Are we giving the time over to prioritise mental health conversations.
We'll all probably have more fire drills a year than attend these sort of talks.
I hope some more people sign up to attend. The first step to understanding, awareness, acceptance and action is talking.
So this is a call, to the blokes out there, If you're struggling, don't keep it all in. Find that trusted person, they might be a friend, partner, family member, doctor, counsellor, manager, anyone.
Just start talking.
So we'd done a lot of intro, a lot of understanding about worry, what it is, how it affects you and we now started to focus more on what you can do about it.
Week 6 - Problem Solving Pt 1 - Problem Orientation
You can work to solve current problems, but not hypothetical ones. It's better to solve a problem than worry about it.
First we started off seeing is we could switch around the negative problem orientation that people with generalised anxiety tend to have. We tend to view problems as threatening, doubt our ability to solve them and believe our problem solving won't work. All this combined affects how we feel about the problem, how we think about it and how we behave towards it.
so what to do:
Week 7 - Problem Solving Part 2
So we were good at spotting problems and last weeks homework was to spot recurring problems in our lives and record them.
So how to solve them.....Well the approach was to use a 6 step process. A process was necessary because when you're anxious you can feel like you aren't good at problem solving, try and solve too many problems, produce vague solutions and make ourselves feel a lot worse. Strangely perhaps I think I'm good at problem solving.
Week 8 - Processing core fears (part 1)
It was no surprise to hear that we worry about things that are important to us and can fluctuate between worrying about these and avoiding worrying about them.
Everyone has these things in their life that are important, they might be about relationships, health, aspirations, values, work. These are the heart of your worry.
With these we often have hypothetical 'what if' worries and tend to choose 2 main techniques to deal with them, neither of which actually work, these are:
You can suppress it, distract yourself, try and avoid thinking about it, avoid situations, reassure yourself but none of that makes it go away.
That's a nice black bear huh.
Nice snout, lovely eyes, big alert ears, powerful jaw, thick fur.
Strong bear, powerful, deep roar, hot breath. Majestic, Scarey. Big Black Bear.
Now close your eyes and try not to think about that black bear for one minute. Bet you can't.
Avoidance doesn't work, unless perhaps you're a mindfulness black bear, i mean belt.
We never build up any tolerance to hypothetical worry if we never face it and don't expose ourselves to it. Bearing in mind that only 10% of hypothetical worries come true that means we spend a lot of time and effort on them and should invest it somewhere more productive.
For homework we had to write about a hypothetical worry situation. In detail, with smells, sights and sounds, describing what we were doing and how it felt, describing the images in detail, not avoiding the situation and making it about a core fear.
This is part of the example we were given. It was tough enough reading that. Homework wasn't going to be fun.
Week 9 - Processing core fears (part 2)
Week 9 was tough. We'd been building up to week 9, we just didn't know it.
We looked over hypothetical worry scenarios, we didn't share, we mostly sat and read them in silence. We made sure they covered all senses, that they didn't include avoidance or neutralisation.
The trainers explained about SUDS, which I was quite excited about because I'm a big fan of sustainable urban drainage, but unfortunately these SUDS were Subjective Units of Distress. This really wasn't going to be fun.
We individually read through our scripts and recorded our SUDS score before, during and after reading, then ten minutes later. I went and sat on my own to do this, it was horrible, I had written about something deeply personal that I was really worried about, something that was grounded in real life, maybe too grounded.
Everyone got quite upset and anxious. We were told that meant the scenario was the right one. Hmmmm.
Homework was to read the scenario out loud 3 times every day for a week and record our SUDS and see what happened. These were my scores. 100 is the most anxious / upset, 50 some anxiety but manageable and 0 not feeling anxious at all.
So exposure to worry helps how you think about it. This was bloody amazing, and also deeply unpleasant.
We probably talked about no pain no gain here, or I might have made that up.
