I cannot help but think how defined I am by the twenty-two years I worked as a full-time emergency physician. Without much guidance, I made certain choices. From my current vantage point of a psychotherapist, and a teacher, I now understand those choices with a greater clarity: I see why I chose to work in a community hospital, where there were both the stark challenges of managing acute medical problems and multiple traumas without a great deal of support, as well as the opportunity to impact the treatment course of my patients in a way I could not at a larger, more impersonal centre. I can also see why I chose to work in a smaller hospital where the I was closer to, and more supported by colleagues in medicine, nursing, and by paramedics, x-ray technicians, security personnel and PSWs.
Despite feeling that, in the ER, I had very much found a home for my innate calling, I could not help but notice the stress that grew year after unremitting year. New technologies came that should have made life easier. A quick run through a CT scan was a lot easier than a diagnostic peritoneal lavage. The hib vaccine meant doing a lot less lumbar punctures on infants. Yet life did not get easier. And nobody talked about that much, in an organized and coherent manner, where we might sense more than the tip of the iceberg of stress, and create personal and collective strategies for dealing with the growing challenges of practice.
Later on, well past my years in the ER, I was fortunate to hear Sandra Bloom, the author of Destroying Sanctuary: The Crisis in Human Service Delivery Systems, speak in Belfast, at an international trauma conference. I also came across Laura van Dernoot Lipsky's book: Trauma Stewardship: An Everyday Guide to Caring for Self while Caring for Others. By the time I heard Sandra Bloom speak for the second time, at the first Trauma Talks conference organized by Women's College Hospital in Toronto, I recognized the various signs of traumatized systems were everywhere. Not so many years into the New Millennium, I could regard the various helping professions - nursing, social work, medicine - and see the accelerating toll of stress and compassion fatigue. And within medicine, I was hearing the same stories - within hospitals, within the staff of the regulatory colleges, within the various teaching organizations - that there was a trend to increasing levels of irrational, depressed and mean-spirited behaviour.
What does happen when we are asked to do the impossible, and saying No I can't is not an option? It's not always a pretty picture.
I'm not sure at this point if there is a way out, at least in the short term. Stress levels continue to rise and current estimates consistently place the number of North American doctors showing signs of burnout at about fifty per cent of the total physician population.
A few years ago, as I sat with this awareness, I also was beginning to better understand the burden of childhood adversity and early life trauma on our resilience in later life. I was learning (something I will continue to develop in this blog) that whether I was dealing with patients or with physician (and mental health care worker) well-ness, I was really looking at two cohorts. One was securely attached and fairly resilient, and did quite well with the usual interventions mentioned in general well-ness programs; the other group came with significant early life adversity and responded poorly to the interventions that were being bandied about in medical circles.
The Caring for Self Series came into being with the thought that it could touch both cohorts. I realized that we could all benefit from increasing awareness, an enlarged self-care toolbox, and a better understanding of the physiology of stress. So this series has aimed to be inclusive, taking us all the way from developing skills for better regulating our autonomic nervous systems to finding healthier and more rewarding ways to flourish in families, communities, and in our larger society.
In our third year, we are re-visiting old terrain as well as exploring new ones. A major challenge for the series has been to accommodate those physicians and mental health care workers who have been attending all along, as well as those who have been attending sporadically, and those of you who are coming to one of these seminars for the first time. Each presentation has been designed to be stand alone, so - even if you've never been to one before - you won't feel as if you're missing something, or left out.
With my committee at the primary mental health care section of OMA, we are working at building bridges with other organizations so we can bring these workshops outside of Toronto, where we are hearing from colleagues that there is interest and need.
I also hope one day to also be able to present this series in a weekend or retreat format, where we can delve deeper into the experiential experiences (journalling, yoga, Qi Gong, guided meditation, community building) that are at the heart of this series.
