- Good afternoon, everyone and welcome to this webinar on, Anxiety, what it is and how to manage it. I'm very pleased to say that we have Tracey Moggeridge with us, a very experienced mindfulness teacher and coach. Tracey will say a little bit more about herself in a short while. This webinar is one in a series of webinars that are designed to enable all health and social work, social care staff to address the various challenges that are around at the moment, anxiety being one of them at the moment amongst a host of others, I'm sure. What we're trying to do through these webinars is give you the tools, the understanding, the ability to self-care and to do more to cope with the challenges ahead. I should have said, my name is Ray de Souza and I oversee the National Wellbeing Hub, our national advisor for workforce wellbeing with the Health Workforce Director of the Scottish Government and responsible for staging these webinars. Throughout the session, you will have the opportunity to ask questions, make comments, et cetera in the chats in the Q&A box, so please use that function. And at the end of the session, what I will do is put together a number of questions that have been posed to aggregate them if there are many of a similar nature and to put them to Tracey. So, do enjoy the session. And as I say, it is to help you to help yourself and let's take it from here. So, Tracey, welcome and thanks very much for giving us your time. Over to you.- Thank you so much, Ray and thank you to all of you that are here this afternoon. It's great to see so many of you. So, welcome and thank you very much for joining us on this webinar on helping us to actually understand what anxiety is and how we can manage it. My background is in mindfulness, so I will be bringing a mindfulness lens to the session today, thinking about the types of practises that we can deploy to help manage anxiety if we suffer from it. So, the session will have a practical element and I hope give you that sense of kind of empowerment around what to do in managing anxiety if you start to notice it for yourselves. So, before we get stuck in, let's see if we can actually give ourselves the invitation to arrive fully in this moment and actually bring a little bit of compassion as well to the next hour or so and how we look at anxiety. Some of us may have very personal reasons for wanting to understand anxiety better, especially given the challenges that we found ourselves facing over the last couple of years. So, take the opportunity just to settle. You might want to close your eyes, or soften your gaze. You might want to actually just tune into your feet. Getting a sense of what it feels like to grind your feet into the floor. Our feet are quite far away from our heads and anxiety doesn't tend to reside in our feet, so it's a really good place to start. You might notice sensations that are present. You might notice the feeling of your toes, or the feel of your socks against your feet. Just simply noticing. Now, the invitation is to notice your seat, how you're sat. Can you feel your bum on the chair? Your body upright. Maybe you can notice if you're holding any tension and seeing if you can let that soften. And the invitation just to find your hands. What does it feel like perhaps to just get an awareness of the feeling of your fingers, rubbing them together. The softness of your skin. What do you notice? And then just to take a deep, big in-breath and let that go. You might want to ask yourself the question. I do this often on the classes that I teach, just to get a sense of what your emotional landscape is like today. I like to use, sometimes, weather as an analogy here. So, are you feeling particularly sunny, or maybe a little bit grey, a bit cloudy, or foggy? What's the emotional overtone that's with you today? And the reason I invite this is just to get a sense of, that sort of sense of helpfulness when we actually are aware of what is with us in each new moment in the day. There's nothing for us to do with this information right now, but simply just to get a sense of where you are. And perhaps if it is less positive than you would like, what can we take from the next hour that might benefit supporting that sort of noticing. And then when you're ready, bringing yourselves back to the present moment awareness and into this session today. So, why are we here? Well, we're here to talk about anxiety. Anxiety has been on the rise. Back in 2010, according to a review, there was a prevalence of anxiety of around 8.2 million reported adult cases in the UK. So, let's have a look at what recent studies have shown. The ONS conducted a study back in May, 2020, looking at the economic wellbeing in Great Britain. This is sort of in the throes of our first lockdown. And there were around 25 million people, nearly half of all the adult population over the age of 16, who would have been suffering with anxiety. And those people were reporting high rates, anywhere between six and 10 on the anxiety scale. Average ratings in anxiety and happiness looked to improve in the quarter three of 2020, but have peaked and sort of spiked again through this year. We're looking at an average rating of around four compared with the previous quarter. Perhaps an indication, up until very recently, that sense of ease that we were feeling that restrictions were lifting, the vaccine rollout, what-have-you, was having an impact. But we still know that actually anxiety is high and that nearly 14% of people at any point in the UK will be suffering with anxiety. So, whilst it's great and hopeful news(sound cuts out) levels are remaining quite stable, we are seeing more elevated trends, especially for those more vulnerable groups of the population, such as those with a disability, or those people that may be feeling lonely, or the younger generation as well. It's really heartening to see, but it doesn't tell us the full picture. And my sense is as well that with what we've sort of been living with, the anxiety is still very much part of our existence. We have more hope, we have more normalcy, but there's still a lot of question marks. I think we're all feeling that sense of ebb and flow of worry that has been such a big part of our lives over the last couple of years. And what we notice as well, is our stress response. For many of us could simply be just very highly activated, or highly sensitised. So, even small amounts of uncertainty could actually be really quite challenging for us. But there are things that we can do that we can educate ourselves on, which is why I'm sure many of you are here today. So, what is anxiety? Well, let's see if we can look into that with a little bit more detail, I'm rolled over how to talk about this. I'm actually quite practical by nature, so it's easy for me to jump into the factual to understand