Dealing with Uncertainty in a Coronavirus World

Abandoned water oark in winter coronavirus

Attractions are deserted; streets are quiet. These are strange times.

It’s nearly impossible to make plans at the moment, after months of uncertainty and confusion.

How can we cope when things are up in the air, and our routines and goals have changed?

Focus on the things you can predict or manage, sensibly

It’s hard to regain a sense of control or autonomy when it feels like everything is out of your hands – where you can go, who you can meet, and much more. For key workers, life in a pandemic seems like a treadmill of constant shifts; for those who now work from home, it’s harder than ever to separate work life and home life. Everyone is struggling to plan for the future, because of the uncertainty.

Now is the time to look at the things you can predict and rely on. Wherever you live, there are ways to engage with nature: sunrises, sunsets, falling leaves, frosty walks (if you aren’t shielding), and splashing in puddles. The seasons will change, regardless of world events. Those of you without green space or the means to enjoy it can take comfort from a recent scientific study by Exeter University that found viewing nature on TV can be hugely beneficial for mental health, boosting mood and reducing negative emotions. Why not take it further and look up some webcams in nature reserves or coastal resorts?

As the seasons change, so does the calendar, and every week or month contains charity awareness campaigns that you can get involved in. There may well be a cause you can relate to personally, or that resonates with family and friends. You could donate money or goods, promote it on social media, or share your skills with the charity.

Have back-up plans ready

It’s easy to catastrophise when future plans aren’t fixed. What happens if you can’t work? What if your landlord wants to sell your home? What if you split up with your partner? You can be plagued by ‘what if’ scenarios, particularly during a pandemic, but simply challenging that annoying critical inner voice can work wonders. Look at the situation honestly and realistically, and think about the alternative options.

Let’s say you’re worried about losing your job, if the company goes bust or you are made redundant due to coronavirus. Millions of other people around the world are in a similar position, and redundancy isn’t a black mark on your CV. There’s no point filling in job applications just yet (unless you want to change jobs), but you could update your CV every quarter just to be on the safe side, so it’s ready to go if something does happen. You could even research recruitment agencies in your area that deal with your industry, or think about other industries where your skills could also be valued.

Next, look at your monthly outgoings, to set aside some money for a rainy day. Check your direct debits for forgotten subscriptions, and check your bank statements to see where you’re splashing out on non-essential items. You’re still allowed to treat yourself, but you now know some quick ways to cut expenses if needed.

Put things into perspective

Coronavirus has changed every aspect of our lives, and it’s become near-impossible to plan those big events like weddings, holidays, baptisms and Bar Mitzvahs. The regulations seem to change month by month, so those lavish gatherings will either turn into smaller affairs or they won’t happen at all. Yes, it’s sad and frustrating and often expensive, but a little perspective can really help.

Weddings, ceremonies and parties can always be rearranged in happier, safer times, but funerals cannot be postponed indefinitely. Losing a loved one is painful enough, but losing them during a pandemic is truly heart-breaking; you can’t physically comfort someone beyond your support bubble with a hug or a touch of their hand.

How can we ever forget 13-year-old Ismail Mohamed Abdulwahab, who died of coronavirus in March 2020 and whose family were forced to miss the funeral and self-isolate? Ismail’s relatives had to watch a live-stream of the service, and say goodbye virtually to the son and brother they loved; a boy who wouldn’t grow up to get married himself. If you’re mourning the loss of a wedding venue deposit or a honeymoon package, remember to think of the bigger picture.

Start a gratitude journal, or a gratitude list

This may sound a little Pollyanna at first, but keeping a gratitude journal has been scientifically proven to help improve your mood and resilience. It doesn’t have to cost anything – you could just write on pieces of scrap paper if needed, or scribble notes in your work diary – or involve a huge amount of text, but the aim is to list a handful of things you are grateful for each day.

Your list might sometimes be quite basic at the most difficult times: ‘I’m healthy’; ‘My family and friends are safe’. Sometimes it revolves around activities, however small: ‘I watched a documentary on TV’; ‘Found some reduced cake in the supermarket’; ‘Sat outside for half an hour with the sun on my face’.

On other days, your list might be more in-depth: ‘I’m happy for my friend who finally got a promotion, because he has worked really hard. Talking to him about it has inspired me to ask for a promotion, too’; ‘Though I was sad at first when I put on weight during lockdown, I’ve now realised it’s part of adjusting to the new normal. I’m not going to punish myself for eating more, or having less time to exercise in these circumstances. I am just happy to be okay’.

Lastly, if you are really struggling, don’t keep it to yourself. Talking therapy can help you cope with the uncertainty, and what you say will be kept in confidence. There are many different types of therapy, from short-term options like Solution-Focused Therapy, to more long-term treatments.