As you can see below, this series, along with the Main Speaker's Series, is accredited by the GPPA. You can also easily get MAINPRO-C credits for either series by completing the Linking Learning to Practice forms available on the CFPC website: quite a few of our attendees have done this successfully.
I hope to re-engage with some old friends and make some new ones at one of the five presentations we are offering this year.
Caring for Self While Caring for Others
The Education Committee of the OMA Section on Primary Care Mental Health is pleased to present a series of four new workshops. Now entering its third season, this project is dedicated to creating a collective environment while promoting physician resilience, self-awareness and well-being. Moderated by:
Dr. Harry Zeit, MD CGPP, Physician Psychotherapist
Diplomate of the American Board of Emergency Medicine (1990-2011)
The Medical Clinic for Person-Centered Psychotherapy 265 Yorkland Blvd., Suite 403, Toronto, ON M2J 1S5
Tel: 416.229.2399 ext.275 -
Fax: 416.229.9771
Dates:
October 15, 2014 November 19, 2014
Dates:
October 15, 2014 November 19, 2014
January 21, 2015
February 18, 2015 March 18, 2015
February 18, 2015 March 18, 2015
Seating is limited. Please RSVP ASAP by phone: 416.229.2399, ext.125
(Ada or Anna), or via email to: michaelpare@rogers.com
Dr. Harry Zeit can be reached for inquiries only, including requests for repeat presentations of previous or current sessions and workshops, via email to: harryzeit@sympatico.ca
Dr. Harry Zeit can be reached for inquiries only, including requests for repeat presentations of previous or current sessions and workshops, via email to: harryzeit@sympatico.ca
Finding Safety, Strength and Meaning in
Troubled Times
A series of four workshops designed to create physician wellness and resilience
How do we - with clarity and honesty - locate safety and meaning in a trou- bled world? How - with equanimity - do we hold the tension of what we are asked to do, with what we know is possible? How, when our work seems forever incomplete, do we let go at the end of each day? From what sources do we re-charge and derive strength, gratitude and inspiration?
In 2011-12, we looked at new developments in the fields of neuroscience, attachment, trauma & dissociation and integrated mind/body healing. We covered areas within our field which are advancing so quickly that our medi- cal schools and residency programs remain unable to bring them fully into their curriculums. In the following 2012-13 and 2013-14 series, we began to assess the personal and professional cost of practicing without a clear sense of how trauma and stress affect our primitive brains on both personal and collective levels, often hijacking reason, creativity and resilience.
This year, we will continue to deepen our understanding of these new de- velopments in the fields of medicine, psychotherapy and the neurosciences and their profound consequences and implications for our field and our fu- ture. Together, we will explore how this knowledge can help us remain re- silient and to evolve as individuals, individually and within systems. We will learn how an understanding of the ubiquitous effects of stress and trauma on the nervous system is crucial for our own wellness as well as integral to the health of our communities and institutions.
Like last year’s Caring for Self While Caring for Others series, these sessions will blend some teaching and the presentation of current up-to-date videos with experiential exercises and open discussion. Our experiential exercises derive from Yoga, Qi Gong, Somatic and Energy Psychologies, and are designed to be easily applied and integrated into your own personal care plan as well as into patient care. They’re a chance to embody and move while learning to better regulate your autonomic nervous system.
Participants are encouraged to bring material from cases or from personal experience. This will be an opportunity not just for learning, but also for shar- ing feelings and hopes with colleagues and for building community.
The sessions are all stand-alone. Previous attendance is not a pre-requisite. The series is designed to develop and deepen the core theme, but at the same time, each talk is self-contained and complete in itself.
October 15, 2014
Eight Keys for Stress Management
Stress is increasingly recognized as a great hazard to our wellness as in- dividuals and as a profession. In addition, at high levels, it can accelerate disease and aging process. As well, it impacts our ability to relate to others with compassion and empathy.
In this talk, we will review some strategies for approaching and reducing the stress levels in our clinical practice and our personal lives.
