It can seem like everyone around us is making resolutions, setting goals, working out their targets, streamlining, organizing (or so our mind and social media might tell us). For some, this brings a new feeling of hope, that anything is possible, and comes with excitement, a chance to start refreshed and anew.

For others it comes with a sense of dread (“I need to try again and its hard”), disappointment (“I didn’t make it last year”), or discomfort (“This is hard”). First let us start with acknowledging ALL those thoughts and feelings.

Sometimes goal setting is not what serves us best. Sometimes, we don’t need to set ourselves targets, or make resolutions that may or may not be achievable when the world is currently so full of uncertainty. This can leave us feeling discombobulated and without sure footing.

A more helpful way can be to think about making moves every day that take us towards the kind of life we want, and towards the kind of person we want to be, rather than away. And we don’t need a January to find a point of recalibration, a compass, a choice point to navigate these “towards moves”.

The Choice Point

Instead of making resolutions I like to use an exercise called The Choice Point (introduced by Ciarrochi, Bailey and Harris, 2013). This is a brief tool that we can use to bring us back to what matters most, to re-centre, and re-calibrate our compass over and over every day. We can’t fail at this, we get to check in and re-calibrate and flex with every move.

The Choice Point lets us ask ourselves those tricky questions from a deeper, more meaningful place: should I accept this piece of work? Should I step forward for that promotion? Shall I book that annual leave? How much time do I want to spend in the office, or at home? What clients do I love to work with the most? Why am I doing this job? How do I want this telephone conversation to go, or to word that email? With every single decision we can check back in and say, does this take me towards, or away from my values, and what matters to me?

Values

How do I know what my values are? What kind of parent/sister/partner do I want to be? How do I want to show up for my community? What do I want my life to stand for? What kind of person do I want to be?  At home? At work? How much time am I spending in each of those areas? Is this the best balance for this phase of my life? You can learn more about values here.

Hooks

Sometimes when we recalibrate and check in, we get those tricky thoughts that pop up and say “Oh hang on.. what will your colleagues think of you?”, “Don’t let your colleagues down, they are counting on you”, “One more shift won’t hurt”, “Just stay one more hour and say no next time”, “Just one more patient, they need you”. These are called ‘hooks’. They are difficult thoughts and feelings that get their hooks into us and can pull as away from those towards moves.

When those tricky hooks come up pause, breathe, notice mindfully and then make an active choice. Let your mind wander back to task, engage fully and take a step back from the tricky thought in your mind. You might visualise yourself ‘unhooking’. Then experience fully the present moment using all the senses, what can you smell, see, taste, touch. What is right here in this moment for you?

Grounding techniques can be very useful for unhooking. You can read more about grounding here.

Values based action

Now consider what small step takes you towards your values in this moment? What ‘towards moves’ could you make? What are your ‘helpers’, your strengths, your tools and your resources (don’t forget your cheerleaders) that you can draw from in this moment…and this moment…and this moment.

What does this look like?

Here is an example that I have frequently discussed with clients when making decisions feels tough.  This is often because there is a values clash and it doesn’t feel like there is a choice. In this example, the hooks often feel like ‘facts’ until further mindful examination. Labelling our thoughts as ‘hooks’ allows us to step back in order to see where there may be some wiggle room, even when things look fixed and stuck.

Often our ‘towards moves’ are not big leaps, but a series of tiny movements, that open up the possibility of something that feels more aligned with our values. It is those times when we feel most stuck, that often signal a values clash, and that something isn’t working for us.

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So, this year make a choice. You might make a resolution, or set a new goal, or just take a pause and reflect. And if you don’t have the energy, or it feels too much, it’s ok. Be kind to yourself, because at any moment, at any time of year you can pause, reflect on those opportunities to make more towards moves and take those tiny steps towards that valued life.

Dr Claire Hepworth is a Chartered Clinical Psychologist and Coaching Psychologist  who loves to help make work life work well. Claire has over twenty years of experience in Psychology research and practice in the NHS and private services. Dr Hepworth offers therapy and coaching psychology to individuals who wish to enhance their wellbeing or performance. She loves to work with professionals who want to overcome self-criticism, worry and perfectionism and manage stress.  Claire works with organisations to offer consultation, coaching and training to develop evidence based psychological organisational wellbeing strategies. You can find out more about her work here: www.dowhatworks.co.uk, www.drclairehepworth.com

The post A fresh take on making New Years resolutions – The Choice Point appeared first on Dr Paula Redmond, Clinical Psychologist.

So what can yoga do for me when I’m stressed at work?

Work and workplace environments are common sources of stress, so given that we now know the potential benefits of yoga, how can we incorporate it into a working day? Ultimately, the more regularly yoga is practiced, the greater the benefits on our overall wellbeing at any time. It helps to get into the habit of a regular practice where possible (even if only a few minutes per day), much like brushing our teeth on a daily basis benefits our dental hygiene. Therefore, the benefits of any practice of yoga outside of work will extend to the workplace too. Here are some ideas for incorporating practices from the eight branches of yoga at work.

Identify Yoga Time

If you are able to take some time during a lunch break, you may like to use the opportunity to practice a short yoga flow that incorporates both the psychological and physical benefits.

• Find a space you can do this (perhaps outdoors in the summer, or an empty office).
• Practice on your own, or invite colleagues to join you – perhaps it can become a new office habit together where you can additionally reap the benefits of connection through community. Before the pandemic had us working from home, some colleagues and I would enjoy gathering for just 10 minutes of gentle flow together before eating our lunch. It was a lovely way to connect to our bodies and feel we were offering nourishment to ourselves, alongside each other.
• Follow a guided practice – you can find some excellent free online resources to do this. One of the most well-known is ‘Yoga with Adriene’ on YouTube, who offers hundreds of free videos ranging from just 5 minutes up to a full hour of practice. She categorises her videos so you can find one matching what you feel you are in need of, for example: for managing stress, anxiety, anger, or boosting energy.

