And good evening, everybody, and there's people still coming in, I guess. Yeah, there's people coming in and it's so lovely to be here again doing this course. And Tonight we are really focusing on how we respond safely for ourselves and the people that we're trying to help and how we do it in a really helpful way that doesn't put people's backs up, that doesn't make people feel more stigmatised, and so it's some of the communication skills, some of the stuff we need to look out for in our colleagues and ourselves.

And I wonder if you remember when we started this course, I said we would try and make the course as responsive as possible, and I came across some very, very new data about mental health first aid that's only just been released, and it was saying that something that people haven't taken into account is that if, if one of us takes on the responsibility, as I've been I'm suggesting you might You know, you might want to, experiment with doing that, you know, as long as you've got the sort of support. Of the practise right wrapped around you and you get the time and the resource to do it. And what this, this newer evidence was finding that even if we feel supported, Looking after our colleagues or taking on that responsibility sometimes can have something of a impact, a negative impact on our own sort of sense of self.

And so I've added in a couple of slides around that, but I also thought, well, you know, we're missing a trick here because the webinar that. And this isn't me because we haven't got a course sort of lined up or anything, but the webinar vet and myself have really pushed the importance of mindfulness based stress reduction as a strategy for the for the veterinary profession, and I think I was counting before me and Dawn came on this evening, and there have been over 1200, about 1300. Vets have actually across the UK, Sweden, and other places have actually done the whole of the eight-week mindfulness course, which tells me that there's a lot of mindful People in the veterinary profession out there that have worked and done the course to sort of prepare themselves.

And I suppose it got me thinking and I wondered whether, If those of you who are on that course tonight sort of perceive yourself as being sort of enlightened, and I think you probably are, and perceive yourself as being the possible mental health champion of your workplace, maybe something else we ought to be really pushing is for your practise to get in touch with the webinar that. Because I know that the mindfulness based stress reduction courses are available, are available as recordings, and maybe, you know, one of the best things we could do for the mental health of the veterinary profession would be to sit down and work our way through the eight week MBSR course to really learn how to manage stress better and in a more mindful way. And with that in mind, I was thinking about how we look after ourselves, so I've actually included a short meditation today, so I'm hoping you won't mind, but I'd like to for us all to engage in a meditation towards the end of tonight's session just because, and I've included the link so that and hopefully what Dawn will do is just cut and paste the link when we get to it and send it all out to you and you know, like she always does so brilliantly.

And I forgot to say to Dawn actually earlier, I might be calling upon her earlier to unmute herself just so that I can, show you guys a particular technique for, for sort of letting go of stuff when we've, Become very involved. So, at some point, Dawn, I might say, oh, Dawn, would you mind just unmuting yourself just for a few, a minute or two so I can do a little experiment with you. It's a nice one, Dawn, so don't worry.

So that's the plan for tonight. Gosh, it's lovely to have so many of you on board. I wonder how people are doing.

So what we've covered so far is week one we really focused on the importance of an emotional health check for my belief is it ought to be an emotional health check for every. Everybody working, making available emotional health check for everybody working in your practises, and you now have all the materials, you have the training, you know how to do it. So my hope is that we will start to sort of roll out that emotional health check and for those people that feel it would be of benefit for them, in brackets should really be everybody because it's well-being.

And then we looked that week at the importance of coming up with just 3 very small changes. And if anybody's got any views, any thoughts about how they're doing at the moment, now is a really good chance to come in and let me know how you're doing because that gets us all chatting a bit. So there's the Q&A and there's the chat function.

And then last week we just started to look at how do we recognise depression, how do we recognise anxiety, and if we think a colleague of ours is struggling in that that way, how do we feel secure enough to ask a question about the risk of suicide because it's so, so important. And having had a week to reflect on where we are, on what you're learning, on what you're experiencing, I just wonder where we all are with what you want to do with the information that you're gleaning from the course, from some of the strategies. So before we crack on, just if anybody feels able to, it just makes this such a more interactive and fun experience when we start hearing from you guys.

So any thoughts about where you are or are you waiting until the course finishes and then perhaps have a look at the book, have a look and think about how you want to use this, or are people using the material we're doing and we're sharing for your own sort of interest and mental health? So you've started to, people have just started to come in. So let's just See, like I said earlier, Mike, I'm feeling so much better than this time last week, and the last, oh, that's from Dawn.

Oh thanks, Dawn, and that really helped. Last session helped in particular. Oh, that's lovely.