Learning objectives:
Journaling for Wellness
“Writing is a powerful tool for psychological healing. Therapeutic journaling is any type of writing or related expressive process used for the purpose of psychological healing or growth. It includes not only jotting down thoughts and feelings, but other, less traditional techniques like dialoguing between parts of the self, mind mapping, keeping a log and using journaling with EMDR or CBT, among others.” From Amazon review of The Healing Power of Writing.
Learning objectives:
A series of four workshops designed to create physician wellness and resilience
How do we - with clarity and honesty - locate safety and meaning in a trou- bled world? How - with equanimity - do we hold the tension of what we are asked to do, with what we know is possible? How, when our work seems forever incomplete, do we let go at the end of each day? From what sources do we re-charge and derive strength, gratitude and inspiration?
In 2011-12, we looked at new developments in the fields of neuroscience, attachment, trauma & dissociation and integrated mind/body healing. We covered areas within our field which are advancing so quickly that our medi- cal schools and residency programs remain unable to bring them fully into their curriculums. In the following 2012-13 and 2013-14 series, we began to assess the personal and professional cost of practicing without a clear sense of how trauma and stress affect our primitive brains on both personal and collective levels, often hijacking reason, creativity and resilience.
This year, we will continue to deepen our understanding of these new de- velopments in the fields of medicine, psychotherapy and the neurosciences and their profound consequences and implications for our field and our fu- ture. Together, we will explore how this knowledge can help us remain re- silient and to evolve as individuals, individually and within systems. We will learn how an understanding of the ubiquitous effects of stress and trauma on the nervous system is crucial for our own wellness as well as integral to the health of our communities and institutions.
Like last year’s Caring for Self While Caring for Others series, these sessions will blend some teaching and the presentation of current up-to-date videos with experiential exercises and open discussion. Our experiential exercises derive from Yoga, Qi Gong, Somatic and Energy Psychologies, and are designed to be easily applied and integrated into your own personal care plan as well as into patient care. They’re a chance to embody and move while learning to better regulate your autonomic nervous system.
Participants are encouraged to bring material from cases or from personal experience. This will be an opportunity not just for learning, but also for shar- ing feelings and hopes with colleagues and for building community.
The sessions are all stand-alone. Previous attendance is not a pre-requisite. The series is designed to develop and deepen the core theme, but at the same time, each talk is self-contained and complete in itself.
October 15, 2014
Eight Keys for Stress Management
Stress is increasingly recognized as a great hazard to our wellness as in- dividuals and as a profession. In addition, at high levels, it can accelerate disease and aging process. As well, it impacts our ability to relate to others with compassion and empathy.
In this talk, we will review some strategies for approaching and reducing the stress levels in our clinical practice and our personal lives.
Learning objectives:
-
Gain an understanding and awareness of personal stressors.
-
Learn short-term and long-term interventions to manage current life
stressors.
-
Have an opportunity to practice several short Qi Gong exercises, as a
tool for self-care.
Journaling for Wellness
“Writing is a powerful tool for psychological healing. Therapeutic journaling is any type of writing or related expressive process used for the purpose of psychological healing or growth. It includes not only jotting down thoughts and feelings, but other, less traditional techniques like dialoguing between parts of the self, mind mapping, keeping a log and using journaling with EMDR or CBT, among others.” From Amazon review of The Healing Power of Writing.
Learning objectives:
-
Gain and understanding of therapeutic journaling as a tool for both pa-
tient and self-care.
-
Have an opportunity to participate in a therapeutic journaling exercise
-
Review and practice the complete breath, as a tool for regulating the
autonomic nervous system
Guest Presentation by Joy Albuquerque MD on behalf of the Ontario Medical Association Physician Health Program.
Topic: To Be Announced
February 18, 2015
The Inner Life of the Therapist/Physician
“One of the greatest gifts helping professionals can share with others is a sense of their own peace. However, retaining and renewing a sense of healthy perspective requires not only self-care strategies, but also an aware- ness of basic, profound, yet simple, wisdom themes.” A talk inspired by the work of Robert J. Wicks.
