Ketamine- and psychedelic-assisted psychotherapy

20th October 2023 1:23 pm Comments Off

“Pychedelics are rapidly becoming a recognised and innovative method of treatment for many mental health crises”

Psychedelics are rapidly becoming a recognised and innovative method of treatment for many mental health crises, including suicidality, refractory depressive disorder, chronic PTSD and others.

Depression is a well-recognised and all-too-common cause of problems in the workplace and domestically. A family member’s depression can have ramifications for the extended family and the children of the depressed person, especially in the case of maternal depression (Barker et al., 2012).

While many sufferers of depression improve with prescribed antidepressants, especially when combined with therapies such as CBT and talking therapies, approximately a third of patients in the UK sadly will remain refractory to treatment or only moderately improve.

The evidence

Over the last 20 years, ketamine, an antagonist of the N-methyl-D-aspartate receptor, has been described to have antidepressant properties. Nowadays, a literature search shows many publications with promising results after a single infusion of low-dose ketamine with a rapid anti-depressive effect which lasts for one to two weeks after the infusion.

For patients who cannot attend a psychedelic clinic, intranasal sprays of ketamine have been approved by the Food and Drug Administration (FDA) for the treatment of depression.

Single-dose ketamine infusion has also been used as therapy for alcohol-use disorder with success. (Dakwar et al., 2019). The authors tested whether a single sub-anaesthetic infusion of ketamine combined with motivational enhancement therapy would affect the drinking of participants in the study.

Ketamine significantly increased the likelihood of abstinence, delayed the time to relapse and reduced the likelihood of heavy drinking days compared with midazolam

Forty participants attended five weeks of once-weekly motivational enhancement therapy. During the second week of therapy, they were randomly assigned to a 52-minute intravenous infusion of ketamine at a total dose of 0.71mg/kg (N=17) or the control midazolam at 0.025mg/kg (N=23).

Alcohol use following therapy was assessed using the timeline follow-back method, with abstinence confirmed by urine ethyl glucuronide testing.

Ketamine significantly increased the likelihood of abstinence, delayed the time to relapse and reduced the likelihood of heavy drinking days compared with midazolam.

So, what are psychedelics?

Ketamine, psilocybin and MDMA are all psychedelic therapies. Traditionally, psychiatric pathologies are treated with maintenance drugs. For example, once you are prescribed an antidepressant which helps you, you take it daily until you stop, if you stop.

With psychedelics, the drug is taken only a few times or sometimes only once, alongside appropriate psychotherapy, and then that’s the end of the pharmacological side of treatment. For some patients who suffer from side effects of traditional pharmacotherapies, this will be welcome. For patients for whom therapy has been unsuccessful, this can be life-changing.

Psychedelics are a loosely grouped class of drugs that can induce altered thoughts and sensory perceptions, and some can induce hallucinations.

Ketamine

There are more and more clinics every year opening in the UK specialising in psychedelic psychotherapy. Ketamine-assisted therapy is the most commonly prescribed treatment for depression, addiction, anxiety, eating disorders and PTSD.

Psilocybin

Imperial College London (Imperial) launched the first psychedelic research centre in the world and has recently conducted trials comparing psilocybin therapy with a conventional antidepressant drug (Carhart-Harris et al., 2021).

Results were quite consistent showing that the psilocybin therapy was really quite markedly better at reducing depressive symptoms

Dr Robin Carhart-Harris, research leader, psychiatrist and neuroscientist

During the above trial, all participants received talking therapy alongside either psilocybin or escitalopram – the conventional antidepressant.

Response rates in the psilocybin group averaged at 70 percent, compared with 48 percent in the escitalopram group.

Neuroplasticity

So how do the psychedelics work?

Psychedelic drugs work on the system in the brain called the serotonin system and especially the part of the system involved in neuroplasticity: the ability of the brain to change, be shaped and adapt.

In Imperial College London’s functional MRI research, they found that psilocybin increased plasticity and opened up new communication pathways

In Imperial’s functional MRI research, they found that psilocybin increased plasticity and opened up new communication pathways. As well as psilocybin, scientists also believe you can use MDMA to access a brain state where brain plasticity increases.

MDMA

Earlier this year, the first published study of an advanced clinical trial using MDMA in the US was found to be highly effective in treating PTSD. Researchers at the Multidisciplinary Association for Psychedelic Studies (MAPS) found that after three MDMA sessions, 67 percent of participants no longer qualified for a PTSD diagnosis and 88 percent experienced a reduction in symptoms (Mitchell et al., 2021).

These articles are well worth a read for those interested in psychopathologies, and bring hope to those suffering from refractory depression, suicidality, PTSD and alcohol dependence.

Feeling ok vs feeling better

1:20 pm Comments Off

“The people who continue to feel fantastic no matter what life does or doesn’t throw at them are probably making more of an effort than the people who feel great occasionally”

Last month, I ran a seminar entitled “Embracing change” at a London-based small animal hospital that had recently been acquired by a corporate. There are so many changes when we join a group with a chain of managers and leaders – new protocols, systems of appraisal, pricing systems, and so on.

What do you enjoy doing?
One of our sessions was a contemplative session, where we pose a question and then spend some time in quiet contemplation and stillness thinking about our answers. The question I put to the group was this: “In your precious little free time, do you spend time doing what you enjoy? Or doing what will make you feel better?”

There’s obviously no right or wrong answer here.

We had already learned how to be non-judgemental that day, so there was no self-judgement or self-criticism when we were thinking about how we spend our time away from the practice.

Looking at our answers with clear fresh eyes and curiosity allows us to think factually: what activities do I spend time doing? Then, emotionally: do I enjoy them? And lastly: do they make me feel better afterwards?

Looking at our answers with clear fresh eyes and curiosity allows us to think factually: what activities do I spend time doing?

There was an amazingly lively discussion afterwards. I didn’t suggest what the nuanced differences might be between the two ways of spending time. This was an open discovery of each other’s interpretation of the question.

Some of the delegates felt that the way they spend their time does indeed make them feel better in the long run. Others felt that their own activities and pastimes perhaps didn’t actually result in greater contentment and happiness afterwards, although they were truly enjoyable at the time.

Most delegates, including myself, enjoy the odd binge-watch of our favourite series, beer and curry in hand, followed by sprawling out on the sofa in delicious escapism from the hectic emotionally exhausting practice. Most of us also enjoyed walks in the fresh air, some of us enjoyed exercise, and others reading, cooking, and so on.

The difference was this: the delegates who felt that their activities outside of work resulted in an overall improvement in their mood were typically the people who were exercising, playing tennis, playing music, meditating, journalling, reading, etc, whereas those of us who were enjoying our binge-watching Netflix, eating ice cream and finishing off the bottle of wine knew in our hearts of hearts that it didn’t necessarily result in an improvement in our mental well-being.

True self-compassion is improving your mental well-being from low to good to fantastic, and then reinforcing that strong, unwavering contentment and joy by continuing the activities which improved it in the first place

Improving your mood doesn’t need to be reserved for when you’re feeling low or stressed. True self-compassion is improving your mental well-being from low to good to fantastic, and then reinforcing that strong, unwavering contentment and joy by continuing the activities which improved it in the first place.

Staying non-judgemental, there’s nothing wrong with slobbing out on the sofa and being entertained by streaming networks or drinking alcohol. We knew that. However, it’s a temporary “fix”, not an “improver”.

So, if it’s clear to us what makes us feel better and which activity provides a band-aid to our mood, why is it that some of us choose the latter instead of one of the options which will improve our overall well-being?

We decided it was because often those activities require effort.

What is effort?
It’s putting our mental and often physical energy into something. Sometimes it’s quite unpleasant, like that extra spin class you shoe-horned into your week, or maybe it’s getting up earlier than we want in order to meditate. It might be having water instead of beer. It may also be doing guitar practice when we desperately want to be horizontal instead.

Other times, the means is as enjoyable as the end. In other words, the effort is pleasant, such as having a bath with candles and gorgeous bath foam or sitting in the garden leaving all technology indoors and on silent.

Whether we choose to make more effort or not is our individual choice. Maybe we will only make an effort when our mood is low, and we have a wake-up call that those meditations we did last month aren’t having the same effect now as they did then.

The people who continue to feel fantastic no matter what life does or doesn’t throw at them are probably making more of an effort than the people who feel great occasionally. Maybe activities like running, meditation, piano practice and mindful reading are more enjoyable for some and more exhausting for others. After all, that’s the way life and personalities are.

Happiness is not ready-made; it comes from our own actions

The Dalai Lama
How do I do it?
It’s easy to make a list of “Things which make me feel better”, and to try to dip in and out of it regularly.

It’s important to notice how you feel prior to the activity, during it and afterwards. I usually can’t be bothered to go for a run after work. But once my trainers are on and I’m out the door, it’s “Oh my goodness this is amazing! I feel fantastic! What a treat.” Then afterwards, once the gasping for breath has settled and the muscle aches are setting in, I notice that I have done something for myself which required a hell of a lot of effort, and now I am high on endorphins and I’ll be congratulating myself on being that little bit fitter for the next few days.

Choosing different things off the list keeps it fresh and varied. We’re not going to run, cook healthy food, practise guitar and meditate every day

Choosing different things off the list keeps it fresh and varied. We’re not going to run, cook healthy food, practise guitar and meditate every day, I’m guessing. So, having plenty of activities to choose from means we never need to feel guilty for not doing everything on the list.

Conversely, if the list has only two to three things on it, we may feel obliged to do all three every day before we switch off. That’s unhelpful pressure and will probably end in our giving it up due to repetition and boredom. Most people will have 8 to 10 things that make them feel better. Getting started simply involves writing the list and noticing.

Book Release

7th September 2023 5:29 pm Comments Off

I’m so excited to share with you that my new book is now available on Amazon. All royalties are being donated to Vet Life and also to the provision of free of charge therapy for veterinary nurses in crisis.
It costs the same as half of 1 counselling session.
It is claimable as CPD, so it’s tax deductible and you can use part of your CPD allowance to buy it.
I hope you enjoy.

https://amzn.eu/d/3kJMfcz

From the Back Cover
Explore practical strategies for mental wellbeing across the veterinary professions

Mental Wellbeing and Positive Psychology for Veterinary Professionals: A Pre-emptive, Proactive and Solution-based Approach delivers a practical, hands-on guide to mental health and resilience for individual members of the veterinary professions and for those managing entire practices. Divided into 6 sections, the text offers valuable tools, including meditation, mindfulness, and positive psychology, to help readers grapple with the mental challenges presented by veterinary practice. The author has also included a series of case studies and anecdotes from her experience in counselling members of the professions, including a new-graduate vet, a specialist surgeon, and a head nurse, as they encounter issues like anxiety, compassion fatigue, fear of failure, imposter syndrome, and grief. By learning in advance about the common hurdles they will face during their careers, the reader will discover how to prepare for these in positive and proactive ways.

