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Hi, everybody. I hope that, um, you're having a, a good day. Uh, I'm really glad you joined me for this little bit of time on selfcare and time for us. I'd love to hear what you've been doing to look after yourselves to give yourselves a bit of time and a bit of recharging. So, do, please share in the chat, um, because we can all learn from each other. Um, and it, sometimes some of the ideas people share make me think. Oh, that's a really good idea. I'm gonna do that for my self care. So, what have you been doing? And we're going to start the session in about, in a couple of minutes. So, just a little bit of time for us to share. Hope the sun is shining where you are. Uh, it'd be nice to hear from somebody. Hi, Anna. Good to see you doing lots of crafts. Oh, I love doing crafts, which really helps me and also find the gym, which is odd for me, but it's really helping. That's really good. I've ne never actually been to a gym but, um, if it's helping and it's about finding the right thing. I think that's great. What's done doing grafts? Just help. I think it's a kind of an adult way of playing. Really? I think that that's, uh, really important. I had a bit of a treat over a weekend and had, um, our eldest grandchildren who were all adults with us and, um, all the girls who decided to go and have a, um, a pedicure and choosing the colors and I, I think that was a bit like playing, you know, we need to play more as adults. Hi, Sally. Nice to have you with us. Ok. I think we'll, we'll make a start. Um, and hopefully you'll find this session interesting or helpful. I'm really glad to have you with me. I'm just trying to move my slides on, but they're not playing with me at the moment. That would be good. So today we're going to look at self esteem and it's quite an important subject in, in terms of how we feel. Um, and we kind of, I don't know, sometimes we don't think about what, you know, what's our self esteem like. So see how you find it. Um, and we're also going to look at sort of improving it, working on different areas. Um, we're going to talk a little bit about panic attacks and we're going to do a lovely meditation on decluttering our minds, which I, I hope that you will enjoy one of the hardest things you can do, said the mole is to be gentle and patient with yourself. And we're often much harder on ourselves than we are with anybody else. We judge ourselves quite harshly and we dwell on our failures and perceived shortcomings. We compare ourselves often unfavorably to others. And sometimes we even tell ourselves that we aren't worthy of love or happiness. Sometimes your mind plays tricks on you. It can tell you you're no good. It's all hopeless. But remember this, you are loved and important and you bring to this world things that no one else can. So hold on our self esteem is so much about how we value and perceive ourselves and based on our opinion, but often about, based on the opinions we've picked up that other, we think other people have on us. Um So I mean, another word for it for, for some of us is self confident, but it can affect whether you like or value yourself as a person, how you make decisions and assert yourself. Um It, it, it affects whether you can recognize your strengths or not, whether you feel able to try new or difficult things or show kindness towards yourself. And it's about moving past mistakes without blaming yourself unfairly, which is a difficult thing sometimes. And sometimes it's about whether we even allow ourselves to take the time that we need, whether we believe we matter and whether we think we're good enough. And even when, whether we think we deserve happiness. So what can cause low self esteem? And you can see a list of things on my slides there. It can come from all sorts of places. Um And it can come based on our experiences when we were much younger, based on experiences at work families, the dynamics, the culture, all kinds of things. Um But, but it can really be, really affect how we enjoy our lives, how we are able to feel joy, really. Um Sometimes we feel we have to be perfect in order to achieve. So that feeling um pressure to meet unrealistic expectations um and social media can only make that worse sometimes. So you might have had, as it says, some of these experiences and you might have had difficulties that aren't listed here. Um Everybody is different. So have a think, have a little think about how you feel your self esteem is and is it a mental health problem? I love this quote because it is so true. Every time I tried to praise myself, it felt tainted with all the self doubt and self hatred that's been there all my life and it was then I realized I needed some help. So we really do pick up what we think of other people's opinions. Now, often other people's behavior comes from their own internal struggles. But we see it as a reflection on us and that can be quite damaging sometimes. So how do we improve our self esteem and remember different things work for different people. So these are just ideas. Um But, but social media I mentioned just now can really have an effect and it's really important to remember that that people get to choose what they present. Um But actually in reality, no one's life is perfect and really everybody has insecurities and sometimes the people who look the most confident are the people who are actually the least, but they've learned to put a mask on. So get to know yourself, think about what makes you happy and what you value in life. Um Some people find it helpful to journal about that and to capture it, try and challenge unkind thoughts about yourself. So you might automatically put yourself down. But if you find yourself doing this, it can help to ask, would I talk to a friend that way? Say positive things to yourself that can feel a bit weird. But actually some people do it even in front of a mirror, which is really hard. Um But it