Pressing the Pause Button - Managing your psychological wellbeing during the COVID-19 crisis
Pressing The Pause Button
Alistair the Lead for Clinical Psychology Services will be sharing tips and advice to support your psychological wellbeing during COVID-19.
We know that you are playing a vital role in caring for patients with Covid-19 and supporting the running of our hospitals. Yet, looking after ourselves - physically and psychologically - is essential if we are to look after our patients.
Building personal resilience and staying positive are key elements of this. So the plan is to write to you every day, with practical tips and pointers for you to follow to stay well. Each memo will have a short mental health workout, usually via a video clip link.
Over the next few days, we’ll expand more on the tips and pointers identified by each letter in the FACE COVID framework. In the meantime, if you’d like to talk to one of the Clinical Psychology team email us on firstname.lastname@example.org For Children’s CSU staff keep using email@example.com
|FACE COVID’ is a set of practical steps for responding effectively to COVID-19 using the principles of acceptance and commitment therapy (ACT). Here’s a quick summary of the key steps: CLICK HERE|
Workout 1 -This workout introduces you to the FACE COVID framework.
This is a list of very practical steps for managing your psychological well-being during the COVID-19 crisis. Watch this five-minute clip by Russ Harris, a Clinical Psychologist who is a true giant in the world of mindfulness and acceptance and commitment therapy. CLICK HERE
Workout 2 - Focus on what is in our control.
Right now fear and anxiety are inevitable. These are normal responses to the situation we find ourselves in – one that still seems laced with threat and uncertainty.
You will have heard the phrase it’s OK not to be OK, but sometimes, we don’t know how not to be OK or what to actually do about it. So here’s something to try today.
Focus on minimising the energy - the time and effort - we put into trying to deal with things that are out of our control, and re-investing that effort into what we can actually control.
So today’s workout is to pause for a few moments and list the things that are under our influence, right here and now. And then keep doing those to get through your day/evening CLICK HERE
Workout 3 seems simple enough - Acknowledging thoughts and emotions - but it can be tricky as doing this can be a painful or difficult experience. So take a moment to watch this 1-minute clip to get started. CLICK HERE
Now pause and reflect on how you’re thinking and feeling with kindness (as you would with a close friend or relative). Ask yourself the following:
Looking after ourselves is vital in this phase of tackling Covid 19 head on.
Workout 4 - Today’s workout might seem a little strange at first, but bear with me. It’s about Connecting with your body – sort of ‘physical mindfulness’. Take a moment to pause and connect with your body. You’ll find your own way of doing this but here are some suggestions;
The thing is that once you get the hang of it, in later workouts we’ll go through how to put it into practice when you feel stressed or worried.
Workout 5 - Many of you are getting in touch to say how you’re enjoying the mindfulness exercises. Today builds on workout 4 techniques and focuses on engaging in what we’re doing. But before we do, have a look a the clip. CLICK HERE
Now take a few more moments to run through it for yourself - to get a sense of ‘where you are’ before re-focusing on the activity you are doing or are about to.
In this way we are taking control of what we can control. This is overall strategy in coping with the current crisis.
Workout 6 - It seems different teams are at different stages in tackling Covid-19. Some are bearing a heavy burden, others less so, but none the less - extremely busy. So today, I’m hoping the attached image chimes with all of you. Take a moment to engage with it and consider where you feel you and your team are. CLICK HERE
None of us can control what happens on the journey this image conveys. We can’t control what might happen in the future or how the virus might affect us or our families or communities. And it’s utterly normal for us to get lost in our stress - but it’s not useful or helpful. What is - is to control what we can control. And we can control what we do. And what we’re all doing is massively important
Workout 7 - Controlling what we can at the moment, means considering taking Committed Action - the second ‘C’ in our FACE COVID framework. This means the action we take because it’s important and aligns with our core values - even if it does bring up difficult thoughts and feelings.
I wrote yesterday about what we can do right now no matter how small it might be - no matter where we are in the trajectory of tackling Covid-19 - that improves life for others or ourselves. Whatever the answer is, we need to act and engage in that action fully.
I know we’re are all doing this day-in day-out, but today’s mental health workout is to watch this short clip. I hope it helps think about how to take committed action whilst dealing with the difficult feelings and thoughts it might bring up: CLICK HERE
Workout 8 - We’ve received some positive feedback about yesterday’s Committed Action memo. Thank you all so much. This workout develops this idea now and focuses on Opening up. This phase of the FACE COVID framework can take a bit of time to get hold of, so my plan is to stretch this out over the next two or three Pause Buttons.
In this context, opening up means making room for difficult feelings and being kind to ourselves. Upsetting or stressful thoughts and feelings are going to keep showing up as we move towards the recovery phase of this crisis: fear, anxiety, anger, and so on. Remember we can’t stop them from arising - they are normal – and they’re going to flow whether we like it or not. But we can open up and make room for them: acknowledge they are normal, let them to be there (even though they hurt) and treat ourselves with kindness.
Watch the clip to start with - it’s called ‘the struggle switch’. CLICK HERE
Doing this whilst being kind to ourselves is essential - especially in our carers roles. We’ll do a whole lot better at looking after others if we’re also taking care of ourselves.
So ask yourself - ‘if someone I loved was going through the experience I am, feeling what I am feeling; if I wanted to be kind and caring towards them, how would I treat them? What might I say to them? Then try treating yourself the same way.
Workout 9 - In the FACE COVID framework V is for Values. Committed action and uncoupling from unhelpful thoughts and feelings should be guided by your core values - what do you want to stand for in the face of this crisis? What sort of person do you want to be as you go through this? How do you want to treat yourself and others? Your personal values might include love, respect, humour, courage, honesty, caring openness, kindness or numerous others. Look for ways to get through your day according to your values. Let them guide and motivate your committed action.
Before reading on please watch the clip. CLICK HERE
So as this crisis unfolds there will be all sorts of obstacles; goals we can’t achieve, things we can’t do, problems for which there are no simple solutions. But rather than live by struggling trying to achieve goals we can still live and work by our values in lots of different ways.
Workout 10 - Before we finish off the FACE COVID framework, today’s mental health workout acts as a refresher of the mindfulness coping strategies we’ve covered so far.
It focuses the exercises we have covered on preparing to leave home to come on to a shift or starting a day’s work, as well as keeping hope throughout.
This clip is a little longer than usual (about 6 minutes), but it’s well worth it. So when you can, take some time and have a look at it. CLICK HERE
If you like, give the workout a go tomorrow before your shift or day ahead.
As we all consider recovering our work activity, we face the prospects of living with new normal ways of working for some time. Maintaining a positive outlook and utilising psychological coping strategies are going to be important to get us through.
Workout 11 - The final elements of our FACE COVID framework are about Identifying resources and keeping our Distance. These don’t immediately lend themselves to interactive video clips but they are still really important to cover.
Identify resources for help, support and advice. This not only relates to our own needs, but to those of colleagues, friends, family and neighbours. The Trust Health & Wellbeing group have compiled a huge range of resources for all kinds of support and you can access them all here. NHSE have also a super range of different kinds of support too.
There are concerns that staff are as likely to get Covid-19 from other colleagues as they are from patients. Distancing at work is going to be really important as we all start to plan re-starting activities that ceased over the past few weeks. So the final FACE COVID workout is to watch this clip. It’ll be familiar to many of you by now but it seems a fitting end to the framework. CLICK HERE
The next few ‘Pause Buttons’ will focus on developing psychological coping skills and self-soothing. We’ll also have some pretty good Apps to share with you along the way too.
Workout 12 - Today we’re going to start moving on to consider how we physically respond to threat.
We often think we know all about the symptoms of anxiety, but more often - we don’t really understand why these feelings can overwhelm us.
Today’s mental health workout is to watch this short video that talks about the fight, flight and freeze (FFF) responses; CLICK HERE
You may feel that your threat system is constantly ‘switched on’ at the moment as you face the challenges of treating Covid patients or the prospects of re-entering the workplace in the ‘new’ and uncertain normal. It might be switched on at home as your think about work, or how Covid-19 is affecting you and your family. Although this is very normal, it can make looking after ourselves and others more difficult.
Understanding our FFF responses is the first step in taking control of those responses. Remember, let’s take control over what we can control. Whilst we can’t completely switch off our threat system, we will be introducing different techniques and strategies to help calm and soothe it.
Workout 13 - Yesterday we covered the physiological changes that occur from our threat system becoming activated. Today’s workout is about finding ways to release this stress by relaxing our body. If we feel physically relaxed, this can lead to a sense of calmness too.
In normal times, breathing is unconscious but we often struggle to notice how our breathing changes when stresses or anxious. There is a lot of focus on how we’re breathing at the moment, with us maybe ‘over-focusing’ on the warning signs of the virus.
So, right now (or when you can) take a couple of undisturbed minutes to close your eyes and focus on slowing your breath right down. I’d like you to;
Repeat this a few times and notice how you feel afterwards.
