Wonder Woman/Super Man – what’s so great about them anyway?

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This post is inspired by a patient I have, we’ll call her Jane. In reality the patient I met today is like so many that I have, and your doctor has, met before. It could easily be John, or Jenny, or Jeff.

Jane is in a cycle of trying to care for family members and hold everyone together, but the cracks are starting to show. The strain of being everything to everyone is leaving little time to tend to her own needs. Her stress levels are through the roof, she isn’t sleeping well at the moment, her appetite is a little off, she is struggling to focus at work and feels like she is on the verge of tears or anger most of the time. Sound familiar?

It’s not Jane’s fault, she is doing what she knows best. She is trying to support her family whilst being a productive colleague, a good friend, a good spouse… She’s trying to be Wonder Woman and she’s mad at herself because she is struggling. She berates herself for not being “strong enough” and that she “needs to snap out of it” but try as she might, she doesn’t see how she can.

I talked with Jane about imagining ourselves in a house. For any house you need a solid foundation, and that foundation is our sense of self.  The walls of the house our are natural defences to protect us from the storms of life. Repeated adverse life events or stressors, just like a real storm, can chip away at the walls of the house, they might even break the windows.

If our house is built on solid foundations, and we have developed coping strategies that are effective for us then we can weather those storms. If our defences are low – perhaps we have lots of stressful things happening at the same time which are rocking the walls of our house, or our foundations are built on shallow ground, then our house is going to start tumbling down.

Without the house to protect us, we are exposed to the harsh realities in life.

This is where I found Jane today. Her walls are tumbling in, she is trying desperately to barricade the doors and windows but she cannot keep up with the demands that life is throwing at her. Simply put, she cannot be everything to everyone. She is not Wonder Woman.

Fortifying our proverbial houses is tough, especially as we often have to try and fight these fires whilst carrying on with our normal lives.
The first step is acceptance. Accept that you cannot do everything.

“Serenity is accepting the things we cannot change,

courage to change the things I can and

wisdom to know the difference”. 

Acceptance does not mean berating yourself for weakness. It is not a flaw to accept that you need help or that you are struggling. It takes strength of character to stand up and say to someone you need some support.

Next comes rebuilding. For those in caring roles this can be especially challenging. As a carer your focus is inherently on those your care for. Shifting your focus back to you can be unsettling, upsetting and hard to do. However to care for another in the way you want to, you have to be able to care for yourself.

One of my favourite analogies (and I have plenty) relates to a broken leg. If you have a broken leg, society at large knows how to react. They can see the plaster cast and the crutches, they can mentally apportion the right amount of sympathy and understanding. Bones heal, the injury is visible, and it’s much easier for people to get their head around.

Stress, burn-out, depression and anxiety all have few outwards signs. Unfortunately a stigma can still exist around these problems and society can sometimes feel unsure about how to ‘handle’ someone who is suffering. But just because it isn’t visible, and just because it isn’t physical, doesn’t make the problem any less real or relevant.

To rebuild takes time. Patience. Support. Effort. It isn’t easy. Remember that a difficult path can sometimes lead to beautiful destinations.

Talking therapies such as counselling and CBT should never be overlooked or dismissed. Having someone else, impartial to your situation, help you to talk through your current troubles can be a real life saver – and can help to set you up for your future.

Some patients might need medication from their GP. I would always encourage anyone who is facing difficulties in their life that are starting to overwhelm them to speak with their doctor.

Part of rebuilding is learning about yourself. Really understanding yourself is the key to your success. What are your warning signs that things are getting too much? What can you do when those signs start to appear? What strategies to do have to protect that proverbial house?

Whatever it might be, find what re-centers you. It might be yoga or meditation, it might be catching up with an old friend, watching a favourite film, reading a book, going for a run or taking the dog for a walk.  As long as its a positive action – that doesn’t mean opening a bottle of wine or similar.

