An overactive harm-alarm: Harm OCD

If you suffer from harm OCD or think you might, this post may be triggering for you - perhaps ask someone who understands your situation to read it first and recommend if its suitable for you or seek professional advice before you read.

What is harm OCD?

I'm going to quote things here that say it far better than I could. The OCD Centre of Los Angeles put it like this:

'Harm OCD is a manifestation of Obsessive Compulsive Disorder (OCD) in which an individual experiences intrusive, unwanted, distressing thoughts of causing harm. These harming thoughts are perceived as being ego-dystonic, which simply means that the thoughts are inconsistent with the individual’s values, beliefs and sense of self. Harming obsessions typically center around the belief that one must be absolutely certain that they are in control at all times in order to ensure that they are not responsible for a violent or otherwise fatal act.'

How do I experience this day to day?

I'll use the example of a walking group I used to lead. All we had to do was meet at our office and go on a half hour walk. What could possibly go wrong? And what could that possibly have to do with people drowning or dying? I hope you've lost me now and think.... huh? What have those horrible things got to do with anything? If I haven't lost you then you're one of my people!... We're the ones with overactive 'harm-alarms'.... we suffer from Harm OCD. 

I'll try to explain. When my husband or therapist, and I suppose people who don't have Harm OCD, think of taking out a group on a walk they think... 'I hope its a nice day' or 'I'm looking forward to being out by the river'. There may be some anxieties but these would hopefully not interfere with their normal life in the lead up to the day. Unfortunately my brain, along with other sufferers, doesn't process things like that. 

I become aware of my own voice telling me, 'I'm responsible for their safety, if anything happens to them it will be my fault, you don't want to be locked up do you? Better make sure you keep everyone safe then! You can't miss any risks, someone will die and you'll know it was because of you.' It's is like there's another me and it keeps tapping me on my shoulder and it's obsessed with preventing others from being hurt. It likes to show it to me on a big screen too, showing the imagined harm happening. This is really upsetting.

The thoughts and images are accompanied by safety behaviours or compulsions. In this case I had to count people almost constantly during the walk making it really difficult to have conversations and I had to ask people to stay away from the water every five minutes, much to their annoyance. I also thought of avoiding it all together, as I became so convinced someone was only moments away from harm. The week afterwards I had to find discrete ways to check if everyone was still alive, in case I'd accidentally allowed them to get lost on the walk and they hadn't returned home. That was really embarrassing. I had to also ask for constant reassurance from my husband that the walk would be ok, and living with my daily fear and distress in the days before was debilitating to us both. 

The OCD Centre of Los Angeles also say this:

'It is not fair to say that one form of OCD causes more pain than another. In our experience of treating individuals with OCD, those with compulsive hand washing appear to be in no less pain than those who live in fear of being sexual deviants or psychopaths. What sets Harm OCD apart is the way in which it attacks the things we love the most, and does so with such brutality and lack of mercy as to astound even the most creative minds. The moments that we most want to be highlighted by memories of peace and contentment suddenly become contaminated by mental imagery of horrific violence and feelings of relentless guilt.'


This is exactly it. I hope one day to become a mum, but I worry my baby will hurt itself and it will be my fault. This sort of worry is normal but in OCD its obsessive and relentless - its intrusive images and obsessive fear and its disordered because it prevents you from living a normal life. Instead of day dreaming about cuddles or baby's first steps, for Harm OCD sufferers its more likely to be baby's first trip, fall or choke. It's constantly obsessing over safety to make sure you don't inadvertently harm someone, and it attacks the things most important to you.

If you'd like to know more about the kinds of thoughts and obsessions that characterise Harm OCD then there's a really good questionnaire from the OCD Centre of Los Angeles to help you identify the extent of the illness and understand more about its nature http://ocdla.com/harm-ocd-test.

So how can we deal with this illness?

I don't know yet...sorry!.... well I don't have all the answers. I'm still in treatment, but, here's a few things that have helped me so far:

1. I identified the problem and told someone 

Part of the problem with Harm OCD is that its hard to tell anyone. You're so ill that you are sure you must be reckless or dangerous and you feel incredibly ashamed. The first step on a long recovery was telling my husband and my GP. I now go to an expert therapist, I've got a support group and I've found some people I can talk to about it (and I have my blog!). 

2. I temporarily stopped being in situations my anxiety was too high for

When I hit breaking point it had become so bad that I simply couldn't function on my University course anymore. It was tough to step back, I had no job or course and I started medication and therapy. But it was what I needed. You can get back to these things, but sometimes you have to stop life for a bit and get help. Just like any physical illness we go into hospital for, we need treatment for mental illness too. I'm now back at work and I lead a pretty normal life.... I just spend a lot of time in therapy, I run a support group for anxiety and OCD and I spend a lot of time learning self-help techniques, but I am getting better... slowly.

3. I went back to face triggering situations in a graded way with professional help and I volunteer a lot

When I was out of work I used voluntary work as a way of building up my confidence again and I still use it now. When I'm volunteering I'm helping others and myself, and that gives me a great self-esteem boost. There is also less pressure. I can face a triggering situation and its much less daunting to ask for help or step back than it is in the workplace.