Breathe

Take a moment to pause. Place one hand over your heart and the other on your belly. Your eyes can be closed, or open with gaze lowered if it’s more comfortable for you. Take a long, slow breath in through the nose, filling your belly with air and feel your hand gently rising here as you do. Pause for a moment at the end of the inhale, then breathe out as slowly as you can, gradually releasing the air from your lungs. Feel the warmth of your hand directed into the heart. You could also add a mantra here, if you wish. Notice how you feel after a few rounds of this. Another great technique to promote a calming connection between mind and body is Alternate Nostril Breathing, which you can find a demonstration of here.

Mindful self-compassion

When you next grab a cup of tea or coffee, see if you can use this moment to tune into the sensations as you make yourself a drink: the smells, the colours, the sight of the steam rising, the heat from the mug… Notice this as a moment of reconnection between your mind and body, and a moment of practicing ‘santosha’, one of the Niyamas.

Shift

Before transitioning from one task or space to another (such as from a meeting to a clinical session), try spending a minute practicing a round or two of slow ‘sun salutations’. Not only is this a traditional and energising way to start your morning, it is a great sequence to reset the mind and body and shift any tricky stressed energy or emotions that feel a bit stuck. As you flow from one movement to the next in synchrony with your breath, you bring quite a literal change in perspective with each different posture. Practice with an intention to observe and move in a way that feels good for your own body; yoga shouldn’t be about how you look. Sun salutations also help to get blood and oxygen flowing through your body as you move mindfully, which has a refreshing effect. See this video for a demonstration and this article  for variations and information on safe practice.

Embody

Take a moment to tune into your body and mind; notice your current body posture, facial expression, and energy level. With this information, see if you can feel a sense of what your body and mind need right now. Then move into an asana (posture) or two that help you to embody this.

For example, if you are feeling anxious and want to nurture and embody a sense of courage, you could mindfully move into a Warrior 2 posture: spend a little time here to feel into your body, generate a felt sense of strength, stability, and warming energy as you actively engage your muscles while rooting to the ground beneath your feet. When you feel you have the posture, focus your eyes on one spot (in yoga we say “find your Drishti; point of concentration”). Stay here for as long as you wish, remembering to take long, slow breaths through the nose.

What about using yoga to manage stress when I’m at home?

Here are some ideas for incorporating some yoga practice into your home life – which will also have a knock-on effect on work stress:

• Protect some time in your day to practice – whether immediately before or after work, or last thing before going to sleep. Identify a time that seems the most doable for you.

• Let others know that this is your time for yoga and if you want to practice on your own, ask not to be disturbed. Or invite your partner, child, or housemate to join you! While yoga can be a personal practice (and can broaden your sense of connection to all living things), it is also a great way of connecting with others and feeling a sense of community.

• Find what works best for you and your wellbeing, which may be a mixture of both individual and shared practice. You could use the free resources mentioned here, or find yourself a class to attend online or in person. There are many options available now, so you can also ‘shop around’ and see which suits you best.

• If you are looking for deep rest and relaxation, or stress affects your sleep, you may gain particular benefit from yoga nidra, which is a highly accessible guided meditation practice done lying down. You can find free audio recordings online here.

As a clinical psychologist, I have been excited to explore the practice of yoga and the ways in which it can support psychological wellbeing, including as a supplement to talking therapy. With its wide variety of practices, I believe yoga can be accessible to all, but of course there are other mind-body practices that you may feel more connection with, such as Tai Chi, or Qigong. There are many different traditional and modern methods for practicing all branches of yoga and therefore it can be quite confusing to know where to start. You may wish to explore some of the different approaches (such as Vinyasa, Hatha, Yin, or Restorative) and see which you find most accessible and that you most connect with and find benefit from. As popular YouTube yoga teacher Adrienne would say, “find what feels good” – it’s about what works for you in service of your values.

Please note – if you’re planning to practice yoga for the first time, please take a moment to assess if your body is ready for some of the physical practices. In particular, if you have any health conditions or concerns, recent illness, or have doubts about your fitness and health, then check with your doctor first for any advice before starting a new form of physical exercise. You may also wish to practice under the guidance of a qualified yoga teacher, either in a private session or group class.

Dr Bethany Stroyde is a Clinical Psychologist and Yoga Teacher with a special interest in mind-body approaches and works with adults. You can contact her at BethStroyde@Protonmail.com, follow her on Instagram at @heartmindbodypsychology, and find her website at heartmindbodypsychology.com.

The post 5 practical ways to incorporate yoga into your working life appeared first on Dr Paula Redmond, Clinical Psychologist.

When people think of yoga it might conjure up images of glamorous young women twisting into challenging shapes in exotic locations – thank you social media. It’s also not uncommon to hear people say, “I’m not flexible enough to do yoga”, which seems to reflect and reinforce an unfortunate misconception about what yoga actually is and who can practice it.

Naive for years myself about yoga (I had assumed it was simply an exercise regime similar to Pilates!), it was a day of training during my Clinical Psychology doctorate that opened my eyes to the full scope and potential power of yoga to transform our lives for the better. I learned that anyone can practice yoga and feel the benefits.

How and why can yoga help with stress?

