Dr Rachel Lee

Three ways to do more of the things that matter to you. 

When you are busy caring for others, whether at work, at home or both, it can be easy to overlook things that boost your mental health and wellbeing. This might be because of a perceived lack of time, or conflicting priorities, or due to thoughts or worries that it might be selfish to focus on your own needs. However, we all have a limited capacity to handle difficult situations and care for others. Our internal resources to handle stress are not bottomless, so just like a bank account, we need to make additions as well as withdrawals. Here are three strategies to help you:

1. Ask yourself whether you are living according to your values.

At busy times it can be easy for our lives to become unbalanced. We may find that our focus has shifted, and the things that usually help us to cope with busy times have slipped away. 

If you find yourself feeling like your life has become unbalanced, take some time to sit down and think about what’s important to you. What sort of person do you want to be, what do you want your life to be about? Which are the areas that are most important to you? Now thing about how you spend your time. Are you spending time on all the things that matter to you, or are some being neglected? If you are neglecting some areas, can you think of some small steps to help you get a more healthy balance?

2. Add in one pleasant experience or meaningful activity each day.

When we engage in pleasant experiences and meaningful activities it is like making a deposit into our emotional bank account. These activities help our well-being and create a buffer against life’s up and downs. You will recognise that it is much less upsetting if you stub your toe at the end of a day when you did great things, than if you stub your toe after a stressful and upsetting day at work. If you are feeling like your internal resources are depleted, try planning in a pleasant activity each day for week and then notice how this feels. It doesn’t need to be a big thing; it could involve sitting in the garden with a cup of tea, reading a book before bed, going for a walk or a run, or watching your favourite TV programme. Doing things that matter to you will reduce your vulnerability to being overwhelmed by emotions.

3. Identify and work towards your long terms goals.  

Another way to reduce our vulnerability to being overwhelmed by emotions, is to accumulate positive experiences over the longer term, by taking regular steps towards longer-term goals. Think about your values and then think about something you would like to achieve in the next 6-12 months. Identify a specific goal. Now spend some time working out the small steps that will take you towards this goal. Keep breaking things down until you have some small manageable steps that you can plan into your diary. Then make an action plan. Setting a written intention to act can be really helpful when you start to have doubts or struggle with low motivation. Imagine yourself completing the goal. How will it feel? Use this to motivate you at times when you are tired or get side-tracked by other areas of your life.

And yet, some stress may be good for us. Research from Berkeley University, California [Kirby 2013] concluded that brief significant but stressful events caused stem cells to grow,  improving mental performance a few weeks later. So some level of acute stress may indeed help us to improve how we perform. Stepping out of our comfort zone and into a new stretch zone may indeed help us to strengthen and adapt our cognitive muscles!

But where is the point at which an acute stress episode tips over into long term, chronic stress? Longer term, chronic stress can lead to an increased risk of issues such as obesity, heart disease and depression, so how do we recognize when we might be at that increased risk?

The original Life stressors index was formulated by Holmes and Rahe, two psychologists in 1967. Their research was based on monitoring the health interventions for a group of individuals who had been through the following life events, and assigning each event a ‘ Life change Unit’ score   :

• 1. Death of spouse or child (100)
• 2. Divorce (73)
• 3. Marriage / relationship separation (65)
• 4. Imprisonment (63)
• 5. Death of close family member (63)
• 6. Injury or illness (53)
• 7. Marriage (50)
• 8. Job loss (47)
• 9. Marriage reconciliation (45)

10. Retirement (45)

Interestingly, moving house, which so many of us quote as one of the most stressful events we can experience does not actually appear in their listing!

But this is a list which was compiled over fifty years ago – how relevant is it for us now?

There’s no official update to the Holmes and Rahe indez, the closest and most recent update is a listing compiled by Web MD in early 2022. 

                      1.Death of a loved one

                      2.Divorce

                      3.Loss of a job

                      4.Increase in financial obligations 

                       5.Getting married

                       6.Moving to a new home 

                        7.Chronic illness or injury

8. Emotional problems
9. Taking care of an elderly or sick family member
10. A traumatic event 

Comparing the two lists – and moving house is now included –  as are financial worries, hugely relevant as we focus on the cost of living at present. And so is ‘taking care of an elderly or sick family member ‘, something which many of us can relate to as successive generations live longer.