something. But anxiety often isn't factual, or rational. If it was, it would be really easy for us to fix. So, I wanted to kind of delve into my personal experiences around anxiety as someone who has suffered and still does. Even today, this morning, in the run-up to delivering this session for all of you, I could sense my anxiety was on the rise and it translated into less helpful coping mechanisms around worrying, which I'll come to later. But I wanted to share at this point too, that there's a great toolkit of things that we can do, which I'll uncover today. So, how do you find anxiety if you're one of the sufferers? I find that it's really discomforting. I find it has that sense of being highly strung. It keeps me on my toes in that permanent fight, or flight, distracted, exhausted sort of sense of being. Going back 20 years ago, I used to have panic attacks, really horrible, out of nowhere, or so I thought. I was in a new job. I had started as an events manager, coordinating a really big conference. There were high expectations placed on me and that I had placed on myself. As a bit of a perfectionist I am prone to worry and it was a perfect storm. I found myself completely consumed by worrying thoughts. I wouldn't do a good enough job. What if it all went wrong? What if I miss something? How would I cope? And without realising, over time, this behaviour was starting to have a real impact on me. I was hiding away from friends. I was buried into work. I was working long hours. The very things that I was actually trying to avoid. I was irritable, struggling to concentrate. I was taking it out on my loved ones. Then one day in the ladies' loo of all places, I was gripped with pains in my chest and I was struggling to breathe. I was able to make it into a colleague's office and said to her I thought that I was having a heart attack. Luckily for me, I wasn't and the wisdom on her part with a brown paper bag and sitting down and talking to me, I was able to get back onto my feet. But that was a real defining moment for me that something needed to change. And so, the last 20 years, or so have been a learning curve, understanding anxiety, trying to befriend it. Seeing it as a call to action. I think that's been one of the most helpful learning experiences for me. So of course, we've had such a pretty rubbish time, I would say, probably for most of us over the last couple of years. And I'm finding that anxiety is still the elephant in the room that we either cannot see because it blends in so well with the background. It takes over and smothers everything that we do, or we've learned to live with it. We don't necessarily even see the part that it plays in our daily lives. Or we can try and ignore it and hope that it goes away. I don't know whether any of you are resonating with this. But I suspect for many of us that we thought that with lockdown easing, it would end, the worrying time for many of us, but in fact actually is presenting us with a new set of challenges. How we work in this hybrid environment perhaps, going back to old routines around commuting, or even just the uncertainty around, will have Christmas? Is there more on the horizon? So, I think one of the things that is sort of helpful here to say is actually when we're thinking about anxiety, how can we start to befriend it and its less obvious message that it is a call to action? That it's something that we need to pay attention to. So, anxiety is actually a really natural response and can be incredibly useful. It is our body calling for attention. In many ways it actually helps us to avoid dangerous situations. The difficulty arises is when it starts to grow from mild and occasional to a full-blown anxiety disorder, which is likely to be more severe, longer lasting and interfere with work and relationships. We get very used to worrying. It can be a fabulous problem-solving tool, but the challenge is that we can actually find that there can be too much to worry about and that we deploy worry as a behaviour more and more. That it becomes less supportive and can make it much harder for us to sort of cope. There are different types of anxiety, as you can see here. I've just listed them out. So, generalised anxiety, which is that overwhelming sense of worry and restlessness. We might find that we're living with anxiety more days than not. It can have physical and psychological symptoms as well. It can be quite difficult to control and it could be about a number of things. And then another type of anxiety is panic disorder. Now this is, as I shared, where people might have a tendency to panic attacks, or maybe afraid that when it's going to happen where you might've experienced things like dizziness, feeling nauseous, sweaty, or rapid heartbeat. The other is phobic disorder where someone who experiences phobias and avoids, or restrict themselves because of a specific fear about places, or events, or public places, travelling, for example, like travelling on planes. The other is post-traumatic stress disorder. Usually after a distressing, or a really catastrophic event, the death of a loved one, or being witness to the traumatic event as well. The way that manifests is we tend to see a re-experiencing of that event, flashbacks, anxiety in certain situations that might trigger those memories. And then finally, obsessive compulsive disorder, which is less common, but painfully disabling. Usually around obsessive thoughts, or compulsive, or repetitive behaviours that accompany these thoughts such as switching on and off the lights, or checking to make sure that you've locked the door more times than you would want. Now, all of these can have a really tight grip on the person and many people do not fit neatly into one type. It's very common for people to have some features from all of these. I found this workout on Google. For me, this helps to sort of unpack anxiety a little bit more and actually make it feel a little bit more relatable. I find it gets to the nub of the emotions, the thoughts, that weighed-down quality that anxiety tends to have. I've circled one word in particular, threat. So, anxiety is caused when we see a possible threat to us, to our life. There are risk factors to being susceptible to anxiety, such as genetics, being a more sensitive person to threats present in the world, or even persistent and ongoing stress such as we find ourselves in possibly right now. It's a brain, body, whole person impact. It's not like living with a sprained ankle where some elements in the day, if you aren't on your feet, you might forget that you have it. It's kind of weaved into all elements of our lives and I think the words that we find here probably help us to get a sense of that. So, let's have a look at ways in which it actually manifests for us physically. This list isn't exhaustive, but it's a good