Anxiety can also cause physical symptoms, such as difficulty breathing or chest tightness. If symptoms become overwhelming and disrupt everyday life, an anxiety disorder may exist.  Anxiety disorders are prevalent and cause intense, unpleasant feelings such as helplessness, an impending sense of doom, and fear.

  • Generalized Anxiety Disorder (GAD)

You have intense and persistent concerns about the future, making you feel out of control and unable to engage in positive and meaningful activities. You feel restless, irritable, and can’t concentrate. You often feel fatigued and may engage in catastrophic thinking.

Other anxiety problems people experience are:

  • Career-Related Stress
  • Panic Attacks
  • Social Anxiety
  • Phobias
  • Obsessive-Compulsive Disorder (OCD)



Depression can seriously affect mental and physical health, if left untreated

When feelings of despair and hopelessness, sadness, irritability, self-doubt, loss of any pleasure and a distorted and negative sense of self persist, then depression may be an issue. Depression can seriously affect mental and physical health, if left untreated.

Some common symptoms include:

  • Depressed and sad mood persisting for longer than two weeks
  • Reduced or no interest in things you previously liked doing
  • Feelings of helplessness
  • Guilt and self-loathing
  • A feeling that life is meaningless
  • Loss of sex drive
  • Poor concentration and indecision
  • Social withdrawal
  • Insomnia
  • Fatigue or loss of energy
  • Feelings of worthlessness
  • Preoccupation with death

Grief & Loss

Although each person’s grief & sense of loss is unique, the experience is shaped by their culture, family of origin, previous life experiences and community they live in

Grief and loss are not only limited to the death of a loved one. Grief can come at the hands of a broken relationship, the loss of a job, the death of a pet, or a disabling injury or disease. The bottom line is that if you’ve lost someone or something that was an important part of your life, you may experience debilitating grief as a result. Grief is a person’s experience with personal loss and has many forms: mental, physical and social.

Some of the most common mental health symptoms associated with the grieving process are:

  • Frequent crying
  • Feeling Depressed
  • Numbness or shock
  • Anxiety
  • Fear
  • Increased drug or alcohol use
  • Anger
  • Guilt
  • Loneliness and isolating behaviors
  • Identity Related Concerns

Self-esteem is often thought of as confidence, but it can go much deeper.

Low Self-Esteem

Your self-esteem is your sense of worth, which greatly affects how you interact with the world, what your expectations are, and what you feel you deserve. Self-esteem can go to extremes in both directions: High self-esteem leads to an unearned sense of entitlement and the inability to admit to or learn from mistakes.

Low self-esteem, on the other hand, leaves you feeling like a failure and unworthy of even the smallest rewards or acts of kindness. Low self-esteem can go a step further and lead you into bad situations where you feel you deserve to be treated poorly.

If you spend an inordinate amount of time wondering about what others think of you and worrying that others find you less than desirable, these are signs of low self-esteem. This often leads to feeling uncomfortable in your own skin or like you’re never enough. You obsess about your relationships and work overtime to keep them going. You take the blame when you shouldn’t and maintain poor boundaries.

    Anger Management

    Anger is a powerful emotion that ranges in severity

    from mild annoyance through intense fury

    It’s also a perfectly normal and acceptable human emotion. Aggression is a natural way to express anger and can help you to fight or defend yourself.
    However, if you are overwhelmed by anger and unable to control the way you express your anger, you may have a problem. It’s not helpful or safe to aggressively lash out every time you get mad about something.
    Anger management is a specific type of therapy that teaches you to control and express your feelings. You can learn and practice the differences between being assertive and aggressive. And you can learn techniques to stop your anger from overwhelming you and how to redirect those emotions and energy toward healthy, constructive behaviors.

      Work / Life Balance

      Work Life

      Work is likely to invade your personal life – and maintaining

      work / life balance is no simple task

      If you are finding it difficult to balance the different elements of your life, you are not alone.  Many people describe “overload” associated with their numerous roles they are responsible for…work, home and family, friends, physical health, volunteer and community service.  Out of time & out of energy, you realize the impact on family, work and yourself.  Feelings of guilt and anger begin to manifest in family relationships.  Not giving yourself quality time, is like running on empty.

      Interpersonal issues and differences in work style can lead to increased stress in the work place, and feelings of anxiety, depression, resentment, and confusion about one’s job and employment goals.  Sometimes the ability to actively and effectively perform your required work responsibilities become impaired.  Conflict in business are usually exacerbated by personality issues, meaning the most difficult issues are the ones that ‘push your buttons’ for reasons you don’t understand. 

