Dr Afrosa Ahmed is from Guy’s, Kings’ and St Thomas’s Medical School, qualifying as a General Practitioner in 2005. She subsequently became a Mindfulness Coach, graduating from the UK College of Mindfulness Meditation. She is an accredited teacher on the Mindfulness Teachers Register who will be delivering a talk about the science behind mindfulness!
WPMN Presents Mindfulness
Summary
This on-demand teaching session is a must-attend for medical professionals interested in incorporating mindfulness and self care principles into their practice. Dr. Ahmed has 20 years of experience as a GP and further qualifications as a mindfulness coach that she will share with the audience. She covers three main concepts: living in the present moment, finding balance between being in ‘doing mode’ versus being in ‘being mode’, and understanding the mind’s natural tendency to focus on negative events more than positive ones. Attendees will learn techniques to implement mindfulness in their everyday lives and practice, plus tools to help break the cycle of negativity to improve their wellbeing.
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Learning objectives
Learning Objectives:
- Identify the difference between the doing-mode and being-mode.
- Recognize their mind's natural inclination towards a negative bias and its consequences.
- Comprehend how to implement a more balanced blend of doing-mode and being-mode (relaxation) into their daily lives.
- Understand the effects of continual stress and the importance of rest in healing.
- Reflect on how they can empower their patients with options through the implementation of mindfulness.
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The following transcript was generated automatically from the content and has not been checked or corrected manually.
So, Doctor Ahmed is a graduate from guys Kings and Saint Thomas's medical School. Uh She qualified as a GP um in 2005 and she subsequently became a mindfulness coach, graduating from the UK College of Mindfulness Meditation. She's interested teacher on the mindfulness teachers register and she sees patient's on Harley Street. She has a special interest in children's health and she's a personal tutor at the University College of London for Medical School where she incorporates mindfulness and self care principles to her medical students. So we're really excited to welcome you to the stage and to share your knowledge about mindfulness and how we can incorporate that into our practice. So, thank you everyone for being here and for anyone that's joined late, please feel free to use the chat function to ask any questions throughout. Um And then we can go through those at the end. Okay. Thank you over to you. Thank you. Thank you for that introduction. Um So let's, let's get on with this. You've already told the audience a little bit about myself. Yeah. So I was been a GP for about 20 years um and just done some extensive teacher at UCL in Kings and now I mentor for medical school admission's. But this is really what I've come to talk about is my role as a mindfulness coach. Um And I'll tell you a little bit about how I fell into that. Um You know, I've been a GP for a long time and I felt in my everyday practice as a GP, we were kind of treating patients', you know, about seeing them for depression, anxiety and seeing them a lot more over time. It's very, very common, especially with COVID where they would present. And not only that in my professional life, I hearing more and more of doctors who were unhappy, um even colleagues who have taken their own lives, you know, this was also becoming more commonplace. So I tried to explore what else there was that we could offer patient's as a, as a doctor because the really realistic situations they come with the depression, the anxiety and then that we refer them on to a counselor or in most practices. Now, a mental health nous. And I just felt that that really wasn't getting to the crux of the matter. And I wanted to explore other avenues to help my patient's. So it wasn't really a personal life event as such that got me into mindfulness. You know, I hadn't personally faced anything traumatic myself, but really kind of exploring avenues and I wasn't really happy with what was on offer. Um we do a lot of CBT that we refer our patient's too. But again, it doesn't suit everyone. And I think medicine is about giving options to your patient. So you empower them by giving them options and not having a one kind of policy or one treatment fits all. And this is really how I stumbled across mindfulness is that I looked at all different things and I thought this really resonates with me. Um So, you know, mindfulness is one of those things. It's actually very simple. Um It's the ability to be fully present, sounds simple and you know, it doesn't sound particularly difficult. So why is it so hard to implement or why is it not utilize more often? And actually mindfulness itself is such a big concept. There are books and books and you know, courses on it. And if you do a course on mindfulness, it's like an eight week long course. Um And to appreciate the gravity of the importance of mindedness, I think we have to go back and look at the way we live our lives right now. And once you