kindness

Mental health and exercise

Me on my bike

This week, we heard about a US study which apparently showed a link between exercise and improving one’s mental health.

“How marvellous” cry quite a few people who have been fortunate enough never to experience any sort of mental illness. “Here is proof” they go on to say “That lying around in bed all day is bad for you. Next time I meet someone who says they are depressed, I will tell them to go out for a jolly good walk. A bit of fresh air will blow the cobwebs away. After all, I always feel better after a walk/run/session with my personal trainer/ swim in the health club pool ” they remark helpfully.

Thank goodness for wise owls like Dr Dean Burnett who, while welcoming the study, reminds us of the likelihood and risks of overstating the findings, and of its limitations, such as that the participants self-reported their improved mental health, that most of them didn’t have a serious mental illness to start with, and that anyone with anything other than depression was excluded from the study.

Exercise can play a positive part in managing our mental health. But it’s not a magic cure-all. Here are some things I’d like anyone feeling excited by this study to do. And a few that I and others with similar experiences would prefer you not to do.

  1. Please read Dr Dean Burnett’s brief analysis here.

  2. Learn how depression is a physical illness and why exercising when you are having a severe episode can be very harmful here.

  3. Remember that prevention may be better than cure, but that to muddle the two is both dangerous and cruel. Imagine telling someone having chemotherapy just to eat more vegetables? It’s the same with mental illnesses (of which there are many) as with cancer. What helps us stay well is not an alternative to the treatment we need when we are poorly.

  4. Remember that many people who experience mental illness face other challenges which compound their situation, including poverty, insecure housing and post-traumatic stress. So please tread gently. Don’t make suggestions that seem obvious to you but may be daunting, even terrifying, or that they just can’t afford.

  5. Do all you can not to offer advice to your friend who seems be showing signs of mental illness. Instead, sit with them and just listen. Help them by showing that you care enough to stop whatever else you are doing and giving them your undivided attention. Be patient. Be courageous. Be quiet. Be there.

  6. IF they should decide that they want to try a bit of exercise, offer to walk, run or cycle beside them. Show them that you have their back.

Finally, in case you or anyone you know needs it, here is My Letter To You. 

Take it gently. This world is a tough old place.

Thank you.

 

 

 

 

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My Brew Monday

This morning, Samaritans volunteers were shivering on Brighton Station, Hove Station and 80 other railway stations around the country. We’re at it again tonight. If you see us, feel free to say hi, and take one of our free Brew Monday teabags or SHUSH Listening Tips leaflets. You can pop a few coins in our collecting tins. And talk to us about how you are doing.

You can even discuss the possibility of volunteering as a Samaritan yourself. Samaritans are ordinary people. We have no special powers. We don’t get paid but we do get the most excellent training and a great deal of support to do what we do. Read more here.

Let’s be honest. There is no such thing as Blue Monday. It was a clever advertising gimmick thought up by a travel company 15 years ago. And yes, Brew Monday is a bit of a gimmick too. But it’s a good way of grabbing people’s attention for a much better reason than selling them a holiday they may not be able to afford. Brew Monday is a way of reminding people that they have the most valuable thing that other people need. And that’s the gift of their own time. Time to ask the other person how they are. And to really listen to the answer. Time to be with them if they are OK but even more if they are not. And time to help them come to their own conclusions about what action, if any, they want to take. And what better way to help the conversation flow than with a lovely cup of tea? This link will take you to the Brew Monday part of the Samaritans website.

Here are the SHUSH listening tips:

S = Show you care – stop what you are doing, put away your phone, perhaps offer a cup of tea

H = Have patience – forget the emails piling up. And don’t give up.

U = Use open questions. And include space for the other person to think.

S =  Say it back – use their words, without offering an opinion or judgement.

H = Have courage. This can be hard, especially if you get initially get a dusty answer. But please keep trying.

If you want to hear yours truly talking about Brew Monday, Samaritans, and the listening tips mentioned above, you can find me here on Radio Sussex talking with the lovely Allison Ferns from 2hrs 46 minutes – 3hrs.

And most of all, please try to find time this week to have a cuppa with someone and really listen to them. It could make a huge difference.

Thank you.

 

 

Mindfulness and Listening

The Chattri, near Brighton

Christians get upset about the commercialisation of religious festivals like Christmas and Easter. Increasingly I appreciate why.

It is probably just as annoying for Buddhists that meditation, fundamental to a generous approach to the world, also appears to have been hijacked. This Washington Post article suggests that the me-generation has taken a practice essentially about becoming self-less, and turned it on its head to be about self absorption via the mindfulness movement.