starting place and it's something that we can start to kind of have an awareness of. It's also where a mindfulness practise can really support us by helping us to start to notice whether or not these things are happening for us. The invitation here is to have a look at the list. I'll read them out, but are any of these... Are you ticking any of these off for yourselves? Muscle aches, restlessness, headaches, dizziness, nausea, dry mouth. Some of these will be present in certain situations. Some of them may be really low-lying and with us perhaps more than we realise. That kind of knot in our stomach. How many of you may even be suffering with some of these things without realising that actually anxiety is possibly what's at play? So, ways in which it can manifest psychologically. Again, this list isn't exhaustive either. One of the things that I think is important to highlight here is the first one, excessive fear, or worry. This is worth us bearing in mind for a number of reasons. Jud Brewer, who is an American psychiatrist, talks about this. We will all worry to a certain degree at some point about many things in life and it is a natural coping mechanism. But the challenge is to start to notice when it's that excessive fear, or worry and when it becomes a negative behaviour pattern that we sort of subconsciously deploy without necessarily realising that we're doing. Worry can give us a sense of feeling in control over our anxiety, but it can also act as a distraction from the feelings of anxiety itself. And that actually, that sense of it not necessarily being the best course of action for us, but I'll come to that a bit later. And the other ones on the list. So, we might notice that our mind is racing just at the time we don't want it to. When someone asks us a question and we know that the response is there, but we can't find it, our mind going blank. Starting to notice whether any of these things are present for you. Difficulty concentrating, struggling to make decisions, irritability. Who else wakes up at 4, 5, 6 o'clock in the morning with that sort of sense of disordered sleep? Again, starting to notice whether these are behaviours that are arising for you, or perhaps around certain situations. You might notice that you're more impatient with others, feeling on edge. And that sense of those unwanted and repetitive thoughts. Mark Williams who's one of the founding fathers of mindfulness in the Western world said recently,"We need the mind's activities to practise on."There's no need to be frustrated when thoughts occur,"but rather that our mindfulness practise"is to see the mind at work, befriend it,"so that we can change the way we relate to thoughts"and what they might be telling us." So, we might have that sense of thoughts that are continually there, repetitive, unwanted, but that actually they might be there trying to help us become more in tune, more aware to what our needs are. Other ways in which we may see anxiety playing out for us in our actions. Often these are the very things that we may actually benefit from, but that we start avoid doing. We might find that actually we start to experience distress in social situations. They start to hold no joy. They can feel quite overwhelming at the thought of spending time with loved ones. We start to avoid the very things that kind of top our levels back up again. Hobbies might disappear. Our loved ones might get pushed away. We stop doing the things that are nice, that we enjoy, in order to cope with the demands that are placed upon us. We might also start to avoid the things that feel hard, or that challenge the types of things that when we're on our A-game, we would tackle without too much of a second thought. If you think about our brains and the evolution of our brains, our brains really like an easy fix. As children, we absorb and learn really easily, building neuro pathways that allow us to utilise the skills of things like autopilots because our brain wants the shortcut. It wants the path of least resistance. And then if you think then, adding stress to that mix, our brains really don't want to have to tackle the hard things and it will do its level best to hijack us and resist and we will go into that avoidance mode. However, I'll come to that shortly. Avoiding things just tends to make things worse. It's almost a delaying tactic, if you like. So, the opportunity here is for us to notice when these things are happening for us. Are you avoiding spending time with loved ones? Are you avoiding social situations? If so, then maybe it's this sense of a call to action. What can we do to befriend that feeling of anxiety and go, okay, thank you. Thank you for showing me that I need to do something, that I need to listen to what you're trying to show me. That perhaps sitting quietly to understand what it is that's going on so that I can build in what it is that I need and what I can start to do about it. This is a way in which mindfulness practises really help us in the moment to calm a stressed mind and also to mitigate its effects. We need to notice it at play and applying motion and that sense of actually moving forward. Now, this one might be hard for many of us and myself included here. But the best thing we can do to take care of ourselves is to start with us. Most of us, especially those of you in the wonderful caring profession that you're in, it's probably very hard-wired for you to take care of others. I imagine as parents, as carers, as health practitioners, you would tend to the needs of everybody else without even thinking about it. However, it's probably been a long while for most of us, but if ever you take that flights anywhere and you're given that safety briefing, we're always told, apply the oxygen masks to you first before anyone else, even that small child sat next to you. How many of us feel a little bit uncomfortable at the thought of putting yourself first in this way? So, the invite is just to have that reflection. Is there resistance there for you? It's your response, actually, no, it's more important to take care of this person? Well, that's great if you're starting to notice that that is where your resistance is. A really great way of actually illustrating that resistance for many of us with self-care is present. So, what can we start to do with it because it means you're becoming more attuned to what your response is in these situations. So, much in the same vein, with the oxygen mask on the plane, in order for us to be able to take care of and support our loved ones, our friends, our family, our coworkers, we have to apply it to ourselves first. I'm not saying this is easy either. I think it's important to state that, but that actually it is the best route to managing your health in a more positive way. This list will probably be highly obvious, I'm sure, to many of