Living your life, or living your story?

Each of us has our own story. A narrative web of intertwined and interconnected experiences – and our perception of them – complete with stories between stories, and stories within stories.

Unless we’re careful, the stories can become our identity and become our lives, rather than being stories about our lives.

As the unique individuals each and every one of us are, the stories of our lives will each be different, and yet at the same time there’ll be common ground. That’s one of the reasons storytelling is such a powerful means of connecting with others. Compelling stories resonate, they touch hearts as well as minds.

Our stories can develop and grow as we journey through life. Ongoing experiences, and lessons learned, potentially providing a deep, rich, ever-evolving seam of knowledge and understanding from which to draw from as we navigate the terrain of life unfolding before us. Stories can be self-empowering: building and sustaining self-confidence, self-belief and self-determination; and they can also empower others by offering hope, inspiration and motivation. Stories of challenge, triumph over adversity, success against the odds, all being common themes in best-selling books and films.

Although our stories can develop and grow, and our ‘selves’ along with them, that’s not always the case. For many, their stories become final and as a result limiting. Their past experiences forming fixed beliefs which influence moment-to-moment experience, those fixed beliefs becoming rigid filters through which their senses interpret the world and their responses (reactions) to it. Filtering in anything that fits with their beliefs and filtering out anything that doesn’t. Life and living becomes less and less determined on the basis of what the world presents before us and more and more on the basis of what we project onto it.

Past experience, stories, fixed beliefs and filters, can become our ‘reality’. Essentially our interaction with the world becomes a process of identification and projection of familiar patterns and conditioned, unconscious responses to them. Experience (and ‘reality’) is no longer a process of curiosity and discovery based perception, instead experience (and ‘reality’) is determined by what we believe we know about the world – a result of active and passive learning, conditioning and influence. Without any awareness of the process, our past and everything that came with it becomes the structure or model of the world we take to be reality, and we mistakenly take our personal reality to be THE reality. In the words of author Anais Nin: “we don’t see the world as it as, we see it as we are”.

The basis of many of the problems we experience in life, the reasons why we become stuck and the numerous challenges we struggle with, are rarely because of a situation we’re in and more often due to our thoughts about the situation. The stories we tell ourselves.

Such stories can and do limit us, and limit our lives. They can become barriers to growth, defences against making difficult decisions, reasons for not taking personal responsibility, evidence to support our arguments, beliefs and behaviours.

Then there are the stories of perceived lack that we repeat to ourselves. Stories of inability or inadequacy, of being less than perfect, unlovable, unable, incapable or unworthy. All are common themes in the stories people share in consultations. Stories from or about our past that we believe determine who we are and what our lives can or cannot be about. Stories about identity. Stories that become identity. Yet all too often these are not stories of our own making, they’re stories imposed upon us by others, when we were young, impressionable or vulnerable. It’s worth remembering our past has the power to influence, and not determine, our present or future. Unless we choose otherwise.

If I asked you to share your story, right now, what would be the story that you shared? Would it be a story of adventure, a story of challenge or change, a story of following your passion, or a story of why you can’t do or be what you want to do or be? Would your story be about never having enough time to do all of the things you have to get done in a day, never mind the things you’d really love to do with your life (my friend’s story recently)?

Would it be a story where you’re so much a part of someone else’s story that you no longer have a story you can call your own? A story where you’re happy to not, or not have to, live your own life? Is your story a story that keeps you trapped in a loop of past experience, an experience or experiences that keep you stuck, prevent you from letting go and moving on?

Or is yours a story that drives you forward, motivates, sets you free?

The mistake we all too often make is in believing our stories are who we are, and also all too often and without being aware, we become trapped by them. In a similar way to the elephant who, despite its incredible strength, has been conditioned to believe the thin rope around its lower leg prevents it from moving from the spot it stands in, our stories can bind us to a place in which we exist and survive rather than evolve and thrive.

Some years ago I worked with someone whose years of involvement with mental health services resulted in a story, and an identity, of a ‘mentally ill patient’, and the many limitations that went hand in hand with both. Believing himself to be as much a part of the mental health system as the fixtures and fittings in the buildings he received treatment in, his day-to-day life became one determined by the conditioning and interactions with the system rather than any personal choices he could make outside of the system, or things he could’ve done for himself. The point is, as with the elephant, he wasn’t aware. He was the perfect, passive patient. That was his role, his identity.

And it isn’t unusual for the complex story of anyone’s life to be distilled into a story of role identity. What might be called an ‘I am’ story: ‘I am a nurse, I am a service user, I am a consultant, I am a therapist, I am a mum, I am a manager, I am a carer’. All are common responses when I ask the question ‘tell me a little about yourself’.

Again, back to your story, is it mainly familiar, flat and final? Or is it mainly flowing, evolving and alive? Did there come a point when your story no longer evolved and grew, when you settled into living the story… instead of living the life you wanted to live? As echoed in the tearful words of a participant on a recent workshop (and not for the first time…) “I didn’t come here to be reminded of all of the things I wanted to do with my life and which I have not”.

I don’t do what I do with the intention of bringing people to tears, but it isn’t unusual when people have a moment of realisation or recognition.

What about you? Are you living the structure and routine that frames almost each and every day in the same, safe and predictable way? On the same repetitive and mundane yet superficially comfortable path? A place that feels familiar and secure, but when you take a few moments to examine it, is in fact anything but? Living a life of hoping, hoping to live the life longed for at some point in the future?