realize how you're living your life, you can appreciate where mindfulness can fit in. So the three main concepts that I want you guys to know about. And one is concept number one is that we actually don't practice mindfulness in our everyday life, right? So we basically live in every moment probably. But the now um with my sinuses about living in the present moment. But in essence, our minds are pretty much in the past or they're in the future. So, for example, when you're wandering lane there at night in bed, you know, naturally start to replay the events of the previous day or when you're in the shower or when you're walking or something, your mind loves to remember. That's what mine's due. So they're constantly remembering an event and we spend so much replaying events in our mind. Why did that person say this? Why did I react like this? Why did that happen to me? And we get this monkey mind this chatter. So it's actually unnatural because we've lived this way for so long, unnatural to spend time in the present moment. Now, the other way the mind works is that it spends a lot of time in the future, the other way around. And one of the reasons it does is is to protect yourself. All right. So you start procrastinating, you start thinking about your job, your degree, your house, your money, and you start to plan and protect yourself against any kind of future events of negative possibilities. And again, that takes up a lot of time and energy. But these are the two states that we tend to live most of our lives and we don't live in the now moment. Okay. So that's one concept. The second concept is the doing mode, which is again how most of us like to live our lives and these have all become natural tendencies. So the, the, no, the last 20 years we've just fallen into this way of life, this kind of autopilot, habitual mode of living and the dune mode is basically what the name says and that you feel the need to be constantly doing something. So for example, if you're watching TV, you probably got your phone out and scrolling. If you're in the shower, you're probably thinking about things or planning something, it doesn't physically mean doing it also, mentally means doing and what that means essentially that you don't get to relax. So you might have gone on a holiday thinking, right. Great. I'm going to recharge my batteries, I'm going to relax or I'm going on a lovely spot. I'm going out with my friends. But when you get there, your mind is still on the problems. And most of what happens is that we get home from this holiday and we feel like actually we still need another holiday because mentally we haven't switched off and the opposite to do in mode is called the being mode. So the being mode is essentially to do nothing. You're just in your normal restful state. And I think this is really key is that this is a natural way to do. Natural way to be, is to be in the being mode and to have a good balance of life, you want to not get rid of the doing mode, but you want to have a balance between doing mode and being mode. There are times when you need to be in your doing mode. And what is the doing mode? The doing mode is when you know, you've got a task at hand, you've got a project to, to hand in and you need to be in the do mode to get that project done. And biochemically, you activate the sympathetic nervous system, the body gets activated, you get ready for that task and it's done. What happens is if you don't come out of that doing mode, then the state of stress is continual. So in your life, if there's one thing that you can do is try to incorporate more of what we call the being mode, which is the rest mode. When your nervous system can rest, your thoughts can rest physically, you can rest. And that's where a lot of healing and nurturing takes place. That's concept number two. Then we've got concept number three. And I think this is really important for you to be aware is that your mind has a strong negativity bias. For example, um you know, uh as a tutor, I might have given some reports out and I gave a nine out of 10 and I said nine things that the students said, you know, that they were wonderful out, but they want to talk about that one out of 10. They really want to talk about that one thing that they didn't get well and that will often dwell on their minds and preoccupy them. And that's because the mind has a tendency to remember negative things. So let me give you an example. We, what we do nowadays, isn't it? When we go on a holiday, we might look at the reviews of a hotel or when we're going on Amazon and want to review a product. Usually we look at the reviews and even though there's lots of reviews, it just takes that one negative review and I don't know if you can notice it, but did your mind kind of immediately get drawn to that one out of five? Um, the one down at the bottom in the middle don't stay in this hotel and the likelihood that one review will put you off because of the mind is so drawn to this negativity bias and it just does it naturally and this negativity bias is how you talk to yourself, right? So, um the conversations you have in your mind, oh, I'm useless. One thing might have gone wrong. Oh, that's typical. You know what's wrong with me? And we start to talk