you, but I think it's important just to say. What can we do that really supports. What are the fundamentals that we can get right that will give us great strides in actually taking care of ourselves to have the kind of coping mechanisms that we need when life is changing. First and foremost is creating that sort of wellbeing routine. Making it a habit. Sleep, it's so important. Getting enough and making it routine. Often, I've done it myself, where you just chip away, you think, oh, I'll get up a bit earlier and I'll do a little bit more. But actually in the long run, those sorts of patterns of responses can be less helpful. So, what can you do to make sure that your sleep time is sacred. Eating well. Eating immune-boosting foods, fruit, vegs, nuts and seeds. I know our natural inclination, mine too, is to reach for the sugary stuff, especially if we're feeling in the throes of having a really tough time. But we all know that in the long run, eating well supports our immunity. It keeps us well. So, just having that sense of, where am I today? What can I do to build in those elements of self-care? Reducing caffeine, reducing alcohol, that sugary processed foods. We can start to get creative. We can start thinking about the things that we enjoy. Just carving out little moments of time in the day perhaps to read a book, to sit and look at nature. We can start to think about ways in which we can relax more, whether it's a bath, some meditation, slowing down, listening to your favourite music. And fundamental, most importantly, probably if there's any takeaway from this, it would be to talk to somebody, to reach out, to build that sense of support network. Who do you talk to when you're having a hard time? Who can you reach out to? Who can you just share, just connect, even if it's not about life's challenges, but just that sense of connectedness with others? You may be surprised by the connections that you build by just having the courage to acknowledge and share. I'm sure that, for many of us, people really do understand. One of the things that research has also show us is the importance of getting out into nature. The landscape itself has been shown to really help reduce the symptoms of anxiety. Even things down to the informality of trees, of the landscape can help put our troubles in a broader perspective. Anxiety tends to narrow our focus and dominate our thoughts. So, by actually just taking a look up, even when you're just sat at your desk in the day, looking around, looking outside of the window, it can help broaden that kind of sense of our horizon and help us to find a little bit more perspective on life. Now, many of you might find this quite challenging and think you're already time-poor, where on earth are you going to find the time to build these things in? And I really do understand that. But sometimes it's also the case of just having a little bit of gentle honesty. Are we ticking some of these boxes with consistency? Can we weave some of these practises, no matter how small, just more regularly, into the day? There is research that supports that little and often has far more of a positive impact than going hard and thinking, right, meditate for two hours, yoga for four hours. It's that sense of just little and often that can really start to make a difference. Just a question for you at this point. What thoughts pop up for you when I ask you how it feels to take time for your own self-care? Do you take time for your own self-care? Do you have a sense that it's often enough, or do you tend to put others first? Does it feel selfish? And I don't mean the negative version of selfish where you steal the last bar of chocolate from the fridge, even though you know your partner really wanted to have that today. But the one that puts you on an equal footing with everybody else. And feel free to pop them in the chat box too'cause we can come back to this at the end. Many of us might be thinking, actually, I haven't got time for that, or I don't deserve it. Or, just as common, I will make time to relax once I've done all the 10,000 other things that I've got to do today. I don't need to relax. My life stresses will go away once I've done X, Y, Z. The reason I invite this reflection is that actually noticing if we have resistance is quite important here. We can start to then notice what our blockers are. Whether they are real, whether they are perhaps a story that we're telling ourselves. And those responses where we typically push out perhaps self-care, is actually the opportunity for us to be honest with ourselves and think, it can feel quite unnatural. So, what can we do to actually start to give it to ourselves and take it in? Let's have a look at ways in which mindfulness can support us. The paradox of mindfulness is something that Gary Hennessy, who's the author of,"The Little Mindfulness Workbook," covers. He says, "What we resist tends to persist." We want to get to B, that place of calm, a better place, if you like. How can we achieve it? Well, we have to sit with A. That sense of stress, that sense of anxiety. It doesn't always go well for us when we try not to feel anxious. It leaves us feeling more anxious. It tends to stick around. Our efforts not to be tied to anxiety, to resist it, to block it, to push it back, it tends to tighten the grip that it actually has on us. So, rather than trying to feel calm, what we actually need to do is just to lean in with patients and kindness to those feelings of anxiety. I really understand that this might feel counterintuitive, especially, in very practical terms, if we're experiencing some danger, then quite rightly we should be running for the hills. But in many situations in life, actually that sense of, okay, what is my anxiety trying to tell me, can be more helpful a practise. Being kind with what we find, being patient, being gentle. Noticing the language we might use towards ourselves. Where do you feel anxiety for you in your body? So, leaning in gently. This shouldn't be a practise that we go hard into, but rather just get a sense. Do we notice it as knot in our stomach? Okay, what does that feel like? We might know that perhaps if we're focusing on our breath, that can actually elevate our anxiety, or our stress. So, perhaps we wouldn't start there. We might want to just actually start with our hands, or our feet. From a neurodiversity perspective, people have great success with short practises. The focus on the soles of our feet, or even in our lower back. It's not a place where we tend to notice tension, but it can be a great place to start. So, if you're wanting to get a sense of where anxiety is for you and you're looking at those sorts of bodily sensations, start with your feet, start with your back. Move up into other parts of the body where you start to notice actually where anxiety might