4. Do more of the things your OCD doesn't attack

Running my support group isn't something that everyone would feel confident to do. When I've told people about it they've asked whether I worry about various things? And the truth is I don't. It's something I just don't have obsessional problems with. So I focus on this, on my skills and the confidence I have. I try to use CBT and Mindfulness to look at how I can challenge my OCD using this confidence.

5. Finding a support group, a therapist and self-help

I've been lucky enough to have had excellent treatment using Exposure Response Prevention (ERP), Cognitive Behavioural Therapy (CBT), Mindfulness-based CBT and psychodynamic techniques, and in the last 4 years I have had quite a lot of success in doing the things that trigger my OCD. I had to find private treatment because the NHS doesn't offer the kind of help I needed to get better. Therapy isn't for everyone, but I couldn't have recovered without it. So I would encourage you to explore whats out there, even if the NHS coverage is patchy, there are often private options at a range of prices. 

Support groups can be a really great place to share your experiences and can help you feel less isolated and alone. Again, not for everyone, but worth seeing whats around. With my group I totally respect if its not right for people and I'm more than comfortable for people to come along for just one session, and if its not for them, then no problem.

I'm trying this self-help book at the moment for my OCD The Mindfulness Workbook for OCD and I'm finding it really make sense to me. There are lots of online resources, books and audiobooks now that address OCD with a variety of physiological approaches. Again, its worth trying to see if any of them might appeal to you. Do a Google search now or pop along to your local Library... there might just be some answers there.

That's all for now!

Compassionista xxx

P.S. I must stress that these are my own personal tips and experiences. I am not a trained medical professional and these ideas wouldn't suit everyone. If you are concerned about any emotions, feelings or symptoms your experiencing, please seek the advice of a trained medical professional as soon as possible.

5 Practical Ways to Help Depression: from a sufferer

Depression is a unique, horrible and well hidden illness. But it is affecting more and more people, so I wanted to share some ideas on the things that have helped me get through it, past and present, that might help others. 

Depression can affect people in different ways, so I will try to explain how I experience it. This video puts it perfectly for me. If this sounds familiar, give these ideas a try if you can, they might help.... even a bit.

1. Find a charity that offer peer support

This is similar to my advice on the 'Find Your People post on anxiety.' Peer support, for me, is amazing. It can help so much to find a supportive environment and share experiences with others. It's not a quick fix, because there really isn't one. But when you are having a day when the depression is really bad and getting out of bed seems daunting and seemingly impossible, it can help to know that there are people out there who feel the same and who are rooting for you. 

Charities have a lot on offer now, from support groups and social groups, to advice and coaching services. To know that your support group members care for you and would really miss you if you weren't around or to know that there is a cup of tea with your name on it waiting for you can be enough to help you find the will to fight. I always think having depression makes you physically feel like you're walking through treacle and just having a shower can take me hours. But knowing I have people who care waiting for me helps so much. Or perhaps you're feeling anxious about filling out a form, there might well be a local advocate who can help you do that. 

Where do I find a charity? Google is a great place to start but there are also a lot of information lines that might be able to help provide the contacts of local charities e.g. Mind and Rethink but also your GP will hopefully have links with support that's local to you. 

2. Seek professional treatment

Depression is a mental illness, and mental illness is a serious and real as physical illness. You deserve support to get through this and going to see your GP is really critical to getting well. You're GP will be able to refer you for psychological therapies, prescribe medication if you would like, signpost you to support groups and charities, assess your safety and monitor your illness.

It can be very daunting to make that first visit, but it is very important. If you don't find one GP is very helpful, then you can always try visiting another one in your practice. More and more GP's are making connections with local support services and the profile of mental health is being raised, so it is well worth having a chat to them. See if you can ask a friend or relative to go with you if you think that would help.

I have found talking therapy and mindfulness training has helped me so much and my GP was able to recommend an excellent hospital for me to go to. If you have private medical cover its worth seeing if it covers talking therapies. Sometimes there can be long waiting lists on the NHS, much like many things, and private treatment can be expensive. Personally I've found the money myself and my family have spent on treatment for my mental illnesses is the best investment we've ever made. I recently came across this excellent article on ways to find affordable therapy and sometimes charities provide scalable therapy services, so tip #1 is a good one to follow.

You can access therapy in so many ways too now. Talk to your GP about online CBT, for example from IESO or see if your workplace has an Employee Assistance Program, you can often access free phone or email counselling this way.  

If you do decide to undertake talking therapy you need to set aside time outside of sessions to work with your thoughts and feelings. It is hard work. My house is full of CBT worksheets and I have so many notebooks I'm single-handedly keeping Paperchase going! I practice my mindfulness exercises everyday and I write in my journal to help recognise any unhelpful thinking patterns as soon as possible. So I guess I'm trying to say, it really is worth doing your homework. 

3. Self-care

When you have the flu its best to rest up and get well. Sometimes we're tempted to carry on with a load of cough and cold remedies, but actually rest and care is the most effective way to get well. It's no different with depression. You're body and mind are under attack from an illness. Care is what you need. 

Self-care is different for everyone but here are some ideas to start you off with. 