to ourselves in a negative way and then we look out for negativity and what happens. What's the problem with living like this? Well, the research shows that it is common that we actually do pay more attention to negative events and positive ones that we tend to learn more from negative outcomes and experiences and we actually make decisions based on negative information on positive data. So actually, sometimes we're program like this because this is the way we've always been living. Um Now, you know, there's various theories of how this came about and there's a, you know, evolutionary theory that, um when you were cavemen and you had to, you know, run away from a lion, those who were more tuned to danger around them are more attuned to the negative events. They were the ones that survived and the ones that were happy go lucky and, you know, didn't pay attention to the danger that that was around them. You know, they didn't make it. So that's one theory that this is why this has been passed down. And there has been some research where they put electrodes to brains and they've, you know, done the brain activity. And if you show someone a negative picture or positive happy picture of like a flower and sunshine and meadows, the brain doesn't have as much activity as with the negative events. So, yes, there's a natural tendency to do that. It doesn't serve you. And this is a really difficult one to come over and I'll show you how we get over this, but you really need to be aware of when your mind gets into that negative state because often it's a downward spiral. And what's the problem of this one is that when we get a negative event that's happened to us, you know, whether it's an exam mark or some altercation with a colleague or some altercation with, you know, a parent, a relationship that tends to get locked in our mind. And then we get into this never ending cycle, we react to that. Every time you see that person you react and stress builds up or just thinking about them, you know, you get quite stressful and you react that gets locked into your brain. And then every time you think about it, again, those feelings get, you know, inside and the body cannot distinguish between what's real and what's not. So even if that person is in front of you, you will get the same chemical and physical reaction in your body is if you're just thinking about them. So we're talking about mental stress here as well as physical stress. And because the mind is programmed to think like this, you tend to be like on a radar for other negative events. And then again, you get this downward spiral, I'm just useless. Look at all this stuff that happens to me, but the truth and the reality is positive events happen in your life. But because we're so used to living in this negative way, they kind of just pass us by when we're not living in the now moment when we're not living in the present moment and were too preoccupied with the negative stuff that's always happened to us because that's the story we tell ourselves and the future, which is usually us protecting ourselves against negative things. We just don't get to be in the present moment, which is the space and time you can really grow. It's that present moment where you can find joy and can find happiness. All right. So if we get in this negative spiral of thinking, the positive events just fly right through and we don't even notice that they're there. But actually they're, they're, and they're very common. I can, you know, I practice gratitude a lot. I think that's a great thing to do. It releases happy hormones like dopamine serotonin and gratitude works. If you, I think I always say minimum 10 things you should think about because it really forces the brain to scan for things. And so don't do less than turn if you're going to practice this. Uh you know, I'm grateful for the tap, the, the water that comes out of the tap. I'm grateful. Electricity that gives me light and I can use my laptop. I'm grateful for the table that I can use all the chair that I can sit down all these small things. It doesn't have to be major things like I've won the lottery. All these small magical positive things are happening in your life and can make you feel better in an incident. And I think gratitude is one of those really quick fixes, right? We talk about we want where society like seems quickly practicing gratitude can quickly turn you from positive into uh from a negative into a positive state. So I I love to practice that one. Okay, let's talk about the science of stress a little bit. Um You guys are familiar with this, hopefully with your medical background, got synthetic and the price symptom that nervous system. So the main thing I want you to take away from this is that when you activate sympathetic nervous distance and you know, you get a whole host of events, your heartbeat accelerates, adrenaline gets released, inhibits the digestion glucose gets released. You can think more clearly and you know, run, run for that bus, it gets the muscles moving, it takes away from other areas of the nervous or the body that we don't need right now, that's great. Right? If you're having an exam, if you're running for a bus, if you've got a task to do, we need this, we're not saying it's