be more prevalent and then come back to those places. What we're trying to do here is simply bring awareness to unpleasant, or difficult experiences and that when we do that, it actually changes the experiences that we have, even if it's just ever so slightly. It's important to know that you may not necessarily notice the calming effects that mindfulness has, especially if any experience that you're having can feel quite intense. But the opportunity is to actually just start to pay attention, to become more aware of the experiences that we're having and that you may start to notice that small oasis of calm. And as you practise, that little oasis of calm will grow and it will become bigger. And you'll start to notice that your... You start to notice your anxiety in a calmer way. I think we can come back to that point about worrying too, which is also helpful here. We can resist sitting with anxiety and deploying worry as a behaviour to help us manage the feelings that anxiety can bring. The challenge is to notice when anxiety pushes us to less positive behaviours like that sort of sense of excessive worry, or overeating, drinking too much, spending too much. What kind of behaviours do you deploy when you are starting to feel anxious, that they create less positive life experiences for you? And to think, okay, then this is opportunity to actually sit and notice my anxiety in this moment. Another way that we can start to understand anxiety a little bit more is actually to notice our thoughts. This is where we start to get to know our triggers. The thoughts and reactions that we have to life events that cause anxiety to rear its head. We can use mindfulness practises such as a reflective practise. You might want to think about journaling. You might want to think about poetry, reading some of the words of the stoics, for example and through meditation also. We can start to kind of ask questions around the origin of our thoughts and we can start to alter the way in which we view thoughts. And by that, I mean perceiving thoughts as mental events, so that they are not happening from us, but rather to us. One image that I offer up in the classes that I teach is seeing the thoughts as carriages on a train. You can be taken off on a train of thought. You can jump into one of those thought carriages and it might be, I'm having a really hard time and then you get whisked away on that thought. So, it's kind of seeing it as something that's happening outside of you. Do I want to dive into that train carriage? Do I want to allow it to take me away, or can I start to see it as a thought that's actually happening to me? When we start to view thoughts as mental events, we can start to disassociate more readily from them. If, for example, we're ruminating on the same topic for hours on end, what if I have a reaction to the jab? What if I have to do more travel for work? How will I cope? If we start to become aware of the nature of the thoughts that we're having and more present to them, we can actually start to kind of step in and challenge, is that likely? Can I disassociate? Can I just even label it as a thought and invite it to kind of sit with a little bit more distance. Some days this practise will be easier and some days it will feel that we're getting nowhere. We term this as re-perceiving. It involves looking at thoughts differently. Rather than being immersed in the drama of the story that we might be jumping onto, we're able to just stand back and be a bit more of a witness to it. Another thing that's important to say as well, is we are not our anxiety. We are a person who may be having a spell of anxiety. We are much more than the sum of anxiety and its past. You may find yourself having thoughts that are really critical of yourself for not coping well enough. See the language that I'm even using there. You know, well enough, says who? We do it all the time and that subconscious dialogue starts to wear us down. So, within mindfulness practise, it's that opportunity to start to notice how do we speak to ourselves, what thoughts are we having? And we can start to kind of catch those thoughts and challenge the wisdom and the legitimacy behind them. I think it's also important here to say as well, that our thoughts and feelings are valid. It's really okay to find many life challenges tough. We all handle experiences in very different ways. On some days we might be really on our A-game. Some days we might be the person that others lean on. Some days it might be that it's just simply the other way around. Anyone else get caught in that trap of busyness? That sense of needing to be working at 110 miles an hour? As Maverick from, "Top Gun..." Showing my age here, somewhat. How many of us kind of get really excited by and are driven by that sense of exhilaration when we're working at speed, we're working at pace? And that's fine. But I want to just to highlight the fact that I think for many of us, we've been working at speed and living life at such a fast pace that actually, after a while, it starts to have its consequences. Richard Wiseman, who is a British psychologist, did a study back in the, I think it was early 1990s, that was looking at the pace of life. The pace of life has increased by 10% since the mid 1990s. The study showed that pedestrians, the speed of their walking provided a reliable measure of the pace of life in that particular city and that people moving... That people in fast-paced cities are less likely to help others and that they're also to have higher rates of coronary heart disease. So, that sense of speed, that sense of urgency, can actually have a bit of a negative impact on our health. Evidence has shown that in 2016, 12.5 million work days were lost due to work-related stress, anxiety and depression. So, have you a sense of how fast you are moving? Are you living life more often than not in the fast lane? And what might be the impact of that for you? You might start to notice that you're less there, less present. And can we start to think about what the benefits of actually slowing down might be and the challenges around that as well? So, Alan Watts, I don't know whether many of you would have come across him. He's a British writer who interpreted and popularised Eastern philosophy for a Western audience. Talks of this in a brilliant YouTube video. I won't share it here. But one of the things that he talked about is that sense of always in a hurry to get things finished and only when we finish these things, will we feel that sense of ease. But then often that we find, the things that we finished weren't worth finishing because they were done so fast. Who inhaled that first cup of coffee this morning and could even remember what it tasted like? I know I can't. He even said in this particular clip, those rush hour commuters who grab that instant