If you have more time, or are at home, you might like to listen to this slightly longer clip, which guides you through a technique called Progressive Muscle Relaxation. If you like you can make it a family affair and get partners and kids involved too. There are plenty of these around, but this one has been reviewed by the team and we really like it…CLICK HERE
Workout 14 - In the last two workouts we’ve focused on the physical and psychological benefits that come from slowing our breathing down and taking the time to relax our bodies. We’re taking you through this to build skills in dealing with any threat system symptoms.
Today’s workout is the final part of this and gets us thinking about exercise. There’s been lots about this but with the modest relaxation of the lockdown rules, there is now a new opportunity to exercise outdoors more than once a day. Whilst social distancing will continue to make it harder for us, the psychological and cognitive benefits of exercising are going to be so important in helping us deal with the long second phase of tackling COVID-19.
There’s lots of free exercise and yoga tutorials available online that you could follow. But even if that’s not for you, exercise also comes in lots of different and unexpected forms, for example, dancing, housework, gardening, playing with the kids/dog - all help.
Workout 15 - Today’s workout returns to the ‘V for Values’ in the FACE COVID framework and to consider how we use these in the next phase of looking after patients and re-starting activity and care that has been affected by the crisis.
Our values are ‘what we want to stand for in life, how we want to behave, what sort of person we want to be’. Have a look at the clip again as a refresher: CLICK HERE
Now, today’s exercise is to identify our values. Mark those below with a V = “Very important to me”; I = “Important to me”; N = “Not important to me”. If it helps, imagine that a dinner is being held in your honour. How would you like to be described?
Those that you mark as ‘important’ or ‘very important’ are your values. And living our lives in accordance with our values influences how we approach stressful and difficult work challenges. It ties in with us taking control of what we can
Workout 16 - Hopefully you’ll be starting to get to grips with the foundations of acceptance and commitment therapy (ACT) and acting in accordance with our values.
We hope you managed to identify some of your own values yesterday. It did take a little longer than usual - so don’t worry if you didn’t get time. Try it when you can.
In the past we have also focused on ‘accepting’ and living with unpleasant thoughts and feelings as we act in line with those values and focus on what we can control.
Today’s mental health workout is another refresher on unhooking ourselves from distressing thoughts or worries.
Have a look at this clip. It features Russ Harris in person – the bloke whose voice you’ve been mostly listening to in the clips we’ve shared over the past few weeks. He’s a former Dr but now internationally recognised as a leading light in ACT. He’s a particular hero of ours not least as he puts all his teaching materials on line for free. CLICK HERE
Workout 17 - OK it’s time to try to bring together the elements of our last two workouts (living by our values and unhooking from troubling thoughts/feelings), and towards the how we want to be at work and the life we want to live.
Today’s mental health workout is called ‘the Choice Point’. Here’s Russ Harris again doing a brilliant job of explaining how these two factors come together to help us choose actions that lead us towards our goals. CLICK HERE
In Phase 2 of taking-on Covid-19, we are going to continue to be challenged, physically and psychologically, potentially over a longer period time. in the next workout we will consider how we can keep our motivation going throughout.
There are tricky concepts to hold onto, and so do get in touch with us if you have any questions about them, or to talk to us about anything or arrange a 1-1 with one of the team. Every conversation you bring is important to us and no issue is too small to bring up.
Workout 18 - From all your correspondence it feels like the prospect that Covid-19 is with us for the foreseeable future is starting to hit home. In the ‘marathon’ analogy, it’s like we’re at the point of having completed the first 10K, and feeling a bit exhausted with the realisation there’s another 30K to go!
This point can seem daunting and what we need to be alert for is signs of demoralisation and hopelessness setting in. The mindfulness and ACT techniques we’ve been working on together can really help.
And whilst it would be lovely to practice them facing a pile of pebbles and a sunrise, being mindful is about taking the moments we can in the situations we find ourselves - in a busy hospital in Leeds, looking after sick people in challenging circumstances, as well as looking after ourselves and our families.
But remember looking after ourselves is one of the things we can take some control over. Take breaks and rest during a shift. Actually take some annual leave (rather than save it all up in the hope that we’ll have a proper holiday), to rest, recharge and do some of the things that really matter to us away from work.
Today’s refreshing mental health workout is to really consider how you’re going to rest and take a break. Talk to you manager to arrange it. Talk to one of our Team too if you like. And if we can’t convince you, then hopefully one last clip on motivation from our man, Russ Harris might. CLICK HERE
Workout 19 - In the last workout we talked about fatigue setting-in as we contemplate the next lengthy phase dealing with Covid. As we said, rests and breaks and annual leave are going to be vital in building resilience, but we can still expect to feel more worried and stressed at times.
When we notice we are worrying we might observe ‘what if’ thoughts – “what if something bad happens?” “What if someone I care about becomes unwell?” “What if my patient doesn’t make it through?” There will be many unknowns at the moment, so worries like these are to be expected, even although they are unwelcome. One can lead to another and another until it can quickly feel overwhelming or catastrophic.
In past Pause Buttons, we’ve considered ways in which we can make room for the difficult feelings these worries may bring – observing and acknowledging them, but breathing around them and letting them pass. Today’s workout is to get familiar with the Worry Tree. This guides you through a decision-making process that starts with asking - are these thoughts within our control? can we do something about it right now? - and so on…CLICK HERE
Workout 20 - In the last workout we spoke about trying to contain difficult thoughts or concerns. Previously we have focused on how easy it can be to become tangled up in these, and we introduced different strategies to help you to allow these experiences to just ‘be there’, by opening-up to them and using mindfulness to help tolerate them (the ‘Opening-up’ workout is a good refresher). Today we wanted to build on this further by introducing the Beach Ball.
In the picture you’ll see a person with a beach ball. Try to imagine that it represents all the difficult, uncomfortable and painful thoughts and feelings you may have coped with so far. Even though it’s human nature to want to push these away, doing so is like trying to hold the beach ball under water. Not only does it takes huge amounts of energy and effort, it also stops us from being able to enjoy the water, see the rest of the beach, do the things we enjoy there, and engage. CLICK HERE
Can we find a way to let the beach ball, and all it represents be with us even if we don’t like or want it?
Can we drop the struggle and re-focus our attention on doing things that are truly important to us despite the discomfort?
Think of just one thing you can let be with you today, rather than struggle with it.
Workout 21 - Over the past couple of workouts we have spent a bit of time considering how to cope with difficult thoughts and feelings as we come to work.
We’ve particularly concentrated on metaphors to help reframe these and allow them to be alongside us, dropping the struggle to get rid of them, whilst we focus on what we have to do today, at home or work, or both.
Today, our refreshing workout is about mindfulness itself. There are many myths about it and this clip explains these. We hope it will also start to pull together how the techniques we’ve introduced to you are in some ways, all part of ‘being mindful’.
Many of you have been in touch to say how much you’ve been enjoying the way Russ Harris explains these concepts in his videos. So you’ll be pleased to hear that this is another CLICK HERE
Workout 22 - Hello everyone, if you’ve been following the exercises over the past few days, we’re hoping you will be coming round to the idea that mindfulness is only one aspect of dealing with stress. Yesterday we spoke of what mindfulness actually is and dispelled a few myths about what it’s not. It is more than relaxation or meditation but does incorporate some or both of those elements.
Today we want to share a clip with you about what meditation actually is. Then tomorrow we’ll start to look at relaxation as we build up a range of tips and techniques you can use. The idea is that you can then choose from a ‘menu’ of ideas, rather than everything being for everyone. CLICK HERE
So, back to meditation… Don’t be put off by the word ‘meditation’ and take a look - it’ll only take a minute or so. Go on – you know you want to…
Workout 23 - Hello everyone, thank you all so much for your lovely feedback on the Pause Button. When we hear that you are finding the techniques useful and putting them into practice, it really makes it feel very worthwhile.
We are hearing - loud and clear - that with the lockdown being lifted the outside world feels busier. And together with the hospital getting busier and the planning around us recovering our activity, there is a real increase in the stress levels. It almost feels like we’re facing a new set of uncertainties, different to those we experienced in the first ‘crisis’ phase.
Mindfulness, meditation and relaxation are the three groups of skills we’ve been focusing to help us deal with this. These techniques are proven to be effective in dealing with unpleasant, unwanted or upsetting thoughts and feelings. Over the last couple of days we’ve dispelled some myths about mindfulness and meditation, and today’s focus is on relaxation – in particular - progressive muscle relaxation.
Today's clip aims to show how to recognise tension and then release it. It’s particularly good if we experience the physical symptoms of tension or our ‘threat systems’ being activated to the extent that there are feelings of anxiety.
So, this exercise takes you through a progressive muscle relaxation session. It is a little longer – 6 minutes – and yes… it’s full of Tingsha bells and gentle breezes, but the content is accurate and pretty easy to follow. So take a moment away from your workplace and give it a go or save it until your day is done. CLICK HERE
Next week will build on these skills and focus on different ways of being mindful, relaxing, meditating and self-soothing.
