Thoughts on Record: Podcast of the Ottawa Institute of Cognitive Behavioural Therapy – Détails, épisodes et analyse

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At first glance, perfectionism looks like an asset; however, the same internal drive that fuels greatness can also erode well-being, leaving success feeling empty and unsatisfying. In this episode, we are joined by Dr. Heather Wheeler, psychologist and former elite athlete, to explore the psychology of perfectionism in high achievers. In this conversation we cover: 

• Defining perfectionism: What is it and is it ever adaptive?
• Early Conditioning: The role of coaches, parents, and social environments in shaping perfectionistic traits.
• When It Becomes Harmful: How to recognize when a drive towards excellence is tipping into burnout or mental health risk.
• Identity & Performance: How high performers conflate self-worth with performance—and what happens post-retirement.
• Working with High Performers: Navigating some of the specific challenges that can come with working with high performers 
• Perception by others: How perfectionistic high performers can be perceived by others in an untoward fashion and what can be done about it 
• Evolutionary Significance: The potential evolutionary origins of perfectionism
• Unmet Needs: How leveraging awareness of unmet needs, loneliness and a lack of connection within one's broader life can help high performers achieve a higher quality of life 
• Injury & Recovery: How a perfectionistic mindset can both help and hinder the recovery process.
• Mental Health Risks: Links between perfectionism and anxiety, depression, and eating disorders in high performers.
• Values: Facilitating effective discussions with high performers in therapeutic, parenting and coaching contexts 

Heather is one of Canada’s leading experts at the intersection of mental health and high-performance sport. Recognized for her deep knowledge and skill as a Clinical Psychologist with expertise in performance psychology, alongside her passion and enthusiasm for creating change, Heather’s impact is system-wide; including support for athletes, coaches, sport leaders and organizations across all levels of the Canadian sport system. She has been on the leading edge of the evolution of mental health prioritization in sport in recent years, helping build awareness of the unique challenges related to “mental injuries,” including eating disorders. She is adept at driving high-performance cultures through a series of steps and processes that develop the right conditions for people and organizations to grow to their full potential. As Mental Health Lead for Athletics Canada, Swimming Canada and Canadian Sport Institute Ontario, Heather leads the path for early intervention and treatment of athletes and coaches. She is also the psychologist for the HighPerformance Centre – Ontario (HPC-ON), working with the national swim team athletes and coaches and creating a psychologically-informed environment. She has been supporting high-performance and world-class athletes and coaches on their journey up to and including the Olympics and Paralympics since 2008 and is a provider for Game Plan’s Mental Health Network. Heather has over two decades of experience providing psychological assessment and evidence-based treatment to diverse populations, in both private practice and the public healthcare system.  Beyond clinical practice and leadership roles, Heather is a sought-after keynote speaker and workshop facilitator, known for creating engaging, transformative experiences and workshops related to mental health for high-performers. 

www.heatherwheeler.com 

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Dr. Chris Taplin,a psychiatrist and founder of Ottawa’s TMS Life clinic, joins us for a deep dive into one of the most promising frontiers in psychiatric care: Transcranial Magnetic Stimulation, or TMS. As clinicians, many of us have encountered the heartbreak of treatment-resistant depression — watching clients struggle despite best-practice psychotherapy and pharmacology. TMS offers a non-invasive, evidence-based alternative that is reshaping how we approach these cases. In this conversation, we unpack the science, patient experience, clinical decision-making, and broader implications of this technology. Whether you’re a skeptic, a curious clinician, or already working with neuromodulation, I think you’ll find this a thoughtful, grounded look at where TMS fits in the future of mental health treatment.

Topics We Cover:
🧠 Understanding TMS
– What is TMS, and how does it work?
– FDA-approved indications vs. emerging off-label uses
– How TMS compares to ECT and other neuromodulation tools

🪑 The Patient Experience
– What a typical TMS session looks and feels like
– Common side effects and time course of therapeutic response
– What patients report during and after a course of treatment

🔬 Mechanisms and Research
– What brain mechanisms underlie TMS’s effectiveness?
– Neuroplasticity and circuit-level change
– Emerging biomarkers and predictors of treatment response

🌍 Broader Impacts
– How TMS is shifting the landscape for treatment-resistant depression
– What’s new and exciting in TMS research
– Future directions: Could TMS expand to anxiety, PTSD, or neurological conditions?

