Managing Anxiety in Stressful Times


stress-2902537_1280

One of the most important things in working with anxiety is helping people change their relationship with their anxiety.

With any intense emotion, in some ways, it’s important to make friends with it, to tolerate it and recognise that any emotion is a form of communication with your and from yourself. It’s a signal to pay attention, to pay attention to what is this trying to tell me? What is this feeling, this emotion, this anxiety trying to tell me about myself, about my relationships, about the world?

So, I think the first piece of the work is to try making friends with it.
An often useful metaphor is:  A child is laying in the bed and fears the monster under the bed. What does the parent do?

We might always think that it would be a good ideas a parent to turn the light on. Get a torch and look under the bed for the monster rather than sitting on the bed and saying tot he child, “Oh my god, the monster’s there.”

If we sit on the bed and don’t look at the monster, and we don’t say, “Hi, monster. What’s going on?” – then the monster continues to grow bigger and bigger. Yet when we turn the light on and really look at what’s there, it’s then that we can begin to manage how we’re going to deal with the monster if there’s a monster there. And if there is, how are we going to deal with that monster and communicate with it effectively?

Another way of managing anxiety is to find a message and meaning in it. I believe meaning-focused work can be helpful with many issues.

One of the dynamics that present barriers to managing anxiety has to do with focusing on the future or the past, and not being able to stay focused in the present.

If we think about worry, it’s focusing our attention on the future. If we think about rumination, it’s focusing our attention on the past. Worry and rumination both take us out of the present.

So, intervening in ways that help people ground themselves in the present moment can reduce anxiety. That way, we’re not living in the future of worrying what’s going to happen? or living, ruminating the past, playing over and over in our minds some past situation we regret.

danger-4931411_1280

Another metaphor that many people have heard, and is attributed to Cherokee people is the story of the two wolves.

The grandfather is telling his grandson, “There’s a war going on inside of me between two wolves. And one of the wolves is very, very evil and bad and is filled with anger and arrogance and envy and all these negative emotions. And the other wolf inside of me is really good and filled with empathy and love. And the same fight is going on inside of you, my grandson, and going on inside of everyone.”

And the grandfather pauses, and the grandson reflects for a moment and asks the grandfather, “Well, which wolf is going to win?” The grandfather pauses and says, “The wolf that you feed.”

So that idea that it’s what we feed that grows. And if we’re feeding anxiety and fear and anger, if that’s where we’re focusing our attention, then that’s what’s going to get bigger and bigger and bigger. If we feed kindness and love and self-compassion, then that’s what’s going to get bigger.

One of the things that I’ll work with clients on is what their life would look like if they fed the good wolf.

If your energy was put towards feeding the good wolf, what would that entail? What would you need to do differently to nurture and put energy towards those things?

The first one is in relationship to what I was just sharing, and it’s called the FACTS. F-A-C-T-S — Foundational Attention Centering Techniques.

The FACTS are things like meditation, breathing, and visualization. These are strategies to focus attention in different ways. And these are skills that can be learned.

Particularly for people who have a lot of anxiety, being able to ground themselves in the present, in their bodies, in their breathing, and assemble a visualisation or a mantra, is centering and meaningful to people. So, that’s one set of the core four strategies – again: the FACTS, Foundational Attention Centering Techniques.

The next cluster of techniques that I think is helpful for anxiety are the expressive-creative strategies.

We can help people identify whether it’s expressive arts— drawing, painting, finding expression for the turmoil that’s inside. Active creative activities – problem-solving in terms of inventing something or fixing something, where the attention is on using cognitive processes in the service of creativity. Creating arts as well as daily things — fixing a car, working on a car — having those kinds of outlets are creative expressive strategies. Or, physical movement — dance, sports, athletics, things where we are engaging in expression. So that’s the second.

The third is reflection exploration strategies. Another set of techniques for managing anxiety would be, as I mentioned with the other question – journaling, writing, avenues for reflection where we can take a step back and get a little observing self-activated, really ask ourselves questions about, “What am I thinking? What am I feeling?” Self-monitoring. “When do these things come up? What triggers my anxiety?” So the reflection exploration is about getting to know yourself better. Any strategy that can help you be aware of, again, the triggers, to be aware of the thoughts and feelings. That could also involve dialog, talking with someone, having a sounding board for one’s thoughts and feelings. Again, reflection. Reading, learning, reading articles, getting informed — that gives you a stimulus for reflection.

