pay for parking, and figure out where they’re going and all that. Decreasing the barriers to care and increasing the flexibility of how we do things is an exciting development. It has been moving that way for a while, but in the last two years with the pandemic has really taken off.”

Doing virtual therapy was a pretty fringe notion two years ago before the pandemic hit, but over the course of the last two years a lot has changed. Psychologists who were wary of holding sessions on virtual platforms have learned to do so effectively, and the prevalence of this kind of technology has eliminated some barriers to care, made more psychological help available, and gone a long way toward the continued erosion of the stigma surrounding the seeking of mental health support. Dr. Carleton says it has also helped in other ways.

“At the risk of speaking heresy, I actually think that being required to work remotely – while it may have stymied conferences – has actually increased collaboration in many ways. I can meet with someone in Australia at the end of my day and beginning of theirs, and for half an hour we can swap notes. We’re not locked into a mindset that requires one of us to fly somewhere for 16 hours.”

Dr. Sabourin agrees. Not only are collaborations easier, but getting more psychological care to more people is as well.

“We’re looking at how to increase resources and our reach. Part of this is adapting the ‘stepped care’ model that’s rolling across the country. It’s a little bit of psychology for a lot of people, and then as the needs increase and get more complex you get to a more intense model. We were reading an article in a research journal about this model in Ottawa, and the director of my clinic was saying ‘I wish we could just fly to Ottawa and sit down and talk to this person!’ And I said ‘I’ll set up a Zoom meeting for Tuesday’. It can just happen so fast and we’re so used to the platforms that it almost feels like we are face to face when we talk this way.”

I do this food order thing, where I get food delivered from local farms in my area. The food gets delivered by Miles [not his real name], a big burly man with a beard down to his belt buckle who drives the enormous freezer truck. A little while ago we were talking about this new job I had just started with the Canadian Psychological Association, and Miles told me about a co-worker he was worried about who was becoming more withdrawn. He was worried about his friend’s mental health. Should I reach out to him? Should I leave it alone? As a non-psychologist, I couldn’t give great advice about exactly what to do, but I thought that gently reaching out could never hurt. The next few times I saw Miles he would give me updates about how his friend was doing. One day last summer when I was working out of my garage, Miles and this co-worker were both in the truck and came in to sit for a few minutes. Now every time they make a delivery to my house, we sit for fifteen minutes or so to talk a little bit about our own mental health. How we’re holding up with this pandemic, what the struggles have been for ourselves and our families. Dr. Carleton says this kind of thing is happening more and more often.

“We’ve seen huge improvements in the discussion of mental health. Instead of it being something that’s kept in the dark, people are having frank conversations. The fact that we’re at a stage where we’re trying to mobilize knowledge about mental health to help transition toward substantial change – that’s a monumental shift even in the last two decades. We may not be exactly sure what we’re going to do next, but at least now we’re no longer denying that we have important opportunities for the population with mental health. I think a lot of that’s come about as a result of the advocacy of clinical psychologists and other mental health professionals.”

We’re not all the way there yet – some stigma remains and hangs on, like that image of the cigar and the couch. But mental health professionals continue to work at eradicating it, and clinical psychologists are no exception. Dr. Sabourin sums up the message very well.

“It’s okay if you’re struggling – you’re human. Being a human being on this planet is not easy! We’re all trying to live our life but we didn’t choose who our parents were, we didn’t choose our genes, we didn’t choose the fact that our brains are probably still programmed to help us survive 20,000 years ago and our environment has changed substantially since then. It’s about normalizing that it’s okay when there are times in your life that are harder than other times. We see these amazing human beings who have flourished – like Clara Hughes, the Olympic athlete who recognizes she’s had trouble. We have really famous actors and politicians who are becoming open with their difficulties and that something can be done about it. We’re recognizing as a society that it’s not the case that you’re either well or you’re sick. You can find tweaks. You can find ways of having a bit of an easier go, becoming more comfortable in your skin, being more present in engaging with your kids. Many of us struggle, and the fact that you’re seeing a clinical psychologist doesn’t mean there’s something wrong with you, we’re just all human beings trying to do the best that we can in this not-easy world.”

Criminal Justice Psychology

“I was one of those people who watched shows like CSI when they first came on the air…”

Dr. Sandy Jung’s eyes just rolled out of the back of her head. “Oh no! No, Keira, don’t say that! Noooooo!”

Dr. Keira Stockdale is a psychologist with the Saskatoon Police Service and an adjunct faculty member at the University of Saskatchewan in the department of psychology. She is the current Chair of the CPA’s Criminal Justice Section, and she’s explaining what got her interested in psychology and, in particular, the psychology of criminal justice.

Dr. Sandy Jung is a Professor at MacEwan University in Edmonton. Her research is in forensic psychology, and she is trying to keep it together as she hears the words she dreads the most. TV shows that represent criminal justice science, in inaccurate and badly misleading ways, have been a thorn in her side for some time, it seems!

“I’m cringing because I hear this from students all the time. They get interested because they watch these TV shows and it’s sexy, it’s very interesting. To be honest I never watch crime shows and I still hate them to this day! So when students recommend something like Dexter to me, I just can’t. I won’t.”

Any student who thinks they’re getting into the world of CSI when they head off to school is quickly disabused of the notion. No crime is solved through DNA analysis and the identification of eucalyptus on a shoe sole in an hour. Very few investigations are enhanced by the taking off, and then putting back on, of sunglasses over the majestic riff of Won’t Get Fooled Again. This is, of course, true for Dr. Stockdale as well. She continues,

“I went to U of T to do a forensic science degree. And in the process of doing gel blots to compare the DNA to see if they match at a crime scene, I realized that the classes I was taking about the people who were actually perpetrating these crimes were way more interesting. From there I was fortunate enough to do a placement with the OPP in their Behavioural Analysis Unit. After that I just continued to get more and more people-focused, and that took me down the path of clinical forensic psychology!”

Yes, the Behavioural Analysis Unit is a real thing. Many of us even know all the shorthand – BAU! Unsubs! CODIS! Thanks a bunch, Criminal Minds! It will likely not come as a surprise to learn that a real-life BAU has precious few private jets, video-game spinoffs, or cameos by Jason Alexander. Dr. Stockdale says,

“When you walk in there are no pictures of people and phones ringing and all that – it’s just a quiet office where people do really good investigative work. They also develop risk-assessment tools or other methodologies that we can use to combat crime such as domestic violence and internet-facilitated sexual exploitation.”

So what, then, do psychologists who specialize in criminal justice actually do? Is it like B.D. Wong’s character on Law & Order, or more like John Francis Daley’s character on Bones…”no”. Dr Jung says there are two main types of psychologist involved with criminal justice, but that the field is incredibly broad with hundreds of different specializations.

“A clinician is probably the prototype of what we think of as a ‘Criminal Justice Psychologist’, but that’s only one half of it. The other half is the research and experimental psychology side. Not just research within practical settings like correctional or treatment facilities, but also research in terms of how the legal system intersects with psychology. Every decision that we make has a psychological component to it – it’s making decisions about how you interview a witness, or a suspect. How you’re gathering data and how you interpret it. And in the courts there are so many different decisions that get made that psychologists examine, like sentencing or jury decision making.”

Jury decision making, you mean like that guy in Bull who…”absolutely not”. Dr. Stockdale says that most psychologists who work in this space are, in a way, jacks of all trades and masters of just one or two.

“To be a good forensic or criminal justice or police psychologist, you’ve got to be a good generalist. We’re bringing a lot of our general psychological knowledge and our clinical understanding into this area of practice. At present, working with a police service, I’m working with an interdisciplinary team that tries to assess risk and intervene with serious violent offenders. The team has prosecutors, police, community probation, correctional facilities and mental health workers – and also psychology residents. We’ve developed risk assessment tools as psychologists that our partners in, say, probation or policing use. So part of our work is educating this team about how we can work together to really help these justice-involved individuals with histories of violence. Many have mental health needs, and we want them to get the services they require while promoting community safety. At present, we’re looking to develop greater virtual services and we’re also doing some great stuff with big data, predictive analytics, and modelling to try to improve risk assessment technologies. How do we assess needs for our clients, how do we know who’s at risk for re-offending, and why. We’re also applying that same technology to missing persons cases.”

One of the most well-known missing persons cases in the past decade in Canada happened in the Village in Toronto. Between 2010 and 2017, eight men from the gay community went missing. It was eventually determined that they had been murdered by a serial killer, who was arrested in 2018. The handling of the initial investigations by the Toronto Police Service into these missing people has come under heavy criticism and led to several inquiries and reviews. The external independent review was conducted by Judge Gloria Epstein. It was a failure on the part of the police, and the gay community in Toronto was failed. But Dr. Stockdale is hopeful that meaningful change will come about as a result.

“I’m optimistic that we’re going to see more and more academic partnerships with all areas of criminal justice going forward. We did work around missing persons, that came out of people reported missing in The Village in Toronto. In Judge Epstein’s report, she recommends that police departments (in this case Toronto) work with academic institutions and researchers because then you have people to support you in evaluating your programs and initiatives. People can’t do it alone – it’s a resource issue, but it’s also an issue of cognitive thinking and attitudes. The more we can work in interdisciplinary teams in criminal justice, the more we can guard against biases and maybe test out some of our assumptions or interventions. We can then tailor those going forward.”

The field of criminal justice psychology is always moving forward, always changing, and always (if slowly) getting better. Dr. Jung says the key to this is knowledge mobilization – the process by which research comes up with data and answers and then translates that work into real-world changes and best practices.

“We need to have a lot more knowledge mobilization going forward. There’s still a ton of research that has to be done, but we need to do better at implementing things that we already do know. There are some really nitty-gritty practical questions that we can help to answer. We know that high-risk groups should receive more supervision, but where is the cutoff? How many hours should we spend administering treatment? We’re disseminating this information, but we’re not putting it to use in practical terms the way we could be. The reality is that it takes about seventeen years before any evidence gets implemented. I remember hearing that citation once and thinking ‘well, that’s depressing!’”

Seventeen years is indeed a depressing statistic, and change can certainly appear slow. But Dr. Stockdale says she can see that change in many facets of criminal justice, including the work that she herself has done.

“I look at some of the psychological assessment reports that I wrote for justice-involved individuals years ago, and I realize just how much practice has changed. Canadians are known internationally for our development of risk assessment tools and technologies. Assessment years ago was a judgement call – will this person re-offend? Maybe? Now it’s a lot more structured and evidence-based. Now we look at a bunch of factors and figure out where we can intervene or provide support to reduce a person’s risk for violence, sexual offending or general criminality. Our treatment programs are much more focused than they were decades ago, as we really hone in on these dynamics or changeable factors.

We’re moving from negative and stigmatizing labels toward more positive language. Like ‘justice-involved individuals’ instead of ‘offenders’ or ‘inmates’. We are also moving away from focusing on the negative in treatment of people – and I think this is particularly important for youth in the criminal justice system – we’re accentuating the positive things like strength and resiliency.”

Another way criminal justice is changing is in terms of social justice. Again, this is a very slow process, as the justice system has so many giant components that it is a huge ship to steer. Dr. Jung says that researchers in the area have historically stayed in their own silos, but that this is changing now with social media and digital data making collaboration and interdisciplinary work easier and more accessible. She also says there is a long, long way to go before the justice system in Canada and those around the world achieve the equity toward which they strive.

“There are a few court cases that really brought attention to something that everyone already knew existed, but that we hadn’t investigated as much as we should have. It takes those cases to remind us that this is an incredibly important issue. When it comes to equity diversity and inclusion, there are certain subgroups that have been looked at but not all – we’ve done very little when it comes to gender, for example. I’d say we’re barely scratching the surface of the issue.”

Dr. Stockdale says that in thinking about issues like Me Too, Black Lives Matter, Indigenous oppression, she thinks about how little training in these matters she received when doing her clinical psychology PhD. In addition to educating teams, there’s a need to continue to discuss these issues more broadly. We’re moving into an era of smart prisons and risk-assessment apps, so she thinks maybe we can use technology in positive ways to move us down this road. She is also an advocate for a larger overall shift in philosophy.

“I think there’s a need to involve community groups and organizations, special interest groups who work with some of these populations and people. We, as criminal justice psychologists, like to apply science, but we also recognize that’s only one way of knowing. And in the justice system we have to be open to and respectful of other ways of knowing. That will be a challenge going forward, and I think we need to put a lot of focus there.”

Even the TV crime shows that create interest in criminal justice are starting to make a shift toward social justice themes – at least they’re trying. It’s often awkward, and sometimes ham-fisted, but then most of those shows are already awkward and ham-fisted. We know by now that it was not televised crime shows that got Dr. Jung into psychology – so what did?

“I was going to go into psychiatry, initially. I took a course in the third year of my undergrad at UBC with John Yuille and Robert Hare. Dr. Hare is the developer of the psychopathy checklist, and I found that so interesting and sexy and all of a sudden I was interested in a whole different field. From that point onward I started volunteering in some labs and gaining interest in both eyewitness testimony and psychopathy. I knew at that point I was in for good. It’s been quite a journey from there – I would never have thought I would go from doing forensic mental health to today working with police detectives on how they manage offenders in the community.”

Alright, one more pop culture reference. Dr. Robert Hare appeared in the 2003 award-winning Canadian documentary film The Corporation, where he appeared to conclude that, were a corporation a person, it would check almost all the boxes on the psychopathy list. However, in later edition of his book Snakes in Suits: When Psychopaths Go to Work, Hare suggested his comments were taken out of context by the filmmakers, and that in practice a corporation really wouldn’t meet the criteria of being called a ‘psychopath’.

As the vast subject of criminal justice grows and matures, and the psychology that accompanies it does as well, both Dr. Jung and Dr. Stockdale want to make sure we know that things are, in fact, getting better. That no matter how bad something looks today, remembering what it might have looked like twenty or thirty years ago shows that we are in fact making progress. Dr. Stockdale says,

“You’re safer now than you would have been in previous times, just walking around. Back in the 80s there were all these Stranger Danger campaigns and this kind of thing, imagining that you were most in danger from that unknown person who was lurking around a corner somewhere. Now of course, we know that you’re most at risk from people you know, and we’re all more aware of that now. We may not like these true crime podcasts, or cringe at CSI type TV shows, but I think there may be a protective function in that some of the evidence we’ve learned in criminal justice that’s talked about on these platforms has actually made us safer.”

Dr. Jung cringes.

Sport and Exercise Psychology

Brooke D’Hondt is just sixteen years old, and she already has a team of coaches and experts helping her excel in the snowboard halfpipe. Brooke finished in tenth place in snowboard halfpipe for Canada at the Beijing Olympics, and when the games are over she’ll be going back to high school. Imagine being in her gym class!

Sport psychology sort of emerged from gym classes – physical education originated in the education world, and over time evolved into the sport psychology we know today. Traditionally, sport psychology graduate programs are housed within schools of kinesiology at universities. They offer graduate degrees which produce scientists within the field of sport psychology.

Today, there are two main paths a person can take to become a sport psychology practitioner, and two types of credentials that exist in North America. One is the registered psychologist, who has the broadest scope of practice when they have acquired the training and experience to declare a specialty in sport and exercise or performance psychology. The other is a professional called the ‘mental performance consultant’ (MPC). Those are people with science-based degrees who have done some applied training but have a limit in the scope of their practice defined by the application of psychological knowledge within that performance or sport setting.

