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A trauma shared: Self-care for NHS workers that can help all of us

4/20/2020

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Help for Heroes: A Field Guide to Self Care

Many experts are saying that what we are experiencing now in this pandemic is a collective trauma. Some people are experiencing trauma first-hand, whether through work on the frontline, you or someone you know being ill, or losing someone to the virus.

The rest of us are witnessing a major global traumatic event. We may be feeling empathy for those suffering, feeling guilt and sadness, the grieving emotions, feeling afraid and anxious about loss or dying or losing our jobs, fear that our lives and those we care about will be affected irrevocably.

The effect of vicarious trauma is not to be underestimated: plenty of studies show that witnessing or listening to trauma, or having a family member experience a trauma, can produce post traumatic symptoms in others. A traumatic event can trigger past traumas and produce the same feelings that you haven’t felt for years.
We are all deeply connected; we are all in this together.

If you feel fine, by the way, that’s good. You probably won’t need to read this unless it is to support someone close to you who is suffering.

So, what do you do if you are dealing with overwhelming feelings in isolation, without anyone to turn to?

Help for Heroes, Military Veterans who served in Afghanistan and Iraq, have drawn up a comprehensive guide for NHS workers on how to cope with traumatic stress. I read through the guide and truly believe it would work for anyone suffering with anxiety and stress in this time.

Help for Heroes: A Field Guide to Self Care

Our Field Guide to Self-Care is for the men and women working tirelessly in our hospitals right now. We hope that it’s a useful resource for our healthcare heroes, and for anyone else who may be feeling stressed or anxious during these difficult times.
This field guide is divided into Body, Emotions and Mind. Click on each section and download the workbooks: they are beautifully laid out and easy to read. There are useful videos, too and lots of breathing exercises, which are one of the easiest ways to self-soothe when feeling panicked.

Try this Soothing Rhythm Breathing Exercise.
I would try this anyway; stressed or not. It will come in handy for helping others if they are worried or helping yourself when suddenly overwhelmed.

There is something connecting about sharing our resources and understanding what everyone else might be going through. And something truly uplifting in people reaching out and offering support.
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Living with anxiety in isolation

3/29/2020

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If you struggle with your mind at the best of times, it may be particularly challenging now.

You may feel your panic spike, perhaps triggered by a news announcement, something a friend says, or even just a sudden scene from an apocalyptic movie that sets your heart racing (when this happens, imagine projecting it onto a TV screen).

This is understandable: most people, even if they do not normally suffer with anxiety, are feeling it.

Things to try if you are feeling particularly stressed right now

Calm have a free resource page for guided meditations.

A meditation: breathe into your anxiety (maybe you feel the source of it in your stomach or chest, legs or forehead). Imagine your breath circling it like a nest and ‘honour’ it before releasing it with the out breath. Count your breaths: 5 in, hold, 7 out.

If you think of anxiety as a frightened younger person, a soothing voice (“It’s okay. This will pass”) works better to lower the heart rate and calm the system rather than self-criticism (“Stop being stupid”). Turn down the inner critic and think what you would say to a scared friend.

Make lists: list five things you can see right now in your room. List your favourite TV shows, films or restaurants. Think of things you feel grateful for right now, or good things that happened to you recently.

The following is all true (otherwise you wouldn’t be sitting here reading this), so try saying it to yourself:
 
"All is okay in my world right now."

"I have survived many difficulties."

"Things always work out for me."

and

"This will pass."

Ask yourself what you are really frightened of – maybe write your thoughts in a journal or talk to a friend rather than telling yourself to shut up. Simply being listened to is extremely calming as you will know from therapy. Once you know what’s going on for you, reassure yourself with the reality of the situation; allow yourself to pause and take time out.

There are some things you can do, some you can’t - so focus on what you can do.

I am sure you have already come up with your own ideas on how to get through this. Here are some ideas I’ve heard from other people.

Stay connected online: You can gather in groups on Skype or Zoom. You can share stories and pictures and pieces of information. Some people are doing group yoga or fitness classes, dinner parties and lunches. If you are not tech savvy, now might be the time to gain those skills.

Learn something new: celebrities in lockdown are offering lots of free online lessons. You can learn an instrument (Fender are offering free guitar lessons to the first 10,000 people who sign up), a language; you can write that novel you always meant to write.

Use your imagination: If your mind is becoming adept at creating post-apocalyptic scenarios, it can picture other things, too. Even with a travel ban, you can read books or travel pieces, flick through your old photos, close your eyes and remember your favourite place: imagine you are there.