Or are you instead living life now, in the present, with the curiosity and excitement of a young child or with the wisdom of an ageing adventurer, a mind open to the many possibilities inherent within each new moment: exploring, discovering, creating, enjoying? When we lose our curiosity about life, and consign our interest in living it fully to the ‘some other time when we have the time’ shelf, we forgo our opportunities to engage and evolve and learn and grow. We lose out on opportunities for happiness, joy and fulfilment.

If it seems as if you’ve adopted an acceptance to life being the way it is, of things being the way they are, of you being who you always were…and things forever remaining that way. If you feel you’re unable to avoid the negative consequences of anything you want to do, that everything is beyond your control, that you’re resigned to some thing or things being unchangeable and unavoidable, it may well be you’ve reached the position or place that renowned positive psychologist Martin Seligman refers to as ‘learned helplessness’.

But it doesn’t have to be that way.

Perhaps due to the ever increasing pace of ‘modern’ life it seems more and more people are waking up and deciding enough is enough. They want to engage, or re-engage, with living the kind of life they want to live. Often as a result of the stress and emptiness of the life they’ve been living many have made a conscious choice to become the author of a new story. For others it’s been something of a forced choice, with a wake up call such as a health crisis, relationship breakdown, loss of the job they loved (or perhaps didn’t), the ‘job for life’ which paid for all of the things they didn’t need and also gave them an identity. “Now it’s gone, who am I?” asked one recent client who was experiencing depression shortly after being made redundant.

All too often we become trapped inside the illusion of the story we’re living and the perceived reality it’s created. Recognising they’ve stopped engaging fully in the precious gift of life, and the limited time they’re given to live it, many are also waking up to the fact our lives have sell by, best before and use by dates. And they’re choosing to do something about it.

They’ve decided the stories they’ve been living will no longer be their fully finished narratives, but the stories of their lives so far. Not for them the stories you’ve heard a thousand times before: stories of the daily grind, of the employer who treats them badly, the job they no longer enjoy (or even worse, hate), the relationship that stifles them (and it’s all the other persons fault). And not for them either the stories of dreams left behind in the dim and distant past, of goals they never got around to having a go at, or the deferred happiness that will (hopefully) be realised at the weekend, or when they take a holiday, or when retirement comes, or when this…or that…or the other, happens.

Is it possible to wake up, at any time, no matter why, when, where, who or how, and write a different story? The next chapter? A new book? A new identity? A whole new way of living even?

Absolutely.

How? Well, it’s your life, not mine, and not for me to tell you how to live it, but if you were asking for a suggestion my response might be to think about what it is that brings you joy and begin, or continue, your story from there. Or think about those unfulfilled goals, dreams and aspirations. Or those things you’ve never done and always wanted to. Or the life you always wanted to live but never have. Or the person you wanted to be but never were because you were afraid of what others would think and say.

But, and here’s the bit that results in many bottoms remaining on the oh so comfortable sofa, you have to be willing to take action.

And when might you do that? Again, it’s your life not mine and therefore not for me to decide, but I’d say now is always a good time to get started on anything you really want to do.

But only if you really do want to of course.

A bit about a long walk – reflections on the Camino de Santiago

Hiking the Camino de Santiago was one of those things I’d heard about once. Something that for some reason resonated and stuck with me and as a result ended up on my ‘one day’ wish list. Something I’d get around to to doing one day, when I had the time. The thing is all the list seemed to do was grow longer and longer and the ‘one day’ on which I’d do some of the things I dreamed of never seemed to materialise. Perhaps it’s the same for you? However, an unexpected and significant change in my personal circumstances presented me with the perfect opportunity to make things happen. The one day had arrived.

Redundancy.

Out of the blue, I was redundant. Redundant. It has a certain finality about it. Defined by the Oxford Dictionary as an adjective, meaning: ‘not or no longer needed or useful; superfluous’, it was certainly how I felt when I heard it said to me. Not the kind of thing you want to hear when you’ve worked hard at something for many years. Not something I expected to hear because there was still much work to be done. To be honest I’d never really given much thought to not doing the job I did. in the main I loved it and just got on with it.

Something else I’d never given much thought to, until redundancy, was just how much of my life and my identity, was wrapped up in my job. My every day structure and routine, the many things I did, the places I went, the people I worked with, my sense of purpose and fulfilment… and of course the income it gave me. It seemed all of me was wrapped up in my job. Without it, who was I? Without your job, and everything that goes with it, who would you be?

But redundancy is the topic of another post so I’ll say no more about it for now, except that instead of going with the advice of a number of people – which was to hit the ground running and get another job straight away – I decided to take a year out and do as many of the things on my ‘one day’ list as possible. I dug out my saved list and considered whether there was anything I wanted to add to it. Hiking the Camino was towards the bottom. At the top of the list was my sanity project (anyone who’s ever lost their job needs a sanity project), followed by finishing my masters (I didn’t), spending over a month travelling in Peru (doing some of the touristy things such as visiting Machu Picchu and Nazca, and some of the not so touristy things such as hiking Mount Salkantay and spending time with shaman and healers), converting the loft in the house I lived in at the time, and travelling to New Mexico to visit my good friend Bear.

Amazingly, over a period of around 8-9 months, the one topic that came up again and again, no matter where I was or who I was with, was the Camino de Santiago (and it wasn’t me bringing it up). I took it to be a sign and although I hadn’t set a specific date I began buying things in preparation, including a really good pair of walking boots. I went everywhere in them in order to break them in and they fit me a treat, as we might say in Yorkshire. They’d need to because to get to the end point, Santiago de Compostela, and in the time I’d decided I wanted to get there by, I’d need to walk around 25 miles a day.