Maybe you have some familiarity with yoga already, either from hearing about it, or from having attended classes. However, you may be less familiar with the history, science and full scope of the practice of yoga and its relevance to our wellbeing…

Is yoga not just striking a pose?

Yoga is an ancient systematic practice rooted in Indian philosophy. It is not only the physical practice that we see images of everywhere – that is only one of eight branches of the practice of yoga. Together, the eight branches cover physical, psychological or psycho-spiritual, and ethical practices. They are called:

• Yamas: interpersonal ethics (how we treat others)
• Niyamas: intrapersonal guidance (how we treat ourselves)
• Asana: physical postures and movements
• Pranayama: breathwork
• Pratyahara: controlled senses (aligns with mindfulness approaches)
• Dharana: concentration
• Dhyana: meditation
• Samadhi: enlightenment (links to connectedness and values)

They are listed in this order intentionally, as the first four practices are concerned with how we live in the external world and act as preparation of your mind and body for practicing the following four, that are more concerned with our internal world. While they all connect and build upon each other, we can decide for ourselves which parts work for us in terms of our values and how we want to live our lives.

When I began to learn more about the eight branches, I discovered that there is much crossover and alignment with some Western models of psychological therapy, particularly compassion-focused therapy and acceptance and commitment therapy.  This furthered my interest in how the practices and benefits of yoga could work alongside clinical psychology.

What are the benefits of yoga?

The benefits of yoga have been recognised for thousands of years, but we are now able to examine more closely and objectively the mechanisms of this thanks to modern scientific methods and technology. Yoga practices essentially improve the connection between mind and body, through both a ‘top-down’ neurocognitive pathway and a ‘bottom-up’ neurophysiological pathway. By engaging the mind and body simultaneously and bi-directionally we can improve both our ability to self-regulate and our resilience (returning to homeostasis after stress).

From ‘fight or flight’ to ‘rest and digest’

The role of the autonomic nervous system is key here, with its sympathetic branch (commonly known as ‘fight or flight’) and parasympathetic branch (often referred to as ‘rest and digest’). When the body is in a state of stress, the sympathetic branch is activated. Again, this is not always an unhelpful thing because we need the body to be physically prepared for certain situations through increasing our heart and breathing rate, etc.

However, sometimes we find ourselves in this ‘fight or flight’ mode when it’s not helpful.  Furthermore,  regular activation of the stress response and difficulty returning to a state of ‘rest and digest’ may leave you feeling chronically stressed and can impact on your health.

Through yoga practices we are able to have direct influence on regulating the autonomic nervous system, so that we spend less unnecessary time in ‘fight or flight’ and move more easily and flexibly into ‘rest and digest’, where we feel calm, relaxed, and more able to connect with others.

The evidence for breathwork

Breathwork (pranayama) has the most scientific evidence to date, with numerous studies now demonstrating how changing the way we breathe has significant positive impact on our physical and psychological wellbeing. For example, many breathing practices involve extending the exhale, which stimulates the parasympathetic system and therefore calms our entire system.

Breathwork has also been shown to improve heart rate variability (HRV), which indicates the relative balance between the sympathetic and parasympathetic systems. When these systems are well balanced (good HRV), we are more able to calmly assess and respond to everyday situations, meaning we have more choice and control over our behaviour. Poor HRV makes people more vulnerable to a variety of both physical ailments and mental health problems.

By practicing pranayama we can improve our HRV and help to reduce secretion of the stress hormone cortisol, alongside increasing protective anti-inflammatory markers.

Strengthening mind-body connections

Research has shown that we are more prone to stress when we are out of touch with our body and the signals it sends and therefore less able to meet our needs before those signals become alarm bells. Essentially, the better the connection between our mind and body, the better our ability to cope with stress.

When practicing asanas, we move our bodies in synchronisation with the breath and focus on the sensations arising moment-by-moment. Through this we begin to notice connections between our emotions and our body, enabling us to begin to explore what happens if we move or breathe a little differently, enhancing our interoceptive awareness.

Strengthening this connection between mind and body helps us to better interpret our physical sensations.  This is vital to being able to navigate safely through life (for example, being able to read danger or hunger signals). As Bessel van der Kolk says in his bestselling book, ‘The Body Keeps the Score’: “If you are not aware of what your body needs you can’t take care of it”.

Once we become more viscerally attuned to our needs, we may find ourselves developing a new authentic and naturally arising capacity for self-care.

Other stress-related benefits of yoga

Further benefits related to stress include (but are not limited to):

• Improvements in digestive health including from irritable bowel syndrome, which is often linked to stress or anxiety
• Improving cognitive flexibility by facilitating neuroplasticity through increases in brain-derived neurotrophic factor (BDNF)
• Increased capacity to manage pain, including chronic pain
• Activation of mirror neurons when moving with a group or following a teacher, which increases empathy, compassion and a sense of connection – thereby stimulating our ‘soothing system’ – an antidote to stress.

How to incorporate yoga into your work life

As we have seen yoga can have enormous benefits for managing stress at work and at home.  In the next article I outline practical ways to introduce yoga into your everyday working life.

Dr Bethany Stroyde is a Clinical Psychologist and Yoga Teacher with a special interest in mind-body approaches and works with adults. You can contact her at BethStroyde@Protonmail.com, follow her on Instagram at @heartmindbodypsychology, and find her website at heartmindbodypsychology.com.

The post Can yoga help me to manage work-related stress? appeared first on Dr Paula Redmond, Clinical Psychologist.

Acceptance and Commitment Therapy (ACT for short) offers really helpful ways of responding to overwhelm. They’re not easy, and require practice – but they can be boiled down into 3 core processes: get present, open up and do what matters.

