Pentred TherapyBACP Accredited Counsellor
Duloe near Liskeard and Looe

Blog Post: 'The Listening Hour' (scroll down for other topics)

The Listening Hour is a time each day set aside for connecting attentively with others: so-called 'active listening'.

Listen to Vivek Murthy, US surgeon general under the Obama administration, talking to Rangan Chattergee about active listening as well as loneliness, authenticity and vulnerability. This is a powerful discussion, full of compassion and insight.



We all need to connect with other people and especially when times are challenging.

Technology is a great way to do this but too much screen and impersonal social media time can also be detrimental to mental wellbeing.

Hearing the voice of another human being and really being heard in an empathic way is so important. But even when we are together, we don't always really pay attention to what is being said and pick up on the clues that tell us how the other person is genuinely feeling.

The idea of The Listening Hour is to spend time connecting with one another in a more focussed, attentive and intentional way, every day - ideally face-to-face or, if that's not possible then with the help of the phone or technology like Zoom or Facetime - and with no other distractions.

Morning, afternoon or evening – it doesn’t matter ...

Active listening may use a surprising amount of energy - don't feel the need to stick slavishly to a whole hour of interaction but do timetable an hour each day, for this activity .

Once you have made this very focussed and active listening - Connecting Time - a part of your routine, you might like to gradually incorporate some of the other daily essentials for personal well-being (described by Dr Daniel Siegel as The Healthy Mind Platter):

Reflecting Time - a good way to begin the day. Let your mind turn inwards in reflection, meditation, journalling
Eating Time - make your meals as nutritious as possible, even when there is limited availability and drink plenty of fresh water
Exercise Time - move regularly and as much as you are able + include some strengthening exercises every day
Concentrating Time - do something that requires your complete attention - work, write, do some research, crosswords, puzzles
Playtime/Creative Time - draw, paint, make, bake, craft, garden, have fun, play games and, very importantly: laugh
Down Time - time for relaxation. Play favourite music, watch a film, listen to the birds sing or stand and stare
Sleep Time - bed at the same time and up at the same time, no screens in the bedroom, room as dark as you can make it



Insomnia

Helpful Strategies for Getting a Good Nights’ Sleep

>Get up at the same time every day, seven days a week
>Go to bed at a time that will give you the opportunity for 7-8hr sleep, before your regular getting-up time
>Sleep in complete darkness
>Make sure your bed and pillows are comfortable enough to lie in for the whole night
>Ensure that your bedroom remains at a comfortable temperature for you throughout the night, with your preferred amount of bedclothes/nightwear
>Ensure that your bedroom feels like a restful, calm space that you want to be in
>Use your bedroom only for sleep and sex – no mobile phone, laptop, tablet or TV!
>If you wake in the night and don’t quickly get back to sleep, get up and go to another room and read or listen to music until you feel ready for sleep again – but keep the light levels as low as possible and don’t use a screen
>Eat at least 3hr before your bedtime and not during the night
>Avoid alcohol, caffeine and nicotine, especially after midday – all are sleep disruptors ...
>... and avoid daytime naps
>Don’t use any sort of screen, e.g. laptop or mobile phone, within 90min of your bedtime – the blue light emitted tells the brain that it is daytime and suppresses the production of the sleep-promoting hormone melatonin
>Write a journal, one page or more, first thing every morning and record your worries along with the things that delight you or for which you feel grateful
>Exercise daily, early in the day
>Go outside into natural daylight every morning
>Avoid shift work, if possible. If that’s not possible, reduce light exposure between finishing work and going to bed, e.g. wear wrap-around
sunglasses on the way home from work and don’t switch on any artificial lighting
>Take a warm bath before bed, adding a very large mug-full of Epsom salts to the water
>Take up yoga and/or mindfulness meditation – see this website ...
>Use an App such as ‘Insight Timer’ to find a sleep-promoting meditation, such as this one ...
>Finally, a Vertical Reflex Technique called Diaphragm Rocking may work wonders. This and other self-help hand reflexology techniques for relieving everyday stress and tension are demonstrated in a short You Tube clip by Lynne Booth, the person who developed VRT - or ask me to show you. One client recently told me that, when she does the Diaphragm Rocking at night, just as I showed her, she feels a wonderful sensation of comfort spreading across her chest and then through the rest of her body so that she is able to fall asleep quickly and peacefully.