• See if a friend or loved one can help out with the chores or looking after the kids until you're well.
• See if you can take some time off work or talk to you manager about making adjustments whilst you're not well e.g. regular rest breaks or working a more flexible pattern (you're GP can help recommend this to your work place if you request an Occupational Health assessment). 
• Allow enough time for rest and sleep. If sleep is difficult see if you can create a helpful routine (I will make sure I post about mine in future).
• Set out daily time to do activities that comfort you. Perhaps watching you're favourite TV program, eating your favourite food or doing something you enjoy like going to the cinema. Pick things that are low anxiety and as enjoyable as anything can be right now, given how you're feeling.
• Curl up a lot - get a blanket, a cup of tea, put the TV on and tuck yourself up on the sofa as often as possible. This is what you do for a physical illness, mental illness needs the same care. Whenever you're feeling anxious or low, consider whether you need self-care. 

When I've been really depressed in the past and I felt suicidal, my husband would book cinema tickets regularly. I loved the cinema, we would pick quiet showings where no one was around. I would dress in my tracksuit, buy pick-a-mix and hot chocolate and literally curl up in the dark  cinema and get lost in the film. It was about the only thing I enjoyed at that time. I would call my husband to explain I was feeling suicidal and he would help me to promise I'd wait to see the film before I did anything. And week by week I kept making it to the cinema.... I'm still here 4 years later and I still love movies!

4. Self-help

Self-help books aren't for everyone. But, if you do like reading or you're willing to give it a try, there really is an amazing wealth of therapeutic material out there. When I was really unwell the first time, I was too ill to work. So I needed to create a structure for myself and I wanted to find out what I could do to help me recover. I find when I'm suffering a really bad bout of depression I cannot concentrate on reading a book, I often don't have the energy to even sit up! So I decided to try audiobooks. I would listen, sometimes fall asleep, sometimes cry too much to hear what was being said, but I'd try again the next day, and the next day, and the next day. I'd follow along with a copy of the book from the library. Until eventually I found the ideas were sinking in and I was ready to try some of the self-help techniques recommended.  Now, I have incorporated so many of the techniques I've learned into my life to improve my wellbeing and I use them in conjunction with my therapy.

Here are just a few of my favourites!

• CBT for Dummies by Rob Wilson and Rhena Branch (this helped me overcome my depression)
• Overcoming Perfectionism by Roz Shafran, Sarah Egan and Tracey Wade  (this helped me reduce the risk of relapse)
• Sane New World: Taming the Mind also by Ruby Wax (this helped me realise I wasn't alone and begun to teach me mindfulness to manage my illness)
• The Mindfulness Workbook by Thomas Roberts (as recommended to me by my therapist)
• A Mindfulness Guide for the Frazzled by Ruby Wax (this developed my mindfulness skills and made so much sense to me!)

I thank all you lovely authors for changing my life! I'm serious, these books have!

If all that isn't for you.... how about trying a wellbeing app or an online self-help course. I've never used it myself but the NHS recommend FearFighter, an online CBT based program for fear, panic and anxiety and I've had MoodGYM recommended to me in the past. I haven't tried these yet, so if anyone has, please share your experiences in the comments! Thank you!

And here is a link to some apps from the Mind website Apps for Wellbeing and Mental Health. As I've mentioned before, I use the Headspace app to learn mindfulness meditation. I'm currently working on the depression pack and for me its proving really helpful. It helps me to relate to my thoughts and feelings in a different way, and its comforting to know there are techniques out there to help me recover.

5. One post-it at a time

This was something my counsellor helped me to do. When I was completely broken down and struggling to function at all, she gave me post-its to help change my life. At the time I was living in pyjamas and making whale noises!

(My husband would come home at 5.30pm and run me a bath. I would manage to peel myself off the sofa, take my pyjamas off and get in the bath. Then I would soak until I was all shrivelled up like a pea.... he would try and talk to me, I would just moan. I call this pyjamas and whale noises. If I ever write a book.... that's the title!)

I was tasked with writing out 3 post-its at a time. They were simple things to begin to get me moving. I would stick them up on the wall and just work on one post it at a time. I remember one was to wash up a knife and fork, and that was it (you cannot wash up when you're really depressed, it is physically impossible, unless you're suffering obsession at the same time - then I scream if someone tries to peel me away from it...). That was a tough time. But I've realised now I have an illness. And that's just one thing that helped me to cope.

If you're currently functioning a little more than I was back then, try using post-its to manage your time, celebrate your achievements and pace yourself. Don't forget to include lots of self-care on there!

That's all from me now. I hope this is helpful to someone, its been helpful for me to share.

Take care everyone and take 'self-care',

Compassionista xxx

P.S. I must stress that these are my own personal tips and experiences. I am not a trained medical professional and these ideas wouldn't suit everyone. If you are concerned about any emotions, feelings or symptoms your experiencing, please seek the advice of a trained medical professional as soon as possible.

Guest blog: What do you mean I'm a carer?

With thanks to Compassionista, I present my first guest blog entry! I go by the name RR, and I wanted to share with you some personal experiences of being a carer. I hope that perhaps they help you feel less alone as a carer/family member/friend, and perhaps give you an insight into a world you may be involved in without even realising it.