a bad, we need it. And obviously the opposite to that is a powder synthetic. The problem comes when we can't switch off when we've had that exam, but we can't stop thinking about it because the body cannot distinguish between what's real and imaginary. So if you're still thinking about the exam, about that one mark that you didn't get or that paper that didn't go so well, your body still thinks you're in the exam mode and it's still continually pumping those sympathetic, you know, hormones. And then we get to, into a chronic situation of stress and those could be various triggers for people that could be a job. It could be a relationship, especially if you're living with someone, you don't switch off that sympathetic nervous system and that stress hormone, it could be a lot of triggers. And I think that's one exercise that people need to do is to identify those triggers in their life and see what they can do about them. Because living in a constant state of chronic stress is not good for you. And it leads to things like this, you know, overthinking, living in that kind of survival mode, um not being able to switch off, you get tired, mentally, emotionally, physically, a lack of enjoyment. And we know that stress can lead to physical illness, mental health promises that things are commonly as a GP more and more every day. Heart disease, BP, obesity, emotional eating. I was actually about 56 years ago, I was 25 kg more than what I make way now. And I knew that I was emotionally eaten, but I knew that diets don't work, you know, otherwise there would be no one who would be obese because it was that easy is we would have an epidemic of obesity. So I knew diet wasn't the answer and restricting wasn't the answer. So I decided to look at the wri cause of why had weight gained weight. I was in all my life until I had my kids. Um And I was emotion eating. So I thought, right, that's the, that's the trigger. I need to think about how I can manage my emotions and stress. And I don't like the idea of CBT particularly and again, mindfulness. So a lot of mindful eating meditating in the morning to manage my stress and visualizing for the day that I was healthy, I was exercising that food wasn't something that was going to control my life. So I use a lot of affirmations, a lot of mental reprogramming. And I think the beauty of mindfulness is that you don't need anyone else. And that is the key with this mindfulness is that you can take control of your own state of health because we need to empower patient's right. Yes, we can give these high BP tablets to make sure the BP comes down. But we also want to give them that's going to change those triggers those stressors in their life. You know, we, we band this term holistic care, but we don't actually really, you know, especially as a GP in 10 minutes. What can we do? How much holistic care can we practice? It's, it's quite impractical, which is sad to see. Um but, you know, skin gush into final problems. So getting some sort of, you know, healthy mind mind and physical approach to health is going to do wonders. And I think this is a definitely a growing trend in medicine we still we see in lifestyle medicine which is getting um a lot of exposure. So I think we are getting there. But the practical implementation in the NHS is, is I think that's the talk for another day, probably, right. So you guys are still students, you're very important group. In fact, the data has shown that mental health problems from students has increased fivefold over the past 10 years. I have a feeling this data I got was pre COVID actually. And I'm sure that's more. So we know stress is really especially in the student groups. How can what's mindfulness do? So, so I've kind of taught you how you live your current life. You know, anything far from being mindful is the reality of the situation and what mindfulness does essentially is making you aware of what you're thinking of your thoughts. So it's saying, right, I I acknowledge I'm stressed. So for me, I know that when I'm stressed, I tend to lock my jaws and I tend to carry tension in my shoulders because I'm not really, I don't really know when I'm stressed until the physical is, is one of those things. It's like a weather system. I use these two signs now and I can tell, right? Um Something is happening, there's brewing inside of me. So get to know your triggers, get to know how you physically manifest, stressing yourself. It's different for everyone. I also tend to get a pit feeling in the pit of my stomach again. I know. Right. I'm feeling stressed but to do that, I mean, this sounds really, I used to set an alarm on my phone every hour and it would say check in nothing else, just check in, check into how you're feeling because that is what my place is all about being aware, uh, in that present moment in the now moment. How are you feeling? Uh, so I'm checking in now, I'm feeling quite good in myself because I've come to joint, I can't see anyone on the screen and look and see is my slides, but I'm feeling quite nice. I'm getting to talk about, you know, something I'm very passionate about, um, 20 minutes ago. Well, you know, checking in and I'm thinking, oh, I've got a bit of tension in my jaw. What's going on? Ah, yeah, the