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Hello, my name is Neelam Solanki and I’m an Assistant Psychologist working at the Tavistock and Portman NHS Foundation Trust. I work primarily within the National i-THRIVE Programme Team, however, I was redeployed at the beginning of lockdown to work on a few different projects within the Trust, one of which was here at Together in Mind.

I started at the Trust in February 2020 and was working in my role for about four weeks before we went into lockdown, and my experience from there on has been a little bit “all over the place” to say the least. I found that I was only working for about two sessions (a day) per week in terms of my actual job role, and otherwise I found that I was being asked to help whoever needed it for whichever project, whenever they needed it. Initially this was really exciting and it meant that I got to know a lot of people within the Trust who otherwise I may not have met, but after a while it became exhausting and anxiety inducing as I felt more and more that I did not really have a place, a purpose, or a defined role.

Over the last 6 months, I have been reflecting on what it means for me and others in a similar position as a relatively junior member of staff, and the unique tasks and asks we’ve had which we may unlikely have the experience, the training or the foundation of knowledge to prepare us for. But then, there’s the catch-22, because the fact that we’re not particularly tied to a job role and don’t have a particular job to do that no one else can do, we can be more flexible about supporting other teams and projects. COVID has enabled me and so many others to become sort of a ‘jack of all trades’ but of course the other half of that phrase is ‘master of none’. I am so grateful and genuinely excited about the new experiences that have been presented to me, but it has been difficult to feel settled or like I fully know what I’m doing. And I’m certain that this isn’t just the case for more junior members of staff, COVID has meant that everyone has felt unsettled and lost at some point.

Another consideration is that as an Assistant Psychologist who intends on applying for clinical training later this year, everything that I do in my job is for the purpose of giving me the relevant experience and skills and knowledge and confidence to be an attractive candidate. Although there is some safety in the knowledge that all of the other hopeful assistants in the country are likely feeling the same way, there is still that feeling of dread that we don’t have a safety net. Developing my psychological skills hasn’t been a focus over the last period, so then what do I talk about in my application? What does this mean for my future?

It’s hard not to think about the 5,500 final year medical students who had to graduate early to join the workforce, as the need to manage COVID was, and still is, so high. I cannot begin to imagine what the impact of suddenly transitioning from student to doctor would be, particularly on their confidence and feelings of preparation, and what a hit their mental health and wellbeing could have taken.

During these times, things like inductions, training, support, and supervision have understandably taken a backseat because there are more pressing issues, however the impact of this is that the more junior workforce lack the confidence in themselves and the feeling of ability to do the tasks we are being asked to. For me, and in particular after taking the wellbeing quiz on Together in Mind, my profile came out as ‘More Frantic’ which made complete sense. The panic of feeling displaced, not particularly useful but also feeling as though I’m giving 110% to multiple teams all day every day took its toll.

But it is not all doom and gloom. The opportunities have been amazing and truly insightful, and although it might have taken a few months, the relationships that I’ve been able to build with such a huge range of people from different teams, divisions, disciplines and organisations feel positive and strong. I do not think that I’m particularly qualified to advise anyone who may be feeling this way at all, but to keep to the trends of the last 6 months I’m going to do it anyway: always ask for feedback. Talk to your line manager when it feels like too much. Say no if it’s not manageable. Resist the urge to want to prove yourself at every opportunity – it’s exhausting. Take breaks! Take that FULL lunch break away from your screen.

The point of being a junior member of staff if that eventually we hope to be senior members of staff. It’s hard to forget our goals when everything is so unsettled but the one main take away I’ve learnt is to use every experience to my advantage and learn, learn, learn. And to have frequent pet breaks. And to never run out of milk for tea. And have a really well-stocked snack cupboard.

Good luck to everyone and well done for coping as well as you have. Thank you for listening.

Neelam Solanki is an Assistant Psychologist working within the National i-THRIVE Programme Team at the Tavistock and Portman NHS Foundation Trust, and has also been working on Together in Mind. Neelam shares her experiences of being a relatively junior member of staff through periods of great change and uncertainty, and its impact on her wellbeing and future.

My name is Dominic O’Ryan and I am Lead Psychologist with Substance Misuse Services at Camden and Islington NHS Foundation Trust.

There are times when we might feel that everything is running away with us …

We feel lost and distressed.