Dr. Zarina Giannone has taken both those paths. A registered psychologist with a specialization in sport and performance psychology, Dr. Giannone did her graduate training in counselling psychology, but pursued applied training within sport psychology (the MPC). She says,

“Sports psychology is one field within the broader sports science domain. Even my own work as a sports psychologist is just one slice of a larger pie, in that it covers the application of performance psychology. It involves taking science and theory and applying it to real-life situations.”

The mental health of athletes has never been in the spotlight to the degree it is today. Elite athletes are talking about their mental health, stepping away from their sports to take care of it, and being fairly public about their struggles. Naomi Osaka, Simone Biles, Calvin Ridley, Clara Hughes, Andy Robertson, the list of athletes who have publicly started speaking about mental health is growing longer by the day. This is a trend that excites Dr. Giannone.

“Even through my seven years of grad school, I’ve noticed some changes which have been really exciting. In the early 2000s, the field focused more on traditional mental skills that were taught to teams, athletes, and coaches. Imagery, arousal regulation, attentional control, that sort of thing. These are important skills that, if mastered by athletes, can enhance performance. They are also transferable skills that can enhance general well-being and life functioning. In the last little while, personal psychologists and MPCs have been more highly sought. This is, among other things, because of the fact that athletes feel more comfortable disclosing mental health challenges. The stigma around these things has been reduced. And that means that the role of psychologists in sports clubs and organizations is more in demand.”

The Indianapolis Colts, for example, have launched an initiative called Kicking The Stigma, and the face of the campaign is their standout linebacker Darius Leonard, who opens up about his anxiety attacks and depression. But for every team that embraces mental health issues and tries to tackle the stigma around them, there seems to be a story about another group that has yet to catch up. The Canadian Hockey League recently came out with a devastating report about a culture where a “code of silence” enabled off-ice misconduct to become the norm. Says Dr. Giannone,

“I’m aware of some organizations and teams that do take mental health very seriously, and there are sport psychologists who are involved in working with problems from a social justice perspective. For example, those working with sexual abuse or misconduct cases. Those psychologists have had an impact in terms of creating systemic change in some organizations. You’re seeing more mental health policies being implemented, or diversity and inclusion policies. Hopefully people will experience the impact of those things, and it will be a matter of time before all major sport organizations get on board.”

This year at the Olympics is the first in a long time where NHL players are not there. That means that the hockey teams competing against one another fall into two categories – either a group of players who have been playing together in one situation or another for a long time, or a roster cobbled together from the best players available who have little experience playing with each other. How do you build team dynamics and trust? Dr. Giannone says this is currently becoming more the domain of sport psychologists and MPCs.

“Sport psychologists are doing more than offering traditional mental skills training and assessments. My work today focuses on optimizing performance, but it also extends into helping with other sport-specific challenges including interpersonal team dynamics, training leadership, and supporting diverse mental health challenges experienced by athletes like burnout, depression, anxiety, or disordered eating. In many ways, the role of the sport psychologist has been reimagined and now involves addressing both the psychological health and performance needs inherent in sport.”

Dr. Giannone’s main job is in private practice at the Vancouver Psychology Centre, where she sees both general psychology clients and others in her specialty practice in sport and performance psychology. In that space, she sees a wide range of athletes and performers – anyone from youth to professionals. On occasion she’ll take a contract with a team where she’s implementing a mental skills program or providing other group-based services. She also works with the Canadian Centre for Mental Health in Sport (CCMHS), where she provides mental-health-based services to athletes and performers.

“Since 2013, federal funding for services has really expanded, and quite rapidly. There are now a few federally funded services for national-level athletes. For example, there’s Game Plan, which offers a wide range of services to carded [elite level] athletes in Canada. My work with the CCMHS is for any level of athlete, coach, or administrator where certain people can access funding for that. Other countries are a bit behind on this stuff, making Canada a leader in this space.”

As with all major events in the past two years, COVID is a central issue at these Olympics. It has disrupted training, hampered team-building, and caused many athletes to miss their shot at competing on the world stage. It has even cost some athletes a chance at competing after they got to the games, when a positive test ended their Olympic journey early. Dr. Giannone has seen all the ups and the downs the pandemic has created for athletes of all levels.

“Near the beginning, sports were on pause. Major tournaments were postponed. At that time, it was really about modifying and shifting psychological services to an online delivery. We did some team-based things where there were more than 25 people on Zoom! Over the past year, a lot of athletes have returned to sport, and there are new types of challenges we’ve never faced before. The content of the work has shifted – like think about a youth athlete, where they haven’t been in a high school competition in two years. They were in grade 8 and now they’re in grade 10. What that means for them developmentally and in terms of sport-specific skills development is interesting.

A focus of my research is around identity development in sport. What happens to it when someone experiences injury, or retires, and the identity loss that comes with that. A lot of identity threat has come about as a result of COVID, from kids all the way up to Olympians. These people who derive such self-esteem and value from sport are involuntarily forced to put it aside for some time. That can be very disruptive for people.

I’d say, conversely though, COVID has provided athletes a unique opportunity for people to engage with their sport in a new and different manner. Maybe someone never had the time before to watch video of themselves, and they’re able to learn about themselves differently now. Maybe they’re able to do a bit more weight training. It has been striking to me how people have been so resilient and creative throughout this.

Something that really stood out to me at the beginning of the pandemic was a shift from physical and mental skills training to fostering new conceptualizations of team culture.  I remember stepping into teams and helping to facilitate goals, helping to cultivate team values and relationships. Not that I wouldn’t do that during a regular season, but the pandemic really placed the spotlight on that because there wasn’t much else to do when everything was so up in the air.”

Athlete mental health is a rapidly expanding field. The role of psychologists in tackling some of the social and systemic challenges like athlete misconduct, mistreatment in sport, abuse and harassment, cultural inclusion and diversity, are really coming to the forefront. Psychologists are involved in helping to create support, but also in trying to promote systemic change within systems and organizations, and all of that trickles down to athletes. But their influence and involvement no longer end at the locker room door. Says Dr. Giannone,

“Sport psychology professionals have now gone outside of the traditional sport and exercise setting. They’re working with performance issues in other domains. It’s common to have sport psychologists working in the military, with performing artists, first responders, or with high-ranking business executives. Pretty well anyone in high-pressure scenarios. I would anticipate seeing more psychologists  with these specialized skills making their way into diverse settings.”

The Olympics are on right now, presenting a series of high-pressure scenarios for elite athletes for public consumption, all day every day. We can share in the joy of the Canadian women’s speed skating pursuit team pulling out an improbable gold medal performance, while also empathizing with the heartbreak of the Japanese team whose stumble in the last turn gave that gold medal to Canada. Our eyes, the eyes of the world, add a pressure that doesn’t exist at any other time for these athletes. It can be a difficult situation, and one where a psychologist can help them navigate through it. Whether you’re Jennifer Jones, competing in your second Olympics at age 47, or you’re a 16-year-old snowboarder who is about to go back to geography class.

Psychopharmacology

It generally takes about ten years of schooling in Canada to become a psychologist. It’s one of the longest, most intensive fields of study there is as it generally requires a PhD or PsyD, those programs are quite small, and it takes longer to complete a psychology doctoral program than most others. Imagine going through all that, and then deciding ‘you know, I could really use a little more school’. What kind of keener do you have to be to take on MORE education when you’re finally done?

This is the decision made by those who choose to follow the path of psychopharmacology. Dr. Diana Velikonja is a neuropsychologist by training. She is a clinical psychologist, and has a masters in clinical psychopharmacology – that allows her to do consultations with regard to psychotropic medication.  She has worked with people who have had head trauma, is the Past President of the Ontario Psychological Association, and has led initiatives to advocate for the scope of practice for psychologists in Ontario to include prescribing psychotropic medication. She explains psychopharmacology this way:

“For a lot of emotionally-based or cognitively-based challenges, there are specific types of medications that are used called ‘psychotropic’ medications. They’re primarily used to treat conditions like anxiety, depression, hallucinations. For mental conditions or addiction issues, they help manage the symptoms. Psychopharmacology is really prescribing medications in conjunction with other evidence-based treatments. The reason psychologists are involved in this is that we’re trained in behaviour and therapy-based interventions, and those of us who have sought additional certification with regard to prescribing psychotropic medication are able to integrate the two – the behavioural and the medication in order to help guide patients toward the best strategies to manage the symptoms they’re experiencing.”

Prescribing medication to treat mental illness has, at least in Canada, long been the domain of psychiatry. Psychopharmacologists are some of the very few psychologists who have that level of knowledge when it comes to those medications. Dr. Amir Ali Sepehry is the Chair of Psychopharmacology Section at the CPA. He has a PhD in neuroscience, post-doctoral training in neurology, a masters in psychiatric science investigating medications, and other training in spinal cord injuries, and counselling psychology. Dr. Sepehry is currently teaching at the Adler University (Vancouver) and collaborates with UBC, and working with forensic neuropsychologists on medical legal cases. He says the field of psychopharmacology is both very old, and very new.

“It goes way back to when people with a variety of specialities used substances, herbs, and so on for the treatment of mental illness. However, there has been an incredible acceleration in the past five years, because much has happened. One part of that is the SARS-COVID-19 we have experienced. There are minor developments happening, as many of us are trying to repurpose medications.”

A person’s normal anti-viral immune response requires the activation of the inflammatory pathways of the immune system. ‘Cytokines’ are produced as part of that immune response. An unchecked and outsized immune response is known as a ‘cytokine cascade’ or ‘cytokine storm’. This can lead to tissue damage, and has been seen in many severe cases of COVID-19. It comes about as a result of an overabundance of pro-inflammatory cytokines. Dr. Sepehry says this is one of the ways psychopharmacologists are looking at the repurposing of existing medications.

“Anti-depressants have shown anti-inflammatory properties, so they could be used toward the cytokine cascade that is evolving as a result of COVID. We are still at a stage where we have to see the long-term effects of COVID on the brain and behaviour, on personality changes and mental illness, and the potential recovery. There is more need for psychologists to get involved. We know that there is an increased rate of mental illness, particularly among older adults, who contracted COVID. So the involvement of psychopharmacology is crucial.”

Dr. Velikonja suggests that there are other ways medications can be studied, especially as we learn more about the effects of COVID, both short-term and long-term.

“Medications may be able to be repurposed to deal with things like the fatigue, what people talk about as the brain fog, the stuff that comes with what they call ‘long COVID’. When people have a lack of energy or physical motivation to do things, there’s probably some targeting that can be done in that domain.”

These past two years have seen a mobilization of scientific expertise the likes of which the world has rarely, if ever, seen. Experts from virtually every scientific discipline have come together to deal with every aspect of the pandemic, and interdisciplinary and cross-disciplinary work is at an all-time high. Psychopharmacologists are used to working in an interdisciplinary way, and bring an enormous breadth of expertise to that scientific table. Dr. Velikonja sees their involvement in this enormous effort as essential.

“I think it’s crucial from many perspectives, in that everybody’s talking about the next big wave, which is the mental health wave. We know that there are a lot of challenges in the field of psychiatry, in terms of the number of practitioners who are available. I think psychologists are well-positioned to be in that role, to work with psychiatry to look at prescribing and the integration of behavioural strategies. We will need all hands on deck as the wave of mental health issues is unfolding.”

That wave is unfolding now, as we see more instances of domestic violence, an increase in rates of depression, anxiety, and trauma, and more problems with substance use. What this wave will look like a few months or a few years from now is anyone’s guess. But when that time comes, it will remain an “all hands on deck” situation. And we can feel a little better knowing that some of those hands will belong to the people who have spent years becoming experts in their various fields. The scientists for whom learning just one thing is not enough, who want to learn more and more. You know - the keeners.

Psychologists in Hospitals and Health Centres

“My suggestion to my friends, family, and people on the street, is to drive carefully. Look both ways before you cross the street. Eat your Wheaties and take your vitamins.”

I’m speaking with Dr. Kerry Mothersill in September 2021. Alberta is still in the middle of their fourth wave of COVID, the Delta wave. Omicron has not yet been discovered by scientists in South Africa, and Alberta ICUs are already at their limit. Dr. Mothersill is issuing this warning because he doesn’t want anyone to get into a car accident, show up at the Emergency door of the nearest hospital, and be turned away because they are at capacity.

“ICUs and other hospital-based services are under a significant crunch, and though I tend to be optimistic I’m not so optimistic to think that within 18 months we’ll be out of a pandemic situation. The difficulties we’re experiencing at the moment tend to get lost down the line. It’s important to be informed and to base our decisions on the best evidence we have. It’s important that we all be mindful right now of the challenges in the healthcare system.”

It is now February 2022, and Dr. Mothersill’s comments seem particularly prescient. Alberta is now putting together field hospitals in Calgary and Edmonton in preparation for an expected surge. Although this will mean additional beds, health-care workers are unsure they will have enough staff to manage them. Dr. Mothersill is mainly in private practice now, but is still heavily involved with the public health system, training residents within Alberta Health Services.

The pandemic has been stressful on everyone, but no one has been affected more than health care workers in hospitals. Many psychologists who work in hospitals have been working overtime trying to help their colleagues cope with the overwhelming and unending toll the pandemic has taken on them. But not all hospitals are the kind that are being overwhelmed with COVID patients.

Dr. Kelsey Collimore is a psychologist working in the Mood and Anxiety Disorders Program at the Royal Ottawa Mental Health Centre and a Clinical Investigator with The Royal’s Institute of Mental Health Research. The Royal is a specialized mental health centre that provides tertiary care to individuals with complex and treatment resistant mental illness and/or substance use issues. Dr. Collimore says the pandemic has affected her program much differently than many other general hospitals – mostly in the shift to virtual services.

“Virtual care was something that was in place at The Royal prior to the pandemic. Of course it has really been propelled forward across all of health care as a result of COVID. I think the shift toward telemedicine has been somewhat helpful, in that now we have a better understanding of where we might want to continue with some of those services. I think there’s a real place for them going forward. As of now, we have returned to some in-person services, but most are still primarily virtual.”

Dr. Stephanie Greenham, the Chair of the CPA’s Psychologists in Hospitals and Health Centres, is a clinical psychologist working at CHEO – a pediatric health and research centre in Ottawa, where she is the professional practice leader and coordinator for psychology. She is also a psychologist and clinical lead with the inpatient mental health unit. With so many children experiencing the pandemic in ways that affect their mental health, CHEO has certainly been busier over the past two years. So what kind of services does CHEO provide, and how do psychologists factor in? Dr. Greenham gives an example.

“We have a specialty service that provides outpatient care for children and youth with complex chronic pain that integrates care from the physical, psychological, and pharmacological perspectives. Psychologists play a key role in program development and evaluation. The multidisciplinary team involves physicians, nurse practitioners, psychiatrists, psychologists, social workers, physiotherapists, occupational therapists, and pharmacists. They work collaboratively with children, youth, and families to provide a multidisciplinary assessment and interventions. That could be individual or group interventions run by psychologists or other members of the team, family therapy, follow-ups with physicians, and medication management. It’s very much a team offering!”