So, yeah, I'm glad because, you know, as, as we saw last week, we can go between those four boxes, you know, where at one minute we're in a place of well-being and in a very small space of time we can find ourselves in a place of struggle. Thank you, Dawn. Anybody else, any thoughts about, what we've been covering, what we've been sharing, any thoughts at all?

I'll move on, but, it would be lovely, lovely to, to hear from you all. That was two lovelies. So let's, let's have a look.

Do you know, about that emotional health check, I was in a school today with, quite a lot of, year 13, I think that's like our old sixth form. And quite a lot of year 13 young people, and I was sharing the emotional health check with them that we've adapted slightly for young people, and they so got it, you know, and that sense of just making those three tiny changes that can have such an amazing impact on our overall well-being and even if that tiny change is just, you know, one of them was talking today. And was saying that actually to limit the time he spends on his Snapchat and I and I said, goodness, would that make a big difference?

Oh, he said it'd make a huge difference, he said, because I look at so much negative nasty stuff, and he said, and I think if I stopped doing that, I would feel so much happier. So you know, just these tiny changes can make such a difference. So I thought that was interesting today.

And with that in mind, I just wanted to think about the stance that we take towards our colleagues and just to, Really have a think about this word empathy, because I really believe it's our number one strategy. Do you remember when we did our very first session, I showed you the, Kindness continuum, which was from the intelligent Healthcare book, and the kindness continuum, just saying that if we can be a warm, kind, empathic workforce to each other. Then it just makes such a difference to the well-being of the practise that we work in.

So when we think about empathy, my favourite way of thinking about empathy is the ability to sort of stop. And Try and Create enough calm. And to use our experience and to open ourselves up.

And to try and get a sense of what that person that we're with is experiencing. And to try and show understanding. And warmth And I think it's that understanding and warmth that makes the massive difference.

And I was reminded of a very old but very famous study by a guy called Goldberg in the 1980s, and I think there, there's some funny bits in this, so excuse me. So what he did was he was in Glasgow and he was researching postnatal depression. And what Goldberg found was that when he spoke to a load of women, it was a qualitative study, and he said, you know, tell me about how your husbands respond to your, you know, when you've given birth and you're feeling a bit down, and they said, oh, the main and the sort of findings showed that the main way that the men in their lives, this was the 1980s, so maybe it's all changed.

But the main way the men in their lives responded when they were feeling down was to do more washing up and more hoovering. And the women said that isn't what we want. We actually want someone to sit down with us and talk to us and listen to us and to try and understand why we feel the way we did.

But instead of that, the men hoovered more and washed up more, probably very well intentioned, but it didn't seem to make a whole bean of difference to their wives' mental health. And so what Goldberg did was he trained a load of health visitors. To only offer active listening visits and to show empathy.

And his results showed that just sitting with somebody with no strategies, particularly, no tools, but just to sit with somebody who's in a place of distress. And to listen and to respond and to nod and to smile and to just be there with them made an enormous difference equivalent to that of a dose, an effective dose of antidepressants, just sitting listening warmly and empathically. And I think that we forget that groundbreaking research.

It's just so, so important. So I guess if we see one of our colleagues struggling, maybe I think what I'm saying is the first thing. We probably need to do is to create some time.

Find a suitable space where we won't be disturbed. Make space for our own minds, open up our hearts, and just be there for them, you know. Just sit there with them, allow them to talk, listen.

Respond empathically and curiously, you know, there's curious, we miss curiosity, and if somebody says something that we don't understand, not to pretend we get it all, but to say, you know, tell me a bit more about that because I'm not quite understanding that. And do you know what, when you say that someone feels so listened to. And, and, and it's like, well, I'm not willing to move on until I properly do understand the place you're in because we can't give empathy unless we understand where that person is, is coming from.

So, One of the things that we really need to do, look at that first, the bold one, is we need to focus on conveying empathy but not on changing the person or their perspective. And I think the biggest mistake we make sometimes is we weighed in with our size 12 boots trying to tell the person that, you know, you need to change the way you're responding or you need to see this from a different perspective. And very often the person in distress or crisis.

Isn't a place of readiness. To even see it from another perspective or to hear that maybe they've got it wrong. What works so much better is to be really clear that our role initially is to focus on conveying empathy rather than diving in and saying, oh no, no, no.