At these times it’s helpful to pause for a moment, to drop anchor…

Dropping anchor won’t make any storms go away, but it may allow us to notice what is happening, gather our inner resources and make steps towards self-care and action.

Our mind might tell us that it is not worth pausing because the risks are too great. If we stop even for a minute, we might become even more lost. We might discover something that we couldn’t bear, or we couldn’t manage.

Notice these thoughts and be kind to them. They are there to try and protect us from harm.

And then we can sit up or stand, plant our feet firmly on the ground, adopting a posture of someone being attentive. And alert. And kind.

Acknowledge what other thoughts are here? Are there thoughts about being overwhelmed? About not being able to cope. Maybe thoughts about never being good enough.

Maybe there are no thoughts in particular.

And rather than trying to change the thoughts or push them away or chase after more worthy thoughts, just notice what is here now.

And notice the feelings that are present alongside them. Maybe give these feelings and emotions words that describe them for you. Notice worry. Notice fear. Notice sadness. Notice anger with ourself or others. 

And just connect with and notice what is here in the body. Become aware of what’s happening in the body.

Perhaps notice a heaviness. Or the breath being short or shallow.

Notice the heart racing. Notice tension or holding or bracing.  Or stillness.

And be aware of immediate behaviours, perhaps avoidance, procrastination, perhaps too many biscuits, being snappy with colleagues or giving too much of ourself to others without attending to our own needs.

And then at that moment, allow the thought that maybe, just for now things are okay.

Bring to mind purpose, intention, values.

And then bring to mind just one or two behaviours that map onto those intentions and values. Behaviours that can be started and embodied straight away.

Perhaps taking a break, going for a short walk, sitting quietly for a little while longer. Or maybe there’s an email or a brief report that could actually be finished in a relatively short period of time, if only it could actually be started.

Perhaps something about turning towards a colleague. Asking them for something or offering them some kindness.

Whatever it is, whilst it may only be a small action it can still be a valuable action.

And maybe it is important to drop anchor a few times each day. And that’s alright. It’s okay to pause. And it’s certainly alright to check in on our intentions and values and sense of purpose.

And it’s always alright to turn to friends, family and colleagues to make connections, offer help and ask for help.

To be human. 

Dominic O’Ryan, Lead Psychologist with Substance Misuse Services at Camden and Islington NHS Foundation Trust. Dominic contributes some thoughts and practical guidance about how to find ways to pay the necessary attention to how we are in the context of a global storm that has in some ways come to feel like just the way things are.

Hello, my name is Jane O’Rourke, I’m a Child, Adolescent and Family Psychotherapist and a yoga and mindfulness teacher. Today we are going to be practicing triangular breathing. It’s a way of helping us to slowdown in our day, just finding a few minutes for ourselves to slow the breath so that we can slow our minds, a feel a little bit of steadiness and calm.

So finding a comfortable posture so you can be standing if you like, or maybe if you would like to sit in a chair, find a cushion and sitting on the floor, making yourself comfortable. Softening the jaw, relaxing the shoulders, softening the space between your eyebrows so there is no tension being held in your face. And then just noticing how you are feeling in this moment, I like to call it an internal weather check. So noticing how you are feeling physically, any tension being held in the body and noticing how you are feeling too. It can be really helpful to name what those feelings are.

And then, begin to imagine a triangle in your mind. So let’s start at the bottom corner of the triangle and breathing in for 1, 2, 3, hold the breath as you imagine in your mind’s eye coming up to the top of the triangle for 1, 2, 3 and then breathing out for 1, 2, 3 as you come back down to the bottom of the triangle. Breathing in, 1, 2, 3, holding the breath for 1, 2, 3 as you come up to the top of the triangle, then breathing out for 1, 2, 3 as you go back down to the bottom of the triangle. Breathing in 1, 2, 3, hold the breath for 1, 2, 3, as you come up to the top of the triangle and then breathing out 1, 2, 3. Breathing in 1, 2, 3 holding the breath for 1, 2, 3, and then breathing out 1, 2, 3. Breathing in 1, 2, 3 holding the breath 1, 2, 3, then breathing out for 1, 2, 3. Last time, breathing in for 1, 2, 3, hold the breath for 1, 2, 3 and then breathing out for 1, 2, 3.