Talking to a qualified therapist can be as easy as arranging a video call, so you don’t have to leave home to have your therapy session. Contact Christine Tizzard Psychology to arrange your consultation with one of our therapists.

Written by guest contributor Polly Allen for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

Poor Mental Health Considered ‘Normal’ for Older People, According to New Report

Elderly Asian lady with headscarf and glasses, wearing jumper

We need to better understand older people and their needs.

A new report from charity Independent Age, called Minds that matter: Understanding mental health in later life, has revealed the national picture of mental health in older people.

1 in 4 people believe that poor mental health is a normal part of getting older.
Roughly 1 in 10 people in England aged 56 and over will have moderate to severe anxiety or depression. This translates to 1.2 million people.
Only 13% of those aged 65 and over believe that older people are represented in mental health-related marketing campaigns.
Nearly 1 in 10 older people will develop complicated grief after the death of a loved one. Those who have suffered a bereavement are up to four times more likely to experience depression than older people who haven’t been bereaved.

However, the report did highlight the positive experiences of many older people who had talking therapy, such as CBT or counselling, for mental health issues. It found that 54% of older people were aware of talking therapy.

The report drew attention to the range of barriers that prevent those aged 65 and over from being part of the NHS’ Improving Access to Psychological Therapies (IAPT) programme, such as long waiting times and a lack of choice in the type of therapy offered.

At Christine Tizzard Psychology, we know that each person has their own treatment needs, and talking therapy must be tailored to fit them. Giving a client a one-size-fits-all solution isn’t the way forward, nor is a long wait for treatment. If the gap between treatment being needed and actually beginning is too great, the client can deteriorate and they may need a more complex intervention.

Independent Age also drew on earlier research, called In Focus, which explored the difficulties that may add to an older person’s poor mental health. In Focus found that older people with severe depression or anxiety were more likely than their peers to:

Care for someone for 35 hours a week or more, or be receiving care themselves.
Live in housing that needs repairs or maintenance work, such as damp-proofing and insulation to keep warm in winter.
Be in financial difficulties or on low income.
Face limitations in what they can do, due to physical health problems.

This is understandable; living conditions and healthcare needs (or caring responsibilities) will naturally have an impact on mental wellbeing. In turn, mental health issues can also affect how much you can do around the house, your finances (for example, compulsive spending, difficulty managing money, or struggling to pay bills on time), and your physical health.

Many people have physical symptoms of mental illness, from tension headaches to stomach cramps. Add this to the physical consequences from living in a home that needs major repairs or maintenance – for example, damp problems exacerbating asthma or lung conditions; poor insulation triggering colds – and the physical signs of ageing, and it’s no wonder older people might struggle to manage their moods and wellbeing.

Talking therapy is just one part of the solution, but it’s an important pillar for anyone struggling. Some over-65s may feel it is too late to change their mindset, condition or behaviour, but the right therapy can safely help them address issues, no matter how deep-seated.

Another benefit of private therapy is the lack of limit on appointments, whereas NHS models are tied to a fixed number of sessions for each patient; the Independent Age report mentioned ‘the negative impact of only being offered a small number of sessions’. If something takes longer than expected to unpick, it isn’t a problem in private therapy, as long as the patient is still available and open to treatment. When the number of sessions is low and cannot be changed, it is harder to explore the whole picture.

Managing mental health is an ongoing process, and so is each person’s treatment plan, regardless of age or circumstances. There is always time for older people to seek help, and there are people ready to listen.

Ways to Self-Soothe When You Have Intense Anxiety

Don't Panic message - tips for managing anxiety

How can you get to the stage where you don’t panic? Read on.

We are living in a particularly anxious time as the coronavirus pandemic unfolds, and it is understandable that many people will find themselves managing anxiety about their health, job, home, and other issues.

Whether you’ve got a long history of anxiety or you are experiencing it for the first time, there are things you can do to deal with intense anxiety.

Give yourself a butterfly hug

It may seem strange, but wrap your arms around yourself (cross them as if you’re trying to touch the back of your shoulder blade with the opposite hand). Close or partially close your eyes. You then move your arms as though they are butterfly wings, freeing your hands, whilst breathing deeply; you can tap your arms, shoulders or knees to create a rhythm to focus on. Any thoughts that you have during this time should be treated as fleeting thoughts: you can acknowledge them, but let them pass by.

This action has proven psychological benefits through what is known as bilateral stimulation, and it is a technique often used in EMDR therapy. You can teach people of all ages, including children, the butterfly hug. It was developed in the late 1990s by therapists working in disaster zones, as a way to treat survivors of trauma.

