A number of publications are directly relevant to the wellbeing of healthcare professionals – you can find these below:

The Burnout Booklet

The Burnout Booklet: A Health Resource for Patients and Practitioners By Katharine Murphy and Olivia Glaze

This beautifully illustrated booklet draws on lived experience of burnout to offer a range of metaphorical ways of describing burnout. I often talk about how the word burnout can mean many different things, and it’s important to understand the individual experience of this to be able to respond in helpful ways. This booklet can help individuals find ways of expressing their experience and also help supporting professionals think in a more nuanced way about the issue.

Creative hobbies and work recovery

Recuperating, Revitalising, and Reaffirming: the experiences associated with creative hobbies, and their impact on recovery, wellbeing, and work by Delores Hill

This research project explored ways in which creative hobbies can support work recovery. This is a concept I often explore with health professionals I work with. It is the idea that what we do outside of work can help to replenish what is depleted by our experiences at work. It requires us to be attuned to our needs and be intentional about how we can support ourselves with what we invest our time in outside of work. Creative hobbies offer ways to meet a range of needs through supporting detachment from work, providing a sense of mastery, lifting our mood, and connection with values. This article describes Hill’s research in a very digestible way, and offers useful practical applications.

Creative Toolkit for palliative care professionals

Co-producing a ‘creative toolkit’ to support the mental health and wellbeing of palliative care professionals: a community case study By Marie A. Clancy, Caitlin R. Kight, Jessica Stein, Naome Glanville, Anthony C. Wilson, and Richard G. Kyle

This publication explores the growing pressures faced by professionals working in palliative care, particularly in the wake of COVID-19, and highlights how a culture of prioritising patient needs often leads staff to neglect their own wellbeing. It presents a co-produced, arts-based “Creative Toolkit” designed to support the physical, psychological, social, and spiritual health of staff through reflection, relaxation, and connection.

Drawing on a small-scale case study, the paper demonstrates how creative approaches can help staff process difficult experiences and build a sense of community, with highly positive participant feedback. While the findings are context-specific and further research is needed, the publication makes a valuable contribution by showing how creative, arts-based interventions can be meaningfully integrated into workforce wellbeing support.

Art therapy to reduce burnout

Art therapy to reduce burnout and mental distress in healthcare professionals in acute hospitals: a randomised controlled trial By Megan Tjasink, Catherine Elizabeth Carr, Paul Bassett, Gehan Soosaipillai, Dennis Ougrin, and Stefan Priebe

This study examines whether a brief, structured group art therapy programme can improve burnout and mental wellbeing among hospital-based healthcare professionals. In a large, multicentre randomised controlled trial involving NHS staff across a range of roles, participants were assigned either to six weekly art therapy sessions or to a wait-list control group receiving usual support.

The findings show that those who took part in the art therapy programme experienced significant reductions in emotional exhaustion, alongside improvements in stress, anxiety, depression, and detachment from work, with benefits sustained at three-month follow-up. While the study had some limitations, including its reliance on a wait-list control and limited subgroup analysis, it provides strong evidence that a relatively short, manualised and theory-informed art therapy intervention can meaningfully support staff wellbeing and could be integrated into hospital workforce support services. The lead author, Megan Tjasink has been a guest on the When Work Hurts podcast – you can listen to her talk about her work here.

The Body Hotel Self-Care Suite

The Body Hotel Self-Care Suite: Evaluation By Teresa Filipponi, Carolyn Wallace, and Thania Acarón

This publication evaluates The Body Hotel Self-Care Suite, a creative, movement- and body-based programme developed to support the wellbeing of palliative care staff within NHS Wales. Focusing on teams at Velindre NHS Trust, the study explores whether embodied, creative practices can enhance wellbeing, psychological safety, and day-to-day working relationships.

Drawing on interviews and pre- and post-programme questionnaire data, the evaluation found that participants reported increased energy, emotional resilience, self-awareness, confidence, and self-compassion, alongside a stronger sense of connection with colleagues. Staff also described applying tools from the programme to manage stress, communicate more openly, and foster more supportive team dynamics. While based on a small, self-selecting sample, the findings suggest that creative, body-based approaches can play a valuable role in supporting workforce mental health and cultivating more compassionate and sustainable workplace cultures.

It’s clear that the arts and creative practice can play an important role in supporting the wellbeing of healthcare staff. Creativity & Wellbeing Week is coming up (18th – 24th May 2026) – this is a great opportunity to consider how you might be able to bring more creativity into your workplace and life.

On 19th May I am running an online workshop for doctors with Dr Alison Smith of Earth & Bloom called Shaping Self Compassion. It’s a hands on workshop using clay to explore and nurture compassion for yourself, something many of us in helping professions struggle to access. It will be a gentle evening combining the soothing and tactile experience of working with clay and other natural materials with a listening circle. Booking closes on 5th May (to give us time to get your goodie bag to you), so secure your place today!

The post Creative health and wellbeing for healthcare staff: a research roundup appeared first on Dr Paula Redmond, Clinical Psychologist.

Working as a staff health and wellbeing psychologist offers a range of opportunities to be creative. As an evolving area of intervention it invites innovation, and permission to try new things.

One of the initiatives I am most proud of is the development and delivery of an art and wellbeing collaboration called Take heART. A project that seeks to improve the experience of staff, patients and hospital visitors through creativity and the arts. But how, as a psychologist did I find myself involved in this work? Let me share a story with you.

© Shaun Armstrong

My story

For a long time I believed “I’m not creative”. This was the story I told myself….and others.  Stories that started when I was a child: attempts to learn a musical instrument, dance lessons, trying art and drama at school all seemed to feed this narrative. The crush of comparison with others reinforced a well-crafted story: “this is not for me, others do it better”. 

I pick this story up many years later when, as an adult patient I experienced the positive impact art and creativity can have on wellbeing. I was undergoing treatment that required frequent visits to hospital. With this came a lot of waiting. Waiting to get assessed, waiting for treatment, waiting for results, waiting rooms and a lot of uncertainty.

As I spent an increasing amount of time in a waiting area, I gravitated away from the main room to a smaller space. To a light filled corridor. A place where there was less waiting and more….. just being. As I made this my new regular spot, my attention was drawn to the art, a picture that sat squarely and proudly on the wall. A familiar, predictable and engaging sight. I recall an abstract depiction of a cell, inside the body. It was beautiful. On a bad day it was slightly painful to look at. It did not shy away from what those coming to the hospital were doing, the treatment they were having.