And then just allow the breath to go at its own pace, so not forcing anything, giving yourself a few moments now just to ground a little more, feel the steadiness of the earth beneath you… and lets finish by doing this internal check-in once more, just noticing how you are feeling in this moment physically, what emotions are arising for you, everything included, nothing excluded. Just noticing how the breath is now, just taking the last few final breaths here doing this exercise and you can stay a little longer if you need or whenever you are ready coming back into the room in your own time.

This four-minute triangular breathing exercise is for when you want to feel more rested and rejuvenated. Jane O’Rourke is a Yoga and Meditation Teacher, and a Psychodynamic Psychotherapist with Children, Young People and Families. She teaches Yoga4Trauma within the Trauma Service at the Tavistock and Portman NHS Foundation Trust.

Wellbeing Quiz Profile: #MoreFrantic

Hello, my name is Jane O’Rourke. I’m a Child, Adolescent and Family Psychotherapist and a yoga and mindfulness teacher.

So start by finding a comfortable posture. It might be that you want to sit on a cushion or in a chair or perhaps lying down, whatever you feel you most need in this moment.

And start to take a few slow, easy deep breaths, just to let go of whatever you’re carrying around with you today, any emotional baggage. And then either closing your eyes or, just gently lowering the eyelids and then start to bring your attention to your breath. The intention here is to bring a friendly attention. So noticing where you’re breathing most easily. It might be that you can feel the breath most at the tip of your nose, perhaps as a cool breeze on your upper lip. Maybe you’re most aware of your chest, or your belly rising and falling. So bringing a gentle curiosity to the sensations of the breath. Just feeling your breath here for a while. And then when you notice that your mind has wandered as minds do, just come back to feeling your breath again…

Just let your body breathe you. So no holding of the breath or trying to change it in any way. And now put your hand on your heart reminding yourself that you’re bringing a kind attention to your breathing. Our breath is with us from the moment we are born until the moment we die. So our lifelong companion. So allowing yourself to appreciate this breath that sustains us. Wherever we go, whatever we’re doing, it’s always there, it’s there to help us when times are difficult, if we need to slow down, if we need to ground and steady ourselves.

So bringing curiosity and enormous gratitude for this, this breath that gives us life and then exploring how it feels by perhaps putting the other hand on top of the hand that’s already there, on top of your heart. And feeling this as a compassionate gesture for yourself, looking after yourself. Bringing a tender awareness to your breath, be really present to how you are in this moment, looking after yourself.

Not worrying about how many times your mind might wander, just gently returning it back to the feeling of your of the breath underneath your hands. And then gently resting your hands on your lap, just noticing how your breath is now.

Give yourself a few moments to experience the sensations in the whole of your body. A curious observer of what’s happening in your body in this moment. And staying here for as long as you like and then whenever you’re ready, coming back into the room in your own time.

Needing more self-care? Jane O’Rourke leads us through a self-compassion breathing exercise to help nurture and steady ourselves. Jane is a Yoga and Mindfulness teacher and a Psychodynamic Child, Adolescent and Family Psychotherapist. She teaches Yoga4Trauma at the Tavistock Clinic.

Wellbeing Quiz Profile: #MoreFrantic

Hello, my name is Jane O’Rourke. I’m a Child, Adolescent and Family Psychotherapist, and I’m a yoga and mindfulness teacher.

So, come to a sitting posture, where you can find your sit bones on whatever you are sitting on, whether it is a chair or a cushion, so you can sit nice and tall, so a strong erect spine. And if possible closing your eyes or just lowering your gaze.

And then start to bring your awareness to your inner experience. So this is like an internal weather check, so asking yourself what’s your experience in this moment… what thoughts are coming up for you… perhaps even putting it into words, what your thoughts are and acknowledging what feelings there are here in this moment. And in this way we are turning towards whatever it is that we are feeling, so any sense of discomfort or unpleasantness, and maybe some pleasant thoughts too, just acknowledging whatever it is you are experiencing right now. And then what body sensations are here right now, perhaps just scanning through the body, picking up any sensations of tightness or discomfort, just acknowledging your experience.

