Therapeutic writing workshop

I absolutely love this. I used to be one of those who felt they had nothing to write about. Now, I just write. If someone reads it, great, but I write for me first and foremost and it’s incredibly therapeutic.

Words for Wellbeing

This post is based on a handout I created for a 2-hour workshop on getting started with writing for wellbeing.

Research shows that writing can benefit your health and wellbeing, but so far no-one knows how it works. No special talent, ability or imagination is needed. Many people would enjoy writing, and benefit from it, if they just had a push to get started. Whatever you write is right for you. Trust yourself to write whatever you need to write.

My advice to people about writing for wellbeing is based on my belief that many kinds of writing can be therapeutic in different ways. For example: you do not have to write about unhappy thoughts for writing to be therapeutic. People can also benefit from writing about happiness or joy, or writing about the world around them.

The types of writing I use and recommend include: mindful writing, writing a…

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Work Blues

Before I get started today I will concede that my inner critic is turned up to 11 here. It’s in control, and as such I should probably walk away from the blog, but I want to write some of this down.

I find that I have walked myself, willingly, into another situation I am struggling to cope with.

I started a new job around 8 weeks ago. I knew when I was applying and interviewing for the job that I was to be working night shifts. 10pm-8am to be precise, four nights a week. I figured I could do it. I have worked unsociable hours before (even nights, but a while back admittedly) and believed I could again; my days would just be upside down for a little while.

The first 3 weeks were 9-5 in the classroom. The next 4 weeks were on the job, but in a supported environment. Those 4 weeks were 3-11pm. I loved those hours. I’m a morning person, so I could get up, do the things I needed to get done, and then head off to work.

This week, though, is my first on nights. I did Monday into Tuesday, and Tuesday into Wednesday. I’m sitting here now with the prospect of having to go in tonight too. I am not feeling good about it.

And let me be clear, I like the job on the whole. The company seems to be good and the people are great. But it’s the sleep. I can’t sleep in the day. I’ve tried. And people have said to me, or at least inferred, that I haven’t given it very long. They are probably right. Even after the 10 hour shifts I get home and have, at most, 4-5 hours sleep.

Sleep is a big deal for me. It has a direct impact on my mental health. If I can’t sleep properly, I am not myself. I am withdrawn and distant. The signs are not looking good for now either. I got up at around 8.30am this morning (didn’t work yesterday) so had a regular night’s sleep. I tried to go to sleep this afternoon ahead of tonight’s shift. I may have got around 30 minutes and then I was wide awake again. So now I will head off to work and go through ’til 8am and I’ll be a wreck tomorrow when I am going to a good friend’s wedding.

So what do I do? My mind jumps straight to quitting. But of course, it’s not that simple. First I have to cross the battlefield that is my mind and consider all the negative consequences and dodge the covering fire of my feelings of inadequacy around work. These are my current worries about this situation:

• I’ve let down the people who hired me
• I’ve let myself down by feeling unable to cope with this assignment
• I can’t seem to sleep in the day
• Lack of options if I quit
• Financial problems if I quit
• Possibility of having to move home if I am not earning
• I’ve fucked my work life up

In some ways, the quitting isn’t the problem. There is a bigger work problem at play. I don’t know what the hell I’m going to do. Since redundancy I have tried a few things and have been unsuccessful. My confidence in my work abilities has been knocked on its arse and now I look at jobs equivalent to what I used to do and wonder if I could do them again.

I also must acknowledge that maybe I haven’t given myself the best chance to succeed at this. I haven’t carved out the time to do mindfulness in two weeks. I am not eating properly – which is also partly a function of being on weird hours. I mean seriously when you have a lunch break at 2am, what do you eat? You don’t want to eat.

So I’m in a massive quandary. I can’t see the wood for the trees. I wish I could offer a better insight or positive thought to the end of this, but I just don’t see it at the moment.

Therapy and Honesty

I started afresh with a new therapist last week. I have been referred to a Cognitive Behavioural Therapist (CBT) and have an initial 6 sessions.