Workout 24 - Today we press our own pause button on mindfulness and relaxation techniques. Before continuing our development of these skills and how to apply them to stress as the lockdown lifts, today we invite you to focus on what it is that contributes to us not feeling safe about venturing out again or re-starting parts of our old lives.
The media often refer to Covid as an ‘invisible killer’ - one that we can’t see. When it strikes, there is no immediate treatment. As we take all this in, it’s no surprise that we can be frightened of going out or returning to the workplace, etc. Our threat system is designed to ensure we’re safe, but the problem seems to be that we perceive we are no longer as safe as we once were. However, there have always been risks to our safety; we’ve never been 100% safe, but somehow we felt ‘safe enough’ to go about our business. And so to increase our confidence as we move forward (following all the guidance on social distancing and hygiene), we need to balance our perception of risk. When we contemplate how much risk we face from Covid, we must also try to tune-in to information that counter-balances the risks.
Have a look at this article on the BBC Health webpages, which explains things more clearly. CLICK HERE FOR BBC ARTICLE
Then take another look at Russ Harris’ clip on threat systems. CLICK HERE FOR RUSS HARRIS CLIP
Tomorrow and for the rest of the week, we return to relaxation techniques, which we hope will be useful in coping with any stress and anxiety. But as we do, it will also help to hold in mind the information that keeps our worries in perspective.
Workout 25 - In this workout we return to mindfulness and relaxation exercises.
Walking is a great form of exercise something we do every day (particularly under lockdown). Yet, more often than not we walk from one place to the next without noticing how we got there. Does this image chime at all?
Walking mindfully is taking our walk whilst staying in the present moment, through connecting with our bodies and the environment around us.
So today our refreshing exercise really is ‘refreshing exercise’ - as we’ll be taking a ‘mindful’ walk.
This can be done anywhere, for any length of time. It doesn’t even have to be outside!
But before you start, pick where you’re going to go. Start by taking a few slow breaths in and out notice the air come in and out of your body. Focus on the sensation of walking, notice your feet contacting with the ground one by one.
As you start to notice this allow your mind to explore other senses. What can you see? What can you smell? What can you hear? What can you feel?
If it helps, then this clip takes you through a series of prompts to consider whilst you walk (make sure you skip the ad at the start!) CLICK HERE
Let us know what you think of this and the other mindful/relaxation techniques we’ll be introducing over the next few days. The more feedback and direction you can give us, the more closely we’ll be able to ‘hit the spot’
Workout 26 - Continuing with this week’s focus on being mindful and relaxing, today we’ve come up with some suggestions on how to relax in short bursts – on the hoof, as it were – in the situations we find ourselves. There are very simple things that we can do. And the most effective involve our five senses. You’re likely to already have your own favourite, ‘go-to’ source of comfort, however, today and tomorrow we’ll suggest some broad ways we’ve come up with to engage each sense.
TOUCH - our skin is the largest organ in our bodies - and with it being super sensitive to external stimulus, it makes ‘touch’ a powerful tool in our ability to relax and unwind. Water is one of the ways that we can feel instant relief - soaking in a warm bath or going for a swim – might not be instantly accessible but we can achieve a similar sense of warm touch by sitting outside in the warmth of the sun or changing into your most comfortable clothes.
TASTE - while it's best not to try to use food for comfort all the time, there is a lot to be said about its’ effects on our mood. Rather than turning to junk food, try sucking on a hard sweet or sipping a cup of soothing herbal tea. You may also find ease in a comforting meal.
SMELL - There are many ways you can take advantage of soothing scents. Browsing a flower shop or spending time literally "smelling the roses" in a garden can lift our mood. Aromatherapy oils, or a favourite hand cream or simply stepping outside and taking in some fresh air can provide instant relief.
Remember… if you would like to have a 1-1 staff support session with one of the Team, our email addresses are firstname.lastname@example.org and email@example.com for Children’s staff.
Workout 27 - Today we finish off our ideas for short relaxation exercises by engaging our senses; and today it’s sight and sound to calm, and comfort ourselves.
SIGHT - Distraction is a good thing, particularly when our minds are stuck on our stress, or worries. Distracting ourselves visually can be as simple as finding something interesting or amusing on our social media feeds to look at. However, the more cognitively interactive the vision, the more distracting and relaxing it will be. Try to reflect on happy times or hopes and dreams. Try to relive moments and really cherish what you recall. You might want to look through pictures - loved ones, or a happy holiday. Try not to just glance through and swipe on. Look at them mindfully, recall the scene and people, how you felt, what happened before and after, or what emotions it conjures up . If this doesn’t work, you can always daydream… places you want to go, or even just look around for things that make you smile.
SOUND - Our sense of sound is just as effective as the rest of our senses in setting up a positive emotional state. No matter where we are, we can feel these effects by listening to our favourite music or singing to ourselves. We can even try saying positive statements to ourselves – sort of verbal self-encouragement.
The idea behind us invoking our senses is to create as many techniques as we can to have at our disposal, and practice when we’re experiencing distress. If you try any of these ideas or come up with your own do let us know via email. We’ve already had some feedback that the hand cream idea seems to work.
Remember, whatever impact Covid has had on us, it can’t cancel Spring. Try to mindfully enjoy what you can of the lovely weather. Focus on enjoying who you’re with and where you are, or what you’re eating and drinking. Say to yourself ‘no matter what else is going on, just for this moment I’m going to enjoy this…’
Workout 28 - In workout 24 we focused on our threat system. You might remember this system aims to ensure we’re safe.
This weekend, we’ve all hopefully enjoyed some sunshine and new freedoms, yet we continue to feel we’re not as safe as we were. Remember though, there have always been risks to our safety. We’ve never been 100% safe, but somehow in the past we felt ‘safe enough’ to go about our business. With the recovery phase rollercoaster ride set to continue for some time, we are likely to feel the ‘threat in the air’ as we move on.
Our ‘threat system’ fits into a simple model of our emotion system called the ‘3 Circles’. We like this a lot and have used it in our staff 1-1 support sessions. People have been really positive about it. So we wanted to share it more widely. It’s a great way of making sense of the ‘rollercoaster’ and how we’re feeling, as well as finding ways to bring some balance back into our lives.
So today’s mental health workout is to take a look at the 3 Circles Model in this clip. It’s a really clear explanation of the model; CLICK HERE
We’ll go through more of this during the week, so do get in touch if you want to ask any questions or talk more about it. Remember too, if there’s anything that’s bothering you, email us. One of the Team would get back to you pretty quickly. The emails remain the same;
Workout 29 - Yesterday we focused on the ‘threat’ system from the 3 Circles Framework of our emotions. The two other systems in this model are in the illustration below. All 3 are present at the same time, but in different amounts.
If you’ve been feeling a sense of threat recently this is currently your biggest circle. This means you’re having a very normal and ‘automatic’ human response to things, but one that can be unpleasant and upsetting. It’s also a sign that we need to take extra care of ourselves as living in ‘threat’ mode can be exhausting and leaves us open to feeling more stressed.
So what can we do? Over the past weeks we’ve introduced a range of calming exercises, including mindfulness and relaxation. Today’s workout is to go back to some of these. Choose one or two that you found particularly useful and go back over them.
In the 3 Circles Model, you have already started to activate your Soothing System (Green). Inviting other systems in helps bring balance to the system and regulate the sense of threat.
We’ll be going through the Dynamic and Soothing systems over the next few sessions and show how these link together.
Workout 30 - We hope you’re becoming more familiar with the ‘3 Circles Model’. We think it links well with many of the ideas and exercises we’ve introduced in previous Pause Buttons.
For the rest of the week we’re going to think a bit more about bringing balance to our systems. Today, we’re going to focus on the Drive System (the Blue Circle) (yesterday this was also referred to as the Dynamic System).
This system can bring positive emotions linked to achievement, pleasure, fun, motivation and reward.
Sometimes though, our Drive System can also be fuelled by threat and it’s true to say that threat based drive’ has dominated both at work and home recently. This, along with less access to things we enjoy that would normally trigger ‘positive drive’ is exhausting!
So today we’re inviting you to start to take steps towards re-balancing and re-fuelling your ‘Blue Circle’. Engaging in activities that stimulate our Drive System in a positive way can be fantastic way of helping us re-charge and re-connect with things that are important to us that may have had to take a back seat. This can really help bring some balance at times of ongoing threat.
So you might want to try:
Workout 31 - Hello everyone. We hope you’re getting to grips with the ‘3 Circles’. Following on from yesterday, we’re now going to focus on strengthening our ‘green’ Soothing System. The ‘Green’ system is vital to help turn-down or turn-off, our ‘threat’ system emotions.
Today’s exercise is to have a think about things that help bring a sense of being at peace, calm, contentment and soothing. Examples might be listening to soothing music, doing mindfulness or relaxation exercises, walking or sitting in nature, etc.
These can be really simple things, but it’s the planning and doing them that’s important here. So try to plan and do something every day, no matter how small. Remember all the mindfulness and relaxation exercises from last week? Take another look - mindfulness is a fantastic way of activating our Soothing System.