So – be aware of your own levels of stress, and think about what might be causing it. And if you are feeling the impact of longer term, chronic stress then please do make sure you seek out some help for yourself – the team here at Healthy You can help!!

Sue Noyes 

6/6/22 

1. Ask yourself whether you are living according to your values.

At busy times it can be easy for our lives to become unbalanced. We may find that our focus has shifted, and the things that usually help us to cope with busy times have slipped away. 

If you find yourself feeling like your life has become unbalanced, take some time to sit down and think about what’s important to you. What sort of person do you want to be, what do you want your life to be about? Which are the areas that are most important to you? Now thing about how you spend your time. Are you spending time on all the things that matter to you, or are some being neglected? If you are neglecting some areas, can you think of some small steps to help you get a more healthy balance?

1. Add in one pleasant experience or meaningful activity each day.

When we engage in pleasant experiences and meaningful activities it is like making a deposit into our emotional bank account. These activities help our well-being and create a buffer against life’s up and downs. You will recognise that it is much less upsetting if you stub your toe at the end of a day when you did great things, than if you stub your toe after a stressful and upsetting day at work. If you are feeling like your internal resources are depleted, try planning in a pleasant activity each day for week and then notice how this feels. It doesn’t need to be a big thing; it could involve sitting in the garden with a cup of tea, reading a book before bed, going for a walk or a run, or watching your favourite TV programme. Doing things that matter to you will reduce your vulnerability to being overwhelmed by emotions.

1. Identify and work towards your long terms goals.  

Another way to reduce our vulnerability to being overwhelmed by emotions, is to accumulate positive experiences over the longer term, by taking regular steps towards longer-term goals. Think about your values and then think about something you would like to achieve in the next 6-12 months. Identify a specific goal. Now spend some time working out the small steps that will take you towards this goal. Keep breaking things down until you have some small manageable steps that you can plan into your diary. Then make an action plan. Setting a written intention to act can be really helpful when you start to have doubts or struggle with low motivation. Imagine yourself completing the goal. How will it feel? Use this to motivate you at times when you are tired or get side-tracked by other areas of your life.

It may not always feel like it, but emotions are our superpowers. Anxiety shows up when there is a threat and helps us avoid unnecessary harm. Sadness helps us connect with others and get the support we need when we experience losses and disappointment. Anger helps us fight for what’s important to us. 

However, there are also times when our emotions are amplified and can lead is to act in ways that are unhelpful and which we may later regret. Here are two strategies that will help you when you get “hooked” by unhelpful emotions, thoughts or memories.

1. Engage your wise mind

Marsha Linehan proposed that there are three states of mind; emotional mind, reasonable mind and wise mind. When we are in emotional mind, our behaviour is based on our emotions; we are at the whim of our emotion action urges and make choices based purely on how we feel at the time. When we are in  our reasonable mind, we choose actions based on intellectual knowledge, facts and reason. Wise mind is the intersection of emotional and reasonable mind; it’s when we use our inner wisdom to choose behaviours based on both (i)  how we feel and what’s important to us and (i) the logical information available to us. 

Strategy: Next time you find yourself in emotional mind, and realise that you are being driven by your emotions, see if you can slow things down. 1. Notice the emotion you are feeling and name it. 2. Take a steady breath. 3. Think about what you are responding to and ask your wise mind “What is the most effective thing for me to do now?”. Or, if you are in a dilemma, ask wise mind a question (e.g “What should I do now?”), then sit back and listen for the answer.

1. Weather an emotional storm by “Dropping Anchor”. 

It is very easy to get “hooked” by unwanted thoughts, memories or emotions and when this happens we can easily feel overwhelmed, like we are in an emotional storm or tornado. At times like this,  “Dropping Anchor” can help you to steady yourself so that you can avoid being pulled off course, much like a boat’s anchor stops it being blown around in a storm at sea. 

Strategy: 

A – Acknowledge your difficult thoughts, memories and emotions.

Label your experiences. E.g. “I am feeling anxious” “I am having a memory from when I was 17”.

C – Connect with your body. 

Start to gently move your attention away from your mind, by moving parts of your body, e.g. wiggle your toes, shrug your shoulders, give yourself a hug, move around, or stretch. Whatever feels comfortable for you. Notice that you can control what you do with your body. You are in control of this moment.

