Mental Health First Aid

I am now a qualified Mental Health First-aider! I completed a two day course run by MFHA England on 17th and 18th of February (been playing catch-up ever since because of losing those two days of work!!) in order to be a Mental Health First Aider for my team at work, along with a colleague of mine who did it the same week but a different two days.

Part of my certificate!

This blurb is also on it:

The course took place entirely online and consisted of 4 live sessions and 4 independent learning modules, all of which were integrated in their online learning platform. The course took place entirely online and consisted of 2 days which included 4 live sessions and 4 independent learning modules, all of which were integrated in their online learning platform. We also received hard copy materials – a thick manual and a workbook – in advance of the course. Before the pandemic they did face to face classes but, like everyone else, they had to adapt to the pandemic.

In this post, I will share one key concept and a related concept that I found really helpful and that I think could be helpful for anybody and everybody to know about, and how I have already integrated it into my teaching.

Stress Container

MHFA Stress container

This is the first time I’ve come across the idea of a stress container and having a stress container but a quick Google shows that it turns out to be in wide usage. It has been adapted for workplace training materials, for students etc. The size of your stress container is influenced by your frame of reference (another useful concept) which is your window on the world. It in turn is formed by, amongst others, age, gender, work, hobbies/interests, place of birth, early childhood experiences, socio-economic background, cultural influences, sexuality, education, aspirations, spirituality, likes/dislikes, any disability, any chronic illness, family situation/size, achievements, values and relationships. Currently, also experiences of the pandemic. Depending on your experience of any of the above, the size of your stress container may be bigger or smaller i.e. you can tolerate higher or lower levels of stress before the container is filled up. If it gets full, problems develop – chronic stress, exhaustion, anxiety, depression etc. Stressors can be many and varied and may be in there temporarily or long term. Importantly, they may be good (e.g. a wedding next year, a new job/a promotion, a new relationship), stressors aren’t necessarily bad but whether good or bad, take up space in your stress container levels.

However, we can open the tap and let some of the contents flow out from the bottom. This means using helpful coping strategies such as meditation, connecting with others, exercising, getting enough sleep, participating in hobbies/leisure pursuits – generally anything that helps you relax without further damage to your body/mind. Of course, people also use unhelpful coping strategies in order to cope with the stress of life, such as smoking, excessive alcohol consumption, overeating etc, which may numb the effect of the stressors but not relieve it. This is akin to the tap getting blocked so the contents of the stress container cannot be released, which again leads to problems developing as overflow/overwhelm happens.

So that is the general idea of it. It is a way to conceptualise/visualise stress levels and coping mechanisms. This in turns allows you to evaluate yours – is there more in it than you realised/thought before considering what is in it? – and recognise when it is filling up and take positive steps to relieve that (and feel justified in doing so – it is all too common to feel guilty for taking time for oneself in whatever format that takes!). It can help you make sense of why something that “doesn’t ordinarily bother you” or that you “normally find easy enough” is difficult on a certain occasion or occasions. If you are anticipating a number of incoming stressors, you can prepare by proactively using your preferred positive coping strategies and planning how you will continue to do so when the stressors enter your container. It also allows you to visualise how and why things different affect different people differently and to differing amounts. For example. a busy period at work may be experienced differently by someone who is also going through relationship difficulties or suffering with poor health or struggling with home-schooling children. Depending how full a stress-container is, a seemingly small thing can be the final straw for someone because there just isn’t space.

To me, none of the above is particularly new in and of itself but the stress container metaphor helps give it all coherence and, importantly, while the locus of control for some of it is outside our control (stress container size, stressors), it does show that we do have some control which it is important to exercise for our wellbeing, in terms of which coping strategies we use and when/how often we use them. I have already used the stress container/stress bucket metaphor with my students since learning about it. I did a mid-term feedback form and one of the questions asked them how they are feeling at the moment and stressed/under pressure/tired were common themes. Which is normal on an intense course like the one they are following with us (multiple modules, not only Academic English, and a heavy assessment load all round). In a subsequent lesson, as part of responding to the feedback I introduced the stress container/bucket, using images found online, reassuring them it was normal to feel stressed (it doesn’t mean they aren’t good enough to do the course or that they are a failure or anything like that – which is not a common assumption to make when you are in the midst of doing something that generates stress!) and that the important thing is to deal with it appropriately so that you don’t reach the point of overwhelm, and got them to share their favourite positive coping strategies in the chat box.

Having awareness is the first step towards having more control. If you are aware of what is happening, you can do something about it before you reach a crisis point. I plan to return to it periodically (another bonus of a coherent image is that it is easy to keep coming back to it because there is something tangible to come back to!) and continue with my Wellbeing column on our Class Noticeboard Padlet – where each week I share a resource/idea relating to promoting mental health and wellbeing (see examples below).

I don’t know how much of it they access but at the very least it, in combination with the feedback form question and feedback, sends the message that mental health and wellbeing is important, that mental health isn’t something that is only talked about when things go wrong and that things being difficult is nothing to be ashamed of. It also means that as time wears on (we are still in term one for this cohort!), and the stress load increases for these students (if not this year, then when they go on to university), they will know they aren’t alone with it, hopefully feel less ashamed than they might otherwise have to own it and be more willing to access the support that is available to them.

To finish off, here is an MFHA link from a 2018 campaign which focuses on stress and contains a little slide show about the stress container and some awareness raising activities. I hope it, and this post, will be of some use for you. I would recommend to anybody thinking about it to do a Mental Health first aid course both for personal gain and for better ability to help others.

IATEFL Training session – Mental health, Resilience and Covid 19

By dint of starting work verrrry early in order to get all my marking done, I have made time to attend this training session run by Hayley Broughton-McKinna for IATEFL. It is on Zoom! I must be the only person for whom it is the first time to use Zoom… (I’ve done Google Meet and Blackboard Collaborate and Microsoft Teams just!) Apparently it is a Zoom webinar room so as participants we just use the chat box, so not quite like being a student! Here are my notes from the session, with my own thoughts/reflections (added retrospectively) interspersed in italics.