The Royal provides a much different type of care, primarily geared toward adults. They work with a particular client population or a particular group of clinical disorders, for assessment and treatment. They also place a large focus on evaluation and an increasing focus on clinical research integration. The people Dr. Collimore sees are often those for whom traditional treatments haven’t worked.

“I work with adults with a range of depressive disorders, bipolar and related disorders, traumatic stress or anxiety and related disorders. Most often I work with individuals who historically haven’t responded to various treatments and have had their symptoms for quite some time. Often I work with clients who have a more complex clinical presentation – meaning that they have more than one difficulty with a lot of stressors to consider within the context of service delivery.”

Psychologists who work in hospitals have a certain kinship with one another, which is why the CPA created the Hospitals and Health Centres Section. Dr. Mothersill, who practiced in hospitals for about 40 years in Ottawa and Calgary, is one of the founding members of the section.

“There were a number of us who felt there were particular challenges and opportunities for psychologists who were working within the publicly funded health care system. People working outside of industry, outside of private practice, outside of government. We created the section to discuss issues that were pertaining specifically to practice within hospitals and various health care clinics.”

Today’s Chair, Dr. Greenham, explains that while initially the section was made up predominantly of psychologists working out of hospitals, that makeup has changed over the years.

“Members of this section include psychologists working in rehab centres or other types of treatment centres affiliated with public health. They’re clinical psychologists, health psychologists, neuropsychologists – who happen to be working in the public health system.”

Dr. Mothersill says there are a few reasons this shift has happened.

“Things have evolved in publicly-funded healthcare over the last several decades, so as much healthcare as possible is being delivered outside hospitals – in urgent care centres, clinics and the like. There is a continuum of care that’s provided from very intensive in hospitals to less intensive outside with which psychologists are involved.

Up until maybe ten years ago, most emerging psychologists coming out of grad school, especially those who specialized in clinical psychology, neuropsychology, or health psychology, had a desire to work in a hospital setting or a publicly funded health system of some sort. I think in the last decade, and increasingly so, this is no longer the case. A growing percentage want to enter directly into the private practice field. There has been a growing number of large private practices, where many psychologists can work and consult with one another. I think this poses some challenges for publicly funded systems to attract and hold onto psychologists within that system.”

Dr. Greenham points to another place that is attracting psychology grads – primary care.

“I think there are increasing opportunities for psychologists in communities to get involved at the primary care level, where they’re becoming embedded within primary care practices with primary care physicians and interdisciplinary practices within the community.”

The more psychologists are involved with primary care, and with clinics and therapy centres and multidisciplinary teams across Canada, the more involved they are in every facet of public health. And the stronger their voice will be when they give advice like;

“Drive carefully. Look both ways before you cross the street. Eat your Wheaties and take your vitamins.”

Black Psychology

“What field can be more anti-racist than psychology? We are here to promote human beings, human development, and human well-being! There is no field that can address racial issues better than psychology.”

Dr. Jude Mary Cénat is passionate about making psychology anti-racist, and inviting his colleagues in the mental health field to join the movement. Dr. Cénat is an Associate Professor in the school of Psychology at the University of Ottawa, and the director of the Vulnerability, Trauma, Resilience and Culture Research Laboratory (V-TRaC Lab).

Canada’s racialized populations experience unique traumas and mental health concerns. Black Canadians are no exception. In addition to the things that affect everyone – the pandemic, work stress, family issues – they must contend with societal racism and workplace hostility/microaggressions that remain a fact of everyday life in this country.

“We cannot continue to perpetrate and encourage racial discrimination. We cannot continue to be ‘colourblind.’ People who experience high levels of racial discrimination are thirty-six times more likely to present with severe symptoms of depression.”

The effort to make sure psychology leads the way it can, and should, in addressing racial issues is one of the principals that led five CPA members and affiliates to become the driving force behind the creation of a new Black Psychology Section at the CPA. Kafui Sawyer, Anita Shaw, Dr. Helen Ofosu, Dr. Monnica Williams, and Dr. Erin Beettam see the mission of the section as promoting and advancing practitioners, educators, students, and scientists of psychology who identify as Black and who are concerned about psychology-related issues that impact Black people. Each of them has seen that impact, some personally, in their own careers.

Dr. Helen Ofosu is an Industrial/Organizational psychologist, Executive Coach, and HR Consultant in Ottawa. She works with organizations including government departments, to improve organizational culture and inclusion.  Over the past two years, during the pandemic, she has noticed a lot of racialized employees choosing to find work within more inclusive organizations, as they are realizing that working from home, they are no longer subjected to the everyday indignities they experienced in a physical workplace. “These things have been happening for years, but now people are removed from that environment, and they have the peace of mind that comes from doing their work without worrying about microaggressions, or getting the side-eye, or being excluded from lunches, coffees, and conversations. When all of that is gone, people feel so much more relaxed because they can just focus on doing their work.

I think the real trigger was in the summer of 2021, when a lot of organizations were planning their return to the physical workplace. It was only when people started to realize ‘oh my goodness – I might have to go back to the office’ that they started thinking ‘wait a second – I don’t think I can go back to the office. I don’t want to go back to the office! I don’t want to go back to the way things were.’

During all that reconsideration, a lot of people figured it was a smart time for them to find a different place to work, where there’s more representation, more inclusion, more diversity, and just a better workplace culture. From what I’ve seen, people are reflecting on a lot of things during the pandemic. So, they’re looking for a way to find employment where they can just be themselves, and focus on doing their work instead of focusing on self-protection from all these emotional assaults.”

Anita Shaw is a PhD student at the University of Northern BC in Prince George. She says,

“While I’ve been doing my PhD, I’ve also been really thinking about decolonization. Not only decolonizing my own thinking, but about how psychology has contributed to colonization, and how it could contribute to decolonization. I’ve been working with a mentor who is an Indigenous scholar, and we’ve developed a template for a course curriculum for decolonizing psychology.”

Kafui Sawyer is a psychotherapist, a trauma consultant for Health Canada, and the Clinical Director for Joy Health and Research Centre. She helps families through traumatic experiences, assists government employees who have suffered as a result of experiences (such as racism) in their workplace, and much more. Often clients will ask to work with her specifically, because she is Black and shares a lived experience with those clients. She says that the most rewarding thing for her is working with complex cases like personality disorders, as clients transition from a disordered personality to a more grounded place.

Ms. Sawyer notes that the Section founders’ hope is “to create a space where people with similar values and beliefs can make things work. We hope it brings like-minded people together so we can have a home in the CPA.” For the founders, the Section is an opportunity to create a space where people can bring common their interests and experiences together in a way “that empower us to be better.”

The Black Psychology Section is an important space for allies of Black members, students, and affiliates as well. Dr. Erin Beettam identifies herself as a Child & Adolescent Clinical Psychologist. While she trained in School Psychology, her work has primarily been in hospitals, pediatric psychiatry, and the public mental health system. Erin specializes in treating adolescents and young adults in anxiety, depression, emerging personality disorders, and eating disorders. Presently she works in a school board and has a private practice. She notes her growing awareness “of the lack of available and effective services for people of colour, for Black communities, in the workplace, and in educational settings”. This awareness has led her to examine what she “can give and do to provide support in the changing landscape.”

Dr. Monnica Williams is a researcher at the University of Ottawa who has long been an advocate for inclusivity in research. For too long, people of colour have been excluded from research of all kinds, notably in a variety of psychological fields.

“So much of the research we see is exclusionary, and it not only perpetuates the problem but it’s also a symptom of the problem. Part of the issue is that we don’t have enough researchers of colour to do the research for people of colour.

I do a lot of research bringing these issues to light – how treatments might need to be adapted for people of colour, how therapists who are getting trained now can learn more about how to treat people with a more inclusive lens. Everybody needs to understand best practices when working with race, ethnicity, and across cultures.”

It is these best practices when working with race, ethnicity, and across cultures that Dr. Williams’ colleague at the University of Ottawa, Dr. Cénat, is promoting as well. He and his colleagues have created a course called ‘How To Provide Antiracist Mental Health Care’, approved for Continuing Education credits by the CPA. Dr. Cénat hopes that all mental health professionals, and Canadians by and large, become committed to anti-racism.

“As Ibram Kendi said, there is no ‘racist’ and ‘non-racist’. There is racism, and anti-racism. If you are just ‘non-racist’, you aren’t taking actions that can push back against racism. And you have to take action against racism because that is how we can create an anti-racist society.”

The Black Psychology Section, approved by the CPA Board in November 2021, is now accepting members.  Once membership is established, the Section will propose its Terms of Reference to the CPA Board for approval and then go on to elect its Executive; all steps which should be completed in 2022.  The Section’s purpose will include working with others to increase the presence of Black professionals in psychology and to increase access to mental health, wellness, organizational, and consultation services for the Black community; especially those who experience unique barriers to accessing appropriate mental health care and other psychological services (e.g., training, leadership, organizational interventions, basic and applied research, etc.). The Section may ultimately become a community space for CPA members, students and affiliates interested in these issues and, especially for Black students, educators, researchers and practicing psychologists. For more information about joining the Section, go to https://cpa.ca/sections/black-psychology/

Clinical Neuropsychology

The word “neuropsychology” is a mouthful. It feels like one of those words you might use when you want to seem smart. Like “nomenclature”, or “cumulative”. Because it takes so much time to say, neuropsychologists have come up with a clever way to shorthand the term – they say “neuropsych”. Leaving out the last two syllables has, over the decades, undoubtedly saved countless cumulative hours in university department conversations across Canada.

Add the word “clinical” and you’re in a whole new world of nomenclature. One which Dr. Kristina Gicas, Chair of the CPA’s Clinical Neuropsychology Section, is happy to unpack. Dr. Gicas is a clinical neuropsychologist and an assistant professor at York University, where she trains clinical neuropsych students. She teaches, does research, and also does some clinical work in Toronto. She says,

“Clinical neuropsychology is the study of the relationship between your brain and your behaviour. We look at the structure and function of the brain, and study how that relates to thinking abilities. This includes things like attention, memory, language, visual skills, processing speed and even emotional functioning.”

Neuropsychologists are experts in investigating these brain-behaviour relationships, and using that information to do a number of things. The number one thing they do is diagnosing things like injuries or diseases that are affecting the brain (concussion, stroke, tumors, dementia). They also seek to understand normal human development and aging. Another area of specialty of neuropsychologists is in designing and implementing interventions to improve peoples’ day-to-day functioning.

The CPA calls the section Clinical neuropsychology because all neuropsychologists are trained as clinical psychologists first. The neuropsych part is a specialization, where practitioners take additional courses – for example, doctorate courses in neuroanatomy (another mouthful of a word – only this one has no convenient contraction). They learn about assessment tools and cognitive tests – what they mean, how they’re used. Most psychologists can administer these tests, but it’s neuropsychologists who can link them to brain functioning – that brain-behaviour relationship.

Maybe you’ve noticed that one of your parents is starting to become more forgetful, and is less able to pay attention to tasks than they once were. You might take them into the doctor, who might then administer a test to them – like the MoCA (Montreal Cognitive Assessment) test. This is a preliminary screener that can help determine the degree to which intervention is needed. If your parent meets a certain threshold, they might be referred to a clinical neuropsychologist like Dr. Vinay Bharadia.

Dr. Bharadia splits his time between a private practice, as Lead of Neuropsychology at TELUS Health Care Centres in Calgary and the University of Calgary where he trains PhD and Masters level psychologists.. He works mostly with brain injuries, dementia, Parkinson’s, Multiple Sclerosis, and other neurological conditions that affect cognition. He says,

“If you get referred to us, we do more robust testing of memory and attention and other cognitive areas, after a screener from your GP like a MoCA. We also look for depression and anxiety, as those can affect cognitive ability as well. We then relate the tests we do to the hippocampus, or the thalamus – brain parts that we know are related to memory, or other areas and neural networks. We look at your medical history, your MRIs and CT scans and so on, and we put it all together and look to get a diagnosis or treatment moving forward.”

A lot of the research done by cognitive scientists – like Jonathan Wilbiks in the Brain and Cognitive Sciences Section  (see earlier Psychology Month piece) informs the work done by clinical neuropsychologists. The cognitive scientists come up with research and data, and it’s then up to clinical neuropsychologists to apply that knowledge in a clinical setting to enhance the lives of their patients. And those patients vary a great deal depending on their condition, their symptoms, and their age. Says Dr. Bharadia,

“If you’re a 25-year-old presenting with symptoms of depression, you’re probably not going to see a neuropsychologist. You’re more likely to see a clinical psychologist, or a counselor, and maybe a general practitioner (GP) for medication. But if you’re a 55-year-old with depression, hopefully the GP is thinking ‘what else could this be? What else looks like depression in your 50s?’ With a few other factors in your medical history and things you might see on an MRI, it could be a symptom of Frontotemporal Dementia, which can look like depression in certain age groups. At which point they might be a good candidate for testing with a neuropsych to refine the diagnosis.”

This means neuropsychologists work a lot with GPs, psychiatrists, neurologists who are doing MRIs, and many other professionals in the world of brain science all of whom have overlapping expertise. If the 55-year-old with symptoms of depression meets with this team, they may determine that the cause is neurological – in which case they will suggest one treatment path. If, however, they determine the cause is psychological, a neuropsychologist is trained (remember – they are clinical psychologists first) to work with the person to heal.

Neuropsych as a formal field is 70 years old. The seminal work of Dr. Brenda Milner at McGill in the 50s with patient H.M. was groundbreaking in our understanding of memory. This revolutionary work was done alongside neurosurgeon Dr. Wilder Penfield. Dr. Milner is STILL PRACTISING at McGill at age 102. Some other pioneers set up a neuropsychology program at the University of Victoria, where Dr. Gicas did her undergrad. This, (along with her fascination with the brain and fervor for science in general) led her down this path. She says,

“I remember reading a book by Oliver Sacks, called The Man Who Mistook His Wife For A Hat (1985). It’s a series of neurological kinds of cases and I was just hooked after that.”

In an episode of Parks and Recreation, Ben can’t understand the relationship between Jerry (Jim O’Heir) and his noticeably better-looking wife Gayle (Christie Brinkley) and speculates that it is as a result of a neurological disorder (“one of those Oliver Sacks disorder thingies – like maybe she thinks Jerry is a friendly hat?”). It may not be the best example of neuropsychology in popular culture, in that it gets it quite wrong – but it isn’t that easy a study to get right! That is, unless you can circumvent the cumulative effect of all the difficult nomenclature.

Sexual Orientation and Gender Identity

“I don’t like beer anymore”

There’s a commercial running on TV where a guy confesses to one of his buddies, in an ashamed whisper, that he no longer enjoys the taste of beer. There is an implicit understanding between us, the viewers, and the guys in the commercial, that disliking beer is affecting that guy’s sense of masculinity. That enjoying beer with the boys is a part of his male identity that he is ashamed to lose. And that disliking beer makes him more ‘feminine’, and therefore less worthy, than the others.

Dr. Rhea Ashley Hoskin is an AMTD Global Talent Postdoctoral Fellow at the University of Waterloo, where she is cross-appointed to the departments of sociology and legal studies and also sexuality, family, and marriage studies. She is the secretary/treasurer of the CPA’s Sexual Orientation and Gender Identity Section (SOGI), and her work broadly looks at sexual and gender diversity – more specifically, societal treatment of femininity and “Femmephobia”.

