Showing posts with label Mental health at work. Show all posts
Showing posts with label Mental health at work. Show all posts

Saturday, April 28, 2018

A SIMPLE WAY TO REDUCE ANXIETY

Give yourself time | Photo by Kalen Emsley on Unsplash


I would like to introduce you to Time Decompression; or Time Expansion, if you prefer.  It is a technique I developed while researching counselling psychology, and studying the way time seems to work in therapy sessions.

If you have ever watched yourself when you were anxious, or reflected on it afterwards, you may have noticed that anxiety often has at its root an impatience for things to be otherwise, and quickly.  Perhaps you are anxious because you have an exam next week, and you do not feel that you know enough.  This kind of anxiety has four components:

1. You feel that something in your life needs to change
2. You feel that it is difficult or fearful for you to effect that change
3. You (consciously or unconsciously) conceptualise a time limit for that change
4. You (consciously or unconsciously) feel that the time limit is too short

WHAT I NOTICED IN COUNSELLING SESSIONS
Therapy sessions are often set at 50 minutes.  Some therapists try to offer convoluted reasons for this, but the main reason is that an hour is western humans' go-to time for meetings, and therapists need to wee, and make notes (10 minutes therefore deducted).  The strictness is so that therapists can appear very professional.  I mean, really, what would therapists have to denote ther professionalism if they did not control the time, and pathologise anyone else who wanted to control it?!

What I noticed was that anxious clients often felt the need to cut meetings short, and certainly were out of the door quicker than depressed clients.  It was as though anxious clients lived in accordance with an invisible rule: get home as quickly as possible.  Home, whatever it was conceived to be, was a place of safety.  Time pressure was evident pretty much all the time, even in micro-behaviours.  Such clients tended to be watchful of other people's movements, and keen to detect when it might be time to move on.  It was as though they were alarm clocks, set with a hair-trigger mechanism, liable to panic at the least provocation.

Time felt compressed.  As a counsellor, I often rely on absorbing a sense of where a client is in the moment.  Internalising into myself what was going on for them, I became aware of a kind of impatience, and over-watchfulness, together with a sense of personal inadequacy - a feeling, in short, that, as above, (1) something was wrong, (2) it was difficult to confront, (3) it felt urgent or pressing, and (4) waiting was not an option.  Thus the body became a kind of pressure cooker, boiling up with urgent need, perhaps the skin flushing, panic symptoms arising... all in a kind of impatience with the world.

I don't want to pathologise my clients.  I experience the same thing too.  Most of my human knowledge is gained from self-observation.  I am at least as guilty of anxiety as the next person.  But I am outlining what I think I saw.

HOW THIS APPLIES TO EVERYDAY SITUATIONS
This, to me, is to do with our experience of time.

We all, consciously or unconsciously, apply time frames to our lives.  You might feel you should be married by the time you are a certain age, or out of bed by a certain time, or have disposed of a lost loved one's possessions by a certain month... we are often full of self-imposed requirements that our worlds change by a certain time.

In my research, I took this thought, and tried to apply an opposite.  If anxiety is often characterised by time compression (i.e. wishing things could quickly be otherwise for us), then perhaps anxiety could be reduced by time-expansion (or time decompression), by lowering the pressure to change our world in a short time.

TIME-EXPANDING TASKS
I began to ask myself: what tasks do we perform which might be time-expanding, and anxiety-reducing?

A CLUE IN BOREDOM
In my ponderings, I noticed that boredom was a kind of opposite of anxiety.  I noticed that, when bored, individuals' adrenal systems closed down, and they started to fall asleep.  They no longer needed to be alert and hyper-sensitive.  Now, I bet you have never heard a doctor prescribe boredom as a medicine for patients!  But perhaps it is not such a silly idea.

Boring situations have certain characteristics, which are in many ways the opposite of the anxious characteristics:

1. We feel that our challenge or extreme action is not necessary
2. We feel that it is all too easy to assimilate and experience
3. There seems to be no time limit to things (such as an interminably boring lecture!)
4. There seems to be no urgency (perhaps everything is flat, routine, predictable)

DESIGNING YOUR OWN TIME-EXPANDING ACTIVITIES
I am not suggesting we live our lives permanently bored!  But I am suggesting that we apply to anxiety an opposite context, in order to balance it out and calm it.

If you are anxious, I suggest you design for yourself an activity which consists of the following:

1. A manageable, minimal level of challenge
2. A fairly easy thing to get your head around
3. A time guide which is much longer than the activity needs
4. Something that is not urgent

An example for me: if I wish to calm down easily, I pick up my boots, and polish them.  I know how to do it; it's easy; I give myself half an hour, much longer than I need; it's not urgent (my life won't end if I can't polish my boots!).

For you, it may be something else.  But try to choose something easy, and give yourself a longer time than necessary to do it.