Ground yourself in your environment

Focus on your senses – for example, touch the different textures around you, whether that means a soft scarf, a woven cushion, a leather bag, or a brick wall. Seek out a cold sensation from ice cubes, cold water, or something fresh from the fridge, like berries; alternatively, if you crave the comfort of heat, use a hot water bottle or have a hot shower. Feel the gradual flow of that new temperature and breathe deeply.

Use your hands or feet to slowly grip and release objects, or just clench and release your fists. Feel the ground beneath your feet (or the chair underneath you if you are sitting down). Feel the weight of your body on these surfaces and acknowledge you are anchored to them right now. You may want to tune into the noises, but don’t do this if the noises are causing you stress – you need to tune out of them instead, which we’ll cover next.

Cut excess noise or awkward silence

Drown out stressful sounds, or fill the void when total silence makes you anxious, by developing your own playlist of helpful sounds. This could involve listening to music, podcasts or the radio, or even using a white noise machine, which produces basic sounds that you play over the top of a distracting sound to help your brain block it out (you can also get white noise playlists on YouTube and Spotify).

Noise-cancelling headphones will help, too. Sometimes you might not want to listen to anything, but just use the headphones to turn down background distractions. If a particular noise is triggering for OCD or PTSD, this is something you can work through with a therapist. In contrast, if you feel hypersensitive to all noise, it’s worth visiting your GP.

Look at photos or artwork you enjoy

Focusing on positive, funny or poignant images can help when anxiety hits. Keep a selection of photos stored in a specific album on your smartphone (call it something like ‘Uplifting’ or ‘Distraction’), or keep printed versions in your purse. It doesn’t matter how weird or wonderful your uplifting images are – personal photos, internet memes or cartoon cats – because they’re only for you to see. Sometimes just looking at these images can interrupt the ruminating thoughts that fuel your anxiety.

You can also personalise your workspace to varying degrees, depending on what your job is and what the regulations are. Framed family photos are a step too far for many employers, but you can pick a computer screensaver and wallpaper featuring your favourite artwork (as long as it’s nothing offensive or explicit), or perhaps get a custom-made photo print mug to drink your morning coffee from.

Get a pet, or borrow one

If you’re lucky enough to have a pet, you’ll know they can boost your mood and keep you company. Creatures with fur, like dogs, cats, rabbits and guinea pigs, are particularly soothing (as long as they’re well-trained!); even the act of stroking their fur will relax you. Not having the space, time or money to look after a pet doesn’t mean you have to live an animal-free life; schemes like Borrow My Doggy allow you to take someone else’s dog for a walk, or you could volunteer at an animal shelter or charity.

Some pets are specially trained as therapy animals to help people with anxiety and a range of other conditions. Hospices have also been known to host therapy animals so their residents and day patients can spend time with furry friends. Meanwhile, at Christine Tizzard Psychology we have an autism assistance dog called Gus, who helps us during autism assessments.

Written by guest contributor Vikram Das for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

Covid-19 Virtual Assemblies: An Important Factor in Children's Mental Health

As lockdown continues, children’s moods are lowering

Pupil having online lesson on laptop from home

Online connections are important for children’s mental health.

A recent webinar, From surviving to thriving, was held by our sister organisation, Lighthouse Psychology. It was set up to help parents speak about challenges that they might be facing since lockdown measures began. The webinar also provided a forum where possible solutions to identified difficulties could be explored.

The most significant issue that parents reported was a gradual lowering of their teenagers’ mood over the last few weeks. Mood dips have been accompanied by a reduction of their children’s motivation levels, particularly for school work. This loss of motivation is very closely linked to a loss of connection with their friends.

At first glance this is confusing; it’s fair to say that older children and teenagers have never been better connected due to all the social media platforms available to them… but therein lies the problem. Communication via WhatsApp, FaceTime and Messenger does not work for any sustained period. It is fine as an addition to normal contact with friends, but in isolation it is not enough.

The information provided by parents also resonates with psychologist and therapist observations at CTP and Lighthouse Psychology. Older children and teenagers are feeling a sense of disconnection and loss. As one teenager put it, “We have a laugh on WhatsApp”, “It’s a bit of craic”, ” We are not being ourselves, they don’t see the real me”. It is clear that normally many childhood and adolescent woes are discussed face to face or between several friends. This happens informally while they are engaged in other activities.

Peers are vital. Peers provide a frame of reference; a mirror if you will, a mirror where the emerging self is reflected back. This is an important process in identity development. It might seem dramatic, but consider this: children are beginning to feel a profound sense of disconnection and loss. The necessary confines of lockdown have, for many, led to a sense of isolation and confusion about their identity.

How to help children’s moods in lockdown

A very interesting finding described by one of the participants was this; her son’s community college have been providing a weekly assembly via Zoom; this has been a weekly lifesaver. Pupils groups are able to visually see each other on the screen, for a few minutes. The cohesion of the group, albeit virtually, provides a sense of normality. Importantly, pupils can wave and gesture to each other for a few seconds before the assembly starts.