“Femmephobia is about the way society devalues and regulates femininity, which can target anybody. It can target a cisgender man who orders a salad, or is seen somehow as being feminine – because femininity is often viewed as a social demotion. We also see femmephobia targeting women in science who might be seen as ‘too feminine’ and might be treated as though they are incompetent because they wear too much makeup or because they ‘don’t look like a scientist’.”

In the commercial, the guy’s buddy treats his announcement of no longer liking beer with a shrug and doesn’t seem to think this makes Guy One any less of a man. Then, of course, he offers him something in place of the beer – a hard liquor that we, the viewer, can infer to be an adequate replacement and equally manly in the eyes of society.

Femmephobia affects both gay and straight people, both men and women, and even those who identify as non-binary – the push and pull of defining your public persona through what is seen as feminine is something we all carry with us, mostly subconsciously. Every one of us is touched by it in some way, whether it’s men who order a regular beer instead of a light beer, for fear of seeming too ‘feminine’, or women who wear less makeup to appear more intelligent or ‘professional’.

Dr. Karen Blair is an assistant professor of psychology at Trent University, and has been the Chair of SOGI since 2014. She says,

“One of the neat things about Femmephobia is that once it clicks, you begin to see it everywhere. You start noticing all the different ways we devalue femininity. With men, we have a pretty narrow range of “acceptable femininity” – and in most cases, we prefer they have none. In the football locker room when a coach wants to insult a team, he might say they played ‘like a bunch of girls’. That’s meant to sting, and the players get the message that the coach is unhappy. If a man walks too ‘feminine’ or talks too ‘feminine’ or talks with his hands, we take him down a notch for it. We use femininity in our society as a weapon or an insult.”

With the occupation in Ottawa getting under way a couple of weeks ago, attacks on the Prime Minister increased notably – both within the group of insurrectionists and also on social media. Dr. Blair and Dr. Hoskin track this sort of thing. What do attacks on public figures and politicians look like, and how is Femmephobia so often a part of them?

“When people want to attack Justin Trudeau, they do a few things – one, they tend to call him by his first name. When we were upset at Stephen Harper, we still called him Harper. But when we’re upset with Trudeau, we use his first name – and some even call him Justine. Why should it be an insult to call someone by a woman’s name? Why is it insulting to feminize another person? The answer is misogyny and femmephobia. It’s not just politicians like the Prime Minister, we’ll do this across the spectrum. When people want to make fun of Putin, or Trump, one of the common memes on the internet is to add makeup to their faces to make them look like an overdone woman. No matter how you feel about Trudeau, Trump, or Putin, they’re all taken down with this same attack of ‘femininity’. It’s used to say they’re lesser, they’re stupid, they’re silly, they’re frivolous, or they’re extreme. All these things can be conveyed just by making them feminine. Which leaves you wondering – what are we actually saying about people who are feminine? It’s kind of like when people used to say ‘that’s so gay’, when what they meant was that something was stupid, or silly.”

‘We’ (society) have come a long way in the last few decades. When the SOGI section started it was the early 2000s, and one of the big pressing issues at the time was same-sex marriage. The extension of civil rights in Canada to same-sex couples was top of mind for many psychologists, and there is a policy statement from the CPA at that time stating our support for this notion of same-sex couples having the right to marry one another. It seems a little quaint today – like, of course we support that – but Dr. Blair says that at the time it was quite a novel and exciting statement.

“A lot of the research at the time, the early 2000s, was showing that same-sex relationships were the same as mixed-sex relationships in that they’re good for people, and healthy, and that love is love. These were the kinds of things researchers were focused on. They were trying to support policy-makers in understanding that when people are cut out of an institution like marriage, it changes the relationships they have with their family, their friends, and their coworkers. For instance, consider something as silly as holiday parties at a company where invitations are extended to include spouses. If you were a same-sex couple in 1999, it would be really unclear as to whether your partner was included, and in some cases it would be quite explicit that they were not.”

Many people at that time felt like they couldn’t talk about their partners at work or couldn’t have a photo of them on their desk. Psychologists working in this space were able to point out how things like that took a toll on peoples’ mental health and their well-being over time. Dr. Blair continues,

“A lot of research showed that families of LGBTQ people didn’t really ‘get it’. And that they really didn’t get it right up until the moment they were at the wedding. At a wedding there are social scripts that tell us when to get up, when to clink our glasses, when to applaud, and so on. Being able to put same-sex relationships into this social ritual that people understood created a situation where family and friends could understand the relationship – which then led to greater support from the inner circles of many LGBTQ individuals – which then led to greater mental well-being for the whole community.”

That mental well-being has taken a hit during the pandemic, for a variety of reasons. Bre O’Handley is a Master’s psychology student at Trent with Dr. Blair as her supervisor. She is working on a thesis that looks at LGBTQ well being during the pandemic and how supports might play a role in that.

“I’m looking at the trajectories of well-being for LGBTQ people during COVID. There’s a lot of research all over the world that has found that LGBTQ people are faring worse during this pandemic. Their mental health has been affected more, they’re reporting higher levels of depression, anxiety, and stress. Everybody’s experiencing COVID and social isolation, but there are additional factors that could impact LGBTQ people. They could be living in an unsupportive environment, especially if they’re younger. They’re being separated from affirming communities – like if you had a group of friends at school who supported and accepted you, but now you’re not going to school. The pandemic reduced access to LGBTQ resource centres. For a long time, trans people were unable to get hormone replacement therapy (HRT) and gender-affirming surgeries, as those were deemed non-essential at the beginning of the pandemic and supply chain issues delayed shipments of important drugs and hormones.”

There were even discriminatory COVID policies in a number of countries. In Peru, a rule was instituted that said men could leave the house only some days, and women could leave only on other days. This left trans people, and people who didn’t identify as either male or female, in a significant bind. Many experienced harassment and hate crimes while they were out of the house. Bre’s research doesn’t tackle the discrimination, so much as the supports that are needed for those who are on the receiving end of that discrimination.

“How do we foster resilience in these circumstances, and how are LGBTQ people coping in this pandemic? If I feel connected to the LGBTQ community, that should buffer some of the issues that affect mental health. But how do we separate that out from more general social supports? Is just having supportive people and family around you enough, or do you need that social connection with others in your peer group to truly maintain resilience? This circumstance now, with COVID, gives us a little bit of an opportunity to tease that apart.”

There is always more work to be done, and always new challenges that arise. Same-sex marriage has now been the law of the land in Canada for sixteen years. Adoption by same-sex couples has been legal in all Canadian provinces and territories for a decade. Conversion therapy is now banned, and many members of the SOGI section were actively involved in discussions with policy-makers to make that happen. Today, the focus on gender identity is catching up to the fight for equal rights for gay and lesbian couples. Says Dr. Blair,

“You can know a lot about sexual orientation and sexual minorities and still manage to know nothing about gender identity or gender minorities – and vice versa. The two came together as a CPA section when the topic of gender identity was less prevalent, and the focus was probably more on sexual orientation at that time. Over time, gender has become an equally important topic to sexual orientation within the section.”

All of us in Canadian society are learning a little bit more about sexual orientation and gender identity, just as the scientists are learning more and telling us about it. Dr. Hoskin frames this in terms of Femmephobia.

“Our ability to see femmephobia comes from the study of sexual and gender diversity. Femmephobia is illuminated by our ability to tease apart gender identity from sex assigned at birth, and gender expression. When we can see those things as different, we can see how gender expression comes into play and how it’s regulated by society.”

We all form part of that society, and how we regulate our attitudes toward the LGBTQ+ population is an enormous part of preserving and enhancing their mental health. It could be using the correct pronouns to address someone, embracing your lesbian daughter, or something as simple as stating with firm confidence,

“I don’t like beer anymore.”

Psychology Careers and Professionals

In June of 2014, ISIS invaded Kurdish-held territory in Northern Iraq, capturing Samarra, Mosul, and Tikrit in quick succession. Dr. Shahnaz Winer was a young single working female teaching psychology at a Middle Eastern university in the region, the place where she was born, and her family insisted she get out. She was quickly on a plane back to Canada as Kurdistan descended into turmoil and violent bedlam.

Dr. Winer reminisces fondly about her time teaching in Iraq, and says it was one of the best times she’s had in her career. She is obviously very sad about the fact that this chapter had to end, and especially sad about how it ended, but she didn’t stay down for long. She began a string of jobs dedicated to the one thing that has driven her throughout her career - the application of psychological science and knowledge to enhancing the everyday lives of…well…everybody! Through a series of jobs, in and out of academia, she ended up starting her own business. And it was as the owner of that business that she presented to students at last year’s CPA Career Fair.

Some of the most well-attended and highly-anticipated events at the CPA are the Career Fairs we have held the last few years. At these events, students have an opportunity to learn about various career paths and positions for psychology graduates outside of the health services delivery and academic settings. They  were able to meet with individuals in those positions to explore the vast job possibilities available to someone with a psychology degree.

People like Sophie Kenny, who works with eye capture technology at VPixx Technologies. Or Anne-Marie Côté who coordinates virtual field trips for students in remote northern Indigenous communities with TakingITGlobal. Or even our own Deputy CEO Lisa Votta-Bleeker, whose work at the CPA certainly falls outside the realms of academia and clinical practice.

These events allow students, professionals, and other interested individuals to network with one another in a setting designed to expand the options available to psychology graduates and, indeed, to all those interested in a less conventional career path. But what if those like-minded people could network with one another year-round, instead of a few times a year at these one-off events? That was the thinking behind the creation of the new Psychology Careers and Professionals Section at the CPA.

Dr. Winer has partnered with Dr. Votta-Bleeker to launch this section. Dr. Winer has a PhD in Cognitive Neuroscience from the University of Waterloo and is one of the people in psychology who took that non-traditional career path. The business she created, Vibrant Minds, is an online education platform where Dr. Winer takes principles of psychology and combines them with other interests. She creates digital products that help people plan, set, and achieve their career and life goals.

“The one thing that I love is that I’m able to reach an international audience of students with this. I can connect to so many different people, and to help them apply what psychology teaches us and what academic research has discovered.”

Dr. Winer did spend some time in a traditional academic role, as a professor. She says that when she taught, she noticed the students gravitated much more toward one particular type of lesson.

“The sections students were really excited about were the ones where they could apply what they were learning to their own lives. For example, if we were learning about memory, we would do an entire section about applying the knowledge so they could study better and remember things for tests more effectively. So it was that application that got me really excited, and I felt like that was something that was largely missing between traditional psychology and all the other professions and fields. That bridge between the academic side and then reaching everyone else with that information.”

When this new Careers and Professionals Section starts filling out its membership, most of those members will be people who bridge that gap. They are the people who take psychological science and principles and apply them to every conceivable industry across Canada. They’re the ones making air travel safer, workplaces more inclusive, and creating high-performance buildings that minimize environmental impact. Having this new place to collaborate will bring all those diverse people together.

“This section was really inspired by the need to provide a home for those of us who, like me, have psychology backgrounds but didn’t follow a traditional path. I became a member of the CPA when I was a student, but when I left academia, I left the CPA because I thought there was nothing there for me any more. And it was actually very lonely! It had been wonderful to have that kind of community, the support, and the resources that the CPA offers. So when I was approached with this idea of a new section geared specifically toward those interested in fields outside the typical psychology fields, it sparked my interest right away!”

The Psychology Careers and Professionals Section is at the stage right now where the section has been approved, and their next task is to recruit the founding members. With 90 new members in only the first few weeks of registration, the section is off to a sprightly start. Dr. Winer has a vision for who she hopes those initial members might be, including a diverse mix of established professionals, those early in their careers, as well as students.

“We want to create a welcoming space for students who are exploring their options. This is such an important group to me because I feel like I was very privileged. When I was in grad school completing my PhD, for the first year or so all the information provided to me, all the workshops and seminars and career fairs, were all geared toward the steps to take to get into academia, or the steps to get into clinical practice. I wasn’t sure at that time what I wanted to do, but I wanted to know what options there were.

My supervisor, Dr. Myra Fernandes, really thought we should explore all the options available to us. So within our own lab, she created a seminar series where she would bring in different speakers. For example, someone with a psychology background who was working for the pharmaceutical company Eli Lilly came to speak with us. The exposure to these other options inspired me and gave me a lot more knowledge, but my friends who were in grad school at the time weren’t being exposed to this or given this other information.”

Some of the other people who have expressed interest in the section are professionals interested in networking with each other, those keen to mentor students, along with those who have gone the academic or clinical route but who have other interests. Others are doing something many psychology grads do, like research, but they’re doing it in a hospital, government, private sector, or start-up setting instead of a university and, as such, don’t feel as connected to the traditional academic side of things. Says Dr. Winer,

“There are many individuals who fall into the in-between, and that’s the great thing about this wide spectrum. We’re welcoming anyone from anywhere who wants to join and connect with this group of people who have a variety of interests.”

Dr. Winer felt lucky and grateful to have had those experiences in grad school, and to have taken a non-traditional career path as a result. In addition to serving as Dean of Social Sciences and a variety of teaching jobs and her current business, she spent some time as a curriculum developer and educator, the principal of a coding school for youth, as well as a facilitator and coordinator for the Memory and Aging Program at a group of senior homes across Ontario.

It's experiences like these that Dr. Winer wants to share with the other members of the new section – with the like-minded individuals who have chosen a different career path, and with the students who could benefit greatly from being exposed to these options they might not otherwise see. The idea is one big, long, ever-evolving and ever-growing career fair. One that creates a home for psychology graduates who might otherwise feel like they are on an island, and one that runs, collaborates and networks not just for 48 hours at a time, but 365 days a year.

Counselling Psychology

Syd Barrett created Pink Floyd in 1964, and was the driving force behind their seminal 1967 album The Piper at the Gates of Dawn. He lasted for only one more album, A Saucerful of Secrets, before drug use and mental illness led to his departure from the band. He then hid from public life, obsessively guarding his secrecy for 35 years until his death in 2006.

Counselling Psychology might well be the Pink Floyd of CPA sections, in that they insist on having five members on stage at all times. A collaborative and inclusive discipline, it makes sense that when I asked to interview the CPA’s counselling section, a full five-person panel showed up.

Dr. Marvin McDonald is a professor at Trinity Western University in BC. He’s the Syd Barrett of the group (in that he was there from the start – he has lasted far longer than two albums), the Past Chair who helped get this section to where it is today. Dr. McDonald has a little more experience than the others, and has certainly seen the evolution of the discipline. He says,

“When I went through my doctoral studies in the US in the 80s, the ethics course was an option! It was not a required course - just to give you a very concrete example of how things are different today. The good thing about this transition over the years is that the professional standards have corresponded with empirical evidence. When I started my early psych pathology course, the data from community-level surveys for mental health needs had not yet been pulled together. There was still an active question in the literature about gender differences in mental health needs. It wasn’t until the late 80s and early 90s that the data demonstrated clearly that more women than men sought help, and that men had higher rates of substance use and addiction. These are the kind of understandings that have advanced counselling psychology in recent decades, and they affect practice greatly, not just on the research side.”