So the first three — the FACTS, the expressive-creative strategies, the reflection exploration strategies. And then the fourth is what I call healthy lifestyle and values congruent self-care.

We’re looking at four areas of turning your attention. And again, all these have a commonality of where we put out attention – turning our attention to healthy habits, healthy relationships, healthy pleasures, and a healthy world.

So, what kind of healthy habits can we develop? The healthy habits that relate to diet, nutrition, and exercise all help with anxiety management. Healthy relationships, healthy pleasures.

So how do you relate to anxiety: you can go down the list of all the ways that you respond once anxiety has come up. One of the first ways you can change your relationship is to change your initial interpretation of what it means that you’re feeling anxious.

Most people’s initial interpretation of anxiety is, something really is wrong, or something really bad is going to happen, or there’s something really wrong with me – I don’t belong here.

And one possible other interpretation is, this anxiety is arising because I care about this; I care about this person; I care about this situation.

There are other possible interpretations: this is a moment that matters, or, anxiety is arising because anxiety is how I do life. I mean, there’s a lot of different interpretations you could have. But that’s one relationship you can change: that very first thing you say to yourself about what you believe it means. You can also change your habits of behavior, which is the sort of non-avoidance; if you know that, when you feel anxious, the first thing you do is you try to escape it by avoiding the cause of the anxiety – maybe you start to work on that behavior if that happens. Maybe you notice, when that’s not possible, you try to numb what you’re feeling with a drink or with food; maybe you start to change that habit.

You can also change your relationship to your anxious self. You can have more compassion for the part of you who is anxious rather than feel like if you were the right kind of person, you wouldn’t have anxiety; there’s something wrong with you; there’s something wrong with your brain – that sort of broken brain model of anxiety. You can also develop different brakes for the anxiety.

So, what do you do when the anxiety feels like it’s spiraling out of control?

cyclone-2100663_1280

Most people’s attempts to break it are avoidance, or control coping – where people have rituals where, if they do something, they can make themselves feel better. In dysfunctional anxiety, often people are insensitive to safety or support to you – so something that you can change your relationship to is, when you’re trying to put a brake on the anxiety spiralling out of control, you can maybe think about attending to safety cues or support cues: In this moment, are you safe? Are you breathing? Who supports you? Who cares about you?

The resources that I know we’re going to talk about – that there are a lot of other things you can use as brakes to the system spiralling out of control. So those are all things that I would consider part of your relationship to anxiety.

The great thing, as we’ve been talking about, is, when you change these things, you really do change your experience of anxiety – and sometimes the anxiety goes away, sometimes it doesn’t. But you have so much more freedom and flexibility in response to the anxiety and having the choice in how you respond to your anxiety is a key art of relieving it to some degree.

 

 

References:

Four Core Strategies to Neutralize Stress and Anxiety

Shelly Harrell, PhD, Kelly McGonigal, PhD, Rick Hanson, PhD and Ruth Buczynski, PhD

NICABM

Collaboration and Sharing Knowledge


It has been a very busy 18 months and the hard work is definitely paying off. The funny thing is, as the incredible golfer Gary Player was famously quoted as saying, the more you practice the luckier you get, it is so true.

Persistence, focus and determination to succeed, along with the adaptability to changing circumstance because, “No plan survives first contact with the enemy”, are essential elements in staying on the right path to fulfil your aims in life.

I have worked extremely hard, along with my friend and cofounder of Icarus, David Bellamy, to develop a system that provides immediate access to mental health treatment for veterans and all UK uniformed services. It is designed to help from crisis point right through to being self sustaining again, and to work with GP’s and other mental health professionals, as well as other organisations and charities to access practical help that they need.

This spirit of collaboration and sharing knowledge is fundamental in helping not just other people but also ourselves. This is why when I was approached by the marvellous Samantha Field at Field & Field to join her and Dr Iain McGilchrist at their 4 day event in June, The Divided Brain, to present my work based around the Immediate Care Process that we use at Icarus to work with those at crisis point I absolutely jumped at the chance.