One thing that fascinates me to this day was that I could get all the way starting point via public transport. I could literally get on the (then) 760 Leeds bus, more or less right outside the front of my house, and travel all the way there via buses and trains. And I did.

Filled with a mixture of excitement and trepidation, not least because of the many uncertainties the journey before me held, I stepped on the bus with just the clothes I was wearing and a small backpack with a change of clothes and other essentials. So began an adventure that lasted three weeks but which I’ll remember forever. A journey of around 500 miles.

The Camino de Santiago consists of a number of ancient trails, with many different starting points.The route favoured by the vast majority of people is what’s known as the Camino Frances, a journey which begins in St-Jean-Pied-de-Port, a small and picturesque village in the foothills of the French side of the Pyrenees. From there the first stage sees the traveller take a steep and arduous hike up and over the Pyrenees before crossing the border into Spain and descending down the other side and into Roncesvalles. Altogether it’s a journey of around 500 miles across the many regions that make up northern Spain. And what a journey it is.

It’s a journey of many types: physically, psychologically, emotionally and metaphorically. A journey of introspection and reflection. A journey where some people lose themselves, and some people find themselves. People talked about the camino being a ‘wake up’ journey. That they woke up to what was really important in their lives… and what wasn’t.

A journey of challenging simplicity, to life and the daily living of it. How far will I walk today? When will I stop? Where will I eat and what will I eat? Will there be a bed? What do I do if there isn’t.

It’s a journey of uncertainty, never really knowing what’s over the next hill or around the next bend.

A journey that kicks you out of your comfort zone(s) and connects you with growth, determination and resilience. A journey that can stretch your capabilities way beyond what you thought you were capable of, and tests your patience to the limit. Ever slept in a dorm with 49 strangers? Queued for an hour for a shower (that was then cold and little more than a drip)? Struggled to sleep because the person in the next bed would win an olympic gold medal for snoring, and yet she was only one of ten people snoring that night.

And then there’s the beauty. Beauty in the scenery, in the sunsets and the sunrises; in the moments that take your breath away, in the paths that wind their way across miles and miles of open countryside: endless fields of corn and wheat, grape vines and sunflowers, seemingly stretching out to infinity, and through dense woodland too. Through quaint, ancient, picturesque villages, delightful towns and sprawling cities.

And the incredible beauty of people. In the warmth, compassion and kindness of complete strangers, many of whom don’t speak a language you understand but who share a common language of connectedness.

Lots of people, hundreds of thousands in fact, from many different countries and from all walks of life, who set out to complete some or all of the Camino de Santiago every year. For some it’s a pilgrimage – the path of St James – for some it’s a challenge, and for others it’s an adventure. Of course it’s also all three, and probably more, for lots of people. As well as an outer physical journey it’s also an inner, psychological and spiritual journey

Along the way I met and talked with many people who were captivated by the challenge of completing a 500 mile hike but only wanted to do it the once. And then others who came back again and again and again. Not only because they loved to walk, but because of the experiential nature of the journey. The many aspects they got pleasure from and the sense of achievement and fulfilment that resulted both from the planning and completion. It was often shared that it’s not about ‘the’ Camino but about your Camino. It’s about what it means to each individual and that there are many, many lessons along the way… if you’re open to learning that is.

Perhaps hiking the Camino de Santiago is something you might want to add to your one day list?

Whether it’s on there or not don’t leave the things you’d love to do until it’s too late.

Buen Camino

 

 

Frozen by the fear of a two minute task

the-fearless-presenter-4Monday morning, almost 6am, and Chris had spent another sleepless night, the fifth in a row, in turmoil. Thoughts about something she might have to do within the next few days completely consumed her. And it wasn’t only the thoughts, though they were bad enough, it was also the associated feelings of dread, anxiety and panic.

As a manager with over 20 years experience she was comfortable with doing most things. But not this. She was gripped by something that filled her with fear to the extent that she wanted to run away. “What’s wrong with me, why can’t I do this?” she thought, berating herself repeatedly for her perceived inadequacies.

The previous Wednesday Chris had read about a forthcoming training programme and immediately felt excited about applying. However, part way through reading the application process she was stopped dead in her tracks. In order to be considered she was tasked with producing and submitting, by the Friday coming, a two-minute video presentation. The knot in her stomach was instantaneous, a wave of nausea washed over her. And for good reason, or so it seemed. The thought of presenting absolutely terrified her.

Fortunately though, her critical inner voice immediately took charge and provided her with all the reasons she needed for not applying. “What a relief, I’m off the hook”, she said to herself. “If I don’t apply I don’t have to worry about doing a presentation, and if I don’t have to do a presentation I no longer have to feel the way I’m feeling.”

Relief?

Not at all, Chris really wanted to be on the training programme.

It would be an odd individual who got relief from not doing something they really wanted to do, and yet that’s the conflicting situation so many people end up in. Stalemate. Relieved at not having to do something they’re fearful of, frustrated and disappointed at not being able to do something they’re attracted to. To add to the problem it isn’t unusual for people to also then get caught up in a loop of negative, self-criticism.

Very often people think that the ‘problem’ is with them personally, that they’re defective or dysfunctional or damaged in some way. After all, public speaking is something everyone else seems to take in their stride, is it not? No it isn’t. The truth is the paralysing effect thousands of people experience when even just considering the possibility of having to speak in front of a group – whether that be an interview, a team presentation or a conference speech – is incredibly common. So common in fact that it should be viewed as the normal, not abnormal, response. The fear of public speaking, or ’glossophobia’ to give its formal name, is possibly the number one fear for most of the population, considered to rank even higher than the fear of death.