I'm going to do a part 3 to this thread, as just remembering the hypothetical worry exposure is enough for today
We had homework, to set goals for the course. These had to be SMART (specific, measureable, achievable, realistic and timed). My goals included "To be able to turn my phone off for the evening and not worry about what i am missing out on or not replying to people and worrying what they would think". I had never done that. Start small.
Every week we had to fill in a questionnaire to track how we were doing. It looks like that above. It was 'interesting' filling that in every week.....
Week 2 - Worry Awareness Training
We reviewed goals. We looked at the CBT model in more detail, building it slowly step by step. And covered:
Week 3 - Intolerance of Uncertainty
Being unable to tolerate uncertainty is like a psychological allergy and a small amount can lead to a reaction. I realised then I had been uncertainty intolerant for a long time. Uncertainty drives worry and worry drivers uncertainty. Arghhhhh.
We talked about how being intolerant to uncertainty can mean that we avoid uncertain situations (we stop going out for example) and we attempt to eliminate uncertainty by being in total control.
The key is accepting that you can't control what happens but you can control your thoughts.
Attempts at control are often shown by sticking to routines, avoiding responsibility, eating the same food, over-planning and making hasty decisions to avoid experiencing uncertainty.
Trying to be in control takes up a lot of time and affects your wellbeing, I know its affected mine. We looked at how being intolerant of uncertainty can manifest itself in your behaviours. i think I ticked nearly all of these.
So you change by acting like you were tolerant. Fake it till you make it. Hmm I wasn't convinced.
But anxiety and discomfort is NORMAL when doing things the first time. We were all normal in the room, we just had our sensitivity switches set onto high.
Homework was to tolerate some uncertainty. I think its fair to say we were all pretty worried about that.
I tried to procrastinate less and reply to some questions I had been putting off, and i did.
I tried to seek less reassurance from my best friend and told them that's what I was doing and asked them not to reassure me when I asked.
Week 4 - Positive Beliefs about Worry
Key learning - action creates motivation, not the other way round.
We talked about how we can worry because we think it is a good thing and it feels like it has value, and when we think things have value we keep doing them.
Positive beliefs about worrying include:
After this for homework I made a major step. I used to go to church a lot as a kid and have always carried on saying a prayer before I went to sleep. It was always a long list of worries and I believed that saying it would make things better. I decided to stop. It was really difficult. I'd probably had the same sleep routine for 30+ years. I tolerated the uncertainty and challenged my positive beliefs about worry.
I wouldn't have done that without the CBT.
Week 5 - Re-evaluating the usefulness of worry
Because we were all starting to feel more comfortable with the group the trainers decided to mess that all up and make us act in a courtroom scene challenging positive worry beliefs. Uncomfortable, yep, but effective and also another great uncertainty tolerance test.
The cost of worry is greater than the value, because the value is nothing and the cost is significant. We talked about if:
Choosing to be active means you can then either problem solve or treat situations with imaginal exposure (more on that in week 8).
Not wasting time worrying means you have time to do other things. It was around now that I started painting.
Homework was to continue to tolerate uncertainty and to challenge a belief about worry when you started worrying.
That's the end of part one. I hope its been interesting. I'll do part two later, maybe today.
Woop Woop another guest blogger, this time from another colleague Caroline.
She's pushing Mental Health Issues in my local office, which is great and is passionate to champion openness and understanding.
Like other guest bloggers there is often a slight hesitation initially then a keenness to share and a recognition that even to write it helps.
So here are a few words about her 'Journey' - i know I love the subtle musical references....
Take Care Paul
Keep going but look out for the potholes
Paul asked me a few weeks ago if I’d write a guest blog, which both touched and terrified me! I’m no writer but I want to try because I think we need to be open about our mental health experiences. My dream is that we’ll eventually talk about health, just health, and instinctively know that we’re talking about physical AND mental stuff.
Health is health.