And here’s a new exercise too. It’s a really nice mix of connecting with the mind and body (which is unsurprising as the tutor is both a clinical psychologist and a yoga instructor). It’s a bit different from the other ones but it’s quick, and so a fantastic ‘go-to’ exercise for self-soothing. CLICK HERE
It’s been so great to hear from you. We’ve been particularly encouraged by the ways you’ve been using the techniques. In fact, we want to write a PB that focuses on examples of how you’re putting these into practice. So really – you’ll be doing the writing! Tell us about exercises you’ve found particularly helpful or the ones that aren’t so good via the usual emails; firstname.lastname@example.org and email@example.com for Children’s CSU.
Workout 32 - Hello everyone, today is our last look at the 3 Circles Model. Feedback from people attending our staff support drop-ins has been that illustration below was helpful as a ‘mental check in’- working out how our circles are looking and what we can do to bring balance. Today’s theme is connection - this is really important in stimulating our Soothing System.
Connecting with others is trickier with social distancing, busy lives and new demands. We’re all having to be more creative in how we connect. Faces and voices work better than texting at stimulating our Soothing System and so when we can’t meet face-to-face, video and telephone calls are pretty good. But it’s easy for our minds to be distracted. So however we’re trying to connect with people, try to focus on being ‘fully present’ with them - being ‘in the moment’ with them, using mindfulness techniques.
Connecting with nature or the world around us is really useful too. There’s loads of research showing the positive effects of this on our wellbeing. This really stimulates our ‘Green Circle’ and is even more important during stressful times. It’s another fantastic ‘go to’ strategy at the moment, particularly as we might not feel as connected to others as we once were.
So our final refreshing mental health workout of the week is to try these online nature resources. We hope you’ll like them as much as we do.
If you feel on your own with your worries or stresses, please do get in touch. We’d love to listen and help out.
Workout 33 - Last week we finished explaining the 3 Circles Model with a focus on feeling connected and being ‘fully present in the moment’ when we’re with people who are important to us. We’ve covered this quite a bit in previous PBs but a central theme in mindfulness is the repetition of 'bringing our attention back' to what is important and in line with our values (remember those too?).
So this week’s theme is called ‘Mindfulness Happens Here’. Have a look at this image.
It’s not wrong to be ‘in’ the past or future. Of course we need to plan ahead or process what’s happened to us. But living in the past or dwelling on the future too much can leave us feeling overwhelmed and anxious. And so to balance this out we need to take a break from it and focus on the importance of being ‘in the present moment’.
There’s no clip today - plenty of those coming up later in the week. Instead today’s workout is simply to notice when you’re ‘time-travelling’ and spending too much time in either the past or the future. Slowly bring your thoughts back to where you are. Connect with the present and what you’re doing and take control of what you can.
Workout 34 - Continuing with our ‘Mindfulness Happens Here’ theme could not be more timely. Every day we get lots of confusing messages about how lifting the lockdown will affect us and our families; at work, at home, at school. Should I go on holiday? Should I send my kids to school? Did that coughing bloke in the supermarket have Covid? More and more people are out and about. We’re going to start wearing masks in the hospital. If we focus too much on this stuff, it can really build up our stresses and worries.
These aren’t just going to go away. So we have to find a way of letting unpleasant thoughts and worries be present without struggling with them. Today’s exercise takes us back to a Russ Harris clip and something he calls the Struggle Switch; take a moment and have a look; CLICK HERE
‘Focusing on the present’ – ‘being in the moment’ - and taking control of what we can – is a really effective way of coping. Let’s try to put our energy into taking control of what we can ‘in the present moment’ – truly being with our families online, being with patients in the hospital, completing that business case you’ve got to write, going for a walk, and so on... It is going to be okay. We can deal with anxiety and distress. We just need to learn some new ways of doing it.
Please don’t feel alone with your worries or stress - and don’t think twice about getting in touch with us on our usual emails; firstname.lastname@example.org and email@example.com for Children’s CSU.
Workout 35 - This week’s ‘Mindfulness Happens Here’ theme has returned us to being in the present moment whilst dealing with unpleasant thoughts and feelings.
Yesterday we focused on not struggling with them and letting them be present. But if it was that easy to do, we’d have done it already - right?
And so we need some tools to help us. We’ve shared a lot of the ones we find useful in our work with patients and parents who are living with chronic conditions. There is particularly strong evidence for these being effective in people who have chronic pain. So for the rest of the week our exercises will go back over these techniques.
Today’s mental health work out is to look at one of our favourite clips on this – the Sushi Train. Take a moment and have a look…CLICK HERE
So remember, as you go through your days and weeks, let unpleasant thoughts and feelings circle round, don’t pick up on them unless you have to.
And don’t believe everything you think!
Workout 36 - Hopefully you’re getting the gist that being in the present moment requires a bit of work to let go of the struggle with unpleasant thoughts and feelings or things we can’t control.
As promised, this week we’re focusing on the techniques that might make this task a little easier and make more sense. Some of you have been in touch to tell us how you’re using the ideas, and it’s so encouraging for us to hear. Thank you for this. You know… the thing is, as we learn new skills, is not to expect to get it right straight away. So hopefully a bit of repetition and different ways of conveying the same thing, will develop our understanding and confidence in putting them into practice. We particularly loved to hear that some of you are sending the emails home to practice once the day is done.
Anyway, on with today’s mental health workout… it’s a variation on yesterday’s – called ‘Leaves on a Stream’. It builds on the understanding that we can be selective about the thoughts and feelings we attend to, by actually talking you through doing it – with a lovely lilting voice-over. It’s not long - about 3 minutes – but probably not one to be done on the hoof. Send it home, or get the headphones on and watch during your break. CLICK HERE
Workout 37 - It might feel even harder to be in the present moment, mindfully, when it’s dank and grey and ‘rodding it’ down outside. But that’s the skill. Being present does not require us to face a beautiful sunset, with little around to upset us. It is about being able to connect to the present moment in the situations we find ourselves. Have you ever watched a toddler eat an ice-cream? They don’t care if it’s smeared all over their face or if they’re getting soaked in the rain. The look of pure enjoyment on their face for me captures the essence of mindfulness; of truly being in the present moment.
But as always, Russ Harris explains it better than we can. So our last workout of the week is to watch another of his clips. Just to keep things fresh, there’s a bonus multiple-choice question on it at the end…CLICK HERE
The definition of mindfulness is;
We’ll be sure to give you the answer on Monday, but for now - be mindful in the moments you find yourself over the weekend. Don’t hesitate to contact us with any questions or worries you might have firstname.lastname@example.org and email@example.com for Children’s CSU.
Workout 38 - The answer to Friday’s quiz was of course, all 4 definitions are correct. Living in the present moment, despite anxiety or unwanted thoughts and feelings, is the first major goal of Acceptance and Commitment Therapy (ACT).
We use this kind of therapy a lot in our work with patients and families. We like it because it’s effective. And one of the reasons it’s effective is because it quickly makes sense to people. If there were an ACT motto, it would be something like…
“Embrace your demons, and follow your heart”
(Russ Harris, 2007)
Over the past week or so we’ve been slowly introducing the first ACT goal by focusing on living in the present moment and sharing tips and ideas on how to do this, rather than fight against unpleasant thoughts and feelings.
Remember ‘acceptance’ it’s not about giving in. It’s about letting go of struggling with it. And although today’s workout is another recap of this central idea, we’ve saved best ‘til last. It’s one of the most commonly used and useful ACT metaphors for ‘letting go’ - called the ‘Unwanted Party Guest’. Have a look…CLICK HERE
For the rest of the week we’ll start concentrating on the second ACT goal again - taking committed action towards living our life in accordance with our values.
Workout 39 - Today we return to an important goal and coping strategy - living our life in accordance with our values.
Our values are what kind of person we want to be and what we want to do with our time. I was taught an easy way to think about values as being ‘describing-how-we-do’ words (adverbs); generously, honestly, adventurously and so on…
Whilst our values can motivate us (e.g., choosing the jobs we want do), they also guide our actions and behaviour. This really helps us to ‘live-in’ and enjoy, the present moments. Today’s workout is in 2 very quick parts - about 5 minutes in total.
Part 1 is to go back to the ‘V is for Values’ clip for a refresher - CLICK HERE
Part 2 is then to look back at Workout 15 above and identify some of your own values.
When we are anxious or fearful, we sometimes avoid those things, rather than tackle them or let them just be with us. There’s a lot of anxiety around about coming back into work in the hospital after a long period working from home or self-isolating. Concentrating on our values and then acting in alignment with them, helps us remember what’s important to us, for example, about our jobs, and what we can actually take control of in our daily lives.
Workout 40 - I hope you had a chance to look at yesterday’s clip on our values.
To recap, these are not handed down to us by our parents or elderly relatives, telling us how we should act or behave. Nor are they about things we feel we 'should do' or 'must do'. Our values are so personal to us. They are the qualities that we feel are really important, the kind of person we would like to be. They motivate us in doing what we want to do with our time and guide our actions and behaviour. They give us our sense of purpose.