coffee because that's a punishment for being in a hurry. And I thought that that was just quite, quite an interesting observation. So, what can we do to practise greater knowing awareness? What can we do to slow down? To notice the day, to feel the wind in our face? To take a break at lunchtime, go for that walk, take a stretch. Tune into whether or not we've got a knot in our shoulders that might need loosening. Someone else once said... I have a funny feeling it was probably Alan as well,"We do not listen to music to get to the end." Are we adopting this mindset in our own working, or personal lives that continually feed that sort of anxious mood? And what can you do to slow down for you? Well, let's have a look. There are a number of things that we can do. We can use what is inherent within us. We have all of our senses, typically. We have the sense of taste, of touch, of smell, of sound, of sight. Smell that coffee, taste that coffee. Feel the fabric of your socks as you put them on in the morning. When you're listening to music, are you listening? Are you listening to the different instruments that are at play? Can you notice the colour of the sky? Maybe even the wrinkles and the grooves of your skin, or relief, if it's a little bit kinder than looking at your own skin? Can we think about mindful walking and mindful movement? As you wake up in the morning, can you do it a little bit slower? Children are fantastic to watch for this. Notice how they dawdle, how they take everything in. It can be a great thing to do mindful walking if you are feeling agitated and that sense of anxiety.'Cause actually sitting down and trying to get that sense of relaxation could be very hard to do. There's studies that show that movement is a great way for allowing stressors to move through us more effectively and supporting the decreasing symptoms of anxiety. How repetitive movements, such as walking and dance, can be great for soothing our activated stress response system. I'll come to the sigh shortly. But what can you do to take a pause, take a break? What can you do to be a human being rather than less human doing? Can you take opportunity in your day to take those micro moments where you just are still? Allow your body to digest its lived experiences, giving yourself time to process your day. I mentioned it before, but journaling, perhaps even something around gratitude practise. A grateful disposition, when researched, has shown it can protect against depression and anxiety, partly because it has been connected to a lower level of feelings of inadequacy and self-criticism, which can be really prevalent when we think of anxiety. So, being grateful gives us more opportunity to show kindness. We're more likely to show compassion, to be more supportive towards ourselves when frustrations and setbacks occur. So, what might you be grateful for in your day? Who might you be grateful for today? And then meditation practise. Let's have a look at what options are available to us here. So, I mentioned it before, a physiological sigh. If in doubt, sigh it out. If you're having a moment in the day where you start to notice that you're feeling agitated, you can't focus, your head is busy, have a physiological sigh. And sighing does two things. It helps us rebalance the ratio of oxygen and carbon dioxide in the lungs and the bloodstream. Too much carbon dioxide can leave us feeling tired. It can impact on our productivity and also on our cognitive function. But it's... Sighing also tells our nervous system that everything is fine and to stand down. You might even notice that you do it yourselves, or you see in others. I think we've often witnessed it watching TV programmes, someone will just go. (sighs) It's that sense. What can you do to take a big inhale and then let that go? And it's a really quick and easy practise. I would suggest, if you're noticing moments where your anxiety is on the increase in the day, do that two or three times. That can really help just to regulate yourself back to a more comfortable place. And also from that calmer places when we start to begin to notice the judgement that's in our thoughts, or the feelings that we're having as well that we talked about earlier. Anxiety has that fidgety, that restless tone to it and one way that we can tackle that is shake it out. We... It's used apparently by performers before making stage appearances. You might want to just simply physically sit there and shake your hands seven or eight times. So, you might want to take one hand at a time and then do the same with your arm, your legs, your whole body. I mean, not great if you're sat down, but what can you do to just give your shoulders a bit of a wriggle. Let go of some of that tension. David Bertelli talks about tension and trauma releasing exercises and has some great exercises that you can watch. Some really good videos on his website that are really helpful. So, I would invite that practise as well. In the moment practises. We did one at the very outset. So, that tuning into your feet, that finding your seat. But with everything with this, I would say start small. Anxiety has that sort of overwhelming feeling to it, so if we attempt, as I mentioned before, to go for a five-mile run to de-stress, or meditate for an hour, that can feel impossible. So, what can you do? Can you just wiggle your fingers and your toes? Can you start to ground into other parts of your body and take yourself out of your head? What can you do to take the pressure off? And it might be that sense of getting a sense of sensations, or feelings in your toes, in your fingers. You might want to deploy a breathing exercise. There's a fantastic one called the five-finger exercise that tunes into more of our senses. So, what you would do is, you would place your index finger on the outside, at the bottom of your wrist on the outside of your thumb. And you watch, as you trace your finger along the outside of your thumb, up to the tip and then you draw your finger down the inside of your thumb, up your index finger, sorry, first finger and around. What you're doing, is starting to not only notice visually, but feel that sense of touch as you trace your finger around each of your digits on the other hand. You might get a tickling sensation. You might start to notice cold in your hand, or warmth in your hand. And just get a sense of what's here. And what you can also do, is actually follow your in-breath as you trace your finger up the outside of your thumb and then use your out-breath on the downward path. I hope that's making sense, but obviously we can come to any questions at the end. That can be a really lovely practise and I would say do one hand, or the other. Or you can even use your feet as well. When we're taxed, when we're stressed, or anxious, our brain cannot access our more developed