Over the last few months, Paul and I have shared snippets of our own personal health journeys and it’s been brilliant to know that there’s someone else out there who ‘gets it’. Someone who understands how tiring it can be to wear your “I’m fine” face and who knows good it feels to be honest about how you’re feeling without the fear that the other person will start talking about the weather or try to fix you! You wouldn’t try to fix someone’s broken leg, so why do people feel the pressure to fix your broken mind?!
More often though, self-reliance isn’t the best answer for me. Recently I realised I wasn’t coping at all well with life. A string of events over a 5 year period left me feeling a bit broken and bruised. Worn down. I felt very stressed and uncertain about everything. I knew I wasn’t feeling right but couldn’t explain what was wrong. Choosing happiness wasn’t an option. It was different to anything I’d experienced before. Grief following bereavement made sense. Fear and anger after harassment. Loss and loneliness after divorce. They were utterly horrible but logical reactions to a bad thing. This was a different kettle of fish.
Eventually, I broke. To my eternal shame I nearly hurt one of my kids in a moment of – what? – rage perhaps. Frustration. Helplessness. Exhaustion. I nearly hurt her, nearly. Nearly was just too close and too terrifying to ignore. I went to my GP, talked, cried and she diagnosed depression.
The diagnosis was a bit strange really. I felt surprised for a moment and then utterly relieved because someone had listened, understood and said it’s okay. She explained that depression is usually a combination of our reactions to life events and a change in brain chemicals. It’s hard to know which causes which. It is not a choice. For that reason and to my own surprise I started taking anti-depressants and after a few months I felt “me” slowly emerging from the enormous cloud of “stuff” that had dragged my mind down for so, so long.
After a few more months I smiled and meant it. I was calm with my kids. I remembered that my husband is really quite nice after all. I got some work done. I started recovering.
I’m still smiling and still recovering. Slowly but surely. It’s not a straight and smooth road (beware of sneaky big potholes) but I’m on it and going roughly in the right direction.
I’ve often heard it said that we shouldn’t dwell on the past. I tend to agree but I do think we should learn from it.
Me? I’ve learned that not talking about stuff is really, really bad for me. I’ve learned that you can be open about your mental health issues without fear. And I’ve learned that people will listen if you give them and yourself the chance. You don’t have to be alone.
Just don’t stop believin’......
It was a revelation.
Not the painting, that was extremely average but the process of painting.
I was entirely absorbed in what i was doing for the hour it took me to realise how hard water and boats are to paint.
I suppose in a way it was a kind of mindfulness meditation. All my attention was on the view, the paint, how much the boat sail I captured didn't really look much like a sail.
It gave my brain a lovely mini break. No other thoughts intruded. It was just me, the view of the bay and the paint.
I painted a person after that. That really wasn't good, but it made me and the person who was lucky enough to be my muse laugh, so it was good in that way. I'm not sharing that one. Then I tried flowers.
I turned the tele off to do the flowers (they're supposed to be Tulips if you can't tell). It doesn't matter to me that its not great (and I'm definitely not fishing for compliments) but it matters that it gave my brain some time off.
So maybe try something new. You might be good at it. More importantly it might be good for you.
We know exercise and connecting with people are good for anxiety, but if you're not feeling like that then a quick trip to the shops, a view of google images and an hour of 'masterpiece' creation is an excellent way to relax.
I did this one today. I actually think its not bad (mine is on the right), although stars are bloody hard to paint.
It actually looks a lot better not next to the original, honest.
I might try pottery next, so I shall be watching Ghost tonight to do my research.
"Ohhhhhh, my love, my darling, I've hungered for your touch......"
I'm pleased to say another colleague/friend has agreed to contribute a guest blog about his experiences.
Once again, I am immensely thankful that they are helping out in this way to break down the barriers and the stigma.
And with that I'll hand over the keyboard to Jack.
