1. Surrey Arrhythmia Support Group: Living with a cardiac condition Jenny Cove, Clinical Psychologist Davina Moses, Clinical Psychologist

2. What are your experiences Emotional impact? Areas of life affected? Challenges?

3. Common feelings ShockShock Anxiety/ uncertainty re futureAnxiety/ uncertainty re future Loss of control/confidenceLoss of control/confidence Anger/frustration/resentmentAnger/frustration/resentment DenialDenial Sadness/Grief/LossSadness/Grief/Loss DepressionDepression WithdrawalWithdrawal Social isolationSocial isolation

4. What areas of life can be effected? 4 Physical functioning Health Relationships Work Social lifeMotivation Self- esteem Emotional health

5. Stress levels: health related; financial; work Neurological impairment Medication side effects Loss of function Daily activities- slower pace Lifestyle changes (smoking, alcohol, diet) Change in role- marriage; family; work Challenges to Cope With

6. Adjustment What does adjustment mean?  Living with a physical health condition can result in a range of emotional difficulties at different times and may present on-going challenges.  Part of adjusting and ‘living well’ with a physical health condition is acknowledging the impact it has on all these areas of our lives, but not feeling powerless.  In essence, adjustment means maintaining a reasonable quality of life in the face of your current difficulties.

7. Adjustment Adapted from Kübler -Ross, 1969

8. Acceptance An on-going process involving:  Living in the present moment  Engaging fully in what you are able to do  Adapting to changes  Living life to the full in spite of the condition, but not necessarily being happy it is here  Although it remains unwelcome, “it can become part of you that can be cared for, rather than a stranger to be feared or fought.” (Nash, 2013).

9.  Returning to work  Venturing too far from home  Re-exploring sexual relationships  Over-activity  Active play with children/ grandchildren  Fear of over excitement Common Causes of Anxiety

10. Symptoms

11. Cognitive-behavioural theory

12. Trigger - Danger: e.g. anxious thoughts, frightening situations Physical effects e.g. heart pounding, shaky, short of breath Thoughts “I’m having a heart attack” “I’m going to die” Behaviour Escape, avoid situation, dial 999 VICIOUS CYCLE OF ANXIETY Feelings Anxiety, fear Anxiety

13. What do you do to manage anxiety?

14. Tips for coping Breathing techniques Relaxation Distraction Enjoyable activities Appetite/sleep Problem-solving Keep a diary Identifying social support systems Talking

15. Setting Goals & Pacing Decide on the goals you want to achieve Break them down into small chunks Time-table rests Gradually increase what you do over the weeks, as you get fitter

16. Building up confidence… Set small goals at 80% confidence level Success increases confidence in ability Confidence and success increases the chance of further success If you could change one thing about your life what would it be?

18. Aims of Mindfulness Our mind is constantly working to understand our current experiences, including any pain, discomfort or distress we feel It zooms in on our suffering as it tries to find a solution This “zooming-in” can amplify our suffering Our mind searches for a solution in the past experiences we have had – and this can flood the mind with unsettling memories Questions can start nagging at you “what will happen if it gets worse”, “I can’t cope with this” “I just want it to stop” – so future worries also increase our suffering Mindfulness does not aim to get rid of suffering, just make sure suffering doesn’t dominate your life Mindfulness teaches us to repeatedly bringing our attention back to the current experience It aims to develop our ability to step back from ruminating about the past or worrying about the future and simply allow experiences to unfold

19. Further sources of Support British Heart Foundation - https://www.bhf.org.uk/https://www.bhf.org.uk/ Local Psychology services - accessed via your GP Psychology self-help resources – www.get.ggwww.get.gg Mindfulness - www.franticworld.comwww.franticworld.com

20. THANK YOU