brain, our cortex. So, what it tends to do, is actually default to our more automated brain functions. So, one of the things that we cannot do if we are having a hard time is actually to think our way out of things. Our brains need a breather. When we start to use these small in-the-moment practises, it gives our brain a chance to reset. You'll start to notice actually that you feel a little bit calmer. We're not striving to feel calm, but these practises will help provide that sense for you. So, it's important to say, it's not about finding relaxation here. It's actually about trying to bring ourselves into the moment and tuning into other parts of our body, so that our brain has that chance to settle. Another thing that we can do is, what's known as coherent, or resonant breathing. It's a form of breathing that involves taking a long, slow breath in and then a long slow breath out. It's typically around a rate of five of these inhales and exhales in a minute. This breathing exercise can really help calm the body that has an impact on our autonomic nervous system. So, what you would do, is aim for a five, or six-second inhale and then a five, or six-second exhale. You can start with four seconds if that's more comfortable. So, we'll just have a little go now. So, taking a breath in for five and then letting that go for five. Again, breathing in for five and out for five. And have you a sense of how you're feeling now as a result of having just done that very light-touch practise? You might want to use this practise, perhaps 2, 3, 4 times. Try it just for a minute, for a couple of minutes and see how that goes for you. To some, a breathing technique, where we focus on drawing out the exhale, has a very relaxing and tranquillising effect. But a breathing practise can also be a challenge for those of us who may have health difficulties around breathing. So, with everything, the invitation is to do what's right for you. You know your body. You know yourself better than anybody. But the invitation is here to practise, to experiment, to learn what works for you. And if you are somebody that breathing would be a challenge for, you might want to engage your other senses. You might want to look around the room and notice light, or colour. You might want to listen to sounds. You might want to tune into birds. You might want to just even hear the hum of your laptop. What senses can you tune into that will support you? And then the invitation finally is... And this one is a lovely practise. I was going to offer, as we've got a few minutes left, a meditation practise for us today. So, it'll take between six and seven minutes. And it's a loving kindness meditation practise. This could be one of the hardest practises to do, giving that sense of loving kindness to ourselves, but it's exactly the prescription that many of us need. So, we've all been sat here for a little while. The invitation is to just notice if you're feeling a bit discomforted, can you have a shake? Can you have a wiggle? Can you settle into a seated position that really supports you in this moment? The invitation is to develop a new default setting. So, rather than, why me, to perhaps, why not me? Why not give yourself some loving kindness in this moment? And for some of you, if a meditation practise isn't something that you're keen to explore maybe, yes, to use the next six, or seven minutes just to sit quietly, perhaps using one of the other practises that I've covered today. I will sound about a bell at the end, so that you know when to rejoin. So, take an opportunity just to settle into your chair. You might want to lower your gaze, or close your eyes. You might want to place your hand on your heart space. Taking our attention to our heart area can feel really supportive. That sense of touch. What's it like to put your hand on your heart space? Feeling that sense of warmth, that sense of kindness and compassion. Perhaps checking in, how are you feeling? What is here for you in this present moment? Can we start with some kindness towards ourselves? We can start to drop in some phrases, sowing the seeds of care. May I be well. As if you're dropping a pebble into a small pond, that phrase, allowing it to gently ripple through your body. May I be well. Breathing in that kindliness and allowing it to flow through you. May I be happy. Sitting with that phrase and allowing it to be with us. How about, may I know peace. Breathing in a sense of peace. A sense of ease. May I know peace. You may want to use imagery here in your practise. Imagining something like the sunshine at the end of the day. That deep red, orange sun. Can you visually imagine the sun? Don't worry if you can't imagine it well, or fully, but just try to get a sense of that warmth. Those warm rays filling up your body, spreading through you, through your heart space. Its warm glow travelling into your chest, into your arms, into your abdomen. Filling you with that sense of warmth, that sense of softness, of kindness, of gentleness. Breathing in that warmth. Using our breath to allow kindness to flow in in a natural easy way. Imagining kindness in the air that we breathe, with gentleness. As we breathe in, we breathe in kindness. As we breathe out, that kindness sinks into us more deeply, more fully. What's it like just to give yourself this gift of kind gentle, warm attention? Noticing if we're having judging thoughts. That's okay. What's it like just to bring back that sense of kindness? That sense of offering it to ourselves. Allowing kindness to flow in. Getting a sense of where peace and gentleness and calm might be for you. You might notice that your hands feel at ease. You might notice that your heart space feels reassured, supported. What's it like just to give yourself that gift of kindness in this moment? Turning your attention back towards those phrases. May I know peace. May I live with ease. May I be well. May I be free from difficulties. Allowing that sense of kindness, that gentle reassurance just to be present, even if it's just for a moment. And so, I'll draw this meditation practise to a close.(bell rings) You might want to just become more aware of your position. You might want to stretch. You might want to wiggle your toes. You might want just to feel how it feels to have been sat for just a few minutes and tune into what's here with you now. You might want to just share how you're feeling in a one word in the chat box. And just see if it's any different to how you were feeling when you first came into this session an hour ago. I will just... Yeah. I will just leave this slide here for a moment too. I think it's important just to signpost if you are struggling with anxiety, if you're concerned for yourself, or the health of others. There are lots of resources out there, as I'm sure most of you are aware, but I don't think it hurts just to go over them again. Lots of charities. There's professional help from your GP, from counsellors. There's support groups. And not least, the importance of family and friends. And again, those self-help strategies that I've spoken about as well. What else you can do. There's lots of information on the website for the organisation that I worked for. There's meditation practises, there's thought pieces. So, do have a look at those as well. Now, I'll invite questions and reflections. And thank you ever so much for being here and sitting with this for today. It's much appreciated.