When you notice yourself caught in the midst of an emotional storm (this could be anxiety, avoidance, anger, overwhelm – anything that means you feel caught up, and disconnected from living the life you want) follow these three steps:

Get present

This will help you to “drop anchor” to keep you steady in the midst of an emotional storm. Getting present can help you make mindful choices about how to respond to the situation and the difficult thoughts or feelings that show up.

There are 3 steps: Acknowledge, Connect and Engage.

Acknowledge your experience

Notice what thoughts, feelings, memories are present for you right now. Try to name them if you can.

Connect with your body

Push your feet into the ground or Intentionally move your body, noticing that it is containing all your thoughts and feelings.

Engage with the world around you

Notice the room around you and engage your senses. What can you see, hear, smell and taste?

Click HERE to access four dropping anchor audio scripts from Dr Russ Harris, a leading ACT author.

Open up

Once you are feeling present and aware of what’s going on for you, opening up to difficult thoughts and feelings allows you to drop the struggle with them, and have greater freedom in how you respond. Do this by:

Being curious

Observe the workings of your mind and the sensations in your body like a curious scientist. What do you notice? Don’t try to alter or change them, just notice them.

Making room

Imagine breathing into and around your feelings, making space for them.

Offering a kind hand

Place a hand on your body where you feel the most discomfort. Imagine a sense of kindness, warmth and care flowing from your hand to your body. Try to treat your feelings as you would a wounded puppy, or a priceless piece of art.

This audio recording (again from Russ Harris) will help you practise these skills.

Do what matters

Our lives are enriched when we take actions that are in line with our values.

Ask yourself these questions to help clarify your values:

• What do you want to stand for in the face of your current struggles?
• How do you want to treat yourself and others?
• When it comes to work what sort of person do you want to be? What strengths and qualities do you want to develop?

Then decide what action to take – pick one or two of the values you identified above and look for opportunities to sprinkle these into your day.

At the end of the day take some time to reflect – notice what it was like to take values-guided action. What difference did it make?

You can read more about clarifying values here.

If you’ve found this helpful you can download a pdf workbook version of this blog here.

If you’d like more support to work through these ideas in therapy book a free 20-minute call with me.

The post 3 steps to overcoming overwhelm – get present, open up and do what matters appeared first on Dr Paula Redmond, Clinical Psychologist.

Key elements of a grounding kit

1. A container

Choose some kind of container to keep your kit in. This could be a box, basket or a little bag.  You might want to have one at home that could contain larger items, and one to keep with you when you’re out and about. Choosing a container that you really like can create a sense that this is an important and valuable process, and communicate compassionate for yourself in moments when this feels far away.

2. A reminder of the process

Grounding techniques involve three processes, summarised by the anagram ACE – acknowledge, connect, and engage:

A – acknowledge your experience – notice what thoughts, feelings, memories are present for you right now. Try to name them if you can.

C – connect with your body – intentionally move your body, noticing that it is containing all your thoughts and feelings. This can be as simple as pushing your feet into the ground, or doing some basic stretching.

E – engage in the world around you – notice the room around you and engage your senses. What can you see, hear, smell and taste?

Include something in your kit to remind you of this process, like the prompt card below. You can download it here.

3. A pen and little notebook

It can be helpful to write down or draw thoughts, memories or feelings as you become aware of them.  You could choose a special pen and notebook, or just include some loose pieces of paper.

4. Objects to activate your senses

This will help you to connect with your body. You might want to include items that tap into a range of senses, for example:

• Movement – a reminder to stretch, take deep slow breaths, or push your feet into the ground
• Touch – a little pebble, a stress ball, hand cream
• Smell – an essential oil, a candle
• Taste – strong mints

It’s important to notice how your body feels when doing these things, and how your difficult thoughts and feelings can exist alongside these experiences. Your thoughts and feelings are present, but there is also a body around them, that you can control and that can experience a range of things.

5. Reminders of the things that matter most

Include some symbols of things that are important to you, to help you keep engaged with the world beyond the emotional storm you currently find yourself in. This could be a note to yourself, a photo, or an object that has meaning for you. You can be as creative as you like and include anything that you know will have enough resonance and meaning to reach you when you’re struggling.

How to use a grounding kit

Once you have put your kit together keep it somewhere you know you’ll be able to find it when you need to.  When you notice yourself being caught up in an emotional storm, being hooked by difficult thoughts and feelings, grab your kit and use it as a prompt to practice grounding.

Remember that grounding is not the same as distraction, and its aim is not to make you feel better.  The purpose is to keep you steady so that you have more freedom to decide how to respond in the face of challenging circumstances – rather than being pushed around by your thoughts and feelings. Sometimes working through this process can help our mood, and if this happens enjoy it. But don’t feel bad or criticise yourself if you don’t feel better. If you do notice self-critical thoughts, you can always use grounding to help keep yourself present in the face of these.

Practise, practise, practise

Like any skill, grounding and the dropping anchor technique take practise. It’s always best to practise during times of low stress, so that you can more easily draw upon these skills during tougher times.  So if you think a grounding kit could be a helpful tool, commit to putting one together and trying it out.

As you practise with the kit you might find that there is one particular item that is most helpful for you, or that really symbolises the process. If that’s the case it can be helpful to keep this object with you when you’re not at home (e.g. in your pocket), so you can access it easily.

The post Creating a grounding kit appeared first on Dr Paula Redmond, Clinical Psychologist.

In this blog I will outline how to get greater clarity about what matters most to you, step-by-step.