Believe it or not, a 'values-led' approach has been written to help people stuck in refugee camps in Syria and Uganda often for very long periods - years even! And it's proved really useful.
Today's refreshing mental health workout is simply to watch this short clip by an American comedian Michael Jr. We feel it beautifully illustrates quite simply, how things are different when we act in accordance with our values. As Michael Jr puts it – when we know our "WHY" (our purpose/values), our "WHAT" (our actions) has more impact.
It really is well worth a watch - and one of our favourites from training courses. We hope you enjoy it. CLICK HERE
Always remember - if you would like to talk things through or ask any questions, email us on firstname.lastname@example.org And for Children’s Hospital staff – it’s email@example.com
Workout 41 - We've been thinking a lot about how to develop the idea of values – the qualities which are really important to us and which guide how we want to be in life - and in particular how they pop up in our daily lives.
Values bring energy and direction but they also bring up feelings – they’re two sides of the same coin – and we can't have one without the other.
For example, we feel:
The only way to solve this is abandon the value or live with the feelings. Here’s a couple of examples:
Russ Harris, the guy whose video clips we’ve been sharing, actually doesn’t like being interviewed. He gets a full range of anxiety symptoms before and during them. However, he makes room for those feelings and accepts them, as his values drive him to sharing his ideas and materials freely, to as many people as possible.
Two of my values are ‘helpful’ and ‘useful’ (not that my line manager would agree maybe…), but not physically being in the hospital as much recently, and not being part of the front line, leaves me feeling a bit guilty. I live with this feeling by putting the energy into writing this memo everyday – controlling what I can control.
‘In our discomfort we find our values, and in our values we find our discomfort’. And so today’s workout tries to help tap into this. During the course of your day, when you are having a difficult/unpleasant feeling or thought, ask yourself:
"What does this feeling/thought tell me about what is important to me?"
If you haven’t done it already, on a blank piece of paper, write down a list of your values as they occur to you. Try to write them as an adverb - a description of how you want to be seen to be doing things (a handy tip is that the word could end in ‘ly’ - honestly, compassionately, helpfully, and so on…)
If you have any questions about this, or would like to talk about anything, email us on firstname.lastname@example.org , and for Children’s Hospital staff it’s: email@example.com
Workout 42 - It’s our last look at values for now. Over the last few days we’ve focused on how values are different from goals. A goal can be finished, ticked-off the list. A value is never finished. If we value our health, we don't eat an apple then call it a day. It’s an ‘apple a day’ forever. So in the same way, we can always keep moving in line with our values.
Today’s workout is to look back at the ‘Choice Point’, how we can avoid some of the things we are frightened of, that aren’t in line with our values. But the clip also shows how any action we take can move us in the direction of our values. CLICK HERE
Did you manage to write down some values yesterday? If so - great! Keep that piece of paper it in your pocket or bag and carry your values around with you. If you didn’t, have a go. If it helps - here’s a list of 50 of the most common values to choose from. CLICK HERE
Workout 43 - This week we’re moving away from mindfulness and ACT approaches to coping with unpleasant thoughts and feelings. Instead we thought we would try to debunk a few myths about mental health and focus on what is actually involved in taking first steps into talking about things.
Today’s mental health workout is simply to take a few moments to digest this list:
Often, taking the first step into a talking therapy is the hardest step. There’s still a lot of misconceptions about talking to a professional. And whilst getting over the threshold initially is always a unique experience, people often say at the end “that wasn’t as bad as I thought”.
Workout 44 - Talking about psychological problems with a professional is one thing, but what about when people we care about or work with start to talk? Often what they need is ‘a good listening to.’ Being a good listener is both passive (sitting silently), and active (responding carefully). Doing this keeps the focus on the issues the person has raised.
Today’s exercise follows on from yesterday’s. Simply take a few moments out of your busy schedule to digest this list of things that are important in a good talk.
f someone has taken that initial step to talk about their problems, it’s important we try to make it as positive an experience as possible. That’s what a psychologist aims to achieve when starting therapy – that Conversation #1 leaves the person feeling ‘listened to, valued, and supported’, so they come back and have Conversation #2.
Remember if you would like to have Conversation #1 with one of the team, don’t hesitate to get in touch with us; firstname.lastname@example.org and for Children’s staff – it’s email@example.com
Workout 45 - Being a good listener is both passive and active. Passive listening is remaining silent after you’ve asked someone a question. Sounds easy right? But it’s harder than you think. When you’re listening to someone today, try to count to 10 and literally after you’ve asked them a question. See how long you can last before you break the silence. Remember whilst you may feel the awkwardness, the other person probably won’t as they ‘think’, ‘feel’ and decide how to respond.
Being silent is a great start in becoming a good listener. How we respond is ‘active’ listening. Have a quick look at this clip, which has 6 tips on active listening responses and a handy factsheet: CLICK HERE
If you would like to experience some active listening and empathy, have a chat with one of the team, don’t hesitate to get in touch with us at the usual email addresses firstname.lastname@example.org and email@example.com for Children’s CSU.
Workout 46 - Hopefully you’re getting the hang of some of the key skills in listening to, and understanding, people. Using reflective questioning wasn’t included in the 6 tips from yesterday, however these are really effective, and we’ll focus on these today.
Reflective listening is a bit like a “checking-out” process. It’s like saying back what someone has said but using our own words. This style of responding shows that we’ve heard the person and tried to understand what they’re saying.
The reflection allows the person to agree or disagree that we’ve understood them accurately. Whether they do or they don’t, the conversation nearly always develops as the speaker feels ‘heard’ and goes on to say more or will correct our error in understanding. Reflective listening is useful in so many situations, but particularly when a friend, relative or colleague is experiencing a difficulty or problem.
Today’s workout is just to watch this light-hearted clip of reflecting and active listening in action. It’s taken from the series ‘Everybody Loves Ray’ and shows off Ray’s active listening skills he’s just learned on a parenting course. CLICK HERE
If you would like to experience some active listening have a chat with one of the team. Don’t hesitate to get in touch with us
Workout 47 - We hope you have enjoyed our focus on active listening skills. Being listened to empathically can be a really powerful emotional experience – one that is often more positive than people initially fear.
The active listening skills we’ve shared with you this week are our ways of getting conversations going. As clinical psychologists, on top of good active listening skills, we have 3/4-year training in the basic science of psychology before training for a further 3 years in psychological therapies. There’s no magic or mystique in what we do. And no - we don’t ‘analyse people from how they’re holding their coffee cup’. Psychological talking therapies develop conversations, use the basic science of psychology to understand and explain problems, and then use psychological therapeutic techniques to help improve things or facilitate change.
To round off this week’s exercises here’s a clinical psychologist in action. It’s longer than our usual clips – about 10 minutes - so take some time out to see active listening in action;
We can all be better listeners… to our families, friends and colleagues. Don’t be fearful of giving these techniques a go… And don’t be fearful of stepping forward if you’d like to have a taster ‘talking’ session. We’d love to listen:
Workout 48 - Whilst our experiences of Covid-19 are different from each other’s, we are united by two common themes. Firstly, for some time now we’ve all had to bid farewell to our “normal” day jobs and roles to some extent. And secondly, we’ve all been living in a high threat mode, which has activated our ‘threat’ systems, leading to all sorts of unwanted, unpleasant thoughts and feelings. I don’t know about you, but we’re finding it exhausting!
So, as we are now well into planning the “new normal”, re-opening services and planning how to be back at work, we wanted to spend time thinking about what it’s like to return “home” from the experiences we have had.
Today’s workout is to take a listen to this 5-minute podcast, which develops the ideas we’ve shared here: CLICK HERE
Remember too, if you’d like to talk to one of the psychology team, we’re still very much here for you – in the staff support hubs – and via email and phone:
Workout 49 - As we start to get clinical services up and running again, there can be a sense of frustration that things are moving slowly or it can be hard work. We have to think about the new realities of coming into work - masks, office-hygiene, social-distancing - and that’s before we even start to reinstate our clinics/theatre lists and appoint patients who have been waiting to be seen. One of the biggest losses seems to be contact with our colleagues – the support, the camaraderie, the banter….
Today’s workout is to try to consider putting it into perspective. Perspective is in the eye of the beholder – it’s how we see things. Take a look at the cartoon below. You might have seen it before, but this time ask yourself:
Remember the mantra that has served us well so far - ‘take control of what we can control’. Learning to accept where we are with all the frustrations, and taking committed action in line with our values, might just be enough to help us refresh our perspectives on where we actually are now.
Remember as always, if you’d like to talk to one of the psychology team, we’re still very much here for you – in the staff support hubs – and via email and phone; firstname.lastname@example.org and email@example.com for Children’s staff.
Workout 50 - Face masks are now officially part of our everyday lives at work. From what we’ve been hearing in our conversations with you, both individually and with wider CSUs, is that having to wear a face mask every day can be anxiety-provoking.