Do you know, I heard this the other day actually, . And it was, it was tragically from a student nurse, a mental health nurse. So I'm a trustee of a local mental health charity called the Lowdown, just fabulous.

We just won the Prince's Award, the Queen's Award for charities, and I was doing some training, and so one of the student nurses was sitting in on a case with me. And she butted across and said, No, no, what you, what you're doing, she said, it's all wrong. You need to see the glass half full, not half empty.

And I looked at this client who was going through a really difficult time and I just thought that was probably the most unhelpful thing anyone's ever said to them. What we would have, and we were at that stage where all we needed to do was to sit. And take their time.

I'll just check, Sue. Dawn, Sue is just saying that she's got a bit of a problem with audio, and she's asking, is it, is it her audio, or are we having any problems? I can hear you fine, and I'm, I'm hoping that everyone else can as well.

Would you mind just typing to Sue? Yeah, of course. Oh, thanks a million, cause, I think it probably is Sue's audio, not ours.

Thanks a million, isn't she wonderful? So once we've I think conveying empathy needs to be our initial strategy, and with mental health first responder, remember it's not our place to change the person or to shine a light that their perspective might not be that brilliant. You know what we're doing is we're there for them.

To provide the support, listening, and then to help them find, should they need it, the appropriate help for what they're currently presenting with. The second thing we can do is it's about this is about mirror imaging. And there's some wonderful research into this thing that we call relatons, and you will have come across this with as people working in beds.

Jane said mine had a couple of skips in the audio, but it's all right now. Oh, I am pleased. So you know when you're with somebody who comes to the veterinary practise with their pet and they're terribly, terribly anxious.

And they're gabbling and talking very fast. One of the best ways that we can actually Bring down their distress. Is by talking slowly.

And not too slowly, obviously, but in a very paced, slow, deliberate, warm, empathic way. And the idea of the relatons, which there's a lot of research for now, is that if, if two people stand very close to each other and one person's heart rate is bumping away and the other person is very calm. After a short while, the person with the heart that's bumping and bumping and bumping, their heart will sort of sink with the calmer person's heart if we just sit and stay with the calm.

So one of the things we can do is be very, very mindful. That we don't look like we're in a hurry. Because otherwise people sense that and they say, oh God, no, you know, you're too busy to hear this.

Last thing we want is we slow down. And we slow down because we don't want them feeling that we're hurrying. But we also slow down because it just allows them to slow down themselves.

And it just works time after time after time. So The last one on this slide, but I think it's really, really important, is there's an acronym that we use sometimes called SOLA. So it's SIT.

With an open stance, just lean forward slightly. Attend to what they're saying. And respond Quietly and empathically and relaxedly.

So Solar, but it's, to be honest, you know, it's just about that. We want to be giving off a body language, we want to be letting that person see there's no hurry hurry up in us. And so we just sit, leaning forward slightly.

Open stance. And never looking at our watches, you know, and there is something about that. If we're going to offer mental health 1st 1st response to someone, you know, we don't want to do it in a 10 minute window.

We do need to speak to somebody on reception and say, you know, one of our colleagues is struggling. I'm going to need 25 minutes here. You know, And, and, and, and I suppose that might cause some difficulty with it.

Oh, I'd be interested in that. Here we go, a bit like a poll. Help me out, guys.

If you went to some, to somebody in your practise and said, you know what, one of my colleagues just needs a little bit of time. Would you mind just diverting the traffic of work somewhere else because I need 25 minutes just to help my colleague. Would that be, would that be OK?

Because, you know, I've told you before, I do a lot of work with GPs. I can imagine that being hugely frowned upon by the receptionists in a GP practise because of that sense of You know, trying to get as many people through the door as possible because of the sense of hurry up that general practise always exists in. So my question to you guys is, If you were working and one of your colleagues was distressed and you approached them and said, Would you like to talk?

And they said, God, yeah, I really would, and you approached somebody in the practise and said, I am going to need 25 minutes. Can we just find that for me? Would that be something you could do?

Have a think about that. I really like to hear from you on that one. Dawn, the same for you, I suppose, in the webinar that if one of your colleagues was really struggling, because when I came to your office, it's an enormously busy place.

Would, would that be OK, for you? So, I got some really nice ones in. We've done this in the past for a client, so I'm confident the same compassion would be granted for our staff.

Oh, what a great answer. What a great answer. Anybody else, you know, being able to just stop and say, I'm going to need, not necessarily right this minute, I'm just going to need some time because one of our colleagues just needs a chat.