The children are able to see that their friends are well and coping, and this simple arrangement becomes a focal point in their week. It’s an easy and brief rejoining of the ties that define them. Virtual assemblies cannot span the void but they are able to provide a little more support at this difficult time. Congratulations to those schools who are already doing this – the boost to mental health and motivation is immense.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, Clinical Director of Christine Tizzard Psychology and Lighthouse Psychology Ireland.

Parentification: What is it, and how can you help a parentified child?

Child looking at play house parentification — Some children don’t get to ‘play house’ – they end up running the house, and taking on adult-level responsibilities.

When a child is forced to take on the parental role by their own mother or father (and not as a recognised young carer in cases of parental illness), we call this parentification.

The term was coined by psychiatrist Ivan Boszormenyi-Nagy, one of the founders of family therapy as we know it, in 1965, and expanded upon with psychiatric social worker Geraldine M. Spark. Later, psychiatrist Mara Selvini Palazzoli, one of the founders of Milan systemic family therapy, wrote about parentification in the 1980s.

In 1997, Gregory J. Jurkovic published Lost Childhoods: The Plight of the Parentified Child, where he explored many different case studies, such as that of seven-year-old Jenny, ‘serving as her mother’s confidante, dutiful helper, and primary source of support. She often advised her about relationships, finances, and major purchases. Jenny also assumed considerable responsibility for her half-brother’s care.’

Types of Parentification

Parentification can take two different forms, or be a combination:

Instrumental parentification sees the child take on practical parenting tasks that should not be a child’s responsibility, such as paying household bills or looking after their siblings.

Emotional parentification sees the child consulted like a therapist or confident by the parent, discussing deep emotional issues or decisions that should not be their responsibility.

In either situation, the child doesn’t have a ‘normal’ childhood, as they are made to grow up very quickly and without the emotional and practical support that a parent should give them.

The boundaries and safety involved in good parenting – setting bedtimes, age-appropriate games and chores, rewards for good behaviour and progress and telling them off for bad behaviour – are absent. The child is forced to create their own structure and boundaries and feels the burden of responsibility at an age where they should be growing and learning at their own pace.

Their schoolwork and friendships will inevitably suffer under the strain of this role as the default parent. It is hard to relate to peers with ‘normal’ childhoods, and cope with a busy school day on top of adult-level home responsibilities.

However, they may struggle to speak out about what’s happening at home, especially if it’s all they’ve ever known. They often feel guilty for not doing ‘enough’ to solve a parent’s problems, but they should not be held responsible.

Representations in Books and Films

You might recognise stories of parentification in fiction, such as:

Book: The Illustrated Mum
Jacqueline Wilson introduces us to Dolphin (known as Dolly) and her older sister Star, who live with their vulnerable mother. Star is frustrated at being a parentified teenager and resents having to care for Dolly whilst trying to be independent and experience life as a ‘normal’ teen. Dolly also feels the loss of her absent father and she is struggling at school because of her chaotic home life.

Book: Sal
Mick Kitson’s novel is a coming-of-age story about a teenage girl and her younger sister, terrified of their abusive stepfather and alcoholic mother. Whilst the sisters’ actions are extreme – running away to the Scottish Highlands – their feelings are not, and Sal’s interest in survival skills creates an interesting parallel with her situation.

Film: What’s Eating Gilbert Grape?
The character of Gilbert Grape (played by Johnny Depp) is forced into a parental role, as his father and older brother are absent. He is left to care for two family members with complex needs, and his older sister also adopts a parental role, effectively becoming a housekeeper.

Patterns of parentification may come from the parent’s own past experiences, such as a traumatic incident that continues to affect their everyday life, or a sense of unfulfillment from their life before having children. The parent can become co-dependent on the child as a result.

Addiction and Parentification

Parentification can sometimes be the result of a parent’s addiction issues, as explored in this article from The Atlantic. Until the addicted parent receives treatment or the child can be parented in a different environment, the imbalanced relationship will continue.

Addiction is an illness and not a choice; the parent may not be able to see the damage they are doing, but it is not safe for a parentified child to be the caregiver for someone in the grip of addiction. It may take a long time for everyone involved to acknowledge this. Fortunately, there are some brilliant charities supporting the children of those with addiction issues, such as NACOA and Al Anon.

Moving into adulthood, a parentified child can sometimes continue to form difficult relationships with friends and partners; it may be that they subconsciously seek out others who need to be taken care of, or that they seek out someone very dominant and controlling who won’t meet their emotional needs, because their childhood has been shaped by having those needs left unmet. Their sense of self-worth can be very poor.