Readers will also find:

A thorough introduction to effective strategies for dealing with the difficulties of the veterinary professions, including mindfulness, empathy, and emotional intelligence
Comprehensive explorations of meditation, including body scan meditation, breath meditation, imagery, and mini-meditations
Practical discussions of specific challenges faced by veterinary practitioners, including moral injury, client complaints, burnout, imposter syndrome, and a loss of confidence
Fulsome case studies, including a veterinary nurse’s journey to mental wellbeing
Dr. Laura Woodward is well positioned to write on the topic, as both a working veterinary surgeon and an accredited counsellor and has crafted a text that is perfect for veterinarians, veterinary nurses, and practice managers. Mental Wellbeing and Positive Psychology for Veterinary Professionals will also benefit veterinary students, student veterinary nurses, and teaching staff seeking a comprehensive resource for veterinary mental health.

About the Author
Laura Woodward, MVB; CertVR; CertSAS; Dip Couns; MRCVS is the Founder of a counselling and mindfulness practice for veterinary professionals and also a surgical veterinarian at the Hampstead Village Vet Hospital in London in the United Kingdom. She is also mindfulness teacher, a positive psychologist, and is training to be an equine psychotherapist.

The Author has assigned a share of their Royalty to Vetlife and another to free of charge therapy for Veterinary nurses

Stress and Psychoneuroimmunology

1st July 2023 3:20 pm Comments Off

What is stress?
More importantly, what is stress to you? What is your stress at the moment?
The word ‘stress’ is such an all-encompassing word. A single word for the effects the world is having on different people in monumentally different circumstances at the same time.
These people might be working in a busy veterinary hospital, they may be the owners of the pets in that hospital, they may be crossing the channel in an inflatable dinghy, they may teachers in the US worried about gun crime, they may be hospital patients themselves.
In his book Full Catastrophe Living, Jon Kabat-Zinn tells the story of how he tried and tried to change the title of the first draft of the book over a decade ago. He just couldn’t find a name for the vast array of difficult experiences and stresses a human will come across in their life apart from ‘The Full Catastrophe’.

In Buddhist teachings, we learn about The Four Noble Truths which contain the essence of the Buddha’s teachings. It was these four principles that the Buddha came to understand during his meditation under the bodhi tree.

The truth of suffering (Dukkha)
The truth of the origin of suffering (Samudāya)
The truth of the cessation of suffering (Nirodha)
The truth of the path to the cessation of suffering (Magga).

Suffering, The Full Catastrophe and Stress, these are all words which by their nature will describe complex scenarios and emotions.
But the simplicity of at the heart of this word search is apparent: we are trying to unify a multitude of human experiences and responses in life and describe them with a single word or phrase. We’re communicating a distress.

Being stressed is neither right nor wrong. Feeling like you shouldn’t be stressed about work when others are less stressed about their life difficulties is being judgmental and self-deprecating and not helpful.

Stress can originate from a huge variety of sources and can be felt in our head, our stomach, our chest our mind. It will revisit us many times a day in all its various forms.
If we accept that life will have stressful events, we can work with it effectively rather than exhausting ourselves trying to fix it, avoid it or prevent it.
If the Buddha was able to break down the human existence into four truths, maybe we can look at stress in this way too. Most of us like flow charts, spider diagrams and spreadsheets.

Chicken and egg question
So, is stress the cause of our rapid heart rate? Or is stress our rapid heart rate in response to something that is happening?
In other words, which came first? Do I feel stressed which makes my case difficult? Or is that case a stressful case causing me distress?
In realty, the stress and the stressors are interconnected and inseparable.
So, in order to decrease the discomfort, maybe we need to identify and face the event or the fact (the stressor) and then examine our responses to it (the stress).

To make it a bit more complicated, sometimes the stressor comes from within us rather than being an external event or situation. For example, my ruminations may be causing stress. My thoughts may be rational, or irrational (based on statistics) and cause me stress.
It can take a bit of work to identify what’s what. It can take days with our eyes closed, sitting on the cushion to untangle the plethora of stressors, catastrophes and sufferings.

Using mindful curiosity, along with a willingness to explore with fresh eyes, we can untangle the stressors, the responses, the internal and the external. The untangling in itself is a valuable and fruitful exercise.
Some people, me included, find it easier to triage the stressors and identify the stressful emotions with pen and paper. The flow diagrams, strategies, pros and cons lists are some methods which can help.

If you enjoy running on adrenaline and caffeine, and many of us do, what’s the appeal of leading a less ‘stress-filled’ life when we’re happy as we are?

Psychoneuroimmunology

Hans Selye said “Between stimulus and response there is a space. In that space lies our freedom to choose our response, and therein lies our freedom”.

He also proposed that long-term exposure to stressors without our learning how to alleviate their effects on our bodies and our minds could compromise our immunity and therefore lead to decreased resistance to viruses and bacteria.
We now know so much more in the field of Psychoneuroimmunology, (PNI), but Hans Selye said it first.

The upside of this is that if we learn to adapt to the inevitable and varied stressors in our lives, if we manage to experience joy despite experiencing hassle at the same time, we will feel less daunted by the shock of the next stressor coming around the corner at us and the one after that and the next one etc.

We will also fight off viruses, SSI’s and the debilitating effects of arthritic pain better than if we don’t learn to adapt.

“We cannot stop the waves, but we can learn how to surf” Jon Kabat-Zinn

Psychoneuroimmunology (PNI) is a novel interdisciplinary scientific field that examines the relationship of the mind to the patient’s neurologic, endocrine, and immune systems by examining critical parameters such as the effects of mental stress on wound healing and infection rates. Techniques that modify a patient’s emotional and mental responses to illness and surgery have positive effects on their physiology resulting in improved recoveries and higher patient satisfaction rates.(1)

A young friend of mine was recently diagnosed with chordoma of C1-C2: a locally invasive tumour expanding rostrally into her pharynx from her upper cervical spine.
The statistics for this don’t exist, just a few case reports it’s so rare.
She was given the choice of having her upper cervical spine removed through her mouth or allowing the tumour to progress.

It would involve many teams of surgeons and anaesthetists, a day and night in theatre, fusion of her remaining cervical spine to her skull, tube feeding, maybe a tracheotomy. Heart attack, stroke and death were all possibilities.
Why was she encouraged to go through this by the surgical, oncological and anaesthetic teams?
It was because they had got to know her. This woman is strong, determined, unshakeable. They new her life story and realised that she had been surfing the waves of life her whole life. Ironically, when we swim in the sea, she prefers to stay in the shallows.
But whatever life had thrown at her, she had faced it with profound self-awareness and the ability to accept stress as part of the normal human existence without detracting from her happiness and enjoyment of life running beside the stressors in parallel.

Once she had decided to go ahead with the surgery, word of her courage and determination got around the London medical world.

The world-renowned surgeon who had written and co-written those few case-reports heard about this woman who takes on stress and challenges and surfs with them, and he decided he would cherry-pick this case for himself. He swooped in and took it from the original surgeons. He knew that attitudes like hers get results.
It’s a happy story about an amazing woman who defied all the odds, came through the most ambitious of surgeries, and stunned the medical teams with her rate of recovery.

We’re not all built like that. Her grit and determination to fight for life and to be there for her family is legendary and inspirational.
The moral of the story, however, is that, if we can allow our stressors to be recognised and acknowledged, if we can accept that they may cause us stress, suffering and the full catastrophe, we can learn to surf the waves without being shocked or surprised that they keep on coming like a good beach in Cornwall.
That will subconsciously build up our resilience and inner strength, so that when bigger stressors come along, we might be pulled under temporarily only to resurface nearer to the beach, rather than succumb to a tsunami and go under for ever.

Tagge EP, Natali EL, Lima E, Leek D, Neece CL, Randall KF. Psychoneuroimmunology and the pediatric surgeon. Semin Pediatr Surg. 2013 Aug;22(3):144-8. doi: 10.1053/j.sempedsurg.2013.05.002. PMID: 23870208.

Feeling Good vs Feeling Better

3:03 pm Comments Off

Last month I ran a seminar entitled “Embracing Change” at a London based small animal hospital which had recently been acquired by a corporate.
There are so many changes when we join a group with a chain of managers and leaders. New protocols, systems of appraisal, pricing systems, etc.

One of our sessions was a contemplative session i.e., where we pose a question and then spend some time in quiet contemplation and stillness thinking about our answers.

The question I put to the group was this: “In your precious little free time, do you spend time doing what you enjoy? Or doing what will make you feel better?”

There’s obviously no right or wrong answer here.
We had already learnt how to be non-judgmental that day, so there was no self-judgment or self-criticism when thinking about how we spend our time away from the practice.
Looking at our answers with clear fresh eyes and curiosity allows us to think factually: What activities do I spend time doing?
Then emotionally: Do I enjoy them?
And lastly: Do they make me feel better afterwards?

It was an amazingly lively discussion afterwards. I didn’t suggest what the nuanced differences might be between the two ways of spending time. This was an open discovery of each other’s interpretation of the question.

Some of the delegates felt that the way they spend their time does indeed make them feel better in the long run.
Others felt that their own activities and pastimes perhaps didn’t actually result in greater contentment and happiness afterwards although they were truly enjoyable at the time.

Most delegates including myself enjoy the odd binge watch of our favourite series, beer and curry in hand, followed by sprawling out on the sofa in delicious escapism from the hectic emotionally exhausting practice.
Most of us also enjoyed walks in the fresh air, some of us exercise and others reading, cooking etc.

The difference was this: the delegates who felt that their activities outside of work resulted in an overall improvement in their mood were typically the people who were exercising, playing tennis, playing music, meditating, journalling, reading etc. whereas those of us who were enjoying our binge watching Netflix, eating ice cream and finishing off the bottle of wine, knew in our hearts of hearts that it didn’t necessarily result in an improvement in our mental wellbeing.

Improving your mood doesn’t need to be reserved for when you’re feeling low or stressed. True self compassion is improving your mental wellbeing from low to good to fantastic, and then re-enforcing that strong, unwavering contentment and joy by continuing the activities which improved it in the first place.