Thank you so much for that, Roxanna, because again, you know, I think we would probably, GPs would say, oh, yeah, yeah, that's what we do, but I can guarantee, . Yeah, we will give the time, and reception may not be told because we would go direct to the person in need. The times we go to then are impulsive.

A vet did it for me when I had a crisis moment and they stayed with me for 20 minutes and the client understood when they went down. Oh my goodness me, that's fantastic. And, and that's what we need, you know, maybe you don't need, maybe we, maybe I've got this wrong, maybe you're, you, you know, maybe what you'll find is that people would be understanding, and I think in truth, people usually are.

You know, it's weird in GP surgeries, it's usually the receptionist in the GP practise that's huffing and puffing because they're getting stick from all the people who are saying, Well, my appointment was 20 minutes ago. Dawn is saying, yeah, we would do that in the webinar that, and Gabrielle, Gabrielle has come back and said she's really grateful to work in a small practise that's not only, and that this is not only supported but encouraged. Whoa, and that's what we need, isn't it?

We need our workplaces to be warm and empathic in themselves, you know, and to get the importance of this stuff. Because look at that bottom phrase. If somebody in the practise is struggling, their distress increases.

If they Find themselves feeling isolated as we found with the Goldberg study, just by showing empathy and warmth, we can help the person in front of us to find calm and probably to feel a little bit held, you know, and I know this is a bit of an old sort of thing, but a problem shared. Is a problem halved. I'm not sure that that's entirely true, but a problem shared certainly makes our experience of the problem we're going through feel a little bit less torrid.

So thank you very much, everybody. That was, that was lovely. It's great to hear from you all.

So Oh my goodness me, I hadn't realised this was quite such a blurry slide. Do you know what I think, I think I must have my glasses on when I stuck this on. So let's have a think about triggers.

We don't really need the, the picture there because there's, there's a whole range. I think, I think it is really useful as mental health first responders to have a think about what are the common triggers within the veterinary profession that, Can lead to somebody being in a really dark place. And that first one on the top left is bereavement.

And I think that probably isn't with you guys solely about when we lose someone. Close to us. Relative, friend, colleague, etc.

I think sometimes. I did some work with 1 to 1 work with a male vet actually, online, as I sometimes do using FaceTime because they lived in a part of the country that wasn't accessible for me, and I remember him saying that there are times when you've got to know an animal. This was a dog actually, and you've got to, you've seen that dog from pup right the way through, and then it becomes our responsibility to, Help that animal to a peaceful end.

And sometimes there's the assumption, I imagine that vets get used to that and veterinary nurses get used to that, but I wonder if you actually do or whether Bereavement is bereavement linked to perhaps some of the animals you care for is also an issue, and I don't honestly think there's much research into this, but it'd be an interesting area to look into because, I don't know if you know, but the love of my life is Billy the Mindful dog, and, he's 7, but you know, the thought of Billy not being around is just Well, it's, it's pretty devastating and, you know, but he's my dog, isn't he? So, bereavement. Whether it's let me see if anyone's helping me out with that one.

Not yet. And so bereavement is absolutely a trigger for anxiety, for low mood, and really commonly what we call an adjustment reaction where the person is trying to adjust to carry on living despite no longer having that person with us, and an adjustment reaction looks like a case of mixed anxiety and depression. And it sort of remits itself normally within a few months, but that doesn't mean that somebody isn't going to need bucketfuls of empathy and warmth and understanding.

And our role there is if we know, I think that a There's somebody in our practise who's experienced a bereavement. It's to just be very aware that a person is someone who may need support. The second one there is relationship breakdown.

Oh, my goodness, babe. Now I've had sort of bouts of new referrals coming in where you've had about 12 or 13 people who are struggling, you know, 6 months after a relationship breakdown, and again it's something of an adjustment reaction, you know, and so relationship breakdown is another one that we need to keep a real eye on, you know, a real eye on. The other one, and I'm going to add one in here, is having children.

So if we have colleagues who become new parents for the 1st, 2nd, 3rd time, we really shouldn't underestimate what an impact that can have on that individual's mental health, both, you know, for men and for women. You know, and the other one I think is becoming much more of a, a recognised issue is when our children leave home, you know, we joke and say, oh, thank God, but for most of us. We are left feeling somewhat bereft, you know, so.