The first session didn’t go well. I felt like the therapist was simply trying to boil down what he considered to be my problems into something that he could define, describe, measure and cure. I will concede that this process and the therapist’s insistence that I needed to ‘buy in because it works’ made me check out mentally a little bit. As you may know if you have read earlier blogs, I have a problem with public transport. Stripped down, actually the problem isn’t the public transport but the people on it. The therapist was adamant that exposure was the way forward. He also wanted me to write down what was going on for me at the height of my anxiety. I told him that in the setting of a quiet and calm therapy room, I could see the merit and think rationally about it. However in the grip of anxiety and panic I couldn’t imagine reaching for the paper to write it down.

I have worked on graded exposure over the last 18 months and whilst I have pushed myself beyond what I though I could do, I didn’t truly feel like I’d made significant progress (particularly here the public transport – other areas of my anxious life have improved considerably).

I have also been through enough different treatments and therapies over the years where I feel like I know what I need. And so this clashed head on with what the therapist was saying to me.

I left the first appointment thinking ‘screw this guy’ and ‘I can’t work with him’ and ‘I’ll ask the service to assign me a different therapist’. A couple of things that had resonated with me from that session though. The first had been when the therapist suggested, gently, that I might have been being obstructive almost as a safety behaviour. As much as I didn’t like hearing that, it is true that therapy is a two-way street and I have found that anything less than bringing your full self to proceedings and being ready to challenge yourself means you won’t get what you want to achieve from therapy. OK fair point. Keep an open mind, Greg. The second thing he emphasised was that he appreciated honesty and if I felt something wasn’t right or working for me, I was to talk to him about it.

As this Thursday’s appointment approached I wasn’t feeling great about going back. I realised that I was going in without a plan or any suggestions to change. In that moment I resolved to prepare to be honest and give the therapist a chance to hear me and reassess.

Honesty felt like a difficult one in this context. I thought back to other times I felt like I wasn’t happy with how things were going in therapy and found a theme. I hadn’t said anything because I was worried about hurting the therapist’s feelings. I felt like they would take my feedback to heart and feel professionally wounded. Clearly, this is a projection of my own feelings. It also talks to a lack of assertiveness – this is not self-criticism really, it’s an observation and something I am owning and working on 🙂

So what did I have to be honest about? What did I want to say? I went back and told him that I had been frustrated and that I felt like I hadn’t been heard in that first session. I told him that the exposure hadn’t changed the thought processes and I wanted to work on the those. I let it out. I wasn’t personal and I wasn’t emotional. I just stated what I needed and how I saw us working together.

The therapist, to his great credit, listened to me and thanked me for my honesty and told me he respected it. We agreed that our focus would shift towards the cognitive side of work and started on that immediately.

I left the therapy appointment much happier than I had the previous week. I felt like I was starting something significant. I felt inspired to do work outside of the sessions to try and maximise what I can achieve in these time limited sessions.

It remains to be seen how this works for me. The journey continues…

Mindfulness – Mental Health Awareness Week 2015

This week (10th-17th May) is Mental Health Awareness Week for 2015 and one of the focuses of the week is mindfulness. For the uninitiated mindfulness is described by NHS Choices as:

Mark Williams, professor of clinical psychology at the Oxford Mindfulness Centre, says that mindfulness means knowing directly what is going on inside and outside ourselves, moment by moment.

“An important part of mindfulness is reconnecting with our bodies and the sensations they experience. This means waking up to the sights, sounds, smells and tastes of the present moment. That might be something as simple as the feel of a banister as we walk upstairs.

“Another important part of mindfulness is an awareness of our thoughts and feelings as they happen moment to moment.

“Awareness of this kind doesn’t start by trying to change or fix anything. It’s about allowing ourselves to see the present moment clearly. When we do that, it can positively change the way we see ourselves and our lives.”

I have been drawn to mindfulness for a couple of years without being able to fully commit to it. Commitment is key to mindful practice yet I have previously been unable to master it or practice it regularly. Sometimes this has been because my anxiety was such that subjecting myself to even a few minutes of being in the present, and not distracting myself with radio, tv or other things was too tortuous to even comprehend. Other times I would simply forget for a few days and fall out of the habit.