(For an interesting and informative article on reflexology and sleep, written by Lynne Booth, visit this link).



Inflammation and 'Blue Mind' (probably not what you think!)

Chronic inflammation - we are beginning to understand just how significant this may be in many disease processes, from cardiovascular disease (heart attacks and strokes) to autoimmune diseases such as rheumatoid arthritis and possibly even in depression.

It is therefore also likely to be relevant in counselling - lifestyle factors can exacerbate or mitigate inflammation and so maybe it is important to look at these factors, alongside the counselling process, for those who are depressed.

Every one of us has a 25% chance of developing depression at some point in our lives, so it is something that is likely to affect us all, either directly or by association.

Professor of psychiatry and author, Edward Bullmore, explores new developments linking depression with inflammation of the body and brain in his book, The Inflamed Mind - A Radical New Approach. He discusses ideas from the book with Rangan Chatterjee, in one of the 'Feel better, Live More' podcasts - click here to listen - and in this Guardian article.



Stress is known to be a major cause of inflammation as well as a major cause of depression - so is there a causal link between inflammation and depression? Prof Bullmore is undertaking research into this area - if you are interested in taking part in this research, have a look here ...

***

I love to be by the sea and always feel really energised by a beach walk or swim.

Wallace J. Nichols dives into why being close to water is so therapeutic in his book 'Blue Mind.'

The term “blue mind” describes a mildly meditative state that we can fall into when near, in, on or under water. It's the opposite to “red mind,” in which we may feel anxious and over-stimulated - a common experience for many, faced with all the demands of modern life.

Some therapists are making use of this in therapy: take a look at this article from BBC News ...

... or just head to coast!



Mindfulness, Reflexology and the Relaxation Response

I have been thinking about the similarity in benefits between regular Mindfulness-based practice and reflexology treatment (see the Home page too).

I looked up a meta-analysis of research into Mindfulness meditation and the immune system and there is some evidence to suggest that physiological change, commensurate with normal immune system activity, is produced with regular frequent practice. I wonder if we will ever have similar research into this effect for reflexology? The first step is the knowledge that both reflexology and Mindfulness practices promote the relaxation response, which reduces stress:

In an un-stressed state, the body is better able to heal itself and to fight-off illness and the effects of aging: Immune function is improved; fatigue, irritability and perception of pain are reduced; the mind is sharper and more creative; energy, motivation and productivity increase; sleeping patterns improve.

In the study mentioned above, I came across a word that I had never heard before: salutogenic.

It describes an approach which focuses on factors that support human health and well-being, rather than on factors that cause disease (pathogenic). So I suppose my holistic and humanistic approach to clients might be described as salutogenic.

The word is rooted in Latin and Greek: salus meaning health and genesis meaning origin.

Recovery is often a prerequisite to health so, from here, my 'surfing' led me to the idea of recovery and the 'recovery model.'

This model emphasizes and supports the potential of the individual for recovery, particularly from mental illness, in which recovery is seen as a personal journey rather than a set outcome (thank you Wikipedia!). This is very much my philosophy in terms of counselling.

The mnemonic CHIME helps to identify the elements that are required to encourage recovery:

Connectedness - social connection and supportive relationships
Hope - self-esteem and resilience, allowing imagination of a future that holds positive aspects
Identity - a strong sense of self as an individual of value, as part of but distinct from a wider community
Meaning - values, beliefs, purpose/role
Empowerment - autonomy and self-management including coping strategies such as mindfulness practices, counselling, medication and seeking out help and support

These things seem obvious when written down but how often do we put all of them together? Counselling does work with all of these aspects - but therapy is is a luxury for many and unattainable for many more. And how many are there who lack the security of a safe home or sufficient finances, which make personal empowerment a realistic prospect?

Food for thought ...