Today’s exercise is to read through this very short article. It helps to understand and normalise the anxiety and reminds us that ultimately masks are safe. It also asks us to reflect on any negative/catastrophic thoughts we might have as a first step in reducing our fears. CLICK HERE
If you’re not affected by this, I bet you will know someone who is. We often don’t ask if our colleagues are OK about wearing a mask, but maybe we could, particularly those who are not in clinical-facing role?
Tomorrow we’ll focus on the last element of coping with mask-anxiety identified in the article by returning to mindful breathing techniques.
Remember, if you would like to talk to the team, do get in touch via the usual emails;
Workout 51 - Following on from understanding and accepting mask anxiety yesterday, we would encourage you to really ask your non-clinical colleagues in particular as to how they’re getting on wearing a face mask. We received a few comments and questions after yesterday’s PB, asking about coping techniques that can be done on the hoof.
So, today’s exercise is to listen to this mini podcast called the ‘Butterfly Breathing Technique’. It’s an easy and helpful technique to use when feeling stressed or anxious. It can be done in the situations we find ourselves in at work, but probably needs to be practiced during a break or at home first.
OK, OK… I know what you’re going to think when you start listening to it… ‘this is too weird’ but stick with it. It really does work! I’m listening to it again now as I write, and find it has slowed me right down. I really like how she describes our breath as ‘our companion for life’ and how it mirrors what we’re doing or how we’re feeling.
I hope that as you do the exercise, your own breathing slows, and you feel more in control of it. I’m also hoping it helps if you feel panicky when wearing your mask. Try it without the mask on first and then listen again with it on.
Workout 52 - I hope you found the ‘Butterfly Breathing Technique’ useful if you’re struggling with your face mask. However, this technique can be adapted to almost any situation you find stressful. Keep it in mind if you start to struggle with any worries.
Fears and frustrations about returning to the workplace and getting services back up and running seem to be all around at the moment. So I thought it might be useful for the final exercise of the week, to go back to the ‘F’ in the ‘FACE COVID’ framework that we worked through at the start of the crisis – ‘Focusing’ on what is in our control. I think this is perhaps even more apt now as so much more might feel out of our control and re-focusing our efforts and energy on this might be helpful.
Simply look at this image again and try to make a list of the things that you can actually have control over – at work and home – and focus on these things.
Don’t hesitate to get in touch with us on the usual emails;
Workout 53 - Last week the psychology teams have been picking up on people starting to feel overwhelmed and exhausted. We often do what we have to in order to get through a crisis. It’s when that phase is over that we start to notice the impact on us.
Now it seems we’re shifting from coping with the crisis, to feeling overwhelmed with the prospects that Covid is with us for a long time. How on earth are we going to: keep going? keep coping? We’re feeling exhausted from the crisis phase only to be faced with having to work very differently and in some cases, ‘start again’ in how we work.
We have to accept that this is the case. We don’t want it. We don’t like it. But it’s here none-the-less. Remember, acceptance is not ‘giving-in’ but rather letting go of the struggle. Remember the ‘beach ball’ analogy? CLICK HERE
So, in the midst of a pandemic of feeling overwhelmed and exhausted, it feels very timely to introduce today’s workout. It’s called ‘Dropping Anchor’. Not only is this a metaphor for pausing for safety during emotionally turbulent times, it’s a skill for handling difficult feelings, thoughts and bodily sensations as they arise - grounding and steadying ourselves, disrupting our worrying and re-focusing our attention on what we’re doing. The better we anchor ourselves in the here and now, the more control we have over our emotions and actions.
Have a look at this clip on how to ‘Drop Anchor’ – it’s really quick – only a minute! We’ll focus on this coping technique this week. CLICK HERE
Workout 54 - How did you get on with dropping anchor? Feeling overwhelmed seems to be a common experience at the moment. Overwhelmed with the realisation that Covid is going to be with us for quite some time. Exhausted with recovering from the crisis phase whilst at the same time anticipating a second spike and working very differently - in some cases, ‘starting again’ in how we work. There can be a sense of despondency that services or care pathways that have been honed over years are having to be redesigned.
Remember we need to drop struggling with this, accept it and divert our energies into doing what we can, when we can, with what we can.
We think developing the skills to ‘drop anchor’ is worth doing to help get us through our days and workloads. Today’s exercise builds on yesterday’s introduction. It’s simply to take a look at this infographic: CLICK HERE
Feel free to print it off and put up in staff areas and or use it as you like. And don’t hesitate to get in touch with us on the usual emails; firstname.lastname@example.org and email@example.com for Children’s
Workout 55 - Remember this image? We shared it at the start of the crisis back in March…
From what we’re picking up in our staff support hubs, phone calls and emails with you all, it still seems that we are far from feeling like we’re in the last part of the picture. In fact, it seems that we’re still in the middle of ‘the perfect storm’; physically and emotionally recovering from the crisis phase, working flat out on the recovery and anticipating the ‘second spike’.
Today’s workout is simple. It pulls together the coping skills we’ve been sharing into our psychologically proven, 5-point plan. If you are struggling, feeling overwhelmed or exhausted;
“Drop the anchor. Stop the struggle. Control what we can. Take a holiday. Repeat”
OK, now say it over and over. And here’s all the links together to help you do it.
We’ve been getting busier on the hubs again. Many of you still like that face to face contact. So please, don’t struggle on your own. We will get through this! So don’t hesitate to get in touch;
Workout 56 - Thinking about ‘where we are now’ and reflecting on our progress is an important phase in living with the pandemic. This cartoon conveys a typical trajectory of disasters and disaster-recovery. And if we are truly at the disillusionment stage, it’s important that we do what we can to not become demoralised and overwhelmed. Developing a repertoire of coping skills will get us through. Remember the plan; “Drop the anchor. Stop the struggle. Control the controllable. Take a holiday. Repeat…”
What we daren’t speak too much about though is something called ‘post-traumatic growth’. This can be both tangible (e.g., re-building services) and psychological (e.g., re-appraising our priorities and activities). So, today’s exercise introduces this concept. Try to consider three positives that have come from your experiences so far, both at work and home. Consider in what ways they might lead to growth and regeneration.
Thank you for all your feedback and words on encouragement. Do keep getting in touch with us;
firstname.lastname@example.org for Children’s
Workout 57 - With the turmoil that’s going on it might feel ridiculously hard to plan anything - even a break with the family. And we’re sensing that this is starting to feel tiresome and disheartening.
But we’ve come across a useful way to understand what it means to grapple with change and live with uncertainty. A psychologist called William Bridges has come up with an explanation of ‘psychological transitions’. This highlights that our minds are catching up with the new reality and the actual changes that are happening. The three stages of transition that people pass through are;
People pass through these stages at different speeds, often moving backwards and forward rather than passing through each one in order.
Our last mental health exercise of the week gives you the choice of a 10- minute read or a three-minute watch. Or you could take a proper break and do both (with a refreshing hot drink of course…).
Read this short article which explains the psychological transition model more fully. It’s great and gives leaders a plan to follow in supporting their teams by helping them navigate the three stages.
Watch this clip from our favourite ‘Youtube-er’, Russ Harris. It focuses on how we can stay motivated when faced with things we find difficult, particularly as we’re in the ‘neutral’ zone of transition. CLICK HERE
If you’re not working at the weekend be sure to have a good break, and if you are – remember, be sure to drop an anchor, drop the struggle, control the controllable, take breaks, repeat!
Workout 58 - On Friday we shared the psychological transition model which explained how we might be feeling at this stage - the ‘neutral stage’ - of the crisis.
Being in the neutral zone, where past ways of working have changed or disappeared without the future ones being apparent, can raise people’s anxiety and reduce their motivation. We’ve been hearing of your experiences feeling unsettled and out of sorts, and how some of you are doubting yourself or your abilities to cope.
However, people have also responded by showing resilience - ‘let’s just get on with it’ - and flexibility - taking on new roles and responsibilities. So, it’s not all negative - this phase can be an incredibly creative time too.
This week we’re going to focus on being in the neutral zone and what we can all do to cope. Here’s another link to the transition model as a refresher (but this isn’t today’s exercise…) CLICK HERE
Today’s workout reminds us not to struggle with the difficult feelings that arise from this state of affairs, but rather, accept them – they’re inevitable. Whether they’re old personal issues that have returned or got worse - like anxiety and panic - or difficulties at work - like team issues, relationships or processes – the trick as always is to tolerate them and control what we can in line with our values.
Have a look at this new short clip; CLICK HERE
Taking control of the controllable might simply be just talking about how you’re feeling, rather than struggling on.
Workout 59 - It seems the frustrations of being in the ‘neutral’ zone are taking their toll. We’re hearing stories of how some of you have been battling on with stress, anxiety or panic, which had been problems before Covid struck, and which are now worse. We’ve also come across tales of frazzled colleagues being impatient or curt as we navigate uncertainty and frustration with getting services back up and running. Things don’t quite ‘work’ as they used to and new processes are not progressing as quickly as we’d like them to.
We will get through this transition phase together. One of the key coping strategies is – you’ve guessed it – by taking control of what we can control in alignment with our values.