Don’t do too much: This is also a great time to pause and let go of that command to ‘be productive’. It’s a bit of a survival response – stay busy, don’t think – and can end up feeding your insecurities. Because you will get tired and give up. Carve space to you do nothing much. Stare at the sky or close your eyes and rest. Take time to reflect on what really matters in life or daydream an ideal existence.

"Every man rushes elsewhere into the future because no man has arrived at himself," Michel de Montaigne.

Go outside: You can mediate while walking absorbing and noticing everything you see. You can exercise outdoors, walk your dog or go for a run, join a food queue and listen to one of these free books.

Cultivate your family relationships: You need to respect your home spaces right now. Apply the same ideas above to your close ones. Listen, don’t judge, ask rather than yell, and go for a walk or take a shower if things get too heated. Make a list of what you do love about these people and keep checking it. If someone in your household is particularly toxic, try seeing them as the scared, small child they really are, and don’t let them project their fears into you.

I love Ester Perel’s podcast – she’s a relationship therapist and you get to listen in on other people’s marriages. It’s brilliant. It also reminds us that no relationship is perfect; whatever two people create together is totally and often ingeniously unique.

If you look at the world right now you can see panic and sadness, yes: but also, some amazing positive changes to the environment - for example, the massive drop in Co2 emissions. Here is some good news on goodnewsnetwork.org - we need balance, not black and white thinking.

I’d say every one of my anxious and depressed clients are intelligent and often very creative people – those overactive imaginations of yours need an outlet, your sensitivity is your finely-tuned response to everything around you. You have all experienced something in your past where you learned the world wasn’t a safe place, and triggers will send you right back to that time, making you rigid in your thinking and defended. But you also, throughout your life, adapted to that past trauma. Look at what you have achieved. Even if the past haunts you occasionally, you are okay, you survived.​

There is a possibility, however far away, that may emerge from this kinder and wiser, in a better and more sustainable world. We need to hold onto that belief right now and prepare to make it happen.

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Time to learn new ways of being

3/24/2020

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We’ve all had to make a massive adjustment in the past week in order to stem the tide of the coronavirus. We will all respond differently, processing in our unique ways. There are lots of challenges and our response to some of them will transform us: let’s hope so. We can’t continue the way we have been. We will also mourn our lives before the lockdown; from small, every-day rituals (meeting a friend for a coffee) to more troubling losses (jobs, support such as carers or childcare).

Rather than tell you what to think or do, I can share the ways I have been adjusting to the lockdown and hope to connect with you in our shared strange new world.
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My response to crisis is generally to go into a spin, doing practical things like setting up my home-working situation, reaching out to everyone I know online, and going grocery shopping while trying not to panic buy. (I keep thinking of the cover of the Hitchhiker’s Guide to the Galaxy – DON’T PANIC! in alarming red letters. Perhaps that’s a book we should all be reading now).

At some point, I listened to a meditation that warned against getting caught up in the idea of being productive.  
This is the old way of being, it’s partly why we are in this mess – always consuming and producing for no purpose other than to feed my ego and quiet old wounds. Of course, we do it to pay bills and survive, but it’s not the only way. People throughout time have found different ways of living; it takes effort, creativity, big thinking and courage. And time, which is something we now have.

Right now is the time to pause and take stock: I want to come out of this ideally alive and well, but also newly resourced, equipped to live more sustainably and compassionately and connected to the wider world – and today, this is not just an ideal, but a life and death reality.

Why do I have to feel useful? Why can’t I just ‘be’? What am I avoiding? Fear, of course. Helplessness, uncertainty, disconnection. Yet these are very real things and we live with them every day, let alone in a pandemic.  
I have always been drawn to existentialist and phenomenological philosophies that put forward the theory that the only reality is our experience. Your reality is different from mine, but it is no less true. When I try to experience your experience, I always do it from my own point of view, muddied with my own experiences. I can put my experiences aside to an extent and listen to yours, imagine myself in your shoes. When doing that, when taking time to be with you, I can often feel some deeper connection that makes me feel less alone. This is storytelling; this is counselling; this is friendship and love.   

I’m not talking about your beliefs – that you are unworthy and have to produce good work in order to have value (although I can relate to that), or that you are the greatest person that ever lived (Trump) – but about your experience right now in the present moment. Where are you? What can you see, smell, touch and taste? What does your body feel like? What are the feelings inside you that arise? What are the memories and thoughts, the sensations, the imaginings? What have you learned from your life that matters or helps you right now in this moment? Who inspires you?