Art is open to the interpretation of its audience. What I took from it was an intriguing, distracting, honest depiction of a medical, but also emotional, process that myself and others were navigating. Art has power and presence, particularly at times of difficulty and distress. This was the start of my connection with art in hospital.

The final thread of this story can be found a few years ago. After working for much of my career in mental health services I lost my love for the work and my wellbeing started to suffer. I had an instinctive need to pause. Rather than asking myself “what should I do next?” I considered “what gives me a sense of purpose and enjoyment at work?” Supporting other staff and working in services and systems that invited creativity were up there. And so my journey working in a staff support role started. I initially worked during the pandemic with critical care and respiratory medicine staff followed by a trust-wide role. I was outside my comfort zone but inside my creative zone.  

Working in stressed and stretched care systems with limited resources and navigating unchartered territory invited new ways of thinking and working.  As both an ‘embedded’ and trust-wide staff support psychologist I was struck by the challenge of how, with limited resources my role could offer meaningful, effective and sustainable change. In a busy, unpredictable, often anxiety provoking environment, how could the hospital setting feel more welcoming, calming, engaging and soothing?

The Take HeART project

© Shaun Armstrong

Take heART has grown from connection and collaboration. It is a true team effort, a network of staff, departments and community partners coming together to try new things. As a psychologist I have been well placed to bring psychological theory and frameworks to help shape and evolve this development. To operationalise what can feel like abstract ideas such as ‘compassion’ and ‘trauma-informed care’. To support the creation of places and spaces that trigger our emotional soothing systems. Creating conditions for individuals to slow down, connect with their values and importantly with others including the local community. To enable appreciation and gratitude to be cultivated. Also, this has been an opportunity to raise and evolve the profile of my profession, to highlight how psychologists can support not just wellbeing but ‘well doing’.

How you can get started

While supporting wellbeing through the arts and creativity can be powerful, it can feel difficult to initiate and challenging to translate into behavioural change. Especially when working in high demand, low resource systems.  It can be helpful to start small and think BIG. 

‘ARTS’ is one way to guide this process and ask a number of important questions – consider Access, Resources, the Team and how to Shout about it. Try to do so with curiosity, care and a small dose of optimism. We do not need to have all the answers.

© Shaun Armstrong

Access

How can you make what you do as accessible as possible to ALL staff , especially those who do not see themselves as creative? What are the different ways individuals can participate? What invites curiosity and playfulness? What gets in the way of involvement, what are the internal and external barriers? 

For example, how could you not just invite staff to step away from their day-to-day busy environments but also bring art and creativity to them? Why not display art in team areas including staff rooms, offer a touring ‘art cart’ or join an existing staff event such as a team away day or trust staff engagement event?  

Katie Allen and Bedford Road Primary School

Resources

What resources and motivates you and others? Start with YOURSELF….what do you need? What inspires and supports you?  What are the existing budgets you can tap into? Do you have charitable funds you could apply to for initial ‘pump priming’? Are there individuals within your trust who could apply for external grants?

One starting point might be to consider what you already have. Why not create an inventory to log current artwork in your workplace? How might you showcase this?  Maybe set up an art trail? What skills, knowledge and experience would help you grow your projects? What are the strengths and skills you can bring to the work and how would you like to develop these?

Working within your limits is also important to sustain yourself and others. Developing a project plan/timeline, keeping a log of hours spent on a project and setting flexible deadlines can all help with this. As your project evolves and you seek funding, ensuring tasks such as project management and installation are budgeted for. This will create capacity and help you make a case for additional resources. Setting up a regular working group offers an opportunity to review workload, engage and inspire others and in turn create a team.

© Shaun Armstrong

Team

Who can you connect with? Who else is doing (or trying to do) this kind of work in your workplace?  Why not start with just one other person? There can be real power to partnership working. What other parts of your organisation might help?  Organisational Development, the Communications Team, Charitable Funds, Estates & Facilities, Wellbeing Leads and the Senior Leadership Team?  What about those outside your organisation?  Local artists, schools and art colleagues.  Link in with other trusts where they have more well-established arts and wellbeing programmes etc.

Feel free to reach out to take heART via our website or email.

Katie Allen and Bedford Road Primary School

Shout

Once you have started to test out some ideas, how can you shout about and showcase what you are doing and trying to do? You do not need to wait until you feel you have a well-established project. Shout early on.

When starting take heART we found it helpful to identify a name for our group and key aims and vision for the work, which could be easily disseminated.  Having a logo can help create ‘a brand’ and enable others to recognise and link different projects. Gathering feedback has been important.  Sharing what staff say about their experiences can bring the work to life. Working with our Communications Team and photographing what we do has raised the profile of our work. 

Visual artwork displayed in high footfall areas can have a powerful impact and create ‘positive gossip’. Why not walk around your work space with the Estates Team and consider where the high impact and easy to display areas are (e.g. main entrances, stairwells, lifts, corridors and waiting rooms)?  Installing large poster frames is a relatively quick, cheap and easy way to create spaces to display artwork.

Also get good at shouting about your profession and your role, showcase what psychology can bring to the table. It is not just the stories we tell ourselves, but the ones we choose to share with others that can spark change.

To find out more listen to Rachel’s in-depth discussion with Paula on the When Work Hurts Podcast.

The post Take heART: Bringing together psychology and art for NHS staff wellbeing appeared first on Dr Paula Redmond, Clinical Psychologist.

What is creativity?

We often think of creativity as referring to the Arts – the accomplishments of painters, writers or composers. Yet creativity is an innate human characteristic, and one that uniquely sets us apart from other species.  Consider how many different ways humans have developed to build homes, cook eggs or make clothes. These solutions are beyond what we need to survive, yet they are imbued with meaning, pleasure and joy.

The creativity researcher Frank X Barron defined everyday creativity as something (a product, idea or behaviour) that is both original and meaningful. A creative act is one done with intention, creates something that didn’t exist before and has meaning to you.

It doesn’t need to be meaning in the deep philosophical sense, but meaning in that it communicates something, solves a problem or has an impact.  This isn’t about producing art intended for a gallery, but about the process of tapping into your own innate creativity in a way that is meaningful to you – whether the purpose is to create something beautiful or useful; or just to give yourself time to play.

5 ways creativity can protect against burnout

Burnout is characterised by emotional exhaustion, lack of personal accomplishment, and a detachment or cynicism towards work. One can experience some or all of these dimensions to varying degrees. It results from chronic workplace stress due to demands outstripping resources.

