RESILIENCE PART 2. Shirley Remington April 2015

Transcription

1 RESILIENCE PART 2 Shirley Remington April 2015

2 Aims for today Review basics Understand scientific background Some tools for developing personal resilience Key take homes and quick wins

3 Sir William Osler ( ) In no relationship is the Physician more often derelict than in his duty to himself Keep Calm Stay Safe

4 Doctors bad habits? Medical school Alcohol consumption Socialization and exercise decrease. Stress increases, depression and isolation increases. Environment has low tolerance for fallibility Maladaptive behaviors form easily. Going in when sick, self-prescribing Guilt and perfectionism, thinking errors, emotional burden Poor Habits: gambling, junk food, drinking, poor sleep hygiene Keep Calm Stay Safe

5 4 decades in NHS- Henry Marsh Decline in authority of doctors and rise of management Reduction working hours/job planning Closure small hospitals Real technological progress-redundancy of skills Targets reduced waiting lists with fewer resources Marketization

6 Definition The Latin derivative, resiliens the pliant or elastic quality of a substance. a capacity to absorb negative conditions, integrate them in meaningful ways, and move forward.

7 Transition cycle- Williams 1999

8 It is not the stress it is the state of mind, that matters when one is stressed HANS SELYE ( ) Keep Calm Stay Safe

9 Reasons Why -----

10 More reas0ns Keep Calm Stay Safe

11 NEUROSCIENCE ADVANCES -why resilience training works Functional MRI Brain Plasticity Brain Training Changes to stress management Evolutionary Maladaptation Understanding of human behaviour- Chimp paradox

12 Evidence Military programmes Treatment of Mental health problems-positive psychology approaches Education Uk GP

13 Common themes in developing resilience Understanding of self and self mastery Interactions with others and wider world Meaning beyond self- values-goals-focus Positive approach-perspective Personal growth Care of health Learning from overcoming challenges

14 PERMA-Seligman Positive emotion - tunable by writing down, every day at bed time, three things that went well, and why Engagement -tunable by preferentially using one's highest strengths to perform the tasks which one would perform anyway Relationships tunable:listen-respond positive /negative passive/active Meaning -belonging to and serving something bigger than one's self Achievement -determination is known to count for more than IQ

15 Resilience Prescription Carney 2007 Find resilient role model Recognise and develop signature strengths Reframing thoughts Personal sense of purpose Physical well being Social support Quick wins

16 Importance of strengths Recognition of these Understanding self Understanding role and skills required Develop strengths Achieve sense mastery

17

18 Signature Strengths What are your signature strengths? Think about them in terms of 1 problem solving 2 interacting with others 3 staying motivated

19 Exercise Discuss a challenge you currently have? How will your strengths help? How can you further develop these? What areas are a development need and how can you change these? Can you think of your use of strengths in the past?

20 E+R=O Events(antecedents) + Thoughts(beliefs) = Feelings and actions(consequences)

21 Thinking errors All or nothing thinking Over generalising Mental filter-everything is negative Jumping to conclusions Mindreading Magnification Emotional Reasoning Should must ought to statements Labelling and mislabelling

22 Thought Record Situation Feeling Thinking Challenge/alternative -(Evidence/Thinking errors) ACTIONS Use thought record to interview each other about a recent issue you have dealt with

23 Carneys moral compass What do I believe in so much I will take a stand on What are my skills and energies and leadership traits What does my perfect world look like How do I want to contribute to it What brings me joy What will make me feel free and healthy What do I want to learn What is my unique calling purpose 5 years on what will I be proudest of What is my bucket list

24 Time Don t say you don t have enough time. You have exactly the same number of hours per day that were given to Helen Keller, Pasteur, Michelangelo, Mother Teresa, Leonardo da Vinci, Thomas Jefferson, and Albert Einstein H. Jackson Brown Jr.

25 No time prescription for health Physical: the 7 minute exercise regimen- ( 7-minute-workout.html) Cognitive : 5 min mindfulness technique Happiness: 3 things you are proud of achieving today Random act of kindness Do something unusual: clean teeth with other hand Learn a new skill Purpose

26 4 deep breath technique 4x4x4x4x4 Breath in through your nose filling up your belly for 4 seconds Hold for 4 seconds Exhale through your mouth for 4 seconds Hold for 4 seconds Repeat x 4

27 Well-being exercise Write down 3 things that went well in last day Why were they positive? Discuss with partner After Seligman

28 Encouraging optimism-really Profession still respected NHS key public issue for election Still caring patients and trainees High standards Most problems are remediable More emphasis on caring for doctors well being- Trusts,GMC,HEE

29 Finally- random acts of kindness Thanks and Questions