Coping with Difficult Life Events

Spring usually brings the promise of sunshine, warmth and new growth in the world around us - but if you are in a dark or difficult place, those things may feel impossible to reach. T. S Eliott wrote, in his poem, The Wasteland,

April is the cruellest month, breeding
Lilacs out of the dead land, mixing
Memory and desire, stirring
Dull roots with spring rain.
Winter kept us warm, covering
Earth in forgetful snow, feeding
A little life with dried tubers.


There have been many shocks and upheavals lately, both nationally and globally.

These, as well as our own life events, may provoke a sense of personal chaos and destabilisation.

It is common to experience these kinds of feelings in the face of significant difficulties and normal to try to avoid thoughts and emotions that threaten our equilibrium with their unfamiliarity and power; such feelings are very scary. It takes courage to speak out about such personal matters and to seek support.

But can we protect ourselves and those we care about from the devastating effects of trauma?

Trauma and turmoil are an everyday part of normal life. Resilience, awareness and compassion, including self-compassion are possibly the three key factors in helping us to cope with the difficulties that life inevitably throws our way at times.

Follow this link to The American Psychological Association for 10 suggestions for building resilience.

Awareness may be developed through keeping a journal, mindfulness practice, working with a personal counsellor and frequently checking-in with our own feelings - what is going on for us, physically and emotionally, on a regular basis. With awareness, we can become more flexible and begin to change the things that may be blocks to our personal growth.

On compassion, Erin Lanahan says,

Act lovingly toward yourself and do things that nurture you

This is not selfish, it is self-care. It is only through the cultivation of compassion for ourselves, that we can ultimately feel true compassion for others. Our kind nature will become visible and others will be drawn to us. Our connectedness will provide us with resilience and our compassion, with joy and fulfillment.





Mindfulness - yesterday is history and tomorrow is a mystery but today, now, is a GIFT ...

Mindfulness - being 'in the moment' or present.

Coincidentally, the focus of my yoga group recently has been meditation. We start each session with some quiet sitting, often focusing on our breathing, to settle our minds and bring our awareness back to our bodies and how they are in the present moment. We then progress to some gentle stretching exercises and postures to further this process, before resuming quiet sitting or lying at the end.

But being still doesn't suit everybody and is not the only way into being more mindful and meditative. We can develop mindfulness through practice in all aspects of daily living: when cleaning our teeth, washing up, commuting; it is a question of training the mind to really focus on each activity as it is carried out and so noticing what it feels like to be fully engaged, mentally and physically with the task in hand, rather than doing one thing while the mind is somewhere else entirely!

Of course, the mind will wander and random thoughts will pop up - that's what minds do and that's OK ... it can be noticed and the mind gently brought back to the task in hand, without criticism or judgement. But daily practice is essential and it is helpful to form a habit of doing it at the same times each day - this way, the brain will be expecting to switch into a mindful mode and it will gradually begin to feel more easily achievable. Look at the Headspace website for some free basic Mindfulness training.

Walking in the natural environment and dancing also offer wonderful opportunities to cultivate mindfulness. We are fortunate enough to be able to walk into the woods from our front door here at Autumndale and I sometimes walk with clients on fine days.

And I have just been introduced to a dance movement meditation practice called 5 Rhythms. Sessions are held locally, in Midhurst and Alton and are open to all, regardless of ability, age or gender. You do not need to have had any previous experience of dance and do not need to be super fit - you decide your own pace and there are no steps to learn ...

... I have never danced but went recently and found it an extraordinary and exhilarating experience. I was self-conscious initially but quickly realised that none of the other dancers were either judging me or 'expert' dancers themselves and I was able to give myself up to the music and dance!

Chanting is a similarly 'mindful' activity.

Some Benefits of Mindfulness Practice:

• Anxiety, stress, depression, exhaustion and irritability all decrease with regular sessions of meditation. Memory improves, reaction times become faster and mental and physical stamina increase. In short, regular meditators are happier and more contented, while being far less likely to suffer from psychological distress.

• Mindfulness can dramatically reduce pain and the emotional reaction to it. Recent trials suggest that average pain ‘unpleasantness’ levels can be reduced by 57 per cent while accomplished meditators report reductions of up to 93 per cent.