THE BENEFITS OF TIME-EXPANDING ACTIVITIES
There are several benefits to this approach.  I have used it a lot myself (I am my biggest experimental guinea pig!); and friends and clients have seemed to find it helpful.  A few classic benefits are:

1. It reduces adrenaline levels.  We all need to use our adrenaline systems, but not all the time, and not on overdrive!
2. It makes you feel more peaceful.  Your friends will appreciate your chilled-out manner :)
3. It broadens your attentional bias (when anxious, your world compresses; when peaceful, you can see more)
4. It gets something useful done! (Even Formula 1 drivers need their cars cleaned... you are giving yourself a 'pit stop'.)
5. It teaches your mind, conscious and unconscious, that everything is not urgent.  And it really isn't.  The universe has billions of years available.

Think of your diary as an elastic band.  When your appointments are constricting and urgent, you will feel your flow constricted and strangled by urgency.  Your body will tell you that it is tired, but your adrenaline system will tell you that things are urgent.  This is the formula for adrenal fatigue.

Time-expanding activities relax the elastic band a little.  Your life is still held together by a little structure, but you have room to move, to breathe, to be yourself.

SUMMARY
When anxiety is getting the better of you, try to find a simple activity that you enjoy, and give yourself a nice long time to complete it, much longer than you need.  You will find your adrenal system relaxes, your attentional system expands, and you become more peaceful.  What more could you want?

If you are interested in practicing this or other forms of relaxing activity in your life, do get in touch, and I'd be happy to work with you, and learn from you, in developing helpful techniques.  Everyone is different, and I welcome the opportunity to meet others who want to join together and find practical ways to be peaceful.


Friday, March 9, 2018

HOW WORKPLACES COULD IMPROVE MENTAL HEALTH

Requiring a doctor’s certificate for time off can trap staff at home, fearful that they must be completely ‘well’ to return. In contrast, a continuous-protection, ‘how can I help?’ attitude can break the cycle.  Photo by Asdrubal luna on Unsplash


Workplaces make a lot of noise about mental health, especially the big ones.  But I wonder whether some of the central ways to improve mental health are being missed, through a misguided attempt to look good at the expense of real change.

The UK is still stuck in a kind of dark ages when it comes to managing mental health.  We haven't yet worked through several of its ethical dilemmas, I suspect for fear of being politically incorrect.  The result is a strange mix of attitudes, hypocrisies and legal conundrums which leave employees and HR departments reeling.

THE BIG TENSIONS

Three tensions perhaps dominate when it comes to mental illness.  If an organisation cannot work out its policies with regard to these tensions, then it will be stuck in limbo.  Everyone involved will be left with an uncomfortable feeling that the right solution has not been found.

TENSION 1 - THE MEDICAL MODEL Vs EXISTENTIAL AWARENESS

An organisation that focuses on the medical model will find itself constantly asking for medical evidence of mental illness. 

  • This leads to further unhappiness in the employee, as they repeatedly return to doctors and hospitals to ensure that the right evidence is available
  • It also encourages some employees to stereotype their symptoms in order to 'achieve' a recognised diagnosis
  • Furthermore, it creates a problem if the employee recovers.  At the point where illness recedes, the employee's protection can disappear overnight.  Sometimes this leads to a relapse, as it is the only way the employee can access further help

An organisation that focuses on an existential model has a better chance of providing consistent support.  (By existential, I mean taking the employee's valid human experience seriously at all times, regardless of diagnosis.) This is because:

  • The employee's subjectivity is respected, and to a large extent their view is treated as evidence in its own right
  • Employees are allowed to be themselves, without having to conform to particular symptomatic rules
  • The border between 'ill' and 'well' is soft rather than hard, meaning that care can be offered irrespective of the employee's state

Even so, an existential model has its problems.  Old-style administration does not work, as 'illness' cannot be 'proven' in the same ways.  Organisations are terrified of being taken advantage of, and therefore are at a loss of how to invent new approval systems for, say, time off, without requiring medical opinion.

TENSION 2 - AN ILLNESS MODEL VERSUS AN ABILITY CONTINUUM

Most organisations still function on an illness model.  If you're ill, you take time off.  If you're well, you come back.  Some organisation do offer flexibility, but it's slightly clumsy.

  • An illness model dehumanises employees with emotional difficulties, as it implies that they need to be 'cured', rather than perhaps changing the organisation itself to make space for different emotional responses
  • An illness model can misdirect attention away from an unhealthy organisation, and scapegoat employees, who might be perfectly healthy if it weren't for emotional toxicities in the organisation itself

Some organisations now operate on more of an ability continuum.  This has some advantages:

  • Employees are encouraged to be open about what they feel they cannot do.  Focus can then be on finding ways to overcome the issue together, rather than forcing interpretation 'inside' the individual employee
  • Organisations can become more flexible, as a problem solved for one employee can help thousands of others

Again, an ability continuum has some issues.  Not least, it can be expensive to adapt an organisation to incorporate different abilities.  It can feel inefficient.  This is not a problem for me, because I think efficiency is overrated.  But efficiency is still worshipped in many economies.

TENSION 3 - A PERFECT PUBLIC IMAGE VERSUS AN IMPERFECT PUBLIC IMAGE

This is the biggie.  We still exist in a world where organisations try, prima facie, to portray a perfect image.  Everything must be said right, everything must be seen to be done right.  You can see it when scandal hits: heads roll, as though we could easily identify the 'imperfect' staff, and by sacking them suddenly make our organisation 'perfect' again.