Exercise can be an incredibly powerful tool at boosting how we’re feeling when we’re struggling. Physical activity is not only good for our physical health but for our mental health too. Not only does it increase endorphins that help promote good feelings, but it also can help with issues such as insomnia.

Being you is enough. You don’t need to be Super Man or Wonder Woman. Besides, they wore their pants over their clothes, and when you stop and think about it, what’s so great about that anyway?

 

 

 

What makes you happy? Mindfulness, Hygge and beyond.

It’s International Day of Happiness, a good time to think about what makes us happy and steps we can take to improve.

Our emotional wellbeing can have an impact, both positive and negative, on our physical health. It’s a fact backed by countless studies including the annual World Happiness Report.

In 2017, Norway topped the polls of the World Happiness Report. They’re joined in the top four by Denmark, Iceland and Switzerland. The rankings look at the main factors that are considered to support happiness: caring, freedom, generosity, honesty, income and good governance.

The 2017 report also examined the social foundations of happiness and it’s importance and demonstrated how work is also a big part of our happiness with unemployment being linked to lower scores.

Within countries, differences in happiness appeared not to be explained by discrepancies in income, but by difference in mental health, physical health and personal relationships.

Patients with chronic illness and chronic pain have higher rates of depression and we know that depression can worsen our experiences of illness and pain – the physical and the psychological are intrinsically linked.

When faced with troubles – stress at work or home, financial worries or health worries, it can be easy to focus on these and lose sight of what keeps us happy. In psychiatry sometimes these are referred to as protective factors – unique facets our lives that keep us safe and happy. For some, it might their family, their spouse, pets – to be honest it can be anything, as long as it works for you. Imagine the scene from Harry Potter – where he has to visualise a happy memory that Harry Potter before he could fly a broom – it’s the same principle! By understanding those principles that truly make us happy, we can call on them in times of need.

Not losing sight of those factors, or the bigger picture, are similar to concepts explored by mindfulness. A Buddhist philosophy that promotes the focusing on the here and the now, and quietening our minds to the external stressors. Mindfulness is gaining popularity in and outside of medicine and it’s ability to help with problems such as anxiety are becoming more apparent. There are lots of really useful online tools for mindfulness and if you’re someone who has anxious tendencies, they are worth exploring.

One way to naturally boost those happy feelings are exercise. There is a unique sense of wellbeing that comes after a work out or after exerting yourself. The process itself promotes the release of endorphins that boost our mood. Not to mention the added benefits on the body, the heart, improved sleep etc.

In honour of International Happiness Day, I have been reading about Hygge.

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A cosy, bubble of good feelings that has come from our Danish cousins – it might not be that much of a coincidence that they made into the runner up position on the World Happiness Index after all.

Hygge, which has been open to some speculation, has saturated our media – newspapers, blogs, insta posts, of late. So popular, the Oxford Dictonary short-listed it as a word of the year in 2016 (it lost out to ‘post-truth’). But what is it all about? In short, it’s an approach to living that embraces the positive and enjoyment in everyday experiences which are thought to be core in the attitudes of Scandinavia.

Whether you choose to follow the teachings of mindfulness, the concepts of Hygge, you work it out in the gym or another path to happiness, remember this: your emotional health is as important as your physical health. We are well when we are holistically well, our body and mind working well together.

 

 

 

 

Your sense of self: the magic five.

Self Confidence.

Self Esteem.

Self Worth.

Self Belief.

Self Respect.

All priceless. All fragile. All unique.

Our sense of self is intricately tied to our personalities, experiences, belief systems and the bubble we find ourselves in. It can take a life time to build and a second to shatter.

 

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On the face of it, the five S’s may all seem similar concepts but each one is a like a snowflake – outwardly uniform but subtly different to the next.

