Christmas, your way

We are well and truly in the midst of the festive season, and whether or not you celebrate Christmas and New Year, living and working in Ireland there are likely to be parties and social events happening everywhere you look.

It’s a wonderful time of year for those who enjoy these occasions, but I know more than one of us is dreading the endless small talk and fear of social awkwardness at festive parties, or else the exhaustion family members can sometimes unwittingly cause over Christmas or New Year itself.

The terms ‘introvert’ and ‘extrovert’ – originally spelled ‘extravert’ – were popularized by Swiss psychiatrist Carl Jung in the early 20th century. His idea was that most people would be at some point on a spectrum between the two points – as he said: “There is no such thing as a pure introvert or extravert. Such a person would be in the lunatic asylum.” In the years since Jung’s research our ideas about introverts and extroverts have changed, and until recently it was widely believed that pretty much everyone could be divided into two camps: outgoing (extrovert) or shy (introvert).

Susan Cain’s book Quiet: The Power of Introverts in a World That Can’t Stop Talking, published in 2012, did a lot to combat the simplistic view of extroverts as outgoing and introverts as shy. While it’s true that those things may align, it’s also possible to have a shy extrovert or an outgoing introvert, as the terms are actually more to do with where a person gets their energy from. If you find yourself lonely and frustrated after a day alone and can’t wait to get out to a bustling party, you’re closer to the extrovert end of the spectrum, while if you find parties, however enjoyable, to be thoroughly exhausting, then you’re more of an introvert.

Cain argues that society has a bias in favour of extroverts. If this is particularly true at any time of year, it’s definitely the Christmas and New Year period. Work parties, drinks with the neighbours, drinks with friends, Christmas reunions, the big New Year party… it can be endlessly exhausting, and it’s ok to admit that, however much pressure you may be under to look like you’re having the time of your life.

While the easiest solution for an introvert struggling through the festive season is to simply not accept any party invitations, this sadly isn’t practical and risks offending friends, weakening professional ties and inflicting loneliness on yourself.

There are no hard and fast rules for making it through, but recognising where you are on the extrovert/introvert spectrum can really help. If you know you’re an introvert, it’s very helpful to plan ahead before social events – book in some quiet time to recharge in the days before or after an upcoming party, or plan a set time to leave each event or suitable excuse for doing so. If you’re spending time with family, planning activities or outings can help structure time and take the pressure off everyone to come up with conversation – even if it’s just going for a walk or playing a ridiculous game.

It’s important to note too that while it isn’t a good idea to refuse every invitation and shut yourself up in a cupboard until February, you are under no obligation to say yes to everything. There is nothing wrong with passing up the odd event in favour of some quiet time, leaving early, or even choosing not to drink alcohol on the odd occasion in order to conserve energy. These steps can be difficult, especially in our culture, but I would urge you to have the courage to lay out your own boundaries – you may find that your family members, friends or colleagues respect you even more for it.

Give a little, get a lot

Volunteering is something I’ve often recommended, as I’m a firm believer in the widely-held view that doing good for other people means also doing good for yourself. But in the week after International Volunteer Day, let’s look at why that is the case and what evidence there is to support it.

 A 2017 Volunteer Ireland report used an online survey of almost 1800 volunteers and three focus groups made up of volunteers to examine the health benefits the volunteers believed they experienced. The report noted: “The analysis of the online national survey and the three focus groups show that volunteering can have a significant positive impact on a person's health and well-being. This is further supported by research in a number of countries linking volunteering with positive health and well-being.”

There are a number of other sources of evidence around the benefits of volunteering, most of which based on studies done in the US.

Volunteering could help job-seekers find work

A 2013 US government study run by the Corporation for National and Community Service found a link between volunteering and finding employment. The study examined the answers of 70,535 people to the Current Population Survey between 2002 and 2012, monitoring their results to questions about employment status and whether or not they volunteered. While they did not establish a causal link, they found that volunteering is associated with a 27% higher chance of employment. Another 2013 study by the Center for Economic and Policy Research, also based in the US, examined those looking for work in the country between 2008 and 2011. It found that unemployed people who volunteered for between 20 and 49 hours a year were 57.3% more likely than non-volunteers to be in work the following year. 