Many organisations operate on the perfect public image model because the public expects them to.  Particularly charities.  The recent furore over Oxfam staff conduct is a case in point.  A big 'imperfect' label has been plastered all over Oxfam.  Now, it thinks, it must not stop until it can give itself a big 'perfect' label again.

  • Being perfect is unrealistic.  We are discovering that in personal lives: we now need to apply it to organisations.  The perfect public image model can lead to good staff being sacked in order to appease, and to falsely reinventing the organisation as re-perfected
  • Perfect public images are by nature oppressive to both employees and customers.  Everybody has to be fake.  A kind of fake-speak evolves to take care of the mythical perfection.  Phrases like 'we are doing everything we can' are born, which essentially mean nothing, but sound perfect
  • Information is withheld.  On a perfect image model, no one can find out anything bad about the organisation.  So staff are punished if they speak outside the organisation's world, and everything difficult is referred to a legal department

However, some organisations have worked out that this is all an illusion.  They go for the imperfect public image model.  They allow themselves to make mistakes, and do not scapegoat those mistakes; they own them and discuss them.

  • Openly imperfect organisations show themselves to be evolving
  • Openly imperfect organisations enhance mental health by reducing the requirement to fake everything, which is a key cause of mental illness in its own right
  • Being open about imperfection means that problems do not have to go into purdah while they are 'resolved'.  Think of the pain for families when the NHS has to keep quiet about a bad patient experience.  Think of the pain of NHS employees who are told to keep quiet while 'investigations' are carried out.  Openly imperfect organisations know that the truth does not need keeping quiet, except where respect demands specific discretion

SUMMARISING THE THREE TENSIONS

In general, we could divide the world of organisations into two types:

TYPE 1 - WE ARE PERFECT, AND WHEN SOMEONE IS ILL WE SIGN THEM OFF.  THAT'S OUR DUTY DONE

You can see this through the eyes of those who are off work with stress.  Often, there is little contact with the organisation.  I remember during my counselling training, when my father was dying, I took time out.  At exactly that point, when I asked what support would be available, the answer was: 'While you are on interruption, and we will not be able to provide any contact, support or counselling.'  So there you are, even an organisation that existed to train counsellors, was unable to see its way to actively support those who needed time out.  More than that, they saw it as their legal duty to dissociate.

Look out for organisations that insist on appearing to do everything perfectly.  Governments do this.  In the quest to appear to root out badness, they will sack individuals at a moment's notice, and then blithely say they have got rid of the problem.  High-performance organisations often do this: their message, to themselves and others, is: 'We are all well; if someone is ill, they cease to be functionally part of our operation.  So we remain well.'

The logic is undeniable, but so is the inhumanity.

TYPE 2 - WE ARE OPENLY IMPERFECT, IN AN IMPERFECT WORLD.  WE LISTEN TO THE SUBJECTIVE EXPERIENCE OF EMPLOYEES, AND WE TRY TO MAKE NEW THINGS POSSIBLE TO HELP.  OUR DUTY IS NEVER DONE.

In these organisations, the experience of the stressed can be different.  Instead of 'Come back when you are well', the message is 'How can we help you through?'  There is never a point at which the organisation disengages. 

Look out for organisations that are open about their faults.  Look out for leaders and managers who, instead of seeking fake perfection, get their hands dirty and are prepared to involve themselves in problem resolution. They are rare, but intensely valuable.  

There is a humanity is such organisations which is not logical, but you will know it when you experience it.  It feels warm, as though you are being allowed to make yourself at home.

A SUMMARY

Personally and professionally, to encourage mental health in all those around you, maybe try the following:

  1. Listen to, and accept, their personal account of their experience, and work with that
  2. Try not to divide people into those you feel are unworthy of their problems, and those who are having 'real' problems.  It is arrogant to require some kind of certificate of authenticity for other people's unhappiness
  3. Focus on how you can help individuals do their next thing.  Adaptations might happen in you, in your joint environment, or in them, but it is unlikely that the only solution is for the other person to adapt.  It makes no sense
  4. Be openly imperfect.  Everyone can then breathe a sigh of relief, and get on with negotiating life calmly, without your frantic insistence that 'everything is fine', and your constant scapegoating when it is not.

For organisations, in particular:

  1. Respect every employee's personal experience.  Don't invent an ideal employee and only listen to them
  2. Let employees take time out when they decide; don't always be requiring independent proof.  You wouldn't do it to your partner (I never heard anyone say to their partner 'can I have a doctor's certificate?' when time out was requested!)
  3. Focus on enabling employees.  Adapt, adapt, adapt
  4. Think about how, in your conduct and your publicity, you can quit being all perfect and patronising, and start being openly friendly and imperfect.  The public will like you better that way anyway

IN A COUPLE OF SENTENCES

Companies, please ditch the constant requirement to appear perfect.  Especially senior management.  It's not healthy, and it's not even believed. 

Instead, make a home for people where they can be themselves, and negotiate their empowerment with them as they go.