kids are playing up and I need to go and do a talk in 20 minutes. But then I kind of think, ok, I know rather than going down that downwards spiral of being stressed, you know what? I know it's going to be okay because I've done 100 of these. Right. And the kids are always around and they know that I'm doing this talk, it's going to be fine. I don't need to procrastinate it. I don't need to dwell on those negative events. In fact, I'm going to think of every time I've done this talk and how well it's gone within two minutes. It was just fine and I was calm. All right. I didn't need, anyone, didn't need a pill. Let's talk to myself. It was all good. So you need to take a step back, acknowledge how you're feeling. Take a step back from those thoughts, separate yourself. You are not part of those thoughts. Don't get caught on that train, right? So, mindfulness essentially is put in space between the situation and the Axion that's going to happen. So that rather than seeing that person or all right, I've got anatomy always stuck at anatomy. And then those feelings get, you know, you get worked up because you're stuck in the past. You're using the past to determine what actions you're going to take. Put some space between you. The situation on the Axion. Marvelous doesn't promise you'll never have stress in your life. And that's not what it's about, it's about your reaction to that stress. There's going to be stuff in your life, you're going to have ups and downs, you're going to be moments that are difficult and it's going to, you know, challenge you mentally, physically, whatever it is, you need some sort of mechanism in place to make sure you can deal with that. And this is what I'm advocating today. So where does mindfulness come in and the science side of things, it stimulates your parasympathetic nervous system. So yoga tai chi, all the similar things, right? They turn the tap off to the sympathetic nervous system. You're releasing the lovely hormones that cause your heartbeat to slow down your digestion to improve those happy hormones that make you feel good. And that's what mindfulness does, right? The switching on that parasympathetic nervous system, you're working with your body, we're just, I kind of call it like a hack were just hacking into the system, making use of what it's supposed to do. And as I said, mindfulness, I wouldn't say it's like, right, I can go and listen to a nap and I can practice mindfulness. There's a lot of theory behind it. This is like courses and degrees and diplomas you can do on mindfulness. And these are some of the principles that it's based on. Um, you could do an hour's talk on each of these. I think the ones that are important would be patient. Mindfulness isn't a pill that you take and you'll feel better tomorrow. It doesn't work like that. It's dose dependent. The more you put in, the better the outcome is going to be, you've got to do the work, beginner's mind. If you've had some idea about mindfulness or you've come with some preconceived ideas or notions you might think, oh, or is it associated with certain religions? Um, do some reading and research and a lot of those myths. I think you need to let go. It's something for everyone. It's not associated with any particular way of life, for culture. Um, it's just something very natural. So I would say, right, when you come to these courses have a beginner's mind, forget everything that you've been taught. I think acceptance is a big one. We have a lot of problems, especially young people about accepting themselves that everything's fine. you're fine just the way you are. And it's again noticing all those small and positive things, which there are hundreds of things that are going right in your life and letting go, a lot of letting go um letting go criticism of yourself, letting go of reacting to negative events in the same way that you become program too. And the most important one I love is gratitude because I think we call that a natural antidepressant. It just really lift you up and very quickly you get results very quickly. Just um some studies about my purse in academia. There's been lots of research on this and these are some of the outcomes that that happened. Curiosity um kind of that thinking you're more open to things. So people learn better. Um increased of focus, your clarity, resilience. People have known to have reduced problems, behaviors as well, kind of really challenging that stress response and how you usually deal with stress in a different way. Just some sprain scans. This was before and after mindfulness. So you can see like the red activity before the mindfulness, that's your angry kind of phase. And then within 10 minutes, you kind of calm down very, very quickly, get very quick results for that. And again, some more data, this is by the University of Manchester. They looked at cancer patient. So they did an eight week mindfulness course and then they followed these patient's up. And I think what's really interesting in this case is that even after the course was finished, the data was looking really good eve after six months of following up, the sleep had improved, that nervousness and worrying had improved. They felt happier, they concentrating more. And that's generally the