2020

Number one

They tell you to put your own oxygen mask on first. The idea is simple, though it could be lifesaving. Take care of yourself first because if you don’t you might not be able to take care of others. I used to wonder, in the moments before take-off when despite all the well-worn statistics about flying being safer than driving a car the recesses of my imagination never quite seemed to have got the memo, would I be able to put my own mask on first? In the moment of panic would I be able to pause and look to my own needs before those of my nearest and dearest?

That was back when getting into an aeroplane was an option, of course. Now it’s been six months since I’ve even considered the idea.  Until recently lockdown was steadily easing across the country, and even now with new uncertainties and restrictions re-introduced in the midlands, people are still returning to a kind of normal compared to the situation in recent months. But building a new sense of normal is going to be different for everyone, and everyone has the right to follow government guidelines at their own pace. I have noticed in recent weeks trying to find a way to say “no” to requests and suggestions from friends and family who are in a different headspace. No to the group of friends who have invited me out for a meal because I don’t feel comfortable taking the train at a peak time to get there. No to the elderly neighbour who wants me to come in because I can’t countenance putting them at risk.

airport-3511342_1920.jpg

Some people characterise themselves or others as people-pleasers, but I think to an extent we all are. It’s what we’re hard-wired to do – the more we please others, the more we fit in, the safer and more stable we feel. Sometimes the word “no” can feel like the hardest word to grasp for, as we’re faced with yet another request for our time, energy or resources. Often there’s no request at all, we just find ourselves in the familiar position of doing something we don’t really want to do because we feel like we don’t really know how to say no to it.

It’s easy to think you don’t ‘deserve’ to be finding the crisis difficult to deal with, perhaps if you have not been as badly affected as others. But there is nothing to be gained by that – support your friends and family who are struggling, donate to charities helping the most vulnerable, but also recognise that you yourself need taking care of too.

 

Small discomforts

About a year ago I joined a new art class. It was local, the timing suited me, and I had been wanting to make more of an effort to bring out my ‘creative side’, so I went for it. What I didn’t realise until I got to the first session was that this wasn’t a class following a set programme, with a new cohort of students every few months. This was a steady group, many of whose members had been there for years, and which rarely saw new entrants. I was the only new joiner for many months.

This art form worked in a particular way with a very specific technique and certain key equipment – this is why there was a class running, as even with years of tuition pupils still needed guidance. I had not worked with any of these techniques or equipment before, and I could tell immediately that I was going to stick out. Try as I might to learn quickly, in the first few sessions I could feel that I was slowing the class down, making repeated mistakes, and frustrating the instructor with my lack of progress.

viktor-jakovlev-rK0o6Qy1aLo-unsplash (1).jpg

It was really difficult. But that was the joy of it. I had chosen to put myself in this difficult situation, I wasn’t at risk of any danger or hardship, I was just having a hard time. I had signed up to this class to try something new, and I was definitely getting that. I was reminded of a very simple but profound realisation outlined by Roz Savage, a woman who left both her job and her husband to row solo across the Atlantic in 2005. As you might imagine, she finds the experience quite challenging. One day she is so frustrated, exhausted and lonely that she goes up to the front of the boat and begins to scream at the water. This venting of her frustration leads to an epiphany.

She writes: “When I was preparing for this, every time someone asked me why I was doing it I said I wanted to get out of my comfort zone. And getting out of my comfort zone is, by definition, going to be uncomfortable. Being uncomfortable doesn’t mean I’m failing, it means I’m succeeding. The impact of the epiphany caused me to lose my grip on the roll bar and I lost my balance. I nearly tumbled head-first into the water, but I regained my handhold just in time and considered this startling new discovery.”

In many ways this is a very obvious statement, but the clear way that Roz expresses it made me stop and think. She continues: “If I could find the strength to stay out here, in the zone of my discomfort, eventually my bubble of comfort would expand, and catch up with me. Its boundary would extend to include this place which right now felt so new and scary. Given enough time and repetition, the uncomfortable would become comfortable, and I would have achieved my objective. Until now I had not appreciated that the discomfort was an integral and necessary part of the process, but now I could see my situation from a different perspective. I perceived that discomfort was actually my friend, because it meant that I was on the right track.”