The argument is plausible, but I disagree, perhaps because my first experience of mindfulness was not at a self-indulgent spa. It was gained through hearing from mental health colleagues and patients engaged in mindfulness as an evidence-based method for helping to live with disturbing voices in the head, one of the most unpleasant symptoms of schizophrenia and other psychotic illnesses.

I wanted to learn more. I went on a few courses, Buddhist and secular, and began to practise myself. I was also lucky enough to play a tiny part in supporting The Sussex Mindfulness Centre which today goes from strength to strength in helping patients and practitioners to practise mindfulness in their daily lives.

There will be some reading this who detest mindfulness. I accept that it isn’t for everyone. I know that it doesn’t actually solve anything. And I am aware that when it is suggested casually to those in distress, it can belittle the depth of trauma and anguish they are experiencing. Mindfulness can be seen as a panacea, even a mumbo-jumbo cult. And in the workplace it can be misused as a low-cost alternative to comprehensive employee support.

I really do appreciate these views. And yet having experienced anxiety and depression myself and been helped by those who practise mindfulness, I know it doesn’t have to be that way.

Because there is something wonderful about people who are truly mindful. I’m learning this while I develop as a Samaritan. Listening really carefully without judgement to someone in distress seems to me to be the very essence of mindfulness. Samaritans don’t just learn how to do this once. We spend our first year in training. And then however experienced we are, we listen very carefully to one another, in order continually to improve. Because we don’t just care about our callers, we care about our fellow Samaritans.

A Samaritan shift can be the ultimate mindful practice. The room is peaceful and quiet. You listen, moment by moment, to your caller. You are listening in order to understand. You respond only when the caller seems ready, and use their words to reflect what you have heard. You give them space and time. You do not make suggestions and you do not judge. Your whole purpose is to be there with them while they explore their feelings and make their own decisions, if indeed they feel that any need to be made. The time simply disappears. At the end of your shift you debrief to another experienced Samaritan, not really about the calls, but how you handled them, what you might do differently another time and how you are feeling yourself. You are reminded of the valuable service you have given. And you go away feeling calmer and lighter because of the mental discipline and compassion you have been practising. That is my sort of mindfulness.

If you want to know more about how Samaritans listen, here are some wonderful tips.

And for those who like meditation, this is one of my favourite practices. It is about loving kindness. The point being that only if you are kind and forgiving to yourself can you be truly kind to others. It may be a huge effort. But it is really worth it.

This blog is dedicated to a good Samaritan who helped me to listen. May they rest in peace.

So what do you do these days?

Me and my friend Sally at the end of Ride 100 in 2016. Still laughing despite the pain.

People sometimes ask what I do these days. Here is a snapshot.

Today, I will be one of 12 Samaritan volunteers from the Brighton, Hove and District branch at TransPride.  This is a community event for people from the trans community to come together and be themselves in a safe, supportive space. Samaritans know it can be an alienating and difficult experience for some people just to be who they are. We are there to listen, but also to talk about what we do, in case anyone is interested in volunteering with us. I am really looking forward to it.

On Monday, 24th July 2017, Samaritans will be at railway stations across the country encouraging people to listen to one another and to know they are not alone. Volunteers from our branch will be on Brighton, Hove and Haywards Heath Stations from 7 – 9 in the morning and 5 – 7 in the evening, handing out leaflets, talking to commuters but most of all, listening. This national series of events is part of the ongoing partnership between Samaritans and the rail industry. Next time you travel by train, if you turn over your ticket you might see one of our messages. Please also look out for our posters on every station. As they say, we are in your corner.

On 6th August, we will be on the road again, this time at Brighton Pride, a massive event celebrating all things LGBT. We will have a well-staffed stall to publicise what we do. And because we also know that supposedly joyous occasions can be unbearable for those who are feeling lonely or desperate, we will be there as well for those who need us.

And I am back on my bike on Sunday 30th July 2017 raising money for Samaritans. You can read more about it here, including how to donate. No pressure, though – we all do what we can. 

I first learned about Samaritans aged 11 via an article in Readers Digest. I then read Monica Dickens’ novel The Listeners, based on her experiences of being a Samaritan volunteer in London soon after the charity started 64 years ago. Later, I read the collected short stories Is there Anyone There? edited by Monica Dickens and Rosemary Sutcliffe. And I called Samaritans once or twice, from a red telephone box like the one on the cover.