      When your everyday juggling act has stopped being a motivating challenge and started being harmful to your health… when you may be experiencing symptoms of poor work-life balance,  here are some signs:

      • You feel like you’ve lost control of your life
      • You often feel guilty about neglecting your different roles
      • You frequently find it difficult to concentrate on the task at hand
      • You’re always tired
      • You repeatedly find yourself irritable
      • You experience weakening coping skills
      • You are getting more & more headaches
      • You feel anxious &/or depressed

      Don’t ignore these potential warning signs.



          Trauma can affect a person’s self-esteem and ability to form healthy relationships, standing in the way of forming a positive and happy life

          A traumatic event is one in which a person believes their life or physical / psychological integrity, or someone else’s life or physical /psychological  integrity, is being threatened.  Typically it involves a loss of control, betrayal, abuse of power, helplessness, pain or loss.

          This can include events such as assault, a serious accident, or injury. It can also be a result of disturbing on-going situations such as living amongst violence or with terminal illnesses. Trauma affects each person differently, however, survivors often experience unwanted feelings of fear and helplessness.

          When you experience a traumatic event, you may have an immediate or delayed response with mental, emotional, and physical symptoms. Your symptoms may subside as time passes or you may develop Post Traumatic Stress Disorder (PTSD), with lasting psychological issues stemming from your trauma.

          Some common feelings that people may experience post-trauma include:

          • Fear and anxiety
          • Guilt and shame
          • Anger and rage
          • Sadness and hopelessness
          • Numbness

          People often experience physical symptoms as well, such as:

          • Feeling restless or on edge
          • Difficulty falling or staying asleep (including nightmares)
          • Increased heart rate and shortness of breath

          Although we cannot erase a person’s traumatic experiences, our therapists at Dr. Kaffko & Associates, can help you process the experiences that you’ve had and help get you to a point at which you have more control over your memories of the event(s), rather than the memories controlling you.

          Sexual Assault

          Sexual assault can have psychological, emotional and

          physical effects on a survivor

          Sexual assault occurs when one person inflicts unwanted, nonconsensual, sexual contact on another. Sexual assault can occur between adults, or an adult may assault a child. While women are more likely to experience sexual assault than men, men and boys can also be assaulted.
          This violation of your body and your sense of self has a traumatic impact on your life leading to negative self-worth, self-destructive behaviors, poor health outcomes and a variety of mental health conditions. You may develop anxiety disorders such as post-traumatic stress disorder or obsessive-compulsive disorder, depression, eating disorders, or in rare cases, dissociative identity disorder.
          You may have trouble trusting others and have a disproportionate sense of danger in the world. It’s also common for sexual assault to cause feelings of guilt or shame, which can have a lasting effect on your self-esteem and ability to deal with stress.
          You may experience impulse control problems, self-harm behaviour, frequently lashing out in anger or engaging in high risk activities with no regard for consequences. Therapy and support from others can help heal the wounds of trauma allowing for growth and self empowerment.

            Couples Conflict / Enrichment

            There’s a common misconception that couples only need couples counselling when their relationship is in crisis

            There’s a common misconception that couples only need couples counseling when their relationship is in crisis. However, couple therapy is a specific type of psychotherapy that helps couples improve their communication skills, learn to recognize and resolve conflicts, and build healthy, loving relationships.

            Intimacy comes in many forms: emotional, physical, intellectual etc. It can be difficult to determine where the disconnect stems from with your partner and how to change the dynamics of the relationship to improve the intimacy. In therapy, help to focus on the problematic patterns offers techniques on how to re-connect with partners.

            Couples therapy is suitable for all types of intimate relationships, regardless of marital status or sexual orientation. You may have couples counseling to strengthen your relationship and communication skills, or you may have a specific problem or issue that you need help to resolve. Some couples use Couples Counselling as a means for closure and separation.

            Common relationship concerns we work with are:

                • Excessive arguing
                • Losing connection
                • Life stage changes
                • Fertility issues
                • Distrust
                • Considering Divorce
                • Co-parenting
                • Infidelity
                • Anger Management 
                • Sexual Problems

            Couples therapy can address despair, mistrust and loneliness in the presence of the other, and patterns of conflict within the structure of the relationship.  Our goal is to facilitate emotional healing.