There are some great and very accessible spiritual teachers – such as Eckhart Tolle  - who tell us that what we feel and see is all there is: past and future don’t exist. We only have now. And now. And now.

I couldn’t live every minute of every day like this – I love distractions, books, films, conversations too much, even more so right now. But if I feel my anxiety peak and start worrying about the future, which I cannot possibly predict, or if I need to think calmly about a problem, I can stop, breathe and tell myself:

“Everything is okay in my world right now”.

​And if you are reading this, then you are okay, too.  
 
These are things I have turned to this week – some you may like, some not:
Hurry Slowly – A podcast by Jocelyn K. Glei – she’s really smart and wise herself, and talks to other creative, clever people.
Calm – have a free resource page for guided meditations.

Down Dog - the Yoga app is offering freebies. But you can also do yoga classes on You Tube.

Russell Brand on You Tube – he has a touch of the wannabe celebrity prophet, but he is a good mix of the brilliant and humorous and kind – he has lots to say about this situation that you can take or leave, but will not bore you.

Station Eleven – I don’t know anyone who wants to read this book about a flu epidemic (I wonder why...) but for some reason, I can’t get enough of it. Maybe I’ll regret it later. Amazon, for all their faults, are delivering essential items only, but you can still download on Kindle.
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I will keep posting and sharing ideas and inspiration from other people - my best resource right now.
Stay well. 
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Anxiety

2/4/2019

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The key to managing your anxiety is understanding it. This is something we can explore in therapy, as anxiety comes in many forms and is unique to individuals. But there are things you can do to manage your anxiety at home.
 
Regulation

Anxiety is often a sign that we don't feel safe or secure in our lives. It is important to know if this is happening now (ie you are in an abusive relationship) or if it is left over from the past and has been triggered by a recent loss or stress factor. This is very common - we are wired to protect ourselves from future harm and danger - and does not mean you are going mad.
If it is the latter, you can help reassure yourself that you are safe here in the present moment.
You can learn, or re-learn, to self-soothe at any age through repetitive practice and reading. Here are some simple things I recommend you try each day.
  1. ​It will pass. If you are anxious or depressed, it can feel like it's going to last forever. Remember you didn't always feel this way and that you will be okay again. You feel this way for a reason that you may need to process and understand. If you experience emotions that make you feel child-like and overwhelmed, you can say to yourself: I am an adult, I am no longer a child. I am [age]. I have survived a lot worse and I can cope with this situation.
  2. Don't fight it. Mindfulness experts often compare emotions to clouds. Notice how your feelings change and eventually subside. If you try to fight them, or stop them, you can magnify their intensity. You can be curious about your feelings rather than afraid, but if that is too difficult, distraction is a good short term solution: watch TV, read a book, go for a walk or do some yoga if you have a lot of anxious energy.
  3. Mindfulness meditation: studies have shown that just ten minutes practice every day for eight weeks can change your brain. You can find guided meditations online, download phone apps, or on websites such as the NHS or Mind.
  4. Take deep breaths: Breathing deep into your belly and out again slowly. It might feel weird or uncomfortable at first, but it gets easier with practice. Start by counting 3 in and 3 out. When that feels comfortable, count 5 in, hold 2, breathe out 7. It’s the breathing out that slows your heart beat. Do this for two minutes.
  5. Write: If you feel anxious, write down what you are anxious about. Or write a list of things that make you happy, things you still want to do with your life, and what matters most to you. See Write for more writing exercises.
  6. Compassion: Notice when you have critical or judgemental thoughts about yourself. Try and change that to a more compassionate response: imagine for example what you would say to a friend. Being kind to yourself is part of the ability to self-soothe. You can do this through touch, by simply resting your hand on your shoulder.
  7. Ask for help: Anxious people often have low self-worth or are ashamed of being needy. Calling someone you trust when you feel down and being able to share how you feel is a natural and important part of human relationships. If you heard your friend hadn’t called you when they were suffering, how would you feel?
The important thing to remember is that your survival system will still operate if you are calm. Being relaxed does not mean being switched off. In fact, it can mean that you are more alert and focused, and better equipped to respond to real danger rather than reacting to everything and feeling so exhausted you can’t think straight.

Resources

​Apps
headspace.com

sam-app.org.uk

calm.com

insighttimer.com

Reading
Wherever you go, there you are: Mindfulness Meditation for Everyday Life - Jon Kabbat-Zinn

Rewire your Anxious Brain – Catherine Pittman

Reasons to Stay Alive – Matt Haig
​
First We Make the Beast Beautiful – Sarah Wilson

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