case, you know, if you keep going and you employ the skills that you keep doing, you'll see results. And I think the mistake people make is that they embark on one of these, you know, I'm going to change my life. I'm gonna look into my nose, I'm gonna look into anxiety once uh something happens to them. And I'm saying, right, things might be great. That's fantastic. But don't wait for something to happen to change your life in, in a positive direction, whatever is, it might not be mindfulness for you but do some sort of invest in some sort of well being program, you know, would we take our care of ourselves physically really? Well as doctors, we tell power patient's to eat five fruits today, avoid smoking, you know, limit your alcohol intake. But what do we tell them to take care of their minds? And I think that's a real gap in what we're telling our patient's because, you know, when we were young, our needs are very simple. We were babies, we cried and someone changed unhappy and fed us and that was fine. But as we grew older, our needs became more complex. Suddenly, loneliness, boredom, stress, anxiety. And as we went through school, we're not really taught how do you deal with these? Right? And in the worst case scenarios when your needs are meant you turn to drugs, you might turn to alcohol to fill that void because you've not been talked. So, um that's one thing I do tell patient's if I can in that 10 minutes, invest in a well being program, whatever it is that makes you happy that, you know, mentally keeps you good. You know, the way that you look after your physical, that you go to the gym, you go for a walk, invest in the same amount of time energy in your mental well being. So more data. This was three months after completing a mindfulness for health course. And they sent a survey and noticed that patient's actually used the healthcare service less after a mindfulness program. And pain is a very good one for minus a lot of evidence for pain that patient's were taking less pain relief as well. So a couple of benefits of mindless. Hopefully I've not scared you too much and I've convinced you about the benefits cardiovascular health, especially when, um, stress is, you know, part of the problem with hypertension, um, energy levels, immune system because you're low in your stress levels. It's really helps with pain relief, um, insomnia, especially, you know, that over thinking that you get at night trying to get out of that rut. And one thing I think is what? And certainly in my case is that when I all the time, you know, especially as a mom, you kind of focusing on taking care of everyone else and you're kind of need to get lost. But I think that's the wrong way to go about it. And I've realized the hard way is that once you invest in yourself, you have a ripple effect on all your relationships they naturally flourish. Um, and I think I'm married to an interventional radiologist who really kind of said that this was all kind of airy fairy, didn't really believe in it and I thought that's fine. I'll just show you by example. Um And now he's really changed because he can see the benefits of it. Um And how much calmer ir I am and that ripples to your close relationships. You don't even have to do anything. You just continue to do your stuff be into your well being and you know, it will radiate to other people. So just to give you that NHS website, there is something on mindfulness on the website as well. It's definitely more and more of everyday language. Even some of the hospitals, they're running mindfulness programs. This by guidance Saint Thomas is um they do for long term health conditions. A lot of the NHS trusts are doing it for things like pain cancer. Um Just general well being. So it's definitely out there in the mainstream and I think I'll just kind of talk a little bit now coming towards the end of it is how you can practice it, hopefully convince you of the benefits of it um awareness. It's, it's really simple, right? It's just to be aware of how you're feeling, being aware is going to ground you in the present moment and to get out of that caught up being caught up in the past, being caught and then caught up in the future with all the worries and you know, procrastinating and overthinking and getting stressed. We use the breath and that is the key as an anchor. We use the breath to kind of ground you stay in the present moment and the beauty of the breath is that it's with you all the time. Wherever you go, right? You don't need a yoga mat, you don't need dumbbells or whatever for exercise. You don't need any tools but yourself be committed, right? When you start on a well being program, whatever is that you decide to do so. Right. No matter what, I'm going to do this for the rest of my life every day. And that is not hard because you brush your teeth every day, you drink water every day. There are so many things you do on a daily basis. This is just one of them that are going to add on and keep a very open mind. Okay, that no matter what there's going to be ups and downs, I'm going to really connect with this, but I'm going to give it a go and I'm not going to go back into my old ways of thinking the biggest excuses that I don't have time. Right. That's the big excuse, be