1. It's OK to be a carer

There's something quite disconcerting about the first time you are referred to as a "carer". You've been with your partner for however long and feel like you know them inside out. You know their brilliance, their flaws, their likes/dislikes, and their passions. In fact you don't just feel you know, you know you know. So when someone refers to you as their carer, you think to yourself, "Eh? I'm not a carer - I'm their partner! What are you talking about - they're not in need of a carer!" Then you take a step back and realise that all this time, it's not them that you've not known about or been aware of - it's you. You've perhaps always spent time helping your partner through difficult times, or supporting them through anxiety/panic attacks, or helping them through depression, but you may never have considered yourself as a carer. It may feel quite uncomfortable to class yourself as a carer, but believe me that part of our journey has been critical to us. As soon as I was able to step back and see what I was doing, I was able to start supporting myself too. Anxiety/depression/any kind of mental ill health is like a virus - it starts in one, then spreads to others. It's very difficult to stay afloat sometimes but this is exactly why it's so important to recognise that if it is in your family, you all need help and support.

2. No-one teaches you how to handle this

It seems obvious, but there genuinely is no manual for how to approach life when there's mental health difficulties involved. I spend so much of my time wondering if I am doing the best thing for my partner and whether other people would be more able/if I'm the right person for them.

I promise though - if you're with your partner, you listen, hug, and support them - you're doing a great job. Don't be too hard on yourself if you can, there's no "correct" way.

3. You'll feel very conflicted about lots of things

I've been with my partner for 10 years now (for my sins) and time seems to have genuinely flown by. I thought I'd never get to the age where I understood and appreciated cliches but sadly I think I have succumbed to the Hollywood notion of time flying. It has been 10 wonderful years, but 10 years full of challenges, heartache, and fear with lives surrounded by mental illness. I've always wondered to myself if I would have changed any of it and in truth, it's a difficult question. I would give literally anything I have ever experienced/owned for my partner to not have to go through what she does, without even thinking about it (in fact if anyone can offer this service, I do have quite a nice car you might like). On the other hand, all of the experiences we have been through has made us who we both are. I love my partner and I wouldn't have her any other way. Quite a dichotomy! How the hell am I meant to reconcile that?! Answer is - I don't think I can!

4. It might be quite difficult to keep track of your own wellbeing

This really is a bugger. Remember what I said about mental illness being a virus? Yeah it really does get places. It's very hard to balance a life with someone when there's mental ill health in the middle of it, and I've often found times where I am so focused on my partner that the next day I'm feeling like utter rubbish. I've had quite a few tests for some physical illnesses that have shown nothing. Why I wonder? Because they were much more likely to be affected by stress.

The clincher? You might feel guilty if you prioritise yourself. Oh yes - your brain is good at playing the guilt card! I've had to learn though that I'm of no use to anyone if I'm burned out, frazzled, and stressed - I have to make sure I look after myself just as much as I do anyone else around me.

5. Get ready to be angry

Yes, it is unfair.
Yes, the NHS struggles with mental health.
Yes, this is happening.
Yes, you may be in it for the long haul.
Yes, some people may not understand.
Yes, I promise you, there are people out there that can help.

Anger is common. It's a massive deal all of this, and your emotion needs to express it somehow. I know I need to both let my anger be, but to also challenge it where possible.

6. You'll want more than anything to be their Superman/Superwoman

This is possibly the hardest and most heart-breaking part of being a carer. There's nothing I wouldn't do to help my partner through a difficult period, but sometimes all you can do is to be there. Not to give advice, help, or anything. Actually just to physically be there. If you're wondering what to do and how to help, and that nothing seems to be helping - just try being there. There's nothing more important than just being there selflessly and non-judgementally for someone. Trust me, they'll thank you for it so much more than anything else. Nothing has ever put across the difficulty of being a carer better than this picture (it's from a wonderful book you can get here: https://www.amazon.co.uk/Living-Black-Dog-Matthew-Johnstone/dp/1845297431)

These points are just the tip of the iceberg, and I could go into more. I hope though that if, like me, you are caring for someone (or even if you know a carer) you can start to feel less isolated, less alone. It's going to be scary sometimes, but you'll get through. You're doing a wonderful job.

Next time I'll post about some of things I try to do to keep myself afloat, and also some of the things I have been able to help my partner with over the years. In time, I'll also share some of my experiences around therapeutic services, talking therapies, carer support, mental health charities, and others, and I hope that they will be of some support.

Until next time!

RR ~

Top Tips for Managing Anxiety (and Depression) Part 3 - Helplines

Hi everyone,

A short post today on my next tip! Its nice for you to have different length posts to read and also because today has been a day of simply surviving... This picture comes to mind and really helps.

Today I'm blogging about Tip #4 Mental Health Helplines

In our house I have the numbers for my favourite helplines on a pin-board near my wristbands and numbers chalkboard (see Tip #1). If my numbers get too high and I feel the anxiety or depressive feelings need to be let out and I REALLY need a listening ear, then I know these numbers are there. The phone comes out and so do my emotions! And I feel LIGHTER.... 