I think it’s important to emphasise that Roz is speaking about discomfort, not hardship – there is a limit to this theory and it isn’t advisable to push yourself too far in the name of personal growth. On top of this it’s not always the right time to seek out discomfort, sometimes just getting through each day is challenge enough. But sometimes in those tough moments it can help to think of the positive side of that discomfort. I began to relish being the worst student in my art class, and eventually, after much tutting and headshaking and having to re-do poorly executed tasks, I can say that I have improved! I suspect my learning curve will continue to rise steeply for some time, but I love this new skill with all its challenges.

Ticked off

A friend of mine recently told me she had been ‘verified’ on Twitter. If you’re not familiar with the social media platform, being verified is when Twitter classifies a person’s account to be both authentic and of public interest, resulting in a tell-tale blue tick being added to their account name. While it’s not directly linked to the number of followers a person has, or how famous they are, there tends to be something of a correlation. In a very superficial way, people in the public eye sometimes joke that you have ‘made it’ once you achieve this verification.

There is no doubt that Twitter’s blue tick is an extremely important feature of the platform. It is most useful when differentiating between the genuine account of a public figure and other accounts with a similar name, either by coincidence or because they are parodies. But when it comes down to it, the feature can be used as the ultimate popularity contest between those who use Twitter in a work capacity. Those wishing to influence others consider verification a goal to be achieved, and I have more than once heard of grown adults behaving in a hostile manner towards others over jealousy caused by that small blue tick.

dragon-2634391_1920.jpg

When my friend, I’ll call her Emily, was verified on Twitter, it caused her to re-evaluate her attitude towards the site. She needs to use it for work, but in the past has been very careful to resist the temptation to check her feed in the evenings and weekends. A good trick for her was to only ever log in on her work computer. However, through working at home during lockdown, she found the lines between work and home becoming blurred, and began checking for updates on the site more regularly. Then her work arranged for all its employees to be evaluated for Twitter verification, and she got her blue tick. Not everyone did though, and Emily was intensely relieved that she had not been left off the list while colleagues who she is in competition with were. She told me she found herself searching for the names of former colleagues and current competitors, and feeling pleased to see that many of them did not yet have a blue tick. It gave Emily a small sense of joy every time she saw a tweet from other people who were still not verified – some of them with hundreds of thousands of followers, and high-profile careers, books or TV shows to their name.

It probably won’t surprise any of you to know that these petty comparisons did not make Emily happy. After several weeks she decided to take a break from the social media site in order to reset, as she can do her job in the short term without it. She told me she had always been proud of her good habits around social media, but the fact that she was drawn into unhealthy behaviours so quickly shows how important it is to continuously evaluate and maintain good habits. In my sessions I often speak about the difference between the intense but brief pleasure of external validation and the longer-lasting steady trickle of self validation. External validation is sometimes compared to a drug – a hit of it feels great but quickly fades, so you find yourself seeking more and more, but no matter how much you get, it is never enough. Emily has now managed to break the bad habit she fell in to, and while in no doubt that her Twitter verification is a useful tool, she recognises that her work, and that of her competitors, has value regardless of whether or not it comes with a small blue symbol attached.

When to stop

I recently took part in a day-long event over video call. It was similar to the meetings and sessions I would have during a normal work day, but it continued for the whole day with no respite, and by the end of it, I was absolutely exhausted. This is normal for many people working from home, with hours of back to back videocalls day after day leading to ‘Zoom fatigue’, a well-established phenomenon by now.

I tried to limit the effects of this as best I could, including turning the video of my call off whenever possible and positioning my screen so I was looking at it at an angle rather than directly. It did not surprise me however that by the end of the day I was completed burned out. What did surprise me were my actions after the call had finished. Although I was tired and my eyes ached, during my evening of rest I found myself again staring at screens, from my phone to my laptop to the TV.