However, the cycle can be broken – a parentified child can heal the wounds of their childhood with talking therapy. Each case is individual, but your treatment may include Cognitive Behavioural Therapy or possibly EMDR in cases of Post-Traumatic Stress Disorder (PTSD).

If you have been a parentified child, remember that:

Your value is not dependent on how much you help a parent.
Whatever they say, you are not responsible for your mother or father’s happiness, or that of any siblings.
Forgive yourself for any feelings of guilt or anger.
Spend time discovering your sense of fun and play.

You may have spent years or decades putting others first, but it’s time to put yourself first. Help is out there, and talking therapy can make a huge difference to your outlook.

Coronavirus - How to Reduce Anxiety in Your Child

How do you explain Coronavirus to children? We have some useful tips.

It is a fact that many of us are genuinely concerned about Coronavirus – this is normal and understandable.

Many of our children are worried too, and their worry increases when they see we are anxious. This is because children look to us to feel safe. When parents or teachers act scared (and it is natural to be scared), children pick up on that fear.

Often, in a well-meaning attempt to prevent children from feeling scared, parents will ‘’play down’ the situation or worse, dismiss the child’s anxiety. Doing this, however well-meaning the intention, will cause a large spike in the child’s anxiety.

Following a dismissal or denial of their fears, children often feel totally unable to share their anxieties in the future. This invariably leads to greater misery and occasionally longer lasting problems. The good news is this can easily be prevented.

These simple tips will help you explain to your child the reality of the Coronavirus, and reduce their fear level.

For children with autism, a longer period of explaining will be necessary. It is a good idea to develop a social story to illustrate the information that you are trying to get across.

Find out exactly what they know about Coronavirus

Children are sponges – they hear the news and they see the front page of newspapers. What they don’t know, they often make up. It is important that you ask them exactly what they know about the Coronavirus. School playgrounds are awash with information – much of the information is wrong, exaggerated and concerning.

Checking out what they think they know is the first step to reducing their anxiety level.

Age-appropriate honesty is best

It is really useful that you explain to your child the facts as we know them, but at a level that is appropriate to their age. Tell them that the virus started a very long way from home in Wuhan, China. Explain that the virus has made many people sick; hiding the truth usually backfires.

Say that the virus has spread so quickly because China is a very populated area with crowded cities and transport systems. You can explain the concept of close contact and how disease spreads. Do this in an age-appropriate and matter-of-fact way, and stress that the UK and Ireland are many thousands of miles away from China and separated by oceans.

It is important to say that there are cases in other countries and in the UK (remember the honesty bit) but tell them that doctors in the UK and Ireland are highly trained and very well prepared to deal with the cases that have or may have entered the country.

If kids are old enough, explain how intensive care works. Talk about Hazmat suits and how they work. This normalises a scary concept and develops a ‘peg’ on which to hang this and further updating knowledge.

Help them feel in control

Tell them that the virus is really low risk to them. Do emphasise the need for good hand hygiene and robust cough and sneeze discipline. Children also feel better when they feel a little more in control. By engaging in actions that are helpful, they will feel empowered rather than useless and out of control.

If you provide this information in a ‘matter of fact’ way, children will not be so alarmed. They will know you that you feel in control (even if you don’t feel that way).

It’s important to say that people who are weak, unwell or both are more at risk. Do stress that doctors and nurses have hospital beds ready to help people breathe if breathing becomes hard for them, and that a hospital has been specially built for patients in China. You can say that some people who are already weak may die, but that the children around you are strong and that they live very many miles away from any cases.

What you are trying to do is ensure that children have good information, give them perspective and above all let them realise the adults are dealing with it. Always provide the worst part of the story first, followed by the optimistic part.

Children panic when they see us panic

However scared you may be, and most of us are, try to speak in factual terms rather than emotional terms. Use the same voice that you would use when you say “dinner’s ready” – just matter-of-fact.

If you child persists with questions, calmly continue the conversation in an age-appropriate way. Remind them we can take steps to stay in control, be sensible with hygiene, and keep as healthy as possible, and that they don’t need to wear face masks.

Encourage autonomy

It is really important to let your child know that they too can prevent any spread of the virus. Tell them about hand washing for hygiene, and teach them to sing ‘Happy Birthday’ twice while hand washing. Tell them about covering their mouth when they cough and sneeze into the inside of the elbow if no tissue is available.

These things make them feel in control, which ultimately reduces fear. They’re also useful precautions in a normal cold and flu season.

Information for Teachers on Coronavirus

It is crucial for the psychological health of the children that they all have an age appropriate understanding of Coronavirus. This needs to be covered in school.

We recommend the information is conveyed by a form teacher during registration, and it can be adapted according to the students’ ages. Time should be given for children to ask questions.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk) and Lighthouse Psychology Ireland.