really does help and we get more used to it practice saying no, you don't have to be aggressive to say no. And being assertive can be difficult if you're not used to it but agreeing to too many things um to please others can be draining. Um And it can help to pause and take a breath and think about how you feel before you agree because often we, we say Yes. And then afterwards we go through the reasons and we may regret it. Try to avoid comparing yourself to others. For example, it might help to limit how much time you spend on social media or online and do something nice for yourself. Just make your favorite meal or play a game you enjoy whatever it is, read a book that you love and try to recognize the positives at the end of the day, just say to yourself, you know what was positive today and it can be something as small as feeling of sunshine on your skin or an interaction with some somebody. Um But, but what that does is it challenges us um because often we concentrate on the negative, so celebrate your success, no matter how small it may, may seem, take the time to praise yourself except compliments. We often push them back, don't we? Because we feel uncomfortable um And ask people what they like about you people you trust and that you know, well, and then listen to what they say cause you might hear things you don't recognize. Building a support network is a really helpful thing. And many of us do have that in, in health and in nursing. I think there are a lot of supportive people around us but have a think about the way that other people see you. And I think that quote there for the first time, I thought there is no way all these negative things can be so true when people in my life love me for who I am. So talking to some somebody that you trust, having someone listen to you and show they care can help. And I think sometimes if that's what you need, it's worth highlighting that to the person you're talking to and saying I just need you to listen because people often want to solve problems that actually, that often helps us not feel heard. Um Focus on the positive relationships in your life. Uh It might feel difficult to control who you spend time with. But where possible, it really can help spend more time with people who make you feel good about yourself. Think about peer support. There are many online communities that help with that. Like one of them is called side by side talking therapy is a really useful tool to help us grow and understand ourselves as we go through life. And if and if that feels good for you have a go um If you look on the NHS website, there are, there are and it that was shared with the resources of the session. One there are resources for how you can do that. Um You may, some people find that useful. I certainly have maybe set yourself a challenge. Um Volunteering is really helpful. I volunteer for Shout, which is the wellbeing online crisis service. But, but I do always say this with a bit of an important warning in health, you work incredibly long hours caring for lots of people. So you need to get the balance right. And if actually what's lacking is care for yourself, then volunteering isn't what you need to do. Steps more uh sorry, sets more goals. I think that can be really important. We think we want to get to the top of the mountain. But actually, it's step by step and remember that and learning fun things instead of always doing the learning in terms of our career development can also be really helpful. And this is so important often when we're worrying or we're trying, we're ruminating as I talked about in my last session, we're trying to understand something that's happened at work maybe or something outside work, we end up with poor sleep and then we worry about sleep. So, so we just get into this vicious circle and there's some great apps about sleep including sleep. Yeah. So if sleep is a problem for you and for many of us in healthcare, it has been and have a look at what can help. How can we make a move to feel better? And there are just some suggestions on screen now, writing out can help empty it out of our mind and stop ourselves ruminating. If we're tired, have a rest. If we're stressed, go for a walk and open your eyes and really look at what's around music can help when you're feeling angry. Um and reading when we're bent out can be helpful, you can see them, there just have a think about what would help and then do it. That's the difficult thing to make happen. You could, what would you tell your younger self you're enough as you are. Don't worry, love yourself and love. Others said the horse. And of course, Ca Mole has to say Kate and you can see the link to Charlie Maxie's work in the handout from the first course and focusing on what we can control is really quite important, especially when we're in uncertainty. And many of us go through periods of uncertainty in our life, both as a, in a career perspective or in a personal perspective. But finding things that you can manage and small escapes that make you happy when you're in that unsure waiting period can really help immerse yourselves into little things that you look forward to things that bring you joy, joy, like being outside, reading, having friends, sharing or having a laugh, just focus on what you love right under your nose. And we forget to do that. It's quite surprising, but we do actually forget to do that and curb rumination because worry isn't preparation. Another empowering act that takes your mind off. Worry is to do something for someone else in need maybe. But remember that nothing beats kindness. Said the horse, it sits quietly beyond all things very, very important, that sense of community that sense of being valued. So have a think about what would take that for you and maybe that's already happening in your working well. So do you remember that it's important? And I think this is really important when you finally learn that a person's behavior has