Staying non-judgmental, there’s nothing wrong with slobbing out on the sofa and being entertained by streaming networks or drinking alcohol etc. We knew that. However, it’s a temporary ‘fix’ not an improver.

So, if it’s clear to us which makes us feel better and which provides a band-aid to our mood, why is it that some of us choose the latter instead of one of the options which will improve our overall wellbeing ?

We decided it was because often those activities require effort.

What is effort?
It’s putting our mental and often physical energy into something. Sometimes it’s quite unpleasant like that extra spin class you shoe-horned into your week, or maybe it’s getting up earlier than we want in order to meditate. Or it might be having water instead of beer. Or it might be doing guitar practice when we desperately want to be horizontal instead.
Other times, the means is as enjoyable as the end. In other words, the effort is pleasant. E.g. having a bath with candles and gorgeous bath foam or sitting in the garden leaving all technology indoors and on silent.
Whether we choose to make more effort or not is our individual choice. Maybe we will only make an effort when our mood is low and we have a wake-up call that those meditations we did last month aren’t having the same effect now as they did then.

The people who continue to feel fantastic no matter what life does or doesn’t throw at them are probably making more of an effort than the people who feel great occasionally, Maybe the activities like running, meditation, piano-practice, mindful reading etc. are more enjoyable for some and more exhausting for others, that’s the way life and personalities are.

How do I do it?
It’s easy to make a list of Things Which Make Me Feel Better, and to try to dip in and out of it regularly.
It’s important to notice how you feel prior to the activity, during it and afterwards. I usually can’t be bothered to go for a run after work. But once my trainers are on and I’m out the door, it’s “oh my goodness this is amazing, I feel fantastic, what a treat”, then afterwards once the gasping for breath has settled and the muscle aches are setting in, I notice, I have done something for myself which required a hell of a lot of effort, and now I am high on endorphins and I’ll be congratulating myself on being that little bit fitter for the next few days.
Choosing different things off the list keeps it fresh and varied. We’re not going to run, cook healthy food, practice guitar, and meditate every day I’m guessing. So, having plenty of activities to choose from means we never need to feel guilty for not doing everything on the list.
Conversely if the list has only 2-3 things on it, we may feel obliged to do all three every day before we switch off. That’s unhelpful pressure and will probably end in our giving it up due to repetition and boredom.
Most people will have 8-10 things which make them feel better.
Getting started simply involves writing the list and noticing.

“Happiness is not ready made; it comes from our own actions”.
The Dalai Lama

Equine Psychotherapy. What is it?

22nd October 2024 1:07 pm Comments Off

Most of us know how being in the presence of (healthy) animals generally helps us to feel calm, mindful, and content.

Of course, being in the presence of ill or injured animals can bring us many emotions such as excitement if you’re like me in the presence of a nice fracture, stress, sadness if we see a terminal patient, and many, many other emotions in between.

For now, I’m talking about being with animals who don’t need our veterinary skills. Animal-assisted therapies can include PET, Pat dogs, EFL (Equine Facilitated Learning), EFP (Equine Facilitated Psychotherapy), and many others.

Equine Facilitated Psychotherapy (EFP) is different to anything I thought I knew about the mental health benefits of being with animals. It’s very different. It may appear to be vague, but I have been blown away by the effects this therapy has on clients coming from so many different walks of life. And yet there is so little discussion compared to talking therapies.

There are no treats or riding of the horses. Therapy horses are different to riding school ponies or horses in a livery yard. Usually, natural horsemanship is practiced with turning out, barefoot, track grazing, and socialisation high on the agenda for their care.

In therapy, the therapist is the ‘Facilitator’. In EFP, the horse is seen as a co-facilitator. So, there is usually the client and the horse, and then there is the psychotherapist who is guiding the session and often just observing the horses reactions to the client and vice-versa.

Horses are excellent teachers in our journey to discover and understand ourselves. This is because they are herd animals, social by nature, and therefore have a heightened awareness of the rest of their herd members, which includes us.

We might never before have experienced such genuine deep attention to us by another. The horses have no agenda, they aren’t trying to get anything from us, they are focused entirely on the present moment. Mindful. Curious about us. Eager to be with us.

We know the benefits of focusing on the present moment. John Kabat Zinn describes mindfulness as “Focusing on the present moment, on purpose, non-judgmentally”.

This focusing on just here and just now for as long as we can, instead of rehashing the past or worrying about or planning for the future, makes us feel more grounded, more settled, more peaceful in our heads. This we have described in previous articles.

Horses are preyed upon in nature, and so have a keen ability to sense changes in their herd members, and they do the same in their interactions with us.

It’s so interesting to watch a group of horses sense each other’s behaviour.

Even without an ear twitch or vocalisation, or any movement at all, the horse can feel something and convey that feeling instantly e.g. short-lived stress because something moved in the bushes, and all the others look up, look around and decide as a group if this thing is worth stressing about.

This ability of horses to communicate through vibes is now apparent to me.

They sense changes in emotion, energy levels, behaviour, focus and attention, and they immediately reflect that information back to us. In that sense, they are our mirrors. And such huge mirrors they are, even the Shetlands. They are glaringly honest in this.

Horse-human connectedness, the ‘magic of EFP’ can be partly explained in neuroscientific terms by the fact that there is a remarkable similarity between the limbic (emotional) brain of horses and that of humans. Much more so than the limbic systems of cats and dogs.

The limbic system is a group of interconnected structures which regulates our emotions and behaviour. The limbic system works together with the cerebrum and cerebellum to process memory, thoughts and reasoning

This similarity in our limbic systems may explain in some part the bonding we feel with a horse which is a different type of bond to the one we form with a cat or a dog.

Another possible explanation, which I found hard to subscribe to until I investigated it scientifically, is that the horse thorax has an unusually large and powerful electromagnetic field. Bear with me on this. All animals can sense an electromagnetic field, and it has an effect on us. The effect on me is usually mesmerising. Others describe it as calming or hypnotising.

It can be measured.

Magnetocardiography (MCG) is a technique to measure the magnetic fields produced by electrical currents in the heart using extremely sensitive devices such as the superconducting quantum interference device (SQUID)

There are many wellness devices on the market the size of a yoga mat which generate an electromagnetic field to aid wellness. While they are FDA approved and seem to be very helpful for many users, they are not evidence-based therapies.

Martiny, Klaus et al (1), showed that in patients suffering with depression whose depression was resistant to traditional antidepressant medication, Transcranial Low Voltage Pulsed Electromagnetic Field therapy (T-PEMF) showed a clinically and statistically significant better outcome than treatment with sham T-PEMF, with an onset of action within the first weeks of therapy.

Neither of these are proof that it is the electromagnetic field of a horse which makes equine therapy different to other animal assisted therapy. However, I needed this and much deeper exploration with double blinded placebo-based trials, before I was able to see EFP as a realistic and effective type of therapy.

Horses can serve as both our mirrors and our teachers in terms of emotional intelligence, congruence and relationships.

Emotional intelligence is self-awareness, self-regulation, motivation, empathy and social skills.

When we are with a horse in that safe space where there are no other distractions, we have to be self-aware. That is being aware of how we are feeling, what’s going for us emotionally, and how we convey or don’t convey that on the outside.

Self-regulation makes us stop, pause and choose our reaction to an emotion rather than just acting reflexively or the way we’ve always reacted. During equine therapy, everything slows down. And therefore, creating this space and time between emotion and action becomes easier. Once learned and re learned while at the therapy sessions with the horses, this self-regulation becomes a healthy habit and our new normal.

Equine therapy does not focus on ‘goals’ or ‘end points’, So, while motivation to get what’s best out of a particular situation is part of emotional intelligence, it’s less important and even unimportant in EFP.

Empathy is a huge part of EFP. Through our relationship with the horse, their needs are very obvious even to someone who may normally find social cues and clues difficult to recognise. Also, the horse is neither emotionally complex nor needy. These baby steps of understanding how someone (the horse) is feeling and being able to be in that space with them, teach us so much about ‘walking a mile in some else’s shoes’ when it comes to people.

Social skills. Again, through small steps with the horse where we use eye contact, relationship skills, self-awareness, mutual positive regard with the horses, and reacting to their signals, we learn social skills which we can then use with more hard-to-read individuals (people).

Lessons learned with our equine companions are experiential, i.e.

in-person through actual experience, and therefore the associated new neural pathways are more easily created and reinforced.

When something is learned, relearned and set down in an experiential and feeling-based way as it is in EFP, the learning can be more easily transferred to the human-human sphere of relating, creating lasting and positive change for the therapy client.

And these intelligent, sensitive creatures are also our friends. They live entirely in the present, offering us patience, forgiveness and another chance when we get it wrong.

Congruence

Horses are radars for incongruence and will reward us when we behave in a way that is in keeping with who we really are and what we are truly feeling.

I have seen this so many times in this training. If we or the client are not focused on the present moment, or if we are showing our false self (incongruence) because that’s what we’re used to doing as a form of self-protection, horses generally don’t like that. They just walk away and choose not to bond with that incongruence.

It fascinates me every time.

This offers valuable learning opportunities in terms of true self/false self, emotional fluency and congruence and relationship skills.

Being congruent, i.e. our true self, is so much better for our mental wellbeing than is being what we think we should be from watching TikTok and scrolling through Instagram. Often, we’re not aware that we’re doing it, but in EFP it is pointed out to us by the horses. When we let go of all that stuff and choose to be present and mindful, that same horse will stop eating and walk over to us to just be with us.

The magic of EFP is when we know that the horse has chosen to be close to us physically and emotionally because we have chosen to be in the present moment, showing our true self and letting go of our ‘stuff’ for that moment.

When you get to that sweet spot with a therapy horse, it’s like being sucked into a vortex and for those precious moments nothing matters apart from that close bond. Sounds, sights, thoughts, they just evaporate away while you and the horse are in a trance-like state. It’s so powerful and therapeutic and I would have never believed its power before training as an EFP psychotherapist.

Transcranial Low Voltage Pulsed Electromagnetic Fields in Patients with Treatment-Resistant Depression

Martiny, Klaus et al. 2010

Biological Psychiatry, Volume 68, Issue 2, 163 – 169

Nature along with mindfulness; the evidence base for combining them to promote better concentration and improved stress management.

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Summer has arrived, the days are long, and we’re all commenting on how the sunshine brings a smile to people’s faces.
Even the dogs in the park seem joyous now that the winter blues have faded into our memories.
This time of year, often gets us out in nature because we don’t have to go out pre-armed with boots, hats, scarves, and gloves. We can just go as we are, it’s so much easier.