Is it any wonder so many people stop before they even get started?

But what exactly is it that people are fearful of? Whilst the fear has its roots in many sources, from experience I’d say it’s rare someone actually has a fear of public speaking. Most of the people I’ve worked with are bright, articulate professionals who speak with other people every day. It’s not about speaking.

And nor are the majority of them tormented by another commonly held belief, that it’s about the ‘fear of failure’. Sure, it’s connected with a fear of failing and I’ll get to that shortly.

It could be argued that the fear of failure stems from unrealistic expectations people have about themselves and about what they should be capable of from the outset? Beliefs sustained by the dis-ease of perfectionism: ‘I have to get this perfectly right, the first time, and every time’. In truth that’s like saying you should be able to ride a bike from the very first moment you get on it. Life isn’t like that, no matter who you are or whatever it is you want to do. Especially if you want to do something well, including being you.

When we further explore what also drives fear, other common feedback includes:

  • What if I get it wrong?
  • What if I look stupid?
  • What if I sound as if I don’t know what I’m talking about?
  • What if I forget what to say?
  • What if I don’t know what to say?
  • What if someone asks a question I don’t know the answer to? (always high on the list)

So, whilst it may seem that most, if not all, of the ‘stuff’ that gets in the way of getting started is the notion of not being able to do all of the things they’ve mentioned – failing – what really paralyses people and stresses them to death is what will others think of me if I fail?

And even then we’ve not got to the actual root of the problem.

Which is?

Thinking, overthinking, and catastrophic thinking…and that then leading to the feelings that take us down the path of paralysis. (Did you know you can do the opposite and slip into wonderfully resourceful and empowering states?)

Anyway, we could explore the topic of fear forever and not move any further forward. It’s in the way though so let’s not fight it or deny its existence. My suggestion is that you accept it, surrender to it even. If you believe the thing that’s stopping you is the feeling you’ve labelled fear, it isn’t. If you believe you have to overcome the fear before you get up and speak, you’ll be waiting a long time. Possibly forever. (And, by the way, if ever you meet someone who’s about to get up and speak, who tells you they feel no fear before speaking in front of a group, check their pulse. Chances are there won’t be one. Do them a favour and call the emergency services. Or call an undertaker.)

Why not allow the feeling you’ve labelled fear to be your guide to what will help you do whatever it is you want to do? A sign that you’re stepping out of your comfort zone, a signal that there’s growth on the horizon, if action rather than avoidance is your response.

All of the ‘what ifs’ identified above provide us with clues and questions to guide our thinking on a way forward. Clients, whether it’s in personal coaching or a workshop, often begin by telling me they want to be confident speakers or presenters. Great speakers are prepared speakers and confidence comes with competence. So if you want to get up and speak or give a great presentation: make sure you’ve done your homework, done the preparation, and put in the practice to make it happen.

And, just in case you’re wondering whether or not Chris did her presentation and got a place on the course? She did indeed.

She gave herself a break, and got out of her own way.

You can do the same.

Trapped by holding on

Trapped by holding on

In the past, in some indigenous cultures around the world, they discovered an ingenious method for trapping the monkeys they loved to eat. They would hollow out a gourd, cut a small opening in the side, and then place a tasty treat inside. The monkey, being very bright, would quickly find the gourd and the opening, slip its hand inside and grasp the treasure. Once grasped though there was no letting go. However, with its hand made into a fist it was unable to remove it and as a result was prevented from escaping…and destined for the pot.

So, the question is, is there anything you’re clutching onto, unwilling to let go of, anything that fulfils a need in the moment but by grasping and holding on prevents you from having something that’s more important, such as being fully alive and truly living life, perhaps?

Pause, think it through. What could you let go of to allow something in that adds to your life instead of taking something away?

Good health isn’t only the result of good healthcare services

Good health isn’t only the result of good healthcare services

I thought I’d start this one with a quick quiz. What’s missing from the following three images?

What's missing?

Quite some time ago I ended a previous blog with a quote from the NHS Five Year Forward View:

So this Forward View sets out how the health service needs to change, arguing for a more engaged relationship with patients, carers and citizens so that we can promote wellbeing and prevent ill-health.”

Too often any initiatives arising from statements such as the one above are health service centric, that is to say they tend to put health services at the centre of any ‘health’ developments. Broadly speaking they usually look at how people can fit better into ‘health’ services, with a belief that improvements in health will come about as a result of increased provision and easier access. They don’t engage with, they do to. The underpinning principle is ‘not only do we know what’s best for you, we know best how that should be done and how and where it should be provided’. And often the very initiatives that were intended to meet rising demand actually increase it and in so doing add further pressure to a system that is struggling to cope.

Making people passive recipients of health services won’t ‘promote wellbeing and prevent ill-health’. People are not lifeless mechanisms that simply need to be fitted in and fixed, they are living, breathing, thinking, feeling organisms. They don’t fit neatly into categories, care pathways, complex systems and one-size-fits-all services.

So, instead of creating demand which then has to be met (by a dwindling workforce), how about seriously considering how demand might be reduced and how health and wellbeing can be promoted? How about placing ‘health services’ on the periphery of health and wellbeing developments and positioning the determinants and enablers of good health, and the people they affect, as the central focus?

The Forward View emphasises the need for health services to develop and evolve in order to meet the changing needs and demands of the population. But do they? Is that really the best approach to solving the challenges of spiralling (preventable) ill-health and the promotion of wellbeing? Or (option b) does the population need to develop and evolve to reduce the needs and demands on health services?