It reminded me of some thoughts I noted down months ago about the idea of ‘stopping cues’ popularised by Australian psychologist Adam Alter. He addresses the question of why we all seem unable to tear ourselves away from the screens in our lives, and I found his ideas compelling. I put them on hold for a little while as during the height of lockdown I didn’t think anyone’s first priority was trying to achieve less screen time. We were all overwhelmed by our new situation, and if Zoom calls with family and endless TV programmes eased the upheaval a little then it was worth it.

stop-634941_1920.jpg

But now we are so many months into lockdown, into long-distance relationships with friends and family, and for many into working from home, that it’s worth thinking about how to make our relationships with those screens more sustainable.

Adam Alter argues that in the past, almost every activity we took part in had a ‘stopping cue’, to let people know when it was time to stop and move on to something else. For example, you would finish a newspaper or magazine, get to the end of a chapter in a book, or reach the end of a television programme and have to wait until next week to watch the next one.

Nowadays there are no stopping cues – we are encouraged to keep scrolling and scrolling and scrolling with no end on social media, games continue from level to level and videos and television programmes continue on autoplay. There is no end to the web pages we can search through, no end to the online shopping catalogues we can browse.

One solution Alter offers to this is to create artificial ‘stopping cues’, limiting use of screens in a certain location or situation. Alter, for example, does not use his phone at dinner time. Many people recommend the tactic of not using your phone in your bedroom, although for some this is too ambitious. Set times of day also help – for example not looking at any screens in the first half hour after you wake up, or the last hour before you go to bed, or simply using a stopwatch function to show yourself how much time you have spent in one screen-time sitting.

Part of the problem with this in the context of lockdown is finding other things to do in that time. I have found audiobooks a lifeline, as they provide entertainment without me having to look at the screen, and being read to is much easier than reading after a long day. I like to listen to them on loudspeaker, as I find earphones to be almost as wearing as looking at a screen, which opens up opportunities to share audiobooks with others.

The Center for Humane Technology suggests making a few alterations to your phone settings to make social media less addictive. These include turning off all notifications which are not comments or messages, so that the only nudge you get to use the app is when it involves interacting with other people, or changing your apps from colour to greyscale to make them less appealing. It also suggests not choosing the ‘stay signed in’ option on any sites so that there is one extra step to make you think about whether or not you want to be there. The Google chrome extension Inbox When Ready is another useful tool, which delivers your email in regular batches so you are not distracted by every one that arrives.

Alter cites research that divides phone use into two groups; functions that make us feel good, and those that make us feel bad. Among the bad group are unsurprisingly social networking, gaming, entertainment, news and web browsing. In contrast, relaxation, exercise, reading and education were all uses that made people feel good. Now more than ever as we are leaning so heavily on technology to help us through the crisis, it is vital we free more time up for those positive uses and cut down on the negative ones.

Making the right choice about spine surgery

For some time I have been wanting to take a look at some of the contributors to the book which I co-edited, Psychophysiologic Disorders: Trauma Informed, Interprofessional Diagnosis and Treatment. In this blog I’ll focus on the chapter on back pain. David Hanscom MD is an orthopaedic spine surgeon based in the US, and is one of the professionals who shares his expertise.

He himself suffered from symptoms of Psychophysiologic Disorders (PPD) for 15 years before he finally managed to resolve them. He didn’t understand how until he heard a lecture by Dr Howard Schubiner, which informed his own approach to patients with PPD. He has since launched his own website and written two books: Back in Control: A Surgeon’s Roadmap out of Chronic Pain, and Do You Really Need Spine Surgery? Take Control with Advice from a Surgeon.

Over the last five years Dr Hanscom and I have developed a supportive relationship. I’ve been impressed by his enthusiasm and determination to consider the welfare of the patient from every angle when assessing spine pain. He has no qualms about the use of surgery when necessary, but through his experience he recognises that a ‘hyper vigilant’ nervous system may be playing a significant part in the patient’s pain.

aldi-permana-TBWqoG1k7ks-unsplash.jpg

In his chapter, Making the Right Choice About Spine Surgery, Dr Hanscom explains why spine surgery is not always the best solution for back pain, and argues that in many cases in the US it is overprescribed and can even be harmful. In his former practice he used to act as ‘salvage surgeon’, treating patients following a failed operation. But, he says, he could rarely return those patients to the condition they had before the failed surgery.