E – Engage in the world around you. 

Notice what is going on around you. What  can you see, hear, smell? Now do something that matters to you. Move around, get active. 

These strategies all involve gently shifting your awareness and attention away from your internal world and into the present, so that you can feel more in control of your actions and choices. Some people call this mindfulness. We have lots of tools within this app that will help you to train your attention in this way. Explore and see what works for you. 

Marina Keegan was a 22 year old Yale graduate, a young woman with a bright future whose life was tragically cut short five days after graduation in a car accident.   Her posthumous book ‘The Opposite of Loneliness’ created by her family became a global phenomena and her reflections on the nature of human connection are wise beyond her years.  Keegan’s article sparked my interest in the nature of loneliness, a phenomena I have since explored as the focus of my doctoral portfolio, in my training to become a Health Psychologist.  

By way of introduction to the topic it is helpful to distinguish loneliness from social isolation. They are related but very different experiences. Loneliness comes from our appraisal of the quality of our social relationships, we experience loneliness when we find we lack connection with others that is meaningful to us. This is different from social isolation which describes the number of social contacts we have.  Therefore, we can be lonely in a crowd.  

It is important too that we don’t pathologize loneliness, it is a normal (though unpleasant) reaction to loss and for many it is transitory, for example, my son (aged 17) and daughter (aged 20) were home during the covid lockdown; despite having family around them, they missed connection to their peers and also to their grandparents.  When my children were young, I experienced periods of loneliness that came from being at home with two young children, where I had no immediate family or close friends with whom I felt I could share the more difficult days.  Loneliness is most commonly associated with our later years and old age, where we are more likely to experience multiple losses of key relationships.   Loneliness then, can be experienced at many points in the life span, it is transitory, and most people will find ways to re-gain social connection with others.  

It is when loneliness becomes a chronic condition that intervention is likely to be needed. Chronic loneliness, defined as habitual avoidance of social contact, has been shown to be as damaging to our physical health as smoking 15 cigarettes a day.  The last ten years has seen a growth in the number of studies which are helping us to better understand loneliness, its causes and importantly what we can do about it.  This is the legacy, in large part, of the MP Jo Cox who campaigned to raise awareness of loneliness in the UK.  After her untimely and tragic death in 2016, colleagues and family continued her work with the Jo Cox Foundation and events such as The Great Get Together.  

A recent report published in 2020, by the Campaign to End Loneliness called ‘The Psychology of Loneliness’, shows how psychology can offer effective solutions to addressing chronic loneliness with cognitive behavioural therapy, mindfulness and positive psychology all shown to be effective in the treatment of chronic loneliness.   My own use of Acceptance and Commitment Therapy showed too its effectiveness in treating chronic  loneliness.  

I will leave the last word to Marina Keegan’s  whose reflection on the opposite of loneliness ends with: “It’s not quite love and it’s not quite community; it’s just this feeling that there are people, an abundance of people, who are in this together. Who are on your team”.   Psychological therapies to address loneliness can be a first step in re-connecting with those who are in your team.  

What does menopause mean to you?  Is it a normal life event?  An illness? Something to get through? Natural part of an ageing process?  A medical condition?

How we perceive our experience of the menopause actually matters and can impact on our overall experience.  Research suggests that our attitude to menopause is often related to what we actually feel, physically and psychologically.  For example, it is experienced differently across cultures. So it seems that women in general are having less problems with the menopause beyond the western world and there are a number of explanations for this relating to climate, life-style, diet and cultural taboos. 

What is menopause?

Menopause is now talked about more than ever before, thanks to media attention, with many celebrities on board with the conversation, and more information in the public domain.  However, there are still  myths out there and confusion about symptoms and available treatment. 

Basically, menopause means the last menstrual period.  Natural menopause takes place when the ovaries stop producing oestrogen and progesterone, our female hormones, any time from 45 onwards although the average age is 51.  Then there’s the women who experience ‘early menopause’ which is associated with damage or removal of the ovaries due to surgery or chemotherapy.  

There are two stages of menopause: peri-menopause is the stage from first experiencing symptoms to post-menopause, which is the stage following the last period.