Trauma therapy is “the best gift I ever gave myself”, says stalking survivor

Stalking survivor anonymous — Being stalked can feel like losing a part of yourself. Credit: Giovanni Calia via Pexels.

Nicola Roberts, the singer-songwriter, actress and entrepreneur best known for being in the pop group Girls Aloud, has spoken out about her experience of having trauma therapy as the survivor of a stalker.

Speaking to the Guardian, Nicola described trauma therapy as “the best gift I ever gave myself”, after her five-year ordeal of being stalked by an ex-boyfriend.

Stalking is defined by charity Women’s Aid as ‘a pattern of persistent and unwanted attention that makes you feel pestered, scared, anxious or harassed’. The Suzy Lamplugh Trust expands on this: ‘if you are receiving persistent unwanted contact that is causing you distress but the person has never threatened you, this is still stalking and is not acceptable.’

Examples of stalking behaviour include sending gifts, unwanted communication, following someone or spying on them, damaging property, making threats of violence, or committing assault.

The Suzy Lamplugh Trust continues: ‘Stalking often has a huge emotional impact on those it affects. It can lead to feelings of depression, anxiety and even post-traumatic stress disorder [PTSD]. It can be a psychological as well as a physical crime.’

A new court order, called the Stalking Protection Order (SPO), will apply from Monday 20 January 2020, allowing police in England and Wales to prevent suspected stalkers from contacting their victims for two years. It can also be imposed as an interim order whilst a decision is being made about a potential perpetrator. The SPO can include making the suspect take a rehabilitation course or complete a mental health assessment. It is a criminal offence to breach the SPO.

Nicola was stalked from 2012-2017, and during this time she received 3,000 messages on social media from her former boyfriend, including threats to burn and stab her. As part of his campaign of harassment, he created 35 fake social media accounts to bombard her on Twitter and Instagram. He also sent her flowers, and began threatening one of her friends. Their relationship, which lasted 18 months, ended in 2008.

A lifetime restraining order was imposed in 2017, banning her ex-boyfriend from contacting her and her family and banning him from being within 250 metres of them. However, her stalker ignored the restraining order just months later by following Nicola on Instagram. The Criminal Prosecution Service decided not to prosecute, despite the restraining order being broken.

Newsreader and presenter Emily Maitlis is another high-profile victim of stalking, having been pursued for 25 years by a man she met at Cambridge University. Emily’s stalker was jailed in 2018 for breaching a restraining order against her, imposed in 2009; he then breached the order again in 2019 by sending two letters to her mother.

In an interview with BBC Radio 5 Live, Emily spoke out about the long-standing harassment and intimidation she has suffered, comparing the effects to that of a “chronic illness”, and stating that she doesn’t believe the criminal justice system will prevent her stalker taking action.

Recent statistics of stalking in England and Wales show that:

Almost one in five women and almost one in 10 men aged 16 and above have been victims of stalking.
Up to 700,000 women are stalked each year.
Though stalking is not exclusively carried out by men against women, 80% of stalking victims are female, and 70% of perpetrators are male.

In a pilot study by Sussex Stalking Support and the National Centre for Cyberstalking Research at the University of Bedfordshire for National Stalking Awareness Week 2019, it was revealed that 8 out of 10 stalking victims had symptoms of PTSD.

Trauma therapy can help stalking victims unpack their feelings in a safe environment. Legal proceedings against stalkers are long, complex and frustrating, with complainants often left on edge and vulnerable. Talking to a therapist means the victim has a non-judgemental space where they can restore their confidence and learn to process what has happened.

Nicola Roberts says of trauma therapy that “it’s just changed me in the most amazing way, for ever”, which really sums up what this psychological approach can do. Therapy cannot erase what’s happened, but it can help victims manage the emotional turmoil and painful memories.

If you are the victim of stalking and you need advice, please contact the National Stalking Helpline on 0808 802 0300. If you feel you are in immediate danger, please call 999.

Your New Year’s Resolution: Learn to Say ‘No’ and Stop People-Pleasing

Saying no — ‘No’ can be a powerful word.

At the end of 2018, one in five British people made a New Year’s Resolution (according to YouGov). However, resolutions are notoriously hard to keep, and many people ditch theirs by the time February rolls around.

One of the most fulfilling resolutions you can make at any time of year, but particularly heading into 2020, is to say ‘no’ more often. Say ‘yes’ to the things you want to do and can do, but stop getting stuck in the people-pleasing trap.
People-pleasing can feel addictive because you make others happy, and you often end up solving their problems, but it isn’t healthy, so that’s why you need to change your outlook.

Mental Health Risks of People-Pleasing

From a young age, we are taught that putting other people’s needs before our own is admirable. There’s nothing wrong with being empathetic, but constantly putting yourself last is actually very damaging. You may find yourself trapped in toxic relationships, burned out, or plain miserable.