Rates of burnout in healthcare have never been higher.  Organisational and political factors are responsible for unprecedented levels of service demand, dwindling resources, and a massive retention and recruitment crisis. We can feel helpless in the face of these systemic issues that we have no control over.

But it is also true that there are resources we can draw on to help sustain and empower us – and creativity is one such important resource.

Creativity can help buffer us against the strains of working in healthcare by helping us:

1.Switch off

Being able to switch off and disconnect from work in your free time is crucial to managing a stressful job, especially one that is emotionally taxing.  Studies show that being able to psychologically detach from work at the end of the day/shift mediates the impact of job demands on burnout risk.

But this can be very hard to do, particularly when your work involves a lot of complex cognitive labour.  Creative tasks can really help with this because they require concentration and often the use of our hands. This taxes the working memory, meaning there is less room for our brain to continue to think about work.

2. Find rest

Creative tasks such as painting, knitting, drawing or writing require us to physically slow down. Absorbing ourselves in the sensory experience of the materials we are working with can help us achieve a flow state and soothe the autonomic nervous system.

Creative endeavours don’t need to be calm and quiet though.  We can also find rest in more energetic pursuits, like dancing, or Jackson Pollock-style painting – especially if what you need is emotional rather than physical rest. Find the creative pace that suits what you need.

3. Connect with others

Creative hobbies can help us to connect with others, and guard against the encroaching withdrawal and disconnection of burnout. We can connect to like-minded communities who share our love for a particular craft; we can create gifts for people and keep them in mind while we create; and we can use our creativity to connect to the values and causes that really matter to us (the Craftivist movement is a great example of this).

4. Re-humanise

Working in big institutions like the NHS can be a very dehumanising experience. We can feel devalued, ignored and unseen. I often hear health professionals talk about how they feel like just a name on a rota, with their unique skills and needs disregarded.  Even worse many experience a sense that even their basic human needs can’t be met at work – the need to go to the toilet, eat healthy food, rest.

Having a creative outlet is a chance to make your unique stamp on the world, even if no-one else ever sees what you produce. You get to choose what and how you do it, and can respond to your own sensory needs without having to ask permission.

5. Cultivate self-compassion

As healthcare professionals we are usually awful at being kind and compassionate towards ourselves. We are very good at heaping criticism and judgement on top of our already battered souls.  Creativity is about play and making mistakes is part and parcel of the process. It’s a great opportunity to practice tolerating (and even accepting) mistakes, uncertainty and imperfection. It also gives us opportunities to learn how to tune in to what we need in any given moment so we can respond with care.

How to bring more creativity into your life

1.Fill your feed

We know that viewing art can give us an emotional boost and reduce physiological stress – whether it’s viewed in person, in a book or electronically. If you’re like most of the people I meet (including myself) you are probably drawn to social media in times of stress – which can only make it worse.  But if you can fill your feed with creative inspiration this will not only help to balance out the doom and gloom, but give your brain an instant dopamine hit.

2. Work and play

Find ways to bring creativity into your workplace. This can be a great way to build connections with colleagues, and make work a better place to be. Listen to this episode of the When Work Hurts episode in which I spoke with Dr Heidi Edmundson about how she has brought everyday creativity into her A&E department.

3. Developing an everyday creative practice

If you can do something creative every day, no matter how small, you will soon start to notice the benefits. Spending just 5 minutes a day is all you need. If you can have some basic tools ready and available you can grab them whenever you have a free moment. Knitting is great for this as it’s really portable and you can make progress towards a bigger project by doing just a few stitches at a time. Amy Maricle of The Mindful Art Studio has some wonderful resources for creating little art in very short spaces of time. And for more ideas check our this blog post by psychotherapist Karolina Christopher on creative self-care.

4. Carve out time

If you find it hard to establish a regular creative practice, or you want to deepen your skills, it could be a great idea to sign up to a regular class, a one-off workshop or a retreat. This will allow you to really focus on the creative process without all the distractions of everyday life. This is a great way to give yourself some restorative time, and develop a deeper connection to your own creativity so that this can be a resource you can continue to draw on to help sustain you in your work and prevent burnout.

If you enjoy knitting join us at our next Creative Restoration retreat! This is a day designed especially for overwhelmed and exhausted health professionals where we will teach you about the therapeutic benefits of knitting and how to weave this together with knowledge and skills from the psychological science of wellbeing. Our next retreat is on 1 October 2022 (with bookings closing on 16 September). You can find out more information here.

The post How creativity can protect against burnout appeared first on Dr Paula Redmond, Clinical Psychologist.

It has a deep meditative quality, forcing us to slow our breath and heart rates, calming our thoughts, steadying our hands and allowing us to live in the moment. I started after suffering a suicidal breakdown following severe post-natal depression and PTSD. As I healed I felt the need to be creative and so I tried embroidery. It immediately calmed me and I was addicted. So addicted that I’m now a professional full-time hand embroiderer specialising in human anatomy.

Happily, you don’t have to be a professional stitcher to also experience mindful embroidery. It’s open to anyone with minimal equipment and can be done in your own home. Here’s what you need to try it:

[Editor’s note: all the pictures are mine – Paula’s – all the wonkiness is mine too!]

Embroidery equipment

(all of which can be cheaply purchased from LoveCrafts)

• The PDF pattern and the stitch video that accompanies this post (which you can download here)
• An embroidery hoop no smaller than 7in diameter
• A crewel needle (although any needle with a large enough eye for your thread will work)
• Embroidery thread (one skein is more than enough. Just chose a colour that you love)
• Carbon paper to trace the PDF pattern onto fabric
• Any cotton fabric (I use calico but you can recycle a non-stretch garment or even a tea towel)
• Sharp scissors

Preparing your fabric

Prepare by downloading and printing the PDF pattern. Place your fabric right side up on a flat surface, place your carbon paper ink-side down on top of it and the pattern on top of that, design facing up.

Hold the corners down with anything heavy. Trace over the design with a pen or pencil pressing hard enough that the ink leaves a ‘printed’ design on the fabric.

Then remove the inner ring of your embroidery hoop (loosen the top screw) also laying it on a flat surface. Place your fabric only over the top of it so that it sits evenly on all sides and the design is facing up. Slip the outer ring down over it so that the fabric is trapped between both rings with the design at the centre. Tighten the screw while also gently pulling the fabric so that it becomes taut in the hoop. Keep tightening the screw and pulling the fabric, but without distorting the design, until you can drum your fingers on it. That’s when it’s ready to stitch.