Dr. Tanya Mudry, professor of psychology at the University of Calgary and a counselling psychologist with a few clients in private practice, is the new Section Chair. She is the David Gilmour of the group, in that she replaced Dr. McDonald – and in the sense that she keeps the group moving forward with a definite sense of purpose. She describes Counselling Psychology as

“A pretty diverse group. We tend to work in communities with families, children, and couples. We often work with people who might be struggling with life transitions – maybe having family problems or marital problems – and with people who have mental health issues or substance use disorders. We tend to take a diverse perspective – many psychologists will lean toward a particular method of doing therapy, whereas counselling psychologists are more all over the map. Some like to think about your past, and how you grew up. Some like to think about your social context or what’s happening inside your brain, and still others are focused on social justice issues and advocacy.”

Dr. Janet Miller is the Richard Wright of this Zoom call (Wright was the keyboardist for Pink Floyd, known for his skill with a variety of instruments and for the syncopated jazz rhythms and melodies he brought to the music). Dr. Miller works at Mount Royal University in Calgary, but not as an instructor. She’s a full professor in Student Counselling, and also has a private practice in the city. She brings an improvisational jazz style to the conversation, when asked how counselling psychology might affect the everyday life of someone who is not, themselves, in counselling.

“Maybe you’re walking up to the till at the grocery store, and you are unaware that the clerk had just come from a counselling session where they had processed their social anxiety so they could have that job and be front-facing and manage public interactions! They learned how to be in their body, they were able to be centred, and they were able to put anxiety to the side for a little while so they could experience people. Maybe they had some coping mechanisms that they employed so that when you arrived to pay for your groceries you had a smooth interaction. You were able to enjoy the process of buying groceries, and they were able to enjoy their work and go home with some energy to their beautiful family.”

Nick Mason is the only member of Pink Floyd to appear on every one of the band’s albums. The percussionist, he is emblematic of the Floyd sound throughout the band’s history and wrote some of their greatest songs. The Nick Mason of this group is Dr. Houyuan (Hy) Luo, the classic definition of a counselling psychologist. He has a private practice in Toronto and is the Chair-Elect of the Counselling Psychology Section. Dr. Luo says that while the pandemic has made providing counselling more challenging in certain ways, many of his clients are embracing the new delivery method.

“I have been providing 100% virtual counselling since March of 2020. I work in downtown Toronto, in among the skyscrapers, and a lot of people were not yet back at their offices. They actually preferred online counselling because it was easy, and convenient for them. Now that more people are vaccinated, they are slowly returning to the office and the expectation is that we will gradually start offering in person counselling too.”

Dr. Luo is interested in expanding the field of counselling psychology to include more people of colour, as there is a real shortage of psychologists who can share lived experience with their clients who may come from different backgrounds.

“In Toronto where I work, it’s a city with so much diversity. When clients want to work with a psychologist who shares the same ethnic background, they struggle to find one, even in Toronto. We really need to help BIPOC undergrad students, as soon as they get into University, to make sure they’re being supported along the way.”

Also very interested in social change, also an advocate for social justice, is Dr. Jessica Van Vliet, the Roger Waters of the group. Roger Waters, the bassist and primary songwriter for Pink Floyd, is the member who moved the group in a more explicitly socially conscious direction (think The Wall).  Dr Van Vliet, a professor at the University of Alberta in Counselling Psychology, says the biggest shift recently in counselling psychology is toward social justice.

“Social justice has always been important in counselling psychology, but now more than ever. It’s now really in the forefront of what we do. We’ve always had a focus on diversity, but now more than ever I think our discipline is taking a leadership role in the area of working across cultures and with diverse peoples, issues and methodologies. I also think leadership and advocacy are becoming more highly valued and more in focus in our field.”

For the time being, the biggest issue in Counselling Psychology – and in virtually every other industry, profession, and psychological discipline in the world – is COVID. It has increased the demand for counsellors who can help people with burnout, depression, hopelessness, and all the other mental health issues that have arisen as a result of the pandemic. We recorded this Zoom call in October of 2021, and Dr. Mudry’s thoughts at that time seem prescient.

“One of the areas where counselling psychologists are going to be instrumental is in the recovery from COVID. I’ve recently been involved in some work around burnout among critical care workers, and I think that’s going to be huge. In Alberta in particular and across Canada, our health practitioners are super burnt out. Also families and individuals struggling with having to work from home, a lack of social interaction, our kiddos are struggling with going into and then out of school. Counselling psychologists are going to be super busy in the next couple of years.”

How will Counselling Psychology, specifically, help with burnout and all these other issues? Dr. Van Vliet sums it up thusly,

“Part of what we do is we change the dialogue in peoples’ minds. We help shift that dialogue from ‘what’s wrong with me?’ to ‘what’s right with me?’ That strength focus, that positive piece of counselling psychology is a huge strength of our field. I think it has had a major contribution to how people regard themselves, other people, and their world.”

Very few, if any, people know what Syd Barrett did for the final 35 years of his life. In the late 70s, Roger Waters saw him in the department store Harrod’s in London. Barrett noticed Waters, dropped his bags, and ran out of the store. It was the last time any member of Pink Floyd saw their founder. We know that he became an avid gardener, and dedicated himself to painting, but that’s about it. One hopes he was mostly okay for those final years, and that he was able to work through some of his turmoil with a professional who could help make things a little better. A professional like, for example, a counselling psychologist?

Traumatic Stress

“In the 80s and early 90s, there was nothing known about the victims of child sexual abuse. Now, there are volumes of research on the subject.”

Dr. Rachel Langevin is an assistant professor of counselling psychology at McGill University, as well as a clinical psychologist who does a bit of private practice. She is currently the Chair-Elect of the CPA’s Traumatic Stress Section. She says her PhD advisor was one of the pioneers in researching the sexual abuse of children in Quebec and Canada. At the time she decided to work on this, it was a reality that many people didn’t even recognize existed. The first step had to be acknowledging, socially, that the sexual abuse of children DID exist, and that often it happened within families. It may seem difficult to imagine now, but it took a very long time for this kind of abuse to be recognized as real in the public at large.

“In the early 80s, some researchers in the States, like David Finkelhor, started trying to really understand child sexual abuse and the specific impact it had related to other traumatic experiences. One of the first to start working on it here in Quebec was Martine Hébert, who was my PhD advisor. Her advisor had been a specialist looking at perpetrators of sexual abuse, but not victims – and Dr. Hébert was the only one looking at that side. She did her research with a lot of autonomy, because no one else had that expertise!”

Today, child sexual abuse is one of the most-studied types of child maltreatment. Research into traumatic stress has come a long way in a short time. Dr. Jenna Boyd is a psychologist at an anxiety treatment and research clinic at St. Joseph’s Healthcare Hamilton, and an assistant professor in the department of psychiatry and behavioural neuroscience at McMaster University. She is the current Chair of the CPA’s Traumatic Stress Section, and specializes in the treatment of Post-Traumatic Stress Disorder (PTSD).

“Cognitive Behavioural Therapy (CBT) is my main area of practice. A little more than 20 to 30 years ago, the main therapies that we’re using now were just emerging. From the perspective of treating PTSD, there was almost a thought that we couldn’t really treat it, but we could kind of help people cope with it. Today, we do have some really effective treatments.

Potentially traumatic experiences are pretty common. Over the course of their lives, most of us will be exposed to a traumatic event. It could be the death of someone close to us, a serious injury, sexual or intimate partner violence, or a frightening near-death experience. For some of us, it’s part of our jobs – a first responder or someone in the military could be exposed to a traumatic event more than once in a day. ‘Traumatic stress’ is what comes about as a reaction to that trauma.

It’s quite normal to have a stress-based reaction to a traumatic event or series of events. Most people who are exposed to one will have some kind of stress-response as a result. Many people will recover over time through a process of natural recovery, but others may go on to develop PTSD. This is where the symptoms related to the trauma persist over a longer period of time. Dr. Langevin says those symptoms can be multiple, complex, and varied.

“We encounter many different symptoms in this line of work. Re-experiencing symptoms, like nightmares, intrusive memories. Someone might be doing something and suddenly an image pops into their head causing distress. Every time they’re exposed to something that might resemble the trauma they endured, or something that makes them think about it, they will have a stress reaction, and anxiety will rise up. That might lead them to the second category of symptoms, which is avoidance. People start avoiding things that remind them of the trauma because it’s too stressful and uncomfortable.

The third big category of symptoms is a change in cognition, mood, and self-image. This includes things like self-blame, taking an overly large share of responsibility over what happened, feeling disconnected from others, or feeling no emotion whatsoever. And finally, there are arousal and reactivity symptoms. This is a more physiological response, and includes things like always being on your guard and looking over your shoulder, being very easily startled, difficulty sleeping, irritability, and possibly self-harm behaviours.”

When a clinical psychologist specializing in trauma sees someone who presents with a cluster of these symptoms, that persists for a month or longer after the traumatic event, and those symptoms are affecting that person’s life, that’s when they start talking about something like PTSD. At that point, it is no longer a normal reaction, and it requires attention. As Dr. Boyd says, there are now many ways that attention can be delivered.

“We now have Cognitive Processing Therapy, Prolonged Exposure Therapy, Eye Movement Desensitization and Reprocessing (EMDR) to name just a few. These treatments have had a lot of research supports behind them over the past 20 or 25 years. We now know they’re really effective for many people, and we have tools where we can say ‘let’s try this and see if we can get you to a place where you’re functioning better’. Many people can return to some of the things in their lives that have been taken away from them.”

Treatments are always improving, clinical psychologists are always innovating, and researchers are continually expanding our understanding of trauma, stress, and the interaction of the two. Dr. Langevin’s current research is looking into the intergenerational continuity of family violence, including child maltreatment and intimate partner violence.

“We know that a parent who was maltreated in their childhood is at increased risk of having a child that will also experience trauma and maltreatment – whether or not it’s at their own hands. Sometimes the mistreated parent becomes a perpetrator of abuse, and other times that doesn’t happen but the child still ends up being mistreated by someone else in the environment. There’s this continuity that we see in the data and in clinical practice, but the mechanisms that are responsible for this – the protective factors, the risk factors that are involved – are still trying to be understood. What makes one parent end up in a cycle where there is repetition of their own maltreatment history with their child, versus parents who are able to break those cycles? We’re looking to help parents who have been in this situation end the cycle, and foster resilience and positive adaptation in their children and themselves.”

Dr. Langevin is quick to point out that treating traumatic stress, and the problems that come along with it, go far beyond PTSD. She says,

“Everything can be associated with trauma, including behaviour problems, emotion regulation, depression, anxiety, bullying, difficulties with attachment and relationship. There are a host of different areas where we can see the consequences of traumatic events. PTSD is just one part of it, there’s a lot more. And we’ve come a long way in learning about it!”

Addiction Psychology

“I’ve never had a client when I ask them what brought them in here today say ‘I wanted to become addicted, so here I am’. That has never happened.”

Dr. Andrew Hyounsoo Kim is an assistant professor in the department of psychology at Ryerson University and the Chair of the Addiction Psychology Section at the CPA. A clinical psychologist (Interim autonomous practice), Dr. Kim completed a residency at Royal Ottawa Substance Use and Concurrent Disorders unit. He points out that no one starts out using substances or engaging in a behaviour with the goal of doing it to the degree that it’s going to interfere with their functioning.

Almost everyone has tried alcohol and other drugs. There are few Canadians who have not placed a bet or played an online video game. Some folks end up doing these things in an excessive sort of way, or engage in them more often and for longer periods of time than do others. But very few people develop an addiction. We all make the choice to try some of these things and might make the choice to continue doing them to some degree – but no one chooses to become addicted.

Addiction is one of the most highly stigmatized mental health conditions. In an effort to move away from that, and to create a greater understanding among the public, there has been a real shift over the past decade to move away from stigmatizing language. Researchers and clinicians in this field no longer use the words ‘dependence’ or ‘abuse’ but rather refer to ‘substance use’. Dr. Kim says,

“We no longer use the word ‘addict’. Instead we say, ‘a person experiencing an addiction’. We don’t use the word ‘junkie’, and even ‘clean’ is no longer in our vocabulary because those words are laden with negative meaning.”

The word ‘addiction’, in and of itself, is widely used – and widely misused – in society in general. We tend to use it to describe anything that people will engage with for a long period of time.

“Think of all the ads you’ve seen that say something like ‘this TV show is really addictive’ or ‘I’m addicted to this game’. People use the term a lot, without really knowing what it means. Addiction has a very specific meaning that is far more nuanced than just an activity someone engages in for long periods of time. It encompasses not just the biological (the brain) but also behaviour, emotions, thoughts, and the consequences that come about as a result of it.”

In addition to misuse of the word, there remain a lot of misconceptions about addiction itself – that it is a moral failure, or a personal choice, and that becoming addicted is an indication of a lack of character. Dr. Kim continues,

“At the very beginning when you’re starting to engage in an addictive behaviour there is of course a personal choice. But over time, it becomes a lot more complex than just lack of free will. There are changes that occur in the brain and to a person’s emotional and psychosocial context and it really moves away from being something a choice to a compulsion – that they engage in it even if it is no longer pleasurable. If all it took to stop was for us to say ‘stop using’, clinical psychologists who specialize in addictions wouldn’t have a clinical practice. Addictions are much more complex than just stopping.”

Dr. Nassim Tabri is an assistant professor of psychology at Carleton University. His research is focused on addiction and mental health, particularly the transdiagnostic factors that are present across a range of problematic behaviours such as gambling and disordered eating.. He says,

“In thinking about what constitutes an addiction, and how one can potentially develop an addiction, think of it this way. You try alcohol for the first time, or you pick up a video game and start playing. It doesn’t necessarily mean that a person who tries these things that have high addiction qualities will end up developing an addiction. Addiction happens when they persist in these behaviours, even though the fun has been taken out of it. Now it’s about doing it because you need to do it to function more so than because you’re enjoying it, and because not doing it makes you miserable.”

Addiction psychology is a vast science, touching on virtually every aspect of our connected lives. Ads, games, phones, and more are designed using principles derived from that science. But there is a definite threshold to behaviours that constitute addiction – it’s not an exactly defined threshold, in that it might be a little different for each individual experiencing addiction, but it is a pretty high bar in terms of the activity, or substance use, or behaviour affecting that person’s life. Dr. Tabri says,

“’Addiction’ is a term that should be reserved for an extreme condition. When you see ads, or gamble, in a way they’re nudging you to engage in a certain behaviour. Whether someone develops an addiction or not really depends on their risk profile (biopsychosocial risk factors). Milder engagement in these activities, even though you’re being influenced, doesn’t merit the term ‘addiction’.”

I haven’t touched my phone in about two hours. I pick it up and scroll through the notifications – CBS Sports wants me to know that the Denver Broncos have hired Green Bay’s offensive co-ordinator Nathaniel Hackett as their new coach. The Flipp app would like me to see the new deals available this week at Loblaws. My little mobile game wants me to know my lives have been refilled, Shoppers Drug Mart is very worried that I might miss out on my chance to get 10,000 Optimum points by spending $40 in their store, and Twitter has sent me eight notifications about eight new followers I’ve picked up today.