And then just starting to direct your attention to the breath, focusing on the physical sensations of the breath itself… moving in to the sense of the breath in your abdomen, noticing the contraction of the breath and the out breath and the expansion of the abdomen on the in breath. And in this way we are using the breath as an anchor to the present moment. A smooth in breath, a smooth out breath.

And now expanding your awareness to the whole body, perhaps imagining in your mind’s eye your body here, your posture, noticing your facial expression, and if you become aware of any difficult sensations, breathing in, on the in breath to any discomfort, and breathing out on the out breath, a releasing and letting go.

And then whenever you are reading, coming back into the room in your own time.

Jane O’Rourke guides us through a 3 minute Breathing Space. By turning towards our experience we can release and let go of tension. Jane is a Yoga and Meditation Teacher, and a Psychodynamic Psychotherapist with Children, Young People and Families. She teaches Yoga4Trauma within the Trauma Service at the Tavistock and Portman NHS Foundation Trust.

Wellbeing Quiz Profile: #MoreFrantic

Hello, my name is Jane O’Rourke. I’m a Child, Adolescent and Family Psychotherapist, and I’m a yoga and mindfulness teacher. Today we are going to do a really simple practice for when you don’t have much time but you would like to steady and calm.

So coming to a seated comfortable posture, so it might be on a chair or maybe you can find a cushion to sit on on the floor. And the aim is to try and get a nice straight back, so find your sit bones, so your spine can rise nice and tall and your shoulders can slide down the back, and your neck can be nice and long. And I invite you to put a hand over your heart, and the other hand, the finger tips just touching the floor, or maybe on your lap so you can feel the steadiness of the support of one hand and the other hand is in touch and supporting yourself. And then start to allow the breath to settle and relax, and just being in touch with how you are feeling in this moment.

And then I am inviting you to bring your focus to the breath at the tip of your nose. This is a really simple exercise, just being aware of the breath as it enters the nose, the in breath, and as it leaves the body through the nose on the out breath. Noticing the texture of the breath as it comes in and the slight warming on the out breath. Each breath a new breath of life, bringing oxygen to every cell in the body and a releasing and letting go on the out breath. And don’t worry if your mind wanders off as minds do, just gently bring back the focus to this next in breath coming in at the tip of your nose. Feeling the rise and fall of your chest on the in breath and the out breath and the steady rhythm of your heart. And then when you have taken your last out breath, placing both of your hands on your lap and just taking note of how you are feeling in this moment, and stay here for longer if you like, otherwise gently taking your time to come back into the room in your own time.

Jane O’Rourke guides us through a breathing practice for when you do not have much time but would like to relax and calm down. Jane is a yoga and mindfulness teacher and a Psychodynamic Psychotherapist working with Children and Families. She teaches yoga4trauma in the Trauma Unit at the Tavistock and Portman NHS Foundation Trust.

Wellbeing Quiz Profile: #MoreFrantic

Hi, my name is Heather Chambers and I am a black Assistant Psychologist working in the MOSAIC CAMHS’s team for children with disabilities. I’m sure by now you’ve all either seen or heard about the very public way in which George Floyd was killed. Like many other black people I’ve spoken to, his death and the way in which he was killed, touched something deep within us. It was something strong and unique, and it was something that united us all in our blackness. It was a united understanding, a united understanding that not only could George Floyd have been any of us, but also that his experience is us. When I watched his killing on national TV, I felt a pain like I had never felt before. I grieved for someone I had never met. I grieved for the world and the human race.

This pain and this grievance led me to think about my own experience of racism, and what that looked like growing up as a black female in the UK. I collected these thoughts into a poem, and I’m going to share those with you today.

Portraits, affixed to the wall of a gallery, tell the story of lands and great leaders of time gone by. Every great period of time has a story to tell. Every great period has something to solidify the greatness as a memory, to permeate that particular moment in time, so that when the future arrived, we would all remember, said greatness.

But do you remember my greatness? Do I even remember my own greatness? Are portraits of my ancestors affixed to the walls of the National Portrait Gallery, the Tate, The British Museum? Are the true stories of British colonialism plastered inside the pages of English history books?

So much of my history is lost. I don’t even know, and don’t think I’ll ever even know my true surname.

Surviving slavery was greatness, surviving racism for 400 years is greatness. Surviving being black is greatness. Being black is laced with the magnitude of greatness. And yet, somehow, I do not see this greatness anywhere. I do not hear it. People do not speak of it. The greatness that is so strong and solidified in my heart has been tarnished with a view of weakness.