Nature exposure
There are many studies below which provide evidence that attention and working memory are critical coping resources for stress. They can be dramatically improved through nature exposure.
Mindfulness
We also know that mindfulness is a resource for coping, because mindful attention can facilitate effective appraisal and cognitive flexibility for coping. Mindfulness practices also lower cortisol levels, reduce distress across various samples including veterans with posttraumatic stress disorder (1) cancer patients (2), and children (3)
Prolonged mindfulness practice is associated with increased ability to self-regulate automatic or habitual responses to stressors.

So, can you imagine how utterly mind-blowing and life-changing practicing mindfulness while outdoors in nature could be for you?

Nature exposure
Being in nature is positively associated with emotional and psychological wellbeing (4). That is, a feeling of judging life positively and feeling good.
Even indirect exposure to nature, such as looking out a window onto a park, is positively associated with wellbeing. (5). How often do you check out the view the first time you enter your hotel room?
Being in nature promotes our personal wellbeing through two pathways which you may find yourself becoming aware of next time you’re in nature.
Firstly, directed attention which means that we’re focusing on purpose on the nature around us. Like with meditation, it takes effort, and we can become fatigued until we’re more practiced at this. Secondly, involuntary attention which involves intrinsic easy-going interest in the environment, and which requires little effort at all.
Here’s the great thing: by spending time having this easy-going intrinsic interest, it actually improves our ability to have the focused attention (8)
Not only that, but it also improves our working memory (9), executive functioning (10), and self-regulation (11).

I don’t know about you. But when I’m having a full-on day at work in the hospital, I need focused attention, good memory, high functioning and self-regulation all running at full throttle.

Mindfulness
We already know that mindfulness is associated with wellbeing in so many ways: reduced stress, more positive state of mind, tolerance of pain, better quality sleep, reduction in depressive symptoms. (6)

John Kabat-Zinn defines mindfulness as “paying attention, on purpose, to the present moment non-judgmentally.”
What this means is that we actively focus on the present moment, without straying into the past or the future. We see our emotions with curious eyes without judging them as right or wrong, or as anything in fact. Just feeling them and accepting that they are present.

Mindfulness and connection with nature each, separately, have been shown to cultivate good attention and to restore attention which has waned, which is essential for us to manage daily activities and our work effectively. (7)

Stress management in the veterinary industry is something I get asked a lot about. Many of us are under an enormous amount of stress and we see it as a normal part of the job. Sometimes we like stress as a driver of performance; like healthy stress with the pleasant adrenaline high which comes with an urgent case or a large caseload. When stress becomes an unhealthy way of being it’s because it’s depleting our personal resources at a rate greater than which we can replenish those resources.
Heathy coping with stress or adrenaline highs is called coping and it involves the appraisal of stressors using our internal non-judgmental attributes and often external resources such as going outside for a walk, a run, a breather.
Being in nature has a stress-buffering effect on personal wellbeing and is a very valuable external coping resource (12)
On top of that, being outdoors in nature improves our ability to concentrate and also our working memory (13), which are, in turn, vitally important for effective appraisal and development of our coping mechanisms and strategies.
Do you see the circle?

Berman et al (14) ran an interesting study comparing the people who had been on an urban walk with people who had been on a nature walk after a recent stressor. Those who had been on the nature walk significantly improved in working memory and were better able to reflect on the stressor and cope healthily with it compared to their urban walking counterparts.

Another really interesting study (15) found that public housing residents with a window view of green trees and green areas were better able to manage life’s regular stressors compared with those who had a view over more urban areas or ‘barren’ view.

So, with all the evidence above and all these references below, we simply cannot afford to let the opportunity of sitting outdoors meditating for any length of time (even one minute) pass us by.
Take this practice into the Autumn and Winter months with a blanket and a mug of hot tea, and the proof is here that you will become more mentally well than you ever thought possible.

(King et al., 2016),
(Carlson, Ursuliak, Goodey, Angen, & Speca, 2001)
(Mendelson et al., 2010).

.4. Nisbet, Zelenski, & Murphy, 2011; Windhorst & Williams, 2015

(Kaplan, 2001)

6 (Morone, Lynch, Greco, Tindle, & Weiner, 2008)

Kaplan, 1995
Ohly et al., 2016)
(Berman, Jonides, & Kaplan, 2008),
Schutte, Torquati, & Beattie, 2015),
Kaplan & Berman, 2010).
(Chawla, Keena, Pevec, & Stanley, 2014),
Kaplan & Berman, 2010),
Kaplan & Berman, 2010),
Kuo (2001)

The case for Positive Psychology to combat Burnout and Depression

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Burnout and depression report hospitalists in the US
A recent report looking at the quality of life in US hospitalists (hospital workers) showed that, while burnout and depression are major worries for the entire medical profession, they were a greater risk for workers treating patients full time in a hospital environment.
We are not, of course, human medical hospitalists. Neither are we in the US. However, being an experienced hospitalist in the veterinary sector in the UK, and listening to my clients in therapy (vets, vet nurses and doctors), I can see that the similarities are striking, and we can learn from this review.

This review (1) questioned hospitalists regarding their efforts towards having a well-rounded life, and how much their employers are helping to address burnout and depression risk.
The good news is that there is definitely a greater awareness in our UK veterinary world of the risks of poor mental health, depression and burnout compared to previous years. I have been working in London for 20 years and we have gone a full 180 from head in the sand, stiff upper lip, to now talking about mental healthiness being something we are all allowed and encouraged to focus on. The concerns I have are that sometimes we don’t know how to ‘do it’. Often, we are given a load of phone numbers pasted to the back of the toilet door as though they are all the resources we need. I know first-hand that that method doesn’t work with the majority of staff suffering with poor mental health.
I also belief (being a positive psychologist) that we would be much better off economically and emotionally if we addressed mental unhealthiness before it becomes a crisis.
It’s a bit like brushing your teeth really well after you’ve been told you need root canal treatment.
Or have you ever examined a dogs teeth to see deep layers of rock-solid calculus present and the owners ask you about whether they should now start to brush their dogs teeth?
Or have you ever shut the stable door after the horse has bolted?

Here’s another thought.
Do you ever look at your carefree happy kids and hope that they’ll keep this sense of joy forever with them despite the inevitable life hurdles they’ll face as they become older? It’s easier to hang onto that ability to enjoy life rather than desperately attempt to scrape ourselves back to that childhood bliss after we’ve let it go in pursuit of greater achievements like status and tangible achievements.

We should be aiming to have a life peppered with joyful moments instead of aiming to get through it intact in spite of our careers.
There will always be challenges for our entire workforce. It was Covid for several years, now it’s the financial pressures and public judgments of our finances, next year it may be something else.
We cannot postpone our happiness to the other side of these challenges.
Here are a few more parallels with us which I found in that study.

Job Stress and Burnout

Women experienced burnout more than men did. (I note that it was split in a binary fashion into men and women; a limiting factor of course).
Ask yourself “What’s your immediate reaction to hearing this?”
When I put this question to my colleagues, the answers were mostly “shame and embarrassment” from the female workers, and “surprise” by the males.

I can’t measure the significance of this and it’s not a double- blinded, placebo-based study. Neither is it looking at the results of veterinary professionals in the UK, nor is it asking other genders their opinions. However, shame is an emotion I often see in my clients: shame when they show vulnerability which they and many others see as a sign of weakness.
Why my male colleagues were surprised is again open to interpretation. I wonder if it’s because females cover up their stress, depression, and burnout more than males because of that shame we feel when we’re not seen as ‘strong enough for the job’.

What stressors at work contribute to Burnout?

If you are a line manager, practice manager or if you are in any way responsible for a clinicians job description, please ask yourself the following questions:

Am I giving my clinicians too much admin to do? Is it really necessary to do that much e-learning? Am I sending out too many emails with too many clicks to get to the actual information? Am I scheduling webinars during clinicians work hours as if I don’t realise they’ll be up to their eyes in clinical tasks during that webinar? It can make you look out of touch. Also, those tasks won’t be done, and the webinars will be ignored, perpetuating the divide between ‘people on the shop floor’ and ‘the powers above’.
Do you respect your clinical staff? Do you really understand the day-to-day workings of the clinic/s you oversee? If you do understand, do your clinicians believe this?
Do your staff feel adequately remunerated for the hours they work? Have you asked them? Would they prefer less hours with less pay? Do you know?
When clients disrespect your staff, do you have their back?
Do you allow your clinical leads and experienced staff to make decisions they are good at making? Have you decreased their autonomy in any way? If you have, do you know in what way it has affected them?

Duration of Burnout
The results of this study showing that burnout is a long-term state correlates with what I see in my counselling rooms.

When Burnout is primarily due to our job stresses and work environment, it’s not going to change just by going on a nice holiday or having a weekend off.
When we return, the same stressors are likely to still be in place. Burnout isn’t an acute state. It is the result of an accumulation of concerns, many of them embedded in the makeup of the workplace.
I don’t say this to make you throw your hands up in the air and give up. My hope is that we will learn to face the plethora of varying stressors, observe the emotions they bring up in us, and still manage to concurrently enjoy other factors in the workplace, life outside of work and those holidays. Adversity co-existing with happiness.

Personal relationships and Burnout

I suppose this statistic isn’t a shock.
What is surprising is how many people, when struggling with poor mental health, simply cannot see how it is affecting their relationships with their partners, children, parents and friends.
When we become practiced at noticing the small things around us which are ‘okay’ or even ‘good’, then our workplace stressors take up less of our headspace. This takes effort because we are so used to only focusing on problem lists, tasks which need to be completed and things which need to be fixed because they’re broken. It’s the tiny, good things which don’t need our attention that can bring us robust joy in the long run. And yet if we break the habit of a lifetime and make the effort to focus on what’s going well e.g. a game of hide and seek with your kid or a well made shape on the foam of your cappuccino, then, and only then are we giving ourselves a chance to balance the weighing scales a bit where burnout, depression, and exhaustion are on one end of the scales and joy is on the other.

How about your Employer?