How to embroider mindfully

Pick a light, comfy and calm spot in your home. It might be in a favourite armchair or at a well-lit table. By doing this your body and mind will soon associate that space with slowing down and stitching.

Arrange your chosen spot so your needles, threads and scissors are easy to reach. The point is that you focus on mindful movement rather than constant rummaging and fidgeting.

You might like to use a scent that you can associate with your embroidery. It could be a candle, aromatherapy oil or just your favourite cuppa steaming at your side. This is about engaging all of your senses.

When you’re ready to stitch… do nothing at all. Shut your eyes, taking slow and deep breaths to centre yourself. Feel your embroidery hoop in your lap. Do this until your heart rate has slowed and your breathing is even.

Embrace the slow speed of what you’re about to do. Remember that you’ll take your time, look carefully at each stitch and notice the sound every time the needle pierces the fabric… the treasure is in the journey, not the destination.

Use the stitch shown in the film if you don’t know any others. It’s a basic stitch so you won’t get drawn into the technicalities of anything complex. Start wherever on the design feels comfy and trace the lines of the pattern.

Enjoy using the same stitch repetitively. Each stitch is supposed to be identical to the last but for now just notice how they differ or improve as you move across the fabric. And be happy with any wonkiness. It’s a sign that you’re tried something completely new which is always a step forward.

Notice all of your senses when you stitch. How does the fabric feel against your fingers? What does the needle sound like as it punctures the weave? Can you see how the thread twists as you work it? And can you taste or smell the cuppa that accompanies you?

Use your stitches to regulate your breath. Draw the needle up with the in-breath and down with the out-breath. It takes practice but it is deeply absorbing. You’ll notice the difference it makes to how you feel and even the neatness of your stitches.

Allow your mind to wander but always come back to your current stitch. All sorts of thoughts pop up when you embroider but use the pulling of the thread as an anchor, bringing your attention back to the fabric.

Notice how you feel as time passes. Have your shoulders relaxed since you began? Does your heart rate feel more even? Does any anxiety feel less nagging?

Use a mantra, phrase or word that helps focus your mind. So each time you take the needle down into the fabric you could say to yourself “I am….safe/ loved/ hoping/ supported/ healing”. Try whatever reassures you.

Remember that your stitches never have to be pretty or perfect. In fact I always tell new embroiderers to create something ugly. It immediately dissolves performance pressure and helps them get used to the needle and thread. Feel free to make a mess!

If you find reassurance in community think of all the people who have stitched over the centuries. Imagine them making the same movements, tackling the same challenges or working the same lengths of thread. The method of embroidery is virtually unchanged. The only differences are the images we stitch.

Remember that your stitches give you a voice. Look at the fabric in your hands and think about what YOU would like to say with it. Perhaps you’d like to stitch something that soothes or a word that express your rage. Like handwriting, embroidery is a tool that bestows you with power.

When you have finished (and this could be when you’ve had enough, not just when you’ve completed your hoop) sit with your work. Notice whether it’s knotted, neat, wonky or attractive and at how the stitches have evolved. Notice too how you feel in yourself. What’s changed in your thinking and your physical body since you first started stitching?

Finally, ask yourself if you’d like to try this again. Be honest, even if you want to throw the hoop across the room. Identify what you enjoyed about it and set a date with yourself to repeat the practice regardless of how your work looks.

Finishing off your embroidery

Once you’ve finished stitching there are a few ways you can use your embroidery. You can use it as a patch on a bag or garment, frame it, or leave it in the hoop as a hanging. Maybe give it away as a fun gift for a friend – and make another for yourself!

If you want to keep it in the hoop and create a hanging here is one way of doing this: take a long piece of thread that is a bit longer than the circumference of the hoop. Knot the end. Do a long running stitch around the excess fabric, about 2cm long, and 2cm apart.

When your stitches meet pull the thread tight to gather the excess fabric neatly at the back of the hoop, and tie a double knot.

Tie a ribbon to the screw and you’re done!

Remember that everything you need to embroider is online, from YouTube videos through to kits that are ready to stitch. Also visit www.dmc.com where you can find free downloadable patterns. And if you want inspiration try the Instagram hashtags #hoopartembroidery, #handembroidery and #embroiderywip for lots of ideas. Good luck!

Cath Janes is an anatomical embroiderer, selling her clinically accurate medical illustrations to medical professionals across the world. You can find her at cathjanes.com.

The post Do no harm but take no shit – Mindful embroidery instructions appeared first on Dr Paula Redmond, Clinical Psychologist.

What is this project all about?

This project combines both craftivism and mindful embroidery, and is a collaboration with Cath Janes. It brings together the threads of connection, creativity and compassion:

Connection: to values – such as fairness and social justice, but also fun and playfulness. The motto “Do no harm but take no shit” can be interpreted in lots of ways. To me it means standing up for the rights of healthcare workers to be treated as whole people, and that doing a good job for patients shouldn’t mean having to sacrifice your own wellbeing.  It’s also a project that is designed to be fun and playful – both things that we all need more of.  Finally, approaching the project in a mindful way enables us to connect with ourselves and the present moment more fully – allowing whatever we are feeling, thinking and sensing to just be, for a little while at least.

Creativity: using our hands to make something and getting engrossed in the creative process has loads of benefits for our wellbeing. The pattern is a starting point – you can make your own choices about colour and style as well as what you might decide to add or leave out – put your own creative stamp on it!

Compassion: taking time out to do something that’s just for you is one way of showing yourself compassion. The motto “Do no harm but take no shit” also captures the idea that we can be both compassionate to others and have healthy boundaries.  Also, self-compassion isn’t always nice – sometimes we have to use swear words!

 

I hope you enjoy it – please do share your projects with me on Twitter @DrPaulaRedmond!

The post Do no harm but take no shit – a mindful embroidery and craftivism project appeared first on Dr Paula Redmond, Clinical Psychologist.

Unravelling the therapeutic benefits of knitting: a personal story

On reflection, my journeys with knitting and clinical psychology have always been interwoven.  During the first term of my doctorate, I visited my mum for the weekend.  She told me that she had met the parents of a recently qualified psychologist whose urge to do something entirely unrelated to psychology during her doctorate had led her to learn to brick-lay.

My mum felt I should learn to knit, so (mostly to please her) I took some needles and yarn and she showed me the basics.  It was amazing that even though my brain had forgotten what to do, my hands clearly remembered the movements from the tiny, holey mouse-blanket I had made on my Donald Duck needles at the age of about 7.