more to do with their internal struggle than you, you learn grace. And so often we see people's behavior and we see it, everybody sees it through the filter of their own thinking, which is based on their own experiences in their lives. And then we, we make decisions about their way that they treat us the way that they value us, that's often completely false. And if you've ever challenged it and or asked the person about it as I have done often, it's very rarely the problem that you think it is. It's nearly always to do with the way that they're experiencing their lives and what's going on for them. So try and be aware of that because it causes us so much unhappiness. I think. So, I wanted to talk a little bit about panic attacks. Um I used to not include panic attacks when I was running my courses, but I was asked by so many people to include them. And I thought, why aren't, aren't I including them anyway? Because they're so common when I'm on shout. Um We often have people texting in who are in the middle of having a panic attack and we help them get to a calmer place. They are really frightening. And even if you're, you have a clinical background as we all do, it can still feel really frightening and, and in the midst of it you can still think, oh my God, I'm having an M I, this isn't a panic attack because that's how frightening they all are. So, have a look at that cycle there. So there's always a trigger. But remember that the trigger isn't necessarily in the moment. So what can happen is that we've got more and more adrenaline in our bodies as a result of just going through stressful days, day in day out, stressful moments. Um And then something happens that just tips us over into the balance of having a panic attack. And we don't think I'm having a panic attack or we might be thinking I'm dying. This is really frightening because they are, it is as you can see the feelings there, physical sensations of an adrenaline response are frightening. So your heart is racing, you having palpitations, nausea, et cetera. And then our thoughts, our thoughts are really powerful in a panic attack. They're what tends to continue the cycle. Our thoughts tell us well, that's it. I'm right. You know, this is a, a life or death moment and I'm right to be frightened. Now, what can happen then is that we try and avoid the situation that triggered us in the first place. Um, and that can be quite dangerous because what happens is our lives get smaller and smaller. So say you have a panic attack. It could be anything, it could be out outside walking a dog in the street near you. It could be in the supermarket, it could be presenting to an audience. It could be, um, dealing with a dying patient, whatever it is. But if we start, if that's when we have a panic attack, we assume that's why we're having it. Whereas actually, it's a combination of adrenaline that's built up over time and we, we start trying to not do the thing. And um, and then we get more isolated and our lives get smaller so it can happen if we don't listen to ourselves really, if we keep ignoring how we're feeling. So we end up feeling so anxious, that's how it happens. Um, panic attacks occur when our normal sensations of anxiety are experienced as dangerous to us. Um And then we believe the symptoms means that we're going to have this heart attack, as I said. So, I mean, naturally nobody wants to have a panic attack. So we start avoiding those situations, as I said, and the main problem with panic disorder is when those adrenaline feelings really kick in and it can feel like we're choking or suffocating. So these physical feelings of adrenaline are normal and it's simply the body's alarm system being activated in order to help us escape from a dangerous situation. So, although it feels dangerous, it isn't. Um And as I've just said, anxiety grows and layers up and in the end, a relatively small extra anxiety can tip us over the edge into a panic attack. And if you've had one, then you know what I'm talking about. So what can we do to stop panic attacks? So, in my last session, I did something called the stop breathing technique. Um and we'll do a very quick couple of breaths in a minute just to remind you a little bit about that. But actually, when you're having what having a panic attack focusing on deep and slow belly breathing can really help. It's hard because when you're having a panic attack, you're hyperventilating. Remember to always have a longer slower out breath than the in breath. Uh because that activates the parasympathetic nervous system and gives us that feel good feeling. So as you can see, they just noticing the thoughts and feelings and then thinking about breathing um again, can help and thinking about just once the worst of it stopped where to focus with your full attention. We talked quite a lot about mindfulness. Last session and using grounding techniques can be important. I'm gonna share one or two of them with you and in the information after this session, you'll be able to find links to these things um that I hope can be helpful. So let's just do um a quick stop technique just a very quick one. We did the whole thing last week where I gave you more information about it. So if you're not sitting properly, let's sit properly with our back against the back of the chair and our back supported. Um, and our thighs parallel with the ground. Our feet flat on the ground. Having our feet on the ground in a panic attack is really important. We want to feel grounded, lowering our uh our shoulders and having your head well balanced. We're just gonna take two breaths. So we're gonna breathe in together cause and then a long slow out breath, relaxing your face and shoulders, menopause and another breath in and another long slow out breath, relax in your hands and jaw and then slowly come back. So just taking two breaths, I hope you can feel can make a difference. But there are other things as well that can be helpful. So