Wednesday, 20 November 2019

When The Fear Won't Go Away

As part of my job I am ‘lucky’ to be offered the opportunity to teach other clinicians the theory and skills needed to use Acceptance and Commitment Therapy (ACT) in their own clinical practice. I put ‘lucky’ in inverted commas becomes this privilege comes with a price tag: anxiety. You may be surprised to hear that I experience anxiety, when people first come to see me they often want to be anxiety (etc) free and anticipate as a psychologist that I must be. I make no apology for bursting that bubble, as in doing so I hope that you may be able to see more clearly that anxiety is a normal part of life, usually showing up when you care about something.  The skills I teach are about how to flexibly respond to difficult emotions with kindness and by allowing them to be there just as they are, start to even use them to your advantage. So I thought I’d use my recent experience of anxiety, when teaching at ACT Week at The University of Birmingham, to share some key principles of the ACT processes with you, in the hope that it might give you some ideas about how to befriend your own inner demons.

What I love

What’s so important here that I am willing to experience anxiety?

I love sharing my passion and enthusiasm for a therapeutic intervention that I find effective and I want to facilitate others’ learning and development in this area.  I enjoy the opportunity of connecting with people at the start of their ACT journey and of being able to offer support informally and formally after the event.  As a trainer I want to be authentic and bring my clinical and personal application of ACT to the party - to share what the theory looks like in practice, how to use it clinically and 'be' it, modelling how I use the skills personally to live more of the life I want to.  I want to be able to show that we are all ‘in the same boat’, that no-one is broken, rather that we can all get stuck in the struggle with normal experiences.

I value personal challenge, learning and my own development and want to learn skills to enable me to be engaging and effective as a trainer.  I enjoy the variety that preparing and delivering teaching brings to my usual day to day one-to-one therapy and supervision interactions.  The learning required to refresh and update skills also massively improves those interactions as it expands my knowledge and repertoire of tools (it is easy to fall into a habit of using a favoured few metaphors and exercises otherwise).

I also love being a part of a welcoming, inclusive supportive community of clinicians whose values are the same as my own.  I get a sense of belonging from being a part of this ‘tribe’ and want to share this and encourage others to join.  

What I fear

What internal demons show up and potentially get in the way of what matters? What hooks me? What do I do when I’m hooked?

For some time before and during the event I notice a tightness throughout my core, my chest and my gut, my jaw goes tight and because of this tension headaches are common.  I normally take in paracetamol and in previous years I've taken wet wipes and fresh deodorant to cope with the nervous sweating too! (I'm finding it easier to share over a blog....and now I'm wondering if it is too much….!) It’s like my body can’t cope - and actually it is! It's working perfectly fine, doing what it’s evolved to do when perceived danger is present, preparing me to fight, flee or freeze.

Sally FM (the name I’ve given my mind) has a long back catalogue of tracks to play on repeat around my inadequate skills and knowledge as a clinician and as a trainer.  She is fearful of my inadequacies being exposed and tries to protect me with scaremongering tales of not being able to answer questions and messing up demos to get me to stop - every year she says to just get through it and for goodness sake don't put yourself through this again!  Sally FM tells me that I'll let my usual co-facilitator down (and I notice I'm getting tearful as I write this, a measure of how much I love and respect him as a person, clinician, supervisor and trainer). She tells me I'm the pity invite to train and that he really wishes he'd asked someone else and now he's landed with me and doesn't know how to get rid of me. She compares me to other trainers who are more read/skilled/compassionate/engaging/funny blah blah blah!

When I'm hooked like a fish on a line it can take me off course and lead me to excessively read texts again and source new ones in preparation, I can be seen sticking to ‘comfortable and safe' sections of teaching content to be delivered, and deferring to co-trainers for things I know they like to do and are “way better than you at” (Sally FM says).  When hooked by her familiar stories of inadequacy I can try to include too much information, examples and exercises and be rigid with slide content/order rather than responding to the room and allowing people time to experience what I am trying to introduce.  I can become quiet and rush the punchlines in the examples/jokes (“because you’re just not funny and this is awkward”).  Sally FM tells me that I may share too much (In preparing for this I re-read feedback comments I have received….they all appreciated my sharing…. “Oh but what about the ones who wrote nothing?”)  It really is like a never ending game of chess between the positive and negative thoughts, maybe it is time to be like the board - in contact with the ‘demon pieces’ but not hooked into a battle with them…