Physical symptoms

Symptoms vary between individuals and depending on whether you’re at peri or post-menopausal stage.  It’s a time most commonly associated with physical symptoms, including hot flushes, insomnia, night sweats, palpitations and joint pain as well as uro-genital symptom such as urine infections, vaginal dryness and diminished libido commonly associated with the post stage.

Psychological symptoms

Although much of the attention relates to the physical symptoms, it’s important to understand the psychological impact of menopause.  Feelings of anxiety, mood swings, irritability, low self-esteem and depression…?  You’re not alone.  Whilst hormonal changes are thought to be responsible for some of these, we know menopause doesn’t take place in isolation and social context is important.  It often comes at a time of life change, family change. Those with children may be experiencing empty nest syndrome.  Many now too are at the time in their life when they will be carers for an adult parent.  This at the same time as working longer.  Often referred to as ‘Women in the Middle’.

Tips and strategies

It’s important to be prepared for ageing generally but specifically for the changes around the transition to menopause and after. Making changes to your lifestyle by taking responsibility for your health should start now.  Keeping active and managing weight are associated with better health outcomes related to cancer and chronic diseases such as diabetes, cardiovascular disease, osteoporosis and dementia. Also, reaching out for support and advice for symptom management, including whether or not to take HRT.

Managing stress and anxiety

We’ve already talked about the impact of menopause on emotions which can be more difficult to manage than physical symptoms.  Most self-management techniques start with lifestyle changes and an acceptance of the menopause process.  It can be a time of confusion when we are struggling with a new identity.  Self-compassion is important.  Be kind to yourself and treat yourself as you would treat someone you care about.  Learn to care about yourself.  

Serenity and Power

And finally, acceptance??

This is a time to begin

Your life.  It could be new.

The sheer not fitting in

With the old who envy you

And the young who want to win,

Not knowing false from true,

Means you have liberty

Denied to their extremes

At last now you can be

What the old cannot recall

And the young long for in dreams,

Yet still include them all.

‘Accepted’ Elizabeth Jennings Collected Poems

Dr Gill Smith 30.5.22

Dr Sarah Barker

Many people are aware of the benefits of mindfulness for mental health but finding time to practise in a busy world can be a challenge. Creating moments of mindful awareness can be a great first step in embedding a mindful practice into daily life. These small moments are entitled ‘micro moments’ and provide a pause that allows mental recovery and improves our overall well-being.

Interestingly, if you do an internet search for ‘micro-moments’, this term is also used within internet marketing as companies compete for our attention. Moments are classified as ‘wanting to know moments’, ‘wanting to go moments’, ‘wanting to buy moments’, and ‘wanting to do moments’. This contrasts with the ‘present focus’ used in mental health.  Bringing mindful awareness to how we spend each moment can be helpful in leading a more values-driven life that we more actively choose.  In what way do you want to spend this moment, and this next moment, and this subsequent moment? Being clear on the values we want to underpin our life can help us to choose how we spend each moment, and lead to greater satisfaction and enhanced mental and physical health. Acceptance and commitment therapy (ACT), a Third Wave cognitive behavioural therapy, emphasises values and present focus and is offered by many of the practitioners at Healthy You, and can be a helpful exercise in thinking this through. 

The benefits of mindfulness and being present focused are many, and an increasing body of research discusses the benefits for health and conditions such as chronic pain.  Mindfulness can help to calm the central nervous system or bring more energy if you are feeling hypo aroused.  When you are stressed finding ‘ mindful flow’ in activities such as art can be incredibly helpful. Noticing the colours, textures and movement whilst painting, or the vibrations and rhythms whilst making music can support and enhance creativity. You can also focus on your breathing; briefly narrowing your focus of attention, then widen this out again. Your mindfulness practice does not have to be at a special set time- it can be brief micro moments that punctuate your day.

An easy way to embed this into your life, is to choose two or three activities that you repeat daily, such as cleaning your teeth. When you are engaged in these activities, bring your full awareness and attention to the task. Use all of your senses to engage with what you taste, see, smell, feel and hear. When you notice your mind drifting away to memories or images, bring your full attention and all your senses back to the raw experience of the here-and-now. This technique can be used whether you are at work, commuting or with family and friends. When you pay full attention to these small moments of life, your overall contentment and happiness can increase.