 Volunteering makes you feel like you have more time

Research shows that people who volunteer feel like they have more time to spare. Cassie Mogilner, Assistant Professor of Marketing at the University of Pennysilvania, who led the research, wrote in the Harvard Business Review: “The results show that giving your time to others can make you feel more “time affluent” and less time-constrained than wasting your time, spending it on yourself, or even getting a windfall of free time.”

In a series of studies, Mogilner divided subjects into groups, instructing one group to help another person, by writing to a sick child, or editing a disadvantaged student’s essay, and the other group to do something else. In one study the second group wasted time counting the number of ‘e’s in a piece of text, in another they did something for themselves, and in a third they simply left the research lab early. Mogilner found that in each experiment the people who had helped others felt they had more time than the other group.

Results showed an interesting explanation for this: people who gave time helping others felt more capable, confident and useful. They felt like they had accomplished something, and this made them feel like they could accomplish more things in future. 

Volunteering is good for your health

A study from Carnegie Mellon University found that adults over 50 who volunteered for more than 200 hours in the past year were less likely to develop high blood pressure than those of the same age who did not. Lead author Rodlescia Sneed suggested that the link could be due to increased activity while volunteering, or a reduction in stress. She said: “Many people find volunteer work to be helpful with respect to stress reduction, and we know that stress is very strongly linked to health outcomes.”

A report for the Corporation for National & Community Service said: “Over the past two decades we have seen a growing body of research that indicates volunteering provides individual health benefits in addition to social benefits. This research has established a strong relationship between volunteering and health: those who volunteer have lower mortality rates, greater functional ability, and lower rates of depression later in life than those who do not volunteer.”

Volunteering makes you happier

 A 2008 study our estimates suggest that people who volunteer report better health and greater happiness than people who do not, a relationship that is not driven by socio-economic differences between volunteers and non-volunteers. 

So what are you waiting for? Get out there and start volunteering. Ask around in your local community or search the Volunteer Ireland website for ideas here.

Resolving Chronic Pain: Some exciting news

Here at Resolving Chronic Pain I have some very exciting news to share: the textbook on chronic pain which I have been working on for several years has finally been published!

Entitled Psychophysiologic Disorders: Trauma Informed, Interprofessional Diagnosis and Treatment, the book is a collection of chapters written by experts in the field and edited by David Clarke, Howard Schubiner, myself, and Allan Abbass.

Sixteen practitioners, experts and patients contributed to eighteen chapters to create both an inspiring blueprint for existing health practitioners and a roadmap for medical students about to embark on their careers.

Psychophysiologic Disorders (PPD) is a term used to describe chronic or unexplained pain for which stress is the root cause, also sometimes known as ‘Stress Illness’. Part One of the book describes the condition and its history from ancient times up to recent medical scholarship. Part Two is a collection of essays from medical practitioners writing about the integration of PPD into their professional practice.

My involvement in the book has been hugely challenging and exciting in equal parts, both as an editor with input into the curation of the text as a whole, and as an author contributing to a chapter on the history of PPD and another wholly devoted to Resolving Chronic Pain.

Other chapters in Part Two focus on topics including diagnosis and treatment in Primary Care, the psychology of pain, stress illness recovery and expressive writing. Contributors from five different countries each bring a unique perspective to the book from their own particular field. From a neuroscientist to a gastroenterologist to a psychiatrist to an orthopaedic spine surgeon, the authors reached a consensus on a core set of principles and applied them to their own experience.

The idea for the book was conceived in April 2015, germinating from the seed of Dr John Sarno’s work in the 1980s-2000s. The initial idea was followed by many exchanges between myself and the other editors – tentative in the beginning, and then more and more assured and rewarding as the book evolved. David Clarke in particular has been a privilege and an inspiration to work closely with. I think we both agree there is enough fascinating history of this condition to fill an entire book, and deciding what to include or leave out was a real challenge at times.