This is a fantastic event filled with leaders in their fields of expertise and incredible to see how their work links in with Iain McGilchrist’s in how each hemisphere is responsible in different ways for different elements of who and how we are. He has shaken up old theories and created deep discussion and understanding and this is why it is such a fascinating event to be part of.

I will be running a 1.5 hour workshop on Sunday 9th June. If you have not heard of this event and want to know more the link is below, I highly recommend you take a look and if you have the time to attend it will be well worth booking your place sooner rather than later.

http://www.field-field.com/courses/iain-mcgilchrist-exploring-the-divided-brain/

Hope to see you there.

Simon

Urgent Request for Assisstance From Icarus Online


There is and urgent and very serious case that Icarus is working on with Help a Squaddie, please read, share and help in whatever way you can.

Thank you

https://icarusonline.net/urgent-request-for-financial-support-for-a-royal-marine-veteran/

ICARUS Online in the News


At the beginning of the week I was interviewed by a journalist from my local paper the Press and Jornal and talked about the work that me and David Bellamy are doing to help bring change to the military charities sector and also to speed up access to treatment for veterans, uniformed services & their immediate families.

Have a read and please share.

Thanks

https://www.pressandjournal.co.uk/fp/news/aberdeenshire/1438690/turriff-based-ex-marine-sets-up-new-helpline-for-former-military-personnel/

ICARUS: Please Help to Share Who We Are and What We Do


This is just a quick post to ask all of my wonderful 10,477 followers who will see this messsage to please click the link below and click Like on the new Facebook page for the not for profit organisation that I have set up with my friend and colleague David Bellamy.

It will make a massive difference for us to have every one of you liking and sharing our page as it will help us achieve our aim of helping as many people as possible in the UK’s uniformed services that are struggling with mental health concerns and don’t know where to turn, have been dropped by other providers or even turned away. Sadly yes this does happen.

So please help us by hitting over 10K likes and just imagine how many people we can reach if you all share the page too, mind blowing possibilities.

Thanks for reading and helping us make a huge difference for so many people that need what we do.

Click below and make a difference

Icarus Online Facebook Page

Simon

ICARUS Online


As there has been a lot of work, conversations, research and thought gone into the free helpline that we set up in January, and with our efforts to reform the military charities sector and close the excessively large gaps in the system, I thought an update was in order to let everyone know  what’s going on.

I had a great conversation with Lord Dannatt last month and he is in full agreement with our purpose in setting up the free helpline (which has morphed into a treatment line, more on that shortly) and what we are doing and has kindly given his full support and backing ongoing.

Meanwhile my friend and colleague David Bellamy has been communicating with General Peter Currie, General Andrew Graham, General Sir John McColl, chariman of COBSEO and Colonel David Richmond, chairman of the Contact Group set up by Prince Harry, they too are in agreement that the militray charities sector needs shaking up, tightening up and reforming which is now beginning to happen.

David Bellamy is an extraordinary man with one hell of a life behind him. He was in the British Army and served in Dhofar in the 70’s during the Secret War. He has worked as a commercial diver, worked for Lloyds of London and was instrumental in setting up their first Kidnap and ransom insurance package. David, like myself was trained by Stephen Brooks, the founder of British Hypnosis Research and Training Institute and is the worlds best teacher of Ericksonian Hypnosis and Psychotherapy.

It has lead to a slight adjustment in our plan and the development of a name for this not for profit organisation we have created. So we are now called ICARUS, which stands for Immediate Care, Assessment and Rehabilitaion for Uniformed Services, which means we cover all branches of the military and emergency services because there are many veterans working in the civilian uniformed services that deal with horrendous situations on a regular basis and also may well need our help.

The history behind ICARUS is the ancient Greek story of Icarus and his father Daedalus who told his son not to fly too close to the sun with his homemade wings of feathers and wax as the heat from the sun would melt the wax and he would fall into the sea and drown. So the story is about high flying ambition, which is what we have for the accessibility of the best treatment for all uniformed services and veterans. The psychological element of it, the Icarus Complex, which is about the highs and lows of what used to be called Manic Depression and is now Bipolar Disorder, our aim is to help anyone in the uniformed services with a mental illness to learn to deal with it and live a full, happy and successful life for them.