People-pleasers typically have low self-esteem – much of your personal value will be measured in your relationships with others, and in the fear of being alone or rejected.

By being a ‘yes man’ or ‘yes woman’, you hope it will keep you in everyone’s good books, and you’ll feel rewarded. In contrast, you may struggle to ask for favours, help or commitment from others, afraid of being too demanding. This puts you at a disadvantage in your relationships and forces you to place little value on your own happiness.

When you say ‘yes’ to everything, you flood your calendar and to-do list and you make it impossible to prioritise. Any sense of order or priority is fleeting; it will only last until the next favour is asked, when everything is thrown into disarray to make room for it. Your physical health will also be compromised by such a packed schedule.

The Benefits of Saying No

By turning down commitments you know you’ll resent, dread or struggle with, you are empowering yourself. You will begin to build stronger and more equal relationships.

Downtime is just as important as busy or exciting times. Your mind and body need to rest, and this can’t happen if you’ve overcommitted yourself. Without downtime to compensate, you can’t perform at your best.

The temptation to say ‘yes’ can often be wrapped up in the expectation that you will get something back – for example, money, attention, affection, favours in turn, or loyalty. In practice, there’s no guarantee you will get anything back from the arrangement. Remind yourself that any promised advantages might never happen.

Friendships and relationships shouldn’t be based on favours and transactions. People should spend time with you because they like you, not because of what you can do for them.

How to Say No

Start with low-risk scenarios – say no to that last drink in the pub, or to cleaning up your teenager’s kitchen mess at home. Don’t start with something huge.
Practice in the mirror to boost your confidence. You can even have a ‘script’ if it helps. For example: “Thanks for the invitation to your hen party! I can’t make it, but I really hope you have fun.”
When faced with someone who doesn’t like being turned down, you could give a specific reason whilst you’re getting used to being assertive. Equally you could answer: “I can’t go into the reasons why, as they’re quite complicated, but I definitely have to say no.” The more you practice saying ‘no’, and apply it in real life, the more you can move towards not needing a reason at all.
Remember there are only 24 hours in a day, and most of those have to be spent working, sleeping, and managing basic tasks you couldn’t avoid even if you tried. The amount of time you have to yourself is precious, and you cannot claw time back from working or sleeping without serious consequences. You will never be able to do all the things you’d like to agree to, let alone the things you don’t want to do but feel obliged to take on.
If you’re guilty of saying ‘yes’ in the moment, only to regret it later when you weigh up the effort or stress involved, take a step back. Tell the person asking that you cannot decide without checking a few things in your calendar first, and you will give them an answer later. However, if you already know the answer is no, why prolong it?
Try to separate the person from their demand: saying you cannot do your friend a favour does not mean you are rejecting their friendship or trying to make life difficult for them.
Be mindful that saying no will feel harder if the person you turn down is battling issues of their own. If they get upset or offended, they might be taking out external stresses on you. Their own mental health issues, such as Borderline Personality Disorder, may also add complications and make you feel guilty about saying no. This doesn’t mean you should reverse your decision.

Take these tips into 2020 and feel the power of saying ‘no’.

45% of Young Workers Don’t Speak Out About Mental Health Problems

Working woman mental health — Are you putting on a brave face in the workplace?

A new survey has revealed the state of workplace mental health in the UK, particularly amongst young workers aged 18-30, and has found that 45% of young workers don’t feel they can express their mental health problems.

Furthermore, 48% of workers aged 18-30 have experienced suicidal thoughts. This statistic is particularly shocking, especially when coupled with the knowledge that young people are struggling to talk about poor mental health in general, as early intervention could prevent someone’s negative thinking patterns progressing to suicidal thoughts or ideation.

The survey of over 2,000 working people, conducted by Accenture for workplace mental health conference This Can Happen, shows that discussing mental wellbeing still feels taboo for many employees.

Amongst the other findings:

85% of workers have a close friend, family member or colleague who has experienced mental health issues.
76% of workers said mental health problems – their own, or those of someone close to them – had affected their ability to enjoy life.

The survey revealed that, despite the growing awareness of mental health as an issue for employers, the culture for discussing and supporting wellbeing had not necessarily changed in recent years.

27% said employees in their workplace spoke more openly about mental health than in the past.
20% had seen more workplace training offered to help them self-manage mental health issues.

This begs the question: what are employers not understanding about their professional and ethical responsibilities towards the workforce?

With work making up such an important part of our lives and our routines, the mental health policies and attitudes of employers can make a real difference to our wellbeing.

However, there were some positive statistics from the survey, particularly around supportive workplaces:

81% of those who discussed their mental health problem at work had a positive reaction, such as empathy or kindness, to speaking out.
31% of those who spoke out about their mental health problem at work said it helped them move towards getting help.

