Sarah Lawson
Cognitive Behavioural Therapy in Edinburgh

Topical tips

New Year Resolutions

This is the time of year when many people feel inspired to make changes to their lives, but for some of us these New Year resolutions may already have been broken.

If you want to make changes then it is likely to be more helpful to think about long term goals - perhaps over the whole of the coming year. This is how we work in a CBT approach, looking at specific, realistic goals over a given time-scale. If you set yourself unrealistic goals (or resolutions) then you are more likely to fail and generate unhelpful thoughts. An example of a thought might be – ‘I am useless, so weak-willed, I can’t even give up... (supply the substance – alcohol, chocolates, cigarettes)... for 2 weeks.’ If your initial goal was to give up for 2 weeks, and you achieved that, then you have succeeded!

Denying ourselves things we enjoy can be difficult - for instance, dieting in a cold dreary part of the year when we are less likely to be active and feel like eating comfort food. Focussing on positive changes and adding realistic time-scales may work better. This might include:

• Setting yourself a realistic goal of weight loss by your summer holiday
• Breaking this down into small targets for each month
• Introducing more fruit and vegetables into your diet
• Researching some low fat recipes and practising them
• Building in more frequent exercise in gradual stages, rather than joining a gym and feeling guilty at the cost when you only manage to go once or twice a month

Previous topical tips

Autumn

For many of us this is a beautiful time of the year, with hopefully some crisp sunny days and changing leaf colours and the promise of winter pleasures. For others, who are susceptible to the shortening of the days, it can herald a period of gloom, reinforced when the clocks go back in October and we can anticipate leaving for, and returning from, work in the dark. This is particularly noticeable in Northern Europe - the further we are from the Equator, the less constant the light levels.

Some people, possibly 1 in 50, are susceptible to SAD (Seasonal Affective Disorder) and it is also likely to affect women more than men. It leads to general symptoms of depression such as persistent low mood, tiredness and poor concentration; and some more particular symptoms such as sleepiness and craving for sweet foods. As this is associated with the drop in light levels, the most effective treatments is light therapy using a special light box which simulates natural daylight.

Luckily for the majority of us any symptoms are more likely to be mild – a case of Winter Blues. Many of us will recognise the craving for more warm comforting food – baked potatoes, hot chocolate drinks – with unfortunately an increase in calories. It is just the natural primitive response of our bodies to prepare for a period when food was less plentiful, as historically was the case in winter. Now of course, we have the opposite problem of food being ever too available!

So what to do? Well, avoid too many carbohydrate heavy meals and snacks as they can make you sleepier. Take the opportunity of getting outside on any bright days when you can, lunchtimes and days off. And if you have the chance to take a break somewhere warm and sunny then do grab it!

Keep Cool This Summer

Summer is here, the schools are closed, the rush hour seems less rushed and maybe you could take time out to just sit and be. I am referring to the ability to be mindful, to be in the here and now, and just experience your thoughts and feelings and the sensations in your body without judging or pushing them away. Mindfulness has its history in Buddhism and for me this brings up a mental picture of a calm practitioner sitting cross legged on a low stool, having achieved a state of calm acceptance after many years of study and possibly sacrifices.

More recently mindfulness has moved into secular life and been recognised as promoting mental health. Presented as a structured 8 week course, its use for recurrent depression has been recommended by NICE. It also has applications for promoting physical wellbeing, such as for managing pain. There are a number of significant people who have worked on researching and developing mindfulness based cognitive therapy (MBCT), including Jon Kabat-Zinn and Mark Williams. See oxfordmindfulness and recommended books at end of article.

Mindfulness based stress reduction (MBSR)recognises how important it can be to relieve the daily pressures and anxieties that can build up as we all become increasingly wired up, constantly available to friends/family and work via mobile technology, living in a ‘24/7’ society. A useful introduction to this theme is by Jon Kabat-Zinn introducing mindfulness to Google employees - watch it on YouTube here.

As a therapist I have studied mindfulness and introduce it to clients when I think it will be helpful. You can find out more about mindfulness generally and courses locally here.

Books: the CDs included with these titles can be a great help with your mindfulness practice.

• The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness (includes Guided Meditation Practices CD). Williams, Mark; Teasdale, John; Segal, Zindel; Kabat-Zinn, Jon (Authors)
• Mindfulness: A Practical Guide to Finding Peace in a Frantic World (Includes Free CD with Guided Meditations). Williams, Mark; Penman , Danny (Authors)
• Jon Kabat-Zinn has a range of titles available on meditation.

Spring

Spring has definitely arrived. The weather has been lovely some days, with enough warmth to go without a coat (briefly!); the clocks have gone forward giving us lighter evenings and trees and plants seem to grow before our eyes. Maybe you are not feeling great but there are benefits to be had in pushing yourself to get out in the fresh air and sunshine.

You may have heard of SAD, Seasonal Affective Disorder, which can affect people in the dark winter months, particularly in the more northerly countries. Lack of natural light can trigger depression or low mood, sleepiness, low energy and cravings for sweet foods. Even for those without a clinical diagnosis, this trend can be felt by many of us in the dark winter months when we rarely see daylight on work days. We then lack the stimulus to produce serotonin which naturally lifts our mood.

So, now we have a chance to get some more natural light, try and grab a bit more. See if you can add a bit more open air activity into your day, perhaps a walk at lunchtime or when you get home from work; or when away from work, leave the chores undone for a while and make time for yourself. Hopefully you will notice a lift in mood and an increase in energy over the next few weeks.