Dr Hanscom divides patients with spine pain into two groups: those with a structural abnormality which shows up on an x-ray, CAT scan or MRI, and those without. In the cases of a structural abnormality which corresponds to the pain, he advises that surgery is an option after the nervous system has calmed down. Without evidence of a matching abnormality, so the pain is non-structural, he does not consider surgery an option.  

He explains that because many people with spine pain also have significant stress and/or other psychophysiologic issues, surgery or treatment of just the spine does not solve the problem. He says: “Rather than assessing for psychosocial stress, many patients and health care providers consider surgery as the definitive solution. Operating in the presence of a hyper vigilant nervous system often makes the pain worse, in spite of a well-done procedure. Just because rest, physical therapy or injections have not worked doesn’t mean a patient should head for the operating room.”

Dr Hanscom advocates for the patient to be more involved in the recovery and decision-making process, and for medical professionals not to assume that surgery is the definitive solution when there is no structural abnormality. Surgery should only be done for a structural problem with a calm nervous system.

Psychophysiologic Disorders: Trauma Informed, Interprofessional Diagnosis and Treatment is available here, and you can find out more about David Hanscom and his work at his website here.

Stormy weather

Yesterday I was speaking to a friend who told me she doesn’t want lockdown to end. She has become used to working from home and shopping and socialising remotely. As she spoke, I couldn’t help remembering that this was the same friend who in March had been saying how much she hated the idea of working from home, that she wouldn’t be able to cope without going shopping in person, and that she couldn’t imagine being at home all the time with her young children.

The things she said she was worried about were exactly the opposite in each case, but the thing she was really worried about was the same: change. Most people are resistant to change, it’s a well-known part of human nature, even if it doesn’t necessarily make sense. Change is just as capable of being good as it is of being bad, but perhaps it comes down to the old wisdom of ‘better the devil you know’.

It’s not unusual to be worried or angry about a restructure at work for example – in fact a family member went through one of these recently and described the extreme resistance to the change from colleagues, despite many of them being perfectly happy with it after it had taken place. A large part of the reason for our resistance to change is fear of the unknown – in a work context this might be fear of losing your job, or finding yourself with a less amenable boss.

This got me thinking about types of change I don’t find myself resisting. Moving house, changing job, getting a new pet, these are all exciting and positive changes, in part because we choose them ourselves. That is the crucial difference – the changes we don’t feel resistant to are the ones we believe can control.  But the reality is that the outcome of these changes is never really guaranteed – nor, when it comes to it, is the outcome of every day we live. Anything could happen, at any time.

In her memoir 'The Rules Do Not Apply' American journalist Ariel Levy tells the heartbreaking story of how the life she worked so hard to piece together dissolved into tragedy caused by factors outside of her control. She writes in the introduction: “Until recently, I lived in a world where lost things could always be replaced. But it has been made overwhelmingly clear to me now that anything you think is yours by right can vanish, and what you can do about that is nothing at all. The future I thought I was meticulously crafting for years had disappeared, and with it have gone my ideas about the kind of life I’d imagined I was due.”

tree-102809_1920.jpg

The book does not have a simple happy ending, as there is no easy fix for Ariel’s suffering. However, there is a sense of building resilience over the course of the memoir. She loses her house, her partner and her job in one fell swoop, and the only thing Ariel has left is herself.

As we’ve discussed before, a good tactic for coping with big changes and feelings of helplessness is to create small areas of life where you can feel in control in a healthy way, such as keeping a certain part of your house in good order. However, there are still going to be huge areas of your life outside of your control, and that is not just true of the aftermath of the coronavirus pandemic. You can adapt to changes whether you control them or not. In these cases, it’s important to remember that the one thing which will remain constant is yourself. Both your body and mind will evolve of course but the essence of you, what makes you you, can weather any storm. 

Having better conversations

During the past few months I’ve spent a lot of time on Zoom. Haven’t we all? From meetings to social calls to virtual events, most people have been spending a lot more time than before on video calls. I’ve also reconnected with some friends and family members who I had fallen out of touch with – some of whom I hadn’t seen for decades. There’s nothing like a global crisis for an excuse to get back in contact.  