Learning objectives:
1.) Gain an appreciation of self-reflection as a tool to continually re-discover meaning and perspective.
2.) Explore self-reflection as a means to find and share a sense of inner peace.
3.)Have an opportunity to practice several short elements of yoga and gain a deeper understanding of the potential of this practice to be a part of self-care.
Erotic and Perverse Transferences/”Doing” Hope
Have you ever experienced strong, erotic or sexual feelings and impulses toward a patient? This is a chance to better understand the origin of these desires, as well as a way to process them safely.
We finish by an exploration of Doing Hope - in preparation for the theme of the upcoming OMA annual conference where our section collaborates with other sections on the theme of hope in medicine and in psychotherapy. How do we cultivate hope and scaffold it as something do-able and real, rather than lose ourselves in wishful thinking and illusion?
Learning objectives:
The Inner Life of the Therapist/Physician
“One of the greatest gifts helping professionals can share with others is a sense of their own peace. However, retaining and renewing a sense of healthy perspective requires not only self-care strategies, but also an aware- ness of basic, profound, yet simple, wisdom themes.” A talk inspired by the work of Robert J. Wicks.
Learning objectives:
1.) Gain an appreciation of self-reflection as a tool to continually re-discover meaning and perspective.
2.) Explore self-reflection as a means to find and share a sense of inner peace.
3.)Have an opportunity to practice several short elements of yoga and gain a deeper understanding of the potential of this practice to be a part of self-care.
Erotic and Perverse Transferences/”Doing” Hope
Have you ever experienced strong, erotic or sexual feelings and impulses toward a patient? This is a chance to better understand the origin of these desires, as well as a way to process them safely.
We finish by an exploration of Doing Hope - in preparation for the theme of the upcoming OMA annual conference where our section collaborates with other sections on the theme of hope in medicine and in psychotherapy. How do we cultivate hope and scaffold it as something do-able and real, rather than lose ourselves in wishful thinking and illusion?
Learning objectives:
-
Gain a deeper understanding of erotic countertransference.
-
Gain an understanding of personal vulnerabilities to enacting counter-
transference fantasies.
-
Experience an opportunity to reflect on the role of hope in medical and
psychotherapeutic practice.
-
Have an opportunity to practice several short bio-energetic exercises, as
potential self-care tools, and as an introduction to the work of Alexander Lowen M.D.
OMA Section on Primary Care Mental Health
Dr. Harry Zeit
Harry Zeit graduated from the University of Toronto Medical School in 1982. He practiced until 2005 as an American Board certified emergency physician, and was active in the Canadian Association of Emergency Physicians.
Harry currently runs a private practice in general psychotherapy, with a spe- cial interest in trauma and in newer, integrated psychotherapy models. He is a graduate of the Sensorimotor Psychotherapy Institute’s training level one (trauma) and level two (attachment and development); in April, 2013, he completed the certificant level in the first ever Canadian level three train- ing. He also holds certificant status in the General Practice Psychotherapy Association of Canada (GPPA).
Harry will be again be assisted by Irina Dumitrache. Irina has graduated from two yoga teacher training programs, at the Yoga Sanctuary in Toronto and at the Yoga Therapy Toronto.
Please follow the Education Committee Blog for further news and information: http://wildpsychotherapyfrontier.blogspot.ca/
Previous Sessions:
Session One: Trauma Stewardship - Part 1 - Wednesday, November 1, 2012 Session Two: Trauma Stewardship - Part 2 - Wednesday, November 21, 2012. Session Three: Building Resilient Lives and Responsive Systems - Wednesday, February 20, 2013
Session Four: Post-Traumatic Growth and Flourishing -
Wednesday, March 27, 2013
Session Five: Psychophysiologic Disorders, an Alternate Model of Stress- Induced Illness. Befriending our Brainstems: working with intrusions of animal defenses in ourselves and our patients. Breath work for Affect Regulation - Wednesday, October 16, 2013
Session Six: Guest Speaker, Ted Bober, from the OMA Physician Health Pro- gram. Cultivating Physician Health and Excellence -
Wednesday, November 20, 2013.