Hayley is from PMAC. Im not sure what it stands for, need to look it up… but it aims to give people the tools they need to keep a workforce healthy, happy and functioning, and productive. She talked about her experience and warned us some themes may be distressing.

First thing I have noticed, Zoom audio quality is MUCH better than Blackboard Collaborate. <sigh>

The first portion was about Stress management

Life is already stressful, lockdown has added to that bringing with it lots of changes and worries.

  • Relationships with ourselves and those around us may have changed due to lockdown.
  • Work has been affected (not half!) – with furlough and working from home, and job losses and new jobs being hard to get, some jobs are more exposed and more at risk too.
  • Fear around the virus itself is a thing too, not knowing what the future will hold with it, doctors not knowing how best to treat it.
  • The grieving process has been made even more difficult and complicated.
  • Current affairs issues such as Black Lives Matter and conspiracy theories also affect us. Small talk around Covid19 has become very common but we can unwittingly have a big impact on people by doing this, depending on their experiences/situations.

Hayley introduced these terms:

Stress – how affected you are in mind and body by pressures that are unmanageable.

Trauma – impact of overwhelming stress, when coping is exceeded.

“The impact of Lockdown” might have meant spending a lot of time at home. For some people that’s great, for others they feel really trapped and isolated, out of control.

  • Some people may not have had access to safe outdoor space/sunlight, leading to poor mood and vitamin D deficiency. It is also living with constant fear and uncertainty.
  • We went from this is a virus that only affects the elderly and those with underlying conditions to this is a virus that affects everybody. So there is trauma around the fear of being ill but also around surviving, in terms of guilt.

I get this. I’m worried about getting ill (especially as I had a bad virus at Christmas through mid-Feb, the memory of which is enough to keep me being careful. Going from running the better part of 20 miles to being barely able to move is not nice. And the thought of losing, possibly permanently, some of my lung function is scary to me. At the same time, because I have been incredibly lucky in where I have lived through the first lockdown, almost feeling guilty not to have suffered more. 

  •  Grieving loved ones and family members, made more difficult as you may not be able to be around people who you can talk to, share memories with, to celebrate someone’s life with all who loved that person. This in combination with other people being excited about restaurants reopening and suchlike.
  • Grief also covers our life and sense of purpose. Routines and purpose may have been lost. Our reality is shaped by who we are in different circumstances with different people. You at work can be different than you at home than you with friends. We may have lost those different aspects of ourselves.

I’m still working, remotely of course, but I can imagine how much bigger an effect the whole thing might have had on me if I didn’t have the continuity of my job, crazy as it has been, through it. It stills seems strange to think that, apart from my co-ADoS who came round once for some socially distanced outdoor working (we thought it might be a regular weekly thing, the weather thought otherwise!!), I’ve not seen my colleagues since mid-March apart from a small number in video chats (=my 2 programme leaders and the rest of the ADoS team + [separately] the dozen or so teachers – a different dozen-ish this term to last – that I have done weekly module meetings with). We are definitely continuing to work remotely for at least another term (not sure if we teachers will go back to the building occasionally in the mean time or not), so by the time we go back to the office it will potentially have been nearly a year! Extraordinary. 

  • Working from home has minimised separation between work and home.
  • We may be grieving relationships that have been lost due to lockdown.
  • Sleep is also affected. Lack of sleep can lead to impaired immune functioning, more headaches, nausea, difficulty concentrating but also impacts on mental health as you lack the energy/strength to deal with things as they arise. Resilience is affected.

I have been really lucky with sleep. I have the odd bad night but by and large my sleep is good and I have a good pre-sleep routine to help that. 

So, there has been a real crisis of mental health during the pandemic.

  • Eating disorders are often triggered by feeling out of control.

Yep. Mine was triggered by losing my horse Alba nearly 2 years ago now. Then it was re-triggered when I was ill over Christmas. It liked me not being able to eat much and would have liked to keep it that way. So it was still very much present when Covid19 kicked off in the UK. I’m incredibly lucky that I have a very supportive girlfriend who has helped me be able to manage it better. 

  • People who are struggling have had less to distract them and resources available prior to lockdown may be no longer available.
  • Learned helplessness response may kick in because people feel they don’t have it in them anymore.
  • People with children who see work as a bit of respite from the parent role lost that during the lockdown.
  • Some people have got used to being alone at home and will be struggling with going back out into the world and to work.

This may be me when we do get to the point of returning to work. It will have been a LONG time so some readjustment will be necessary. 

  • Health is also impacted by the long term stress effects but also people have avoided seeking medical attention or been unable to access it. What is urgent or essential to you might not have been considered urgent enough to be provided during the pandemic. To not have access to support for your health can feel really difficult.

I have a weird eye condition going on, and getting it seen to has been complicated by Covid. I went to the pharmacy first, hoping I could just get something for it but they can’t give me anything over the counter. So I had to phone up for a GP appointment, which will be a phone appointment, so which has involved taking photos of my eye and uploading them to a link sent to be via text message. And we will see what happens next! Obviously this is all very minor compared to what some people will be going through. 

Lack of control has led to many people struggling massively.

  • Control includes routine, and not having that can be distressing. Emotion regulation can be more difficult when there is no predictability. This is also affected by not having the distractions you are used to having to help with it e.g. going to the gym, doing courses and other such coping mechanisms.

This really upset me at the start of lockdown. Feeling like my life had been thrown up in the air and all the bits were all over the place, and that I had to pick them all up and reorganise them again. Routine is very important to me, as it feels safe. Fortunately in the UK we were allowed out to exercise once per day so that was one organising principle – go for a run early early so that as few other people as possible would be out and about. I had also invested in a turbo trainer so that I could continue to do some cycling exercise, so there was that for late afternoon. Obviously there was work, with its meetings (so many meetings!) and lessons. I also established routines with my girlfriend – daily video chats, daily exercising via video chat and weekly virtual dates. I overdid the exercise initially so had to work out how much was the right amount and what to do instead of the dropped sessions (yoga, piano, art). 