Step 1 – Pick a life domain

Our values can vary depending on the context. To help you get specific start with one domain of your life, perhaps one that’s troubling you right now. Life domains include: work, education, family, parenting, friends, romance, health, fun, finances etc.

Step 2 – Consider what qualities you want to embrace

Values are about the type of person we want to be and the sort of qualities we want to be embody. Complete these sentences:

“In this domain of my life

• I want to treat myself with __________
• I want to treat others with __________
• When things get hard I want to stand for _________

Step 3 – Imagine your own funeral

This is an idea from Russ Harris. Imagine you somehow get stranded on a desert island, and everyone thinks you have died. Somehow you are able to tune into the livestream of your own funeral. The people most important to you all get up to say speeches about you. What would you want to hear them say about the sort of person you were, in this particular domain of your life?

Step 4 – Imagine a miracle

Now, imagine that within this domain you have achieved all your goals – you have everything you could ever want. You also have the approval of the whole world so that whatever you do is good and right in everyone’s eyes.  How would you choose to behave?  How would you act towards yourself and other people?

Step 5 – If you are stuck

If you have worked through the previous steps and are struggling to identify your values here are some helpful tools:

• Values checklist – from Russ Harris (shared with permission) – use this for inspiration, or to narrow down and prioritise your most important values.
• Values sorting exercise– this is based on the above checklist, and is a neat way to sort through a list of values to identify those most important to you in a particular domain of life.

Step 6 – Summarise

Create a summary of the key values you have identified for this domain. You might want to make a note of them in a journal, write a memo to yourself, or do something creative to represent them. Whatever you do, keep it handy so that you can remind yourself of these values whenever you feel in need of guidance, motivation or meaning.

Step 7 – Take action

How could you live these values today? What one thing could you do right now that would be a move towards the sort of life you want and the sort of person you want to be?  Taking values-led action isn’t always easy, and can raise a lot of discomfort and difficult feelings.  If you notice this happening, acknowledge it, try to accept that this is normal and to be expected, and use grounding techniques to help you stay focussed on doing what matters.

Step 8 – Repeat

Repeat this process for your other important life domains.

Next Steps

Knowing your values and taking committed action are core processes within Acceptance and Commitment Therapy (ACT).  If this approach resonates with you and you think you would like help to clarify your values book a call with me.

The post Step-by-step guide to knowing your values appeared first on Dr Paula Redmond, Clinical Psychologist.

The problem with goals

We live in a very goal-driven culture. This permeates many aspects of our lives such as education, work and health.  We’re often told that if we want to achieve anything we need to be clear about our goals.  And we can’t have any old goals – they need to be SMART goals!  This can be really helpful for enhancing productivity, but often it doesn’t quite deliver us to the promised land of fulfilment and life satisfaction.

Think back to the last big goal you achieved. Perhaps something you had worked long and hard for. Maybe passing an exam, losing some weight, or getting a promotion.  Hopefully it felt good and you were able to celebrate and enjoy the achievement. But how long did this last until you started to set your sights on the next thing? How long before you started to compare yourself to where you want to be next, rather than focusing on where you are now and how far you have come?

There are also times when we’re not able to achieve our goals. This is often due to reasons outside of our control.  Not everyone enjoys the same privileges or opportunities. We might have perfectly SMART goals, and then something unexpected comes along to derail us – illness, redundancy, bereavement, a pandemic, or extreme weather.  Sometimes our goals just aren’t achievable, and it’s not about working harder or smarter, it’s just about life being unpredictable and really crappy at times.  If we are overly focussed on achieving goals these kinds of set-backs can be devastating. We might start to question our self-worth and lose a sense of meaning and purpose in life.

But if we can focus on pursuing our values we open up far greater opportunities for living a rich and fulfilling life, no matter what comes along.

What’s the difference between goals and values?

Goals are the things you want to do, but values are about the person you want to be.  Goals are achievements that can be ticked off a list, whereas values describe how you want to behave and what you want to stand for.  While goals are focused on the future, values are available to you in the here and now.

For example, ‘getting a promotion’ is a goal, but ‘working with dedication and commitment’ are values.  Whether or not you achieve a promotion you can always embody dedication and commitment.  Living in line with these values may help you achieve your goal, but even if it doesn’t your actions will be enriched with a sense of meaning and purpose.

Getting married is a goal, but being loving and caring is a value.  You can treat others with love and care no matter what your marital status, and achieving the goal of marriage doesn’t necessarily mean you will be loving and caring.

So values are like the direction on a compass, like going West – you can always go West, no matter where you start from.  Goals are like the landmarks along the way – things you can tick off your list.

Why are values important?

Values have 3 important functions – guidance, motivation and meaning.

Guidance – Goals can enrich and enhance your life, but unless they are guided by your values they are unlikely to support you in living a rich and fulfilling life.  Even more importantly, when we are faced with difficult choices values act as an inner compass.  Being clear about what really matters to us and what we want to stand for enables us to decide what the right thing to do is.

This isn’t always an easy process, as at times our values can appear to be in conflict.  For example, you might feel a tension between your values of taking care of others and taking care of yourself.  However, if you can mindfully tune in to how you really want to live your life (rather than how you feel you should be living) this can help you to resolve these dilemmas and take committed action.

Motivation – living in line with our values often raises discomfort and tension.  For example, it isn’t easy saying no to the 3^rd slice of your grandmother’s delicious cake, even when you really value living healthily.  It can feel painful to say no to requests for help, even when you know this is important for your self-care.  It’s scary standing up for others when they’re being treated unfairly, even when justice is a core value.

We all want to avoid pain, and often go to great lengths to do this. But there are times when we have to make room for discomfort and pain in order to do what matters. Being clear about our values – the sort of person we want to be – can give us the motivation we need to do what matters even when it hurts.