This has meant a lot of conversations, and it has made me consider how important good, meaningful conversations are. In centuries gone by people used to set a lot of store by the ‘art of conversation’ and it was even something taught to wealthy young people in order to help them progress in life! Even today, being a good conversationalist is still a prized attribute, and it helps you have better conversations and build better relationships.

American journalist and interviewer Celeste Headlee has written a book about that very subject: ‘We Need to Talk: How to Have Conversations that Matter’ is based on a TEDx talk Headlee gave in 2015. In it she gives 10 suggestions for better conversations, including giving your interlocutor your full attention, trying not to ramble, and avoiding getting bogged down in too much detail – names and dates are not always needed to tell a good story.

adult-3086304_1280.jpg

She also advises never to compare your own experience to that of another person, which I would heartily agree with. Two people may have been through the same experience, but it will have had a different effect on each of them. It’s perfectly possible to connect over those shared experiences without having to compare them.

One tip I have picked up from my many Zoom sessions is to decide in advance whether I want to invite coronavirus to the call. Sometimes you need to talk about the current situation – it affects every part of our lives after all. But sometimes you need a break. I find it easiest to just agree with others on the call that we won’t talk about it at all, as in my experience once you start, it’s hard to stop. So far no one has had a problem with this, everyone else seems to be sick of talking about it too!

Another is to always have a ‘spare’ topic of conversation up my sleeve on big group calls with lots of people. It never ceases to amaze me how quickly silence can descend on a call of 15 people and how hard it is to break once it sets in. I can never think of anything to say on the spot, so I try and have an observation or question ready just in case – however trite, it gets the conversation going again. This is not something I do with individual calls, as I find that brief pauses or moments of silence can provide opportunities for the other person to raise a topic which is important to them.

Finally, on those group calls don’t be afraid of the 40 minute timer! Those of you who use Zoom will know that the free version will cut calls off after 40 minutes. This is a result of not paying for the app, but honestly I would pay extra for this feature. It brings a call to an end after the perfect length of time with no awkwardness, and I find that if calls are kept short and sweet its much easier to schedule them regularly – if you know a call will take two hours you may be less willing to make time for it. Or if you are calling someone you don’t know very well or haven’t spoken to in a long time, a 40 minute cut-off can make the conversation seem less daunting.

Don't forget the fun

Late Sunday morning a week ago found me lying on the floor of my kitchen counting very loudly from one to 26. The reason for this was not complete lockdown madness – not yet anyway – but a charity initiative called the 2.6 challenge, urging people to complete activities for charity on the day when the London Marathon was due to be held. As a former runner of the marathon I wanted to get involved, and recruited the rest of my family to help.

This is what led to me lying on the floor – doing 26 spine curls while shouting the numbers out as I did it so that everyone else in the family could hear, either from the other side of the room or from their own homes via Zoom. Everyone was doing different activities, from press ups to sit ups to lunges. The problem was that some of us were a little, ahem, faster than others, so there was a bit of confusion with everyone shouting out different numbers at the same time. It was chaos. It was also very good fun, and we all made a donation to a chosen charity after we completed the challenge.

a-joyous-woman-using-a-smartphone-3759065 (1) (1).jpg

The 2.6 challenge was the most fun I’ve had in weeks, and I’ve been thinking about why. Of course it’s nice to do things with loved ones who you’re not able to see in person any more, and donating to charity makes most people feel good immediately. But I think it was more than that, I think having a project that I could organise and execute gave me back a sense of being in control, at a time when everything else is out of my hands.

I’ve written before about the benefits of creating small areas of your life where you feel in control, and I think it’s part of the reason why so many people have turned to creative activities like baking, painting and sewing during lockdown. Having an event to organise is a welcome distraction, however small and informal it may be. My children immediately asked if they could organise another Zoom event for the family based on a similar challenge, and I can’t wait to see what they come up with.

In our house we have also created several routines as a way of trying to maintain some control over our lives and have things to look forward to. On Fridays we take it in turns to choose a film, and often arrange an hour of drinks with friends over Zoom beforehand to kick off the start of the weekend. Wednesday evening is when we eat with family members in their different locations, again over video call, just for 40 minutes.