  • We’ve also largely lost the physical presence of others e.g. a hand on the shoulder, a hug etc. Lots of feelings like anger, disappointment, frustration arise and can also lead to feelings of shame and lead people to react to us in uncomfortable ways as they don’t know what to do with it.

This is difficult. Especially when it will come to seeing people again after a long time. Like when my co-ADoS came round, the automatic feeling is to want to have a big hug having not seen each other for ages. I will be sad to lose that with people. 

  • Precarious finances impact what we can purchase, little comforts that might help.

I’m really lucky to be ok financially because I have a secure (as it is possible to be at the moment) job. 

  • Travel has become more difficult e.g. if you relied on public transport to go to work or the shop, and it isn’t available or it is now much more dangerous, that is difficult to deal with. It can feel like a no-win situation.

I am very lucky to have a weekly Ocado supermarket delivery and despite some kerfuffle initially have managed to maintain that, and share it with my housemate and once restrictions eased also my girlfriend. So the only shop I’ve been in since mid-March is the pharmacy which is less than a five minute walk away. 

  • Accessing support has become much more difficult, and the lack of being able to turn to people when you need them can really trigger feelings from previous trauma e.g. trust issues and that can make it difficult to let people in again and access support when things open up again.
  • Some people have enjoyed working from home but for some people going to work might be the only human interaction or the only respite from responsibilities in the home, making it more difficult to compartmentalise. Home life might be very chaotic and make it very difficult to get work done.
  • People might feel lots of pressure to get back to normal even if they don’t feel ready.

I have a bit of this going on. Luckily no pressure on the work side of things because of the whole remote working for the foreseeable future thing, but I haven’t yet seen anyone apart from my housemate, my girlfriend and the one visit from my ADoS colleague and have conflict between wanting to but not feeling comfortable to and then worrying that people will think I am being antisocial as a result. I am building up towards having some friends (one household at a time) round for pizza in the garden (restrictions permitting! by the time I build up to it that may no longer be an option..!)

Impact on relationships is another thing that has come out of lockdown.

  • It can put pressure on the relationship with the person you live with as there is less escape. Little irritants become big when you are stuck with someone and there is no break. Especially when you are navigating the emotional rollercoaster of trying to cope with the wider situation. Often the little daily small things that push us to breaking point and it is easier to take it out on someone who is around you than on the world at large.

I thought this would be an issue for me, as we have clashed over build ups of little things in the past, but it’s been ok. Actually my house mate has been super supportive of the whole working from home endeavour – letting me use the kitchen-dining room, helping me find my standing desk and plug in monitor etc – and also more generally in terms of helping me find and set up the turbo trainer in the sitting room, for e.g.! Hopefully I am easier to live with since taking up mindfulness and trying to be more aware in my interactions and how they are influenced by how I am feeling. (Work stress used to be a trigger in the past.)

  • For a lot of people it has meant spending more time in abusive situations.
  • Lots of people are now having to deal with relationship breakdowns – friendships, relationships that had been really invested in. Some people have had to quarantine apart and have suffered at the lack of physical intimacy and can lead to trust issues as you can’t physically get comfort/validation/assurance. Couples coming out of lockdown who survived it may now be at risk of separation anxiety. Some couples will feel so unified that there is a bit of co-dependency and resentment/jealousy/hurt when independence is regained. Even if things went really well for you in lockdown, easing out of lockdown can make things difficult.

My girlfriend and I don’t live together, and we had only got together a month or so before lockdown started, so we worked hard to keep things going. She is a keen paddler so once restrictions eased she started doing that again, I join her at weekends. But obviously during lockdown there was no paddling and before lockdown we hadn’t had much chance to figure out normal (and it was out of season) so there has been some adjustment around that. Recognising insecurity in myself, talking with her about it. (Mindful) communication has been key. 

Work relationships have been different. This particularly for colleagues who I consider friends but am no longer working closely with as they have been promoted. Pre-lockdown, it was about having lunch together when we were able to do. In and since lockdown, it has been about being proactive about organising video chats periodically, even though initially it felt a bit awkward and I was a bit nervous (go figure, just me…). Consistently it has been really positive in outcome to reconnect with them. Very important to do and something I need to keep doing! 

Teaching during lockdown

  • It has had a lot less human contact.
  • You haven’t the same small talk and catch up in between actual teaching sessions.
  • The interaction doesn’t feel as personal or genuine. It is easier to lose concentration when you are talking to a screen with no response.
  • There is a lot less separation between work and home, it is always there rather than being left behind at work physically. So more work done outside work hours, as there is less structure.
  • Students may not have the time or space at home to engage fully with the sessions however much they might want to. Their ability to concentrate may have been affected by lockdown.
  • More difficult to check in with students as you can’t see their response or reactions. Very different relationship with the students. You might spend more time worrying about them as a result.

Teaching…this term I really enjoyed it as I had the mental space to fully engage with it and lessons that worked more like lessons (as vs. the 30 minute tutorial slots of last term, though even with those I managed to do trial and error and established a good set-up!). Last term I had my students from the previous term so I already had rapport with them, that remained the case online. This term I shared my co-ADoS’s group and only had six lessons with them. So I did my best but it was difficult! Though by the end I felt I was getting somewhere. Time, eh. I have missed the face to face classroom though. Strange to think even when it becomes a thing again how different it will be. 

Re work-life balance, I have been pretty strict for the most part about maintaining it (bar yesterday when I worked from 7.20 til late afternoon in order to be able to attend this session!) because keeping myself in a state of reasonable wellbeing is essential to being able to continue doing the job. 

Trauma and stress in lockdown…

<ummm Zoom meeting crashed and when I tried to rejoin it said there was another meeting in progress. I can only hope I will be able to access the recording! Oh apparently the whole thing crashed, not just my problem, and now we need to find the speaker again!>

…What is the impact of all this?