Meaning – when our goals are thwarted, or we face loss and suffering, life can feel very meaningless. We can start to lose hope, and a sense of purpose and fulfillment in life.  Unfortunately we live in a world that isn’t fair, and many people can’t achieve their dreams – not because they aren’t working hard enough, but because of structural inequalities and the random horrors of the human condition.  Values offer us a way of bringing meaning and purpose to these experiences, no matter what life throws at us. Values are always available to us and can give us a sense of control within the chaos.

As Victor Frankl wrote “Everything can be taken from a man but one thing: the last of the human freedoms — to choose one’s attitude in any given set of circumstances, to choose one’s own way”.

How to identify your values

You can start by simply asking yourself these questions:

• What do you want to stand for in the face of your struggles?
• How do you want to treat yourself and others?
• What qualities or strengths do you want others to see in you?

For a more in-depth guide to knowing your values check out this blog.

Next Steps

Clarifying values and taking committed action are core processes within Acceptance and Commitment Therapy (ACT).  If this approach resonates with you and you think you would like help to clarify your values book a call with me.

The post Why values are important appeared first on Dr Paula Redmond, Clinical Psychologist.

Is ‘Switching Off’ a helpful idea?

It’s a theme that comes up a lot in my therapeutic work with doctors, nurses, therapists and other professionals. We talk a lot about techniques for winding down and switching off. But recently I’ve been wondering how helpful this is.  Healthcare professionals spend their working hours tackling emotionally and cognitively demanding tasks that require focus and high levels of analytical thinking and problem solving. Is it realistic to think we can just switch this off once the shift is over?  Many of us choose these professions because they closely align with our core values, and our jobs are usually central to our sense of identity.  Is it even possible to decide to switch these parts of ourselves off?

When we get embroiled in a struggle to switch off this can add insult to injury.  Focussing our energies on trying to stop ourselves thinking or feeling about work is only ever likely to work in the short term. And when it doesn’t work we can end up feeling critical of ourselves, more anxious, angry, resentful etc.

Not only is switching off probably an unrealistic goal, but it could potentially have unhelpful consequences.  We’re not actually able to selectively switch off parts of our minds or selves – what can end up happening is that we switch off all together at times.  This often takes the form of feeling disconnected from the people and experiences that matter most to us.  When we aren’t able to be present with the things that bring us joy life can start to feel very effortful and meaningless.

Shifting gear rather than switching off

So how do we ensure work doesn’t become all-consuming without getting caught up in “switching off”?  One answer is to focus on shifting gear, rather than switching off.  Once the working day is done we can intentionally give priority to meeting our personal needs – without fighting with the parts of ourselves that find it hard to let go of work.

This is a bit like shifting from Monday-morning-commute mode, to Sunday-afternoon-drive mode.  The traffic (like our thoughts and feelings) is always unpredictable, but we can choose whether to focus on what the other cars are doing, or just let them be and focus on the journey. We can choose whether to use our energies to compete with the other vehicles that are getting in our way, or allow them to do their own thing.

In doing this we can make room for the thoughts and feelings about work that will inevitably crop up. We can develop an acceptance for these experiences, knowing they are an important part of our lives, but not the only part. We can acknowledge them (like other cars on the road) but  not let them take us off course.

Shifting gear enables us to focus on the things that really matter outside work, without getting caught up in a battle with unwanted work-related thoughts and feelings.  Here’s how to do it…

3 steps to shifting gear

Here are three steps to help you shift gear from prioritising work, to prioritising your personal life:

1. Transitional rituals

Mark the transition from work time to personal time with a simple ritual. If you get into the habit of doing this it will become a strong signal to your mind and body that it is time to shift gear.  This will help to create psychological boundaries around your work, so that you can re-focus on other important aspects of your life.

A transitional ritual can be very simple. For example, listening to your favourite radio station on the way home, having a shower, going for a walk, or changing your clothes. Do it in the same way each time so that it becomes a powerful queue for shifting gear.

2. Complete the stress cycle

Incorporate activities that will allow your nervous system to process the day.  This is not necessarily about conscious reflection, but about giving your body and mind some space to engage its natural processing mechanisms. Carve out and protect time to do these things, either on your own or with others.  Here are some of the key activities for soothing our nervous systems (adapted from Burnout by Nagoski & Nagoski):

• Physical activity – As a wise woman once said, “shake it off”. If you can spend 20 minutes or more each day walking, running, dancing or stretching your body and mind will thank you.

• Breathing – slow deep breathing will calm your nervous system and help you gently connect with your body. Try the simple square breathing technique: inhale for 4 counts, hold for 4, exhale for 4, hold for 4, and repeat. It might help to find something square or rectangular in your surroundings to focus on while you do it – following the sides of the shape as you complete each step.

• Positive social interaction – have a casual friendly chat with someone. It could be a shop-keeper or neighbour. Try not to withdraw into your inner world.

• Laughter – watch or listen to a show that gives you a deep belly laugh; call a friend to reminisce about a funny memory.

• Affection – reach out to those who make you feel safe. Hugs with a loving person, cuddles with a pet, or a spiritual connection with a higher power all offer sources of affection that can let your body know you are safe.

• Crying – having a “good cry” releases the body’s natural painkillers and enables self-soothing.

• Creative expression – engaging in absorbing tactile and multi-sensory activities such as making art or music, crafting and creative writing enables emotional processing and can be very calming.