⚖️ Practical and Ethical Considerations
– Barriers to access and systemic challenges
– How to assess if a patient is a good candidate
– Ethical issues in offering brain-based treatments

👥 Personal Insights
– Dr. Taplin’s journey into TMS
– A powerful patient success story
– Guidance for clinicians exploring TMS integration

Dr. Chris Taplin, MD, FRCPC is a board-certified psychiatrist and the founder of TMS Life, a leading mental health clinic based in Ottawa, Ontario. He specializes in the treatment of complex and treatment-resistant mental health conditions, including depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and sports-related psychiatric concerns.

Dr. Taplin is a nationally recognized expert in Transcranial Magnetic Stimulation (TMS) and completed specialized training in repetitive TMS at the Centre for Addiction and Mental Health (CAMH). His clinical approach integrates TMS with evidence-based psychotherapies such as cognitive behavioral therapy (CBT), exposure and response prevention (ERP), and interpersonal therapy, offering a comprehensive and individualized care model for his patients.

A graduate of the University of British Columbia, Dr. Taplin completed his psychiatry residency in Ontario and has been in independent practice since 2022. He is deeply committed to improving access to innovative treatments and has contributed to academic efforts aimed at enhancing psychiatric education and recruitment.

Outside of his clinical work, Dr. Taplin enjoys spending time with his family, rock climbing, and connecting with nature.

tmslife.com 

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Behavioural activation is one of the best, if not the best treatments for depression. Clinical psychologist and author, Dr. Nina Josefowitz joins us for an in-depth discussion of themes contained in her new book The Behavioural Activation Workbook for Depression.  In this discussion we cover:    

• The basic premise of behavioral activation and how it differs from other depression treatments.
• The negative feedback loop of depression and why it is so challenging to break.
• How behavioral activation addresses the physical and emotional symptoms of depression.
• The role motivation plays in behavioral activation and how individuals can overcome a lack of motivation.
• The difference between the causes of depression and its treatment.
• The importance of individuals assessing their level of depression before starting treatment.
• The purpose of activity monitoring in the context of behavioral activation.
• Common pitfalls people encounter when trying to monitor their activities and mood.
• How detailed activity monitoring should be to be effective.
• Specific examples of mood-boosting activities.
• The importance of identifying personal values when setting goals for managing depression.
• Common avoidance behaviors that perpetuate depression.
• How the physical environment impacts an individual's ability to engage in positive activities.
• Common setbacks individuals face when engaging in behavioral activation.
• Strategies for sustaining progress in managing depression.
• The benefits of combining behavioral activation with medication for a more comprehensive treatment plan.

Nina Josefowitz, PhD, is a clinical psychologist. In addition to her clinical practice, she teaches at the University of Toronto, and has offered training in North America, Asia, and Africa. She is author of numerous professional articles on cognitive behavioral therapy (CBT) and issues related to general clinical practice. Along with David Myran, she coauthored CBT Made Simple and has co authored the new book The Behavioural Activation Workbook Depression (available on Amazon.com). She has appeared in court numerous times as an expert witness in cases involving interpersonal violence. Dr. Josefowitz was on the Council of the College of Psychologists of Ontario for 9 years, and President of the College from 2001-2003. She has published in the area of trauma, cognitive behavior therapy, women’s issues, ethics and clinical psychology.   Dr. Josefowitz is well known for integrating years of clinical experience into a practical, actionable strategies.  