  • Those feelings (everything we have talked about so far) can be very triggering. Particularly for people who have already experienced trauma.
  • Relationships may feel different, you may feel very detached from them.
  • Unprecedented time to ourselves can be stressful/traumatic, may lead to an existential crisis. Lots of big questions can crash around your mind. Loss of concrete knowing who you are, where you are headed in life, can lead to feel confused and overwhelmed.
  • You may feel some loss of identity, as the experiences that contribute to all our different versions of ourselves (work self, social self etc.) are not there.
  • Keeping conversations going without all the shared experience and new experience can be difficult.
  • May struggle to get out of bed and follow positive routines.
  • BLM activism, seeing people being killed, adds to the trauma. As a trauma response, we may shut down. Not consciously but we cannot deal with that level of grief. At the time is perfectly normal and healthy for coping but coming out of lockdown, how do we come out of that?
  • Social media exacerbates individual differences – comparison with others’ lives e.g. when you are having a bad day and see people on Fb/Twitter doing all different things and being productive which might bring feelings of shame and guilt in you. Loss of motivation can result.

I remember during lockdown seeing lots of posts of people baking cakes and suchlike while I was at full stretch with work and keeping my relationship with my girlfriend going. I may slightly have wished for a bit of being furloughed too! I can quite imagine that underneath all the cake photo posting, they were struggling with the massive change that sudden complete absence of work brings. 

  • People are all affected in different ways so can only offer limited support as are coping themselves.

Stress

We’ve talked about why it’s been stressful and why it’s been traumatic but what does that do to for us and to us? Stress is a very subjective thing, relative to our lives and our perceptions. At one time in your life something may seem very stressful, at another it may seem no big deal as your coping mechanisms, support network, context etc may be different. If you don’t perceive something as stressful, it won’t be a stressor for you and you won’t be emotionally and physically impacted.

Physical impact of stress

  • when we encounter a perceived threat, the hypothalmus in our brain sets off an alarm system and that sends signals through our body through nerves and hormones which prompts adrenal glands to release adrenaline (responsible for the fight flight freeze response) and cortisol (affects your body to prime it for response prepares muscles, activates release of things you need to response, suppresses non-essential things like digestive and reproductive system).
  • Normally once the threat passes, your body renormalises.
  • But really acute or prolonged stress can destruct your functioning e.g. digestive problems, slowed metabolism/weight gain especially round stomach as that is protective of organs, concentration is affected, affecting memory which is also affected by sleep.

Having an understanding of all this is important so that we take it seriously in terms of managing it.

I know for me the constant stress of the uncertainty, not knowing when lockdown would be lifted, seeing changes be made but not the one I wanted initially (to see my girlfriend properly) meant that my amygdala was more sensitive. It was something to be aware of, recognise that it was being more easily triggered than usual. And try to soothe it with meditation and emotional connection. 

Mental heatlh issues coming out of lockdown

  • Anxiety will be heightened – vomiting, dizziness, shaking, sweating, feelings of hopelessness and despair.
  • Depression, schizophrenia, bipolar disorder and eating disorders may be re-triggered.
  • Insomnia and memory problems relating to inability to concentrate due to stress and lack of sleep.

Everyone has been affected differently by this pandemic. Everyone has had a different experience of it – lost someone, not lost someone, had a good place to shelter, been in a stressful living situation intensively, had time to take up hobbies, been taken up with working from home and childcare, have had previous difficult life experiences that are re-triggered or not, been in a comfortable space or really cramped space, have financial issues or not, be able to re-energise and rest or not, have coping mechanisms in place on hand or not, have a support network or not.

So coming out of lockdown we will all have very different needs.

And whatever our needs are, as long as they don’t harm others they are valid and it is ok for us to try and meet them. Is what I think. 

It may be just as stressful or more stressful in different ways. Uncertainty is very central. It is not “back to normal” but forward to something else and we aren’t sure quite what yet. Masks in themselves are a big difference to adjust to, can seem intimidating. We have to find ways to adjust with the world as we are meeting it now. There is no one correct way/one size fits all for dealing with it. It might be frustrating, especially as everyone is at different stages, ready for different things at different times. This might lead to difficult conversations and changing relationships. You might need to set boundaries in new ways. You need to allow yourself to be human and feel all the things you feel. Even going back to commuting will feel exhausting as you readjust.

I have not missed commuting to work on my bike – the cycling, the hills, no problem; the traffic, the near misses, the fumes, oof. Not missed. I am keeping fit, going out cycling since restrictions eased and continuing to run, but the stress of dealing with high volumes of traffic again will be hard when the time comes. 

Very important to acknowledge and validate what we have been through and are going through.

Don’t minimise your feelings and do reassure yourself that it is ok to think and feel what you are feeling. What you think and feel are not a reflection of who you are. So it is important to let them be and let them pass, rather than attaching shame to them. You matter, your experiences matter, your reality matters. Stress, pain and trauma are very subjective – if you feel more anxious than others it doesn’t mean they are doing better and you are doing worse, it just means that you are experiencing it differently. And you deserve what help and support you need.

In terms of business best practice – phased returns will be important to let people dip their toes in and readjust. Allows time to communicate problems before they become bigger problems. Make sure you tell your manager what you need. Not always easy to do but very important. And remember it might be obvious to you but not to other people – they may not realise what problems you are having or what is needed without you saying it. Communicating can go a long way. Team meetings can be a good source of ideas of things that might help more widely. Working together to find a way forward. Important to value people, giving them the opportunity to be heard and making adjustments based on that.

Resilience is essential. It is not concrete, defined variously but is about the ability to bounce back after things happen. With it,

  • you are more likely not to dwell on things and learn from things and move forward if you are resilient.
  • You view setbacks as challenges to overcome rather than something paralysing.
  • You don’t see mistakes etc as reflections of your worth, but something to learn from.
  • In the midst of a stressful situation, doesn’t mean you are necessarily super positive, it is more an ability to recognise that some things are outside your control, and allow yourself to be human, to know when to step back and ask for support.
  • You are more likely to adapt, more likely to reach out and feel human emotions, allowing yourself to do that without giving up or letting those emotions dictate your sense of self.
  • You are committed to your values, goals, hobbies, relationships, work, families etc so are committed to finding a way forward no matter what. It’s not easy, it can be scary and it can be overwhelming but ultimately it can be very empowering: “Resilience is knowing that you are the only one that has the power and the responsibility to pick yourself up” – Mary Holloway.