While not necessarily the work of psychologists who specialize in addiction, all these notifications are informed by addiction psychology. All are designed to provoke a response from me, to get me to interact with the app, the store, or the content in a way that maximizes my time on my phone and (by extension) minimizes my time doing other, presumably more productive but less immediately engaging, things. While these things are created and informed by addiction psychology, the fact that they influence me does not mean that I am “addicted” – there is a certain threshold for the use of that term, and until I forego sleep, skip meals, and leave work four hours early to play Words With Friends, I have likely not crossed that threshold.

Dr. Kim says,

“There are principles being used that increase the likelihood of addictive type behaviours on your smart phone. Things that increase the time on the device. Making it more engaging, sending notifications. With video games in particular, things like leader boards, or ‘here’s a special offer today – for only $1.99 you can get extra lives’. Gambling is another example - psychological knowledge and principles have been used to develop slot machines, to make it more likely that people will stay on the device for longer periods of time.”

While the psychological principles of addiction can, and have, been used to create addictive behaviours that sometimes result in an addiction, psychologists who specialize in this field tend to work on the other side of things. They’re focused on prevention and treatment. They’ve created the low-risk drinking guidelines, low-risk gambling and cannabis guidelines, the theories behind Smart Serve certification, and harm-reduction initiatives like safe injection sites. It’s here where psychological knowledge is applied directly to reduce the harms that some of these substances or behaviours may have. Says Dr. Kim,

“Psychology is the scientific study of the human mind and behaviour. So Addiction Psychology in that sense is using psychological scientifically sound methods to better understand why some people may use substances to the point of addiction, why some people may become ‘addicted’, if we use that word. It’s also trying to better understand the effects of substances and other addictive behaviours on the brain, and for me – what I find most interesting – is how we develop interventions, treatments, and preventions so we can reduce the harms and suffering for people who are living or have lived with addictions.”

When we hear the word ‘addiction’, we tend to think of addiction more in relation to substances than to behaviours. Cigarettes, alcohol, the opioid crisis are all top of mind when it comes to addiction – but are those type of addictive behaviours the same as, say, gambling or video gaming? Dr. Tabri says…not necessarily.

“One thing we focus on is the brain. I have a whole lecture talking about the dopamine reward system. I think there is an understanding in the general public that addictive behaviours have similar influences on the brain in terms of hijacking the dopamine reward system. The idea is that you’re no longer engaging in other activities that are meaningful and make you feel good, instead you’re doing this one thing that makes you feel really good at the expense of all the other things in your life.

But are all addictions one and the same in the brain? Not necessarily. The lay theory was once that it’s all dopamine, and that underpins everything. That started with research with rats in the 50s, and the story took hold because it was an attractive one. It grew into the idea that dopamine can explain all kinds of addictive behaviours. But when you look at the literature, what it says is that dopamine is really good at explaining something like alcohol, for example, or nicotine to some extent. But other addictive behaviours like cannabis, not so much. There’s more nuance and complexity going on than just dopamine. It may play a role, but it’s not the end-all and be-all in the brain.”

The science of addiction, and the psychology behind it, is ever evolving as we learn new things and approach them in a different way. Just as we have evolved in the terminology we use around mental health, substance use, and people experiencing addiction, we have instituted many programs, campaigns and initiatives to reduce harms and reduce stigma. Through it all, many things remain true – the most important being:

No one chooses addiction.

Psychologists and Retirement

Many psychologists get into the profession with a goal of advocacy – advocacy for their clients, for the advancement of psychological science, for knowledge mobilization and for ending the stigmas surrounding mental health. Whether this advocacy is explicit or implicit, it is a universal impetus for people who dedicate their lives to helping others.

That motivation to be of service to others does not end when a career ends. Retirement from the profession of psychology does not necessarily mean retirement from advancing good causes. In fact, it might provide more time to tackle those challenges, or even illuminate new causes to champion.

Such is the case for Juanita Mureika and Dawn Hanson, Co-Chairs of the Psychologists and Retirement Section of the CPA. Juanita retired as a school psychologist in 2011, but remains active in the New Brunswick political arena. She spent much of 2021 pushing against Bill-35, which included a decision by the New Brunswick government to take student assessments out of the hands of school psychologists and allow teachers to perform those assessments instead.

Dawn recently retired as the Chair of the Manitoba Association of School Psychologists, but stays active and involved with the recently proposed Bill-64. The bill would do away with all school boards, to have more of a central authority in government in Winnipeg. She says,

“We, as an organization [the Manitoba Association of School Psychologists], are always tracking anything that could impact psychological services in Manitoba, particularly as it pertains to school children and families. I can’t imagine – retired or not – not being involved in these burning questions and issues. We’ve been very involved in trying to shape a new College of Psychologists in Manitoba. Our school psychologists have not been part of the regulatory body before now. So now with the opportunity of a new college coming in, we’ve been working for many years trying to create representation within that college.”

For Juanita, Dawn, and the Psychologists and Retirement Section as a whole, advocacy does not end with retirement. And retirement itself actually creates further areas where advocacy can be very important. Retired psychologists across Canada are very concerned about regulations in their respective provinces for how long files are to be kept. In one province the rule is that files must be kept secure for fifteen years – but if your client is a school-aged child, then those files must be kept secure for fifteen years after the year when that child reaches the age of majority. Dawn says,

“This is very onerous for psychologists who have to somehow find a way to store and maintain these files securely, sometimes for decades! For Juanita and I, most of our practice has been within a school setting, so when we retire from our job, it’s not our problem any more. The school must keep those files safe and secure in line with what is required either by the regulatory body or the province.”

Neither Dawn nor Juanita are affected by this issue, but here they are championing the cause nonetheless. The Psychologists and Retirement Section has sent out a survey to all other regulatory bodies across Canada, including the Territories, to determine what the issues were regarding confidentiality, file retention, informed consent, and more. As of the writing of this article, the responses from those groups are still coming in – slowly. So far, the one thing that is clear is that the regulations, policies, and practices governing file retention vary wildly from one province to another.

Imagine you’re closing your psychology practice and retiring. In addition to a massive number of electronic files, you also have reams of physical paper files that you must keep secure for a further fifteen years. It is likely impractical, not very secure, and possibly illegal for you to keep them in your basement. Are you going to pay for 15 years at a storage locker, on what is now a fixed retirement income? What are your options and how can you go about doing this? And who, depending on where those files are stored, will insure them?

Dawn and Juanita are on the case. It may take a while to procure answers, as every step along the way there is another wrinkle thrown in. Says Juanita,

“Another thing we now have to consider is that many provinces require a professional will if you’re going to retire. So those files will become someone else’s problem if you retire, or if you die. But not all provinces require that. There’s always something new. But if you think about medical or dental records, those are kept for a very long time and so should psychological records be kept a long time. It’s just a little overwhelming for people who think ‘how long will this go on?’”

Juanita, Dawn, and the Psychologists and Retirement Section may be retired as psychologists, but are increasingly involved in advocacy. Within school boards, provincial policies, and the section itself there are multiple opportunities to shape systems for the better. They are going to keep pushing forward on the issues that are important – for retirees, for school psychologists, and for everyone else.

Brain and Cognitive Science

“With so much drama in the LBC
It's kinda hard bein' Snoop D-O-double-G.”

You’re in the audience for the Super Bowl halftime show. Dr. Dre, Eminem, Mary J. Blige, Snoop Dogg and Kendrick Lamar are performing, and you’re grooving to the music. On the big screen you can see Snoop rapping and the music hits your ears. The crowd around you is roaring and cheering. You are lost in the moment so you’re not really thinking – how do I know? How do I know that it’s Snoop Dogg’s voice that I’m hearing? How am I certain that the crowd noise around me is being made by my fellow fans? You don’t have to answer that because your brain is putting it together for you. Snoop’s lips are moving on the big screen, and they seem to match the lyrics you’re hearing. The crowd noise is coming from behind, in front, and all around you and your brain sorts that out for you so you know it’s thousands of people shouting thousands of different ways, and you need not pay attention to any one voice in the crowd.

How your brain performs these tasks is the realm of cognitive science, studied by researchers like Dr. Jonathan Wilbiks, an associate professor in psychology at the University of New Brunswick Saint John. Dr. Wilbiks is the Chair of the Brain and Cognitive Science Section at the CPA, and studies audio-visual integration and multisensory processing – how our brain takes various sensory inputs and makes an implicit decision as to whether those things came from the same source. (Your lips are moving, and I hear singing – it is likely your voice I hear.)

Recently, some of Dr. Wilbiks’ work has been around perception and musical abilities. His lab found that musicians perform much better than non-musicians at tasks when audio and visual are congruent – that is to say the image matches, and happens at the same time, as the sound. But musicians perform worse than non-musicians when audio and visual are not congruent. People who have been trained in music, more than those who have not, use auditory information to help them make sense of something they see.

When Angela Hewitt sits down at a piano and places the sheet music for the Goldberg Variations in front of her, it all makes perfect sense. Each note on the paper indicates a note she must play on the piano, and the two things are congruent – this is something she has done her entire life and it’s easier for her than it is for…well, everyone else in the world. But if, instead of sheet music, she was presented with a cuneiform tablet that represented a musical notation, she might be completely lost – in fact, someone with no ability to read music at all might be able to perform the task better than she could. (The first musical notations ever discovered were from about 1400 BC on a cuneiform tablet in what is now Iraq.)

In the years following the Second World War, the big trend in psychology was behaviourism. You put a rat in a box and expose it to a stimulus, then you measure how it reacts and how those reactions change over time with repeated exposure to that same stimulus. We didn’t really pay a lot of attention to what was actually happening in the brain. Dr. Wilbiks says this was because science is all about observable fact, and there was no way to observe what was happening in the brain at the time. Where this began to change was in the late 60s, when German-American psychologist Ulric Neisser published Cognitive Psychology, which suggested that a person’s mental processes could, in fact, be measured and analyzed. Dr. Wilbiks says,

“The cognitive researchers who showed up in the 60s said ‘there’s a whole lot happening in the brain’. Sure, we don’t know exactly what’s happening there – but something is, so to ignore it completely is a mistake. So they would try to hypothesize about what might be happening, and to try to measure using secondary observations. A simple example would be something like a reaction time task. I give you a button and tell you to push it every time a light flashes on the screen in front of you. People are generally pretty fast at that – maybe 200 milliseconds. But if I give you two buttons and tell you to press the left one when a green light flashes and the right one when a red light flashes, it will take longer. Maybe 400 milliseconds. You can’t see what’s happening in the brain, but you can surmise that if task one takes 200 milliseconds, and task two takes 400 milliseconds, that tells us very basically that processing information in the brain takes time.”

Over time, of course, things moved way past red-light-green-light as experiments became more sophisticated and technology allowed us to actually see what is happening inside our heads. We can see the electrical voltage created by neural impulses in the brain. fMRI (Functional Magnetic Resonance Imaging) machines allows scientists to observe and measure changes in the oxygenation of blood which indicates differing levels of brain activity. We can now tell which areas of the brain are active, when they’re active, and then correlate that with the behavioural information we see.

The field of the brain and cognitive sciences is vast, and has effects that can be seen in our everyday lives in a myriad of ways. Right now, there is a ton of stuff going on where you are. You might be sitting down on a chair. There is other furniture in the room, maybe decorations on the wall. There is traffic going by outside, maybe the dishwasher is going in the background and someone is watching TV in another room, all while you’re reading this article. You can’t possibly pay attention to all of it at once, so your brain filters all of those external stimuli before you even perceive them, so you aren’t overloaded.

Your brain decides, for you, what is consequential. That traffic you hear outside? It can be ignored because it doesn’t present a threat. As Dr. Wilbiks says, cars rarely crash into houses so, while sitting in your house you are free to be unconcerned about the sound of cars. But when you’re walking down the street, the sound of cars is very important to you – if you hear the sound of a car accelerating as you enter a crosswalk, you should certainly turn your head toward that sound to see what’s happening, because now there is a real possibility of danger.

The brain creates these shortcuts to get maximum efficiency with minimum effort, something called “cognitive economy”. Because we use these shortcuts, and we process only the most pertinent information and take the most important cues, we are susceptible to “nudges”. These are little things cognitive science has created to make us behave a certain way. One example is being a safer driver. Dr Wilbiks gives an example:

“You’re on the road in your car, and you know you’re driving on a small residential street. You know the speed limit is 40 km/h, so you’re driving rather slow, and you’re paying attention. Looking for kids running out into the street, a dog running loose, a basketball rolling toward the road. If you’re driving on the highway, you’re paying attention to many other things, but you’re not looking for an errant basketball. Where we can use cognitive understanding and nudges is in a situation where, for example, people tend to be driving too fast on a residential street. We can do things to slow them down. You’ll sometimes see little islands, with a tree on them or something, that make the road a tiny bit narrower. It doesn’t get in the way of traffic, but the average person wouldn’t feel comfortable driving through that narrow gap at a speed greater than 40 km/h.”

The one thing that my brain focuses on, whether I’m in my car or working on my computer, is music. Anywhere it’s playing, in the background or from my neighbour’s garage way down the street, I can’t ignore it. Dr. Wilbiks says one of his favourite classes to teach is The Psychology Of Music, because it encompasses so many aspects of psychology in general, not just of cognitive science. He says,

“I usually scare students in the first few lectures because we start out with physics. The physics of sound, and sound waves, and how that works. Then it’s about how the vibrations get into your ear, how that translates up into your brain and how you perceive it. Then we get into developmental psychology – how do we develop our musical ability, the close parallels between musical development and linguistic development. We talk about treatment – there’s some really cool work being done using music (Melodic Intonation Therapy) to help people who have experienced a stroke recover some linguistic ability.”

We all have two hemispheres in our brain, and there is a part in the right hemisphere where we process music. There is a part in the left hemisphere that mirrors the music part almost exactly, and that’s where we process language. When people who have had a stroke sing the words they are trying to speak they can, over time, train the other hemisphere of their brains to process language again. Eventually they might regain up to 70-80% of their speaking ability as a result. People living with dementia are often able to connect with music in a way they can’t with language, as music can trigger memories that might otherwise be inaccessible.

Perhaps you’ve seen the meme going around that says, ‘my ability to remember song lyrics from the 80s far exceeds my ability to remember why I walked into the kitchen’. This might actually be true, as music from our youth remains a powerful trigger for memories which is why dementia support groups often sing songs together from their youth – Beatles and Beach Boys and traditional folk songs from the country where they were raised. In a few years, things might be a little different – in 2054, those support groups might be singing ‘Gin and Juice’ by Snoop Dogg. Will rap songs produce the same kind of memories and enhance language abilities in the same way? Only time will tell – but when we do have the answer to that question, it will be provided by cognitive psychologists and others in the field.

Health Psychology and Behavioural Medicine

“We know that vaccine uptake varies depending on the vaccine. Even before COVID-19, certain vaccines like MMR [Measles Mumps Rubella] had higher uptake rates than the flu vaccine. There is also a difference between childhood and adolescent vaccines. You could see that with HPV [human papillomavirus] which was administered in schools to adolescents.”