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Treatment resistance/non-response in psychotherapy is a major contributor of disability and loss of functioning among clients as well as a considerable source of  burnout in mental health clinicians.  Renowned psychiatrist and psychotherapist Dr. Allan Abbass joins us for a discussion of treatment resistance/non-response in psychotherapy which includes: 

• how treatment resistance is defined
• the prevalence of treatment resistance in psychotherapy
• structural factors (i.e., the dose of therapy available in public/private settings) that may contribute to treatment resistance
• the biological & social factors that predict treatment resistance  
• clues that treatment resistance may be attributable to an underlying medical condition 
• how psychosocial overlay to prescribing practices could influence treatment resistance 
• the special challenge that adverse early life events pose with respect to creating non-response to treatment
• conceptualization of non-responding clients from a psychological perspective 
• common maladpative therapist responses to treatment resistance in the context of the treating relationship 
• burnout in the context of treatment resistance clients and what can be done to avoid this
• the active ingredients in Intensive Short Term Dynamic Therapy (ISTDP) that help to address some of the unique challenges experienced by non-responding clients
• analogs in CBT to ISTDP that could be leveraged to address treatment resistance
• general tips/perspectives for clinicians relating to treatment resistance in their clients

Dr. Allan Abbass is a psychiatrist, teacher, and researcher. He is a professor of psychiatry and psychology and the founding director of the Centre for Emotions and Health at Dalhousie University in Halifax, Canada. Dr. Abbass has consulted widely with governments, universities, and health agencies on the cost-effectiveness and applicability of short-term psychotherapy.  He has provided over 300 invited presentations around the world as well as ongoing video-recording-based training to professionals in several countries. In addition, he has been awarded many research grants and has over 200 publications.  He is also the author of Reaching Through Resistance: Advanced Psychotherapy Techniques as well as co-author on numerous other books.  Dr. Abbass has been a consultant to the American Psychological Association on the Unified Psychotherapy Project and to the American Psychoanalytic Association, where he serves on the Scientific Committee. He was a board member of the International Experiential Dynamic Therapy Association. He has been an editorial board member for the American Psychological Association journal Psychotherapy. Dr. Abbass is proud to be the David Malan Professor of Psychotherapy at the Tavistock, London, UK.

http://reachingthroughresistance.com
https://twitter.com/ISTDP
https://www.facebook.com/allan.abbass.7

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Dreams have long been a source of fascination, mystery & intrigue, yet there is now an abundance of scientific evidence to shed light on the origins, nature, and purpose of this captivating aspect of the human experience.  Leading sleep & dream scientists Drs. Antonio Zadra & Robert Stickgold join host Dr. Pete Kelly, C.Psych for an in-depth consideration of many of the themes explored in their new book When Brains Dream.  In this discussion they cover:       

• the experiences that led Drs. Zadra & Stickgold to become interested in studying dreams
• a brief primer on the basic architecture of sleep
• the science around why we dream including an elaborated description of their NEXTUP model (Network Exploration To Understand Possibilities). 
• the surprising importance of daydreaming 
• the origin and neurological basis of hypnogogic hallucinations 
• potential science-based frameworks for dream interpretation
• the neurobiology of why emotions and events in dreams can feel so incredibly powerful and significant
• an in-depth consideration of lucid dreaming 
• sleep & dream disturbance in the context of mental illness
• Drs. Zadra & Stickgold's view on the utility of sleep studies
• exploration of the notion of "epic dreams"
• a brief discussion around the biggest unanswered questions around the science of dreaming

Antonio Zadra, PhD, is a sleep and dream scientist at the Hôpital du Sacré-Coeur's Center for Advanced Research in Sleep Medicine and professor of psychology at the Université de Montréal. In addition to numerous publications on sleep, dreams, and dream-related disorders, Dr. Zadra is the co-author of When Brains Dream: Exploring the Science and Mystery of Sleep and the author of The Dreamkeepers, a suspense novel blending sleep science with dream mythology. He lives in Montreal, Canada. 