In my early twenties, I trained to be a Samaritan myself, and volunteered for a couple of years. I loved it. But I was economical with the truth about my own issues. While going through a particularly bad patch, I found I didn’t have enough to give. I should have told a senor Samaritan and taken time out. But instead I just left. I have felt bad about this ever since.

I think I always knew I would go back. But not that it would take quite so long. As I pedalled for 8 hours through Ride London 100 in 2015, raising money for Samaritans, I knew that the time had come. In January 2016, I booked myself into an information event at my local branch. And with support from amazing trainers and fellow trainees, I completed initial training, mentoring and probation and became a listening volunteer again.

What has changed in 38 years? More importantly, what remains?

New technology, of course. Emails and text calls, booking shifts and online recording. But still nothing beats listening to someone by phone or face-to-face. Nor being supported by a fellow Samaritan who somehow notices you’re having a tough call and offers you time to reflect. The equality between volunteers, new and experienced, lies at the heart of what we do. I’m so glad that hasn’t changed.

We had policies back in the day, but not like now. Over-reliance on them can have unintended consequences, stealing time, making people over-cautious and discouraging independent thinking. The policies we are asked to follow are designed to maintain high standards and keep everyone safe. And if they need to be changed, it is up to us to say why and how.

Training is more thorough nowadays – in 1978 selection and training happened over a weekend. But the focus on being there for distressed people hasn’t changed at all.

Once more, I find I get more than I give by being a Samaritan. I love the stillness and focus of the Ops Room. I am inspired by the courage of our callers and the humanity of my fellow Sams.  It is lovely to be back.

It is true that not everyone has the capacity to be a Samaritan. You have to be able to set aside judgement and the humility to learn how to listen really carefully. But I truly believe that many more people could do it than probably realise. All it really takes is genuine love for other humans.

If you are interested in volunteering with us, either as a listener or a support volunteer, please take a look at this. We would be so pleased to hear from you.

 

 

​Girls like Theresa 

Our Prime Minister reminds me of one or two girls I went to school with. Not the ones who were friends with me, I hasten to add. Girls like Theresa had a small coterie who made no secret of their opinion that girls like me were idiots. In my case this was probably true. But not so of everyone on whom they looked down their elegant noses.

Girls like Theresa almost always came top. They were clever. They also worked harder than anyone else. They took copious notes in lessons and revised studiously for tests because they despised failure. They seemed uninterested in the things that distracted girls like me – rule-breaking modifications to our school uniforms to make them less frumpy, for example. Plus pop music, make-up and Boys.

Occasionally a girl like me would get a better mark for an essay or exam than a girl like Theresa. And she would seem rocked by this. She had worked just as hard as usual; how could she have been beaten by someone like me? This outcome did not compute.

Girls like Theresa had parents who were sought after by the headmistress. Unlike girls like me whose parents either sucked up in an embarrassing way or were simply ignored. They won prizes for everything from needlework to deportment. Their school blazers were decorated with team captain, prefect and head girl badges. And correctly, they assumed that they would always be picked to represent the school at games. They had the right equipment, extra tennis coaching and at least one uncle who was a Cambridge blue. Girls like me had terrible kit. We had to fight for a place in the team.

But despite their sense of entitlement, girls like Theresa were also socially awkward. Now I understand the Myers Briggs Type Inventory (MBTI) I realise that they were probably introverted (I). Social interaction could be enjoyable for girls like Theresa. But it also required a huge effort. When an extrovert girl like me tried to chat lightheartedly with a girl like Theresa, she would be haughty and dismissive. I thought she hated me. But maybe she just didn’t know what to say?

Girls like Theresa were likely to have had a preference for Sensing (S) in how they dealt with the world around them. This made them great at retaining facts and revising for exams, but less good at dealing with abstract concepts and seeing the bigger picture. They could learn how to do these things, but they would always be more comfortable with detail. And at times of crisis, detail could overwhelm them.

Girls like Theresa almost certainly made decisions using rational thought and logic (T) rather than feelings. They were uncomfortable with people who expressed emotions too readily. Unless they were encouraged to develop their non-preferred feeling side, they were more likely to offer criticism than praise to others, and struggle to show empathy.

And girls like Theresa were more likely to have a preference for judging (J) and to seek to reach closure rather than to explore new possibilities. At their best, they could be decisive. They liked to plan everything and leave nothing to chance. But without encouragement and support to explore their non-preferred perceiving side, they could be closed to new ideas.