In today’s society when we are so often judged on how well we do our job, how many exams we passed, how productive we are, what material possessions we have or don’t have, it can be easy to conflate our self-confidence by listing our many achievements. However to face and accept our flaws and weaknesses takes real strength. It’s our self-esteem that allows us to look at these facets of our character and not be lessened by them. A robust sense of self esteem enables to us own our flaws, learn from them, use them, grow from them.
Alexander Pope wrote An Essay on Criticism in 1709 and told us “To err is human, to forgive is devine”. Whether you have faith in a higher power is immaterial, and whilst Pope may have been talking about literary critics, his words ring true when considering self-esteem.

Mistakes, flaws and errors are part of what makes us human. Being able to forgive ourselves is part of our ongoing development. We need to acknowledge and accept these to be able to move forwards.

Valuing what we can offer our friends, our family, our colleagues, the wider community or, more importantly, ourselves helps to re-affirm our sense of worth and place in the world. We all have a place.

What we do with that place, to a greater or lesser extent, has much to do with our self-belief. Einstein said that insanity is doing the same thing over and over and expecting different results. If we never change what we put in to something, how can we ever expect a different result?

At a couple of stages in my professional life I have had attacks of “Imposter Syndrome”, a pervasive feeling that at some point I would be uncovered as a fraud. I lacked the confidence and belief in myself and my abilities. The first was immediately after medical school. For years as I rotated through my house officer (residency) jobs, I kept all my old med school notes and textbooks – just in case the university called to tell me they had made a mistake and I hadn’t actually passed my finals!

The second time was shortly after I qualified as a GP. I worried all the time that I would be “found out” and that I wasn’t really “good enough” to do my job. Thankfully with time, supportive colleagues and a helpful husband, I learned to settle in my work. I still have moments when doubt starts to creep in, but using strategies I have developed over time to refocus my self-belief and confidence, I can pick myself back up.

Having a goal – whether it be in your work, your home life, weight loss or fitness goals – and the effort and drive it takes to reach it – all relies on your self-belief. That intense faith you place in yourself that you will reach your target. This one (as they all are) is tricky. It’s vulnerable to knocks along the way and this can lead you to deviate from your goals.

An analogy I often use with patients when we talk about goal setting is to imagine climbing a mountain. When you are in the foothills looking at the summit, it can seem an awful long way up. It’s easy to think of at least ten reasons not to start the journey – it’s a long way, it’ll be hard, I’m not prepared… But if you think of that same journey as a series of shorter journeys, perhaps from the foothills to base camp. From base camp to the next rest stop, and then to the next and so on until you reach the summit. Then at each rest stop allowing time to gather yourself and evaluate your progress. Whilst the journey might still seem a challenge, breaking it down to smaller chunks makes it more manageable.

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A buzz phrase in medicine, and education generally, is SMART. A tool for setting goals, it tells us that goals should be:

Specific (what are you going to achieve)

Measurable (how will you know when you achieve it)

Achievable (is it within your ability – if your idea of art is drawing is limited to stick people it might not be achievable to think you’ll open at the Tate Modern or MOMA in twelve months time)

Realistic (perhaps you are a great artist but accept it might take ten years for an opening in prestigious galleries) and

Time Specific (when are you going to achieve it by)

Either way to get to our goal takes self-confidence to learn our strengths, self-esteem to accept our weaknesses, self -worth to believe we have value and the right to dream and self-belief to push on and achieve it.

Which leaves the toughest one of all, self-respect.

Underpinning all of these is the respect we have for ourselves. Our esteem, worth, belief and confidence are, in general, internal concepts. They are what we think. Our respect is generally what we do to ourselves in the physical sense. Self-respect doesn’t care what happened in the past, it’s about what you are doing right now.

If the other four S’s are talking the talk, your self-respect is walking the walk.

No one, in any shape or sphere can or should take your self-respect. The only person who has any right to your self-respect is you. If you have a bad day, or week, or even a bad month your esteem, confidence, worth or belief might take a beating, but it’s your self-respect that will build you back up.

Self-respect is lifetime work. There will always be critical voices and adverse life events ready to knock you. However if you can ensure you respect you for you, you’ll make it through. Imagine your self-respect as a small seed, planted in the ground. To grow, it needs to be nourished and fed to flourish, ignore it and it will risk withering and decaying.

