Having better conversations

During the past few months I’ve spent a lot of time on Zoom. Haven’t we all? From meetings to social calls to virtual events, most people have been spending a lot more time than before on video calls. I’ve also reconnected with some friends and family members who I had fallen out of touch with – some of whom I hadn’t seen for decades. There’s nothing like a global crisis for an excuse to get back in contact.  

This has meant a lot of conversations, and it has made me consider how important good, meaningful conversations are. In centuries gone by people used to set a lot of store by the ‘art of conversation’ and it was even something taught to wealthy young people in order to help them progress in life! Even today, being a good conversationalist is still a prized attribute, and it helps you have better conversations and build better relationships.

American journalist and interviewer Celeste Headlee has written a book about that very subject: ‘We Need to Talk: How to Have Conversations that Matter’ is based on a TEDx talk Headlee gave in 2015. In it she gives 10 suggestions for better conversations, including giving your interlocutor your full attention, trying not to ramble, and avoiding getting bogged down in too much detail – names and dates are not always needed to tell a good story.

She also advises never to compare your own experience to that of another person, which I would heartily agree with. Two people may have been through the same experience, but it will have had a different effect on each of them. It’s perfectly possible to connect over those shared experiences without having to compare them.

One tip I have picked up from my many Zoom sessions is to decide in advance whether I want to invite coronavirus to the call. Sometimes you need to talk about the current situation – it affects every part of our lives after all. But sometimes you need a break. I find it easiest to just agree with others on the call that we won’t talk about it at all, as in my experience once you start, it’s hard to stop. So far no one has had a problem with this, everyone else seems to be sick of talking about it too!

Another is to always have a ‘spare’ topic of conversation up my sleeve on big group calls with lots of people. It never ceases to amaze me how quickly silence can descend on a call of 15 people and how hard it is to break once it sets in. I can never think of anything to say on the spot, so I try and have an observation or question ready just in case – however trite, it gets the conversation going again. This is not something I do with individual calls, as I find that brief pauses or moments of silence can provide opportunities for the other person to raise a topic which is important to them.

Finally, on those group calls don’t be afraid of the 40 minute timer! Those of you who use Zoom will know that the free version will cut calls off after 40 minutes. This is a result of not paying for the app, but honestly I would pay extra for this feature. It brings a call to an end after the perfect length of time with no awkwardness, and I find that if calls are kept short and sweet its much easier to schedule them regularly – if you know a call will take two hours you may be less willing to make time for it. Or if you are calling someone you don’t know very well or haven’t spoken to in a long time, a 40 minute cut-off can make the conversation seem less daunting.

Don't forget the fun

Late Sunday morning a week ago found me lying on the floor of my kitchen counting very loudly from one to 26. The reason for this was not complete lockdown madness – not yet anyway – but a charity initiative called the 2.6 challenge, urging people to complete activities for charity on the day when the London Marathon was due to be held. As a former runner of the marathon I wanted to get involved, and recruited the rest of my family to help.

This is what led to me lying on the floor – doing 26 spine curls while shouting the numbers out as I did it so that everyone else in the family could hear, either from the other side of the room or from their own homes via Zoom. Everyone was doing different activities, from press ups to sit ups to lunges. The problem was that some of us were a little, ahem, faster than others, so there was a bit of confusion with everyone shouting out different numbers at the same time. It was chaos. It was also very good fun, and we all made a donation to a chosen charity after we completed the challenge.

The 2.6 challenge was the most fun I’ve had in weeks, and I’ve been thinking about why. Of course it’s nice to do things with loved ones who you’re not able to see in person any more, and donating to charity makes most people feel good immediately. But I think it was more than that, I think having a project that I could organise and execute gave me back a sense of being in control, at a time when everything else is out of my hands.

I’ve written before about the benefits of creating small areas of your life where you feel in control, and I think it’s part of the reason why so many people have turned to creative activities like baking, painting and sewing during lockdown. Having an event to organise is a welcome distraction, however small and informal it may be. My children immediately asked if they could organise another Zoom event for the family based on a similar challenge, and I can’t wait to see what they come up with.