I bet if we conducted a study, all of us would identify at least two of our values as being ‘kindness’ and ‘compassion’ and now, more than ever, it’s important we act in accordance with them by being kind and patient with each other. I’m not suggesting we all go around the hospital performing random acts of kindness. But more that we accept and commit to understanding that we all come to work despite our problems.
Kindness is about being friendly, considerate and generous. The Quran tells us that ‘whenever kindness becomes part of something it beautifies it’. And so, today’s mental health workout is just to consider how we can be kind throughout our day. It’s easy to get frustrated when systems break and get annoyed with slow progress and a lack of materials, but in and amongst it all remember…
Workout 60 - Thank you all for your comments on yesterday’s memo. It seems kindness and forgiveness are all around. And it’s important that with kindness, comes compassion.
Being compassionate is feeling for others as they go through their trials and tribulations, particularly during this phase of the pandemic - the neutral zone - as we’ve been calling it. This isn’t just about telling them you care (although that is a pretty good start). It’s about paying attention to people, noticing them, and showing them that you care about them before they seek it out support, or before something happens to them that we respond to with kindness.
Today’s mindful moment takes us back to YouTube, to think more about being compassionate. Have a look at this short clip. CLICK HERE
It’s such a tough time for all of us. From your comments this week and the growing number of requests for 1-1s (which is great!), fatigue and stress are really taking hold. Remember we will get through this. But please, don’t feel on your own.
Workout 61 - Thank you for all your feedback this week. We’ve taken all this on board - and it really helps shape future PBs. There have been lots of poignant comments on feeling overwhelmed and stressed from people feeling they are alone in having these feelings.
This one epitomises it all…‘sometimes feel like I shouldn’t feel so rubbish because I’m not frontline staff, but it’s probably a valid response to this situation’
Firstly, let me stress how you are so NOT alone in these feelings. They are so commonly held amongst us right now. Yes, things are out of our control. Yes, we might feel really ‘rubbish’ and uncertain. And yes, it might feel as though we can’t do anything about it. But we can!
Today’s exercise is a little longer than usual – about 9 minutes. But it brings together a lot of the things we’ve been focusing on this week, and gives some simple ways of detaching and ‘going with the flow’. Put your feet up for a bit and have a look. CLICK HERE
Keep getting in touch with us. As always, if you’d like to talk to one of us 1-1, the emails are; email@example.com and firstname.lastname@example.org for Children’s staff.
Workout 62 - Feeling alone with feeling overwhelmed has continued to be a common theme in our inbox over the weekend. Here is another email we received that was typical…
“Things have been more difficult, and the stress and fatigue are taking hold, but these messages help me feel like I am not alone in this.”
You are far from alone. I feel it, our colleagues feel it, and our families feel it to some extent. They may not show it, or talk about it openly, but it’s there. The issues we focused on last week seemed to really connect with something inside us that recognises these feelings. By sharing our experiences, we connect with each other. Responses alone, either from this memo or colleagues, rarely makes something better. What makes a difference is connection.
And in this way, we start to express empathy. Empathy and sympathy are confusing. As we continue to focus on coping skills for the here and now, today’s mental health workout starts to show how we can all express empathy with each other; our colleagues, our families; our kids
The following clip is by Brene Brown, who some of you may know about already. It is really quite entertaining and I can’t believe I’ve not shared it with you already! It was recently nominated for a ‘Webby’ – not quite an Oscar, but still pretty good. CLICK HERE
Let us know what you think about it on the usual emails. And do keep getting in touch if you’d like to talk to one of us:
Workout 63 - ‘What makes something better is connection’. I really liked this phrase from yesterday’s clip. However, even if we feel connected with our colleagues and act with kindness and compassion, we can still feel helpless in changing things.
Over the next few PBs, we’ll focus on coping skills to tackle helplessness. And, you’ve guessed it, coping starts with taking control of what we can and not struggling with what we can’t.
The real trick is not to try to change too much all at once. Each little thing we do today, means we start tomorrow from a different point. If we rest well tonight, we start tomorrow more refreshed. If we fill in one of the 20 spreadsheets we’ve got to return to our line managers, we start tomorrow with 19.
Remember the beach ball metaphor? CLICK HERE For us this is one of the most powerful images to convey what a waste of time it is to put energy into things we cannot possibly influence.
Today’s exercise talks about controlling what we can a little differently, using a metaphor called the ‘three buckets’. It was from an earlier point in the Covid crisis, but it’s still useful now: CLICK HERE
Workout 64 - Part of coping with feeling overwhelmed is getting some good rest. Usually at this time of year, we might be going on holiday or thinking about one. But at the moment even this can feel stressful - sun, sea and sanitizer seems to be the motto - where will we go? what will it be like?
However, resting involves mentally and physically engaging ourselves in activities that aren’t part of our daily routines or way of thinking. This nearly always happens on holiday but often the answer is right under our nose. It’s the change in mindset that is important.
When we work with patients who are fearful of procedures, we often use guided imagery and distraction techniques, which are also part of mindfulness. The general rule of thumb is that the more cognitively active and engaging the imagery or distraction is, the more likely it is to be effective.
Today’s exercise is to consider what these activities might be for you and your family and plan one soon. If it’s impossible to get out of your routine and work soon, remember virtual guided images can provide a real soothing, relaxing effect too.
Here’s a couple we’ve shared before. Take some time out to listen and relax, either at work or home.
Workout 65 - Continuing with our focus on coping with stress and feeling overwhelmed, today’s PB refreshes our understanding of how different parts of our nervous system are active in creating the symptoms of stress and anxiety (the sympathetic nervous system) and producing response to buffer it (the parasympathetic system).
Rest is crucial to this and we have introduced some of the different ways of resting over the past few PBs. Of course, the most important form of resting, is sleep. And for many of us, sleep has been a problem during the lockdown and beyond. This is too big a topic for one memo, so next week we’ll spread it out over a few.
But for now, we’ll continue the focus on getting some rest periods during the day - making sure we take breaks where we actively engage in activities that absorb us, but which also distract us for a while from the sources of our stress.
Today’s exercise isn’t really an exercise at all, it’s more of an entertaining mini-lecture all about stress symptoms, rest and relaxation. CLICK HERE
Workout 66 - To round off our week of self-care and coping skills to combat feeling overwhelmed, one of the key words has been rest. You may have seen the update on annual leave in last night’s Trust Covid-19 bulletin. It is so important to take some time away from work.
Engaging in activities that are mentally interactive is the key to a good break - not the length or the distance you travel or the nice accommodation you (manage to!) get booked.
Holidays from home are as effective in shifting our mind sets away from work and onto committed action (yes, in line with our values!).
Today’s restful exercise is to consider these quotes and sayings. They all emphasise the importance of valuing ourselves and putting ourselves first, whether we are in a front line role or not.
Next week we’ll have a focus on sleep, but for now, enjoy some of the weekend and get in touch with us if you want to share your experiences of resting and relaxing.
Keep getting in touch with us. As always, if you’d like to talk to one of us 1:1, the emails are; email@example.com and firstname.lastname@example.org for Children’s staff.
Workout 67 - Looking after ourselves first is sometimes hard, particularly when our roles are to look after others. Rest and recharging are really important during the day but what about at night?
Many of you have been talking to us about sleep problems since lockdown started and, for many, these have continued since then. So, as promised, the next few Pause Buttons will focus on getting a better night’s sleep. And yes, we’ll mainly be taking an Acceptance and Commitment approach, with a few behavioural techniques thrown in too.
The problem with a lot of sleep problems is that our minds are trying to do too much – they’re too active! What’s the first thing we do when we can’t fall asleep or wake up in the night and start to worry? We try to put the worries out of our mind, or we try to convince ourselves that things aren’t as bad as all that. We treat our thoughts as problems to be solved. The problem is - all that mental stuff is keeping us awake.
Today’s exercise involves a bit of reading. It’s a general introduction to the approach, written by one of the architects of ACT – Steve Hayes. Have a look here. I read it and it took me seven minutes (and I’m a slow reader!) CLICK HERE
Workout 68 - We started to focus on sleep problems yesterday by introducing an acceptance and mindfulness approach. Here it is again if you missed it…
Today’s focus is about developing good sleep hygiene. It’s not just about avoiding ‘screen time’ and caffeine in the hours before bed. Developing a good bedtime routine helps us wind down and sets up cues to sleep. These techniques are usually associated with helping younger kids settle at night, but the principles are exactly the same for us grown-ups!
As Steve Hayes points out - some of the things we do to solve sleep problems aren’t effective because that they make us do too much, when what we need to be doing is exactly the opposite – nothing.
Here is today’s workout is very brief. It’s a short clip about eliminating bad habits, building up a bedtime good routine and regulating our sleep. This is often referred to as sleep hygiene: CLICK HERE
Workout 69 - Thanks for all your lovely feedback on these daily memo’s. It really means a lot and helps us focus on the topics that you would like us to.
Almost all of us wake-up at some points during our sleep cycle but when our minds are rested and we don’t have small children to attend to, we quickly self-soothe back to the land of nod. However, when our minds are active, thoughts pop up and waken us as we problem-solve.