How to build resilience

We don’t have control but we can learn…

  • We can learn how to reframe things positively, we can form value-based goals rather than arbitrary goals. Value-based goals can bring other things but it is the value/intentions that matter.
  • Locus of control is important – the more control you feel you have the more empowered you feel. There are always thing you have no control over and feel powerless in front of but resilience helps you with that by letting you focus on things that you CAN control, little things. As a teacher there is only so much you can do and then the students have to put in the work.
  • Perspective is important – look at the bigger picture, see negative events as a part of this rather than the whole picture, so then you will be less likely to give up. Zoom out, look at things in the context of the whole not as all-consuming. A positive outlook now might look like believing that things WILL change, even if you don’t know when or how.
  • You need to build a sense of self, confidence in ability to get through things.
  • Relationships are important, and reaching out to people. Treating yourself as someone that matters, including to other people, being as kind to yourself as you try to be to other people.
  • Humour is also very important – the more able you are to able to find something funny, the better you will feel.

Going forward

  • Assess your stress – is it long term or short term? Deadlines? You might have no choice but it is for a short period of time. If it is long-term, you need to take more action/steps/put things in place to make sure you don’t burn out. What are your yearly pinch points? Identify them and make a plan for how you will manage them. Plan to reward yourself afterwards too!

I have done this with my final 3 weeks of term, of which one down and two to go. I also decided to take it one day at a time and not waste energy worrying about how bad it might be. So far it’s been very busy but fine. I’m not unduly concerned about the next two weeks. They will be busy too but I will get through them one day at a time and be ok. And I get a rest afterwards! I am looking forward to my holiday. I’m not going anywhere but I will finally have a good rest. (Hopefully without illness, as Christmas, and without everything being about to kick off, as Easter. There might be local restrictions but it won’t be the first time, so there is that!)

  • Make sure your routine prioritises wellbeing. Routines often revolve around obligation but you need to revolve it around your wellbeing as well, as another key priority. Allocate time to yourself and hold on to it. Doesn’t have to be big things – going for a walk, trying a new class, therapy, whatever you need.

So important! My “me-time” is before work early morning running or cycling, having a lunch break (sitting in the garden when the weather allows), having my hour of yoga, meditating and piano between work and dinner time, and having my bath in the evening before bedtime. And weekends are girlfriend time. All of this contributes massively to my wellbeing. 

  • Make sure you have a sleep routine that is conducive to sleep and primes your brain to be ready for it – e.g. blue light filter, don’t use devices for a period of time before bed, do relaxing activities etc.

Newsflash: you never need blue light in the devices. Filter it permanently! That is what I do and I have a lot less eyestrain as a result, even with lockdown increased computer usage. 

  • Avoid having too much screen time – be mindful of your use of screens and social media and its effect on you. Watching a drama before bed might not be such a great idea.

Bath and meditating for me. And in the bath, listening to restful audiobooks, a bit of languages on Memrise, a bit of sudoku and yes a bit of Facebook scrolling but limited. 

  • Use your summer break to do some therapy, talk through your experiences. It can be really helpful also to develop coping mechanisms for the year ahead.

I wonder about this. I think I am ok but do I/should I wait until I am not to explore this option? Not sure… 

  • Find your sense of purpose – this can be a great guard against stress and ill mental health. It gives meaning to life and helps you refocus during adversity, it helps you know how you are and live according to your values (which we saw value-driven goals are key to resilience), caring for others is important.

My relationship with my girlfriend gives me a lot of purpose. Looking after her, being looked after by her. Working on the relationship, learning about myself in the context of it. Obviously work does too. So too does my veganism. So does learning! There is so much to learn. I have enjoyed learning about brains/minds and how they work in recent months, amongst other things. Work brings lots of learning too, of course. I value connection and compassion, I value learning and being open to learning, and growing. 

  • Play is also very important. Embrace your inner child! Sometimes it needs to be held and reassured, sometimes it needs some fun and laughter and enjoyment! Play is very mindful and brings you back to focusing on the present. Put aside shame/embarrassment/vulnerability to one side and do it!

I hadn’t thought about this before, but yes. Maybe this is why we enjoy our board games and going out paddling and suchlike together so much. 🙂 

  • Reframing – thinking about stress differently. If you see it as useful, it may be less damaging. E.g. the adrenalin rush. Rather than thinking it’s awful, if you smile, you can send signals to your brain that enable you to physically experience it differently. Emotions are very physical. For example, be excited to meet a deadline because then it’s done!!  The worst day at work possible will still be over in a number of hours, even if you aren’t sure how you will get there!

I have been trying some of this! Mindfulness is helpful here because it helps you recognise the stress response earlier and that awareness helps you step out of it. 

What if there is another lockdown?

Well, this seems particularly timely, given the tighter restrictions that have been imposed on some parts of Northern England at very short notice! Fortunately not yet Sheffield. It was a shock though. The speed/lack of warning, particular freedoms (being able to spend time with people) being taken away while others are not (pubs, going to work etc). This, in combination with this session, which I attended mere hours before these new restrictions arrived, has made me realise the importance of the below. The need to reflect, to learn, to be prepared…

Now we have a direct experience to learn from.

  • What has been helpful?
  • What hasn’t been helpful?
  • What has been harmful?
  • Have a plan for your stress. Know what you need in order to help yourself adjust, know what you need from your routine and plan it in.
  • But also let go of what you can’t control, focus on what you can control i.e. how you look after yourself.
  • Let yourself acknowledge when things feel difficult without making that about who you are. We instinctively seek support when things are difficult, because of oxytocin – go with that. Human connection is important. Find out what support services are available to you so that when your body tells you you need it, you can seek it. Oxytocin is very healing. The more social contact/support you allow yourself to seek, the better you will feel long term.