this is one of the activities that we do on shout with our texters, um which really can make a difference. So just have a think about, but we'll just do a couple. We won't go right through the whole thing. But just think in your own mind, what are five things you can see and just list them, look around the room and just list them and then think about what are four things that you can feel. So maybe you can feel your clothes as your arms rest on your lap, maybe your feet flatt on the floor. What can you feel? And then we talk about what can we hear? I can hear my computer's engine whizzing away. And what can we smell and even taste? And what that's doing is bringing us into the present moment. It's making us concentrate on exactly where we are and how it feels. We're using all of our senses rather than being in this frightened space in our mind. And it's powerful stuff actually. So how do we build resilience and help ourselves feel stronger. Gratefulness is a really powerful thing to do. We've talked about taking time for, for ourselves. In fact, both sessions a lot thinking about your perspective can be helpful. I trying to understand where that perspective comes from and then thinking about what you want it to be, maybe confronting your worries. Where do they come from? I'm thinking about. OK, so I'm feeling overwhelmed with this problem at the moment. What would be a solution rather than what is the problem and rehashing it all the time? And what are your gums? Think about your well being at work? It is incredibly difficult to achieve in um as nurses at the moment, but it is so important and people forget this. And if you're not getting any of these, you know, I know how much courage it takes. But it's really important to talk to someone who's managing you, someone a leader and get some support you know, the minimum we need is to keep hydrated to have a toilet break. And I know how hard that is. Um, being the right temperature is important, all of it. But gosh, how many of us actually do that? Having a break, eating. There are really basic survival needs that we, we all have, we are human and that is not asking too much for them, feeling, feeling secure. There are so many teams sadly where there are dy dysfunction in those teams. And I know how hard it is to work in them to try and get some support. If that's the situation, you're in that sense of connection and of being able to help each other. Uh And I think nurses generally are really good at doing that. But if you're in a team where that isn't happening, try to think where you can get that, you know, who does see your work and sometimes it's patients, isn't it? You know, the importance of our work. I think that's not something we struggle with, but, but, but feeling included in decisions, which is not often the case, I'm afraid, feeling respected, that's all important. And then once we achieve that, then we're able to, to, to, to inspire others, we often inspire others without achieving it. But actually, self growth and knowing your worth is something that we teach others through doing it ourselves. We are role models. Um and it helps us to feel fulfilled and be the best that we can be. Just reflect on where you are. And if you're struggling, reflect on where you can get some help, ok. Those are dark clouds said the boy, yes, but they will move on said the horse because the blue sky above us never leaves. So what we're going to do now is do a mindfulness exercise that helps us cope with uncertainty and the anxiety it can bring. So make sure that you are sitting properly as I said just now, but just make sure your shoulders are lowered, your back supported, your thighs are parallel with the ground, your feet are flat on the floor and your head's well balanced and let's just take a couple of deep breaths together. And if you feel able to just close your eyes, you just take a breath in the pause and a long, slow and out of breath and to pause and another breath in and to pause and another longer, slower out of breath. Lovely. So just listen to my voice and use your imagination to help you enter the world that I'm going to describe won't leave you quiet for more than a minute. Um And we will probably do this for about 10 minutes together, maybe a tiny bit longer but not longer. We'll certainly collect finish by the end of time. So don't be worrying about that. So as I say, just settling in now by taking a few slower and deeper breaths, breathing in slowly through your nose. I'm blowing the air out slowly through your mouth and hearing that out breath in your inner ear can help with that relaxation feeling. So with every inhalation, just imagine breathing in calm and relaxing energy with each out breath, imagine blowing out any tension that you're feeling. So we breathing in calm, relaxation and breathing out, letting go of stress. Right. No, letting go of controlling your breath, just allow yourself to trust in the abundant wisdom of your body to breathe. Just right. It's slowing down in a relaxed way and relaxing even more. Just take a moment to scan your body from the bottom of your feet all the way to the top of your head. You just notice any areas of tension that may be lingering. And as you scan, breathe into any areas of tension, calm and relaxing energy and releasing the tension through each out breath. So you're breathing into the areas that you feel a tension, you're breathing calm and relaxing energy in and tension out with each out breath. And at the same time allowing any tension that remains to be just as it is. So breathing in, I'm breathing out just as you are. Never any time your mind starts to wander, try and refrain from judgment just gently bring your attention back to your breath, focusing on the areas in your body. Why you feel the breath for the most perhaps tracking the breath as it enters and leaves the body during each breast cycle. Breathing in no breathing tas um and relax. That's great. Now, with