Here are a few to ponder: 

Samaritans 116 123

SANEline 0300 304 7000 *

CALM 0800 58 58 58 
(a helpline for men who need a safe space to chat and they have a web chat too if you'd prefer)

* I use the Textcare service too. You can register to get free text messages of kind words and encouragement at times of the week you can often feel low. There's lots of other support too, including web forums and Caller Care! Check it out! 

And there's a more extensive list here from the NHS! NHS Mental Health Helplines

Sometimes it can be really nerve wracking to call a helpline. All kinds of thoughts run through my head... what if I clam up and can't speak, what will they ask me, what should I say first, is it weak to call for help.... and the onslaught goes on!..... 

If these thoughts sound familiar or are coming to mind now just thinking of calling a helpline, then I can tell you - take positive action despite your thoughts. We're all human, humans have emotions. Emotions are awesome things. They make us beautiful, give us the power to connect to others and do amazingly fun and kind things together! But they can also make us feel terrible and they're sometimes pretty hard to understand.... But that's normal! Everybody needs to manage their emotions to lead healthy lives. And I've found these helplines are a great way to do this. 

The people on the end of the line are always so kind and understanding, and so proud of you for calling and sharing! Please try to tell yourself you're not weak. How is it weak to take action to help ourselves feel at our best? Surely its responsible and what we all deserve... Easier said then done I know! Particularly with the stigma so many of us face. And I'm not here to tell you how to think, but I do want to encourage others to support their own mental wellbeing and the wellbeing of others. But take it from me, a fellow 'emotionalist' who fights to tell herself she's not weak, far from it, we're brave! 

So when are some of the instances helplines have helped me? 

1. In the middle of the night when I've felt suicidal.

2. When I feel a panic attack building.

3. When I'm on my own, for whatever reason, and I feel down or demotivated.

4. When I feel a problem is overwhelming me and I need to verbalise things to       think more clearly.

5. When I just can't stop crying.

6. When I feel angry (it's a great alternative to just yelling at the nearest poor soul).

And I'm sure there will be more times, and I'm ok with that. I'm so lucky we have volunteers there to listen. 

I hope this might help you to think if you might like to try calling one in future. It can be another tool in the coping strategy toolbox that might just work for you. 

Thank you so much for reading,

Compassionista x

P.S. I must stress that these are my own personal tips and experiences. I am not a trained medical professional and these ideas wouldn't suit everyone. If you are concerned about any emotions, feelings or symptoms your experiencing, please seek the advice of a trained medical professional as soon as possible. 

Top Tips for Managing Anxiety Part 2 'How to create your own Emergency Box'

Hello again everyone,


I hope my last post was helpful to you and thank you so much for reading and supporting me! Now for my next tip!

Oh, and.... I'm going to be TOTALLY honest here, so its like letting any readers in on a life that used to be private. Forgive me if it's too detailed for you, but if we don't start talking about exactly what we do to overcome mental health difficulties then we've missed a trick, because we can help each other.


3. The Emergency Box.

If I become aware that my anxiety is becoming really high or I feel I'm starting to move into a more depressed mood, I get the Emergency Box out. Sometimes I don't manage to realise I need it myself and hubby says, 'I think you need your box honey...' I tell you what though, if I've put my red wristband on and I'm not within 2 feet of that box, I know I need to stop whatever I'm trying to battle through doing or 'getting on with' and use my box.

So, what is in my Emergency Box and what is it for?

My Emergency Box was put together on recommendation of a friend who had made one for someone. It was a box full of all her favourite things that she could go to when she felt really low. It was hoped it would be a prompt towards remembering all the good things in life (which the anxiety goggles make very, very blurry sometimes, like we're swimming under water and we can't see or breath....) and encourage her to keep going and keep fighting to stay well.

My box started off as a big PINK box with flowers all over it from Paperchase (overcoming my anxiety has at times meant its been like stationary on prescription), but has since become a more muted taupe coloured box as I've aged a bit and now only let 'neutral' colours enter my home.... anyway!

What's inside my box?

1. A message to myself from myself. I read this first: 'Well done for coming to the box. It means you're bubbling right now (bubbling is my word to describe very high anxiety, where I feel like my blood is bubbling). I want you to remember the times in the past you've used the things in here to calm you down and you've moved passed the anxiety you're feeling right now. It will be ok. You can do this.'

2. Instructions of how to use the box. When I'm really, really really anxious, I literally need it one-step-at-a-time. So I've written myself instructions for what to use and in what order. It helps me to see past the anxiety googles!

3. A candle. The first thing I do is light my candle. It's just a small candle, and it's white. To me, white signals clarity and peace, the true essence of myself. This is what I'm always aiming to feel. To drown out all the noise, and just let my own natural light shine through and show me the way. This is my 'little guiding light' like the song we used to sing at Brownies. This step gives me great HOPE. Once its lit I know I can start to calm down and enjoy the box! (This might not ring true with everyone, and that's ok. This is an ethos I've developed over the years of overcoming anxiety and depression.... hopefully I can share this more in future. But for now, just think about whether a candle could signal to you how you have survived feeling this anxious before, and you can survive again).