Take Care Paul
I'm not what I say on the tin - By Jack 9/11/17
I’ve never written for a blog before, but my colleague Paul asked me to contribute after we spoke last week about the stigma surrounding mental health. In some respects our discussion was extremely positive but it also highlighted how little we discuss our mental wellbeing with each other. I had absolutely no idea that Paul suffers from similar anxiety issues like me and yet we’ve have sat next to each other for the past 12 months. I guess we’ve been conditioned not to be open and honest about it and that has to change. The stigma around mental health only compounds the problem and so I thought I would share my experiences in support of everyone whether they have mental health problems or not.
I suffer from a mental health condition – from my perspective it seems very boring and mundane in comparison to some of the more serious conditions you read about such as clinical depression, bi-polar or schizophrenia. I’ve never been sectioned, suffered from any psychosis and I’ve declined to take medication.
However, in recent years I’ve realised that my social anxiety has ruled many aspects of my life. In combination with Dyslexia it severely impacted upon my education, it has led to difficulties until recently in forming long lasting relationships and in hind sight has held me back from progressing in my work life.
Like many who suffer with social anxiety I have loads of friends and consider myself popular. But as with many sufferers, my friends, work colleagues and even family members don’t really know the real me. I’m a walking contradiction which can in large part be explained by my teenage years.
As a child I was painfully shy and anxious in large part due to childhood trauma. My shy younger self realised that feigning illness to avoid school and social situations wasn’t getting me very far and I tried to adapt. I created a persona which was in contradiction to my real character. This persona was reasonably confident, and outgoing. It was in effect a mask to hide the social anxiety I felt in social situations.
I became a popular and expanded my social network which in lots of ways was hugely positive. However, it came at a price. My understanding of who I was became blurred and whilst I did not show my social anxiety openly it was eating me up inside. I became disruptive at school and did poorly in exams. I self-medicated with alcohol in my teens and early 20s to cope with the demands of a social life. When I wasn’t inebriated, my anxiety would greatly impair my ability to function in most social situations and I felt out of control. A nightclub or student event would have been the last place I would ever want to be sober.
It also impacted negatively upon my work life as well. I carried my mask into work. Colleagues assumed I was confident but I would struggle with my anxiety which would impact on my ability to complete tasks. I often hid my failings behind bravado and then would spend hours awake at night anxiously dissecting my mistakes.
Like many sufferers of social anxiety it was in my late 20s when things came to a head. I was feeling increasingly down and felt like my life was chaotic and out of control. I was getting increasingly anxious in normal everyday situations. I dreaded my birthday, Christmas’s and avoided family events. I started to suffer quite severe panic attacks on nights out and found shopping trips exhausting. I suffered and those closest to me suffered from irrational mood swings and my tolerance for people in general hit a new low.
On the outside I was still the same to my friends and family but inside I was in turmoil. I did some research into my symptoms online and decided to see if some Cognitive Behaviour Therapy (CBT) might help me deal with these situations better. Almost immediately I was diagnosed with social anxiety and given some tools which help me deal with my anxiety in certain situations.
It was the diagnosis rather than the tools which have benefitted me most. I have felt empowered in the past few years to embrace my less sociable self. I’ve learnt to minimise social activities which cause me stress and anxiety. This has been complimented by a number of coping mechanisms and CBT strategies which allow me to function as myself in my personal and work life.
I no longer see being myself as a negative. In our modern and ‘social’ obsessed society it can be a challenge being ‘anti-social’ but my personality has huge benefits. For example, I can spend the whole day without company and not feel lonely. Because of my hyper sensitivity I’m also very good at reading social situations and empathetic. I’m good in a 1 to 1 situations or small group situations which means I’m often the first person my friends call for advice. At work, I’m much more confident in who I really am and this has led to me being able to focus on my actual strengths and not try to over compensate for my perceived weaknesses.