aware of that. Be aware of that resistance that your mind will, will play. And when your mind is and your life is used to live in a way for the last 2030 years of being in the doing mode, constantly, constantly being in the past and the future of really used to looking at things negatively. It's going to take time for the mind to overcome that and it's going to fight back in the beginning. So again, just be aware of those voices in the head and some of those voices, what does that look like? It will be things like this isn't working. That's a really common voice in the head. And what does that mean? You know, have you lost anything by doing mindfulness? No, you can only have something, there's no side effects of this. There's nothing, there's no money that needs to be invested in this. Right. Um It's so simple to do and everybody can do it, even Children. So have an open mind when you go into this, be committed and do something on a daily basis. We say it takes 21 days to change thoughts at least do it for 21 days. What do you need clothing, know whatever you want, you know, you are as you are. It doesn't require any special posture. Now, there's two types of mindfulness. There's the formal and the informal so formal mindfulness is your meditative state, right? So you do meditate mindfulness, meditation. That is where you sit in quite still or you're lying down, that's a certain posture you're going to adopt. And usually that's in a location which is somewhere that you're not going to be disturbed. Informal mindfulness, you don't need anything. So it's the stuff like when you're washing up, you're noticing the water, the temper of the water, the soaps on your hand when you're in the shower, when you're walking, when you're eating, these are called informal mindless just doing, you're carrying on with your normal everyday activities, but just being mindful of them, just paying attention. So when you're walking, what does it feel like on the ground? How about the weather against your face? How does it feel to move your joints? Anything stiffer than the other one. You just kind of this natural curiosity and getting to know yourself. And then we've got music you can, if you want to have music, I love having music in the background. Um And I do my meditations and equipment, like I said, you only need yourself, which is the breath. One of the reasons I don't particularly like CBT S because, you know, some of the other modalities as well, you're reliving past memories. And I don't think that personally, you know, there's a lot of good about CBT. Um, some people don't get on with it. Some people do for me. I didn't think it was that helpful for my situation personally to relive the past because that's done now. But some people might need to, you know, go through that in order to move forward. There's no blanket rule here. And, um I've been in some kind of sessions where they want to, you know, lied on a couch because I was exploring all these different therapies. And they said, right, tell me what you're thinking. I don't know what I was thinking. I just can't put into it. I didn't, I didn't like to be distracted and, and, you know, cut from the flow of the experience was mindfulness isn't any of that. And these are the two things that I really appreciate about it because uh that's not my, really my cup of tea. So I told you a little bit about why I think as a doctor, this is something that you should invest in for yourself. Your own. Well, being, we've seen a lot of doctors having a lot of stress. You just need to go on med Twitter these days. And it's a, you know, it's probably one of the stressful situations that's going, um, doctors pay doctor strike. Um, you need to protect yourself. Right. And, and if we want to give the best to our patient's, we need to be the best ourselves. So you owe it to yourself. You owe it to your patient's, you, it to your friends and family. People want the best for you. And I think regardless of it's marvelous, are not some sort of well being program that you need to invest in. And I do advocate marvelous to my patient's. I would, you know, and I think there are a lot of NHS organizations that offering free mindfulness classes. Um I would love to do a 10 minute mindfulness practice in my NHS clinic. It's, we're not there yet. I think it's so busy that we can incorporate that kind of thing at the moment. But hopefully something like that would happen in the future, which is why you see, you know, a lot of that actually is in private practice where you've got the time. Um, you know, you get an hour, I can, I can do a whole 30 minutes teaching session and then like a 30 minute mindfulness practice as well as asking patient's what their lifestyle and things like. So, um we just don't have the time resources in the NHS to do that. Unfortunately, hopefully, if anything I've made you interested in mindfulness, I've given you a little bit of flavor, a little bit of spark. Um These are some sort of um if you want to take it further, some extra reading material, um screenshot this, I'm sure this presentation will be shared later. So those are just some of the books. Um There's one of them, I think mindfulness for health and that's advocated by the BBM A. Yeah. Right. That's