In our house we have also created several routines as a way of trying to maintain some control over our lives and have things to look forward to. On Fridays we take it in turns to choose a film, and often arrange an hour of drinks with friends over Zoom beforehand to kick off the start of the weekend. Wednesday evening is when we eat with family members in their different locations, again over video call, just for 40 minutes.

We’re all living in difficult circumstances, through a crisis whose tragedy and hardship we are only just beginning to understand. It can be easy to feel guilty for trying to organise frivolous activities but the reality is that we need fun to keep us going, wherever we can find it.

Finding calm in a crisis

One positive outcome of spending so much time at home is that I have been doing a lot of cooking – along with everyone else, by the sound of it! My social media feeds are full of beautiful pictures of homemade bread, cakes and other delights. It seems that everyone is turning to an easy, wholesome pastime to keep them occupied – even this beautiful letter by Italian author Francesca Milandri acknowledges that the making and eating of food has become one of our biggest pleasures.

I like to bake while listening to audiobooks, often with a cup of tea at hand – or perhaps something stronger if I’m having an evening cooking session. It reminds me of a wonderful book I read recently called A Half-Baked Idea, by Olivia Potts, a woman who quit her job as a barrister after her mother died, and used the money she inherited to enrol on a year-long course at world-famous cookery school Le Cordon Bleu.

It’s not something most people have the money or the inclination for, but I loved hearing about the fantastically difficult creations she was taught to produce, her eccentric tutors, and the jarring difference between her new life of tempering chocolate and whipping meringue, and her old one of rushing between courtrooms and whizzing through stacks of briefing papers.

It’s no surprise that she sought comfort in cookery after her loss. It is widely accepted that cooking relieves stress, as it focuses your attention, yet requires physical activity, giving your brain a break. Donna Pincus, associate professor of psychological and brain sciences at Boston University, explained some of the positive effects of baking to the Huffington Post in 2017.

“Baking actually requires a lot of full attention,” she said.

“You have to measure, focus physically on rolling out dough. If you’re focusing on smell and taste, on being present with what you’re creating, that act of mindfulness in that present moment can also have a result in stress reduction.”

Olivia Potts uses her book to reflect on the lessons baking has taught her. She writes: “I found that hard work (mostly) pays off. I found that there’s no substitute for practice. I found out that it’s not shameful to fail, if you’re willing to pick yourself back up and try again.

“I learned that it was ok to be sad when something went wrong, so long as you show up again the next day and try again. I learned that there would always be opportunities to redeem myself, and that I needed them. I found that patience really can be a virtue, much to my irritation.”

This week, inspired by Olivia Potts and my own need to create some peace and relaxation, I have made soup, scones, and fruitcake, using up all the odd bits of dried fruit I had in the pantry. I might try a fruit pie next!

The joy of small things

After two more weeks of lockdown, I’m still looking out for good news and positive stories. Whatever your situation, this is uncharted territory, and I for one am relieved and excited to have something to celebrate this weekend.

Easter is a special time whatever your beliefs, coinciding as it does with the advent of spring and new life. As is often the case I find myself working on Good Friday, but I’ve been overjoyed to make plans for baking hot cross buns and painting egg shells this weekend – even if supermarket shortages mean I end up baking whatever I can find and painting paper instead!

I was charmed by New Zealand Prime Minister Jacinda Ardern, who this week told young New Zealanders that the government considers the Easter Bunny an ‘essential worker’. In a lovely message she added that the Easter Bunny might be a little busy with their own bunnies at home, so children may receive fewer treats. I remember the days of my own children being overwhelmed by an enormous chocolate egg from every relative and family friend, and can’t help liking Ardern’s suggestion of children drawing their own Easter eggs instead, and displaying them in the window for other children to spot on an ‘Easter egg hunt’ when out for walks in the neighbourhood.