People with an ISTJ Myers Briggs profile can be great team players. They can also become very good leaders, but only if they pay attention to those aspects of their personality that require development. They will always find the demand for frequent interaction with others draining. They need wise and trustworthy advisers to encourage them when to be less cautious and when to follow their instincts. They must guard against making up their minds too quickly when they have yet to grasp the broader picture. And they will almost certainly need help to understand that if you allow your head always to rule your heart, you may come across as cold and uncaring.

I recall a girl like Theresa who became head girl. It started well. But the wheels began to come off quite soon. She lacked confidence to seek wise advice. And she uncharacteristically made one or two rash decisions because she relied on people who didn’t deserve her trust. This made her even more cautious and unapproachable. She ended up as a lesser version of herself than she had been before she first pinned on the sought-after enamel badge. I really hope that she is OK now.

Carl Rogers said: what I am is good enough, if I would only be it openly.

This applies as much to politicians as it does to ordinary people. Even head girls.

Sent from my Samsung Galaxy smartphone.

What would Mary Seacole do today?

Mary Seacole Trustees Karen Bonner and Jermaine Sterling

​On International Nurses Day, I have been thinking about what nursing means in our troubled world. And how nurses through the ages and across the planet have devoted their lives to helping others.

It was lovely for the Mary Seacole Trust to be invited by one of our trustees Karen Bonner to hold a stall at St Thomas’ Hospital as part of the Guys and St Thomas’ NHS Foundation Trust’s International Nurses Day celebration. Our display was right by Mary’s beautiful statue. We sold books and badges and signed people up to our mailing list. But most of all we talked with nurses and members of the public about the legacy Mary Seacole has left us. Despite all the challenges she faced, she refused to give up on her mission to help the sick and dying, including soldiers in the Crimea fighting a world war. She knew that nursing, in the 1850s not yet a recognised, respected profession, is so much more than delivering medicine or other treatments. It is about being with people in life and also in death. It is about combining compassion with practicality. And it is about speaking up when something is wrong and fighting for the rights of those at the bottom of the pile.

Mary continues to be a role model for millions of us. As a middle-aged woman of colour, she knew discrimination and hardship. Mary’s mother was a free-woman in around 1805 when Mary was born, having previously been a slave. Mary experienced racism when she came to the UK, as well as many other challenges and setbacks. But through her courage, tenacity and entrepreneurship, she gained recognition and gratitude not just from those she nursed, but also the British government and media, and even Queen Victoria herself. And yet Mary died in penury. It is only recently that her legacy has begun to be recognised.

Some of the skills and knowledge I acquired as a nurse from 1973 – 2000 remain with me, although I would need considerable retraining if I wanted a job in nursing today. The same would apply to Mary. But the core qualities and values needed to be a nurse have not changed. The ability to listen without judging. To see the person not just their disability or disease. To stand up for those who cannot stand up for themselves. Never to give up on anyone. And to seek out and build on the shared humanity that brings us together rather than the differences that can drive us apart.

Were she alive today, on International Nurses Day 2017, I wonder what Mary Seacole would do? And as I look at her statue as she strides calmly but resolutely towards the Houses of Parliament, I can almost hear her telling me and others who have chosen to become nurses never to give up on our fellow humans. Because we are all part of one human race.

All in the Mind?

I love BBC Radio 4’s All in the Mind. It takes a compassionate, measured view of what’s new in psychiatry and neuroscience. Presenter Claudia Hammond considers research into the normal functioning of the mind and brain as well as mental disorders and brain diseases. Claudia has been quietly beavering away on All in the Mind since 2006, debunking myths about mental health and mental illnesses. She does other cool stuff on mental health too.

In 2015, I was interviewed for All in the Mind about The Recovery Letters, written by people like me who have experienced depression to help others facing something similar. This is my letter. James Withey, the inspiration behind the Recovery Letters, has been working on a book which will include the original letters plus some new ones. It comes out later this year.

Anyway, Claudia ran a positive piece about the letters. So when I was contacted a few weeks ago by All in the Mind producer Lorna Stewart about making another contribution to the programme, it was easy to say yes. This time, it was to ask for my thoughts on a series of questions from listeners about getting the best from mental health services.

I went to the studio and had what felt like a good conversation. My understanding is that there will be short inserts most weeks amongst the main items that make up the programme. It is called An Insider’s Guide to Mental Health Services. Here is a link to the first programme.

Are here are some things I thought about before I was interviewed.