There's another really common trigger, that one on the right, very blurry, but what it's talking about is health scares or physical illness. Again, if we have a health scare ourselves or if a partner, someone close to us, has a health scare, that can count as a real significant trigger for a member of our practise to find themselves in a place of, of real struggle. And if we think about from a more workplace perspective here, starting a new role or moving to a new job or coming to a new practise can also be a trigger because, you know, when we go into a new practise, you know, we feel very comfortable in the what in what we were doing before.

We move into the new role or into a new practise and you know, conditions are different, working practise is different. We have different ways of doing things and it can be terribly unsettled. Again though, I think we're still talking about what we term an adjustment reaction, and normally what people need when we're going for an adjustment reaction is all the way back to the earlier slide is empathy, understanding, warmth, and time, you know, really sort of time.

The nurse, the veterinary press makes very, very clear that one of the biggest instigators triggers of mental health distress in the nursing profession is when the workload increases. Out of proportion with our capacity to manage it, and we call this allostasis. So we find ourselves In such a place of hurry up that we aren't able to self soothe and look after ourselves, and I think in the veterinary profession, just going by the amount of vets that I've seen over the last few years, that I think that workload issue is a crucial trigger that we do need to keep a real sort of handle on.

And some professions, you know, caring professions now are beginning to look at caseload waiting. So it's not how many people we see, but it's the sort of stuff that we see and bearing in mind, you know, the levels of sadness that we are and the levels of difficulty that we are faced with, so we're beginning to have a more intelligent way of looking at workload stress. But again, in any workplace that deals with, you know, where, where the people that work there are dealing with emotional issues, .

Relationships within the workplace. Probably I'm going to guess is the number one reason for us moving into a place of struggle, you know, and very often that's because we're not mindful in our communications. We don't communicate mindfully.

People get the wrong end of the stick, or we become so disassociated from the need for warmth and kindness that we miss opportunities to offer that kindness and warmth to our colleagues. And the final trigger I wanted to really focus on, today was redundancy or fear of redundancy and this sort of trigger just creates a sense of uncertainty and what we know or enforced change of role even, what we know is all anxiety is predicated upon a loss of control. And feelings of uncertainty.

So I guess this slide is suggesting that as mental health first responders, we shouldn't be waiting for people to always come to us. We probably need to be Mindful of the triggers. That potentially push people into a place of distress.

And as warm empathic human beings, we just need to turn our attention to people when they're going through what might be a potential trigger and be brave enough and warm enough to say, how are you? Is everything OK? Because I did hear that, you know, this had happened or that had happened or that we're in a difficult place at the moment, aren't we?

Do you know if you ever need a chat, just come find me. You know, and it, and it, and it's responding to that trigger with warmth makes such a difference. If anybody gets a moment, I, I, I am a curious so and so.

Does the sort of bereavement issue cross over to, the, the, the animals, you see? I'm, I'm sort of guessing it does, but I have really looked through the literature and only seen a very little about this. So I would be, you know, very interested.

So. We've looked at how important this empathic response is and an empathic. Stances we've discussed this issue of .

Being proactive and assertive by Sort of being more aware when there are triggers about, really, really important. What I want to move on to is, look at these stats here. So one of the reasons this is purely linked to the The, the veterinary profession, these, these, these, this data comes from there.

So one of the reasons that people work in the veterinary profession so they wouldn't feel comfortable discussing their mental health with their employer. I don't think I'm suggesting you would, but maybe, it's, there's still some, some crossover here. It's 35% felt that if they came and asked for a bit of help, that their employer would think negatively of them.

And this is such an old. Perception, isn't it, but tragically there are still some occasions and some professions where We know that . We, we absolutely know that an admission or coming forward and saying, I'm in a place of struggle is not always met with warmth.

Empathy and positivity. You know, And, and, and there are some professions where they very much keep it hidden. One profession that I'm very aware of where it's very much still a very hidden thing is within law.

You know, I do quite a lot of work with a couple of solicitors' practises, and they're so, you know, enlightened compared to their colleagues because a lot of lawyers, a lot of solicitors, a lot of legal secretaries working in that sort of environment really do struggle to Seek help because of that issue of affecting their careers. It would be lovely to hear from you guys again whether any of these resonate with you. You know, just get those fingers tapping it just.

Really gets us thinking. I'm really happy if you'd rather, remember I only ever use first names, if it would help not to use any names, if that's what you're worried about, I'm, I'm happy to do that. 32% of people in the veterinary profession still feel that there's, stigma attached to mental health issues.