Health Psychologists and Behavioural Scientists have expertise that spans a very wide variety of specialties and disciplines. Many are also clinical psychologists, licensed to provide psychological services and therapies. Clinical Health Psychologists help people through medical issues, diseases, and chronic conditions. Behavioural Scientists study all of this, especially when it comes to preventative behaviours and behaviours that can affect the progression of a medical diagnosis. What helps a person with a heart condition maintain a strict diet? What affects the consistency with which a diabetic takes their insulin? And – very importantly of late, what factors influence a person’s acceptance and willingness to be vaccinated?

Imagine you have just been diagnosed with cancer. You probably have hundreds of questions and even more fears suddenly thrust upon you. There may be other factors that compound that stress, like the possibility of infertility, the loss of income, or the need to arrange childcare while receiving treatment. You might also now have a whole bunch of new doctors and specialists you never had before – oncologists, oncology nurses, patient navigators, genetic consultants. It’s a lot to handle, on top of trying to come to grips with the diagnosis itself.

One of the people who might help you through this difficult time is a psychologist, like Dr. Gilla Shapiro at Princess Margaret Cancer Centre in Toronto. Dr. Shapiro is a clinical and health psychologist, a behavioural scientist, and a psycho-oncologist (a specialist in cancer). She works with people who have received a diagnosis, with those who are undergoing treatment, and also with people receiving end-of-life care.

“There are many people who experience elevated distress [related to cancer and its treatment] so having a specialized treatment team to support them and their loved ones is really important.”

Some of this takes the form of supportive therapies, and some of it has to do with decision-making. If a person experiencing cancer must make a decision as to whether to begin a chemotherapy regimen, given the devastating toll that takes on the body and a certain percentage chance of it working, talking that through can be very helpful in the process. Trying to decide whether to join a clinical trial can be an overwhelming choice a person with cancer has to make. A psychologist like Dr. Shapiro approaches this in a few ways  ̶

“People need support in different ways and have different concerns that could be social, practical, psychological, or emotional. Some may wonder, how am I going to approach cancer with my children? Others may require support with symptoms like pain, insomnia, anxiety, or depression. There are some types of cancer for which there is a genetic predisposition. So if genetically tested, some people wonder who should I tell, and how do I tell them?”

A team at Princess Margaret is working on developing evidence-based interventions to reduce distress and improve patients’ cancer experience. For example, an intervention called CALM (Managing Cancer And Living Meaningfully) is designed to help patients adjust to living with advanced cancer. It draws from a number of theories in psychology and mental health – relational, attachment, and existential theories – the goal being to address a number of different domains in an individualized way. Symptom management, changes in a patient’s relationship with themselves as well as their loved ones, a sense of meaning and purpose in life, and hopes and concerns relating to the future are all factors that are considered in CALM therapy and are all experienced differently by every person who receives a terminal cancer diagnosis.

One of the reasons Dr. Shapiro chose to come to Princess Margaret was that her supervisor, Dr. Gary Rodin, along with his colleague Dr. Sarah Hales, had developed CALM. Dr. Rodin and his colleague Dr. Madeline Li were also doing interesting work in understanding what factors impact individuals in make difficult health decisions. One big decision in cancer care, one that has come about much more recently, is medical assistance in dying, or MAID. Dr. Shapiro wanted to bring a health equity and policy lens to this work. Dr. Shapiro didn’t start her work in psycho-oncology and behavioural science there though, she began her work in psycho-oncology in cancer prevention and working on vaccines. Vaccines like the HPV vaccine, and how we can prevent viruses that cause cervical and other cancers by supporting individuals in making behavioural choices, like getting vaccinated.

Less than two years before COVID-19 was declared a pandemic by the World Health Organization (WHO), Dr. Shapiro completed her PhD on human papillomavirus (HPV) vaccine hesitancy in Canadian parents. With colleagues at McGill University, she developed scales to measure vaccine attitudes and conducted research to understand the behavioural and social drivers of vaccination in the Canadian population.

. In 2019, she began working with the WHO developing tools for routine childhood vaccination and to measure the behavioural and social drivers of vaccination globally. When the pandemic hit, that work pivoted to understanding adult vaccine acceptance and intention to the COVID vaccines, as they became available

During the COVID-19 pandemic Dr. Shapiro has been a member of Ontario’s COVID-19 Science Advisory Table’s Behavioural Science Working Group and she and her colleagues at the COVID-19 Science Advisory Table for Ontario (many of whom are also members of the Health Psychology and Behavioural Medicine Section of the CPA) published the brief ‘Behavioural Science-Informed Strategies for Increasing COVID-19 Vaccine Uptake in Children and Youth [link]’ in October.

While understanding the behavioural and social drivers that impact COVID-19 vaccine acceptance, she has also developed an interest in another cascading impact of the pandemic: missed or delayed routine vaccinations.  Dr. Shapiro and colleagues at the WHO and elsewhere have recently completed a study looking at missed routine childhood vaccinations in 26 countries during the pandemic [link - COVID-19 and missed or delayed vaccination in 26 middle- and high-income countries: An observational survey].

Imagine you have been through a cancer diagnosis, have been through surgery and radiation, and are now on the other side with a (relatively) clean bill of health as a result. A clinical health psychologist may have helped you through that process, but now there is another, out-of-your control existential threat – a global pandemic. Your continued safety, in your immunocompromised state, relies on those around you getting vaccinated against that pandemic. It’s not an easy place to be, but it is nice to know that Health Psychologists and Behavioural Scientists like Dr. Shapiro are out there, working on that as well.

Community Psychology

“People who are engaged in social change in their communities – community organizers, grassroots social movement folks – have equally rigorous theories about how change works as we might have in academia.”

Dr. Natalie Kivell is an assistant professor at the Wilfrid Laurier community psychology program. She says there are “two…and a half?” community psychology programs at Canadian universities, and that those who work in the field tend to be a lot more involved with the ‘community’ part than the ‘psychology’ part of that job description.

Ann Marie Beals is one of those people. Ann Marie is a graduate student in the community psychology program at Wilfrid Laurier. They are L’nuk of Mi’kma’ki - African Nova Scotian and Mi’kmaq descent, and their work focuses on the erasure of mixed-blood Indigenous-Black communities historically and in the context of today’s society, Truth and Reconciliation, and the ongoing marginalization of both Indigenous Nations and Black communities in Canada.

Natalie’s student Ramy Barhouhe is originally from Lebanon and lived in the United States before coming to Wilfrid Laurier for the community psychology PhD program. His work is focused on colonialism and coloniality – how these power structures have shaped the development of whole community systems in North America and Southwest Asia. How this guides the way people perceive, feel, and experience the world in terms of time, space, morality, power, education, health, justice, politics, economics and more.

Ramy, Ann Marie, and Natalie have come to community psychology via very different paths, but all have similar outlooks in that they all put ‘community’ before ‘psychology’. They are all heavily invested in ways to dismantle our current systems – and they are all keenly aware that they themselves are working within some of those systems. Ramy is studying ways to decolonialize as part of academia, itself a structural vestige of colonial practices. Ann Marie is a member of the CPA, and the Treasurer of the CPA’s Community Psychology section, both institutions that are shaped by the legacy of colonialism. Natalie is a professor in psychology – a field of study that has long been complicit in not only colonialism but also the marginalization of minority populations.

Says Ramy, “the academic world is so intertwined within the neoliberal capitalist system that it’s really difficult to manage the disconnect. The power discrepancy between those who control the flow of knowledge and those that don’t is too big. For example, an academic is getting a grant in order for them to do some research, then they go use a community to get information from that community. But they don’t get approval from that community afterward with regard to knowledge distribution and mobilization. They get the credit, the acknowledgement, and the funding, but the community itself gets nothing from it. They’re just supporting and serving the academic. So that’s one problem with the structure of colonialism within academia that we still need to talk about further and to overcome.

We talk about this a lot in our program, and we acknowledge that we’re part of the problem as well. If we’re doing that research, we’re not absolved from the structure, and the impact it has on the community – we’re still part of that problem. We’re trying to find a way to reimagine this, and it involves a certain amount of respect and humbleness toward the community in which we work. Making sure they get their due, their respect, and even funding to serve their community’s needs. That’s where the shift is – how can we take the resources that are unfortunately part of a corrupt system and use them to benefit those communities? And, how to use their knowledge as their own, and not mine just because I did a survey.”

Ann Marie looks at the current situation, informed by the COVID-19 pandemic, as a window into the work that needs to be done. They say, “one of the things that’s been revealed from this pandemic is how neoliberal austerity policies and practices have affected our health care systems, and how precarious workers in minimum- and low-wage jobs – predominantly Black women, racialized peoples, newcomers, and Indigenous peoples, are disproportionately affected by a lack of compassion, care, and adequate safety nets that were dismantled by neoliberal governments.

As an example, our current Ontario government, within a capitalist system, legislated limited pay increases of 1% for public sector workers like health care workers, as inflation is looming over 4% [4.1% August 2021]. In our community psychology program we have student and faculty researchers who come from and live in communities that are directly affected by neoliberal and colonial practices, such as this one, that continue to widen the gaps in health care and economic stability. At the same time basic human rights such as housing, education, clean water, and quality of life remain not only unfulfilled but purposefully denied. So as a student researcher, I and other critical community psychologists examine the intersections of how power structures such as white supremacy, colonialism, neoliberalism and patriarchy intersect with human beings and with Mother Earth through myriad interconnecting identities.

We look at these power structures, through control of resources on stolen Indigenous lands, anti-Black racism, and colonializing policies. And by that I mean the people who support and hold up these power structures. Sometimes we speak almost abstractly or theoretically about power structures, but we have to be cognizant of the fact that      people      hold up and maintain these structures. They try to dictate how we live our lives, and systemically oppress anyone who does not fit the able-bodied white cisgendered heterosexual man dominated perception of what is ‘Canadian’. For me, it’s always about dismantling the power structures that oppress people in my communities.”

There are several words Ann Marie, Ramy, and Natalie all use quite often – intersection, dismantling, neoliberal, colonialism. Another word they all use, maybe even more often, is “collaboration”. Ramy speaks about working in collaboration with communities, so that the work done there is not extracting, but rather enhancing, the knowledge, the health, and the success of that community. Ann Marie speaks about collaboration in the sense that credit for the work done is not only not the end goal, but antithetical to the process of      self-determination in communities. And Natalie talks about dozens of other community organizations, grassroots activists, and scientific disciplines with whom she works to advance the myriad causes of social justice. In fact, the very first word she uses to describe community psychology is “interdisciplinary”.

“Community psychology is an interdisciplinary, values-driven, action-oriented, community-engaged social science. It addresses social justice at the intersections of racial, climate, immigration, gender, prisoner, and disability justice. We work at the intersections of the complexities of how social justice issues touch each other in an interconnected way. Community psychology is guided by a set of theories. We approach these complex social issues from places of prevention, ecological theory, critical perspectives, and decolonial perspectives. We look to situate relationships between individuals, communities, and societies. If we have equitable and just communities, we have healthier people. And therefore the target of community psychology is figuring out how to rebuild, re-imagine, and co-create equitable school systems, health systems, prison systems and so on.”

Because Community Psychology tackles such a wide array of systems and structures, their work crosses many boundaries into other aspects of psychology – criminal justice, environmental, educational, and more. Although they are small in number, their collaborations across disciplines, sciences, community groups and activist organizations ensures that they will continue to have an outsized impact.

Quantitative Methods

In the very broad field of psychology, Quantitative Methods is the indie college radio station of the group. The one who played U2 and R.E.M. in the 80s before ‘Sunday Bloody Sunday’ and ‘Man on the Moon’ became ubiquitous. The one who “discovered” the Red Hot Chili Peppers in the early 90s before Blood Sugar Sex Magic and the Grammys. Or who, more recently, broke the Black Eyed Peas before the addition of Fergie and all that commercial success.

Quantitative Methods is the kid with the nose piercing and the plaid shirt who was into Structural Equation Modeling, Bayesian Statistics, or Hierarchical Linear Modeling, before it was cool. The one who spent months in their room, poring over the catalogue, learning every facet of this statistical method, before letting go and sending it out into the world to be used by psychological researchers. Most of these methods were studied in depth by a very small group of Quantitative Methods Psychologists at one time but are now used widely throughout the discipline.

They’re also, in another way, the Rick Rubin of psychology. You know how the Red Hot Chili Peppers made the big time with Blood Sugar Sex Magic? Producer Rick Rubin. Slayer’s magnum opus Reign in Blood, Adele’s 21, the Beastie Boys breakthrough Licensed to Ill? Rick Rubin. And for psychological researchers doing in-depth work – whether that be on depression, or vaccine confidence, or PTSD in military couples – the producer working behind the scenes to ensure scientific rigour is Quantitative Methods. The Quantitative Methods Psychologists help them craft their study to determine the best way to collect that data, to account for unforeseen wrinkles, and the sample size that is required to detect relevant effects.

Dr. Rob Cribbie is the Chair of the Quantitative Methods Section at the CPA, and a Quantitative Methods Psychologist in the Department of Psychology at York University. He says,

“It’s about research methods and the analysis of data. People who work in Quantitative Methods do everything from consulting on sample sizes, research designs, and the analysis of the data to researching new or improved methods for analyzing data. We also go into the psychometrics of the tools we use and how well they work.”

So what does this kind of work look like, on a day-to-day basis? What exactly does a Quantitative Methods Psychologist do? Dr. Milica Miočević is the Secretary/Treasurer of the Quantitative Methods Section, and a Quantitative Psychologist in the Department of Psychology at McGill. She gives an example:

“I recently published a paper with a co-author from biostatistics on power prior distributions. We were trying to find a way to use historical data from a study that’s related to the current study, but conducted using a sample from a slightly different population. We thought of ways we could quantify the differences between the participants in the previous study and participants in the current study, and tested whether using our method with data from a previous study can improve inferences in the current study. The article that we published will allow researchers in psychology to rely on historical data to improve statistical inferences of new research studies without requiring prohibitively large sample sizes.”

The field itself is, in a way, rather new. The Quantitative Methods Section of the CPA is celebrating its tenth anniversary this year, and the discipline, while widely recognized today, was much less familiar ten or twenty years ago. Says Dr. Cribbie,

“I remember when I was interviewing for jobs, around 2000, most of the interviewees were asking ‘what’s your area of psychology?’ And I would answer ‘quantitative methods’, and they would say ‘no, we mean – is it depression, is it clinical, cultural – what do you study?’ And I would say ‘well…quantitative methods’. They didn’t see this as a discipline. There’s been quite a shift. Now it’s totally mainstream to say ‘I’m a quantitative psychologist’. The area of Quantitative Methods is so broad now, and there are so many tools that we use, that you really need people who specialize in the different methods.”

With the growth of the field has come a sea of change in the ways psychologists analyze and interpret data. The advent of software programs like R and others have opened up a world of possibilities that were a lot more difficult, even inaccessible, 20-25 years ago. And it is constantly changing. As a new method becomes popular and widespread throughout the world of psychology, quantitative methods psychologists have already moved on to something else entirely. Dr. Miočević says,

“We go through waves of what’s interesting and what we think needs to be developed more. When I was in grad school, Bayesian methods were becoming the popular topic. Now, it seems like it’s Machine Learning, and we’ll see what the next thing is. I feel like every few years we add something new to the quantitative methods toolbox in psychology. Sometimes the novel approaches are coming from statistics, sometimes they are coming from other fields like economics. There has been a lot of change in my ten years!”