But those moments where I could practice mindfulness I was learning to appreciate being in the moment. To be clear, mindfulness as I understand it is not about quieting the mind or chasing off unwanted thoughts. It’s about noticing. This video from the Headspace app (more of which in a minute) has an animation explaining this beautifully:

The Headspace app begins life free and encourages you to ‘take 10’ each day; i.e. carve out 10 minutes for 10 days to practice mindfulness in a guided way. I downloaded it a few weeks ago and, full disclosure, completed the 10 sessions over about 14 days. You then have the option to subscribe for further guided content where you can choose the length of time to practice. Since subscribing I have gone up to 15 minute sessions, and my daily practice has stalled a little; I did it yesterday, but realise I haven’t yet done it today and probably won’t now that I’m about to start work for the day. But, I remain committed to making this a daily part of my life. Good intentions…

And so what has mindfulness done for me? It’s hard to say at the moment. Inconclusive. I am getting better at not judging myself or my experience of it. I find that my internal voice is labelling things, sounds, thoughts and so on. However, as Andy (on Headspace) says during the guided practices, it’s perfectly natural for the mind to wander off. When you catch it, you gently bring it back to the moment. Your breath. The weight of the body on the chair or the floor. I am appreciating those small moments of practice though. We spend so much of the day thinking or worrying about the past or the future, we scarcely stop to check in with the now.

One final thought about the impact of mindfulness on my own mental health. One of my ‘things’ is restlessness. If I’m not doing something, I can get anxious and start focusing on negative thoughts. I believe that mindfulness, with continued practice, will be an integral part of helping me to relax into a more momentary peaceful and calm state, more ready to deal with riding out the anxiety – letting time pass –  rather than being busy, and therefore distracted, all of the time. Let’s see how that works out…

You can learn more information on Mental Health Awareness Week here and over on Twitter using the hashtag #MHAW15.

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Mental Health in the Workplace and Disclosure

An interesting retweet popped up in my timeline this morning (I’m there as @gregeverything by the way!):

I’ve talked here before about the difference between physical ailments and mental ailments from my own experience (here). In an ideal world, we’d be treated just the same whether we were suffering with a broken arm or depression.

My involvement with Mind and Time to Change meant that we visited workplaces and talked to staff about mental health, with the aim of dispelling harmful myths about it. One thing that really stood out to me was how, in general, unprepared and scared managers felt about the prospect of a disclosure or managing someone who had been signed off for a mental health issue. We also encountered managers with damaging stigma too about people they considered were taking advantage of the system.

Coming back to the Tweet, the gentleman says that his colleagues sent flowers when he had appendicitis but when he was signed off with depression, nothing. I wonder if his colleagues know about his depression? If they do, then yeah his colleagues are showing a distinct lack of empathy and a whole lot of stigma around mental health.

I have been fortunate that I have not needed to be signed off from work – actually at my worst, work was a place I felt safe and had a sense of routine. However, had I been off, I’m not sure I’d have wanted my colleagues to know why. I have learned to disclose my problems a lot more, but I only do that when appropriate and/or to people I trust. Not all colleagues fit into that category for me. There’s probably a little residual stigma of my own in there too, not wanting people to know my business, pry or think differently of me because of my illness.

And this way of thinking must put managers in a difficult position. I’m not sure what the legal/HR position is on how much a manager can/should disclose to the rest of the team about why a person is signed off work. All the rest of the team know is that they are having to work harder as a result. It can create a toxic environment. Some managers I have known have disclosed physical injuries to us ‘oh Steve broke his arm over the weekend, the idiot, he won’t be in for a few days’. We all had a wry laugh at his expense and got on with it.

A final thought is that despite the strides we have made, sometimes people don’t have the words when it comes to mental health. Maybe this guy’s colleagues feel embarrassed by not knowing what to do or say. Maybe it’s so far out of their understanding they are paralysed. Lots of possibilities, I suppose.

Some tips on having conversations on mental health are provided on the excellent Time to Change website.

Reflections on the broken ankle

This weekend marked 9 weeks since I broke my ankle in a freak, and slightly ridiculous, volleyball accident. I re-read my post of 6th March (here) and found my mood to be, on the whole, anxious and negative.

So what was the reality?