Staying flexible: surfing the wave

What you would see me do if I was really ‘being’ the trainer I want to be

I have a clear recollection of a moment choosing to pause during ACT week and trying to 'drink in' the experience.  As I do this I feel a real sense of calm, of meaning and purpose.  This can help me stay flexible, getting present and noticing what is really here rather than the story Sally FM plays.  It is the time of year that I feel most alive, in touch with my own inner experience and what matters (it’s also the time of year I feel most scared).  It is helpful to hold that ‘in my pain I find my values and in my values I find my pain’; just like everyone.  There is nothing to be got rid of here, the anxiety is simply coordinated with how much this matters to me and if getting rid of the anxiety meant getting rid of the experience of teaching then I just would not make that choice.  Being in a room full of people who want to be there and know more about ACT is a heady cocktail, there is such an electric buzz.  It was my favourite year this year, I think because I wasn't holding on so tight, allowing myself to be more flexible in delivering content and playful in what and how content was shared: the difference between riding the rollercoaster holding on with white knuckles or throwing your arms in the air! 

Whilst noticing my own inner experience I really try to connect with who matters to me in the room, the delegates, in how I respond to questions/comments and in demos.  I am humbled by their willingness to be so open and really 'go there' and want to encourage and reinforce this bravery through eye contact, pausing and giving space, touch and writing lots of feedback notes giving thanks, expressing appreciation and recognising accomplishment.

Seeing as my inner demons are so strong I try use them to hopefully mine and others advantage and ‘model the model’ (as I am doing here).  The feedback I get is that this has enabled others to do the same in noticing, making room for and sharing their own thoughts and emotions.  People have said it has inspired them to show more vulnerability with clients in the service of enabling the client to be more willing and accepting of their own difficult experiences.  I introduced Sally FM last year and again this year, both times I have received fun feedback notes of my own about retuning her to DAB, and I can't (obvs!) and I'm not sure that I would want to because she is a measure of how much I care and so the time she is not there and goes ‘off air’ is when I am maybe just being static white noise and should maybe go 'off air’ myself.

Taking ACTion

Accepting what demons show up, Connecting with what matters & Taking ACTion

And as I post this I feel a little naked and exposed in sharing my vulnerability and that’s OK if it helps others make room for their demons and embrace a life led by meaning and vitality.

I am also taking ACTion towards being the best trainer I can be by putting myself forward to become a peer reviewed trainer by the ACBS. Something that pretty much everyone fails at first time, and that’s OK because in going through this and getting and acting on feedback I will become more of the passionate, engaging and effective trainer I want to be. I’ve been told that if something is worth doing properly its worth doing poorly first, so here I go…If you were to take ACTion towards something that is important to you, what might that be? What can you do about that today?

Tuesday, 13 November 2018

Practicing Gratitude: Acknowledging with Thanks

Hello, my name is Daisy and I am on a placement with Sally as an assistant psychologist.  At Ahead Psychology, Sally and I invite clients (and we try to remember ourselves), to write down something that we are grateful for each day in a shared journal.  Sally has asked me to write a blog about the importance of gratitude, by giving you this window into our journal we hope to inspire you to notice what is already around you that is often unseen and through noticing these things, inspire you do more of what brings you joy. 

And what is the point? 

It has been found that people who practice gratitude are less likely to be effected by negative emotions and are more likely to feel satisfied with their lives. The Positive Psychology Program discusses “The 28 Benefits of Gratitude”. These all fit into five main benefits:

1.    Emotional– Enhancing happiness, psychological wellbeing and positivity
2.    Social– Improving relationships with others and consequently social support
3.    Personality– Increasing levels of optimism and enthusiasm 
4.    Career– Greater patience and managerial skills
5.    Health– Reducing high blood pressure, sleeplessness and depressive symptoms 

Our mind’s job is to keep us alive and so it is always looking for danger, this normal negative focus means we can often end up existing rather than really LIVING!  A gratitude journal can allow us to shift our attention to the positives around us, however small, enabling us to savour these experiences and begin to consider how we can do more of them!  Through completing the shared journal at Ahead Psychology, people are invited to read and contribute if they are willing, through this we hope to create a sense of connection and shared experience where we can all GIVEand receive inspiration.