It is now available to purchase online from Amazon, by following this link in the UK, and this link in the US. All proceeds will go to the Psychophysiologic Disorders Association, a non-profit dedicated to research into the diagnosis and treatment of stress illness.

Telling stories

I often talk about how we frame our stories in Resolving Chronic Pain sessions. It’s said there are two sides to every story, but how often do you remember that when thinking about your day to day life?

The ‘story’ to which there is more than one side is not just the tales you recount to your friends over a cup of tea, but also applies to the stories you tell yourself.

This is a view shared by Lori Gottlieb, an American therapist who also writes an advice column called ‘Dear Therapist’.

She believes that all of our lives are made up of a series of stories we tell, which are all shaped by our own opinions and prejudices. She explains in a TED talk how this realisation can be immensely freeing, as it allows us to consciously re-shape the stories we tell about difficulties we encounter.

As an example Lori speaks about a woman who wrote in to her ‘Dear Therapist’ column to ask for help with a problem in her marriage – she felt disconnected from her husband, and suspected he was having an affair as he was spending a lot of time on long late-night phone calls with a woman at his office. ‘What should I do?’ she asked Lori.

But Lori looked at the problem from a different perspective. She read out another letter, from a man who felt disconnected from his wife, and found she was not listening to him or giving him the support he needed so he was having to turn to the only friend he could speak to – a colleague at work. While the second letter was invented by Lori, she says the situation is inspired by problems she sees every day.

She explained: “I have to be really careful when I respond to these letters because I know that every letter I get is actually just a story written by a specific author, and that another version of this story also exists. It always does. And I know this because if I’ve learned anything as a therapist it’s that we are all unreliable narrators of our own lives.

“I don’t mean that we purposely mislead. Most of what people tell me is absolutely true, just from their current points of view. Depending on what they emphasize or minimize, what they leave in, what they leave out, what they see and what they want me to see, they tell their stories in a particular way.”

Lori continued: “All of us walk around with stories about our lives. Why choices were made, why things went wrong, why we treated someone a certain way – because obviously they deserved it – why someone treated us a certain way – even though obviously we didn’t. Stories are the way we make sense of our lives.

“But what happens when the stories we tell are misleading or incomplete or just wrong? Instead of providing clarity these stories keep us stuck. We assume that out circumstances shape our stories, but what I found time and again in my work is that the exact opposite happens. The way we narrate our lives shapes what they become. That’s the danger of our stories, because they can really mess us up, but it’s also their power. Because what it means is that if we can change our stories, then we can change our lives.”

We have the power to think differently about the stories we tell ourselves, and examine them from another point of view. It isn’t possible in every case – there are some more serious instances when it isn’t helpful to doubt yourself or the harm another person is inflicting on you. But it is always a good idea to be aware of the stories you tell yourself, and the fact that you, and everyone around you, are sometimes an unreliable author.

Learning something new

We often say that you learn something new every day, but in practice this generally means odd things picked up accidentally – the capital city of a far-away country, the date of a historic event or why milk is white (it’s the emulsified fat droplets apparently). Most of us associate dedicated, focused learning with school or university. But learning something new is a wonderful lifelong ambition – and not just because it improves your skills or employability.

Learning new things is good for you – for your brain, and also for your mind. It gives you something interesting to focus on, a goal to work towards, and a sense of achievement with a new piece of information learned or a new skill gained.

This is backed up by medical research. The Mental Health Ireland website cites a 2004 study of 145 adults in which people who were involved in more learning reported feeling higher levels of self-esteem, self-confidence and purpose, and a better ability to cope with stress.

Learning new things is one piece of advice given by writer Laura Freeman in her memoir about using reading as a route to recovery from Anorexia, The Reading Cure.