Personally, I’d put my money on option b.

There seems to be a belief at some level in the NHS that the NHS has to be everything to everybody and that if something needs to be provided then the NHS, in some way, shape or form is the body to provide it.

And because of that, despite the rhetoric about how things could be different if the NHS ‘engaged with patients and carers’ or ‘harnessed the renewable energy represented by patients and communities…’, it doesn’t seem to happen to the extent that it could.

When healthcare isn’t health care

We’re caught up in a particular paradox when we refer to the NHS as a provider of health care services because in the main it is not. It is a frequently cited argument that the NHS is actually a provider of ill-health services. Recognised as such for example in the document ‘A Call to Action: Commissioning for Prevention’ a challenge is presented to the door of CCGs by encouraging them to be bold if they are to make the changes necessary to meet the health demands of the future by ‘transforming the NHS from an illness service to a wellness service’.

Nice idea, in principle, perhaps.

But I’m going to go against the grain of almost everything I’ve read for quite some time now and suggest it might be an idea for the NHS to stop trying to be everything, and for commissioners to be bold and commission excellent ill-health services separate from excellent wellness services. I think there’s more mileage in freeing up the professionals to do the job they trained long and hard to do, in environments that allow them to do that to the best of their ability, than there is in expecting them to become experts on everything, including wellness, and then constantly beating them over the head for all of the things they haven’t done. The notion of less is more could offer a more realistic direction for the NHS than the current position of doing more with less, coupled with the increasing demands and expectations placed upon services and staff. The latter can only have an adverse impact on staff morale and, of course, patient care. And no one wants that. Unless of course there’s another agenda behind intentionally driving quality and deliverability into an ever descending spiral whilst stating that things could and should be better?

A Call to Action suggests that reallocating resources is one of the ways the NHS could be transformed and one of the ways that commissioners can really make a difference. It also identifies how much money could be saved if the public could be encouraged to look after themselves better.

In thinking about health and how people themselves have the greatest role to play in their own wellbeing, including their capacity to cope, adapt and self-manage, perhaps it’s time to seriously consider the possibility of reallocation not being within the NHS, but in initiatives that work with the NHS? Time to realise the potential within communities, to explore the what of health and wellness and the how and where of commissioning to greatest effect. Because there are other ways of doing things and others who are extremely capable of doing them.

And the quiz?

The simple answer to what’s missing would be wholeness: whole person, whole life, whole system.

  1. A head without a body is going nowhere, and vice versa. Physical health is inseparable from mental health and we need to consider the whole when considering health and wellbeing. TreeandPeople
  1. People are inseparable from the contexts in which they live their lives and so we need to consider how life and living impacts on health and wellbeing, physical and mental, and what strengths, assets, supports and resources people have in their lives that they can draw on.
  1. When people do need input from others there’s a whole ‘system’ of support available, not only statutory services but including the all too often overlooked network of voluntary and community provision. And we need to get better at doing that in a joined up way.

If we’re serious about addressing the health challenges facing our communities then we must look beyond health services to do that. The increasing medicalisation of life experience, together with the professionalisation of any solutions, is not the answer to transforming health and wellbeing. When we also consider social perspectives and facilitate the creation and development of environments and opportunities for connection, growth, and contribution – tendencies inherent in every individual – people are likely to flourish and thrive and a by-product or side-effect is good health and well-being.

Carers and Self-Care: A Selfish or Selfless Act?

Carers and Self-Care: A Selfish of Selfless Act?

Quite often I work with carers and when I do I’m deeply moved by their selfless acts of love, compassion, care and devotion and their generous giving in support of the needs of loved ones: family members, relatives and others. However, it seems the giving often comes at the expense of their own health and well-being. Why might that be so, I often wonder? Is it a conscious choice or is it something done without thought or question? Are selfless acts of care-giving an expectation of society or do they arise from personal beliefs about caring for loved ones?

My mind wanders and I reflect on some of the self-management groups I’ve delivered. It’s something I really enjoy, we usually have lots of fun while we learn and sometimes, because of the topic and the issues it raises, things can get pretty challenging. There’s something about running such groups that can open up a whole can of worms, from the issue of personal responsibility through to whether or not the ‘healthcare’ system does in fact provide health care. Whatever worms surface every group has taught me something new, all of them have been very rewarding, and without question the topics we cover have had a positive impact upon the lives of people present.

Many years ago I was taught about the importance of rapport and wherever I go and whoever I’m working with I’ve come to recognise that it’s the foundation of any relationship. In fact I’ve heard it argued that rapport is everything. Sometimes though, once I think I have it, I have to risk breaking it in order to create a space for discussion. A space in which to get people thinking about how things could be different. That make sense?

Anyway, there I was one evening with a lively group of carers and after introductions, a gentle warm-up exercise and some playful banter, things seemed to be going great. We’d be together for up to eight weeks so it was important to make a good start. I asked how things were going and if everyone was okay. They said they were.

Time, I decided, for the potential rapport breaking moment.

So I said ‘I need to share something early on to avoid it being a problem later. That okay?’

A nodding of heads, in a sea of smiling faces, suggested it was.

‘Well the thing is…I’m not sure we can do the self-management stuff because the trouble with you people – carers – is that you seem to have real problems with two tiny words. You also have another problem in that you’re really selfish.’ (please note: saying ‘you people’ always has the potential to break rapport.)

‘Huh!?!’ Came the response. ‘What do you mean?’

‘You seem to have real problems with ‘I’ and ‘no’. And on top of that you’re all really selfish.’

‘Are you serious?’

