Welcome

Aims and objectives for today To improve our ability to be resilient! We will: - think about what it means to be resilient consider our own experience of stress, and the coping strategies we already possess learn how to breathe more effectively understand the power of positive emotions and how to access these to improve our resilience explore a range of exercises, tools and techniques to improve our coping strategies and wellbeing

Learning needs…. How to manage work/life balance and the daily pressures of being a GP To continue in practice until I retire without becoming overstressed How to survive increasing time pressures.  Coping with stress and complaints

What causes you stress at work? What does this stress do to you? What do you currently do to deal with (and/or to avoid) stress? How would you like to be? What does it mean to you to be resilient?

What resources do we have and can we develop? Physical Spiritual Emotional Mental

Heart rate variability…. The speed of heart beat changes constantly A high Heart Rate Variability is a sign of good health and youthfulness of the organism (good adaptability) Heart Rate Variability reduces with age and poor health

HRV and resilience Greater heart rate variability leads to Improved health Better immune system functioning Better hormonal balance Better judgment Better decision making Better performance

Breathing exercise Focus on your breathing: how many seconds do you breathe in? Breathe out? Try to extend your breaths to(wards) 5 seconds in and 5 out Breathe from the diaphragm Try to fill your lungs front and back Aim for 80% capacity

Accessing resources Write down on one side of a piece of paper everything you can think and feel about a real problem you are experiencing Slow and deepen your breathing and focus on somebody or something you sincerely appreciate Now write down on the other side of the paper everything you now think and feel about the same problem Compare what you have written on both sides. What differences are there between the two lists?

Benefits of positive emotions.. Positive emotions have a number of health benefits on the autonomic nervous system on heart rate variability on the immune system on our capacity to recover from physical and emotional trauma, heart attack and infections on emotional and mental health Studies by Fredrickson et al., 2003; Tugade et al., 2004; Ong et al., 2006; Bonanno et al., 2007

Reflective Diary Gratitude Diary Planning diary Diary Exercises Reflective Diary Gratitude Diary Planning diary PRESENTATION TITLE HERE

Reflective diary Slow down and deepen your breathing Recall a significant moment of calm appreciation Focus on remembering significant events of the day. Try to observe Ask yourself how and what you thought and felt at the time, name your feelings and write them down.

“When you put feelings into words, you’re activating the pre-frontal region of the brain and seeing a reduced response in the amygdale. In the same way you hit the brake while driving when you see a light change to red, when you put feelings into words, you seem to be hitting the brakes on your emotional responses.” Matthew D. Lieberman, Naomi I. Eisenberger, Molly J. Crockett, Sabrina M. Tom, Jennifer H. Pfeifer, and Baldwin M. Way, University of California, Los Angeles, 2007: Putting Feelings Into WordsAffect Labeling Disrupts Amygdala Activity in Response to Affective Stimuli

Reflective diary: Key benefits Process your day’s experiences effectively Bring into your awareness any painful or disturbing emotions, such as anger, fear and sadness Allow yourself to accept these emotions as part of your life Neutralise the negative impact of emotions that are attached to memories by naming them Learn from the events on a deeper level Develop intuitive insight in how to deal with similar challenges in the future Prepare for more deep sleep and less REM sleep (dreams), as you will have already processed the day’s events

Write down 5 things you feel truly grateful for, right now Gratitude diary Slow down and deepen your breathing and focus for a moment on a genuine feeling of appreciation Write down 5 things you feel truly grateful for, right now You might wish to add why you are grateful Focus on genuine feelings of gratitude

Gratitude diary: Key benefits Deepen your appreciation for life Deepen your appreciation for yourself Increase positive emotions Improve low mood Generate enthusiasm and drive

Effects of gratitude and appreciation on happiness and success “The participants who focused on five things they were grateful for were not only happier and more optimistic, but also more successful in achieving their goals, physical healthier, and more generous and benevolent towards others.” Emmons, Robert; McCullough, Michael E. 2003 Counting Blessings Versus Burdens: An Experimental Investigation of Gratitude and Subjective Well-Being in Daily Life Journal of Personality and Social Psychology. Vol 84 (2), pp. 377-389

Visualisation Visualisations - can be either developmental or therapeutic - are most effective when repeated - work best when we focus on how our body feels, as well as on our senses - are more effective the more detail we include - are more effective when we include the impact our desired future has on others - should be practised along with intention.. - and ideally with conscious steps towards reaching our goal (but can be useful even without this)

Exercise : “Best Possible Future Self" Think about a currently difficult relationship or work situation. Imagine that everything has improved greatly, has gone as well as it credibly could. You have worked hard, succeeded in acquiring all knowledge and skills required and received all possible support. You have succeeded implementing your goals in your and others’ best interest. Think of this as the realisation of all of your aspirations for yourself and the person/people involved. Now, write about what you imagined and how you feel about it. Put in as much detail as you can, especially sensory detail. Do this for 20 minutes per day for three days in a row.

Exercise: “Miracle question” Work in pairs Ask your partner to tell you ‘What it will be like when…. (the problem is solved)’? Use the following prompts: What will you be doing / seeing / feeling / hearing instead? Ask for specifics! If that happens what difference will it make? How will others know that things are better? Who will notice first? Then who? (etc) What else will be different? What else? (etc)

Quiz! What does the brain focus on? Completed tasks; incomplete tasks; our ‘to do’ lists. Is multitasking effective? Which of these activities helps us best to relax: TV watching, cooking, listening to the radio Which of these elements do optimum relaxing activities have? The need to focus; physical movement; fresh air; companionship; competition. What is the best way to deal with unexpected demands that occur during the day? Does working within tight time frames make us more or less efficient?

Mental Rehearsing Chose a goal or a skill you want to achieve or develop Establish deep breathing with your feeling of appreciation and maintain it throughout the exercise Imagine yourself having achieved that goal you initially chose. What do you see? (posture, smile etc.). How does it feel? Now review in your mind the steps you have taken from achieving your goal backwards until present day. (Observe yourself from the outside.) Next, experience yourself inside your body and mentally rehearse the steps you will take to achieve your goal. Think about your senses and your positive feelings as you move towards it and achieve it. (Focus on the process). Imagine yourself overcoming challenges and obstacles with confidence.

Mental Rehearsing: Some benefits Create clear vision Make goals achievable Develop personal confidence to take big decisions and see them through Develop and maintain determination Overcome obstacles Achieve aims!

Maintaining healthy relationships (avoiding exhaustion)

Helpful ------------Issue, problem or question-------------- Hindering

Review and move forward….