Themes of Gratitude

In reviewing the themes in the journal The Five Winning Ways to Wellbeing (like a mental health five a day) all came up as things that we are grateful for.

The biggest theme that emerged was CONNECTEDNESS.  Whether this is being grateful to others for giving support or our connecting with others through our actions.  Comments were about opening up to and willingly accepting the support of others, such as work colleagues, parents or friends and subsequently finding people felt more acknowledged and heard. Keeping connected with friends and family also involved simply “having a laugh” and sharing fun times together.  By keeping a note of how grateful this makes us, we can try to incorporate more time in our busy lives to have fun and do something special with those we care about.

It also became clear from reading the journal entries that another of the common themes involved BEING PRESENT and NOTICING and how this gave a new perspective on experiences.  This was particularly clear in entries about the activation of the senses by the outside environment.  Just noticing the “fresh air”, “warmth of the sun” and the “smell of the rain” allows us, for a moment, to let go of the virtual reality our mind often creates for us.  To let go of the internal struggles with our thoughts and feelings and connect with the real world and what is really happening around us. 

This reminds me of a metaphor we use in sessions: The sky and the weather. It goes like this, there is a part of you that is the observing self and that is like the sky, your thoughts and feelings are like the ever-changing weather.  As the sky we can learn to watch our internal experiences the same way we can notice the weather, knowing that sooner or later they will change and no matter how strong the storm is the sky is not harmed by the weather, it always has room for it all.  Take a look at this clip under playlists on Sally’s YouTube Channel to see this metaphor in greater detail:

Something that Sally and I often do in sessions is to invite clients to experiment with mindful eating.   Have you noticed how day to day we often rush our eating, mindlessly putting food in our mouths without noticing the appearance, texture, sound, smell and taste of the food? Eating in this hurried way, we often miss out on the pleasure of food, even finding we’ve over eaten and had something we later regret! Many of the entries in the gratitude journal reminded me of this experience, whereby something that occurred daily seemed to have the same effect of bringing us into the present moment and stimulating the senses, allowing us to take a few moments to be grateful of this experience and not simply taking it for granted. I now try to add mindful eating into my day, every so often just taking that time to appreciate that first mouthful and not lose that moment to every day distractions. I find the easiest time to practice mindful eating is in the evening after a busy day. However, the most beneficial time for me to practice this would probably be mid-day, instead of having a “working lunch” or eating on the go.  The key in all this is to become more aware of thoughts, feelings and sensations in the present, so that we can take meaningful, helpful action! It always comes back to NOTICING AND CHOOSING.

Another theme I noticed was the importance of SELF CARE, often seeing this around exercise.  BEING ACTIVE and making the time to go for that morning run or afternoon Zumba class was important to people, they commented about noticing the excuses of why not to go AND still doing it and then feeling great for doing so! People found that by looking after themselves they were more able to move towards their values, often around being there for others (think putting the oxygen mask on yourself before others on a plane). This though involves a willingness to prioritise our own needs, something that can be hard to do with that little voice saying that “its selfish” AND its possible to make room for that guilty feeling AND still do it! One of the Five Winning Ways to Wellbeing involves GIVING, not only to others, but also giving something to yourself. 

Going forward I would welcome you to experiment with this idea of developing your own gratitude practice for yourself, take time out and step back from your busy schedule and become immersed in the present moment.  Notice the things you may have previously just sleepwalked past/through on autopilot.  Perhaps dedicate a set time in the day, such as before you have dinner or as you get in to bed to think of a few things you are grateful for today, can they give you ideas of what to do more of tomorrow? Sally also has a Gratitude Jar she uses as home, and whether you are family or friends, over dinner you’re invited to pop something in and share a positive conversation.  Another idea on how to practice this is from one client, Lizzie, she has got really into this idea and has discovered a free app called Happy Feed (Happy Feed Website and App); it invites you to note three things you are grateful each day, you can even add photos of moments to savour.  So whatever method you try, be curious and give it a go for yourself today…….

Our invitation for a daily gratitude practice: Give THANKS

imes you’ve been happy that made you smile or laugh
ow you’ve been, what you’ve done e.g. brave, helpful
chievements however big or small
atural world and the beauty of nature
indness of others, things they’ve said or done
urprises (nice ones!)