4. A blank piece of paper. The next instruction tells me to use the piece of paper to write down what I think has bought me to this state. Sometimes its one immediate thing, perhaps I had a triggering phone call from someone, or sometimes its lots of things that have built up. I will just write short phrases or single words. This is the communication and self regulation thing happening again......Now I'm a tiny bit clearer and I can give the paper to my 'safe' person (hubby) so that they can actively begin helping me. If you don't live with your 'safe' person or they're not around at this time, you can send them a photo of the paper. (see previous post on tips to find a safe person) Knowledge is self-regulation, so we're beginning to clear some of the anxiety mist now. 

(There's more though.... in case you're thinking, a candle and a piece of paper and the Compassionista thinks I'm feeling better?!?!)

5. The next instruction tells me to write down my numbers (see previous post) and write it down or text it to my 'safe' person. 

6. Put my favourite song on my ipod speakers. Mine is 'The Way You Look Tonight', the Maroon 5 version - it just makes me feel bouncy!

7. Next is something most people LOVE to do! I eat chocolate! I have, wrapped up in my box, some dark chocolate. I make sure I always replenish it, so its always stocked up! I have been eating dark chocolate (in moderation) ever since I read about foods that can help depression, so that's for about 5 years now! This is just a nice thing to do for yourself. It's saying 'its ok that you feel this way', and it recognises that you need to give your self love and comfort (SELF COMPASSION). It can be anything you like to eat that is a real treat, because in that moment when my anxiety is that bad, my own understanding of compassion says that the primary focus is to help me feel better in that moment, so eating sugary and yummy food is a good thing! I've recently discovered mug cake sachets and added one of those to my box too!

8. Now I read my 'hopes and dreams post-its'. When I was really suffering clinical depression, hubby and I wrote down some hopes on post-its. They were things that even through the dark mist I could see would bring me joy and we agreed they could be possible one day. The deal was that I kept fighting my illness, to get to those hopes. I will share them, as I hope it will help you have your own reflections. I have three pink post-its (they're 4 years old now). One says, baby, one says bunny and one says wedding. When I wrote these they seemed illusive... But now I'm married (and I loved our wedding despite my anxiety), we're buying a place together and we have plans to put pets in it! This helps me reflect and feel HOPEFUL. Now the anxiety mist is really shifting.

9. Chai Latte. Or any beverage of your choice. I find hot drinks incredibly relaxing. Also I know a milky hot drink gets me protein and calories, which my body needs to have to recover from the draining anxiety. This is another important step in caring for yourself. You are worthy of care and you're showing yourself that by making a lovely hot drink. So I keep a pot of chai latte powder in my box and my favourite mug is in there too. (I have a milk frother to make mine.... literally it is AMAZING, get one!) 

This is also a good point to mention mindfulness. If any of you have tried any mindfulness, making a hot drink is a great exercise to practice paying mindful attention. If you can learn to do this you're even further on your way to clearing the mist. If anyone would like to learn mindfulness I would recommend the Headspace app or for this specific activity, week 1 of Ruby Wax's mindfulness course in 'A Mindfulness Guide for the Frazzled.'

10. Next is another activity to bring attention to my senses. As soon as you bring your attention to the senses the self-regulation part of your brain is activated. It is a completely different system to the one thats involved in anxiety. This is why these sense activities can start to calm you down a little and just take the heat off. I have some hand cream from our hotel room when we got married. I keep it in the box, I smell it and gently rub it into my hands. I love the smell and I begin to connect to happy memories. This helps to give my anxiety a sense of impermanence, because if anxiety always stayed, I wouldn't have got through my wedding day! Do you have a favourite hand cream, lip balm, body lotion or perfume/aftershave. Perhaps you just love the smell, perhaps a loved one bought it for you or perhaps it reminds you of a special occasion. Add it to your box. 

11. Next, I look through a few more 'happy memory' items. I have a note card from my husband when he bought me Ruby Wax's Mindfulness book, it reminds me how much he loves and cares about me, and I have a little doll a friend knitted me at Christmas. This particular friend is a very calming one! You might like to choose photos, holiday souvenirs or gifts you've been given. Basically anything you cherish and makes you feel good. 

Wow - there's a lot of steps here... is she still going?.....

Yes she is!!!

12. Now I get into the 'nitty gritty' of dealing with my anxiety. The next step is to use a classic CBT (Cognitive Behavioural Therapy) technique that gets to the bottom of the anxiety and levels it out nicely. I have a copy of an ABC sheet in the box and a pen, all there, all ready for me. I ABC the situation/my emotions/my thoughts and I try to challenge them. I 'take my anxious thoughts to court' to see if they are really worth believing! This gives me a more helpful perspective and moves me towards feeling more balanced and positive once more. 

Now, the ABC technique is a whole post in itself. But it is such an important step in this routine. It moves me past the thoughts that hold me hostage, whilst the other things in my box turn my mind's heat down. I've become quite confident in using this technique, but I've practiced a lot and I've had the help of a psychologist. But I first found it in the book CBT for Dummies. I would really recommend this as a great place to start to learn this technique and become skilled at it. Here is a copy of an ABC sheet I like if you'd like to try one. ABC Sheet 

13. We're nearly there now.... nearly calm... to finish calming down I do a relaxation exercise or a mindfulness exercise. Anything like this takes practice, so if you find one you like and think you could use, practice it often when you're feeling calmer. Then it will serve you well when you're anxious. I will share some of the exercises I use in future. But in the meantime you could try the Headpace app. I use this a lot and I find it really helps. Or if you'd like a relaxation exercise this one is similar to the one my therapist taught me Peaceful Place (Safe Place) Imagery. 