This was the beginning of my journey with therapeutic knitting – to help me manage the demands of the clinical psychology doctorate.

Rhythmical repetitive bilateral movement

As a prolific knitter and quilter, my mum had beautiful woollen shawls draped over the arms of her sofa, and convinced me that with only the basic stitches I could make one myself.  On the way to the train station the next day we stopped at John Lewis to buy me my own yarn and needles and she cast on 5 stitches for me.  It was helpful that this shawl started with only 5 stitches as the number of stitches in each row increased gradually along with my confidence and commitment to my knitting project.

During my first year exams, I remember stopping for a row of knitting every time I needed a break.   At the time I had no idea I was engaging in ‘therapeutic knitting’ but I definitely appreciated the soothing nature of the rhythmical action of forming each stitch, and felt that by focussing on what my hands were doing, it allowed my busy brain to rest.

Researcher and author, Betsan Corkhill, summarises the therapeutic qualities of knitting in her ‘Knitting Equation’ and notes that that the automatic, repetitive and rhythmical movements of knitting have benefits akin to meditation.

I still have and wear my first knitted shawl and it will always remind me of the relief of passing the first year of clinical training and the start of my journey as a knitter.

My first knitted shawl

Making progress in small increments

My knitting skills grew, and by the final year of my training I was busily making a shawl to wear to my graduation celebration.   This deadline taught me another of the major benefits of therapeutic knitting: that you can make significant progress in tiny increments of time.

A few stitches on the bus to work or while waiting for a friend in a café can all add up.  As Betsan Corkhill notes in her book ‘Knit for Health and Wellness’ the ability to make tangible progress in small increments is extremely helpful for new knitters or those struggling with low mood.

As a psychologist, I often relate this to the idea of ‘behavioural activation’ used in a cognitive-behavioural approach to low mood.  The theory suggests that people experiencing low mood benefit from engaging in activities which allow them to experience pleasure and/or a sense of achievement

However when we are struggling with low mood, engaging in any activity can feel overwhelming.  Knitting is a convenient and portable activity that can offer both pleasure and a sense of achievement even if only a few stitches are made at a time.

Connection and community

On leaving the adolescent team where I spent my final placement year, I was stunned to receive a cushion with a ‘rustic’ handknitted patchwork cover as a leaving gift.

A leaving gift

This was presented to me alongside a photo album with evidence that the whole team, including many non-knitters, had contributed stitches towards this gift.  Never has a leaving present been more meaningful or appreciated and the cushion lives in my bedroom to this day, over 13 years later.

The legacy of this thoughtful gift has lived on in another way as I have borrowed this idea to create blankets for several colleagues expecting babies.  In my last Child and Adolescent Mental Health Service (CAMHS) team, a very dear friend and colleague was expecting twins following a very challenging journey to her pregnancy.  After the third ‘rusty knitter’ approached me for help in making something for the babies, I decided that we should collaborate and all knit or crochet squares that I would then join together to make two blankets.

Creating connection and community

While our friend was touched to receive the two rainbow blankets for her twins, the project also brought unanticipated benefits to those of us who contributed.  Many of us stopped working at least once a week to have a lunch break together so we could knit, and I could help retrieve dropped stitches or teach a new person who wanted to contribute.

I certainly felt a stronger sense of team morale during this time, and had conversations with colleagues I otherwise knew little about.  While a few colleagues were admittedly rather reluctant participants, others commented that they had enjoyed learning or remembering how to knit, and appreciated having this little oasis of calm in an otherwise hectic day in CAMHS.

One colleague who was completely new to knitting and crochet continues to this day, 5 years on, and made 91 crocheted hearts as her wedding favours.

A transitional project

Knitting also supported me through the end of my career in the NHS.  Leaving was not a decision I had planned or anticipated and many tears were shed in the process.  By this point, I was choosing knitting projects more mindfully for their therapeutic benefits, and I knew I needed a big project to help me with the transition of leaving the NHS.

The ‘Starting Point’ wrap by Joji Locatelli was released the previous month and as a huge shawl in 5 colours, constructed by working two separate halves which are then knitted together, it seemed a perfect metaphor for my transition from NHS to private practice.

‘Starting Point’

My Starting Point wrap wasn’t finished quickly. I had to take a deep breath and grit my teeth before starting again from scratch with the second half.  This mirrored the many challenges of leaving the familiarity of an established NHS career to build something new from the beginning.

However, during this new phase of my life, I relied heavily on what I had learned as a knitter – the process is as important as the end result.  And that sometimes things need unravelling a few times before they work out.

I honestly feel that I was better able to tolerate the pressure I felt (from within myself!) to make my business a success. I was also more able to be patient in seeing the value of the process of moving towards my goal slowly and steadily.

I love having this huge shawl to wrap around me, which will always remind me of my NHS career and my ability to manage change that I hadn’t necessarily chosen or anticipated.  It also taught me the value of making space for the transition to be a project in itself, and taking it one step (or stitch) at a time.

Therapeutic knitting

It is a common assumption among knitters that it has therapeutic benefits, and there is emerging evidence to confirm this and to suggest that people in a clinical population may also experience a reduction in anxiety and increased sense of calm when learning to knit.

Since starting in private practice in 2017, I have often read, reflected and talked to others about the therapeutic benefits of knitting, but only recently have I started to turn this into action. I am now running a therapeutic knitting group in a local primary school and recording the first series of my podcast ‘Why I Knit’ in which I interview a diverse range of knitters to learn more about their experiences of the therapeutic benefits of knitting.

I have also started to introduce the idea of knitting or other handcrafts when discussing behavioural activation or mindful activities with some of the young people I see for individual therapy.

I hope that this will encourage those of us who are existing knitters to deliberately and mindfully use this craft to its full therapeutic potential, and to introduce some new potential knitters to the idea that knitting could have more to offer than just the ability to make great jumpers!

Dr Mia Hobbs is a Clinical Psychologist working with children, young people and their families. You can learn more about the therapeutic benefits of knitting at Creative Restoration and follow her on Instagram @knittingistherapeutic.

The post Therapeutic knitting appeared first on Dr Paula Redmond, Clinical Psychologist.

Art-making has a range of benefits for our emotional health and well-being. Many people would like to do something creative, but aren’t quite sure where to begin.

But creative activity is something that anyone can enjoy and benefit from, regardless of formal training or artistic skill.