I think Steve Hayes’ psychological flexibility approach is really useful to experiment with here. I know this was in the article in Monday, but these two tips are worth going over it again.
Do let us know how you’re getting on with these techniques. Here’s our emails again to get in touch; email@example.com and firstname.lastname@example.org for Children’s staff.
Workout 70 - We’re continuing on with a focus on sleep and rest. We mentioned sleep hygiene but have saved going into the behaviours we can change to set us up with a better sleeping routine.
Here are 10 tips on some of the things that will help set up good routines and habits. Some of them seem obvious, some will be harder to achieve than others, and we don’t need to introduce them all at once! CLICK HERE
We think that these techniques together with the clip from Tuesday on explaining sleep cycles and patterns are pretty good at setting up a good night’s rest. CLICK HERE
Remember if you can’t sleep, or wake up in the night – ‘rest’ and ‘just notice your worries’ rather than trying to problem-solve them.
Do let us know how you’re getting on with these techniques. Here are our emails to get in touch; email@example.com and firstname.lastname@example.org for Children’s staff.
Workout 71 - Last focus on sleep for now. And today I’ll round up all the ideas we’ve shared this week, with a short workout.
This is about understanding what happens to us when we fall asleep and during deep sleep. It’s really very watchable and at this stage in the week, you’ll be pleased to see it only lasts 2-3 minutes. CLICK HERE
I hope it brings together the understanding of sleep, the importance of establishing a sleep routine and what you can do if you can’t fall asleep.
Remember to get in touch with us and let us know what you think of these techniques. Many of you love the Butterfly Breathing Technique we shared in the week and have been in touch to tell us how you’ve put it into practice.
Rest and relax at the weekend.
Workout 72 - It seems that uncertainty is on the rise again – about restrictions, closures and cohort self-isolating – to minimise the impact of a second wave of Covid-19. And the media seems to be going into overdrive in advising us how to maintain our health and well-being during the Covid pandemic. Some of this information is excellent; some pretty dubious.
The Institute of Psychiatry, Psychology and Neuroscience at Kings College has put together a series of short talks by psychologists on a range of important health behaviours, from sleeping well (which we covered last week) to healthy eating (by Ms Pavlova! Honestly).
Today’s workout is to look at the range of clips and choose one that matches a health behaviour you identify with as ‘needing some attention’. I particularly like the me myself and exercise clip. CLICK HERE
Workout 73 - From your feedback yesterday, it does seem that uncertainty and apprehension are taking grip. If we accept what the World Health Organisation say, things are going to be this way for a while. There is also the uncertainty of whether we’re at the beginning of the second spike. The rising graphs of cases looks familiar if not a bit ominous.
So, in trying to cope with this, we need to fall back on to one of the key principles we’ve focused on over the past few months. And it’s this – that a perpetual state of happiness and being settled is a myth. Life has always been hard and challenging and Covid is one of those phases.
Today’s workout is to look at another very short clip from Russ Harris’ framework - The Happiness Trap - CLICK HERE
As always, he explains things in such clear ways, that I hope you find going back to this idea helps keep what’s happening to us in context. By controlling what we can and dropping the struggle with what we can’t is central to dealing with whatever comes next.
Workout 74. - I’m following my own advice and going on holiday! It will return on 24th August.
Today’s refreshing workout is to help me think about how frequently the PB should be in the autumn.
Your views have been so important since we started all this back in March, and I want to make sure it is frequent enough to be helpful, but not so frequent that it’s a pain. There’s lots of ideas and exercises still to share, but I will be guided by the responses I get back.
Don’t forget that you can also use these email addresses to get in touch to arrange a 1-1.
Workout 75 - Thank you for all your feedback and comments on the Pause Button.
It seems like many of you have found at least some of the workouts useful thus far. So, we’re going to keep going but on a weekly basis for now – every Wednesday.
It seems that uncertainty and upset is still all around. Returning to work feels very different - flexible working, accommodation, resources, being separated from our colleagues all adds to the stress. We might say to ourselves - “well… we should be used to this by now”. But think about it - why should we be? We’re all learners in working and living with a global pandemic and it seems that sometimes we expect too much of ourselves.
We came across a story that covers this in quite a bit of detail; CLICK HERE
It’s mostly about how you adjust to an ever-changing situation where the “new normal” is indefinite uncertainty. Probably one for the bus or some home-reading.
Do let us know what you think of it and feedback on what you’d find useful of us to cover.
All the previous Pause Button workouts are still here for you to access; https://www.leedsth.nhs.uk/staffhealthandwellbeingsupportnetwork/psychology-staff-support/managing-your-psychological-well-being-during-the-covid-19-crisis-page/
Workout 76 - I hope this finds you well and full of the joys of autumn.
Doesn’t quite fit now does it? There seems to be part of the visual metaphor missing on the bottom row, after the storm phase. To me there should be a picture of relentless ‘Yorkshire drizzle’ that’s one minute akin to proper rain and the next like it’s going to dry-up but never quite does… “What a depressing man!” I hear you say.
The Psychology teams across the Trust have now stood down the hubs and 1-1’s and the contact emails are currently inactive. 1-1’s are very much still available via the Trust’s external counselling service and all sources of support are in the After the Storm document.
Workout 77 - I was put on the spot the other day - asked to come up with some quick words of encouragement for everyone who is trying to cope with uncertainties and a slow pace of change. Needless to say, I choked! Totally useless! So I was thankful that today’s Pause Button gives me another go.
And in trying to come up with something useful, I reflected on two things.
First, is that a train can only move as quickly as the slowest carriage and that trying to go faster only leads to more frustration and exhaustion. We have to find a way to roll with the changes that are happening to us and ride out the residual storms. Easy?
Not really…which brings me to the second thing – the beach ball!
Recall that the beach ball represents all the difficult, uncomfortable and painful thoughts and feelings you may have coped with so far. Even though it’s human nature to want to push these away, doing so is like trying to hold the beach ball under water. Not only does that take a huge amount of energy and effort, it also stops us from being able to enjoy the water, see the rest of the beach, do the things we enjoy there.
In coping with the present frustrations, can we find our own way to let the beach ball, and all it represents, be with us even if we don’t like or want it? Can we drop the struggle with those things and re-focus our attention on doing things that are truly important to us despite the discomfort? I really like this imagery and use it a lot with the teenage patients I see. Let the ball bob along - and for now , keep swimming!
Do keep on getting in touch with us via the Comms Team - email@example.com
Workout 78 - We’ve had quite a few people get in touch to say how they are experiencing stress and anxiety in the face of what seems like a long winter ahead.
For a while it seemed like we were getting into a new rhythm of working, where some of the stresses receded into the background. However much we try there’s no hiding from it now and it feels like a long challenging time ahead.
If you are beginning to struggle again, one way of coping is to focus on giving up the struggle with avoiding or ‘boxing-up’ any unpleasant thoughts and feelings. This is called ‘experiential avoidance’, - a tendency to move away from things that are threatening. Whereas coping often involves accepting any difficult thoughts and feelings and making space for them. This way, it helps us put our energies into things we can control.
We used these clips some time ago in the Pause Button, but they’re worth going back to. I hope they make sense in helping to understand that the struggle we have when we put energy into avoiding things which we could put into developing psychological flexibility to tolerate them.
Do keep on getting in touch with us via filling in this form with your feedback and questions.
Workout 79 - Things are certainly hotting up across the Trust as the second wave starts to hit.
Last week we returned to coping with stress and anxiety. And focused on controlling what we can, whilst letting go of what we can’t.
This week, I want to take you back to being mindful as part of controlling what we can and focussing on relaxing our bodies and minds as we prepare for, or leave, work.
Our bodies are always in the present moment, whereas our minds tend to time-travel, wishing things were over or remembering a glorious past. But we are in the here and now, and getting through our days will lead to us getting through our weeks, and months, and eventually this winter.
So today’s refreshing mental health exercise is one of my favourites and is about maintaining hope at work. I hope it helps to prepare you physically and emotionally for the day ahead or returning to work after a break.
When I turned up for a covid test outside the Clarendon Wing the other day, I admired how the two nurses who stood freezing outside in a flimsy gazebo tested me with a smile and warm welcome. They reminded me that we are strong enough to get through this together. After all… each other is all we’ve got right now…
Workout 80 - And so it goes on… everything old is new again, except this time around we’re possibly more tired and fatigued. And so lets go back to the core purpose of the Pause Button - to take 5 minutes out of your day to engage in a refreshing mental health exercise aimed at psychological coping strategies.
Back in March we started with us having to accept that this pandemic is hard and how we need to put our energy into taking control over what we can and let go of what we cant. Remember the FACE COVID plan? I’m thinking that today’s exercise is to have a refresher.
The FACE COVID plan is a list of practical steps for managing our psychological well-being. Here’s the clip again. CLICK HERE
Apologies that last week’s Pause Button did not appear. “Technical issues” I think was the overarching reason. I do apologise…