As the pandemic sweeps the globe, hundreds of millions of people are locked into their homes for months on end, weighed down by aching uncertainty, the wonders of remote connection never quite able to compensate for lack of actual human contact.
The risk to mental health is huge.
Fear and loneliness, worry and conflict
Loneliness, fear of contagion, domestic conflict and abuse, financial fears, depression, and suicide have become grave concerns.1
In the Kaiser Family Foundation Tracking poll, conducted back in July 2020, 53 percent of US adults reported that their mental health had been negatively affected by worry and stress over the Covid-19 pandemic.2 This was up from 32 percent in March 2019.
Clearly mental wellbeing hit a low point recently, and I suspect many people are still suffering – perhaps even more than before.
Mental wellbeing is, of course, the primary focus of concern for people prone to depression and anxiety. But ultimately it’s vital for all of us.
In order to have the spare mental capacity to focus on practical problem solving and long-term goals, to actually enjoy life, we need to feel at least adequately emotionally stable. Things have been, are, and will be, hard. But we are not just what happens to us.
Victims of circumstance?
We’re not merely victims of circumstance. How we respond and what we do, even in small ways, can make all the difference.
So what are some small, inexpensive, evidence-based ways to cultivate wellbeing?
I’m going to talk about a few simple strategies in just a moment. But first I want to give a small caveat.
Sidestepping whatsthepointism
These methods are not necessarily ways of solving external problems. And as you know, high emotion tends to make your clients think in extremist, all-or-nothing ways. So you might sometimes hear your clients decry your suggestions with ‘whatsthepointism’.
What’s the point of relaxing, or getting out in nature, or seeing a friend? How is that going to solve my problems?
Well, if we have to reduce everything down to one clearly tangible point, then I guess we have to admit that no, relaxing every day isn’t necessarily going to shrink your mortgage repayments, or pay that whopping tax bill, or find you a job.
But it may save your health and have unexpected and unforeseen ripple effects.
If I can’t see a point, there is no point
To many 19th-century doctors in London, it probably seemed pointless for physician John Snow to map cholera outbreaks in the city. After all, what was the point of knowing where these outbreaks occurred?
But an unexpected pattern emerged: Snow noticed the cases centred around one particular water pump. And so it was discovered that cholera is a waterborne disease. Not long after, the theory of germs as a means of infection was developed.
My point is that the point of something may be hidden, or unexpected, or multifaceted. It may be a series of as yet unknown positive ripple effects. A single intervention can lead to a cascade and concatenation of effects. So how might you ‘sell’ the idea of regular mindfulness or relaxation to your client?
A beautiful cascade
Here are a few points you can offer in favour of regular relaxation. When we feel calm, we:
- feel better in general
- see further and wider contexts
- gain the spare mental capacity to compartmentalize problems so they don’t feel so all-consuming
- become better placed to problem solve because we regain a sense of hope, become more creative, and think more clearly.
- may experience improvements in immunity,3 blood pressure,4 cardiac health,5 and mental wellbeing.6
- are easier to be around and more accepting of others, which can improve our relationships.
So regular calm is an integral part of wellbeing. I’ve written before about cultivating wellbeing during the pandemic lockdown, but I just want to take the idea of ‘wellbeing’ a little further here.
The heart of the matter
‘Wellbeing’ is quite a buzz word at the moment – but what is the actual basis of wellbeing?
There is of course physical wellbeing, which is an important contributor to emotional wellbeing. In turn, emotional wellbeing helps us sleep, digest, and even move better.7 But let’s go a little deeper.
When we’re blocked from meeting our emotional needs, we tend to suffer. Conversely, when we meet them in balance we tend to feel happier. The extent to which we meet our primal emotional needs correlates strongly with our wellbeing.
But it’s not always that simple.
A perfect life but still depressed
We all know some people who thrive and stay resilient even amidst difficult lives, and others who seem to ‘have everything’ but are still anxious or depressed.
It’s not enough for your clients to simply externally meet their needs.
As well as seeming to meet our emotional needs, we need to feel that we are. Just as some people can eat healthily but have difficulty absorbing nutrients, some people, through past emotional conditioning, don’t feel safe or accomplished even when they objectively are.
It may also be that people who seem to ‘have it all’ are actually suffering from an unfulfilled need we have missed. For example, too much success, accomplishment, or security can interfere with completion of the very important need for challenge, which, for some people especially, is extremely important. Without challenge, life can start to feel meaningless.
So when we look at wellbeing, we also need to look at the personality of the unique client we’re helping. What needs or needs might be especially important for them to meet? For example, everyone needs some social interaction, but some people can naturally get by on a lot less than their more gregarious friends.
So when helping clients improve their day-to-day wellbeing, consider this.
What do they lack?