3. Unhook

Learn ways of unhooking from the pull of work in order to do what matters.  When you notice thoughts or feelings about work getting their hooks into you, stop and take a pause. Use grounding techniques to bring yourself back to the present moment. Mindfully consider what is most important to you right now. What action can you take that will bring you closer to living the life you want?

Next Steps

The ideas suggested here are based on Acceptance and Commitment Therapy (ACT).  If this approach resonates with you and you think you would like help to develop mindfulness and unhooking skills, or to clarify what really matters to you, book a call with me.

The post Shifting Gear not Switching Off appeared first on Dr Paula Redmond, Clinical Psychologist.

My lovely grandmother died a few weeks ago. We were very close and it has been a painful shock.  Since her death I’ve been struck by waves of sadness and grief, often out of the blue. There have been times when I’ve needed to quickly distract myself from this in order to focus on my work and times when I’ve been able to give way to the tears and allow myself to be consumed by my grief for a time.

At other times I’ve wanted to make room for the sadness alongside doing important things. I’ve wanted to be able to be there for family members who are also grieving, keep going with daily chores, play with my kids, or appreciate the beauty of Spring. In those times being truly present means opening up to whatever thoughts and feelings are showing up, but not being swept away by them. This is a tricky balance to find – but grounding techniques can be a powerful way of achieving this.

What?

Being “grounded” means being present – i.e. being consciously aware of the here and now, without being caught up in painful thoughts or feelings, regrets about the past or worries about the future. It is the opposite of being on auto-pilot: those times when moments, even hours, can pass without you really knowing what happened (think of getting to the end of a page and having no idea what you just read, or arriving at a destination with no recall of the journey).

Russ Harris (author and leading Acceptance and Commitment Therapy trainer) uses the helpful metaphor of an anchor in a storm. Difficult feelings and thoughts (whether they be sadness, anger, fear or even boredom) can create an emotional storm in which we can get swept away and caught up, just as a little boat would in the midst of a storm at sea.

We can’t make the storm go away, just as we can’t eliminate stress and loss from our lives. But we can find ways of steadying ourselves until the storm passes. We can drop an anchor. This enables us to re-connect with the present moment, and help us feel less bashed about the storm of our emotions.

Why?

Emotional storms can get in the way of us doing what matters, and making choices in line with our values. We might find ourselves withdrawing and disconnecting from important people and experiences or trying to avoid discomfort through things like over- or under-eating, alcohol misuse, even deliberate self harm. We might find that we take out our distress on others, often those closest to us.

Grounding ourselves can help to create a pause in which we un-hook from the thoughts and feelings that captivate us. Rather than getting into a battle with them we can make room for them, while enabling us to focus on what really matters in this moment.  This might mean:

• Recognising a critical inner voice and deliberately adopting a more compassionate stance
• Being able to process and turn towards traumatic experiences without being overwhelmed by them
• Deciding to step away from the chocolate and pick up an apple instead

We don’t always need to be grounded. Sometimes distraction is just what we need (thank heavens for Line of Duty!). Sometimes we do need space to be immersed in our emotions.  But if we become aware that the pull of these thoughts and feelings causes us or others harm, or takes us away from the person we want to be, grounding techniques can interrupt that cycle. They open us up to other possibilities and give us a chance to treat ourselves and others with compassion.

How?

Grounding techniques generally involve 3 elements (ACE):

A – acknowledge your experience – notice what thoughts, feelings, memories are present for you right now. Try to name them if you can.

C – connect with your body – intentionally move your body, noticing that it is containing all your thoughts and feelings. This can be as simple as pushing your feet into the ground, or doing some basic stretching.

E – engage in the world around you – notice the room around you and engage your senses. What can you see, hear, smell and taste?

A physical prop can be really helpful – especially if you are in a situation where you can’t take time out. For example, a piece of jewellery you can touch or a pebble in your pocket. Some people find that sucking on a strong mint can help – anything that helps you to connect with your body and your senses.

Mindfulness meditations or breathing exercises are also helpful as these enable us to open up to feelings while staying connected with our bodies.

Dropping Anchor Audio

Russ Harris developed the Dropping Anchor grounding technique. I’ve made a 5-minute recording which I hope you will find helpful. As with all skills you will need to practice regularly in order to get the most out of it.  I suggest practicing daily at a time when you are not feeling particularly stressed, so that you can draw on this skill when difficult things crop up.

You can also access Russ Harris’ audio recordings of the Dropping Anchor exercise. He has done 4 versions, ranging from 40 seconds to 11 minutes – try them out and see what works for you.

The post Grounding techniques – what, why and how appeared first on Dr Paula Redmond, Clinical Psychologist.

How did your decision to take a career break come about?

My first proper career break was in August 2017 when I was at the end of my GPST2 year. Essentially, I was exhausted. Leading up to this I had been working in my first GP job, which required a 1 hour commute each way, plus busy days regularly hitting the 11–12-hour mark: the usual GP stuff of going through blood results, post, finishing late, and duty doctor stuff. Often, I wouldn’t even have lunch and survived on something like an energy drink. Being a GP can also be an extremely isolating job and I was the only trainee in the practice. Looking back I’m surprised I hadn’t burnt out by this point- I was barely sleeping, often getting an average 3 hours a night or less.

I then spent late 2016/early 2017 working in Paediatric A&E. The workload was intense, but I could manage that. The main exhausting element was the fixed rota, which anyone who works in an A&E knows can be horrible at times. It left very little time for anything outside of the job- no concept of a social life, no time to do anything. I also went from one viral illness to another, which left me feeling drained. I then really began to ask, “Why do I put myself through this?”

I recognised I was potentially headed for burnout and the deanery were very helpful. They approved my request to take six months off at the end of the year.