• Clinical trials show that mindfulness improves mood and quality of life in chronic pain conditions such as fibromyalgia and lower-back pain, in chronic functional disorders such as IBS and in challenging medical illnesses, including multiple sclerosis and cancer.

• Mindfulness improves working memory, creativity, attention span and reaction speeds. It also enhances mental and physical stamina and resilience.

• Meditation improves emotional intelligence.

• Mindfulness is at least as good as drugs or counselling for the treatment of clinical-level depression. One structured programme known as Mindfulness-Based Cognitive Therapy (MBCT) is now one of the preferred treatments recommended by the UK’s National Institute for Health and Clinical Excellence.

• Mindfulness reduces addictive and self-destructive behaviour. These include the abuse of illegal and prescription drugs and excessive alcohol intake.

• Meditation enhances brain function. It increases grey matter in areas associated with self-awareness, empathy, self-control and attention. It soothes the parts of the brain that produce stress hormones and builds those areas that lift mood and promote learning. It even reduces some of the thinning of certain areas of the brain that naturally occurs with ageing.

• Meditation improves the immune system. Regular meditators are admitted to hospital far less often for cancer, heart disease and numerous infectious diseases.

• Mindfulness may reduce ageing at the cellular level by promoting chromosomal health and resilience.

•Meditation and mindfulness improve control of blood sugar in type II diabetes.

• Meditation improves heart and circulatory health by reducing blood pressure and lowering the risk of hypertension. Mindfulness reduces the risks of developing and dying from cardiovascular disease and lowers its severity should it arise.

The above list was taken from the Frantic World website - follow this link for references detailing research that supports these claimed benefits



Importance of Vitamin B12

I have just discovered that a family member has vitamin B12 deficiency, producing longstanding, significant and frightening symptoms, which have prompted many investigations and treatment - but not for B12 deficiency, the main culprit, until recently.

This deficiency, the incidence of which increases with age and which is relatively common and universally prevalent - is often overlooked in favour of more complex and sometimes less treatable conditions.

A well-referenced article from the December 2013 edition of The Pharmacy Times gives a good overview of the subject - do take a look.

People who drink a lot of alcohol as well as vegetarians and especially vegans are particularly susceptible to B12 deficiency, due to the lack of meat, fish, eggs and dairy products in their diets.

If you are concerned that you have B12 deficiency, see your G.P. who can arrange a blood test.



Beating Winter Blues

Especially towards the end of a long and possibly dreary winter you may begin to feel jaded and long for the renewed energy that a few bright days can bring. You could consider how some simple lifestyle changes might perk you up and keep you going until the rain clouds clear and long, sunshiny days return (or you go on holiday :) ...

  • Exercise - take a walk and appreciate nature, (mud, puddles and all!) several times each week

  • Drink plenty of pure, fresh water - flush your system and clear the cobwebs from your brain

  • Think about your diet - maybe go for low GI foods; reduce gluten and dairy in your diet (we are not all designed to digest them very well and, like stress, they may be a source of Chronic inflammation); have fewer carbs, alcohol and caffeine; more fish and other first class proteins; more vegetables and possibly nuts; kick the sugar!

  • Consider some basic supplements. Well-known nutritionist Marilyn Glenville suggests that most of us could benefit from taking some good quality multivitamins and minerals, some probiotics and some omega 3 fish oils each day

  • Top up your vitamin D - the sunshine vitamin, as reserves are likely to be depleted towards the end of Winter; a vitamin D3 spray is simple and effective but 20 min outdoors in natural light, with some skin exposed, is best of all

  • Sleep - 7 or 8 hours a night if you can, with some before midnight ...

  • Meditate - 'Mindfulness - Finding Peace in a Frantic World' by Prof Mark Williams and Dr Danny Penman is a good starting point

  • Don't forget your friends - make time to socialise; human beings are social animals - we need to be able to interact with other people

  • Have some fun - playtime is not just for children; we all need to play. Dr Stuart Brown says, 'the opposite of play is depression.' See his book, 'Play - How it Shapes the Brain, Opens the Imagination and Invigorates the Soul' or watch his TED Talk

  • Take some time out - treat yourself to a massage, a facial or maybe even some reflexology!