We all need, at least to some extent:
- to feel safe and secure day to day
- to give and receive attention with others
- a sense of some control and influence over events in life
- to feel stretched and stimulated by life – to avoid boredom
- to have fun sometimes and feel life is enjoyable
- to feel intimate with at least one other human being
- to feel connected to and part of a wider community
- a sense of privacy and time to privately reflect
- a sense of status, a recognizable and appreciated role in life
- a sense of competence and achievement, which correlates to self-esteem
- a sense of meaning about life and what we do.
So whenever you hear about some new technique or strategy, you might do well to consider which basic need or needs it can help to complete.
So where do we as practitioners fit into this?
Doing our jobs the best we can
Our job is to help our clients meet their needs for themselves as best they can. We can also help them to face difficult times that preclude them from currently meeting these needs adequately, and help garner hope that one day soon they will be able to meet them.
Another part of our job may be to help them absorb the reality of meeting needs. For example, when we help raise someone’s self-esteem or lower their anxiety, we are helping them feel the reality that they truly are able, or liked, or safe and secure. We help with their ‘absorption’, so to speak.
And of course, needs can overlap with one another. For example, meeting the need for intimacy may give a person a sense of meaning and safety and so on.
Now this isn’t an exhaustive list, but I’m just going to suggest a few activities that we can all begin to cultivate daily in order to increase wellbeing.
Practise mindful calm
Mindfulness – watching our thoughts without trying to control or banish them as we relax, and being ‘in the moment’ rather than projecting our imaginations into the past or future – has all kinds of potential benefits, from alleviating depression8 – presumably because it lowers stress and helps us get a handle on rumination – to slowing the effects of aging.9
I’d recommend aiming for at least 10 minutes a day of meditation or some other deeply calming activity. When we’re calmer, we feel safer and also gain a greater sense of control – two important emotional needs. And relaxing regularly can help re-tune the vagus nerve so that we feel calm more of the time.
You can teach your clients to relax and also view troublesome aspects of reality from the objective observing self part of their minds.
But it’s not just how we think and feel that affects wellbeing.
Move every day
Next, we need to move every day. Exercise, particularly morning exercise, has been shown to lift mood.10 And if it’s intense, it can also complete the fight-or-flight circuit, meaning we’re less likely to feel panicky.11 In addition, when we exercise, the hippocampus of the brain undergoes neurogenesis,12 a process that is naturally antidepressant.13
If all that weren’t enough, exercise also aids sleep,14 which is key to physical and mental health. Finally, exercise can help us feel some level of self-control and a sense of autonomy. I may not be able to control everything in life, but by exercising I can increase the sense of control I have over my body and therefore my mind.
So we can encourage our clients to move and be active, at least some of the time. If the concept of ‘exercise’ is too much for them, we can simply talk about ‘moving more.’
And where we move is important too.
Get out into nature
Encouraging our clients to regularly get out into nature or even some urban green space is an important part of cultivating wellbeing.
Research has found that being outside in natural surroundings increases markers of wellbeing such as mood.15 Evidence suggests it can even enhance immunity.16 It may be that breathing in airborne chemicals produced by plants (phytoncides) stimulates production of white blood cells, helping us fight off diseases and fungal infections.17
But your client doesn’t have to live in some rural idyll. A park or green space in a town can have similar benefits. Interestingly, research has found that two hours a week is the magic amount of time for wellbeing, and this holds good whether you go for a two-hour walk or run in natural surroundings once a week or break it down into daily chunks.18 I’d recommend getting out in nature every day if you can, even if just for a few minutes.
One thing you might also do is have your client hypnotically experience being in some natural place. When we envisage nature we may, perhaps, derive some of the calming benefits of actually being in nature.
Cultivate gratitude
It can be hard to see any positives when times are tough, but developing ‘positivity sensors’ in the mind, even in situations that may seem at first to carry no positives, greatly enhances wellbeing.
From Buddha to Cicero, many philosophers have celebrated gratitude. All the world’s great religions, including Christianity, Hinduism, and Islam, have at various times promulgated the idea that being grateful encourages reciprocal kindness and individual and collective wellbeing.
Research psychologists Dr Michael McCullough and Dr Robert Emmons studied the effects of gratitude on mental health and wellbeing in 700 people.19 Participants were divided into three different groups and asked to keep a daily diary. The first group kept a simple diary of events that occurred during the day, the second group recorded their unpleasant experiences of the day, and the third group made a list of things they were grateful for on the day. This last group was to literally “count their blessings”.
The results showed that gratitude exercises resulted in increased alertness, enthusiasm, optimism, and energy. The gratitude group experienced less depression, exercised more regularly, and made more progress towards personal goals. They were more likely to feel loved and respected. They even showed greater immune function and less physical illness!
As part of an overall strategy, writing down at the end of the day three simple things to feel grateful for can help focus the mind in such a way as to invite these wellbeing benefits into your life.