my last slide. Um Just a lovely quote from John Cavity. And he was actually, I suppose the founder of modern mindfulness medicine. Um He was the one that put mindfulness and medicine together and created these like eight week programs that you could use for things like health and pain, anxiety, depression. He's based in America. Um And he's, this is a lovely quote. As long as you are breathing, there's more right with you than one with you no matter how much is wrong with you. Thank you. I hope that was informative. I'm just going to uh stop share and I hope that stop sharing that. Yes, it has. Thank you so much doctor have. That was really interesting. I've quite liked the whole, the whole being mode and doing mode and kind of like letting go of all the negative feelings and thoughts and focusing on the positive. That's quite, that's quite useful for me, especially, uh, good. Uh, in terms of, if anyone's got any questions, they can just write on the chat, um, block out the sun. I had a question actually. Um, so in terms of how you would incorporate, do you think that mindfulness practices different when you do it in the community versus in the hospital or like when you were telling patient's and what you're adopting for yourself? Do you think there any differences at all? Yeah, I think it's like, you know, you have to tailor it to your audience. It's the same with any kind of consultation. Some people come with a lot of knowledge, some people think, oh no, I've tried that before. I don't want to give it another go. So you have to kind of almost take a history. Um And all of it is really time. Time is the biggest killer of how well the consultation will go like saving private practice. I have an hour to do this. Um I can do it online or in person. I just can't do it in the NHS. Right. Um So that's why some of these, you'll see it more in the, in the hospital setting where they can do these eight week course is um we're not there yet so much in the communities. Some somebody's trust do offer like a community kind of care program. Um I just think you have to tailor it to who your audience is. Some of them are quite cleared up, some of them, not so much, you have to really start from the beginning. I think there's a question in the chat. Um How do you say focused on mindfulness? Which is, is there any techniques, etcetera? Yeah. So like I said, you know, your mind has been used to live in a certain way. So suddenly you're saying right? I'm not going to live like this, I'm going to stay focused and I'm going to be present in the now moment that takes time and effort. It sounds so simple, it's really not easy. Um And if you kind of, you know, within the next 30 seconds, try and stay mindful, your mind is gonna wonder, right? It's going to go all over the place even 30 seconds. It's like almost like someone training for a fight, right? You've got to put in the work. So build up. So start with like 10 minutes a day, build up to 20. If you can get to 40 minutes of mindfulness meditation, that automatically will help you focus, will give you that clarity that you need and all that monkey chatter and all that voices in your head that just subsides, right? Cause it's almost like a mental retraining program. So daily mindfulness meditation is the way to go and whatever you do don't give up whatever is going on around you, you're on holiday, you're at work, you stop, find something either in the day or in the evening, whatever works for. You just find the same time every day to make sure you do a mindful meditation practice. Mhm. That's great advice. Thank you, Doctor Ahmed. Um, just checking if anyone has any of the questions, feel free to post in the chat. Um, but if I may say so, that was a very interesting talk and it definitely, you know, when someone points out certain things that you don't really realize you're like, oh, I do that a lot and that's also very helpful just to start that sort of journey, I guess. So. I hope it's been as useful um, to everyone else as it has been to me and thank you so much, Doctor Rama. Do you have any other words that you'd like to say before we go? No, just, just like I said, even if you don't want to go down mindfulness, I'm just saying, open up yourself to the possibility of taking care of yourself, right? We're in a career that's, we're learning constantly getting. It's a stressful career that we've chosen, you know, and this is we're in it for life. I hope, um, you need to protect yourself okay from all the things are going to come your way. Um And please just look into some sort of well being program and if anything, I hope I've convinced you, mindfulness is the way to go. Thank you very much. Um So I think this will be available on Medal as a recording a little bit later on. Um And we will be sending out feedback forms as well um via email that you signed up to and obviously um any feedback that we get a doctor. Ahmed, we can forward that on to yourself. Um But on behalf of myself and Anjali and WPMM, we really thank you for your talking, your time for this and we hope to um all I suppose, engaged in a bit of mindfulness and see whether I go. It's really mind how you go. Thank you. All right, then take care. Thank you. You too. Thank you very much. Bye bye.