We’re all living in difficult circumstances, through a crisis whose tragedy and hardship we are only just beginning to understand. It can be easy to feel guilty for trying to organise frivolous activities but the reality is that we need fun to keep us going, wherever we can find it.

Finding calm in a crisis

One positive outcome of spending so much time at home is that I have been doing a lot of cooking – along with everyone else, by the sound of it! My social media feeds are full of beautiful pictures of homemade bread, cakes and other delights. It seems that everyone is turning to an easy, wholesome pastime to keep them occupied – even this beautiful letter by Italian author Francesca Milandri acknowledges that the making and eating of food has become one of our biggest pleasures.

I like to bake while listening to audiobooks, often with a cup of tea at hand – or perhaps something stronger if I’m having an evening cooking session. It reminds me of a wonderful book I read recently called A Half-Baked Idea, by Olivia Potts, a woman who quit her job as a barrister after her mother died, and used the money she inherited to enrol on a year-long course at world-famous cookery school Le Cordon Bleu.

bio-4840960_1280.jpg

It’s not something most people have the money or the inclination for, but I loved hearing about the fantastically difficult creations she was taught to produce, her eccentric tutors, and the jarring difference between her new life of tempering chocolate and whipping meringue, and her old one of rushing between courtrooms and whizzing through stacks of briefing papers.

It’s no surprise that she sought comfort in cookery after her loss. It is widely accepted that cooking relieves stress, as it focuses your attention, yet requires physical activity, giving your brain a break. Donna Pincus, associate professor of psychological and brain sciences at Boston University, explained some of the positive effects of baking to the Huffington Post in 2017.

“Baking actually requires a lot of full attention,” she said.

“You have to measure, focus physically on rolling out dough. If you’re focusing on smell and taste, on being present with what you’re creating, that act of mindfulness in that present moment can also have a result in stress reduction.”

Olivia Potts uses her book to reflect on the lessons baking has taught her. She writes: “I found that hard work (mostly) pays off. I found that there’s no substitute for practice. I found out that it’s not shameful to fail, if you’re willing to pick yourself back up and try again.

“I learned that it was ok to be sad when something went wrong, so long as you show up again the next day and try again. I learned that there would always be opportunities to redeem myself, and that I needed them. I found that patience really can be a virtue, much to my irritation.”

This week, inspired by Olivia Potts and my own need to create some peace and relaxation, I have made soup, scones, and fruitcake, using up all the odd bits of dried fruit I had in the pantry. I might try a fruit pie next!

The joy of small things

After two more weeks of lockdown, I’m still looking out for good news and positive stories. Whatever your situation, this is uncharted territory, and I for one am relieved and excited to have something to celebrate this weekend.

Easter is a special time whatever your beliefs, coinciding as it does with the advent of spring and new life. As is often the case I find myself working on Good Friday, but I’ve been overjoyed to make plans for baking hot cross buns and painting egg shells this weekend – even if supermarket shortages mean I end up baking whatever I can find and painting paper instead!

chicken-3607863_1280.jpg

I was charmed by New Zealand Prime Minister Jacinda Ardern, who this week told young New Zealanders that the government considers the Easter Bunny an ‘essential worker’. In a lovely message she added that the Easter Bunny might be a little busy with their own bunnies at home, so children may receive fewer treats. I remember the days of my own children being overwhelmed by an enormous chocolate egg from every relative and family friend, and can’t help liking Ardern’s suggestion of children drawing their own Easter eggs instead, and displaying them in the window for other children to spot on an ‘Easter egg hunt’ when out for walks in the neighbourhood.

Nowadays many people celebrate Easter in different ways, and I have been thinking a lot about new life and fresh beginnings. We have had some new additions to the family this week: four young hens. Some of you will remember the hens we kept several years ago, who we were very fond of. Now we have decided it’s time to fix up our old hen coop and fill the garden with inquisitive clucking (and lots of chicken poo) once again.

In the midst of all this it has been wonderful to be distracted by trying to give these hens the best home – and protection from foxes – possible, and to look forward to their company – and in future, their eggs! I’m planning to enjoy settling them in this Easter weekend, as well as drawing a colourful Easter egg for local children to spot in the window.