Nowadays many people celebrate Easter in different ways, and I have been thinking a lot about new life and fresh beginnings. We have had some new additions to the family this week: four young hens. Some of you will remember the hens we kept several years ago, who we were very fond of. Now we have decided it’s time to fix up our old hen coop and fill the garden with inquisitive clucking (and lots of chicken poo) once again.

In the midst of all this it has been wonderful to be distracted by trying to give these hens the best home – and protection from foxes – possible, and to look forward to their company – and in future, their eggs! I’m planning to enjoy settling them in this Easter weekend, as well as drawing a colourful Easter egg for local children to spot in the window.

The kindness of strangers

I’d like to share some good news stories I’ve been enjoying recently. There’s an awful lot of the other sort, and it makes a nice change to focus on the positive for a while!

Positives like Capuchin Franciscan Brother Richard’s poem Lockdown, which became famous world-over when he posted it on Facebook on Paddy’s Day.

It begins: “They say that in Wuhan after so many years of noise

You can hear the birds again.

They say that after just a few weeks of quiet

The sky is no longer thick with fumes

But blue and grey and clear.”

You can read the rest here.

Feed the Heros, a fundraiser set up by family and friends of healthcare workers, has raised €325,000 to send takeaway meals to those on the front line of the fight against coronavirus, more than smashing an initial target of €250.

GAA clubs around the country have grouped together to offer support to members of the public with shopping or collecting prescriptions, and taxi drivers have been offering transport and delivery services free of charge. Restaurants around the world have offered free meals to children who would normally be fed at school.

Guinness has donated €1.5 million to help support bar staff and help elderly people, through ALONE, the charity for older people. Several NBA basketball stars in the US have pledged hundreds of thousands of pounds to support arena staff out of work due to games being cancelled.

Individual stories stand out too – like the London pub which sent a 90-year-old regular customer a barrel of beer and box of crisp packets for him to enjoy during isolation. A florist in Antrim decided to use up her remaining stock after being forced to close by delivering random bouquets for free to neighbours and friends.

Another woman in the UK created a postcard which people can fill out with their contact details and offers of help with shopping, posting mail or a friendly phone call and then put through neighbours’ letterboxes. Broadway star Laura Benanti posted a message on Twitter asking children whose High Scholl Musicals had been cancelled to send her a video of themselves singing, so she could be their audience. The hashtag #SelfIsolationHelp started by social media strategist Samantha Kelly has been doing the rounds with people offering help and support.

I have heard many personal stories too, of strangers offering kindness to their neighbours or via social media, of communities coming together to support each other and of friends, families and colleagues making an extra effort to be close to one another when isolating apart – including several stories about ‘virtual pub’ sessions over Skype – sounds like a great idea!

Have you seen any other stories of kindness in the past few weeks? Comment below and let me know.

The 98-year-old doctor who cares

“There is no secret to becoming a centenarian, it’s straightforward.”

This is the view of France’s oldest doctor, Christian Chenay, who is still working at his practice on the outskirts of Paris at the age of 98.

“It’s good for my health to keep active,” he added, in an interview with the BBC program Newshour.

But apart from being good for his own health, Mr Chenay is still practising after 70 years because of the obvious good it does his patients.

In numerous interviews with media outlets from across the globe who visit to report on Mr Chenay’s longevity, they extol his caring nature and the trust he is held in by the local community.

“He’s someone you can talk to, who you feel comfortable with,” one patient told media outlet Brut.

“He knows my illnesses inside out, he knows my habits. I don’t see him only as my doctor, to me he’s like a dad,” said another to the BBC.

Mr Chenay sees patients on two mornings a week, and he is the only local doctor who allows patients to turn up without an appointment. If he closed down his practice, he would likely not be replaced as France is facing a drastic shortage of family doctors. In Chevilly-Larue, where Mr Chenay practises, there are only three doctors for a population of 19,000.