I briefly talked to my girlfriend about it earlier today. She agrees that we need to prepare ourselves mentally for another period of being separated, in case that is what happens. It might or it might not. For now, even with the new restrictions if they were to be imposed on Sheffield we would be ok as we are a “bubble” and bubbles are still ok. But the government could just as easily change that, just as it changes any number of things all the time, at any point. As I mentioned earlier, what happened to Greater Manchester et al. gave me a shock. I wasn’t prepared for it at all. That doesn’t mean that from now I want to spend lots of time worrying about it possibly happening – that won’t help. But having a conversation with my girlfriend about how we will manage if it does happen, asking the questions in the list above, that will help. 

There is no “quick fix”. It’s little daily changes that can either make things worse or improve them. Working on these can have an enormous impact. Get to know yourself and what things are difficult, what triggers you have, what you can do when they do arise. Do it compassionately as you would with someone else. Allow yourself to try, allow yourself to fail, be kind to yourself always.

I’m glad I made the effort to attend. It was kind of hard in a way to focus so much attention (was nearly 2hrs worth!) on lockdown and the stress around that. I think it’s human nature not to want to think about it. But it can be done in a constructive way and given the virus is still with us, it’s important to do so. I think we need to avoid the extremes of pretending it isn’t and doing everything same as before and spending 100% of the time worrying about it and not leaving our bedrooms because it’s too scary. But I think for the human mind it is difficult to hold that balance. Total avoidance or being completely caught up in a threat response are much easier, but a lot less helpful. I think as a society we need to face it with compassion for ourselves and for others but that will take work and may be difficult in the face of a government who doesn’t “do” compassion. Still, let’s see what happens and do our best! 

Thank you, IATEFL, for the chance to attend this session! 

University of Sheffield Workshop: Promoting positive mental health and challenging homophobic behaviour – 23 July 2018

On the 23rd July 2018, I was happy to be able to attend an LGBT+ inclusion workshop hosted by the LGBT+ Staff Network and Open@TUOS Allies, deliberately scheduled to coincide with Sheffield’s Pride week. (It also coincided with the one Monday that I didn’t have to lead a module meeting at 1.15, which would have clashed with the workshop and a day in which my teaching hours didn’t clash either!)

It is part of ongoing LGBT+ inclusion work at the University of Sheffield. Other examples include the “Open@TUOS” campaign (which currently has over 2200 supporters across the university, most of whom wear rainbow lanyards as a visible sign of support) and LGBT History Month . According to Professor Gill Valentine, who is the Provost and Deputy Vice Chancellor and who opened the event, the workshops were hugely oversubscribed.

The workshop was delivered by Josh Willersey from Stonewall.

The first session was focusing on mental health.

We started with a matching activity for terminology and definitions relating to LGBT. I was familiar with all the words except “gender variant”. Click on the link to have a go yourself!

Some of the things I learnt:

  • Until 1990, “homosexuality” was on the WHO’s mental illness list. (Very recent past!)
  • A “cisgender ally” is someone who is not trans but supports trans people. (“Cisgender” means your gender identity matches the gender you were assigned at birth – that I knew)
  • 1 in 200 people are born intersex (that’s more common than having red hair!) but often don’t know until if/when they try and conceive.
  • Gender dysphoria can affect intersex people who have invasive surgery at birth.
  • There is a lot of overlap between Bisexuality and Pansexuality (I knew that!). Some people who come out as Bi may actually identify as Pan but not want to spend their life explaining it to people.
  • 62% of graduates who were out at university go back into the closet when they start work as they don’t know if it is ok/safe/acceptable there or not. (You can out yourself by how you answer general questions e.g. answering honestly about what you did at the weekend. You make the decision whether to do that or not depending on how safe you judge that situation to be. This bit I know!)

After the terminology exercise and feedback, we moved on to mental health. Josh used himself as an example of a person who may be perceived to be “happy” (and even receive an award for it at work) but actually simultaneously be going through a hard time. This led us to the first question.

What are the barriers to talking about mental health?

We had to discuss this in our groups and then there was some “whole class feedback”. Here is a list of everything I managed to note down in the course of this:

  • still a stigma about admitting it
  • looked at different to physical health (e.g. at the uni, NHS delivers physical health services, but mental health services are the university’s responsibility)
  • people feel they should be stronger, that mental health issues are a sign of weakness and they don’t want to appear weak
  • labels have certain connotations – a person may be suffering from from a particular issue but not actually match up with peoples’ perceptions of what a sufferer of that issue is and does.
  • people feel like a failure if they have to “admit” to a mental health issue
  • the term “mental health” is too broad to be helpful. E.g. within the NHS they wouldn’t say “let’s improve our physical health service” it would be more specific like “we need to improve our asthma-related services”
  • gender issues e.g. “I am a man therefore I cannot talk about this” (i.e. norms and expectations)
  • cultural issues/pressures (again, norms and expectations-related)
  • lack of support available

Then we had a few statistics:

  • £70-100bn is the estimated cost to UK of mental health issues
  • 91 million working days are lost to mental health, it is the most common cause of absence (UK centre for Mental Health)
  • 53% of people would not feel comfortable disclosing mental health issues to an employer (MIND)

Focusing on LGB+ issues:

  • LGBT+ people are 50% more likely to experience long-term mental health issues
  • LGBT+ people are 2 times more likely to commit suicide than the wider population
  • Bisexual men are 4 times more likely to commit suicide than the wider population
  • 45% of LGBT+ young people are bullied at school, including via social media and text: home is no longer an escape/safe space. They are often bullied for being different, which is closely to linked to gender norms/expectations.
  • Young LGBT people are 6 times more likely to commit suicide
  • Alcohol misuse is 50% higher

Focusing on Trans issues:

  • 88% of trans people have experienced depression vs 1 in 4 of the wider population
  • Trans people are faced with two challenges: dealing with their own experience and dealing with transphobia in society which may take the form of harassment in the streets, people denying their identity, rejection by friends/family/general society
  • Transphobic rhetoric/language use is on the rise at the moment because of the changes in policy being discussed currently that would make it easier for trans people to transition
  • 60% (or 66% I can’t read my writing!) of trans people have attempted suicide
  • 77% have used antidepressants

In terms of health care provision:

  • 6/10 health and social care workers don’t believe orientation is relevant (And if LGBT+ people seek care, they may have to explain themselves/educate the care worker
  • 51%of mental health workers/counsellors/psychologists don’t believe orientation is relevant to mental health
  • 1 in 10 care practitioners believe you can be cured of being LGBT+ (Though there is now a commitment from the government to ban conversion therapy as it is proven to be very damaging)

Intersectionality

  • People with BAME backgrounds are more likely to be detained compulsorily for mental health issues
  • The greater someone’s level of socio-economic deprivation, the higher the risk of suicide being attempted
  • 25% of older people have a mental health problem
  • 54% of people with learning difficulties have a mental health problem

Having considered these statistics, we moved on to the all-important question of…

How the workplace can help/support people

Again small group discussion was followed by “whole class” feedback

  • take time to ask how people are and listen to the response
  • be alert to recognising differences in peoples’ behaviour that may signify that something is not right
  • be aware that people may be putting up a front (and a knee-jerk “yes” to “are you ok?” may not reflect the true picture)
  • be careful how you talk about people with mental health issues – others will pick up on it and respond accordingly (i.e. if you are disparaging or negative, they will endeavour to hide problems)
  • #Timetoalk prompts: shouldn’t need a prompt, caring, supportive discussion should happen all the time
  • if it reaches a “crunch point”, too many opportunities to intervene have been missed – it shouldn’t get that far
  • One of our group who works in the uni health service said they have a buddy system and timetabled coffee breaks for GPs, to combat isolation/stress
  • If someone is off sick, keep in touch with them (in a supportive way rather than a harassing way!)
  • Training about mental health should be offered (awareness-raising etc)

Here is the slide of suggestions that Josh shared afterwards:

We were finally given some suggestions for promoting better mental health in the workplace and some resources relating to LGBT+ and to mental health:

The second session focused on bullying and harassment in the workplace specifically in relation to LGBT+ people. 

We started with some statistics relating to bullying/harassment of LGBT+ people in general:

Bullet point three is partly due to increased likelihood of reporting compared to before but also links to rise in populism and validation of far right attitudes that has been seen in the last 5 years.

Then we looked at statistics specific to the workplace:

We talked about  behaviour and what is unacceptable behaviour:

Homophobia

  • Still rife in modern society, common to hear language such as “poof”, “gay boy” or “faggot”
  • There is still “moral panic” i.e. a fear of LGBT+ being more acceptable having a negative effect on children (why it should have a worse effect than heterosexuality being acceptable, I’m not sure…)
  • Calling something “gay” to mean sad/pathetic/rubbish still common e.g. “This lesson is so gay”. This use of language does impact people who hear it.

Biphobia

  • People consider bisexuals to be “confused”, “greedy”, “selfish”, “going through a phase”
  • People say bisexuals should choose one or the other – “choose a side”
  • People say that you can’t be bisexual unless you’ve slept with ‘both’ genders
  • People consider bisexuals to be more likely to cheat on their partners
  • People say things like “she used to be bisexual but then she married a man” (This does not make her magically straight…)
  • People make assumptions based on who the bisexual person is in a relationship with at that time
  • Bisexual people face discrimination within the LGBT community as well as from heteronormative society

Transphobia

There are more people identifying as non-binary (or various other gender labels, other than male/female) these days. This is partly because there is now the language to express it, there is information available online and times are changing: fluidity is more acceptable among young people. (This acceptance of fluidity and increased likeliness to have a fluid identity applies also to sexual orientation, with 50% of young people identifying as something other than 100% straight in a recent survey)

  • Tends most heavily to be aimed at male to female transsexual as that is the most commonly known about narrative
  • language such as “tranny”, “shemale”
  • People might say something like “you really can’t tell, can you” – which can be hurtful because the transition wasn’t about pleasing people aesthetically, it’s about identity
  • People might say something like “oh she was such a pretty woman before”
  • People might assume that it’s “just a phase”
  • People might police the toilets – “Excuse me, I think you are in the wrong toilet”.

(This seems like a good place to share a photo taken at the IATEFL conference in Brighton this year:)

Like our classrooms should be – nice one, Brighton Centre!

  • Continued use of the wrong pronouns despite knowing the person’s preferences
  • Continued use of an old/dead name -known as “dead naming”, shows non-acceptance of the true identity
  • Asking what someone’s “dead name” was – can be hurtful/upsetting as often it is loaded with trauma for the person
  • Asking a trans person when they will have surgery – not all trans people do a medical transition

Then we considered what barriers there may be to reporting bullying/harassment in the workplace…

  • Fear of the effect on one’s career: not wanting to rock the boat.
  • Knowing that it could be explained away as “banter” (which can cover a multitude of sins)
  • Not wanting to be out to your manager
  • Not wanting colleagues to look at you differently

as well as the impact it can have on the person and the organisation. For a person, they may develop low self-confidence, become demotivated and/or suffer from anxiety/depression. For the organisation, overall it can lead to low staff morale, increased absenteeism, reduced productivity, recruitment and retention problems and possibly costly legal action/

So what can organisations do? 

  • Cultural change (takes time)
  • Policy: it should mention LGBT phobia as unacceptable specifically – it’s a lot harder to report something if it isn’t clearly articulated in company policy
  • Organise training around awareness-raising
  • Make use of inclusive messaging e.g. messages sent to all staff that send a positive, inclusive message around LGBT+ (such as the LGBT+ history month here)
  • Make sure reporting routes are clear to all employees
  • Have an LGBT employee network group

Responsibility

Who is responsible?

  • The source: the one whose behaviour is offensive
  • The target: should tell someone if their behaviour is upsetting. Discriminatory behaviour must be challenged (also among students!)
  • Any observers: there is no such thing as an innocent bystander, you should call out offensive behaviour
  • Person in authority: Managers should address inappropriate behaviour. It is the employer’s responsibility to maintain a respectful, inclusive environment.

How to call out inappropriate language/behaviour

UHT – I UNDERSTAND you don’t mean to be offensive when you say x, HOWEVER, it is offensive (and against company values?) to say x. THEREFORE, please don’t use language like that again.