‘Sure, never been more so. It’s just an observation of course but you lot seem to have real trouble with considering your own needs and a real problem in saying no to any demands from others. And you’re really selfish’

– Some of the comments they threw back at me:

‘How can we possibly be really selfish if we spend so much of our time caring for others? How can we possibly consider our own needs when the people we care for are unwell and for the same reason how can we say no? Wouldn’t we be really selfish if we were putting our own needs first?’

‘Exactly, really selfish.’

‘What are you talking about?’

‘Well, are you telling me that caring is important?’

‘Yes!’

‘And are you telling me that the people you care for are important?’

‘Yes!’

‘Does caring for your loved ones make a big difference?’

‘Yes!’

You want the care you provide to be for the foreseeable future, if not forever, or at least for as long as possible. A life-time perhaps?’

‘Yes!’

‘And…are you telling me that without you the people you care for would be, erm, in a bit of a pickle?’

‘Yes!’

‘Well there you go then. I rest my case, ample evidence of your selfishness…’

Now let me tell you, over the years I’ve been on a few training courses aimed at helping me understand people better. (Actually, I really went to try and understand myself better but that’s a whole other story…) What I’ve learned is that apparently when people look at you in a certain way it can mean a certain thing, and what they say and how they say it can provide clues as to how they might be feeling. Sometimes it’s easy to pick up that for example they’re happy with you (this wasn’t the case here) and sometimes it’s easy to pick up something else. Looking out at the group I would say quite a few facial expressions suggested confusion, others a little anger, and I got an overall a sense of rising tension in the room.

Fab, so I continued…

‘Let me ask you something. If you continually made withdrawals from your bank account and made no deposits what’s the likely outcome?’

‘We’d be in debt.’

‘Exactly. So you recognise you cannot spend what you haven’t got? And of course the deeper we get into debt the harder it can be to get out of it. In fact often it becomes so difficult it can lead to all kinds of other problems such as anxiety and stress and depression. A downward spiral.’

‘And if the people you loved and cared for depended on there being funds in the account would you spend it all?’

‘No.’

‘And how helpful would it be if you not only spent it all but you spent more than you had?’

‘Not helpful at all, probably a bit foolish really.’

Sometimes I’ve been known to go off at a tangent and start to share stories and at this point I decided to share one. It’s actually relevant though because it’s a lovely analogy about self-care and also illustrates, beautifully, how something that could be perceived as a selfish act is actually vital to the survival of others. Perhaps you’ve heard it before?

If you’ve ever flown anywhere, with any airline, you’ll know there’s always a pre-flight safety presentation. Part of it includes the air hostess telling you (and demonstrating) that in the event of the air pressure in the cabin falling oxygen masks will automatically drop down from above each seat. Before fitting the mask over anyone else, even the people who are completely unable to care for themselves, you must always, always fit your own mask first.

Why is that? (I know you’re already telling me, but just in case…)

Because if you don’t take care of your own needs first you’ll very quickly be in a position where you’re completely unable to take care of anyone else’s. Actually, perhaps I need to be blunt. You’ll be dead.

So if the people you care for are so important to you how is it that you’re not doing everything in your power to ensure you can continue to be there for them in the long term? I’m accusing you of being really, really selfish for NOT loving, nurturing, and caring for the NUMBER ONE most important person in your life, and theirs. YOU

By not taking the time to consider and support your own health and wellbeing – your account balance or your oxygen – you leave yourself less capable, and perhaps completely unable, to care for others. Doesn’t matter how much you love them, or how much they need you, you’ll be unable.

Really, really selfish…

‘But it still feels wrong to put our own needs before the needs of others. It seems selfish, I feel guilty.’

‘How about feeling guilty about not taking care of yourself? How about feeling selfish for not taking care of yourself enough to ensure you can care for those you love for as long as you possibly can? If you want to do the BIG guilty and selfish trip how about thinking about how you’d feel if you were gone and their care was left to someone else. Someone who, despite how much they were paid and despite how much they cared about people would never care for them in the way that you do and as well as you do?

Silence

Time to move on and talk about wellbeing and keeping well. About the little things we can do every day to support our own health and wellbeing AND so that we can then be in a better place to support others.

It really is okay to do that.

Selfish is not the opposite of selfless, particularly so in the context of caring for others. It doesn’t mean putting your own needs first at the expense of others, it means putting your own needs first for the benefit of others. Selfish is the interdependent partner of selfless.

Carers not only contribute a huge amount to the lives of so many others, in doing so they also make an enormous contribution to society, not least by reducing the pressure on an already pressured health care system.

Whilst carers may have a responsibility to care for themselves, society has a responsibility to recognise and acknowledge the contribution carers make. And with that a responsibility to find ways to support them with their own health and wellbeing needs. Recently someone pointed out that because there are costs associated with doing that, in the current economic climate it probably won’t happen, because we cannot afford to.

Really? Well perhaps it would be helpful to consider a different perspective. That we cannot afford not to. That perhaps instead of seeing carer health and wellbeing as a ‘cost’ we consider it an investment and in doing so recognise not only the contribution carers make but also the savings society benefits from.

“When I loved myself enough…I learned to meet my own needs and not call it selfish.”

Kim McMillen

Why Health Services Need to Embrace Community Anchors

St Gs

 

A thread running through the Five Year Forward View is the need for the health service to adapt and evolve in order to meet the needs of the ‘demographic time bomb’. That means people living longer with complex and often multiple health issues, many of which are lifestyle related and preventable. The danger is that the emphasis, energy and resources only go into providing health service responses to meet the anticipated demand. Of equal importance is the need to take prevention and self-care seriously with the aim of promoting health and reducing demand. People, even those who are estimated to place the heaviest demands on services, already self-care 99% of the time. They just don’t do it as well as they could. That’s why we’re going to be in a bit of a pickle. What can we do?