So, do you know, if we believe that, Of course, it's gonna hinder us from finding that friend in our practise, that person who we know to be a great listener and saying, oh, you know, can I just have a chat? 32%. Said that actually they would find it really embarrassing to have to share the fact that I'm currently in a place of psychological distress.

And, and God, there's a lot of 32s on this, isn't there? And 32% also doubted whether they would get the support they actually needed from their employer. And 23% here we're back to the same issue, felt that if I step up to the plate and actually share the fact that I'm in a place of struggle, it will affect their chances of profession of progression within that profession.

So let me share, this is a little admission and a truism here. About 20 years ago, I was quite senior in a community mental health team, and I got terribly depressed. And very, very anxious and took about 4 weeks off work.

And when I went back, I got the GP to sign me to write my letter saying that I'd had a really difficult virus. Because I knew 20 years ago that had I gone back and as a mental health professional admitted to being depressed, it would have without a doubt impacted on any chance of further progression. Ain't that tragic?

In this, in the profession, in the mental health profession, that was such an issue. I think we're a lot better now, but I wonder whether this is something that you guys. Still come across, you know, do let me know, see what you think.

Yeah, no, thank you for that. Is somebody just coming back here. Yeah.

Somebody's just come back here. I, I think it's, this stuff is very, you know, let me know if you're comfortable with me saying names, but I'm not going to. I found it really hard to come to my team as I felt it would reflect on my ability to do my job.

And everyone I spoke to before left shortly after, so I gave up talking about it at work. After hitting crisis, I had to tell work. And in truth they'd be more than supportive.

Yeah. So The perception was that this is going to reflect on my ability, but the to do the job, but the reality of, of this was that your workplace were incredibly supportive. And isn't that just classic for the way we respond when we are feeling depressed or a little bit anxious or a face of crisis because our thinking becomes skewed, doesn't it?

So of course that's what happened. Oh, thank you guys. You're really coming in now.

So I think this is so interesting. So another, another one of you guys has just shared that Oh, I, I've scrolled too much. I had a very difficult period a few years ago and I was really struggling and finally got to talk to my boss, to whom I'd worked for for 14 years, who told me that he had other, oh gosh, other things to worry about.

So I carried on until I crashed out and was signed off. I handed in my notice and went for an interview where I told the interviewer that I was currently signed off and why. She was amazing and gave me the job, and with her support, I was able to carry on the difference.

And the difference Carry on. The difference with supportive workplace is incredible. Yeah.

And do you know what, it's so economically ridiculously unviable not to support colleagues because it costs a lot of money to interview, you know, we have to pay people off. It's, it makes no sense at all. The veterinary profession is so much better.

And if we can be open and warm, somebody else has come back and said, you know, I'd agree with all of that, but at the same time I do feel that there are certain colleagues I'd feel more comfortable going to than others. Absolutely, and I'm with you on that, so. I think that sometimes it's about.

With this role, it's about, you know, if we are, if we are saying that, you know, I'm really happy to be a mental health first responder, although I really don't mind if in a place of crisis you go to somebody else, you know, but I'm very happy to help my colleagues. What a difference that makes. Yeah, I think it's a huge issue still, isn't it, and something that sometimes is a perception rather than a than a fact.

Thank you very much, everybody, for that. That was very helpful. So Communicating well, we've kind of .

Touched on this a bit. When we encourage and reassure somebody, what we're really saying is that We say it with our body language, we say it with our language, of course, but what we're saying is, do you know what, of course there's time. Of course I don't mind, you know, and one of the things that really works and it's truthful, I think, in nearly all cases, you know, I feel very, very touched actually that you felt able to come and speak to me.

And I do with everybody that comes. Back for the second session of therapy. It's a, you know, it's a real, it's a real warm, lovely thing when somebody feels comfortable enough to come and talk to you.

And I think when we are communicating well, sometimes we are giving them permission and giving them the strength to say, you know, you really do need to, or, or together, we do need to go and see how our practise can really support you and help you. And I think if we offer people and say, you know, do you want to go as a little team, you know, team Mike, team Donna, let's go together and see if we can sort of get there because It's a very tough thing sometimes to go and see our boss on our own, you know. I think I've already talked about how important it is that we avoid making assumptions, but I haven't yet spoken about being really clear about what am I able to share and what am I not.