Screenshot 2018-03-02 15.32.53

We wanted to be a not for profit becasue there are already 350 plus military charities in a system that is unregulated, poorly structured at present, and with no standards required to be fulfilled and is in desperate need of an overhaul. This is by no means meant to undermine the extraordinary and excellent work being done by so many in this sector, purely that it can be tightened up and improved so that people do not fall through the net, are not turned away or dropped because they are unable to commit to systems that are far too rigid for people with mental illness. And yes this does happen because these are precisely the people I have been treating for over ten years now.

The helpline is now a treatment line to fit with our new name and purpose, although we will provide any help we can in the process. We offer virtual treatment via phone, skype or any other form of video call to speed up access to help, as well as face to face treatment where possible. We are currently working on building a national network of therapists to assist us so if you are interested in getting involved or know someone who might be then please get in touch with me on simon@simonmaryan.com 

Access to our services is open to anyone. In principle, no one will be refused. There will be no discrimination on grounds of length of service, reason for discharge, medical condition or disability, age, physical disability, gender, marriage and civil partnership, pregnancy or maternity, race, religion or belief, sex, sexual orientation, political or other opinion. This is a free service open to all service personnel as set out in our constitution which you can find below.

ICARUS Constitution 28.02.18

The phone number stays the same 0800 689 0864

We are also having a website designed that will list all our therapists, each with a personal bio explaining what they do and how they work. All our therapists will be associates, they will be vetted and cleared by us to ensure that they have the appropriate insurance etc for the therapies they provide. The website is being designed by David Bellamy’s wife Mishi who is an amazing artist, so we are extremely fortunate to have this wonderful lady helping us out. Take a look at her fantastic work here: https://www.mishibellamy.net

We also have a gentleman called Stephen Finlayson who is coming on board to help us promote our services, reach more people and deliver what is needed to those that need. Stephen showed his huge heart and compassion a few years ago when he helped a homeless guy in his hometown of Carlisle, this man, Phil,  turned out to be a veteran as well and Stephen helped him find somewhere to stay, put him in touch with the Royal British Legion and thankfully he is back on his feet, has a home, a job and a girflriend. Phil now helps veterans and is paying back in his own way. This story was covered in a documentary by the BBC and is quite emotional viewing.

Thanks to David Bellamy, we have one very interested coroporate sponsor who is keen to help us deliver our services and we are obviously looking for more to make sure that this not for profit can provide as much assisstance to those serving and veterans struggling with any form of mental illness, to live their lives to their fullest and be happy, functional and succeed. Another part of what we provide is ongoing coaching and mentoring for those that receive treatment from us for as long as they need, and also training those that are interested in becoming a qualified therapist, coach and mentor so that they are then capable of helping others that are in the same situation they used to be in.

If you are interested in helping us with sponsorship, donations or have any suggestions about people, organisations to speak to then please get in touch either through the phone number 0800 689 0864 or by email simon@simonmaryan.com

We are also approaching a few universities with the aim of having our program of treatment as a whole, independently monitored and assessed in order to garner external verification that what we do works. We know it does yet it is hugely beneficial to have that independant review and reassuring for those we help.

So lots has been done, lots is happening and lots still to do. Keep your eyes peeled for more updates as we make more and more progress.

Please like, share and comment with your thoughts and any ideas you have for us.

Thanks

Simon

 

The Importance of Accurate Diagnosis of Post Traumatic Stress.


As a specialist in trauma and Post Traumatic Stress, I read and research constantly for new information and treatment options in order to provide the best possible options for each person I have the fortune of working with.
 
The difficulty can be is that most individuals with PTSD suffer from other mental disorders as well. Studies of the prevalence of PTSD in large samples have found the following mental disorders are most likely to be co-morbid with PTSD:
 
  • Major Depression
  • Substance Use Disorders
  • Dysthymia – persistent mild depression
  • Agoraphobia
  • Obsessive-Compulsive Disorder
  • Generalised Anxiety Disorder
  • Panic Disorder
  • Somatisation Disorder – extreme anxiety about physical symptoms such as pain or fatigue
  • Antisocial Personality Disorder
  • Borderline Personality Disorder
  • Adjustment Disorder
  • Phobias
 
It can be challenging to determine whether overlapping symptoms are best conceptualised as being a part of the PTSD constellation of symptoms or whether they should be attributed to another disorder. Differential diagnosis can be especially difficult when disorders other than PTSD are preceded by exposure to traumatic stress.
 