Session Seven: The Wounded Healer: Shamans and Physicians. Breathwork and Journaling. - Wednesday, February 20, 2013
Session Eight: Exercises to Build Resilience. Mindfulness, Breathwork and Somatic Resourcing - Wednesday, March 19, 2014.
In our second season, we also held a half-day offsite workshop, entitled David Berceli’s Trauma Release Exercises Workshop - November 2, 2013.
Harry Zeit graduated from the University of Toronto Medical School in 1982. He practiced until 2005 as an American Board certified emergency physician, and was active in the Canadian Association of Emergency Physicians.
Harry currently runs a private practice in general psychotherapy, with a spe- cial interest in trauma and in newer, integrated psychotherapy models. He is a graduate of the Sensorimotor Psychotherapy Institute’s training level one (trauma) and level two (attachment and development); in April, 2013, he completed the certificant level in the first ever Canadian level three train- ing. He also holds certificant status in the General Practice Psychotherapy Association of Canada (GPPA).
Harry will be again be assisted by Irina Dumitrache. Irina has graduated from two yoga teacher training programs, at the Yoga Sanctuary in Toronto and at the Yoga Therapy Toronto.
Please follow the Education Committee Blog for further news and information: http://wildpsychotherapyfrontier.blogspot.ca/
Previous Sessions:
Session One: Trauma Stewardship - Part 1 - Wednesday, November 1, 2012 Session Two: Trauma Stewardship - Part 2 - Wednesday, November 21, 2012. Session Three: Building Resilient Lives and Responsive Systems - Wednesday, February 20, 2013
Session Four: Post-Traumatic Growth and Flourishing -
Wednesday, March 27, 2013
Session Five: Psychophysiologic Disorders, an Alternate Model of Stress- Induced Illness. Befriending our Brainstems: working with intrusions of animal defenses in ourselves and our patients. Breath work for Affect Regulation - Wednesday, October 16, 2013
Session Six: Guest Speaker, Ted Bober, from the OMA Physician Health Pro- gram. Cultivating Physician Health and Excellence -
Wednesday, November 20, 2013.
Session Seven: The Wounded Healer: Shamans and Physicians. Breathwork and Journaling. - Wednesday, February 20, 2013
Session Eight: Exercises to Build Resilience. Mindfulness, Breathwork and Somatic Resourcing - Wednesday, March 19, 2014.
In our second season, we also held a half-day offsite workshop, entitled David Berceli’s Trauma Release Exercises Workshop - November 2, 2013.
ACCREDITATION:
Each of these presentations is accredited for two hours of group continuing education by the GPPA (General Practice Psychotherapy Association).
Attendance will be strictly monitored. Please sign in before 7:30 PM in order to receive CE credits.
LOCATION:
OMA office is located at 150 Bloor Street West, Suite 900 (northeast corner of Avenue Road/ Bloor Street West) .
PARKING:
There are several parking lots within a block radius of the office (Cumberland Street, Bellair Street and Yorkville Avenue) and some metered parking on the street. There is NO public parking below our building.
Each of these presentations is accredited for two hours of group continuing education by the GPPA (General Practice Psychotherapy Association).
Attendance will be strictly monitored. Please sign in before 7:30 PM in order to receive CE credits.
LOCATION:
OMA office is located at 150 Bloor Street West, Suite 900 (northeast corner of Avenue Road/ Bloor Street West) .
PARKING:
There are several parking lots within a block radius of the office (Cumberland Street, Bellair Street and Yorkville Avenue) and some metered parking on the street. There is NO public parking below our building.
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