The Forward View presents an exciting opportunity for primary care to build and develop new models of care which are not only better able to comprehensively respond to the demands arising from ill-health but to also build health and wellbeing in communities. How might that be done? There is no single, simple answer and nor should there be if creativity and innovation is to be encouraged. But why not tap into a credible and established resource that already exists?Community Anchors

Community anchors have been defined as ‘independent community-led organisations. They are multi-purpose and provide holistic solutions to local problems and challenges, bringing out the best in people and agencies.They are there for the long term, not just the quick fix. Community anchors are often the driving force in community renewal’.

They’re about people.

If people are the heart of the community then community anchors are the lungs – breathing life, energy and opportunity into the lives of so many and often into the so many that need it most. Provided by the community for the community they are exemplars of community engagement and the doorway to the communities they serve.

St Gs WellbeingTake, for instance, St George’s in Lupset, Wakefield www.stgeorgeslupset.org.uk where, if you were to make the time to visit, you would witness first-hand an example of a ‘cradle to grave’ Community Anchor that makes a positive difference to a great many people. Whether it be the Youth Cafe on a Wednesday, the Friday Lunch Club, the daily nursery or the variety of educational opportunities on offer you’ll find care, compassion and co-production in abundance. People from every generation working together and making a difference. Simple initiatives that provide opportunities for ‘togetherness’, reducing social isolation and building community capital. Structured courses providing education and growth and informal learning opportunities that build self-esteem, self-confidence and resilience, providing people with essential skills for life and living.

Places such as St George’s already draw on the ‘renewable energy’ of carers, volunteers and patients that the Forward View readily recognises as an untapped resource.

For example, very recently over 20 young people gave up their weekend to the give thSt Gs YouthCafeMemberse nursery a makeover, with all of the materials and project support provided free of charge by Hybrid Training and VIY. The redecoration made to the building was instantly apparent but what was also recognisable was the difference the activity made to the people who did the hard work. The people who volunteered their time and energy. They felt good about doing it and wanted to do more. They felt good about themselves and the skills they didn’t realise they had and wanted to learn more. People felt good about the contribution they’d made and wanted to give more. It was a wonderful lesson on the power of investing in people and in a community.

When they took a break and a question was asked about what kept young people well they didn’t say “the health service”, this is what they said: St Gs WhatKeepsMeWell

And when asked if they wanted to play a part in making more of that happen without exception every person asked said they did. These are the very people who will defuse the potential demographic time bombs of tomorrow…if we invest in them now.

So much more could be done, together, to build sustainable health and wellbeing in and across our communities and Community Anchors and the people within them could have a valuable role to play in making that happen. But only if they’re supported to do that.

They don’t need lots of fancy words and ‘blue sky’ thinking, nor do they need nonsensical strategic papers or endless policies, procedures and consultation exercises. Most of all, what communities really don’t need is someone on the outside coming in and telling them what their vision for health and wellbeing should be and how to go about achieving it. Because they’re already doing it.

Hopefully what the Forward View provides is the impetus for new partnerships to develop, built around the needs of the communities and provided by the communities. If we can start exploring, together, how we can build sustainable services, co-productive relationships and healthier communities then examples such as St George’s suggest there’s no shortage of people who want to play a part in that. What there’s often a shortage of is equitable opportunity to the financial resources to make things happen and on a long-term, sustainable basis. The greatest contribution the health service could make to the communities they serve then is to provide Community Anchors with the resources they need to do more of that which they’re already doing and doing very well. Help to create the environments for people and communities to flourish.

And as a bonus the Community Anchors provide an open door to working on at least two other topics of significance. A topic touched on in a previous blog – the enormous prevention agenda, and also the workforce agenda. We need to work on prevention at the level that will make a difference. The personal level. Prevention needs to get personal because self-care is about individuals and about personal responsibility. People won’t come into services to be told about prevention. But they’ll talk about and explore the topic with their peers. The ability of peers to get personal is unparalleled because peers are usually speaking and acting from experience. They’re also in a position of trust, credibility and respect. Peer delivered opportunities allow people to learn with people who understand the position they are in and the path they are potentially heading down. Peer led initiatives open up exciting opportunities for addressing the need to develop ways of doing things differently, together with the roles to do that, because another time bomb on the horizon is the dwindling health and care workforce.

“So this Forward View sets out how the health service needs to change,
arguing for a more engaged relationship with patients, carers and citizens so
that we can promote wellbeing and prevent ill-health.”

Let’s not talk about it, let’s make it happen.

More than a Mental Illness

GlynHello, my name is Glyn Butcher and I’ve been involved with mental health services for over 27 years as a carer, and for 15 years as a service user. I could tell you lots about living with a mental illness and about the very limited life I lived as a result. A life determined by my internalised beliefs about illness and about what I couldn’t achieve because of it. But I don’t want to share a story about mental illness I want to share a story about positive mental health and personal growth because more recently I’ve been involved with mental health services in a different way. I want to share how a change in approach and a change in focus has resulted in a dramatic change in my life. I hope you find it of interest.

My story begins some time back in August 2010 when I mentioned to a senior member of staff at a mental health trust I was involved with that one day I’d like to work in there, doing things like delivering training and workshops. She said it was a good idea and I should give some thought to how I might go about doing that. I thought about it a lot and felt that what I needed was a mentor who could help me to explore things more, make sense of things and find a way forward. Part of the making sense was actually about making sense of me and my place in the world and whether what I wanted to do was in fact possible. I had someone in mind but I didn’t really know him very well and because of past experiences with other people I had real fears about approaching him.