Robert Stickgold is a professor of psychiatry at Beth Israel Deaconess Medical Center and Harvard Medical School. He has published over 100 scientific publications, including papers in Science, Nature, and Nature Neuroscience. His work has been written up in Time, Newsweek, The New York Times, The Boston Globe Magazine, and Seed Magazine, and he has been a guest on The Newshour with Jim Leher and NPR’s Science Friday with Ira Flato several times, extolling the importance of sleep. He has spoken at the Boston Museum of Science, the American Museum of Natural History in New York, and NEMO, the Amsterdam museum of science. His current work looks at the nature and function of sleep and dreams from a cognitive neuroscience perspective, with an emphasis on the role of sleep and dreams in memory consolidation and integration. In addition to studying the normal functioning of sleep, he is currently investigating alterations in sleep-dependent memory consolidation in patients with schizophrenia, autism spectrum disorder, and PTSD. His work is currently funded by NIMH.

https://antoniozadra.com
https://brain.harvard.edu/?people=robert-stickgold

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It is no secret that working within the mental health care system while rewarding, can at times present significant challenges with respect to the provision of optimum client care as well as the well-being of mental health clinicians themselves.  In this wide-ranging discussion, Dr. Connie Dalton, C.Psych, Co-Founder & Executive Director of the Ottawa Institute of Cognitive Behavioural Therapy joins host & colleague Dr. Pete Kelly, C. Psych to reflect not only on the challenges within the mental health care system, but also opportunities for innovation.  In this episode they touch on: 

• consideration of the current situation for therapists in public and private settings with respect to demand for services, community resources available, ability to refer clients to speciality or intensive services etc.
• factors contributing to mental health being the “orphan" of the health care system with disproportionately less resources devoted to mental health despite being a major cause of disability
• candid personal reflections on the emotional experience of working in the mental health system
• identification of, and ideas around navigating competing tensions and values with respect to providing health care within a fee-for-service environment such as private practice 
• potentially self-defeating emotional and behavioural responses of clinicians to constrained resources and feelings of burnout
• the role of, and opportunities for innovation in psychotherapy with an emphasis on a stepped care model of service delivery
• the emergence of iCBT and its role (and limitations) in the innovation landscape  
• reflections on building a private practice that is suited for 2021 and beyond

Dr. Connie Dalton is Clinical Director of the Ottawa Institute of Cognitive Behavioural Therapy and a Clinical Professor in the School of Psychology at the University of Ottawa.  She also served at the regional clinical lead for the Ontario Structured Psychotherapy Program at the Royal Ottawa Hospital from 2018 to 2020. Over the past 15 years, Dr. Dalton has delivered numerous CBT workshops and training seminars in CBT and has actively involved in the supervision and consultation of mental health professionals in CBT including physicians, nurses, social workers, and psychologists at various stages of training.  She has expertise in the treatment of mood and anxiety disorders and has helped to develop and establish CBT programming at the Royal Ottawa Mental Health Centre. Dr. Dalton is currently involved in the development of innovative methods for the delivery of CBT within the community, including home and community-based services, group therapy programs, virtual reality therapy and intensive day treatment programs for mood and  anxiety disorders, OCD and PTSD.

https://www.ottawacbt.ca/dr-connie-dalton

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The emergence and research of psychedelic-assisted psychotherapy has yielded a number of  insights with respect to potential mechanisms of change in psychotherapy.  The experience of "love" (including perceiving the love of others, self-love or even being love) has been identified as a particularly powerful element in some forms of psychedelic assisted psychotherapy.  In this episode, clinical psychologist, research scientist and author Dr. Adele Lafrance and host Dr. Pete Kelly explore the role of love in psychotherapy including:  

• the personal and professional origins of Dr. Lafrance's interest in psychedelic-assisted psychotherapy
• a brief consideration of the kinds of mental experiences reported by clients during psychedelic-assisted psychotherapy, including love from others, self-love or being love
• important caveats around safety & potential disruption in psychedelic-assisted psychotherapy 
• the difficulty in discussing "love" in psychotherapy both among professionals as well as with clients, with an important focus on what is meant by the term "love" in the context of psychotherapy (i.e., not romantic love), professional boundaries,  client perceptions, working with vulnerable populations etc.
• love as a form of truth & relationship to ideas around consciousness   
• the critical importance of self-love in psychotherapy 
• how clinicians can foster self-love as a way of bolstering self-care