Despite some symptom overlap between PTSD and other disorders, PTSD has a number of unique features that distinguish it from other disorders. DSM-5 provides specific differential diagnosis guidelines in order to help clinicians assign the most appropriate diagnoses. I know there is much controversy over the DSM, however it is useful to have some form of benchmark to work from.
 
The following elements are useful in distinguishing symptoms of PTSD from symptoms of other disorders:
 
  • PTSD symptoms start or get worse after exposure to a traumatic event.
  • Stimuli reminiscent of traumatic events that activate PTSD symptoms are often pervasive and wide ranging, as opposed to singular or highly specific as in the case of phobias.
 
Disorders other than PTSD may be caused, in part, by exposure to traumatic stress. Although stressor exposure is part of the PTSD diagnostic criteria, PTSD is by no means the only mental disorder that may develop in the wake of trauma exposure. Examples of disorders that may develop after or be exacerbated by trauma exposure include adjustment disorder and phobias. Other highly prevalent disorders, such as depression and panic disorder, may also be potentiated by a traumatic stressor.
 
It is important to look at the guidelines for making a differential diagnosis of PTSD versus other conditions that are commonly associated with traumatic stress exposure. PTSD can be distinguished from these disorders by its defining symptom criteria (i.e., to meet criteria for PTSD, individuals must demonstrate a symptom profile that is consistent with the guidelines for PTSD). Additionally, exposure to traumatic stress is a requirement for a diagnosis of PTSD; in contrast, for disorders such as depression, panic disorder and phobias, although symptoms may be associated with a traumatic event, this is not a requirement.
 
This is why it is important to gather information from varying sources using a variety of methods in order to ensure an accurate diagnosis which will enable the best possible treatment for all symptoms for each individual.

Forces & Veterans Mental Health Helpline


It’s been a busy time since before Christmas in my house with a trip to New York to speak for the NYPD Hostage Negotiation Unit and the New York Association of Hostage Negotiators and the FBI/NYPD Joint Terrorism Task Force. This month I’m speaking as part of the Seton Hall School of Law in Newark’s Spring 18 Crisis Negotiation Course, to talk about hostage survival.

We also sold our house and found a new one just before I left for New York, so straight after Christmas and New Year, it was all hands on deck to pack up the house ready to move on the 19th January so it’s been a tad crazy, to say the least.

In amongst all this, I have been discussing, planning and beginning the creation of two new initiatives with a very good friend of mine and fellow psychotherapist and hypnotherapist, David Bellamy, read all about his work here: www.davidbellamy.org

Through David, we have connected with three former Generals; Peter Currie, John McColl, and Andrew Graham. We also have onboard former Colonel David Richmond CBE who is about to finish working as Recovery Director at Help 4 Heroes and chairman of the Contact Group.

The first initiative is to update the working structure of the military charity sector. At present it is unregulated, there are no minimum standards of operation required for start-up and ongoing and this has lead to many people being neglected, ignored and falling by the wayside. Over the last ten years, these are the people I have treated for PTSD and all it’s associated conditions and this working group that has come together is in complete agreement that things must change. The irony is that the system is not failing people because of a lack of funding, it is failing them because there is far too much bureaucracy, red tape, and BS.

I am not by any means saying that it’s all bad, there are some great people doing great work for many people, however, as with any system there is always room for improvement and it is now time to implement changes that mean more people can benefit from those positive changes.

Some of the changes being discussed are:

  • a national standard on military charities that require them to furnish proof of certain minimum standards and accessibility in return for which they become approved on a national list.
  • sharing of resources, information, and learning because at present this does not happen. There are 350+ military charities and mostly working in isolation which is crazy considering what could be achieved with total collaboration and cooperation. This would entail national sharing of resources, treatment, response and technical ability.
  • run both initiatives as a not-for-profit organisation

The second initiative which has been easier to get going is a national free phone number for serving and veterans to access advice, help, and guidance on mental health issues.  Ironically, while I was looking into setting something like this up, Lord Dannatt wrote an article in the Daily Mail on 14th January, you can read the full article here, Lord Dannatt’s article in the Daily Mail

In the article, he states that the government had declined the option to set up a 24/7 mental health helpline for serving personnel because it would not be cost-effective. The outcome of their assessment of needs concluded that it would require 40 therapists, cost £2m and attract less than 50 calls per year. This does not make sense because if they needed 40 therapists then they would be expecting far more than 50 calls a year surely?