So I think just saying to people, you know, if you'd like our conversation to be completely confidential, then I'm happy to do that. Wait for it. But I, you know, I do want you to know that if you tell me anything that I think It is risky or dangerous, of course, I'm gonna have to get you some extra help and that would be in sharing because.

It's very unwise to say, you know, I promise you whatever you say to me is entirely confidential because if the person says, which is very rare, but if the person does say to you, you know, that, that, you know, something criminal or they share with you an intent to kill self or hurt others, you know, we, we can no longer keep that confidentiality. So we Our job is to say, you know, I will respect your confidentiality. Absolutely, however, just I do understand that you know, I'm bound by my code of ethics, by, you know, common sense, that if you tell me something that is illegal or I feel it's putting yourself or anyone else at risk, of course I will have to share that.

But anything else, if you want to keep it between us, I'm happy to do so. And I think that we get confidentiality wrong and we get ourselves tied up in some terrible knots if we don't share what we mean. By that confidentiality.

And I think what you're doing with me on this course today is as we build our confidence about mental health, we communicate with others so much more confidently and more usefully. So That's the importance. So This is the new slide that I've put in for tonight, and it came from this new research that says there are times, you know, when When a colleague is struggling and we have spent significant time and given headspace and effort to helping that client, when we walk away from the situation, sometimes what we need to do is we need to sort of Disentangle is my favourite word at the moment.

It's and one of the surefire ways to do it is to use the 54321. So I'm going to hope that Dawn doesn't mind unmuting herself for this one. If you do, Dawn, just say Mike, get lost.

I'd never say that to you, would I? Oh well, you know, you're very welcome to. So Dawn, this, this, this technique is when we walk away or when we, when we just can't get something out of our head, we use the 54321.

So what I was going to ask you to do, Dawn, is think of, just think about something that's really annoyed you, at work or at home. You don't have to tell us what it is, and just let me know when you think you've got that annoyed thing. Very firmly ensconced in your head.

Yeah, I've got it already. Oh, that was quick. So, OK, are you ready?

So we, and the idea that here we do this quite quickly. So just make sure that is that thing still there? Is it still right at the front of your mind?

Yeah, still there. Good. Right, now, very quickly, can you tell me 5 things that you can see in the room that you're in and name them?

Just things in my room. Just things in front of me, do you mean or anything, you know, telly, picture. OK, so I've got a sofa, radiator, candle.

Books And food. Ah, lovely. And now touch 4 things close to you and name them.

Sofa, cushion, books, food. And tell me 3 things that you can hear. Oh wow.

. Can you hear my voice? Yeah, your voice. I can hear the music next door.

OK, that's fine. Tell me two things that you can smell. Candle.

Yeah. And tangerines. And one thing that you can taste.

Tangerine. And what are you thinking of right now? Food.

Yeah, yeah, you're there. So thank you so much, Dawn. You were, you were brilliant.

So, the 54321 is just a very simple, very useful technique. And sometimes if I've dealt with, you know, a post-traumatic stress disorder or bereavement, and the person's walked out from my therapy room and I'm in sort of like, oh my God, you know, and I finished work and it's still in my head, I just stop and I do a quick 54321. And the 54321 completely disentangles me from the emotion and the stuff that was a little bit stuck.

Works every time. If it comes back. And I find myself getting a bit caught up.

What I do is I do the who am I and where am I? So because I was Mike Scanlon therapist 10 minutes ago and now I'm sort of sitting with my wife and my kids, but I'm still in a place of struggle, . Then what I will do is I'll say, OK, so my name is Mike Scanlon, and I live at 22 Trinity Avenue in Northampton.

My wife is called Alison. My dog is called Billy. 10 minutes ago I was in work and now I'm no longer in work.

Now I'm sitting at home and I have an evening in front of me and I'm ready to engage with that evening. And it just needs us sometimes to do the who am I and where am I in order to just move our whole sense of self, and it works again just about every sort of time and it might be a useful one for you guys when you get home from work and you've had a torrid day and work sort of, you know, it's almost like we walk through the door and As we wipe our feet on the front door, our day follows us and wipes its feet on the front door as well. And when we sit down, our day sits on our lap with us.

And if we're finding that happening, 54321, and then the who am I and where am I affirmations just clears us away. And I think given that research today is when you've spent time really trying to support and help a client, you might need to create a little bit of distance and free your mind. So that you don't take it with you for the rest of your day and your night, so I think I'm hoping that's quite useful.