- Tracey, thanks very much. It's refreshing to have solutions offered to people. Judging by the comments. And no surprise, the comments stopped when you started the meditation exercise. In response to your question of how people are feeling now from when they started, the words are far too many for me to read out. But, calm, revitalised."I feel much more relaxed," et cetera, et cetera, along that vein. All very... Peace, of kind of cared for now, which is quite heartening. I do have a couple of questions to pose to you from the chat. There are huge number of questions and we couldn't them all.- Sure.- Many people are... I start with thanking you on behalf of the audience. And they say, the session, the value that people seem to have felt from this, is that you've explained what anxiety is, but offered some solutions as well to help people cope, which has obviously gone down extremely well. But one of the things that kept coming up throughout the presentation was the relationship between anxiety and menopause. And it'd be remiss of me not to... There are a huge number of questions about that.- Yeah.- And people feeling that their suffering had high levels of anxiety and when they started experiencing the menopause... Some called it the early menopause--- Yeah.- but when they started HRT their symptoms, anxiety, seems to have reduced. Can you make any comment on how people can cope with anxiety during menopause and other than medication and the usual offerings, if you like?- Yeah, I can. More anecdotal and lived experiences because I'm finding that I'm in that place myself, unfortunately. What I've found to be incredibly helpful is actually conversation. Talking to friends. I mean, I realise that I'm probably very fortunate there, but I think that there are some incredible support networks out there. I think Davina McCall did a fantastic documentary that highlighted the impact, the symptoms of menopause for women. There's a fantastic charity. I forget the name, but I will look it up and send it over to you, Ray, to circulate where the conversation is happening, where policies are being introduced at organisational level. Where it's a topic that we talk about, that is acknowledged. I think that can go to making great strides. On a more practical level, it's again, perhaps noticing the language that we're using. I think there's a lot of stigma and shame that sometimes is associated for women who are living with the menopause. And it's noticing how are we talking about ourselves. How are we treating ourselves in those moments. So, we're giving ourselves an unnecessarily hard time because we can't think because we've got the brain fog. What can we do to bring kindness and acceptance as well that we might be experiencing and living with this as part of our lives. And walking, meditation practise, taking care of our health through diet, through sleep. Again, they feel really obvious, but I think sometimes we neglect the importance of these things too and all of those can help have a positive impact as well as obviously taking HRT.- I think you're absolutely right because what some of the comments, many of the comments, reflect is that we all know and recognise when things are going wrong, but don't focus on the things that keep us well.- [Tracey] Yeah.- And I think that's sort of... You've reminded us again and again. And I think, again, what seems to be appreciated by the audience, is that reminder of that sort of adage that we hear on our travels. Those who are starting to travel on planes again, that said, apply the oxygen mask to yourself, doing so to others. And to an audience like this, where we're so good at, as you recognise right at the start, that sort of recognising and responding to the needs of others rather than ourselves and sometimes in that process forget the things that we struggle with.- [Tracey] Absolutely.- I think that was a really good reminder to people and certainly something that we try to do through the National Wellbeing Hub. And all the resources that we put out is that, trying to... We almost rephrase that, make and take time for yourself.- [Tracey] Yeah.- But again, lots of people felt that they feel like that's stealing time from caring for others.- Of course.- They feel--- That sense of guilt is often an emotion that we notice for people that are highly empathic, very compassionate, caring. That sense of guilt if you're not taking care of others and you're looking after you. And we all know, we can't give it out if our own levels aren't topped up. So, it's having a realistic expectation of our humanness, if you like, the fact that there is only so much we can do. We aren't super-human. And actually our loved ones don't want it for us either. They would probably be the first to say to us, slow down, take care, look after you. And that advice, we will dismiss it all too readily, but I think it's important just to have an awareness of that resistance that we might have in those moments to take the time for us.- Tracey, I'm aware of time. I have so many questions I could put to you, but I'm aware that some people may need to go back from their lunch breaks--- Of course.- and so on, so. Again, on behalf of the audience and I think what I will do, is speak with you about what else we can do. Certainly a number of people, well, large, very large proportion of the audience have appreciated the practical tips that you've given, the exercises and the practises that you've taken them through, albeit in a very short space of time and asked whether we could sort of highlight that on the site, on the platform, in any great detail. So, I'll speak to you about the ways of doing that.- [Tracey] Yeah, no problem.- Thank you again for giving up your time and for being with us and taking us on the journey of exploration, is probably the best way of putting it, through anxiety and what we can do to help ourselves. And to the audience I say, thank you very much for giving up your time and I hope that you do all you can to stay well and look after yourselves. Do try and attend some of the other sessions on the Focus on Wellbeing Programme. The details are on the National Wellbeing Hub. But in the meantime, take care. All the best. Bye-bye.- [Tracey] Thank You.