14. Finally! I read a positive affirmative quote from a book my Dad bought me Positive Quotations. It's a fantastic way to sense perspective and to recognise that you have managed to relax your mind and body from the difficult place they started when you came to your box. I really love this book, thank you Dad!

And we're there!... We have an Emergency Box!

Wow! That was a long post! I hope it was worth getting to this point though! Please leave comments if you find it helpful or have any questions. I hope this helps some of you or at least is an insightful read. 

Next time, we carry on with the Top Tips including helplines, scheduling your time and self-care. And I'm sure we'll delve into CBT and Mindfulness some more. Oh, and if you're feeling really emotional now, a blog can be a difficult read.... so I'm going to try my hand at making some of these tips into vlogs, so you can watch instead! watch this space!

Thank you so much for reading,

Compassionista x

P.S.

I must stress that these are my own personal tips and experiences. I am not a trained medical professional and these ideas wouldn't suit everyone. If you are concerned about an emotions, feelings or symptoms your experiencing please seek the advice of a trained medical professional as soon as possible. 

Top Tips for Managing Anxiety

Anxiety doesn't discriminate, it really can affect anyone. And it can affect us in different ways, from specific fears and phobias, short term episodes and longer term debilitating mental health problems. I have suffered clinical anxiety for many years, but I also get day-to-day anxieties that are part of a healthy psyche. 

So I thought, given my experience and the commonality of anxiety in different shapes and forms, I would share my tips on how I manage it. Also, I have expert help for my brain, in the form of an amazing clinical psychologist with years of experience, an amazing support group, friends who understand and I've read a lot of self-help books.....(not everyone gets access to such an amazing support network).... so I figure, what I've learned is well worth sharing. 

And of course, one of the best antidotes to anxiety, is learning self-compassion, so this seems a good post for a Compassionista to write!

I have found I need to manage my anxiety with short term and longer term antidotes. So I'm going to share a wide variety of ideas, some quicker to try than others. But I do think there is no quick-fix. What is fixing anyway? Isn't the spectrum of the human condition so broad, that the idea of 'fixing' anyone or ourselves is unrealistic and inappropriate? But anyway, here we go:
Oh - and one more tinny thing (sorry!).... I'm splitting this post into lots of mini-posts... because breaking things down into small steps is a great antidote to anxiety! 

1. Communication - the beginning of self-regulation.

A) If you have a person close to you who you feel can understand and support your anxiety then these communication strategies could help you feel safe in tough times, but they can also be used to communicate with yourself - to know you're own state of mind and act accordingly. 

I have coloured wristbands. I wear them to indicate how high my anxiety is at any one moment. I have red for really really 'get me outta here' high anxiety, orange for 'I'm not so good right now', yellow for 'I'm managing pretty well' and green for 'hey, I'm feeling nice and relaxed.' My husband is my 'person who gets it' who knows what these mean. It is a really easy way for him to be able to actively help me manage my anxiety, without having to communicate verbally. This is great for when we're out with friends or if my anxiety is making it difficult for me to communicate.

It is also a way of me reminding myself to check in with my head. Sometimes, before I used my wrist bands, I would get carried away in a day and perhaps do more than my nerves could handle, speed through the day and find myself with a panic attack for company at the end of it. It helps me pause and listen to my needs. It usually means I put the kettle on practice some self-care!

I loved it when I was at the IOW Festival this year that my colourful wristbands fitted in beautifully - but mine were really saying something.....

Ooooh, and I have black, grey and white ones when I need to be more subtle :)

B) I also use a numbers scale. I regularly rate how anxious I'm feeling on a scale of 1 - 10, where 1 is quite low anxiety and 10 is the highest anxiety. I have a chalkboard in my hallway with chalk easily to hand where I rate my anxiety as soon as I walk through the door. I will also often text the number to my husband on a regular basis. I hope everyone can find someone they feel they can trust to share this information with, and if you're not sure who's up to the job, suggestion 2 should help! 

These numbers serve much the same purpose as the wristbands, but they are also useful in tracking your anxiety across a longer period of time. You can begin to see patterns in your life that can trigger higher anxiety and then take steps to lower it.

2. Find your people.

Ok, this isn't hard now... anxiety is everywhere! You need to find people you can talk to who suffer the same way. I joined a charity offering lots of social activities for people with mental health problems and immediately I realised how free I could be, I could say how anxious I was and everyone was just like, yeah me too! Lets talk about it and feel better. Its like I finally found a volume button for all the judgemental thoughts and I turned it right down! I really found a place where I could start to be myself and my confidence started to build. 