Whilst I’m in a very positive place at the moment, I have to manage my social anxiety every day and I imagine the worst symptoms will rear their head again particularly when I’m going through stressful times in my life. My experiences have highlighted that sometimes we aren’t the person we wish to project and that it’s not necessarily healthy trying to conform. I’m hopeful in the not too distant future, mainstream society embraces social anxiety in much the same way as disabilities such as dyslexia. Rather than being reactive when people reach crisis point, I hope in future that society is more proactive in identifying sufferers and providing tools and support so that symptoms are managed effectively.
When things get on top of you decision making can be one of the things that suffers.
My go to response when I make bad decisions is to apologise, to beat myself up even more, dragging myself further down into feelings of low self worth.
But I know that's not the solution.
I need to stop apologising.
I need to give some space to let the situations get better, not keep digging this hole I find myself in.
I need to stop relying on certain people so much.
From some quick googling www.jneurosci.org/content/36/11/3322 I now know that:
"Anxiety works to disengage the part of the brain that is essential for making good decisions. The area is the pre-frontal cortex (PFC), at the front of the brain, and it is the area that brings flexibility into decision making.
The PFC is the part of the brain that gets involved in weighing up consequences, planning and processing thoughts in a logical, rational way. It helps to take the emotional steam out of a decision by calming the amygdala, the part of the brain that runs on instinct, impulse and raw emotion (such as fear)."
That's what my weekend felt like. It was weird. I'm really not happy about my decision making and wish I could turn the clock back.
But even now my instinct is to keep digging.
But I'm not going to. I'm going to turn my phone off (the tool of choice for many a bad decision) and try and engage my PFC, and if it doesn't want to engage I'll make sure I don't make any decisions. That's probably the best decision I could make right now.
One of the things i've learnt a lot about recently is that I need to be more thankful for what I've got, I need to be better at giving space, I need to be more fun, I need to be more upbeat, stop choosing to be sad and be a better friend. It's not easy but the risks of not doing it are too great, and the rewards of doing it are massive.
I'm ok, because I'm now back in control and making the decision, but make sure you keep an eye out for anxieties impact on the old PFC, he's a sneaky sod.
Take care (especially when you're making decisions).
One of my mates at work formally announced this week he was leaving after 19 years. I'm sad. But sad for me and sad for the organisation he will leave behind, not sad for him because he will make a success of whatever he does.
He's been massively supportive to me (and many others) over the years, great to work alongside and great to work for, although that only ever felt like we were working together on a joint mission which is the best way to work with anyone. A proper team approach.
Much of what I'm doing at work at the moment is because of his vision and support. He gives opportunities you see, thinks of how to include other people and takes risks to do things differently. And that's why I am sad that he's leaving the organisation.
He’s also supported me massively on my mental health journey, re assuring me, sharing, listening to my moans that my illness amplified and seeking to understand. That’s so valuable and I appreciate it and him so much.
I've written before about needing different people and different approaches to change things. wysethoughts.weebly.com/home/the-best-way-to-change-is-by-doing-things-just-the-same None of that is rocket science. But it still often feels like a struggle to embrace that type of diversity. We're good at embracing many other types, but what about the different thinkers, what about the introverts and the extroverts. What about the changemakers (or cheesemakers if you're a Python fan).
We once set up our stand at a department day with a real tree (which we donated to the venue afterwards) and used it to get people to hang their 'acorns' of ideas on. It was a risk, but we got the then chief exec over and chatting. We did things differently and differently can work.
We started exhibiting really professionally. We put on our own conference. We focussed on customers. We made it fun and interesting and pushed the boundaries. We looked for opportunities. We did lots of presentations using only pictures and no words…..
We started to create real change. We did things differently.
I think the organisation will look back in a few years and realise how far ahead of the curve his approach, thinking and efforts were.
So how can we work to retain people who are different thinkers, to keep them motivated, to value their input.
If we want to change we need them on our team. Are they on yours. Are you keeping the changemakers?
Good luck mate, you'll be massively missed.
Mr Paul Wyse