Using the therapeutic arts isn’t about being an accomplished artist; instead, it’s about being attentive to your inner process – that is, your thoughts and feelings – as you create.

Art and Mental Health

Shaun McNiff (1992) talked about how art can be a kind of ‘medicine’ for the soul. In all ages and cultures, people have turned to the arts to express joy and sorrow, to celebrate success or to find solace in times of uncertainty. The simple process of art-making, when approached with curiosity and attentiveness, has healing properties for our mental health.

If you’re into mindfulness, you may have tried one of the colouring books for adults that are now widely available. The activity of colouring in provides order and structure for the mind, while giving you an element of choice as you pick your colours and the type of pens or crayons you prefer.

However, if you would like to expand your creative repertoire, many activities from the discipline of art therapy can be used for personal self-reflection.

Making art can help us unwind as we focus our attention fully on the task in hand. Creative activity promotes a state of flow (Csikszentmihalyi, 2008), which has a restorative impact on our well-being. Being in flow means being totally absorbed in what you are doing, in a way that makes the time fly past, and this releases stress relieving hormones that have a positive impact on our brains.

Doing something creative can also bring a sense of playfulness and experimentation into our lives. Often, a simple image tells the story of how we feel in a way that words cannot easily capture.

As we engage with the deeper meaning of our art work, we can find unexpected layers of emotion and explore new possibilities for our personal situation.

My Own Creative Journey

For many years, I longed to be creative, but memories of art lessons at school seemed to put obstacles in the way. I remember being frustrated and on the verge of tears in primary school just because I couldn’t get my painting to ‘look right.’ What also didn’t help was the teacher telling the class whose painting was ‘good’ (and, by omission, we gathered, whose wasn’t).

Discovering the therapeutic arts allowed me to let go of my perfectionism as I realised that doing art could be both fun and exciting. Art making is supposed to bring you joy – the joy of finding your creative voice and unique self-expression, while engaging with the sensory aspect of different materials and techniques.

I was inspired to embark on my own art therapy training so that I could integrate the creative arts in my psychotherapy practice. I was in creative heaven as I learnt about the benefits of art making for mental health, while also gaining a great deal of hands-on practice in the seven art forms: Art, sandtray, music, clay, drama, movement, and poetry.

While these are the most commonly used art forms, there are many other ways to use the arts therapeutically: embroidery, using objects from nature, and storytelling – to name but a few. A recent interest of mine is labyrinths and how they can be used for therapeutic healing and meditation as you follow their winding path towards the centre.

Using the arts for self-care can be a wonderful way of exploring your emotional states, process your feelings and find out what you need. Here are some simple ways to get started.

How to get started on your creative journey

Developing a creative practice doesn’t need to be complicated – here are two simple ways to get your started: art journaling and using natural objects.

Art Journaling

Keeping an art journal can be a great way to record how you are feeling day to day. You don’t need any expensive materials to begin. Get a regular note book – just make sure that the paper isn’t too thin – and some coloured pencils or crayons. Even a biro will do!

Liberate yourself from the pressure to create something aesthetically pleasing. A great ‘low stakes’ activity is to use lines and shapes. You will find that even simple mark making can express depths of feeling. You can experiment in a similar way with different colours.

Note how your hand wants to hold the pen or crayon, and what energy is present in your mark making – is it serene or more energetic? What does that say about how you feel? Tune into your bodily experience and express it on paper.

Spend some time reflecting on your image and note down any words that come up. You may wish to write a brief reflection at the end. You can also use this sentence: ‘I feel ____ and I need ____.’ Don’t overthink it, just jot down the first idea that enters your mind, and you may discover something you hadn’t thought about.

Don’t be afraid to draw whatever you like. People, places. It doesn’t matter what it looks like. Draw stick people if that helps, it’s the process that counts, not the results.

Add some speech bubbles and give the stick people some words. How are they feeling? What bothers them? What do they need to hear? How do you feel about them?

A fun twist can be to use an old book or novel as your journal. Drawing and colouring over printed text can be strangely satisfying. Just make sure that you haven’t picked up an unread novel by mistake!

Later on, you can get a sketch book, especially if you would like to use heavier materials such as water colour or felt tip pens.

Natural Objects

Arranging objects is a mindful exercise that helps us tune into ourselves. For this activity, you can use some items you have found outside. I am always collecting little stones and other natural objects on my walks. You may find a flower, some dry leaves or cones.

These items can be used to create patterns by laying them out on a tray or piece of fabric. Which ones are you attracted to? Some natural objects have a special kind of symmetry. They are known as fractals, and touching them or even just looking at them can have a calming influence on the brain (Joye, 2006). Again, you can note down words or sentences that come to mind, or draw something in your art journal.

What is Involved in Creative Arts Counselling?

Art therapy, or creative arts counselling (both are similar) is an established method for processing stress, trauma or grief. It is considered a somatic form of therapy as it engages both mind and body. Art therapy can help us connect with our deeper emotional process, and especially those experiences that do not translate easily into words alone (Malchiodi, 2020).

One of the reasons that art making is effective is that it activates the right side of the brain. During the creative process, the brain’s right hemisphere is active in a way that does not happen when we use verbal communication only. The right brain is emotional and imaginative; it holds our non-verbal memories (‘feeling’ memories) which can be expressed effortlessly through the arts.

Some common misconceptions about art therapy are that we must be ‘good at arts;’ that art therapy is only for those who have difficulty expressing themselves verbally: or that your image will be interpreted by the therapist who will analyse its ‘true meaning.’ None of these are true.

In creative arts counselling, different art forms are used in combination with talking therapy. The therapist helps the client reflect on, and find their own personal meaning in their image or other creative piece of work, so that the art image becomes a container for the inner process. This can be a life-enhancing, transformative experience.

For more tips on how to use the creative arts for self-care, or to book a session with me, please visit my website www.karolinachristopher.com.

References:

Csikszentmihalyi, M. (2008). Flow. The Psychology of Optimal Experience. New York: Harper Perennial Modern Classics.

Joye, Y. (2006). Some Reflections on the Relevance of Fractals for Art Therapy. The Arts in Psychotherapy 33, 143–147.

Malchiodi, C. (2020). Trauma and Expressive Arts Therapy. Brain, Body and Imagination in the Healing Process. London: Guilford Press.

McNiff, S. (1992). Art as Medicine. Creating a Therapy of the Imagination. London: Shambala.