I also found a support group - actually, I've have had the support of at least 3 groups at one point! The power of sharing and reflecting..... To voice your struggles, to hear the struggles of others, to talk about the harsh realities of modern life and know that its ok to say 'I'm not coping' is so helpful. Even though sometimes you can feel worse, you gain more understanding of your problems and can consider how you can move forward with them. Knowledge is power! And these amazing people will be there for you every week! Also sometimes, to just listen to others, gives you a break from the constant internal monologue. And then the best bit... when you find you can help someone else - and you realise you might just be able to help yourself too! 

After a long time of attending support groups, I now run my own, closer to my local area. I never thought I'd have the confidence to facilitate one! You never know what you're journey meeting others who suffer could lead too! You can help yourself and help others. 

That's it for now.... phew I hear you sigh... :) Coming up soon: creating an emergency box, picking a helpline that's right for you, self-care, using CBT and mindfulness and doing your favourite things! To name but a few!

Thank you so much

for reading,

Compassionista x

Are you exercising compassionately?

Today I went on a lovely walk in our local park surrounded by wonderful wildlife with a dear friend of mine. This suited my newly formed compassionate approach to wellbeing very well indeed. So what is this shift in attitude, and do you find yourself questioning modern exercise routines in the same way I do?

I have recently suffered a knee injury. It has come about after going jogging. I have been wishing to find more holistic exercise ideas and leave the repetitive and frankly boring (to me) gym routine behind. So, I'd been doing some running. I really connected with the joy and freedom I could experience by grabbing my trainers and running all round my neighbourhood. When I discovered the Headspace session on Mindful running (thank you Andy Puddicombe for bringing such presence to us all!) the deal was sealed! But then, a few sessions in my knee gives way...... 

Was running the cause? Was the freedom and mindful experience to be something I could not enjoy? Well perhaps not for now, but I really believe running was the straw that broke my knee, it was not the cause. The cause was the hours I've spent in front of my TV, alone, doing probably a million squats (by now) with the latest workout DVD that promises a lean body in minimal time. A DVD that seems to take over my mind and body (as if possessed) promising near perfect (or perfect!) results if I just dig deep and work hard..... A video that knows I'm lost down a rabbit hole of wanting and I'll grab onto anything to 'feel' happier.... if I just get fitter.... get better legs.... banish the bingo wings (if anyone knows, please tell me where I can banish them to, then I'll seal them in an envelope right now, never to be seen again) and be more perfect, then I'll be happy.......?

So my knees have decided to give me some guidance.... 'STEP AWAY FROM THE TV AND FOR F***'S SAKE STOP SQUATTING!' Now... lets just pause and rephrase that sentence. Lets be a bit more  compassionate (hehe). What I'm trying to say to myself instead, is, STOP, BREATH and move to a mindful place. It's ok to exercise however you exercise from one moment to the next, because you're human and navigating a complex world of influences. But by bringing mindful attention to the current moment, notice that you're knee is hurt. It needs time to heal, it needs to be listened to. Perhaps you can bring this pain into your awareness to inform you?

So, all strenuous exercise has stopped for three weeks, the microwavable wheat bag has moved in and I've been contemplating. Here is the result;

I've been doing damage to my mind and my body trying to create a physique that can only be found in Photoshop. And mindfulness has helped me tune into this pain. I am a human being - human beings need love to grow. Its time to love myself and exercise can be a great form of self care. I read a fabulous paragraph in the Mindful Diet by Ruth Wolever and Beth Reardon at the weekend and I'm going to share some of it here with you. 

'Not perfect, but Present.... Not only is perfection a myth that's unattainable in real life; perfectionism is counter productive to change. When your goal is perfection, anything less is a failure. So let's trade in all our ideas about perfection - a perfect diet, a perfect bod, a perfect life - for something attainable, real, and useful.' 

So I'm starting to make some changes. I'm smiling at my pale, milky skin in the mirror and bring mindful attention to my thoughts and feelings when I reach for the self-tan bottle. I'm hoping to use my exercise DVD in moderation, choosing titles that focus on the health benefits of improved strength and a healthy heart, rather than the main focus being what we look like. Perhaps I can go to an aerobics class instead, where I can be with others and enjoy moderate exercise in good company. I'm walking with friends and I hope to take up dancing again! I'm looking forward to running once I'm well enough taking care of my body by listening to it and enjoying developing deep familiarity with my neighbourhood and nature. 

Paul Gilbert wrote in his book, The Compassionate Mind, that 'compassion can be defined in many ways, but its essence is a basic kindness, with a deep awareness of the suffering of oneself and of other living things, coupled with the wish and effort to relieve it.... compassion has also been seen as a major healing process for our turbulent minds and relationships.' (Thank you Paul, for all your book has done for me)! To give myself the gift of time with nature on a run, to give myself the gift of spending time with friends on a walk and give something back to them, to give myself the gift of a healthy heart and lungs, to listen to my muscles; rest them when they're tired and to love them instead of hurting them. To get my heart rate up so I can have a healthy cardiovascular system, so my cells can thrive! To give my soul the gift of laughing with friends when I get the dance steps wrong, and to enjoy the moment when I get it right with more wholehearted awareness..... THAT MIGHT JUST BE EXERCISING COMPASSIONATELY!

Compassionista x

P.S. I must have been blessed with an amazingly supportive environment to make this shift and I have been trying to take steps towards it over a long period of time, life is a journey... take time to enjoy it.