An important disclaimer: today’s episode is for general information only.  Although we are discussing insights gained from formal scientific research of psychedelic-assisted psychotherapy, it needs to be underscored that psychedelic compounds are powerful psychoactive chemicals that can carry significant risk of harm for certain vulnerable individuals, especially those with active symptoms of psychosis or bipolar disorder or a clinical or a family history of psychosis or bipolar disorder.  Use of these compounds outside of research settings is also currently illegal in many jurisdictions. As such, in the discussion of psychedelic assisted psychotherapy we are in no way endorsing or encouraging the use of psychedelic compounds for any particular individual. If you are interested in further information around psychedelic assisted psychotherapy please see below for suggestions around sources of reputable information around ongoing research trials in this area. 

Dr. Adele Lafrance is a clinical psychologist, research scientist, author and co-developer of emotion-focused treatment modalities, including Emotion-Focused Family Therapy.  A frequent keynote speaker at professional conferences, Adele has published extensively in the field of emotion and health, including a clinical manual on EFFT published by the American Psychological Association. She is passionate about helping parents to support their kids in a way that is informed by the latest developments in neuroscience. The knowledge and tips in her book, What to Say to Kids When Nothing Seems to Work is an effort to do just that.  With colleagues, she also makes a wealth of caregiving resources available at no cost at Mental Health Foundations. Adele is also a leader in the research and practice of psychedelic medicine, with a focus on ayahuasca, MDMA, psilocybin and ketamine. Currently, she is a collaborator/clinical supervisor on the Imperial College study for psilocybin and anorexia nervosa. She is a founding member of the Love Project.  Adele has a particular interest in mechanisms and models of healing, including emotion processing, spirituality and family-based psychedelic psychotherapy. She is a frequent contributor in the media relating to emotion, health and the science of psychedelics.
https://dradelelafrance.com
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"Success" is something that many strive for, but a deeper consideration of success yields a number of interesting conundrums and considerations around what success actually means and how one might actually go about achieving it.  Best selling author, management consultant and entrepreneur Mr. Richard Koch sits down with host Dr. Pete Kelly, C.Psych for a discussion around: 

• caveats and conundrums around defining "success"
• signs of healthy vs. unhealthy processes around the pursuit of success
• balancing internal (e.g., meaning) vs. external (e.g., recognition) pulls in the context of success
• the importance of leveraging both self-belief and self-doubt to achieve success
• the importance of process vs. outcome for avoiding stagnation
• a brief summary of the 4 pillars of Richard's roadmap for success 

Richard Koch is a former management consultant, entrepreneur, and writer of several books on how to apply the Pareto principle (80/20 rule) (including the international bestseller "The 80/20 Principle") in all walks of life.  His latest book, Unreasonable Success, outlines a roadmap for success drawn from the life, actions and perspectives of several prominent figures in history from a variety of fields who have realized what Richard has coined “Unreasonable Success”.  Richard has also used his concepts to successfully invest in several private equity investments. Richard’s investments have included Filofax, Plymouth Gin, the Great Little Trading Company and Betfair. Previously he had been a consultant at Boston Consulting Group and later a partner at Bain and Company, before leaving to start management consulting firm L.E.K. Consulting with Jim Lawrence and Iain Evans.

https://richardkoch.net/

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The “classical” model of emotions which emphasizes the innate, universal (and even primitive) nature of emotions has been the basis for psychoeducation provided by clinicians to clients about the nature of their emotional experiences. However, there is a very large body of evidence to suggest that emotions are, in fact, constructed concepts that are “wired-in” by culture and reflect consensus-based social realism rather than innate processes. Acclaimed author, professor,  and neuroscientist Dr. Lisa Feldman Barrett joins us for an absolutely fascinating discussion of her constructed model of emotions including:  

• an overview of the classical model of emotions
• an in-depth review of Dr. Feldman Barrett’s constructed model of emotions
• myths about the classical model of emotions that are relevant for clinicians & mental health consumers
• the important role psychotherapy plays in constructing emotion concepts 
• a consideration of the neurobiological mechanics around unconscious processes and actual (vs. theorized) mechanisms of change in psychotherapy
• conceptualizing psychopathology and therapeutic intervention from the lens of the constructed model of emotions
• a neurobiological explanation for the experience of “knowing” one thing, but “feeling” another with implications for therapeutic interventions.         