I once asked a client to notice things to be grateful for in her day. At first she wrote things like “Grateful I wasnt mugged today!” or “Grateful the house didn’t burn down!” But soon she began to notice a nice smile from a stranger, a small kindness here and there, or the way the light played on the trees in the morning. She began to look for, and therefore find, parts of reality to appreciate and therefore connect to.
It may seem that there is little to be pleased about or grateful for right now, but if our gratitude sensors sharpen up we can begin to see what before was hidden.
This next wellbeing enhancer cannot be understated.
Connect with others
Feeling a we, not just a me, is vital for wellbeing.
Research has found that wellbeing and even the rate at which older people mentally decline can be improved simply by socialising.20 But your client doesn’t have to become some social butterfly out partying every night (even if virus-related restrictions allowed!). Just making sure to have contact with people they like on a regular basis can help them hugely.
Socializing can help us focus outward, be creative, and simply laugh more (depending, of course, on who we are socializing with!) – and laughing is great for wellbeing too.21
So if your client can regularly and safely connect with others in these pandemic times, either in person or at least remotely, this will almost certainly help them.
Of course, when they do interact, focusing beyond themselves will not just help others but themselves too. And in no small way.
Engage in acts of kindness
Daily acts of kindness don’t just give others something small to be grateful for, they help you too. Research has found that people who regularly engage in acts of kindness are happier, age more slowly, feel less physical pain, and have more energy.22
Of course, gaining something for oneself shouldn’t be the reason for being kind – which brings us to why perhaps being kind helps us. Kindness helps us connect with others, but it also takes focus away from ourselves. I think that’s at the heart of the benefit of kindness. Also, feeling needed contributes to a sense of wellbeing. So kindness relates to multiple primal emotional needs.
Simple acts of kindness can include giving someone encouragement or a sincere compliment, giving time and effort to a charity, or helping out in any way we can.
Asking your clients how they help others, how they might help people, or how useful they feel can help us gauge what they might need more of.
Lastly, it’s vital to learn and challenge your mind.
Use it or lose it
A mind unused quickly goes to seed, as it were. We’re more likely to misuse our imaginations and worry when we’re understimulated or not focusing on real or immediate challenges.
What if this happens? What if that happens? OMG, what if the very worst happens? The mind is good at creating scary scenarios, especially when it is underutilised.
Reading, learning, doing courses, and thinking in solution-focused ways can all help the brain stay healthy, as can having meaningful conversations with other people. If we can encourage this in our clients, then all the better.
Now you may be thinking, yes, but my clients are too anxious or depressed or addicted to do these things! And yes, we may well have to help them relax, generate hope, and listen carefully to their narratives before we get to the point where we can encourage some of these behaviours. But the fact remains, ultimately every single person can benefit from understanding and utilizing these principles of wellbeing.
So these are just a few ideas for cultivating well being day to day. Mindful meditation or periods of deep calm in the day, daily exercise, getting out in nature, cultivating gratitude, regular socializing, daily acts of kindness, and challenging the mind all help us feel more able to cope and, dare I say it, enjoy life, even in these troublesome times.
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Notes:
- https://academic.oup.com/qjmed/article/113/10/707/5857612?login=true
- https://www.kff.org/tag/tracking-poll/
- https://journals.sagepub.com/doi/abs/10.2466/pr0.1987.61.2.623
- https://www.sciencedirect.com/science/article/abs/pii/0021968174900836
- https://www.jstor.org/stable/40966154?seq=1
- https://www.gatewaypsychiatric.com/pdf/0698042B.pdf
- https://link.springer.com/article/10.1007%2Fs10902-006-9042-1
- https://www.mindful.org/how-mindfulness-may-change-the-brain-in-depressed-patients/
- https://www.tandfonline.com/doi/full/10.1080/13554794.2020.1731553
- https://www.health.harvard.edu/mind-and-mood/more-evidence-that-exercise-can-boost-mood
- https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22043
- https://www.frontiersin.org/articles/10.3389/fnins.2018.00052/full
- https://www.nature.com/articles/tp2012141
- https://journals.sagepub.com/doi/abs/10.1177/1559827610375532
- https://pubmed.ncbi.nlm.nih.gov/22320203/
- https://www.sciencedaily.com/releases/2015/09/150916162120.htm
- https://www.researchgate.net/publication/41027513_Effect_of_Phytoncide_from_Trees_on_Human_Natural_Killer_Cell_Function
- https://www.newscientist.com/article/2206249-two-hours-a-week-spent-outdoors-in-nature-linked-with-better-health/
- https://greatergood.berkeley.edu/pdfs/GratitudePDFs/6Emmons-BlessingsBurdens.pdf
- https://www.sciencedirect.com/science/article/abs/pii/S0277953614005632
- https://www.webmd.com/sleep-disorders/news/20060921/socializing-may-boost-sleep-needs
- https://pubmed.ncbi.nlm.nih.gov/24280475/