Friday, 6 July 2018

10 Signposts to Living a Wholehearted Life

A synopsis and personal reflection on reading the book
‘The Gifts of Imperfection’ by Brené Brown (2010).

I want this to be right, to be appreciated for the sentiment I intend….so I'm sitting here thinking about how to start it and not starting anything for fear of getting it wrong and what you might think……so I'm just going to take a deep breath and begin…..

(I wrote that about a month ago, now I’m feeling a little sick, finding it hard to swallow and noticing a fluttering in my chest as it comes closer to publishing….AND I’m still going to do it! Tonight!).

Does ‘getting it right’, doing what you ‘should’, people pleasing and ‘being liked’ ever govern your behaviour choices? You're not defective, you're not alone, you're human! I was given ‘The Gifts of Imperfection’ by Brené Brown after talking to a friend about this.  I've finally made time for me to read it, perhaps because a similar trigger is looming ……THE BIRTHDAY CAKE! I like to make birthday cakes for my family as a way to show them that I love them.  I enjoy researching and thinking about the cake to make, but when it comes to actually doing it, it can be a bit stressful; I want them to love it, for it to be good, as good as the last one, if not better!  A colleague shared how for her children she’d bought a cake and ready-made icing and the kids had done it and had had a great time!  Wow!  It really resonated with me that that was what it's all about.

It's taken me a while to read and write about the book, as I said because I want to ‘get it right’!  As I start to write I'm noticing my mind (she’s called Poppy), going on about making sure I do the author’s work justice, that I convey key messages and invite you to read more and whether I'll get that right AND I'm just going to write because if I don't it will have no chance of being any of those things….

In this book Brené talks about three gifts that enable us to live wholeheartedly; courage, compassion and connection.  She uses the metaphor of swimming to introduce the idea of learning these things by doing them.  Courage is defined as speaking from the heart and through sharing our imperfections we realise that we are not alone.  Compassion is described in terms of being with pain without blaming or fixing, accepting yourself and others from a point of shared humanity.  Connection is introduced as reciprocally being seen and heard without judgement or hierarchy.

Brené describes how Love and Belonging are fundamental needs for us all to thrive.  Their importance and fear of absence means that we get hooked into performing, perfecting, pleasing and proving ourselves worthy, when we are actually already worthy right now: we are enough just as we are.  Love is about allowing both our vulnerability and strengths to be seen, it's about trust, respect, kindness and affection.  Genuine belonging is about authentically being your imperfect self.  If we think of these as actions and not feelings we can practice them i.e. show it not just say it.

So what is driving us to perform? to ‘hustle for worthiness’? shame.  Shame is the sense that we are flawed and unworthy.  Please don't stop reading, I know it's uncomfortable but not talking about it is what keeps it going, that fear of judgement, disappointment and being pushed away.  Shame Resilienceis the alternative route, acknowledging that you (we) are imperfect (not inadequate), AND still worthy AND that we can still be authentic sharing our story and asking for what we need.

In the book Brené introduces 10 signposts for an alternative shame resilient route:

1.     Authenticity; allowing yourself be seen as you are, letting go of the fear of what people think of you and the need to be who we think we should be 
2.     Self Compassion; tenderly embracing imperfections and being open and authentic, letting go of paralysing ‘other-focused’ perfectionism, that weight that holds us all down
3.     Resilient Spirit; having hope and belief that you can do something that will help, using skills such as reality checking, problem solving, seeking help and letting go of numbing avoidant behaviours ‘leaning in’ to experiences instead
4.     Gratitude and Joy; practicing gratitude by actively acknowledging what we are grateful for activates joy, giving us sustenance for inevitable times of difficulty, letting go of chasing the extraordinary and the fear of losing what we have casts shadows over what we already have that is already sufficient
5.     Intuition & Faith; courageously being with uncertainty, willingly trusting our instinct and letting go of reassurance seeking or rushing in
6.     Creativity; express originality and contribute through making - from cooking to painting, singing to building (it's not indulgent it's necessary!), letting go of comparison, conforming and competition, the need to be like everyone else - just that little bit better
7.     Play and Rest; play for the sake of play and let go of exhaustion and over scheduling being your status symbols by resting
8.     Calm and Stillness; cultivating a place of perspective where you can be aware of thoughts, emotions and urges not controlled by them, a position where you can respond from and not (over)react
9.     Meaningful Work; share our unique gifts and talents, letting go of self doubt (criticism and comparison) and ‘supposed to’ rules of behaviour by acknowledging them and doing what makes you come alive, your career does not define you, it is part of many meaningful things you do
10.  Laughter, Song and Dance; connect by embracing vulnerability and do all freely, letting go of inhibition and the need to be in control and ‘cool’