I do feel very hopeful about this one as regards the veterinary sector in the UK.
All the large veterinary conferences are hosting wellbeing streams now. As these are growing in popularity and size, I have moved from speaking on positive psychology in a lecture area separated from the loud PA system by a crimson curtain, to pop-up lecture pods and now to decently sized lecture theatres.
I see most of the corporates looking for new and effective ways to promote Positive Psychology throughout their workforces, focusing on new graduate vets and nurses, managers and everyone in between.
‘Your employer’ is a human too. Many people along the chain of management and command are struggling with their own issues including job stress, depression, and burnout. Many others are having the time of their lives, and of course there are so many others in between.
At any given moment there are numerous reasons to be sad and numerous reasons to be happy. When we each take a moment to see where our focus is and try to shift it slightly towards the tiny reasons to feel happy, we are not only helping ourselves but also helping those below us and above us in the chain of command.
There’s an increasing awareness among executives in healthcare that wellbeing is a leading quality indicator, if not the indicator of favourable outcomes in patient care, staff turnover and other areas. I’m very optimistic that someday the veterinary world may lead the way on this.

What are your Coping Mechanisms?

This is what I see us do too to combat or attempt to combat the effects of the negative influences on our wellbeing.
What’s important here is to try to remain non-judgmental. For example, if you go for a run in the fresh air to help with your wellbeing and then have a few beers that evening to also help with your wellbeing, neither has to be judged as ‘good’ or ‘bad’.
I can meditate for an hour before dawn and still have a takeaway that evening. The Pad Thai does not undo the loving-kindness meditation.
I can choose to be completely alone, and I can then spend the night at a crowded gig. Both can be good for my mental wellbeing in different ways.
Even though it may seem more extreme, and therefore prone to be classed as ‘bad’, some intravenous drug users meditate effectively, and some alcoholics do amazing voluntary work.
So, listening to yourself actively, and being ‘responsibly selfish’ i.e. making the effort to balance your work with your wellbeing in whatever ways are genuinely effective for you, are life skills. Regularly checking in with yourself after partaking in activities which you expect will improve your wellbeing, and trying to honestly and accurately assess their beneficial or detrimental effects takes time and effort.

Do you talk about it?

Here’s an interesting one: Why might you not tell anyone about your poor mental wellbeing or depression?
We still see poor mental health as a weakness. We are terrified of shame. And I know for sure that sadly, many people do judge those who say they have mental health struggles as unfit for the job.
Can we change this common misperception?, I think it’s happening albeit at a very slow rate. Maybe those of us who feel content and happy at present can be advocates for those who don’t. Speaking out loud about Positive Psychology methodology is the easiest way to do this. The narrative around burnout and depression is nothing new (here I am writing about it again). The narrative around Positive Psychology is current and exciting and yet I believe we don’t shout about it enough.
Mental Wellbeing and Positive Psychology for Veterinary Professionals is a book that has been available for 6 months now. It contains chapters on Stress, Depression and Burnout of course. It also has a large section full of chapters on Positive Psychology and is written specifically for our Veterinary Professions.
Sprinkling 3 or more copies in the practice breakroom for staff to flip open takes such little effort, and yet it opens up conversations around positive psychology immediately. And it benefits VetLife and Veterinary Nurses in crisis who receive all the royalties from its sale.

Running on Empty

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Do you ever feel that you’re just not refreshed enough after sleep or even after a weekend to go back to work and get stuck in all over again?
Do you ever feel that the balance sheet of energy doesn’t balance because work depletes your reserves more than time away from work restores them?
Dou ever feel that a holiday from work just about gets you back to an even keel, rather than building up your reserves in advance of needing them at work?
If you answer yes to any or all of these questions, it may be that you aren’t yet aware of how best to build up all of your reserves.
Or maybe you’re filling one tank of energy to the brim but you’re unaware of the other tanks which need attention too.

I first met Frank, a CEO in a large corporate, when he was on the bottom rung of the corporate ladder beside me. He was ambitious and full of charisma and energy. Everyone who met him liked him and wanted to be his friend. The clients loved him, the team loved him, and management loved him. Before long, Frank was gone. Off to climb the ladder leaving us behind, and we and the clients missed him desperately.
Several years later I met up with Frank again at a Vet conference. He was now a CEO, exhausted, burnt out, and running on empty.
What could have happened to this vivacious, bubbly power bank I’d worked with only 8 years ago?
Well, Frank explained, it’s maths.
The energy, charisma and social interactions had depleted his battery to such a degree that he simply had nothing left to give. He had energised others to do a great job, actively charmed his way to the top, and spent vast amounts of time chatting in meetings and outside of meetings to such a degree that he was now a shadow of his former self.
And he was bewildered too. He had taken time off, worked out three times a week, gone on holidays with his family, eaten well, drunk very little, it just didn’t make sense.

I hear this story time and time again and I was that person too.
Now, with the benefit of hindsight and a lot of psychology training, I know that there’s more to regaining energy than going to the gym, going vegetarian, and going to bed for 8 hours a night.

The 5 energy tanks
Being aware of the 5 tanks means that we can gauge which one’s running low and which ones are nicely tanked up.
It’s also a way of ‘checking in’ with yourself to best choose how to refill each one in a way that works for you as an individual.

Our physical tank
This is probably the one we’re most aware of and the one that gets the most attention. It relates to our physical health, our physical strength and our alertness.
Exercise, eating well and sleep fill this tank up. Being sedentary, eating unhealthily, alcohol, vaping, poor sleep hygiene etc drain this tank very rapidly.
Being non-judgmental, all of the above is our choice. Also, all work and no play makes Frank a dull CEO. But being aware and noticing are the skills of self-awareness we can use here.
Our mental tank
This involves not only how much information we’ve taken in and how clever we are, but also how able to use that knowledge we are.
When our mental tank is full, our focus, our ability to apply this knowledge under pressure in real time, and our ability to have pinpoint concentration despite interruptions and busyness around us are running at full throttle.
It’s exhausting having to pay attention to our task when everybody around us is noisily going about fulfilling their tasks.
Our mental tank can be topped up with CPD, study and clinical discussions.
Our focus can be trained to be laser point sharp with simple meditations such as body scan and breath meditations or, even better, pinpoint concentration on nothingness meditations. All need to be done regularly.
Our Emotional tank
How positive are you feeling? You might be full of physical energy and comfortable with your skill set at work today. And how’s your mood? Are you smiling? A bit meh? A bit down but not sure why?
Our emotional tank gets ignored usually because we’re not sure what it is or where it’s located under the bonnet.
If we remember, our Emotional Intelligence is made up of our self-awareness, self-regulation, motivation, empathy and social skills.
Emotional batteries run on emotional intelligence and they give us the skills and energy to navigate pretty much any of life’s hurdles, challenges and catastrophes without losing the plot or becoming overwhelmed.
The great thing about this battery is that it’s self-charging. In other words, the more we become aware of our emotions and the more we regulate our reactions to those emotions, the better we get at noticing and regulating. It becomes second nature to us.
It may start out a bit time consuming and slow. But with a small time spent practicing, it takes no time and all and this massive skill becomes part of us.
Our spiritual tank
Spirituality is not about religion. It’s about morals, kindness, self-compassion and relationships.
Filling this tank up feeds into all the other tanks. You can never overfill this one. The surplus will help to fill the others and very importantly, it will spill out towards all those you come into contact with.
How do I recognise low levels in this tank?
Maybe you’re a bit impatient or snappy? Maybe you are focusing only on the negative episodes of your day and making them bigger than the day itself? Maybe you have an underlying sense of anger about something or someone within you?
Paradoxically, often filling this tank up is by giving something of yourself to others. Volunteering is a well-known method of boosting one’s sense of purpose and common humanity. It’s a vital skill of the Duke of Edinburgh award undertaken by most teenagers in the UK because of its enormous benefits to the individual as well as to society.
Other great ways to top it up are spending time in nature, without your phone, breathing in fresh air and noticing nature with wide curious fresh eyes. Forest bathing springs to mind.
Meditations such a loving-kindness meditation are particularly good at turbo-charging this tank when done first thing in the morning.
Our social tank.
We know that our social connection is as accurate a predictor of our mortality as is smoking, obesity or hypertension. This tank is depleted by spending large swathes of time alone either because of apathy, exhaustion or low self-esteem.
It’s also surprisingly rapidly depleted by spending lots of time in the company of people who either (a) don’t appreciate us or (b)who we dislike, and (c) want something for themselves from our interactions.
Our social tank is replete after spending time with people who we care about and who genuinely care about us. It can be filled by meeting new people and being inquisitive about them, caring for loved ones and physical intimacy with people who are genuine.

Back to Frank.
His physical tank was quite full because of his healthy lifestyle, good food and exercise.
His mental tank was half full. While he was enjoying learning about management on the job, his gregarious charismatic ways meant that everyone wanted a bit of him. He was constantly interrupted by colleagues, people he had to network with, and others who felt he could ‘fix’ everything by his presence.
His emotional tank was barely recognisable to him at this stage. He found himself being short with people who interrupted him which was not in keeping with the nice guy he was always trying to be. He was reacting reflexively instead of reflectively and often with impatience or anger.
His motivation was at an all time low, and he wanted to leave his job.
Spiritually, Frank had had no time in the previous eight years to be alone in nature, to meditate, to just be.
His job was all-consuming so volunteering or caring for others was out of the question. This tank was dry as a bone.

Surprisingly, after the myriad of social interactions he’d been having for years, Franks social tank was not proving to be the life saver he know it could be. This is because he was spending his valuable time with negative influences in his life, parasites and people who abused his good nature, instead of his long-term friends who knew him inside out and who loved him.

The morals of this story are…………check in with yourself first thing and last thing in the day.
Get used to quickly going through the different energy tanks like a checklist to see what level they’re at.
Act to replenish them in whatever way works for you, make it personal to you.
“Happiness is not ready made. It comes from your own actions” – The Dalai Lama

Are you good enough?

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When I was growing up in Ireland, I was always told to “Treat others as you would wish to be treated yourself”
Instead, I say “Treat yourself as you would wish others to treat you. Treat yourself as though you’re a dear friend”.
We don’t.
So many of us have been told by parents, partners and ourselves that are not good enough. So, we strive more and work harder and we become better at whatever it is we’re doing. We achieve great things. But is that really the healthy way to achieve stuff? Where do we go from there?
Does the inner critic say “Well done. You made it, now just Chill! ”? No.
That voice which we have unknowingly allowed to become part of our psyche is still there like a stuck record saying “You’re still not good enough. Yes, you did an adequate job but hey, that’s your job, it’s what you’re paid to do so no points gained there”.