She says: “There are too many self-help guides that say: get fit, lose weight, make friends, find a hobby, revamp your wardrobe. Clear the clutter to clear your mind. Eat right – and right is always avocado, chia and other whatnot – to ‘improve your mood’. Better they should say: feed your mind. Learn something, read something, see something new: a painting, a church, a bird, a rose garden, a park, a monument, a castle moat white with swans and hidden perch, a mews of hooded merlins, an elephant with ivory tusks and a palanquin throne on his back. Fill your thoughts with the world and what wags it.”

Freeman echoes this again at the end of the book, with the final advice: “Learn something. It is the best medicine. It is the only thing that never fails.”

Learning something new needn’t mean enrolling in a class – while this is a great option, it might not be financially or logistically viable for everyone. It could be learning to cook a new dish, how to fix a frequent DIY problem yourself rather than calling your go-to helper, learning a language online or finding a non-fiction book which sparks your interest.

So what could you learn?

Winter, the Danish way

October is here, and while we may still officially be in autumn, it certainly feels like the winter months are drawing in. Around this time last year I visited Denmark with a friend - the Nordic countries are famous for long, harsh winters, and people living there have had to get used to coping with them. While we were there we picked up a few tips.

Many people find they can struggle more with feeling sad or low in winter, and it’s no wonder: the weather is gloomier, we all get less sunshine, and people are far less likely to get out and socialise when it’s colder and darker. At this stage in October it can feel like the gloom will go on forever, as the comfort of the festive season is still quite a long way off.

That’s why it’s worth taking a moment to prepare for the winter season before it really hits , even if it seems like a very simple and obvious thing you’re planning for.

One of the biggest culprits for winter blues is the fact that people go out less. It’s cold, it’s dark, and an evening by the sofa beckons… But while a night curled up on the sofa is a lovely prospect, spending every evening until May either alone or with the same one or two people may not be the best thing for your mental health. A good motivation for getting out of the house every once in a while is to book something in advance – whether it be an evening class, a film, a one-off talk, or a free community event. If you’ve bought a ticket or told someone else you’re going beforehand, it will give you that extra bit of motivation to get those gloves on when the moment comes.

Exercise can also be more difficult if running or a walk in the rain doesn't appeal. Think about signing up for an exercise class or give in to the inevitable wet and take up swimming!

When winter hits, it’s all too easy for someone working office hours to go through an entire week without once seeing daylight. Get to work before the sun really gets up, eat lunch at your desk, leave work after dark. This is a terrible habit – your body needs daylight, whether or not the sun is shining, and just going for the odd walk at the weekends isn’t enough. Make a rule that you must get outside for 10 minutes or so every day – whether it’s at lunch time or a few minutes snatched between meetings. If you feel guilty stepping away from work, compare yourself to other people in the office who are smokers (if you aren’t one yourself). It’s considered perfectly fine to leave the office several times a day to go for a cigarette, so why can’t you go outside to get the vital daylight your body needs?

On that note, an important trick the Danes have mastered is taking vitamin D tablets in winter. If you live in Ireland it’s almost impossible for you to get the required amount of vitamin D from sunlight during the winter – there just isn’t enough sun! 

Finally, it’s worth bulk cooking a few meals you can stick in the freezer in advance – stews, soups, casseroles and the like. Good, nutritious, warming food for those cold days when you feel a bit lethargic and can’t manage to bring yourself to get the pots and pans out – they’ll make you feel better than reaching for a frozen pizza (although there’s nothing wrong with having one of those every now and then too!)

The mental health charity Mind has some advice on preparing for winter if you find you often feel adversely affected during this season, which can be found here. Bear in mind that there is a medical condition, Seasonal Affective Disorder, which is a type of depression influenced by the time of year. The advice given here is just for helping you to get through the odd low mood in winter – if you think the problem might be a bit more than that, it's good to talk about it - perhaps consider speaking to your doctor. One helpful way of distinguishing between low moods and depression is to keep a diary, and monitor how often these low moods are happening. 

Best of luck in your preparations, and remember, not everything about winter is negative! It can be very lovely too – what are your favourite things about Winter? Comment below to share your thoughts.