Stop, Identify, broaden: Stop the harassment (if you feel threatened, you could just speak to the target so that they aren’t stuck in a 1-1 with the harasser); Identify the behaviour as discriminatory; Broaden the response by linking to company values etc.

I feel <x feeling> when you do <y action> and I’d like you to <a preference>

Having considered these approaches, we looked at three case studies:

Again, group discussion was followed by coming together.

Case Study 1

  • We thought the main difficulty in such a situation is having “a way in” to talk about it. We came up with “I’m sure you’re not trying to cause offence but…”
  • We also thought the response might depend on the environment e.g. if this was at the uni, we’d be acting in a professional capacity and know that it is against organisational values etc. Policies/training may not be in place elsewhere, so if you are elsewhere, you might flag it up to a manager
  • Flip side, if you only speak to a manager, nothing may happen, so it may be better to speak to the receptionists (especially as regardless of location, reception is public-facing so anybody could hear what they were saying)
  • Don’t just do nothing

Case Study 2

After making sure the person being harassed is ok, challenge that person by getting them to explain their statements, using “why” a lot. Challenge their thinking:

  • There are LGBT+ people of all faiths. There are inclusive people and readings in all faiths. The two are not mutually exclusive.
  • Orientation is not “a lifestyle”, it’s part of someone’s identity
  • Both people of faith and LGBT+ have experienced discrimination for that identity
  • Faith values: acceptance and love, not hatred.

Encourage the person who was being harassed to report it

Case Study 3

  • Ask James what he wants you to do/how he wants you to proceed (very important)
  • Offer support/options (e.g. confront the colleagues involved, make a formal complaint)
  • If you are a colleague, encourage reporting
  • If you are a manager, follow it up

Focus on the action

In all cases, it is important to focus on the action rather than the person. I.e. “x is a homophobic thing to say/do”, rather than “you are being homophobic”. If you use the latter, then they will immediately be focusing on defending themselves (“I’m not, I have a gay uncle, I have gay friends” etc!) and that is not dealing with the issue of the behaviour.

Don’t be complicit

It is uncomfortable to challenge but it is also important, as we don’t know who is listening or how it could be impacting them.

That brought us to the end of the workshop.

My thoughts

I feel very lucky in that my workplace (my staffroom, my colleagues etc) always feels like a very warm, safe environment. I love seeing the rainbow lanyards around! It’s a nice feeling. I love that this university is 24th in Stonewall UK charity’s list of the top 100 most inclusive employers.

I think the topic and content of this workshop also has relevance to the classroom and to us as teachers as well as as workers. Statistically, there will be LGBT+ students in our classrooms. We need to actively make our classrooms an inclusive, safe place for them. This means that if students say things that are LGBT+phobic, we, as teachers, shouldn’t be a quiet Switzerland on the issue. We should be calling it out. Obviously this gets a lot more complicated if you are working in a context which is not tolerant of LGBT+ people and/or in an institution whose policy on this is undefined. I think ELT school managers should, where possible, have clear policy around LGBT+ bullying being unacceptable and teachers should be aware of this and know that they would be supported in calling students out on it. (A teacher can’t tackle such a problem without the support of the school – if the student complains, the school needs to be supporting the teacher.) This, of course, is affected by the students as customers perception that is common throughout ELT. Training around how to deal with LGBT+ issues in the classroom may also be useful. E.g. what would you do if in a unit talking about personal relationships, a female student refers to her partner as “she”? Is it a pronoun mistake or an assertion of identity? How do you establish which it is? How do you deal with other students’ response?

I also think that ELT materials need more LGBT+ normative content (gay people rarely exist in ELT course books – as Scott Thornbury famously said, they are firmly in the course book closet), but that’s another topic for another day…

What do you think?

Questions I want to leave you with

  • Is your workplace supportive of people with mental health issues?
  • Does your workplace have policy in place to combat workplace/classroom LGBT+ bullying/harassment/phobic behaviour?
  • Would you feel able to report this kind of behaviour (would you know who to report it to?)
  • Do you think that if you did report this kind of behaviour that something would be done?
  • Have you ever attended training relating to LGBT+ issues?
  • Have you had to deal with LGBT+ phobia in the classroom? What happened? How did you deal with it? (To give an example, I remember I taught a class that consisted of 3 Arabic men and I can’t remember why it came up but at some point they were ALL spouting some seriously vitriolic opinions about gay people. This was in the UK, in 2012. I had no idea what to do and I didn’t/don’t know what that school’s policy was on the issue. It was very awkward and uncomfortable! What would you have done? Fast forward to 2017, working at the ELTC, and in my elementary group, one of my students said he hadn’t seen any gay people in Sheffield/at the university. I challenged that by asking how he knows and gently pointing out that gay people don’t go around with labels on their foreheads to tell us they are gay. Gay people are just normal people. I also included gay family images in my Smartboard materials for the unit on families to supplement what was in the course book and statistics around mental health in wider vs LGBT populations in the UK in the spread on mental health issues. That was a much more benign situation BUT it needed to be dealt with and there was scope for awareness-raising. It DOES happen, the frequency is irrelevant – that it happens at all means we need to be equipped to deal with it effectively when it does. I think it would be useful for there to be more help with how to do that.)

Sorry for an extraordinarily long post, but it’s an important topic and there was a lot of ground covered in the workshop!

Mental Health in ELT – the discussion continues…

A few months ago, I wrote a blog post about mental health in ELT, sharing links to various newspaper articles that point to an increase in mental health problems within education in general, among both teachers and students, and sharing my own experience of poor mental health in the workplace. I am pleased to now share with you all the good news that the topic of mental health, which we can all agree is a very important one, will be the focus of at least one session at IATEFL.

Phil Longwell will be doing a talk about mental health, part of which will draw on the results of a survey that he has published in order to collect qualitative data relating to this subject. It would be great if as many people as possible complete the survey, as this would provide an interesting insight into the state of mental health of teachers in various ELT contexts. I encourage you all to complete the survey and look forward to hearing about the insights gained when I attend Phil’s talk next year.