  • Achy Legs and Deep Vein Thrombosis

    I have just be talking to a client about achy legs and deep vein thrombosis (DVT), subjects that often seem to come up in my reflexology clinic. I thought it might be useful to share some of the information, which I often pass on:

    Firstly, always seek a medical opinion and follow specialist advice, especially if a DVT has been diagnosed or is suspected. Take symptoms of leg pain seriously, particularly following surgery, if pregnant, when using hormone replacement therapy (HRT) or the contraceptive pill or following long periods of inactivity, e.g. following a flight.

    Following a DVT:

    Massage of the affected limb is not recommended until it is certain that no clot remains. Massage stimulates blood flow but may also dislodge any residual clot, which may be dangerous if the clot is then carried to the lungs (risk of pulmonary embolism)

    Have a blood test to check vitamin B12 levels - clots are more likely to occur when there is B12 deficiency

    Long-term anticoagulant therapy may be required

    Use of the contraceptive pill/HRT is not usually recommended

    'Flight socks' may be a useful precaution on any long journey, even by car (and are available from chemists, e.g. Boots) - but check with your doctor

    Vascular studies (e.g. using ultrasound or doppler flow) can confirm if the vessels are clear

    And generally:

    Avoid sitting still for long periods, e.g. at a desk - get up and move around at regular, frequent intervals. Take regular breaks on long car journeys or walk around the plane on long flights

    Do not ignore any abnormal changes in the colour (e.g. red, white, blue), temperature or sensation of part of a limb

    Seek immediate medical advice if there is severe pain or discomfort on dorsiflexion, i.e. when foot is pulled up from the ankle, so toes move towards knees (Homan's sign)

    Varicose veins may cause achy legs - prolonged standing still is the worst activity if varicose veins are present

    Pregnancy, menopause, alcohol and use of statin medication may exacerbate achy legs

    Raise legs when sitting if possible

    Exercise is good - e.g. ankle rotations/calf clench and release when sitting still; yoga; swimming; cycling

    If the blood pressure is low (particularly common in tall, young, fit people) prevent it falling further and possibly encouraging sluggish circulation in the extremities, by always maintaining adequate levels of hydration (water intake/fluid balance) and sodium (table SALT)

    Bath/foot soak using magnesium salts, e.g. Zechstein (the best) or Epsom (cheaper), which are absorbed through the skin (or use a Zechstein magnesium oil spray, which is good for cramp too)

    Self-treat using acupressure points for leg pain (find instructions on YouTube)

    Consider using a good quality multivitamin and mineral supplement, e.g. NHP Healthy Woman Support, possibly with extra vitamins C and D3 + omega 3's

    Investigate the use of red vine leaf extract, for example - see this article from the Nursing Times

    Practice Mindfulness, e.g. with the help of 'Mindfulness for Health' by Vidyamala Burch and Danny Penman

    Regarding footwear:

    Make sure the shoe bends at the toe box but is not too flexible - and that the toe box is not too pointy

    Make sure there is a sufficient arch support

    Choose a chunky heel that is less than 2 inches high

    Ballet flats offer no support anywhere in the foot bed and often rub the heels or big toe joint and/or need to be held on as they have no straps or laces.

    Heels higher than 2” create an unnatural foot position when walking and may adversely affect joints and tendons in the foot and elsewhere, e.g. knees, hips, back

    Feet may hurt more with aging, especially post-menopause in women, because the protective fat pads diminish

    Custom-made orthotics can help to cushion feet in shoes with thin soles (or feet with no fat!) and so offer increased comfort and protection

    Many choose to wear shoes with a thick shock-absorbing sole, such as fitflops (who don’t only make flip flop style shoes) or trainers with a roller sole (but these may not be suitable for those with balance or some musculo-skeletal problems). Ecco and some Rieker styles are OK too. However, there is also a movement advocating the use of 'barefoot' minimalist shoes, such as Vivobarefoot, which allow natural musculo-skeletal function during movement and thus support pain-free activity.

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