How did we get here?
We can blame it on our families (and that is very often the case when we are being driven in our formative years. Literally driven), we can blame it on our spouse who takes their frustrations out on us, and we can blame it on social media, but blaming it on someone or something won’t make it change.
It’s easy to blame social media for making us anorexic, ashamed, over tanned, over botoxed. But it’s the whole of the supremacist culture we subscribe to which is influencing us.
We have to eat gorgeous food and then we have to diet. We have to be entertaining at dinner parties but not too entertaining. We have to look good, sound good, and we absolutely have to feel good and “don’t worry be happy”.
I went on a meditation retreat for 3 days recently. The other people who arrived were trying to get this done as fast as possible. They didn’t have time for a 10-day Vipassana retreat. They wanted a Drive thru retreat.
Oh, my goodness, could I possibly be one of them? Of course I was.
I wanted all the benefits of a full 10-day vipassana but fitted into my busy life of work and parenting my kids. Surely if I was good enough and worked hard enough and meditated the hell out of each day, I could make that happen?
I could not.
It became glaringly obvious that my attempts weren’t good enough. And for the first full day, I found it very difficult to get rid of this feeling that I had messed up. I was inadequate. 3 days wasn’t long enough. I have been meditating daily for 7 years and yet even I can’t get this done.
I spoke to my teacher at the end of the first day. We shared some mint tea and sat outside with the birds.
I told him about how I had wanted to do Vipassana for 10 days but of course that’s not possible because of looking after my kids. That I had tried to do 10 days crammed into 3. That I was not good enough after hundreds of hours of meditation to do this.
He was silent for ages. We sipped tea.
Then he asked, “does it matter?”
Long pause here.
I started to laugh into my tea spluttering everywhere. Oh, my goodness. Of course it didn’t matter a damn bit did it?
Not being able to cram 10 days into 3 is just math. Of course, it wasn’t possible and of course it didn’t matter one jot.

Now I know for sure, if someone had come to me feeling that they aren’t good enough to cram 10-day Vipasana into 3 days, I would have helped them. I would have held a mirror up to them so that they could see that that’s ok. It’s not something to be achieved or finished. Meditation is never finished, completed, like an assignment submitted.
3 days is 3 days and that’s definitely good enough.
That friend would have left my embrace knowing that they are loved and doing a great thing over those 3 days. I would have treated them like I would want to be treated.
I know for sure that I have said things to myself that I would never, ever say to a friend or even a stranger.

The external critic
I meet some people in my counselling rooms who have spent the majority of their lives living with a critic e.g. parents, spouses, peers. So, the feeling of inadequacy is ingrained in them. It’s become their truth and part of their whole persona. Because of the external critic, like an extra layer of domination, they have now developed an inner critic to keep them down in their place when they’re not physically with the actual propagator of this self-doubt; just in case the real world tries to boost their confidence or make them feel better than just adequate.
And thus, the inner critic is born to carry on the legacy of the perpetrator.
How on earth can we shake them off?
If the criticism and assurance that you’re not good enough has always come from your parents, you will believe it as the Truth.
You can’t help it.
And even when you start to outgrow this cloud of unworthiness and peep outwards from underneath it to see that actually sometimes you are indeed good enough or dare I say it good, it takes very little to send you back under that cloud for shelter from the uncomfortable bright glare of praise from others for doing something well.
It can feel ‘safe’ to return to the family bosom of truth where every family member knows the true you; the one who’s not good enough.
What a lot of courage it will take to step away from these firmly held beliefs you’ve had since birth or marriage, and step into the unknown where people who barely know you tell you that you’re good enough, your work is good, your smile is comforting and your taste in music is awesome.

Making friends with your inner critic is the first step.

Making friends with your inner critic.
TikTok, Insta and basically any visuals which tell us that we need something to look better, feel better, be better, are part of our life. Self-hatred or at least self-criticism is big business and drives economies.
Ageism, body-shaming, envy-induction are fantastic tools for selling to us the idea that we just aren’t good enough….yet.
So, noticing that we have an inner critic is the first step. Close your eyes.
Just noticing, non-judgmentally, means that we aren’t seeking to blame anyone or anything for our having this inner critic even though we know the source.
We’re just sitting quietly looking at it.
Then, seeing f you can soften your gaze towards this critic. It doesn’t have to be hated, nor does it have to be gotten rid of.
Can you be gentle towards this misinformed friend?
It doesn’t have to be believed and rule our decisions.
It doesn’t have to be shut in a box in the vain hope it won’t rear its head again. It will.
Instead, how about trying something new and allowing it to just be there, within your space, sitting in the periphery of your mind. Like you know it’s there, you can accept its presence in your life, and you can still say to it “Thanks for the advice, but I’m going to have a different perspective”
Or “I can hear you like stuck record saying I’m not good enough. However, I disagree and I’m bigger than you because I’m tangible. Mate”.

Once you identify your inner critic and once you look them in the eye, once you’ve spotted them, you can give them a name. This disempowers them.
Through my giggling I identified this particular inner critic of mine as bad math (i.e. 3 cannot become 10 just by working hard at it).

When your eyes are closed, focusing gently on your inner critic with curiosity and a gentle mind will disempower it.
When your eyes are open, taking charge of your focus and placing that critic into the periphery of your mind will keep it quiet while you treat yourself like a dear friend and take time to notice what you’re doing very well.

The Evidence-based Value of Trusting Your Employees

12:54 pm Comments Off

Working in a corporate has many pros and cons wherever you are on the ladder of command.
One thing which has become apparent is the distance which has been created between the person at the ‘top’ and the staff on the shop floor. This doesn’t need to be judged as a good thing or a bad thing. Again, many pros and many cons.
However, this sprawling chain of command which looks like a crazy family tree, and this distance created, has meant that the ‘boss’ no longer knows the first name of the vets and nurses, their value, their personalities and therefore how much they are to be trusted.
Years ago, when the ‘boss’ was a member of the shop floor team too, the trust which ensued through close relationships, frequency of meeting and daily mutual observations, created strong bonds between the people bringing in the money and the owner of the practice.
Gallup’s meta-analysis of decades of data from more than 100,000 teams (1) shows that high engagement (i.e. having a strong connection with one’s work and colleagues, and feeling like a real contributor), consistently leads to positive outcomes for both individuals and organisations.
The rewards for the practice include higher productivity, better standard of practise and increased profitability.

Work culture and employee engagement has been the focus of many workplace initiatives recently which is fantastic. Boosting employee mental wellbeing using positive psychology, mindfulness and other strategies has shown to improve retention and performance (Woodward, Laura: Mental Wellbeing and Positive Psychology for Veterinary Professionals).

So now that our employees feel more engaged and better ‘known’ by their employers, and they know that they are cared for as regards wellbeing, how to we keep them in that plane of progression, productivity and profitability?
The answer is Trust.
Trust
55% of CEOs think that a lack of trust between them and the shop floor staff is a threat to their organisation’s growth.
90% of them said that they didn’t know how to increase that trust. (2)
Employees in high-trust companies are more productive, have more energy at work, collaborate better with their colleagues, and stay with their employers longer than people working at low-trust companies. They also suffer less chronic stress and are happier with their lives, and these factors fuel stronger performance.
Compared with people at low-trust companies, people at high-trust companies report: 74% less stress, 106% more energy at work, 50% higher productivity, 13% fewer sick days, 76% more engagement, 29% more satisfaction with their lives, 40% less burnout.(3)

Paul J. Zak used fMRI to measured brain activity of people while they worked. (3). He questioned why two people might trust each other or not. Its our old friend oxytocin again.
He found that oxytocin was responsible not only for joy and pleasure but also trust.
Zak created an experiment whereby people randomly chosen were given the opportunity to send money to a stranger for investment and growth. They measured the oxytocin blood levels in both the senders and the recipients of the money. The participants did not know the purpose of the study or the reasons for the blood sampling.

Zak found that the more money a sender sent, the higher their levels of oxytocin prior to the choice of how much to send, indicating that they benefitted from trusting someone.
Moreover, the more money a recipient received to invest, the higher their level of oxytocin, showing that feeling trusted increases oxytocin.
Then they gave the participants a nasal oxytocin spray (which does increase the blood oxytocin levels) and a placebo spray. All participants remained cognitively unaltered.
The senders of money who had received the nasal oxytocin spray sent vastly more money than the placebo group, indicating that oxytocin can increase ones trust in another person.

How to I increase this trust phenomenon in my practice, my corporate area, my organisation?
We know that oxytocin is associated with joy, sense of purpose and mental wellbeing from previous articles.
We know that stress is an oxytocin inhibitor.
Oxytocin increases empathy and empathy is essential if we are to be good vets and nurses, working effectively in large and small teams and caring for clients.

Meaningful recognition of good work.
Recognition works best if it happens immediately after a goal is met, when it comes from peers and when it’s tangible, unexpected, personal and public.
The added advantage if its public, it inspires others to excel too.
How do I do this?
We have Teams, Group WhatsApp chats, group emails, it’s so easy to tick the immediate, peers, and public boxes.
Tangible, unexpected and personal can all be ticked by a small token (think crème egg, coffee), delivered by their line manager in the middle of a busy day.
This takes no time.
Give some autonomy
Delegation can be so hard to do. Especially if you would do the job better and faster yourself.
However, being trusted to figure things out, problem solve and see a task through from start to finish fosters employee engagement, retention, and productivity. A Citigroup and LinkedIn survey showed that nearly half of employees would forgo a 20% pay raise for greater autonomy over how they work.
How to do it?
Allow senior vets to offer to cap bills for clients, allow head nurses to authorise time off for others, allow receptionists to decide how the reception area should look etc.
By all means mitigate against possible downsides by having pre-agreed areas for autonomy, make sure everything is ethical and in the patients’ interest and then let go.
Enable Choice of work
There’s no point in making a nurse be on the surgical rota if she hates anaesthesia. Its dangerous for the patient, frustrating for the surgeon and most importantly not allowing that nurse to excel.
We all have a bias of interest be it ECC, imaging, client care etc. If we are trusted to choose wisely which role we prefer and get to focus in that area of work, we are more likely to excel at that role than if we are taken away from it regularly to cover areas where we have little interest, or worse, fear.
Ask for help
Asking for help is a very human thing to do and, paradoxically, it increases your credibility as a vet, nurse, or leader.
Asking for help is effective because it taps into the natural human impulse to cooperate with others.

By asking those ‘below you’ in the chain of command, you are showing a degree of vulnerability. This also stimulates the production of oxytocin in you and the staff members who help you. You can’t know everything. Often, the younger, newer, shyer member of staff knows more than you about something.

Encourage social relationships
Encouraging friendship building increases oxytocin in your staff and colleagues.
In a busy hospital, having a chat about yourself in the middle of the day’s probably not possible. In the office, getting through the endless list of tasks and problems and firefighting leaves staff exhausted and desperate for the door.