Karolina Christopher specialises in helping individuals heal from relational trauma using creative, depth-oriented psychotherapy, counselling, and 1:1 coaching sessions. She is a UKCP-registered integrative psychotherapist.

The post Creative Self Care for Good Mental Health appeared first on Dr Paula Redmond, Clinical Psychologist.

My work is very emotionally intense, and it’s been a tough year. The news is depressing and just seems to be getting worse every day.  So that I can really have a break to recharge my batteries I need books that are captivating enough to keep my mind off other things, but not too challenging (emotionally or cognitively).  These are the kind of books that will help me achieve a state of flow, which also leads to a state of rest.  They need to require just the right amount of effort, but also bring immediate reward.

With a little help from family, friends and colleagues I’ve have put together a reading list for all the weary souls out there – 10 fiction, and 5 non-fiction.  I’m going to work through the recommendations I received so that I can add them here once I’ve read them. A big thanks to my mum (who is a librarian) for most of the little summaries.

The sort of book each of us finds rewarding will be different, but if you’re feeling a little lost when it comes to reading it’s a good time to experiment with new genres. I hope you find it helpful, and that it brings some well deserved rest.

(Note: I have included links to hive.co.uk as this is my go-to online bookstore. They offer a more ethical alternative to Amazon as well as a choice of free UK delivery, or collection from your local bookstore. Best of all a proportion of each purchase is passed on to the independent bookstore of your choice. I’m not affiliated with them in any way.)

10 Fiction Books for Weary Souls

1. The Guernsey Literary & Potato Peel Pie Society – Mary Ann Shaffer and Annie Barrows. Post WW2, a young woman journalist from London, looking for a story, corresponds with an unlikely motley group in Guernsey. Uplifting and funny.

2. The Rosie Project – Graeme Simsion. A geneticist who is a little different from the norm embarks on a scientific test to find the perfect wife. Quirky and funny.

3. A Month in the Country – J.L. Carr. Post WW1, a tale of lost love but also a reflection on the power of art to heal, and the consolation of memories.

4. Cold Comfort Farm – Stella Gibbons. First published in 1932, this short novel has stood the test of time. When 19-year -old city girl Stella is orphaned she needs to throw herself on the mercy of her relatives, living on a farm in deepest, darkest Sussex. Somehow, amidst the rustic mayhem and threat of gloom and doom, girl meets boy, generation-old conflicts are resolved, and everyone lives happily ever after.

5. Tears of the Giraffe – Alexander McCall Smith. Features Precious Ramotswe, owner of Botswana’s only detective agency. Gentle tales of misdeeds, resolved with wit, patience, a natural love for humankind and a belief in our innate goodness.

6. The Thursday Murder Club – Richard Osman. The ‘murder squad’ is made up of those closer to 80 than 65 at an exclusive retirement home in Kent. Not as doddery as you might think, when a real murder is committed close to home. Lots of comedic capers – a wittily constructed piece of detective fiction.

7. The Giver of Stars – Jo-Jo Moyes. While not classed as ‘great’ literature, this is a good read. Set during the Depression in Kentucky, it features five pack-horse (or rather pack-mule) librarians who brave the wilds to get books into the hands of the isolated, rural poor. A book about female friendship, nature and the magic of reading.

8. The Tale of Desperaux – Being the Story of a Mouse, a Princess, Some Soup, and a Spool of Thread – Kate DiCamillo. A children’s fairy tale that stirs the soul and reminds us that ‘Stories are light. Light is precious in a world so dark’.

9. Hunting and Gathering – Anna Gavalda. This is a charming book set in Paris. It’s the story of four very different people whose lonely lives become beautifully intertwined.

10. My Brilliant Friend – Elena Ferrante. This is the first of a series of 4 books known as the Neopolitan Novels.  It is the tale of 2 friends growing up in 1950s Naples, following them through the many trials and tribulations of their lives. It is an immersive experience in friendship, growing up, and Italian life.  These are books I wish I hadn’t read, because I’d love to be able to discover them all over again.

5 Non-fiction Books for Weary Souls

1. Olive, Mabel & Me – Andrew Cotter. Scottish Broadcaster Cotter commentates unsentimentally and with caustic humour on life with his two Labradors. A good read!

2. Becoming – Michelle Obama. Michelle’s story of her ‘rise’ to First Lady from her own perspective. Both humbling and inspiring.

3. The Art of Rest: How to Find Rest in the Modern Age – Claudia Hammond. This one is a bit meta. A restful read about how to find rest through reading (and other things).

4. Every Day Nature: How noticing nature can quietly change your life – Andy Beer. A wonderful book that encapsulates everyday mindfulness, while nurturing a deeper connection with nature. Each day offers something new to notice around you, following the seasons, and teaching some helpful facts along the way (like how dock leaves are actually useless for nettle stings!). Beautifully written with wit and wisdom.

5. Salt, Fat, Acid, Heat: Mastering the Elements of Good Cooking – Samin Nosrat. This is such a beautiful and delicious book. If you love food (who doesn’t) this will bring you joy and make you hungry.

I hope these books bring you joy and rest. I’d love to know what you thought of them – email me to let me know!

The post A reading list for weary souls 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.

I’m very grateful for her generosity and courage in sharing her story, and I hope it will be helpful to those who find themselves in a similar position.

How did you come to make the decision to take time out of work?

The decision to take time out was driven by an accumulation of factors. Having striven to achieve a well-regarded position in my higher speciality training I was increasingly feeling like a failure. Prior to starting the post one of my consultant colleagues told me that that department would either “make or break me” and this probably set the scene for me. I perceived the environment to be threatening and judgemental, and felt I received little encouragement or positive feedback. I increasingly compared myself to other junior doctors – people who appeared more confident, more able or more knowledgeable than me; and those who had chosen different speciality training routes or gained extra experience.  I felt like an imposter in the workplace, and I was looking for faults in my performance before they even occurred. I was becoming increasingly deflated and anxious.

My confidence was then further knocked when I was asked to make a clinical report regarding a senior doctor. This experience added to the feelings of being scrutinised and judged when I had to have multiple meetings with various members of the department and deanery.

I recognised I was becoming increasingly stressed and anxious at work. Performance anxiety and imposter syndrome were also starting to have an impact on my happiness outside of work.

I distinctly remember on my run into work one day I found myself wondering if I accidently hurt myself how I would have time out of work. I imagined a broken wrist and 6 weeks off with no questions asked. This was really the trigger moment for me to seek some help and I arranged to have a meeting with the head of the deanery.