You know that one pop song you really like? The one by Taylor Swift or Dido or Alicia Keys or Imagine Dragons with the guest rapper? That guest rapper is Kendrick Lamar. Quantitative Methods is, in a way, the Kendrick Lamar of psychology, though they will likely never get the solo recognition that he did when he won the Pulitzer Prize. They will collaborate with anyone from any discipline, any time – so much so that after a while you barely notice they’re there. Every facet of psychology, every individual discipline, is informed by the latest tools for data analysis, the most up-to-date research methods and practices, and the scientific rigour provided by Quantitative Methods. Says Dr. Cribbie,

“Quantitative Methods span all the areas of discipline. So, if you were to take every section of the CPA, Quantitative Methods play a role in every one of those sections. It’s great that there is this section that allows people with this interest to discuss new and different methods, and ways in which people apply these tools.”

It is for this reason that Psychology Month 2022 kicks off with Quantitative Methods – it is the one section that informs all other sections. Dr. Cribbie, Dr. Miočević, and their colleagues are the cool kids on the block who were way into that research method long before you’d even heard of it. You can follow the Quantitative Methods section on Twitter - @cpa_qm – on their website https://canadianquantpsych.wordpress.com/ or through their section newsletter https://cpa.ca/sections/quantitativemethods/newsletter/ so you, too, can be one of the cool kids who knows things before anyone else!

Teaching of Psychology

Dr. Steve Joordens, psychology professor at the University of Toronto, has an analogy to explain the Teaching of Psychology:

“I think of teaching as a craft. Like a craft beer – if you want to be a good brewer of craft beer, you need to know the science behind the recipes and the way you put things together. In addition though, there’s also a subjective element. The mix of ingredients that really works for you might, for one reason or another, not work for somebody else. So, there’s a mix of knowing the science – knowing the ingredients that could make for a powerful educational experience – but then the professor themselves have to find what works for them, and their class, and the context in which they’re teaching. That’s where the craft comes in, merging the science with the human to create a great educational experience for our students.”

Whiprsnapr Brewing Company in Bells Corners, Ontario has a craft beer called OK Lah. It’s a southeast-Asian inspired cream ale made with coriander and ginger. It is certainly not to everyone’s taste, and when I sent some to my sister it sat in her garage for two years as ‘that beer no one wants’. That said, it remains one of their best sellers year after year. It’s a tried-and-true formula that works for many people – but not most people. As in the Teaching of Psychology, inspiration can come from anywhere, but perfecting the formula for success is up to the individual.

Dr. Elena Antoniadis is a faculty member at Red Deer Polytechnic in Alberta and also adjunct faculty with U of Calgary. She is the Chair of the Teaching of Psychology Section at the CPA, and does research on ways to integrate basic neuroscience applications into teaching in order to promote and facilitate learning for students in higher education. She says,

“Teaching of Psychology is about research-based approaches to enhance teaching and learning in classrooms. Some of the research comes from laboratories doing studies in cognitive science that will inform our teaching. Other forms of research occur in the classroom itself. We’re collecting data in the classroom, and that data can inform our teaching practices. The goal is to effectively design and deliver curricula in post-secondary education by using these research-based studies in order to further inform our theory and our practice.”

In 2016, Beau’s All Natural Brewing Company in Vankleek Hill, Ontario made every employee of Beau’s a co-owner of the company. In 2011, they partnered with a local community organization called Operation Come Home to hire youth experiencing homelessness to deliver their beer. Not only are they a fixture in the community who buys their beer, they are involving the community in every step of that process, which has led them to enormous local success. This kind of approach informs a lot of the Teaching of Psychology, and that community involvement is called “service learning”.

Dr. Elizabeth Bowering  is a professor in department of psychology at Mount St Vincent University and the Past Chair of the Teaching of Psychology Section. She teaches a range of courses like introductory psychology and developmental courses. Some of her research is in the area of service learning. She says,

“In my adolescent development course, I have my students carry out service learning in the community. So they’re working with youth who may be at risk for dropping out of high school. They work with them, doing academic tutoring and mentoring, as a way to encourage them in their own academic pursuits. There are so many ways we’re trying to broaden the teaching/learning process not only for the ones who are already in our classrooms, but to make that accessible for other people.”

The Church Brewing Company in Wolfville, about three blocks from Acadia University, has a terrific gose called Saltwater Joys. A gose made with salt water makes sense – after all they’re right on the ocean and how much more local can you get? But just because something is there, and accessible, and sounds neat does not mean it is necessarily going to work. Dr. Joordens knows this well, as his specialty is in the effective use of technology to enhance learning. He says that in the past decade, universities have been more cautious about jumping on that latest bandwagon.

“Right from the level of procurement, universities are a lot more careful today about thinking in terms of educational practices and making sure they’re evidence-based. There’s got to be research to support this flashy new thing that they’re buying, and we’re not going to have people using it just because it’s cool. One of our big roles is to create that evidence base and support it. You can have the best technology in someone’s hands, but if you don’t support it well, it might not work for them and it might be a failure.”

The Teaching of Psychology involves that research, those supports, and the measuring of the evidence that goes into teaching – but not just of psychology. Although a lot of the work originates in labs, or in psychology classrooms, the hope for all of the research is that it can be applied to other classrooms, in other ways, and by other people to enhance the learning experience for all students. Dr. Antoniadis gives an example:

“A practical application could be enhancing social interaction in the classroom. Social interaction between students, but also between the student and the professor. Or an application could be used to enhance student motivation, or to direct and inform the use of assessments.”

Says Dr. Bowering, “I think regardless of how long you’ve been teaching, you’re always learning something new, and get surprised by the experiences you have inside and outside the classroom. Our section offers support and encouragement for people at all stages – the beginning academic getting their feet wet, the mid-career professor who’s taught a course dozens of times and wants to bring something new to it, or even somebody further along in their career mentoring others. Teaching of Psychology is really quite broad!”

The Lake of the Woods Brewing Company has locations in Kenora, Ontario and in Winnipeg. Much like virtually every other craft brewery, they have recently expanded their repertoire to include craft sodas – for example, their Hockeytown Root Beer. While it seems like a departure from their standard offerings, this expansion to soda has been universally successful for breweries across the country, and has provided them with another product to sell to folks cooped up in their houses amid COVID lockdowns. Just like how, in the Teaching of Psychology, the pandemic has created an opportunity for something that can be universally applied with success across Canada. Particularly, for students who might struggle with the financial burdens of obtaining a higher education. Dr. Antoniadis elaborates:

“In the last year I’ve been doing research on open educational resources. I also found the Diener Education Fund – it was created by two psychologists who happen to be married, who raised funds to pay for course releases for faculty members who are experts in specific subdisciplines. So, they’ll find a person who’s an expert in evolutionary psychology, and ask them to write a chapter on evolutionary psychology. Then an expert in statistics, or in development, and they fund a course release for that person to write that chapter. They designed a website called The Noba Project where faculty members can go in and customize their own textbooks. I can go in and take the chapters that I want, that cover the same material that exists in publisher-based textbooks. So, I’ve built my curriculum to align with learning outcomes. It comes with royalty-free images, power point slides that I design myself, and I’ve integrated this open educational resource into my learning management system. Our study looked at whether this could create a similar experience for a student who would otherwise have purchased a publisher textbook, and the results show that it did. The students had a positive experience, and did meet the learning outcomes in the course. I had an email from a student who said that he had just lost his job, and if he had had to pay for textbooks he wouldn’t have been able to stay in the course.”

Says Dr. Joordens, “I think of us as the ‘how’ people. Society continually brings up issues of things we’re not doing as well as we could: Providing an equitable education experience, providing a high level accessible educational experience, trying to up-skill all our students so they graduate as great critical and creative thinkers and so on. Making sure Indigenous pedagogies are represented in our educational experience. We hear a lot of these desires from society, and the question is – how do you do that? And we’re the psychologists who try to answer that question. It’s a little like they’re describing heaven, and we’re the ones building the stairways to heaven.”

There’s a Stairway To Heaven English Bitter brewed by the Burton Bridge Brewery in Burton-on-Trent in England. At least, until the inevitable Led Zeppelin lawsuit. Steve continues,

“I’ve recently been introduced to the word ‘intrapreneurs’ – those people working within an organization who are always trying to find a different way, an innovative way, to do things within that structure. And I think a lot of us in the Teaching of Psychology area are those kind of intrapreneurs, who are continually saying ‘how can I do this better? Is there something I could do differently that would make my class more engaging?’ that kind of thing.”

In 2015, Brewmaster, Co-Owner (with former Ottawa Senator Chris Phillips) and Intrapreneur Lon Laddell of the Big Rig Brewery in Ottawa changed the formula and ingredients of Iron Arse Ale. Iron Arse is the special-edition beer Lon creates every year for the motorcycle prostate cancer fundraiser Ride For Dad. There was some consternation at the time, as the previous formulation was well loved in Ottawa. But the new formula proved to be even more successful, and the beer even tastier, than it had previously been. I’ve got no further analogies here, just a suggestion that if you’re ever in Ottawa around the months of May-June, you could do worse than an Iron Arse Ale at the Big Rig.

Adult Development and Aging

“This isn’t your fault. Your brain is letting you down.”

There is still, to this day, a lot of stigma associated with memory loss. That’s why Dr. Colleen Millikin uses this phrase when she talks to older adults experiencing mild cognitive impairment or dementia.

“You don’t take it personally when you’re walking along and your knee gives out. But people respond differently when it’s their brain. If your brain lets you down and you can’t think of that word, or you can’t conjure up that name, you tend to blame yourself much more than when it’s your knee letting you down.”

Dr. Millikin is a clinical neuropsychologist with the Winnipeg Regional Health Authority Clinical Health Psychology Program and assistant professor in the Department of Clinical Health Psychology, Rady Faculty of Health Sciences, at the University of Manitoba.  She is the Chair of the CPA’s Adult Development and Aging Section. She works mainly in the public system, assessing older adults where there is a possibility of Mild Cognitive Impairment or dementia. Mild Cognitive Impairment (MCI) is a term that is used to describe memory problems that exist between normal aging and dementia. Compared to others of a similar age, people with MCI are at higher risk of developing dementia over time.

“There are so many things that can interfere with memory that aren’t Alzheimer’s Disease or brain problems. Chronic pain and the medications for it, sleep problems, stress, PTSD, all kinds of things. Even thinking that you might have dementia can be a source of anxiety, and being anxious can make it harder to attend to information and remember it.”

The field of Adult Development and Aging Psychology is a wide-ranging one. It's the study, assessment and management of the physical, psychological, cognitive, emotional and social functioning of people 18 years and up and includes aging in all its forms, milestones, joys and challenges. Dr. Nasreen Khatri is an adult lifespan psychologist and neuroscientist at The Rotman Research Institute, a cognitive neuroscience institute fully affiliated with The University of Toronto. She is registered both as an adult clinical psychologist (18-65) and a gerontologist (65 years and up). She is the Treasurer of the Adult Development and Aging Section of the CPA.

“Specifically, I study the impact of depression and anxiety on the brain, beginning around age 30 and continuing all the way into old age. The biggest misconception about aging is that it is a static category or a state.  It is not.  It begins at conception and is a dynamic, ongoing process.  Aging is simply another word for living!”

Dr. Millikin speaks a lot about the breadth of the field, and the variety of work psychologists in this space are doing. In her field of cognitive impairment, she says,

“Age is the biggest risk factor for developing cognitive impairment, but I have seen people in their 90s with very good brain health and people in their 50s who are living with dementia. There is no single cause for cognitive impairment. In most cases, there is an interaction between a person’s genetics and other health issues.”

Those health issues have begun to be understood a lot more in recent years, thanks in large part to psychologists working in this field.

“We now know that exercise actually grows new cells in the part of the brain  that impacts mood and memory.  The best thing you can do for your brain and to age well is physical exercise. We have also learned that individuals with an untreated history of depression in mid-life have almost double the risk of developing dementia in later life, compared to those who do not share that untreated history. Depression is eminently treatable with a variety of evidence-based treatments. Dementia is currently incurable. Therefore, we do not want anyone to go down the cognitive path from untreated depression to cognitive impairment and dementia. Timely assessment and treatment of depression today may stave off dementia later on. In other words, taking care of your mental health today could save your brain tomorrow!”

Ideally, interventions to promote brain health should begin as early in life as possible. However, there is evidence that making lifestyle changes can reduce risk of progression to dementia even in people who already have mild cognitive impairment. This is what Dr. Millikin and her colleague Dr. Lesley Koven, a clinical geropsychologist, were seeking to address when they set up their Early Cognitive Change Clinic for Older Adults in 2013. They provide assessment to identify people who have mild cognitive impairment as well as an interview to evaluate the mental health needs of the person’s spouse or other close family member or friend.

“We run a psychoeducational program for people with MCI and their family members to help them learn about MCI, strategies to get around some of the memory difficulties, and lifestyle habits that assist brain health. Exercise and diet are important of course, and we’re also learning that sleep is a big one. Sleep is very important for brain health, but older adults tend to have difficulties with sleep at a higher rate. One of the challenges is that a lack of sleep is not good for your memory, but also that a lot of the prescription or over-the-counter medications people take for sleep can interfere with a brain chemical that is important for memory. Fortunately, there are behaviour changes that help with sleep and psychological treatments for insomnia!”

Family members of people with mild cognitive impairment can also experience significant stress. Again, Dr. Millikin stresses the impact early intervention can have.

“We’re increasingly recognizing the needs of caregivers. We’ve known for a long time that family members of people with dementia can experience significant stress. Even when a person has mild cognitive impairment, family members or close friends can still have some stress related to the situation, although they may not identify themselves as “caregivers.”  So if you’re going to do some intervention to help the family member with stress management, that really needs to start as early as possible.

There are many other facets of the psychology of aging and adult development, each as important as the last. Dr. Millikin provides a few examples.

“Dr. Kristin Reynolds, an assistant professor in the Departments of Psychology and Psychiatry at the University of Manitoba, started up a telephone-based program to help people with loneliness during the pandemic. The Past Chair of the Adult Development and Aging Section, Dr. Marnin Heisel, does research at Western University looking at ways to reduce risk of suicidality in older men. Dr. Norah Vincent, a colleague in my department, has developed online cognitive behaviour therapy treatment programs for insomnia.”

Dr. Khatri says the pandemic has had a profound impact on older adults, from mental health (e.g., depression and anxiety)  to exacerbating longstanding systemic issues  in long term care.

“It has shone a light on how we treat our elders and how we should treat our elders. This is a time for reflection to reconsider clinical, governmental and social policies that impact aging Canadians. Canada is an aging nation and as we go forward we will need to apply systemic policies that optimize our brain health (combination of mental and cognitive health) and allow us to grow older with dignity, autonomy and meaning. The future of brain health in Canada is in our hands, and one of the best ways to predict our future is to create it.

Last, the pandemic has taught us that we need to focus on lifestyle factors (diet, exercise, rest, social connection) at every age to keep us physically, emotionally and cognitively healthy and flourishing.”

In other words – there are many ways you might be able to keep your brain from letting you down. That said, it may happen anyway. And if it does, it’s important to know it is not your fault.