“This doctor is really loved because he takes time to listen to you, he calms you down,” Yamina Derni told the Guardian.

“You don’t even notice his age,” added the 63-year-old, who had been treated for benign tumours.

“He’s got an amazing memory and he takes time to investigate the why and how of what’s wrong,” said Sarah Lahrouchi, 31, a patient of Chenay’s since she was born.

Christian Chenay practices in a suburb of Paris.

Christian Chenay is a wonderful example of someone who loves the work that they do and so can continue doing it well past an age at which most of us would retire.

But he also seems to be an excellent doctor and a real asset to the community, as the emphasis of his treatment is on care. One patient even compared him to a psychologist, and it’s easy to see why: Mr Chenay believes in getting to know his patients and talking to them in order to get to the bottom of whatever the problem is.

His approach echoes that of Sir William Osler, a doctor who lived 1849-1919 and is considered by many to be the father of modern medicine. He said: “It is much more important to know what sort of patient has a disease than what sort of disease a patient has.”

He added: “The good physician treats the disease, the great physician treats the patient who has the disease.

Mr Chenay has said that a large part of his work as a local doctor involves helping patients with underlying mental health issues, especially in a low-income Paris suburb where there is high unemployment and many get by on very little.

Mr Chenay reports excellent eyesight and hearing, and says he has no plans to retire any time soon. We could use a few more local doctors like him, whatever age they are!

A brief history of unexplained pain

Pain is a fundamental part of the human experience – from the short, sharp shock of stubbing a toe to the sometimes life-changing agony of chronic pain, it is something that links humans throughout the ages. It is fascinating to chart the study of unexplained pain, and it can be helpful in thinking about our attitude to pain today. The importance of considering a person’s state of mind as well as the physical site of pain has been recognised for many years.

References to pain can be found dating as far back as 2250 BC on Babylonian clay tablets, and it’s likely that pain was at that time blamed on evil spirits. Several thousands of years later in Ancient Greece, philosophers and early doctors were still learning. Though their knowledge of anatomy and disease was primitive, some were beginning to understand the mind-body link much better than many do today.

Fragment of inscribed clay tablet believed to be from Babylon.

In 400BC Greek Hippocrates observed that strong emotion or excitement could cause physical symptoms such as sweat or an unusually fast heartbeat. In his view, treating the mind was as important as treating the body, and it was necessary to view an invalid as a whole, body and mind, in order to heal them.

Like Hippocrates, Herophilus (c.335-280 BC) considered the brain the site of pain perception, and his work was rediscovered by a Roman philosopher named Galen around 400 years later. Galen made the link between emotional trauma and physical symptoms, and wrote in c.150 AD that a patient was “afflicted not by a bodily disease, but rather some emotional trouble grieved her.”

A millennium and a half later, the Frenchman René Descartes concluded the mind influenced the body in the same way as levers influence the workings of machinery, and is reported to have told Princess Elizabeth in the early 1640s that bad thoughts could cause bad dreams and bodily disorders.

French neurologist Jean Charcot (1825-1893) gave a lecture in 1888 arguing that psychology plays a role in the area of nervous diseases. His student, Sigmund Freud, took the influences of Charcot and contemporaries Pierre Janet and Josef Breuer, and surmised that trauma could lead to repression of feelings and memories. With no other outlet, these thoughts ‘converted’ into a physical complaint – ‘conversion disorder’ is a term still used today.

Sir William Osler (1849-1919), often referred to as the father of modern medicine, regarded emotional factors as important in physical illness. He wrote “the good physician treats the disease; the great physician treats the patient who has the disease”.

Francis Peabody (1881-1927), a well-respected American doctor who spent much of his life training and then teaching at the University of Boston, wrote at length about the importance of a personal relationship between the doctor and patient. He famously said that: “the secret of the care of the patient, is in caring for the patient”.