She was the first person to whom I properly expressed how I felt in the department and the culture of fear and judgement that I perceived to be pervasive.  Comments like “these juniors don’t know anything” or publicly criticising others’ management of patients meant I could only imagine what they were saying behind closed doors. She acknowledged my experience and also validated it by stating that this was not the first time that this sentiment had been expressed about this particular department, which thrived on its “prestigious” reputation.

She asked what I wanted, and this is when I expressed that I needed a break, some time away from the department to reassess and reset. She suggested I seek support from the deanery’s mental health team that is set up specifically for medics, and I set up a block of therapy appointments with a clinical psychologist.

What was your experience of therapy like?

I found therapy a genuinely useful and insightful process. It really helped me to clarify my concerns and feelings about work. I discussed my performance anxiety and was asked to justify it: how many lines did you actually miss? how many right decisions did you make rather than wrong ones? It really helped to have to express things verbally to another person, and challenge my way of thinking.

How did you decide to take time out?

Through the therapy process we continued to talk about time out of training and needing a break. We talked about what I would do if I had a year off – maybe working in a hospital abroad. But one day I expressed that if I really had no ties or commitments, I would love to take a year to live in Europe, learn another language and attend art school.

During the therapy sessions we discussed what was holding me back from doing this. The pervading feeling was again one of judgement from outsiders or concerns that it would impact on my career and jeopardise the likelihood of me getting a post in future. In the end though, I reached the conclusion that continuing to work in the same field somewhere else may just perpetuate the issues in a new environment. I realised that in order to really reset, and identify what would keep me happy and balanced, I needed a true break and personal adventure – so off I went.

Where did you go? What did you do? Did it help?

I spent a year in Italy that felt like something out of “Eat, Pray, Love”. I learnt Italian, surrounded myself with beautiful art work, wonderful food, culture and scenery. More importantly, I met great people and established new friendships with people from all over the world, many of whom were embarking on similar emotional journeys, taking career breaks and pursuing their dreams.

The experience was fantastic – I could not recommend it enough.  It was really important to spend time on myself, and pursue a hobby that is not related to medicine in any way. Exploring how I responded to the completely different stress of learning new skills and living in another culture helped me realised that I was my own worst critic. Prior to leaving my job, various people in the department had given me really positive feedback, saying I was suited to the speciality and they thought it was a shame or a waste that I was going. This was a real shock as I had sincerely felt that I wasn’t good enough for the department.

What did you learn through this time?

Following the year off – a year of no night shifts, eating and sleeping at normal times and meeting lots of new people, learning new skills and a new language – I felt so much more like me. I reset the balance of priorities. Medicine can define you as a person and it is demanding. It takes so much more from you than the hours you are physically present in the hospital both emotionally and physically. It is filled with as many highs as it is lows but fundamentally it is still just a job.

At one point I remember reading some of the obituaries in the back of the BMJ, reading about these prestigious doctors who had these amazing careers but one day retired, got ill, or died at work. I wondered how long their colleagues at work missed them for, or if they noticed they weren’t there, whether they really mattered to the people they worked with, and how replaceable we are as cogs in the machine.

No matter how much satisfaction we get from work it is never our sole source of pleasure. The things outside of work actually matter more.  They are the things that keep us balanced. We have to nurture these interests and aspects of ourselves, protecting them from the steam-roller of medicine that wants to take over all of who we are.

What came next for you?

Perhaps my response to the situation I found myself in was extreme but I felt it was better to have time out and then feel that it was a conscious decision to return to work. It was my choice to return.  I was clearer about my personal tendencies to self-doubt and I had certainly shifted my attitude towards making more time for other hobbies and interests.

After my career break, I came back to medicine and the speciality, albeit in a different institution. I now feel more self-assured and secure in my career choice.  Although perhaps I do not yet have the confidence to walk away from the last 20 years of work. Fundamentally I recognise that there is still something about being a Doctor that is too intrinsic to my being that I am not prepared to let go of completely. I know I am never going to be the best doctor in the department, but I can do a good job and remain balanced instead of destroying myself in chasing an impossible standard.

Many people worry that having a career break on your CV might damage their career prospects – has this been your experience?

The majority of my peers have been positive about it, a few are jealous or wish they had done something similar, but there is still the question about whether it has impacted my career prospects. Honestly, I think that it has. People ask about it in interviews – it was recent enough that people note it on your CV and ask about the reasons I took time out. Some respond well to my explanation and others probably think I wasn’t tough enough, should have stuck it out etc.

This does create some worry and anxiety about the future and whether this has hampered my career, but at the time I felt I had no choice. I needed to do something, and this was the path I chose. Others could perhaps have taken a shorter break that wouldn’t be noticed on a CV but this would still come with challenges of explaining sick leave or absenteeism to seniors. Perhaps for others reducing their hours at work would have been enough.

Personally, I think if I was back in the same situation, I would still make the same decision even knowing how it is impacting on me now. I would hope that having gone through my experience means that I would be able to help others and support them through similar crises of confidence in the future.

What changes would you like to see happening in the NHS to meaningfully support staff wellbeing?

I think we are making progress in medicine to remove some of the public judgement of others.  People can choose to work part-time now in certain specialities without citing a reason and this should be universal. Why should we have to explain our lives outside of work and life choices to our employer?

Some are advocating having optional sabbatical time built into training, which I think would be a fantastic step in allowing people to spend time on themselves. I also think the physician support system (Practitioner Health) was brilliant and I would highly recommend it. Being aware and seeking counselling before you hit crisis point is so helpful. I wish I had known about it and done it sooner.

Perhaps we as medics are a bit wary of seeking outside help – we like to believe we are indestructible and somehow different from our patients. We can see counselling as a sign of weakness when instead it should be seen as a strength – being brave enough to undergo self-analysis to unpick our fears and relationship with work.

Personally, I feel that actual psychological support should be readily available for all NHS workers. It is not about having a few posters in the staff-room about self-care or providing access to mindfulness apps. The onus shouldn’t be placed back on the individual – we need to think about how we can create a workplace that is supportive, allowing people to ask for help or support flexible working patterns without fear or judgement.

Next Steps

If this has resonated with you and you want to reach out to talk to someone about your own struggles check out the free mental health support services available for health professionals, or book a free therapy consultation with me.

The author of this story has kindly said that she is happy to be in touch with readers who may be contemplating taking time out and want to find out more about her experiences. If you would like to get in contact please do so via email to hello@drpaularedmond.com

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