the power of your imagination, picture yourself standing in the middle of a large garden filled with an assortment of trees and bushes, flowers of a variety of colors and sizes perhaps take a look around notice any structures in the garden such as an archway covered in jasmine or ivy or maybe a bench or even a hammock in one corner, there's a garden shed and against the shed, be a rake and some other garden tools getting up, you see a blue sky, it's clear and expansive and you feel the warmth of the sun on your face. There's a gentle breeze which soothes your face as well. Just spend a few minutes to take in all the beautiful colors and breathe in the scent of the trees and flowers. And as you do that, you begin to realize that this garden symbolizes your life and all of your experiences up to the present moment. And as you look at the ground under your feet and all around you, you notice that along with many plants and budding flowers, there are a lot of dried and crumpled leaves left behind from the autumn and the winter they're scattered here and there looking more closely. You see that there are even areas where the leaves are packed down, forming a dam carpet blocking some of the plans from reaching the light of the sun. And these leads represent negative experiences, feelings or messages that you've received from others and internalized. And they also represent negative beliefs about yourself or others as well as all the negative energy that you have received through others. You know that the world is full of positive and negative energy and that leaves from other people's gardens can be swept up in the wind and blown into our own. So deciding it's time to clear your space of this negativity. You got the rake begin raking all of the leaves through the gate, pulling them into a big pile in the clearing outside of the garden, a safe distance away from the beautiful trees, plants and flowers that you have planted throughout the years. Just imagine yourself doing that. And once you've cleared out all of the dead leaves, the pile is ready, you decide to burn the pile and get rid of these leaves permanently. We know that other leads will come but we can clear them as well periodically as we maintain our garden, keeping it cancer free. I'm allowing the plants to all the sea water and sunlight in order to bloom to their full potential. So setting fire to the leaves, you watch as the smoke rises up higher and higher until it trails off into a thin trail, eventually dissipating into the sky. And as the fire burns out, you start to feel lighter and free and unburdened. Just imagine that happening. And if you're able to identify any of those messages that are being burned and just disappearing, that's great. If you can't, that's fine too, just visualize it. And what we do is we find we're able to open our mind and heart to new experiences as the leaves are no longer there, we are able to be aware of more positive energy and good health. I start to feel this just throughout every area of our being and then in your garden reaching into your pocket. Now you find seeds that you've been needing to plant for quite a long time. It's time to replenish your garden with healing herds and bright flowers. And do you find that you know instinctively where to plant these special seeds because you've been tending your garden your entire life? So imagine yourself pushing the seeds down into the earth and covering them lightly with the soil. I'm passing them gently giving them just the right amount of water, maybe just have a think about what those seeds might be. No, in our imagination. Let's just take a step back and breathe in the piece of the garden that we've created. Now, slowly gently, just bring your attention back to the place that you're in bringing with you, the peace that you've created in your own mind. This is a journey that we're on. We know that we can come back whenever we wish to continue with the important work of decluttering our mind and heart. Our life is ours to live. And when you're ready, there's no hurry at all. Just let your breathing come back to normal. Maybe just wiggle your toes and fingers, maybe take a stretch and very slowly, open your eyes. I hope that you found that uh, a useful, um, bit of mindfulness and that if you did, you can go back and use it again if it's helpful. And if you didn't, there are so many different types, it's about finding what suits each of us. Sometimes your mind plays tricks on you. It can tell you you no good that it's all hopeless. But remember this, you are loved and important and you bring to this thing, this world things no one else can and hold them. What do you think is your greatest achievement? Fully accepting myself, said the horse, you have permission to rest. You are not responsible for fixing everything that is broken. You do not have to try to make everybody happy. So for now take time for you because it's time to replenish and it's really important to have a little bit of downtime. So have a think about that because when we're often overwhelmed, we just try and work harder. But actually taking five minutes away really does help us to come back, refreshed. So it's good to think about what you're gonna do for those five minutes. But what it does is it helps your brain switch from focus mode to diffuse mode. So in diffuse mode, our brains use different neural pathways and they start to connect bits of the brains we don't use in focus mode. So that means we start to solve problems and use our imagination and become more creative. And it helps us to work better and smarter to have a think about doing something, even if it's just breathing or just walking a little bit or being mindful and looking out the window, whatever it is, just try and switch your brain around, it really does help. Almost everything will work again if you unplug it for a few minutes, including you. Ok? And so that is the end of my session with you today.