You see, I exist in a world in which black history is more than just a month. It lasts for a lifetime. I exist in a world in which people act surprised when I start talking. And proceed to tell me how well-spoken I am. I exist in a world in which I’ve witnessed my brother be stopped and searched by police countless of times, just because. I live in a world in which my teenage self was branded as a bully, because I was strong and vocal enough to stand up to the real bullies.

I live in a world in which I am told all lives matter, and that racism no longer exists. However, if all lives matter, tell me this, why are black people still being killed?

I live in a world which saw the 13th Amendment to the US Constitution passed in December 1865, abolishing slavery for good. I live in a world in which 155 years after the supposed abolishment black people are still being spoken to, and treated like slaves. I live in a world in which George Floyd was allowed to be murdered in cold blood. I live in a world in which this injustice is apparently justice. I live in a world of constant trauma, fear and labelling. I live in a world that is not free. I live in a world that is not for me.

I know that many of you are shocked to see what is going on in America. But I’m not. I’m disgusted. I’m horrified. I’m angered. But I am not shocked. I have grown up around racism. I’ve experienced it first times, countless times, both as a young girl and as an adult. I have lived with it.

I know it exists, and I know it is wrong, and it needs to stop. Society must wake up, open their eyes and start smelling the racial coffee. Stand up for your brothers and sisters, speak out against racism. Be the voice that we need people to be.

So Black Lives Matters does it? In what way does it matter? Ask yourself, how will you show that it matters? How will you educate yourself on black history and what it means to be black? How will you stand up? How will you fight?

The time has come. Let’s fight with our mouths, fight with our words, and fight with our art. Let’s use our voice to make a difference. Let’s make a change. Growing up black was never easy. But I one day hope for a day when it will be easy for the future black generations to come. Because Black Lives Matter.

Thank you for listening to that poem. I just want to note that, although those are my reflections, those experiences are true of many black people across the globe.

And to close I just wanted to draw attention to two words, response and retaliation. In the past when I’ve tried to confront colleagues or friends about racism, they have often retaliated defensively. And their response has often been one of invalidation. The way in which we respond and retaliate to racism is crucial in bringing about change. Responding with empathy, openness, and a willingness to listen to people who have experienced racism first hand is crucial. Similarly, actively looking for racism, challenging racist behaviour, and not staying silent and complacent, are positive forms of retaliation, which are also crucial to change.

I’m tired, and black people are tired. We’re tired of talking and fighting this fight. Talking about being black or being a part of the BAME community, fixing racism, this is not the sole responsibility of those people. It never was. It’s the responsibility of everyone, including white people. To leave you with this, I want you to ask yourself, the next time you witness racism or hear someone say that you’ve been racist towards them. What will your response and retaliation be?

Thank you for listening.

Heather Chambers is an Assistant Psychologist working in the Camden MOSAIC CAMHS’s team for children with disabilities. Heather shares her powerful poem and an accompanying commentary to frame the poem that asks important questions about how all of us can actively do, say, and think things differently when racism is active – our own, or someone else’s. View the transcript to see the images that accompany Heather’s poem.

My name is Melanie Wood and I am a CQC Registered Manager within Independence and Wellbeing, Enfield.

To understand the critical importance of the work that our staff do, it is helpful to understand their working environment and their role.

Our staff go into people’s own homes after they are discharged from hospital, frequently after clients have had surgery, accidents and ill health. We provide rehabilitation and personal care services. Being a front-line carer is not an easy job – you are dealing with people at a vulnerable time of their life, often frail, elderly and recovering from illness, along with balancing the support of their anxious families.

Entering someone’s home with only basic information is daunting at the best of times – dealing with the additional risk of COVID infection, has posed a level of risk we have not experienced before.

In recognising the importance of this role, it is also important to consider how staff have felt during this time about their work.

This key group of staff had to make choices in relation to their work. We had a mixed approach to these, some staff wishing to remain home to protect vulnerable family members, and those who worked above and beyond, working additional hours at times to ensure our clients remained safe.

I experienced carers being tearful and scared, seeking constant reassurance, and as a manager I had to understand this and have empathy. I had to be a leader and had to view things from the perspective of our front-line workers. I had to listen to them!