In The neurobiology of Collective action, Paul J. Zak shows that when people intentionally build a social life at work, their performance improves. (5).

So, when you go to the pub after work even though you’re exhausted, or when as a manager you put money behind the bar or buy everyone pizza at lunchtime, you encourage this social connection.
We know that our social connection is as accurate a predictor of our mortality as is smoking, obesity or hypertension. (6)
So having a beer after work not only makes us happier, it can make us live longer. And if the manager pays for the beer or chips which increases our oxytocin we’ll be more productive too.

https://www.gallup.com/workplace/321725/gallup-q12-meta-analysis-report.aspxshows
https://www.pwc.ro/en/press_room/assets/2016/ceo-survey-2016.pdf
https://doi.org/10.1111/1468-0297.00609
http://blogs.wsj.com/atwork/2014/10/31/flexibility-at-work-worth-skipping-a-raise/?reflink=desktopwebshare_permalink
Zak PJ, Barraza JA. The neurobiology of collective action. Front Neurosci. 2013 Nov 19;7:211. doi: 10.3389/fnins.2013.00211. PMID: 24311995; PMCID: PMC3832785.
Holt-Lunstatd https://dx.plos.org/10.1371/journal.pmed.1000316

Anger after an abusive relationship

12:52 pm Comments Off

So often we’re told that anger is a wrong emotion; one which should not be felt. However, anger can actually be a very powerful and energetic emotion. One which brings energy and colour into our actions. If we allow it to, and if we can do this intelligently.
Rather than judging this emotion as ‘right’ or ‘wrong’ it may be very helpful to relieve ourselves of the need to judge it at all and save our mental energy to work with it instead of against it when it arises within us.

Being abused by another person, especially if they have been a trusted partner or loved spouse is bewilderingly disempowering and easy to succumb to. If we can summon anger to assist us in this time of vulnerability, it can sharpen our senses and bring our power back, serving as a wake-up call that this abuse is not okay, and that I need to, and will stand up for what is right for me and my children or just me and myself.

The energy of anger can feel empowering. It can drive us to act with strength and vigour on behalf of ourselves or others.

Being assertive using anger to fuel our behaviour can indeed be very appropriate and can definitely be not ‘wrong’. However, we absolutely have to be mindful of the seductive effect that this new power can have on us, and not be carried away with adrenaline and more anger. It has to be measured, observed with wide eyes, used for good.

Being in control of your anger is further empowering: knowing that you can turn the volume up and down as you see fit with wisdom as your rudder.
Conversely, allowing this new emotion to take us away on an adrenaline-fuelled high of destruction and violence would just be succumbing to another abusive partner.

Anger can allow us to feel justified, especially if we have been’ wronged’. It can help us to regain our sense of self.
Again, using mindfulness, feeling the anger, giving it a name, and looking at it straight between the eyes, raises our awareness of what exactly we are feeling.
It also defuses the power that anger could have over us. The aim is for us to have power over our anger, not the other way around.
Getting caught up in it and being taken down a rabbit hole of who did this to us, how bad they are, how right I am etc etc could sap our strength just as it’s being regained.

It’s easy to get caught up in our story of who did who wrong. It can be the story we hide behind so that others will understand what happened to us and how bad the other party in the war is. But it’s not necessary if we are trying to simply harness the power of our anger in order to achieve what is just.

Lack of mindfulness, allowing mindless anger and rage to take us over, is rarely useful. It can make original issues so much worse. It can lead to our own lowered self esteem as we judge ourselves as ‘also wrong’. It can be divisive and hateful.
Righteous rage blinds us and can be our worst enemy if a peaceful and just outcome was our aim in the first place.

Using mindfulness and remaining acutely aware of our anger, being present with it, tight chest, nausea, palpitations and all, prevents us from ‘becoming anger’ and seeking its adrenaline-soaked refuge.

“It may simmer within as silent suspicion and resentment, or it may explode into violent rage and devastation.” Bhikkhu Bodhi
Practising mindfulness when angry gives us a choice in this.

Repressing our anger isn’t helpful either. Shutting it in a box and closing the lid simply doesn’t work. It comes back to take up our headspace often at a really unhelpful time e.g. when we’re trying to sleep.
Of course, sitting with our seething anger is uncomfortable physically and emotionally. Staying there, in that uncomfortable place, also provides us with the opportunity to reflect on our loneliness, our fear, our vulnerability, so that we can heal our wounds and emerge not just victorious but healthy and able to move on from the injustice of being abused.

When confronted with a scenario that causes an initial surge of anger, we first must understand how to not act reflexively.
Pause, reflect and then act.
“Between stimulus and response there is a space. In that space lies our power to choose our response. In our response lies our growth and our freedom” Viktor. E. Frankl.

When the urge arises in the mind
to feelings of wrathful hate,
do not act! Be silent, do not speak!
And like a log you should remain.

When the mind is wild with mockery
and filled with pride and haughty arrogance,
and when you want to show the hidden faults of others,
to bring up old dissensions or to act deceitfully…
It is then that like a log you should remain.

Buddhist monk Shantideva

Guilty pleasures

20th October 2023 1:34 pm Comments Off

“When you feel guilty but haven’t harmed anyone, you’re just in the realm of perfectionism or criticism”

In 2012, Goldsmith et al. observed how guilt, which is looked upon as a negative emotion, can have a positive effect by enhancing the enjoyment of a particular “guilty pleasure” (Goldsmith et al., 2012). These pleasures were viewed as hedonistic – as something the world would judge us poorly for doing – by the consumer. We decide we should feel shame for doing, eating or drinking it.

Some participants in the study were primed to feel guilt, others to feel angry or disgusted, while another group were not primed, although none of the groups were aware of this. Then they were allocated various activities, including binge-watching films, browsing dating websites and eating chocolate. The study found that, relative to no priming or negative priming, the negative emotions of anger and disgust decreased the pleasure of the activity, while guilt enhanced it.

[Guilty] pleasures were viewed as hedonistic – as something the world would judge us poorly for doing – by the consumer. We decide we should feel shame for doing, eating or drinking it

So, if guilt enhances pleasure, the marketing strategists are having a field day! Tobacco companies must have read this study and complied joyfully with the pictures on the packets that make smokers feel guilty for smoking. It makes the smoke all the nicer, it seems. In fact, another article shows that incidental exposure to “no smoking” signs ironically boosts cigarette-approach tendencies in smokers (Earp et al., 2013). Thus, anti-smoking and other public health campaigns may ironically increase the very behaviours they seek to reduce.

However, in another study, researchers demonstrated that participants who naturally associated eating chocolate cake with guilt had less belief in their self-control than the people who associated eating cake with positive feelings, such as celebrating (Kujier and Boyce, 2014). So, although the cake brings us more pleasure, it brings us poorer mental well-being because of our guilt, which makes us judge ourselves as weak and lacking in self-control. The authors observed: “Participants with a weight-loss goal who associated chocolate cake with guilt were less successful at losing weight over a three-month period compared to those associating chocolate cake with celebration.”

Anti-smoking and other public health campaigns may ironically increase the very behaviours they seek to reduce

Why am I telling you about this research?

It’s not to ruin your cake eating, honestly. Rather, it’s to enhance it.

Eating cake can bring us huge amounts of pleasure: it’s delicious, it’s sometimes celebratory and it’s social when at communal gatherings like teatime. Guilt, by definition, should be a term reserved for when one’s actions harm another. So, any guilt we associate with this sweet snacking is misplaced guilt. Dr Kristen Neff, an associate professor at the University of Texas at Austin, said: “When you feel guilty but haven’t harmed anyone, you’re just in the realm of perfectionism or criticism.”

Women are more likely than men to feel this misplaced guilt. Society has historically demonised women’s pleasure, even with food. A 1999 study showed that 50 percent of Japanese women associated high-fat foods and cake with guilt compared to only 9 percent of Japanese men (Rozin et al., 1999).

If you are medically overweight, cake is still appropriate to eat. If you’re trying to lose weight, it’s still possible (from the evidence) to have some cake and lose weight, so long as we knock guilt out of the experience. Diabetes no longer means that eating cake is risky now that we have insulin pumps, continuous glucose monitors and, most recently, systems that combine a pump and monitor for algorithm-driven automation of insulin delivery.

The true questions are:

Can we adjust our way of thinking?
Can we change from guilt to celebration?
Can we go from shame to self-compassion?

It isn’t rocket science or magic. It simply takes some time and mental effort to choose to make this change.

What’s the evidence?

Pleasure is not sinful, impure nor overindulgent. And the evidence base is there (because in our veterinary world, we need evidence to make a change).

Eating mindfully, non-judgementally and in a self-compassionate way can help one cope with symptoms of anxiety and depression

In 2015, a study reported that eating mindfully, non-judgementally and in a self-compassionate way (Körner et al., 2015) can help one cope with symptoms of anxiety and depression. Self-compassion, we already know, is a protective factor against depression.

Final thoughts

I meet many people in therapy who are high achievers, apparently successful, happy, beautiful and in great physical shape. But sometimes achieving gets in the way of enjoying, and self-judgement gets in the way of self-compassion. It is possible to have achievements, enjoyment and self-compassion all running together, and it takes effort.

My son asked me to buy him a giant jar of Nutella last week. He’s studying hard for exams and is generally a lovely person to me, his sister and everyone else. I bought it for him, and the first thing I did was dip a spoon into its sheen of deliciousness and eat it. I practise authentic self-compassion, I felt no guilt or shame, just joy and pleasure as I ate it mindfully. It was a true nutty chocolate paradise. I go to the gym because I want to be fit and healthy. They are very compatible side by side. One without the other would decrease my growth and my experience of life and simple pleasures.

Acceptance and commitment therapy: insomnia and anxiety

1:32 pm Comments Off

Acceptance and commitment therapy for insomnia lessens the brain’s level of nocturnal arousal, encouraging a state of rest rather than a state of insomnia

We’re constantly being told we have to strive to be happy, “turn that frown upside down” or – my personal favourite – “cheer up, love – it might never happen”. Consumerism aims to make us happy, and product design is there to make us feel better. So, it’s unsurprising that we subconsciously decide that feeling happy is “right” and feeling unhappy is “wrong” or something which must be changed to restore order.

Teaching the four noble truths, the Buddha tells us suffering is normal: an unavoidable part of being human. So, what does this mean? Should I sit here miserable and never try to feel good?

No, not at all.