I sulked and licked my wounds for a few days (not literally, that would be both weird and probably impossible!). Actually I have noticed this to be something of a pattern for me. For example, recently I have been looking for work. I am happy to say that I am now back in the workplace, but before that happened I received a couple of knock backs from interviews or people just not getting back to me. Again, in the immediate aftermath of the setback I was a little down and didn’t really want to talk to anyone.

The epiphany here is that I think I’ve realised that’s OK. I have recognised that the way I deal with less than positive situations is to initially withdraw and feel a bit sorry for myself. If I try to force a brighter outlook before I’m ready it invariably doesn’t work out. I suppose on some level it is a similar process to grieving. I have a certain image in my head, or routine, and that is interrupted or taken away and I have to take the time to adjust to that.

In the case of my broken ankle, once I was ready I began to rationalise. Yes getting around was going to be more difficult but not impossible. I couldn’t go play sports or train and so I found other focuses for my attention. I made plans of action and followed them through. I arranged to see friends to maintain that social contact that my injury would prevent me from getting in some areas.

And the truth is it wasn’t as bad as I imagined it would be. Imagine that. The reality not being as bad as the thought. Who knew? (Oh yeah, just about every therapist I’ve EVER seen!).

Tomorrow I will be 3 weeks out of my protective boot. I am still hobbling a little but I am on the right track to recovery. Life has changed again because of my new job, but a good deal of normality is returning too!

Deficiencies or Strength?

It occurred to me recently that we’re constantly told, probably mainly by ourselves but also doctors and friends and family, that to have a mental illness is to have a major deficiency. Whilst on some level there’s possibly – possibly – something in that on a technical level, people who have a mental illness are the people who probably the people who least need additional negativity and stigma attached to their condition, given our proclivity to inward reflection and self-criticism.

In my case, as alluded to before, the negative reinforcement comes from myself. I should be able to go on trains and planes. I should be able to go to social gatherings and not be looking over my shoulder every five minutes. I should be in a better place in my career given my experience. Jeez, when I write it all down I realise I wouldn’t say that to anyone else. And yet I say it to myself. As far as I am thinking, I am failing at some important aspects of life or at least not meeting expectations.

It’s true, I wish the above wasn’t true. But I suppose the important thing is continuing the work and acknowledging my strengths.

And so I suppose this piece is about self-kindness. I can change those ‘shoulds’ to ‘coulds’. I can celebrate successes, be they minor to the everyday person. I can take great pride in the fact that, no matter the pace, I am gradually moving towards where I want to be.

Take the time today to remember that however hard things seem right now, you (we) have already been through tough times and come out the other side. Comparison and high expectations are potentially very damaging. Remember, those ‘normal’ people out there that we think have their lives together really don’t (despite what Social Media might tell you!). We aren’t burying our heads and pretending things are OK. We are some of the strongest people around and continue to be.

New Neighbours

Today some new people moved into the flat next to ours. The flat has been empty for a good few months and before that an old man lived alone.

I have noticed this evening the urge to reach for some old safety behaviours.

I have worried about neighbours in the past. I have moved house a number of times because I haven’t liked, or felt threatened by neighbours. This is, of course, all linked to my PTSD and the hyper vigilance that is a particular symptom for me.

I should also say that I actually met the new neighbours last week and they seem like perfectly nice people.

However, a sense of unease is upon me. The fear of the unknown. The change to the status quo.

And so I return to acknowledging the reaching for the safety behaviours:

• Thinking about staying away from the room adjoining the flat next-door, and staying away from the door
• Thinking about closing windows so no outside sounds can come in
• Thinking about having the tv/radio/netflix on constantly to manage what I can hear
• Thinking of how I can move house if things get unmanageable

The positive thing for me here is that I am recognising and acknowledging what is going on. By and large, I have caught myself when any of the above thoughts have cropped up, and not gone with it. I am watchful, I recognise that, but I am not giving in.

I also know that I am trying to get a sense of control when I can’t necessarily control what s going on. I can only control my reaction. I remind myself that what I am experiencing are just thoughts. I am under no direct threat. For me, this does feel like genuine progress. The real test will come if I do start to hear noise coming from there…

Time isn’t static. Journey through today. Shape it towards your goals.

I needed to read this right now