The key areas of fear being experienced was:

  • Do we have the correct PPE?
  • Disposing of PPE safely
  • Being asked to support COVID clients
  • Risks when going home to family
  • Families in the client’s homes not adhering to lockdown measures or social distancing, and having sometimes difficult conversations with them
  • Social media information verses government information was confusing
  • Lack of testing initially available

It is important to share with you the measures we took to manage this situation, which resulted in all care and support services being delivered and staff being more resilient. When I review this today, I realise how far we have come, and what we have achieved as a service. Staff now have the approach “treat everyone as potential COVID”, which reduces the risk considerably. The staff have adequate PPE, and this has played a vital role in staff feeling safe.

We had no prior experience of such a pandemic across all sectors – we were going in to the unknown.

In those early days we were all adrift trying to find some routine, some structure, some consistency whilst information was being cascaded thick and fast; changing frequently, creating confusion and uncertainty. We went into new ways of working, office-based staff and managers having to work from home, to keep environments safe. I felt vulnerable, fearful and at times irritable. The fears being; what if I don’t get it right, what if I provide incorrect information, or not providing the right support at the right time, we could lose staff, or worst still not have the capacity to meet the needs of those we support.

The starting point was to increase Skype meetings. Moral was low, and no one had immediate answers to all the questions.

The Skype meetings with managers of other services within our organisation provided the backbone and support I needed. We were able to identify key individuals to do specific pieces of work, these being:

  • To contact recruitment agencies to obtain additional staff, to manage the reduction in staff available
  • Temporary redeployment of other staff teams, into front-line services to increase capacity
  • Reviewed the infection control policy, and circulate to all
  • Develop a detailed risk assessment, pulling together the government and NHS guidance
  • Contacting PPE providers to source adequate  PPE supplies
  • Consultation with HR to have the appropriate responses for staff experiencing different situations, and options available to them.

I followed on with a daily meeting with my teams. This enabled me to feedback current information promptly and ensured everything being cascaded was understood. This provided a platform for all staff to feedback openly, and without judgement and feel respected.

It was vital everyone was delivering the same message which was current and accurate.

Melanie Wood is an Independent Living Team Manager for Independence and Wellbeing, London Borough of Enfield. Melanie provides a guide to creating consistency in homecare settings.

Hello, my name is Jane O’Rourke. I’m a Child, Adolescent and Family Psychotherapist, and I’m a yoga and mindfulness teacher. Nadi Shodhana breathing, alternative nostril breathing, is really really good for helping to calm and centre the mind, I call it instant mental first aid because it is so good at helping balance the nervous system. In yoga tradition it is believed to synchronise the two hemispheres of the brain and a study has found that people who practice Nadi Shodhana, or alternative nostril breathing reported lower stress levels.

So if you would like to give it a try now find a comfortable seated posture. So, perhaps sitting on a chair or on a cushion on the floor so your back can be nice and straight, sitting nice and tall. And bringing your hand up towards your face, your ring finger is going to be placed very gently on your left nostril and your thumb is going to be placed very gently on your right nostril, and then the index finger and the middle finger are going to be very gently placed on your forehead. So the aim is to keep the breath nice and gentle and soft and relaxed during the practice, so not any forcing of the breath, and the idea is for a regular and even in breath and out breath and very very gentle and soft, so you can barely hear the breath. And I am encouraging you to go at your own pace if you are finding that I am going too fast or too slow. We are only going to do five rounds so it is going to be quite quick but it will be interesting for you to see what the effects are for you. If you don’t instantly feel calm and relaxed by doing this practice it might be something that you need to practice a few times to get the benefits.

So let’s begin, so just starting to take a normal breath in and out through the nose and then gently close off the left nostril with your ring finger and breathe up through the right nostril. Gently place the thumb on your right nostril and lift the ring finger off your left and breathe down through the left. Breathing up through the left, place the ring finger back on the left nostril and breathe down through the right. Breathing up through the right nostril, place the thumb back on the nostril, lift the ring finger off the left and breathe down through the left nostril. Breathe up through the left nostril, place the ring finger back down and breathe down through the right. Breathing up through the right nostril, place the thumb back on the right and then breathe down through the left. Breathing up through the left, place the ring finger back down on the left and then breathe down through the right. Breathing up through the right, place the thumb back down and then breathe down through the left. Breathing up through the left, place the ring finger back down and then bring the breath down the right nostril. And then gently taking the hand away, placing your hands on your lap and just take a few breaths in and out through both nostrils. Allowing the breath just to return to its normal rhythm, so not forcing the breath in and out, just allowing the breath to move in and out through the nose, nice and gently.