This is an edited and condensed version of the history chapter I co-wrote with David Clarke for the book Psychophysiologic Disorders: Trauma Informed, Interprofessional Diagnosis and Treatment, published in November. It was fascinating to research, and we both wished we had more space to delve deeper into the history! The textbook is available to purchase here.

Can you learn to look on the bright side?

Is it still February? It may feel as though this month will go on forever, and indeed it’s often touted as one of the hardest of the year. The glow of the festive season is a distant memory, but spring still isn’t here – in fact quite the opposite in the past few days with sleet, freezing temperatures and storm Ciara causing havoc.

For this reason this blog seemed like a good opportunity to talk about optimism. It’s something we often take for granted, content to label ourselves as either a glass half-full person or a glass half-empty person, but in fact it’s possible to learn to be more optimistic, with small, incremental changes.

Optimism is proven to be good for you. Studies show that an optimistic outlook can improve health and life expectancy, increase performance and reduce stress, which has a knock-on positive effect on health.

One of the most famous authorities on the psychology of optimism is the American psychologist Martin Seligman, who is well-known for his theory of learned helplessness. His book, Learned Optimism: How to Change Your Mind and Your Life, argues that it is possible to make yourself happier and more productive through learning optimistic behaviours.

He summarises: “The defining characteristic of pessimists is that they tend to believe bad events will last a long time, will undermine everything they do, are their own fault. The optimists, who are confronted with the same hard knocks of this world, think about misfortune in the opposite way. They tend to believe defeat is just a temporary setback, that its causes are confined to this one case. The optimists believe defeat is not their fault: Circumstances, bad luck, or other people brought it about. Such people are unfazed by defeat. Confronted by a bad situation, they perceive it as a challenge and try harder.”

Dr Seligman argues that it is possible to escape pessimism and learn to be an optimist, by learning a new set of cognitive skills. With time you can change your thought patterns to consciously label bad events as temporary, confined to just one case, and not your fault.  This is an approach incorporated into Cognitive Behavioural Therapy (CBT), which some people find hugely helpful in dealing with mental health problems such as anxiety, PTSD and depression.

If you think you might like to know more about CBT you can visit your general practitioner for advice. But if you are just interested in improving your health, happiness and outlook on life, then it’s worth thinking about Dr Seligman’s research next time a minor negative event occurs. Spilled tea on your jumper? You’re not clumsy, you were just in a rush. Did badly on a presentation at work? You’re not bad at your job, it was a difficult task. These techniques can enable a sense of long-term hopefulness. It’s worth noting that they won’t work for serious catastrophes, and that the idea is not to become arrogant and simply blame other people for your own mistakes, but in the right context, Dr Seligman can help you to feel that your glass is a little more full.

A lost art

Last week a letter arrived addressed to me. It was from a dear friend whom I haven’t seen for many years, but still feel incredibly close to. We keep in infrequent but regular contact, almost exclusively through letters, sometimes accompanied by the odd photograph to show how much has changed in the appearance of our children - and how little in our own!

Letter-writing is increasingly hailed as a ‘lost art’ – it seems that nobody has time for it any more now that services like WhatsApp and Facebook messenger have made contact with friends living abroad free. While writing letters certainly isn’t appropriate for every relationship, and is no substitute for a phone call, I find it a real joy.

I’ve written before about the benefits of expressive writing, and while the letter-writing I mean in this case is very different as it’s aimed at someone other than yourself, the act of writing your thoughts down can still be very helpful in processing them.

I also think letter-writing creates a unique connection with another person – the feeling of holding something in your hand which another person has also held is very powerful. A Facebook message can’t come close to that.

That isn’t to say that Facebook messaging or WhatsApp or whatever other more modern method you might use doesn’t have its own value. Being able to instantly connect with someone is very important too. But there are some relationships for which letter-writing is perfect. I find that it works best with friends I don’t see very often, and who perhaps live abroad, making it harder to call them or send messages in the same time zone. Writing letters encourages us to keep in touch, as because of the time lag of a few weeks per letter it’s easy to keep the correspondence going, rather than a chat message simply tailing off.