Having respect for yourself means taking care of your body, your mind and your actions. Be proud of you. Don’t settle for something that is less than you deserve. Forgive yourself, we have all done things we are not proud of, but berating yourself for these for the rest of your life won’t get you anywhere. Surround yourself with positive people and influences. Take care of your body – you only get the one. Don’t compare yourselves to others. Theodore Roosevelt told us that “Comparison is the thief of joy”. Treat others with respect but do not allow others to disrespect you.

“Self-respect cannot be hunted. It cannot be purchased. It is never for sale. It cannot be fabricated out of public relations. It comes to us when we are alone, in quiet moments, in quiet places, when we suddenly realize that, knowing the good, we have done it; knowing the beautiful, we have served it; knowing the truth, we have spoken it” Alfred Whitney Grisworld

 

–Alex

 

 

A lost art?

All week it’s National Conversation Week. Sounds simple enough, do we really need to be reminded to put down our myriad of devices to have an actual conversation?

Sadly, we do.

In these days when we can communicate via 180 characters or by stringing emoji’s together, the art of the conversation is risking being lost.

As human beings we crave social connection. Like many mammals, we are social creatures.

 

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Are we hiding behind our devices and forgetting the importance of conversation?

Communication, and conversation, is so pivotal in medicine. Whether it be breaking bad news to a patient or relative, explaining the risks of treatments, or just allowing a patient to talk and unburden themselves. Conversations are two way streets. But it’s in the area of mental health where a conversation can be the most important.

A common feature of depression is withdrawal and social isolation. A patient who is battling depression actively seeks to be alone and will often close down to the outside world. It might seem trivial, but just asking how someone is can make a real difference to the one who is suffering.

It’s a common misconception that talking about suicide with someone who is depressed will ‘put ideas in their head’. Having a conversation, or letting a friend, colleague or loved one know you are willing to have that conversation, can go some way to shining a light in their darkest of hours.

As GP’s, we work within a geographical boundary and have responsibility for the health for patients within that area. Each GP will find their patients in that area can be slightly different – younger, older, rural, urban, higher or lower socioeconomic class, and sometimes a real mixture.

Our practice area contains a high number of elderly patients and loneliness is something we see often. It is not uncommon on a home visit to sit with someone and realise you might be the only person they see that week. As a professional, it’s heartbreaking. As a human, even more so. Unfortunately as a GP in my day to day life, we don’t always have enough time to sit and reminisce with our patients, providing them that social connection they crave. Just as the health service is stretched, so is our social care system. The number of isolated elderly people living in the U.K. will only increase as medicine advances and life expectancy increases. There are charities and organisations which try to help combat the loneliness by providing outreach programmes and day centres.

For me, I wish that we all took ten minutes out of our day to have a conversation with someone who might really need it. We exist in communities but live in our own bubbles. Say hello. Ask how they are. Listen. You don’t know if you are the only person they may speak to that day.

–Alex

Welcome

We’re all on a journey.

Welcome to our very first blog post.

The Soul Medics are a husband and wife team of General Practitioners in the UK who passionately believe in promoting health and wellness. We have over twenty years of medical experience between us, in both the NHS and in private health services.
Prevention is often better than the cure, and we want to help empower others to make choices that improve not only their physical health but their emotional wellbeing. Being well is not just about being on the right medications, although we know all too well that sometimes it is needed.

Tackling problems like inactivity, obesity and stress can seem daunting, especially on your own. We’re here to share our tips, thoughts and ideas on how we can all make those positive choices.

This is a journey we are on as well, so when we are talking about being more active, choosing healthier food options or trying to improve our general wellbeing – we’re living it too.

We woke up midway through 2016 and realised we had gained several stone of weight, our fitness levels were non-existent, we were working long hours and spending little time taking care of ourselves and each other.

So we decided to make a change.

We decided to really practice all those things we had spent years telling patients about. Our journey isn’t over and we would love for you to join us on it.