For quite a while I observed how he interacted with other people and eventually felt safe enough to ask if he would be my mentor. Having spent most of my life hearing a ‘no’ to most of what I wanted to do my expectation was that a no to my request was what I would get, albeit a gentle one. To my surprise the answer was an instant yes.

That person was Steve Tathata and from the very beginning of our work together he took an approach that was completely unfamiliar to me. His focus was on what I wanted to do, on my goals, dreams and my aspirations, and on my strengths and abilities. He began from a perspective of possibility and potential and, perhaps most importantly, the approach taken was grounded in a belief in me and in my future. This gave me real hope and although that was very positive it was also very scary because it had never been part of my life before. I also found Steve’s approach to be unusual in that we rarely talked about what I couldn’t do or about illness, symptoms, diagnosis or treatment. That’s not to say we completely ignored those things but that our work together wasn’t driven by them. He made no judgements about who I was or about my history, I was simply accepted for me and for who I wanted to be. Steve encouraged me to be proud of who I am, to believe in myself and in my abilities, and helped me develop a belief that I can potentially do anything I put mind to providing I also put in the effort required to make things happen.

I spent many years not putting any effort in, blaming everyone and everything else for not achieving anything, wanting to change but believing it was impossible. What I’ve realised is that change begins with me and also that it’s important to have an environment which supports and enables change. I think a big part of Steve’s approach is to create that environment. The other thing that has really helped me is that Steve has a very calming influence and I’m amazed at how this has resulted in me being calmer and more patient both with myself and with other people. I’ve also become more able to say no to things that people wanted me to do whereas in the past I would say yes to everyone for fear of the consequences of not doing so. What would they think of me if I did?

This is something Steve has helped me with as we have a healthy professional relationship where I am encouraged to think and explore my thoughts and gain new understandings. I can agree or disagree with him without fear of rejection or condemnation. I believe one of the most profound learning’s I’ve gained though working with him is how instrumental having a positive and authentic role model is to a person’s development. I believe I’ve learned lots from him although Steve’s view is that he hasn’t taught me anything but simply brought out what I already had within.

One of the goals I had when I began working with Steve was to deliver a workshop, and my biggest dream was to deliver a presentation at a national conference so you can imagine how amazed I was when he said there was an opportunity to do both. In December 2010 I presented a workshop at the National CPA Association Annual Conference to around 40 people including commissioners, nurses, social workers, care co-ordinators, psychiatrists etc on “Involving Service Users in the Care Process”. I couldn’t believe I was up there and not only did I do it I also got excellent feedback. It was an incredible experience.

The presentation consisted of my experience of involvement with mental health services as a carer and a service user and I also talked about the fantastic work of our User Carer Partnership Council with its emphasis on collaborative working between carers, service users, Trust staff and partner agencies. I presented the My Care Checklist as an example of good practice and shared how supporting understanding of a process helps people get the best out of the process because it enables understanding and collaborative working between professionals, service users and carers.

Following the conference I was asked if I would speak at a service user group meeting in another Trust and I did that and the feedback was fantastic. I wanted to dispel lots of the myths around mental illness and help people explore things for supporting people recovering from the experience of mental ill health. I also participated in a five day WRAP and Recovery Educator training course and have been delivering since then.

The other thing that I’ve done since working with Steve is to formally become a volunteer with the Trust. This gives me an immense feeling of pride and a real sense of personal fulfilment that exceeds anything I’ve ever experienced before. In my experience most if not all human beings want to be part of something and to find meaning and purpose. They want to contribute, make a difference and feel valued. I’m not certain where that comes from but perhaps it comes from a basic human desire or craving to belong and feel wanted, needed and loved. For me personally these where the basic human feelings and emotions that I lost when going through my mental health problems because (subtly) the experience of being mentally ill eroded my sense of self and my identity became that of an ill person. Being a volunteer has enabled me to live my life more fully, tapped into my passion to learn and grow and fuelled my hunger to succeed. What I’ve realised over recent months is that I have choices and one of those choices is about being in control of my own destiny.

One of the brilliant things about doing my voluntary work is the feeling of making a difference that it brings. I feel as if an environment has been created which enables me to be me and to learn and to grow and it’s a place I’ve dreamed of being for so long. I now realise how important this welcoming, accepting and non- judgemental environment is and that it’s something I’ve been searching for all my life. I previously always felt like an outsider, that I didn’t belong anywhere and I did not fit in.

I have realised that one of my wellness tools is doing my voluntary work and it as become embedded in Wellness Recovery Action Plan (WRAP). I’m hoping the voluntary work will be a stepping stone into paid work and that’s one of my longer term goals.

So things are really exciting for me at present. Instead of living a life determined by an identity of mental illness, believing that it was in control of me, I’ve realised that I am more than a mental illness. I remember on one of the first occasions we met Steve said he believed we usually get more of whatever it is we focus on. So I’ve changed my focus and I’m no longer a mental illness. I’m much more than that. I’m Glyn Butcher – volunteer, poet, artist, son, brother, partner, role model, educator and more. The list is potentially endless and I’m no longer limited by my own thinking or by the thinking of others who said I couldn’t because I had a label.

Thanks, Glyn

Glyn CPAA AwardsThis article was originally published in the national CPA Association quarterly journal – The Approach – and won the Association’s annual award for the article found most useful by its readers.