This sounds like a pretty obvious list, but it turns out insight isn't enough.  How can we take this knowledge and use it?  In the book Brené talks about ‘digging deep’ DIG being an acronym for getting Deliberate, Inspired, and Going, setting an intention for meaningful behaviour change.  I wanted to share with you what I intend to do, to inspire you …..


1.     Authenticity; write this blog (and keep writing blog posts) letting myself be seen to show others the possibility of being with inner experiences in a different way 
2.     Self Compassion; writing and practicing my own befriending meditation, a personalised practice to help foster an environment where I can be empathic to myself as well as others  (see below)
3.     Resilient Spirit; at certain points ask myself ‘Is what I am doing helpful or healthy for me?’ and adjust behaviour accordingly where possible and where I have to be with difficulty asking what I can do for myself/with others to get through it?
4.     Gratitude and Joy; add things daily to my gratitude jar (and move behaviour towards these things).  Also invite those in sessions with myself to add to a shared journal to aid personal noticing and reflection and inspire others
5.     Intuition and Faith; actively use the Serenity Prayer, at certain points again reminding myself to accept the thing I cannot change, have the courage to change the things I can and the wisdom to know the difference
6.     Creativity; protect time every week for a creative activity e.g. making a picture or baking
7.     Play and Rest; setting boundaries, realistic ‘to do’ lists (based on meaning and enjoyment not ‘shoulds’ and ‘musts’) and say ‘no’ e.g. limiting the size of lists and not doing all the things I should/want to if that would be unhealthy
8.     Calm and Stillness; taking a breath before I speak (especially when noticing strong emotions), protecting quiet time everyday without stimulation (iphones, TV etc) e.g simply walking and really connecting with that sensory experience through noticing what I can see, hear, feel, smell and taste and letting go of mental chatter
9.     Meaningful Work; create a Facebook page of my imperfect creations (pictures, baking, sewing etc) and offer my skills to friends to give them and myself enjoyment 
10.  Laughter, Song and Dance; set a music/dance/games night at home where we listen to music, dance and play games without the tv/social media etc and get Spotify or similar to listen to more and new music

My ‘BRAVE AFRIAD AND ALIVE’ Befriending Practice

Mindfulness introduces a new way of being with ourselves and others, by inviting us to befriend our experiences through curiosity, kindness and compassion.  This acceptance of ourselves and others, just as we are, cultivates an environment that is nurturing and that allows for flexible and healthy emotional processing. Here is the practice I have written for myself, try it yourself or better still create your own!

May I be courageous and allow my imperfections to be seen
May I make room for the fear of judgement and shame and let go of the need to be perfect
May I be kind and understanding to myself, remembering that I am not alone 
May I have hope, self-belief and the willingness to ask others for support when I need it
May I be grateful and see the extraordinary in the ordinary
May I learn to trust my intuition and embrace uncertainty
May I find meaning in creating
May I learn to say yes to play and say no to ‘to do’
May I find perspective from a place of calm and stillness
May I do more of what makes me ‘come alive’
May I let go of the need for control and sing and dance like no one is watching!

So as an update, the birthday has been and gone and I changed my behaviour! I had lots going on at the same time and I still wanted to make my daughter a special cake.  So I asked my mum for help, she baked the cake and I iced it (I did ask my daughter but she wanted me to do it – she was with me and did put the extra sprinkles on though).  Through doing this I saved myself the distress and shared the love.  I’ve created the Facebook page and a friend saw the cake and asked about how to make it for her loved one and so I’ve spread the love even wider than I could before!

If you’d like to find out more check out Brené Brown check out her TED Talks 

To follow up on this blog I am currently developing a workshop to run at the end of summer, please contact me if you are interested to find out more about this.

P.S. If there are typos, that’s OK, I’m only human!