American Hannah Brencher was at a low point in New York when she discovered that writing a love letter to a stranger made her feel better. She later founded a global organisation which does just that - More Love Letters is a network of people who write love letters to those who request them, in the hope of spreading happiness. Since its foundation in 2011 the group have written 250,000 love letters to people in more than 73 countries.

Hannah has since written a book, If you Find This Letter: My Journey to Find Purpose Through Hundreds of Letters to Strangers. In it she writes about the unique vulnerability of writing letters: “You can tell a completely different story to someone when you’ve got all the vulnerable space of a page to back you up. You can say things you might not have the courage to say elsewhere. You can let honestly loose on the page and then fold it up and drop it in the mailbox. Away, away the release of your troubles could fly.”

When was the last time you wrote a letter? When was the last time something came through your letterbox that wasn’t a bill or bank statement? It may be slower than an online message, but letter-writing can offer a unique connection with another person, as well as a soothing writing experience and the irresistible excitement of getting post through the door.

Changing direction

As some of you will know, I started my working life as an actor and dancer. There is something surreal about seeing your face on the side of a bus, advertising a particular production. The theatre wasn’t for me long term, and after my ‘dabble’ in performance arts I trained as a teacher and quickly moved into teacher training and lecturing at university level, which then led me to teaching Pilates.

Now I find myself running the Resolving Chronic Pain c­linic and while my background as a movement specialist and my skills as a teacher are both fundamental to my current work, I could never have imagined myself doing this back when I was desperately trying to learn the words and musical rhythm for the lead role advertised on the side of those buses.

One of the most positive ways in which life has changed in this country in recent years is that people are no longer expected to find one career and stick to it for the rest of their lives, even if it doesn’t suit them. We are ­given the freedom to choose, and while that may have negative effects, as discussed in a previous blog, it also presents us with a world of opportunity if we don’t like where we are just now.

In fact, one of the greatest challenges now faced by those unhappy with their careers is that of finding the courage to start again. It’s easy to feel ‘too old’ to take a new direction. This is ridiculous, because age is relative – I know 20-year-olds who feel ‘too old’ to get on the path they want, which I think we can all agree is a little preposterous, and which proves that age is all about mindset anyway.

Gladys Burrill, to use a famous example of someone who picked up something new very late in life, ran her first marathon in 2004 at 86 years old. She became famous after finishing the Honolulu Marathon at 92 – she walked/jogged it, but she still got all the way round, and in nine hours 53 minutes which is no mean feat.

Helen Glover was a lot younger when she changed direction – just 23. But in further proof that age is relative, that is widely considered late to take up a professional sport. Helen did, and just four years later at the age of 27, she won Gold in the coxless pair at the 2012 Olympics.

John Crace, the British journalist, turned his life around in a different way at 30. He found himself addicted to heroin, having ‘annihilated my entire twenties’, he wrote in GQ magazine. But Crace pulled himself out of a hole, went to rehab, started writing, and now has a family and a career. He writes about it still being a daily struggle, but his life is immeasurably different to how it was 30 years ago.

Brendon Gleeson was in his mid-thirties when he gave up his job teaching Irish and English at the now-closed Belcamp College in Dublin, although he had trained as an actor before taking the teaching job.

Alan Rickman studied graphic design for five years after leaving school, and even went so far as to open a graphic design studio. After three years of successful business he decided to change direction and pursue an acting career.

Anna Mary Robertson Moses, better known as Grandma Moses, was an American folk artist. She worked on farms churning butter and making crisps until she and her husband bought their own farm, which Anna ran for decades. At the age of 76 she developed arthritis, and turned to painting as a hobby she could easily do despite her condition. She took up painting at 78, and became a world-famous artist before her death aged 101 in 1961.

It’s interesting to look back at the winding direction life can take you on, and it’s exciting to think of what might be to come. I hope some of these stories have inspired you to appreciate the twists and turns of your life or to consider new possibilities.