            Fertility Issues


            While the causes of fertility problems are overwhelmingly physiological, the resulting heartache – often exacerbated by the physical and emotional rigors of fertility treatment – may exact a huge psychological toll

            Individuals may experience serious mental health problems on a TRANSIENT basis, as they deal with the emotional and physical roller coaster typical to fertility treatment.  Feelings of low self-esteem, a sense of stigma, pain, loss, frustration, anxiety and depression may be overwhelming.  Relationships may suffer — not only the primary relationship with a spouse or partner, but also those with friends and family members who may inadvertently cause pain by offering well-meaning but misguided opinions and advice. Couples dealing with fertility challenges may avoid social interaction with friends who are pregnant and families who have children. They may struggle with anxiety-related sexual dysfunction and other marital conflicts.

            Women who have suffered multiple miscarriages, are likely to feel anxious about whether they will be able to carry to term.  Drugs and hormones used to treat infertility may cause a variety of psychological side effects such as: anxiety, sleep interruptions, mood swings, and irritability.  And treatment failures, may trigger a renewed cycle of grieving and distress.  Many people report experiencing a constant state of fluctuating despair and hope.

            Fertility issues most commonly explored and discussed are:

            • Depression or anxiety stemming from all-consuming desire to conceive
            • Relational Stress of IVF
            • Decision to use an egg or sperm donor or gestational carrier
            • Deteriorating relationship with your partner
            • Adoption consideration
            • Making a decision to be child free

                Parent Child Issues

                Family therapy helps family members improve communication, resolve conflict and deepen family connections.


                We commonly see the challenges of illness and grief, trauma, transition, divorce, blended families and behavioral conditions.   Dr. Kaffko & Associates provides a safe and confidential place to get support, insight, guidance, information, tools, resources and skills to improve parenting skills, knowledge and confidence.

                Blended families are on the rise.  Becoming a blended family doesn’t always go seamlessly and can be quite challenging.  Often remarriages involve children who are thrust into a world of “steps” – stepmothers, stepfathers, step-siblings, and step-grandparents.  Parents who are proactive in reducing and addressing potential problems can make the adjustment period smoother with family therapy.

                Infancy, early childhood, young adolescence, the teenage years, empty nest syndrome and adult children: Each presents a unique set of pressure points.  Family therapy can help control stress and anxiety, reduce dysfunction and fine-tune parenting skills. It can involve the whole family or just those willing and able to participate. It can focus on marital or financial problems or parent-child conflicts.  Learn how to set boundaries, communicate effectively and resolve conflict in healthy ways.

                Common family problems include:

                • Financial issues
                • Substance abuse
                • Behavioral issues and academic concerns in children and adolescents
                • Mental health concerns
                • Marital conflicts
                • Separation, divorce, or blended family adjustments
                • Chronic illness & disability
                • Balancing work/school and family life
                • Communication
                • Clashing styles in parenting

                LGBTQ+ Issues

                We are an LGBTQ+ affirming practice


                Therapy helps with a variety of life’s challenges, such as gaining satisfying, meaningful, and sustaining relationships, issues such as depression, anxiety, coming out, positive self-identification, integration and acceptance and queer couples issues.

                Some common LGBTQ+ related concerns we work with are

                • Anxiety and/or depression
                • Coming Out
                • Minority stress and micro-aggressions
                • Sexual Orientation
                • Gender Identity
                • Gender reassignment
                • Family and friends acceptance and/or rejection
                • Substance abuse

                The clinicians at Dr. Karen Kaffko and associates honor each individual’s unique process of understanding themselves and their identities, recognizing that there is no one size fits all treatment approach for LGBTQ+ related concerns.

                  Separation & Divorce

                  Family Mediation reduces conflict, which allows for an easier adjustment for you and your children

                  Splitting up can cause emotional upheaval, leading many couples to seek mediation, both before and after separation. In grieving the loss of the hopes and dreams for their marriage, couples must make important decisions about the lives of their children and themselves. Through understanding, open communication and resolving the existing conflicts, agreements are reached that focus on the needs of your children and the best interests of the family. Dr. Kaffko & Associates offer Collaborative Family Mediation, Separation and Co-Parenting Agreements, Divorce Coaching, Parent Coordination and Parenting Plan Assessments.

                    Laying the foundation for future problem solving keeps the focus on the children

                    • Collaborative Family Mediation
                    • Helping children adjust to separation & a new family structure
                    • Separation Counselling for the couple deciding to stay or let go
                    • Separation & Co-parenting Agreements
                    • Divorce Coaching
                    • Parenting Coordination
                    • Parenting Plan 

                      dr. karen kaffko

                      and associates

                      327 Eglinton Ave. East, main floor
                      Toronto, ON.
                      M4P 1L7

                      tel: 416-967-1827
                      fax: 416-691-7820