If you’re worried about discussing a mental health issue in the workplace, take a look at our blog post for advice.

Whatever kind of mental health problem you are facing, it’s important to reach out to somebody. Whilst not all workplaces will offer you the kind of support you need, please don’t suffer in silence. Talk to someone you trust – a relative, a friend, a neighbour or your GP, and take the first steps to dealing with the problem. If your concerns are dismissed, try again with another person you trust. It does not mean your problem isn’t valid.

Getting professional talking therapy will help draw out the issues at hand, in a safe and supportive environment. In your initial consultation, a psychologist will work with you to understand the mental health struggles you are facing, and they can recommend the best therapeutic approach – this could include popular treatments like Cognitive Behavioural Therapy or Solution-Focused Therapy (a fantastic option for anyone short on time).

Making Sense of Avoidant Restrictive Food Intake Disorder (ARFID)

Picking food in the supermarket — People with ARFID struggle to increase and vary their food intake.

A very distinctive eating disorder, Avoidant Restrictive Food Intake Disorder (ARFID), made the headlines recently when a British teenager lost his sight as a result of malnutrition from his ARFID-induced diet. The boy was only able to eat chips, crisps, processed ham, sausages and white bread, because of the condition that limited the range of food he would eat without distress.

ARFID was previously known as ‘selective eating disorder’ but has now been renamed. It represents a very specific type of eating disorder – unlike conditions such as anorexia or bulimia, a patient with ARFID is not trying to lose weight or change their body shape. They simply cannot tolerate certain foods, either because of past experiences, phobias, a disinterest in eating, or a sensory issue.

Their eating habits become so restrictive that they cannot take in enough calories or nutrients to keep their body functioning at a basic level or, if they are a young person, to help them grow, which is where ARFID can sit alongside or coexist with other eating disorders.

ARFID can particularly affect children. You may notice they aren’t growing very much in height or weight, and that they are distinctly nervous around food or they take no interest in eating.

This nervousness is different from the common food journeys that all children go through, such as fads with certain types of food, and being unsure about new flavours until they are introduced gradually. Children can be picky eaters, but they will generally outgrow this – think of all the things you didn’t used to eat when you were young, and how your taste expanded over time.

Symptoms of ARFID

Restricting the different textures of their food – for example, only crunchy or only soft foods.
Their list of edible foods becomes shorter.
Worries about choking on food, or a fear of being sick (emetophobia).
Constant stomach pain – this can include cramps, constipation and acid reflux.
Feeling cold all the time.
Weight loss, and slowed or stunted growth in children.
Low energy, and sleep issues.
Feeling dizzy or faint on a regular basis.
Poor immune system.
Dry skin and nails.
Thin hair on the head, sometimes with a fine layer of excess hair (lanugo) on the body.
Women and girls may find their periods are irregular or that they stop altogether.

With ARFID, a child’s picky eating is much more ingrained, and it will intensify. Their condition can often coexist with a diagnosis of anxiety, or even with autism spectrum disorder. A restrictive diet is particularly common in children with autism, but this can persist into adulthood. In fact, as many as 20% of people with a diagnosable eating disorder (not just ARFID) could also be classed on the autistic spectrum.

People with autism are affected by sensory disturbances and overstimulation. This is, of course, carried into eating and drinking, so flavour, textures, colour and packaging can all have an impact on the food and drink they enjoy. They may develop rituals and repetition around certain foods, and refuse others because of bad experiences.

Autistic people with ARFID tend to be drawn to either soft and smooth food or hard and crunchy food. Adding a new food into the mix, even if it has the same qualities, is not easy – it requires a lot of trial and error and support. As they get older, autistic people with ARFID may find it frustrating that their lack of food variety makes it harder for them to fit in with friends and in social situations.

Those with autism may also have pica, a condition that prompts them to eat non-food substances such as cigarettes, dirt, plastic bags, soap, or stones. Pica is seen as a challenging behaviour, but the reasons behind it are complex, and can include the body craving certain minerals or nutrients, the person enjoying the texture of the non-food substance, or the person being unable to tell whether something is edible or not.

Treatment for ARFID

There are many different treatment options available for ARFID – the most common are Cognitive Behavioural Therapy and Dialectical Behavioural Therapy, but an initial assessment and personalised treatment plan can determine the best approach for each patient. The therapist may also involve exposure therapy in the plan, helping the patient to gradually adjust to new foods through practical tasks.

When a patient is on the autistic spectrum, this requires an even more specialist approach, so it is important to pick a therapist with experience treating people with autism. If the person with ARFID has not yet been diagnosed for autism, an assessment can also be carried out at Christine Tizzard Psychology.