My own research into costs showed that it is cheap to get started and can be increased as demand requires, so we have set up a freephone number 0800 6890864 for all serving and veterans to call should they have mental health concerns for themselves or someone they know. The company we chose to provide the phone service has given us 90 days free trial and then its £24.99 +VAT per month, we have two therapists available at present and we are building a list of volunteers to help as demand grows. So the cost is far from prohibitive as the government suggested.

Our aim for this is to provide unbiased, impartial, confidential, free advice, guidance and help for people serving in the British Armed Forces and veterans with mental health issues. We no longer want people to feel ashamed, afraid, embarrassed about asking for help, and as we are not connected with the MoD or government in any way we offer complete confidentiality. A large part of what we aim to achieve is to create a network of charities and organisations that we can steer people towards to access the specialist help they need that’s local to them. We also provide counseling, therapy, and coaching as part of our service.

I emailed Lord Dannatt and through his PA I now have a telephone conversation booked for Monday 12th February to discuss what we have done so far, what our future plans are and take advice and guidance from Lord Dannatt to ensure that we at least match his expectations of this sort of service.

I have also been in touch with ITV’s This Morning and my email is with the planning team who do the scheduling so I am keeping my fingers crossed. On top of this, a new friend Stephen Finlayson is helping by speaking to his connections at the BBC who he dealt with for a programme about him from a couple of years ago and also introducing me to people he knows at the CTP, (Careers Transition Partnership) who organise resettlement for people leaving the forces.

We are looking for funding and support across the board, so if you have any ideas or would like to help us in any way then please get in touch via my email simon@simonmaryan.com or via the facebook page which is Forces & Veterans Mental Health Helpline Facebook Page 

Please share this with your friends, family, colleagues etc and help us to spread the word about the service we offer and what we are striving to achieve.

Here’s to a very successful 2018 for all of us.

Simon

Mind-Matters Series Video#8: Get Shit Done


head-1345060_1920

 

If your head has ever felt like it is full of too much shit and you can’t think straight, can’t make a decision, can’t get motivated to do what you want and/or need to do and you find yourself procrastinating.

Well, here is a short video explaining why we procrastinate and what we can do to change those negative habits of creating excuses not to do what we want or need to do. Below is a link to my Goal Setting pdf that is yours to download for free and while you’re there take a look at the other downloads available there for free too.

https://simonmaryan.com/free-stuff/

 

Creative Reframing


A wise old gentleman had retired and bought himself a modest home near a school. He spent the first few weeks of his retirement in peace and contentment. However, when the new school year began, the very next afternoon three young boys, full of youthful exuberance and post school enthusiasm, came down his street, banging merrily on every dustbin they encountered. The crashing percussion continued day after day, until finally the wise old man decided it was time to take some action.

The next afternoon, he walked out to meet the young percussionists as they banged their way down the street. He stopped them and said, “You boys are a lot of fun. I like to see you express your exuberance like that. In fact, I used to do the same thing when I was your age. Will you do me a favour? I’ll give you each a dollar if you’ll promise to come around every day and do your thing.” The kids were elated and continued to do a bang-up job on the dustbins.

After a few days, the old-timer greeted the kids again, but this time he had a sad smile on his face. “This recessions really putting a big dent in my income,” he told them. “From now on, I’ll only be able to pay you 50 cents to beat on the cans.” The noisemakers were obviously displeased, but they accepted his offer and continued their afternoon ruckus. A few days later, the wily retiree approached them again as they drummed their way down the street.

“Look,” he said, “I haven’t received my Social Security check yet, so I’m not going to be able to give you more than 25 cents. Will that be okay?” “A quarter?” the drum leader exclaimed. “If you think were going to waste our time, beating these cans around for a quarter, you’re mad! No way, we quit!” And the old man enjoyed peace and serenity for the rest of his days.