Lisa Feldman Barrett, PhD, is among the top one percent most cited scientists in the world for her revolutionary research in psychology and neuroscience. She is a University Distinguished Professor of Psychology at Northeastern University, with appointments at Harvard Medical School and Massachusetts General Hospital. She is also Chief Science Officer for the Center for Law, Brain & Behavior at Harvard University.  In addition to the books Seven and a Half Lessons About the Brain and How Emotions are Made, Dr. Barrett has published over 240 peer-reviewed, scientific papers appearing in Science, Nature Neuroscience, and other top journals in psychology and cognitive neuroscience, as well as six academic volumes published by Guilford Press. She has also given a popular TED talk with nearly 6 million views. Dr. Barrett received a National Institutes of Health Director’s Pioneer Award for her revolutionary research on emotion in the brain. She also received a Guggenheim Fellowship in 2019.  She is also an elected fellow of the American Academy of Arts & Sciences and the Royal Society of Canada.

https://lisafeldmanbarrett.com/

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There has recently been a tremendous increase in awareness and acknowledgment of the systemic oppression and challenges faced by racialized populations not only generally, but in the context of mental health.  Clinical psychologists Drs. Mandisa Peterson & Jude Mary Cénat join host Dr. Pete Kelly for a very important discussion around:    

• the prevalence and nature of mental health challenges among racialized populations
• the important contribution of chronic stress stemming from racism & intergenerational trauma on mental health in racialized populations
• caveats, conundrums & guidance with respect to employing current diagnostic frameworks with racialized or diverse populations
• examples of the everyday challenges that are faced by racialized populations from the lens of racism and discrimination
• Drs. Peterson &  Cénat’s experiences of racism, both personally & professionally 
• barriers to accessing mental health services among racialized populations
• themes to be aware of around cultural differences that can exist with respect to symptoms, help-seeking etc.
• promoting greater access to diversity in training experiences
• structural racism within mental health settings
• resources that are available to help promote better insight and awareness among clinicians as well as reflections on having difficult conversations

https://mentalhealthforeveryone.ca
https://www.changingmindscanada.org
For a full list of resources related to racism and mental health click here.  Sample resources: 

• Racism in Psychiatry by Morgan Medlock
• Black Pain: It Just Looks Like We’re Not Hurting by Terrie Williams
• How to Provide Antiracist Mental Health Care Free Training Modules
• Manual for CBT for English-Speaking People of Caribbean Origin

Dr. Peterson is the co-founder and director of Changing Minds, a not-for-profit organization dedicated to addressing barriers to accessing evidence-based mental health care in the Ottawa area (changingmindscanada.org).  She provides psychodiagnostic assessments as well as individual and group therapy treatment for diverse adult populations. Her primary approach to therapy is cognitive behavioural and she has experience and training in a number of evidence-based approaches, including dialectical behaviour therapy, mindfulness, and acceptance and commitment therapy. Dr. Peterson has a particular interest and experience working with posttraumatic stress and forensic issues. She is involved in the supervision of doctoral students in clinical psychology. She is also committed to continuing program development and evaluation in the community in an effort to develop more effective and accessible mental healthcare programs.

Dr. Jude Mary Cénat is an Assistant Professor in the School of Psychology and the Director of the Vulnerability, Trauma, Resilience & Culture (V-TRaC) Research Laboratory at the University of Ottawa. His research program explores factors associated with vulnerability, trauma, and resilience, with a particular interest in the role of cultural factors. Dr. Cénat conducts research on racial disparities in mental health and social services, the impact of natural disasters and infectious disease outbreaks on mental health, interpersonal and non-interpersonal trauma, and overall mental health. He conducts research in Nor