And perhaps watching your breath for the next minute or two, moving in and out of the nose at a nice, gentle, regular rhythm. Even in breath, even out breath. You can practice this everyday if you like as a way of keeping the mind nice and calm and steady.

 

Jane O’Rourke shares a traditional yoga breathing practice, Nadi Shodhana or alternate nostril breathing, that can quickly calm the mind. Jane is a Yoga and Meditation Teacher, and a Psychodynamic Psychotherapist with Children, Young People and Families. She teaches Yoga4Trauma within the Trauma Service at the Tavistock and Portman NHS Foundation Trust.

Wellbeing Quiz Profile: #MoreFrantic #FeelingHopeless

Recently I was with a group of nursing colleagues and we were discussing their particular experiences of nursing at the height of the COVID pandemic. One nurse in particular, spoke with despair about feeling utterly stripped and bereft of any sense of being an effective nurse, he had seen so many patients die, he had felt so helpless that wondered whether he actually justified the title of being called a nurse.

I could see that my colleagues were nodding in some sort of recognition of what he was saying and the quality of his despair. So I asked him to say a little bit more, and he started to describe a particular patient he had been a key nurse for, and this patient unusually had been on the ward for over three months. In that length of time he had really got to know this woman, he had got to understand her he thought, he had provided her with comfort along with his colleagues, she had become quite a known patient on the ward because of the time she had spent there. He had known what had made her comfortable, what she liked to eat, what she didn’t like to eat, what made her irritable, what made her slightly more hopeful, he cajoled her, he tried to revive the life in her and accordingly on many occasions she did appear to be close to recovery, but then, as is often the case with a patient suffering COVID, there would be a very sudden unexpected and catastrophic decline in the state of health. But because she had recovered many of these dips in her health there was a consensus in the ward that she would probably make it. And then one day he turns up for an early shift and he is told the awful news that she had died very suddenly in the night. “What a waste of time!” he exclaimed, it was a shocking thing to say but it was authentic, and I knew that his colleagues understood exactly what he meant. We acknowledged that very painful and angry state of mind, when one’s efforts, one’s real hard dedication seems to have been worth nothing and that’s what nursing COVID patients often leaves the nurse with. It is a particularly cruel aspect of this type of nursing and this type of illness.

But I thought that it might be helpful to think what else was behind that anger and that sense of futility and we started to think about a sort of intimacy that does play a part in nursing patients who are not going to respond to a care plan or to a medication but who are inevitable there to die. It is a cruel travesty, in terms of nursing, to feel that there is nothing actively, there is no process, there is no procedure that is going to make a significant impact and you are left being a human being, ok with skills, with experience, but ultimately you are one human being with another person, with another human being who is dying. And we thought about the exceptional experience of doing that on behalf of society, being there with the patient at the most extreme point in their life and then inevitable death, and we thought about why it is so difficult in the quietness and in the space of being able to reflect, why is it felt so difficult to appreciate that might actually be a terribly important aspect of nursing. To really be with the patient, with their agony, with their despair, with their hope, with their irritability, that the being with all of those different things that one patient can bring, all those confusing and complicated things that the patient brings with them, that being with is implicit in the nursing role, and perhaps it is difficult for us as nurses to acknowledge it because it doesn’t get measured, it is not included in the care plan, it is not something that we easily can describe, but it is there in what we do and in being with the patient who has exhausted all of the doctors initiatives and skill and experience, it is down to the nurse to be with that patient and to do something that no one else is able to do, to watch, to feel, to be with and to witness.

Maria McMillan is a Psychiatric Nurse and a Psychoanalytic Psychotherapist. Maria talks about the importance, if you are working with those who are very ill or dying, of being there even when you can’t prevent the illness from taking its course. This material relates to a piece of work she carried out recently on behalf of the Tavistock and Portman NHS Foundation Trust.

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