How did you decide what to do with this time?

I had previously taken an F3 year out (between F2 and going into specialty training) in which I did a short film-making course, and then worked as a locum SHO in AMU in a nearby hospital. I also went on a small trip to Bergen in Norway with money I had saved. I felt like a completely different person during that point. So I knew I needed something similar.

I reflected on why I felt like I did at that time. I asked myself what made me happy and what I was interested in. It all boiled down to recognising I liked having autonomy and the freedom to be curious. So I decided to spend more of my savings on doing small solo trips to places I wanted to visit, and just explore my interests. I went to Warsaw, Ghent, Bruges and Montreal, absorbing myself in museums, record stores, book stores, taking photographs, and doing things that interested me. I wanted opportunities to be alone and explore my identity beyond just being a doctor.

Daytime in Bruges

How did the break help?

To me the break helped because it allowed me a space to breathe and reflect- with no pressure. It allowed me to feel what my normal should be. As I was alone, I could seriously think about this.

Late night in Ghent

For example, by the end of the break I began drawing again (something which continues to this day) as well as crafting my own reading curriculum to get back into reading. This would not have happened without the break.

Do you think taking time out has had an impact on your career prospects?

It is something I worry about sometimes. During training, a gap didn’t make a difference, as it was fairly short. Once fully qualified (I’ve got my CCT) I think it can get tricky explaining gaps- but I’m upfront and honest about the reasons for taking a break. I discuss these things openly at my appraisals. At the end of the day I need to do what’s best for me. It’s my experiences of travel and taking time out for myself that have given me the confidence to accept I have nothing to feel guilty for if I do take a break or want to change direction.

What message/advice would you want to give to other medics who might be feeling burned out right now?

If you recognise you’re in burnout or beginning to reach that state- take a step back and take a break. Seek help or support if necessary. Talk to colleagues, friends or family. Prioritise your health and wellbeing always, over anything else. Recognise the issues affecting you and listen to yourself.

In Medicine you deal with the extremes of life. As a doctor you’re exposed to things that most people really don’t get access to. It’s hard not to get emotionally affected, but as a doctor you’re automatically expected to just deal with it. But things can still get to us as we’re all human at the end of the day.

I became a doctor in my early twenties like many people in England. Since then, this is all I have ever known. So this hyper-reality of situations involving life and death, worries about making mistakes, stressful on-calls, time pressures, department politics, seeing people at their worst or in emotional distress/crisis (including being on the receiving end of aggression, violence, threats and sadly occasional racism) has been my normal for the past decade. I’m sure many NHS workers reading this can easily relate.

So when you start to falter or question why you may be feeling like this, it’s easy to blame yourself when in reality if you take a step back from the job and analyse it objectively- it’s really no surprise you can end up feeling burnt out.

What changes would you like to see within medicine/the NHS to improve staff wellbeing?

I would echo the common issues many people state. Poorly staffed rotas, poor funding and issues such as recruitment needing to be addressed as a priority. These would be the core areas to target which I know would dramatically alter the day-to-day pressures of working life.
Other things are appreciating the idea that you can be a doctor and have other interests- that this concept of medicine having to be your whole identity is very antiquated. I also feel encouraging flexibility and ability to take breaks or move around specialities or different career paths with more ease would actually be very beneficial. I feel a lot of younger doctors and the next generation of medical students are naturally doing this, which is encouraging to see.

It’s also good to see programmes such as the NHS Practitioner Health Service becoming more established, so I do feel in some aspects there is some positive change.

What role does creativity have in supporting your mental health?

As a child, I was heavily into art and drawing. I was equally obsessed with music, reading and cinema from a young age. These have been lifelong interests long before medicine came into my life. I never actively talked about any of this stuff when growing up as no one around me was into it. I just loved what I loved.

I was even considering studying English Literature at University- I never had any shame in admitting I loved reading books, poems and plays (and still do). However, the fascination with Medicine eventually won out.

Things are now coming full circle as I recognise that these interests are simply part of who I am and that I can’t do without them. They are equal to the love or interest I have for medicine.

Sketchbook exercise

I think creativity has been something that has kept my mental health generally stable. It’s also got me through some isolated and very stressful times during training, as well as now during this Covid 19 period. It provides an alternative focus and drive that can absorb me regardless of what else is going on. I still get bad days and good days like most people, but overall creativity helps enormously to redirect focus.

For those who want to cultivate their own creativity what would you suggest as a first step?

I think my advice would be just to start doing something for yourself. It could be anything- it doesn’t have to be creative, but something that might interest or appeal to you. Ask yourself what you enjoyed in the past, or what you would do if money was not a factor? Then when you find something, make it an essential part of your routine- something that is a daily or regular habit. It should feel like play rather than work.
My approach is to set projects and try to realise them- just for my own curiosity. I approach them with the same intensity as medicine. I’ve recently got into apps like Bear and Notion- where I’m trying to create a notebook of all my interests/ideas. I’m always thinking of applying different skills to personal projects. I do share some things on social media such as drawings/sketches, but only if I think it can inspire or help others.

My “notebook” using the Notion app. Each abbreviated category link contains content or notes relating to different areas of interest

But most of all, I do these things to nurture my sense of curiosity and to keep learning. For me they are a way of understanding things differently. The important thing is whatever you do- choose to do it for yourself.

As we start to see signs that we may be at the beginning of the end of this pandemic, what possibilities might be open to you for recovery and restoration? What identities and joys do you want to re-connect with?

The post Preventing burnout through connection and creativity – one doctor’s story appeared first on Dr Paula Redmond, Clinical Psychologist.