  1. We are all as different on the inside as on the outside. Advice that works for one person will not work for another. To be honest, the concept of even giving advice on such a sensitive subject troubles me.
  2. On the other hand, there are things it can be useful to think about which people who are distressed or in crisis may either not know or they may forget. Plus, mental illness messes with your head. It can make you think bad things about yourself and consider doing bad things to yourself which you might later regret. It certainly did that to me when I had my last episode of depression. A kind word from someone who has been there might just be a lifesaver.
  3. Just as with physical illness, mental illness isn’t one thing. For example, a chest infection can be painful, even dangerous, but will almost certainly get better with treatment. Whereas lung cancer is likely to be more serious, and some types cannot be cured, just palliated. While no mental illness is nice, they can vary hugely in severity and impact. In our modern world we have become preoccupied with diagnoses, so I won’t start listing all the possibilities here. Suffice to say, some people will experience mental illnesses which cannot be cured. Therefore they have no choice but to find ways to live the best life possible with that particular condition and all it entails. Others may experience episodes of mental illness from which it is possible to make a full recovery. This is a great blog on the subject by Bipolar Blogger.
  4. Staying in bed all day and avoiding other people may be all you can face when you are experiencing an episode of mental illness. But in almost all cases, it is not a good idea. Humans are social and even the shyest and most traumatised among us need human contact. This is why we are encouraged to talk to someone – a GP, a trusted friend or family member, or to call a helpline. Here is a recent blog by me called What to do on a bad day.
  5. All sorts of things can go by the wayside when we are experiencing mental illness: getting enough sleep; drinking sufficient fluid; eating healthily or even at all; taking exercise; going out in the daylight; spending time in nature and/or with animals; being with those who love and care about us; personal hygiene; wearing comfortable, weather appropriate clothes; not self-medicating with alcohol, nicotine or other substances; and spending time doing meaningful things. It is important not to force yourself, but trying to reintroduce a few of these gradually will almost certainly help, even if you don’t feel like it. Just do it gently. Take baby steps. And be kind to yourself. Progress towards recovery is likely to be slow and not linear.
  6. I am sure there will be quite a lot in the programmes about medication. It is a hotly debated topic. I will just say this: the best clinicians will work with you to find the right treatment for you. It might or might not include medication. What is right for someone else may not be right for you. Also, most medications take time to start working. And sometimes the side-effects can be really tough.
  7. It is true that anyone can experience mental illness. But people who face other major challenges find it even harder to cope with and experience more lasting damage than those who do not. These include financial hardship, homelessness or insecure housing, loss of job or role, social isolation, bereavement, loneliness, abuse past or present, bullying and relationship problems can both cause and exacerbate a mental health problem. We are all born with a level of mental resilience which is then either added to or depleted depending on our childhood experiences. How we respond to later trauma is linked to these early experiences. Most therapy is about learning to understand ourselves better and to care for ourselves in a positive, kind way.
  8. Specialist mental health services are experiencing unprecedented demand. They are all making attempts to modernise and improve access to services and the appropriateness of treatment. But severe cuts have been made over the past 5 years which have reduced availability and in some cases removed very good services altogether. The government says they are reversing this. Some of us are keeping a very close eye to see whether they honour their word. But this doesn’t mean you will get poor care if you are referred to mental health services. You may have to wait a while. But you will find that most staff go out of their way to provide effective, compassionate, safe care.
  9. Your key mental health professional is your GP. Many GPs are really good at mental health. It is a significant part of their work. But they are also under huge work pressure. If yours seems to be one of the minority who are not so good, or you can’t get an appointment, you can arrange to see another doctor at the same practice or even change practices. It is a good idea to do this at a time that you are not in crisis.
  10. People who need help with mental health problems are not weak. In fact they have to be very brave to ask for help, and to do the things that are needed to recover. Doctors, nurses and therapists can help, but most of the recovery work is down to you. People who live with serious mental illnesses are heroes. They should be applauded every day for their tenacity, patience and courage.

The most important lesson I have learned, and it has taken me far too long to learn it, is that I need to listen to myself and be honest with myself about how I am feeling. At the time, it seemed that my last major episode of depression came out of the blue. With hindsight, it had been brewing for many months. How ironic that I, who was running mental health services, should have been so bad at spotting my own warning signs.

Intervening early and getting help when you need it should be standard across the UK. I make no apology for encouraging listeners to All in the Mind to ask for help if you need it, and not give up if it seems you aren’t getting it.

And if you are feeling desperate or suicidal, please talk to someone. There are various helplines listed here. The one I personally recommend is Samaritans on 116 123 or email Jo@samaritans.org. They will listen and help you make your own decisions. It may not sound like much, but it can be the greatest gift of all.