The pressure of happiness

I was speaking with a client recently. It was her first session in therapy, and she was understandably nervous. “The goal,” I said, “isn’t to make you happy. It’s to help you to notice when you’re not happy and to be OK with it”.

After I said this, she told me that suddenly a pressure was lifted: she had been yearning and striving for most of her adult life to “be happy”. She felt obliged to be happy for her family, who had invested so much time and effort into helping her achieve her dream of becoming a vet. But then, here I was, saying she could take the lows with the highs and relax a bit.

The non-judgemental part of mindfulness allows us to see our thoughts and feelings with fresh eyes and not to place them into the “good” or “bad” category – they just are

The non-judgemental part of mindfulness allows us to see our thoughts and feelings with fresh eyes and not to place them into the “good” or “bad” category – they just are. If we are truly focused on our thoughts and feelings, we’ll see that we can have many feelings all going on simultaneously: some upbeat and some downbeat.

Every lifetime, every year, every day, there are going to be difficult times, thoughts and feelings, and there are also going to be joyful times, thoughts and feelings. It’s like running for a bus in the rain. You race through the downpour without an umbrella, splashing through puddles in your sandals, and you manage to get on the bus just the second it leaves; you’re delighted you made the bus and you’re soaked through and miserable at the same time.

ACT for anxiety

In the early 1980s, Steven Hayes developed “ACT” or acceptance and commitment therapy (which we have discussed in a previous article on re-entry anxiety post-COVID). During this, he observes that it’s not just what you feel and think that matters – it’s more important to notice how you relate to those thoughts and feelings.

It’s not just what you feel and think that matters – it’s more important to notice how you relate to those thoughts and feelings

ACT has many applications in therapy. Large randomised controlled trials have provided the evidence base for its application in the treatment of depression, anxiety, addiction, insomnia, chronic pain and cancer. But it can also be used with many other difficulties, such as psychosis, stigma, fear of failure and grief.

Anxiety is often due to a lack of psychological flexibility. It’s an inability to come into the present moment and open up to your emotions; to see your thoughts as they are and accept them rather than judging them as too unpleasant to bear.

ACT teaches you to focus on what’s really important to you so you can proceed towards it rather than being paralysed by anxiety. You can develop a sense of self beyond the limited story you’re used to telling about yourself and others – the one that gets in the way.

Carrying on with your day while shouldering these feelings of anxiety and panic isn’t easy, and it takes enormous courage, discipline and practice.

ACT-i

Continuing with ideas of increasing your psychological flexibility, acceptance and commitment therapy for insomnia, or “ACT-i”, aims to increase people’s willingness to experience the conditioned psychological and physical discomforts of being unable to sleep. Paradoxically, this acceptance lessens the brain’s level of nocturnal arousal, thus encouraging a state of rest and sleepiness rather than a state of arousal and insomnia.

Natural sleep involves a slowing down of the psychological pressures and tasks of our daily life at the end of the day. This includes problem solving, social interactions, decision making and being alert, and also a slowing down of physiological parameters, such as heart rate, breathing rate, blood pressure, bowel movements and muscle tone.

Paradoxically, [ACT-i] lessens the brain’s level of nocturnal arousal, thus encouraging a state of rest and sleepiness rather than a state of arousal and insomnia

On the other hand, insomnia is a difficulty with sleeping that typically involves hyperarousal and worry about not sleeping, which causes more arousal leading to even more poor sleep. It is our unwillingness to experience the unwanted thoughts, emotions and physical sensations associated with not sleeping and the ensuing struggle with them that heightens our arousal levels and perpetuates sleeplessness. We’ve all been there – you’re so fed up with lying awake that you can’t let go of that annoyance which also keeps you awake.

So, how can mindfulness help? Well, mindfulness is focusing on the present moment non-judgementally. In other words, it is the ability to objectively and non-judgementally take notice of your internal and external experiences as they unfold.

Mindfulness in conjunction with ACT can help insomniacs stand back and observe their level of wakefulness, unwanted thoughts and emotional reactions without becoming overly entangled with them or judging them – a quality inherent in the normal act of falling to sleep.

How do I do it?

Simple body scans and breath meditation techniques are a great place to start.

However, during these, your active mind might notice that it doesn’t feel sleepy yet. It can become the judgemental voice in your exhausted head and shouts that because it isn’t asleep yet, you must be trying to trick it, so it judges it all as a sham.

[Your active mind] can become the judgemental voice in your exhausted head which shouts that because it isn’t asleep yet, you must be trying to trick it, so it judges it all as a sham

Using these techniques, noticing the thoughts and feelings that arise when you find you’re still awake, and, most importantly, not judging them as wrong but instead accepting that they exist, is a worthwhile direction to take towards what seems to be that elusive good night’s sleep.

A path out of abuse – lessons from Tina Turner and her Buddhist faith

1:24 pm Comments Off

“People around the world have gleaned solace and comfort from Tina’s story, and many have subsequently found the huge burst of courage it takes to say that enough is enough”

Tina Turner, the legendary rock star with an iconic gravelly voice and lyrics which stick in your head, credited her Buddhist faith with giving her the physical and emotional strength to leave her abusive husband, Ike.

People around the world have gleaned solace and comfort from her story, and many have subsequently found the huge burst of courage it takes to say that enough is enough.

“She was my strength when I left my abuser,” former journalist Laura Keeney wrote while tweeting a Turner obituary, “and she introduced me to Buddhism as a balm for my soul.”

Abuse may not be obvious

Being in an abusive marriage or relationship eats you up from the inside out. It’s not just impoverished, uneducated victims who find themselves in the grip of an abusive partner. So often, it’s smart, previously upbeat and strong individuals with a relationship that looks solid from the outside who are suffering desperately behind closed doors.

Ike and Tina were spellbinding together when on stage. Their relationship looked amazing from the outside. The abuser can be the most charismatic of hosts in the home when the door opens to guests, and a monster behind closed doors once the guests leave and they turn their charm off like a light switch.

Abuse can be physical, sexual, emotional or financial, or a combination of any of these.

The abuser is often so controlling that their victim is too scared to leave or to call out their behaviour. Often it seems easier to just stay silent and hope for a better future.

The constant put-downs, gaslighting, insults and rage attacks can make the victim feel weak and terrified, especially when there are children involved. And this is why the cycle of abuse, terror and loneliness continues: because the victim is trying to make it OK for them or for their children. They are scared to tell anyone because the abuser will punish them even more.

“I was afraid to put it out [talk about the abuse] because of what I would get from Ike,” Tina told journalist Carl Arrington. Ike Turner denied he had abused Tina even though he freely admitted that he would “slap her about if she was sad”.

Sometimes the perpetrator is adamant that they are not abusive, often to the extent that they will go on a campaign of winning the hearts and minds of anyone who will agree with them that their actions aren’t defined as actual abuse.

If you’re a seasoned abuser, you can easily become so good at reinventing your private and past self to others that you start to believe your own lies. When this happens, even the abuser suffers because they can’t see themselves for the person they are. Ike claimed that slapping someone for being sad was not abusive.

So, when it becomes public that someone is abusive, the gaslighting continues because the victim gets further abuse for using the word “abuse”. A common defence from the abuser is to tell their victim that they’re losing their mind. It’s called gaslighting and it is the narcissist’s favourite tool.

Gaining strength from Buddhism

Tina Turner is not the only woman to gain enough strength from Buddhism to leave her violent husband.

Meditation helps us to gain focus when we’re reeling from yet another shouting match (which is an ironic phrase because “match” indicates that the shouting is back and forth, and usually it’s completely one-sided).

When we learn to clear our rollercoaster mind, we can see more clearly what we’re enduring

When we learn to clear our rollercoaster mind, we can see more clearly what we’re enduring. Once the fog has cleared, we need to begin the process of forgiving ourselves for getting into this situation. By being self-compassionate, we may be experiencing compassion for the first time.

Tina Turner was introduced to Valerie Bishop, who practised Nichiren Buddhism, by her ex-husband and abuser Ike. Nichiren Buddhists often chant “nam-myoho-renge-kyo” which expresses devotion to the laws of cause and effect. This chanting can be calming for the mind when in turmoil.

She chanted and practised meditation right up until her death in May, and many times said that it was her faith that gave her the courage to save herself from Ike. Not only did she send him packing, but since that day her strength grew and flourished in an exponential way through positive psychology, and her story empowered so many people to also say, “I can have a better life than this” and to leave their monsters.

In Daniel Lindsay and T J Martin’s 2021 documentary Tina, the singer said she was so nervous about doing the interview where she would describe the abuse she had suffered that she asked her psychic if it would ruin her career.

The singer recalled, “She [the psychic] said, ‘No, Tina, it’s going to do just the opposite. It’s going to break everything wide open.’”

And it gained her the added adulation of many tens of thousands of people suffering domestic abuse.

Abuse of another person is wrong. No two ways about it. Abusing someone and not admitting that it’s abuse is narcissistic. Telling a victim that you didn’t abuse them when you did is gaslighting and abusive.

These days it’s even more appropriate to call this behaviour out in the public domain. Children know it’s wrong and they are insightful enough to know what’s abusive and what’s not.

But there will always be what’s called “victim blaming”, where people under the influence of the charismatic abuser tell the victim that somehow it’s their fault their partner became abusive. And the perpetrator claims they can’t help beating, shouting or cheating on the victim because “they made me do it” or some other phrase that they feel makes them blameless. Hard to believe, I know.

Buddhism teaches us to look at the present rather than rehashing the past or getting preoccupied with the future. Only through focusing with pinpoint concentration on your present reality can you assess what’s happening and where you are.

But it’s so hard and sometimes impossible to use breathing or body scan techniques to calm the mind to bring us into our present. While in the foggy world of domestic abuse, our minds are all over the place, in survival mode.

When in turmoil because of abuse, sometimes chanting is the only way to still the mind. Alcohol only numbs it temporarily. Tina used chanting. Repetitive and melodic, it is soothing and possible.

With a clear mind, getting rid of the abuser becomes something very feasible. It’s like looking down on your life from above and it becomes crystal clear what’s happening and what needs to be done. It’s easier than you think.

With a clear mind, getting rid of the abuser becomes something very feasible. It’s like looking down on your life from above and it becomes crystal clear what’s happening

Once liberated, instead of looking backward, you can experience the delightful feeling of freedom in every fibre of your being, and done daily, that brings even more strength and creates a life well lived.

“I was living a life of death. I didn’t exist,” she said. “But I survived it. And when I walked out, I walked. And I didn’t look back.”

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