So the last thing I would like to do, Dawn says it absolutely worked. Oh, cheers Dawn, yeah, it always does, is I'd like to do a meditation with you guys, and this is the meditation I think that my go to if You know, a bit later on, I noticed that my mood has been affected by my day. So I'm not necessarily thinking about it or carrying it anymore.

I just noticed that my mood has been affected by my day. So I wonder if you guys would mind doing a meditation with me, and if you like this meditation, then I've put the URL there and so when you get the film or perhaps Dawn can send it as a one of those little clever things she does, . When she just sort of sends it.

And then that might take us there. So this one's called the 3-stage breathing space with difficulty. And the beauty of it is, is that it takes all of about 3 minutes to, To, to, to, to, to get you there.

Yeah, Dawn has sent it now. Oh, that's brilliant. Thank you, Dawn.

So, and when you go onto that channel, there's loads of my other meditations on there if people are interested. So what I'm going to ask you to do is just to sit and if you've never meditated before, just enjoy it, just see where, just see where this takes us. I'd just like you to make sure that you're sitting and that you're looking dignified.

So, you know, if you're slouching across the sofa, pick yourself up, get your spine nice and straight, get a cushion in the small of your back, perhaps. Make sure you're sitting up. Find a gentle smile on your face.

And let's begin. The three-stage breathing space with difficulty. So we start this meditation by just thinking about the temperature.

Outside the room that we're meditating in. And outside in the cold of the night. And then bringing our attention in and finding the temperature in this room that you're in now.

And then bringing your attention right in. And finding your temperature at the core of you. Noticing the warmth of our bodies.

Just allowing that. And then we find our breath. And we attach our attention to the breath.

And we just stay with our breath as we take a gentle breath in. And we let go out. Breathing in.

And breathing out. Noticing that our breath can act as something of a Base to return to. An anchor.

And then we stop, and we say, So what's happening in my life at the moment? I'm finding it a bit difficult. It feels a bit of a struggle.

And instead of pushing it away as we normally do as humans, we roll our shoulders back and open up our chest. And we just let it in. Whatever it is that's bugging us.

Whatever it is that's A bit difficult, a bit challenging, a bit troublesome at the moment. And we let it in And we make ourselves aware of it. And we name it.

Let me describe what it is that's. Showing up in our lives and Causing distress or discomfort or difficulty. And we sit with it We make space for it.

And we allow it. And we let go. And we take our attention.

And we escort our attention again until we find our breath. And we follow the in breath in. And we breathe out.

Maybe we quietly say in our mind's eye, just breathing in. Just breathing her. Just breathing in.

And just breathing out. Attaching Our minds to our breathing. Anchoring our attention in this present moment.

Let me smile. And we take our attention. And we just check out that the stuff of the day.

Isn't manifesting itself anywhere with physical discomfort or pain or. 10. Muscles.

And if we find tension, or we find difficulty or we find stress in our bodies, We smile, And we deliberately on purpose. Gently breathe in to wherever we feel the distress directing the breath of the in breath. To wherever the difficulty is.

And then letting it go on the out breath. Cleansing our minds and our bodies. And again, where else do I feel?

Any discomfort linked to having Leaned into the difficult stuff. Let me find it. And once again, we direct the air of the in breath to wherever the discomfort is.

I smile. And we let go. And then we Open our eyes.

And we move on with our day. Having lent into the difficulty. Anchored our attention to the breath.

And breathed into wherever it sits. And the three stage breathing space is probably my favourite of the short meditations when I've had a bit of a mare of a day, a difficult day that I just need to let go of. So I hope people enjoyed that, found that useful, and it's one to share with our colleagues, I think, because it's just such a wonderful short meditation.

It's the one I encourage GPs to do when they've had a difficult consultation is to just ring through and say, hold, hold the next person, just give me 4 minutes, quick breathing space with difficulties, cleanse ourselves, let go of the stuff, and then welcome the next person that's coming through the door. So I added that in because I think you guys need looking after. And next week, we're beginning to look at when there's a crisis.

Something traumatic happens and we're looking at . . Critical, a clinical psychological debrief process that we can take to our practises and share with our colleagues so that when something happens in our practise that is hugely stressful or shocking or difficult that we feel resourced to cope with it better.

So this leads us to that wonderful part of the evening where I just say, any thoughts, any comments, anything you'd like to share, any worries, please, please let me know now. If you feel uncomfortable about that and you'd like to chat to me more privately, you just contact, send an email to the webinar there with Dawn, and they will send them on to me and I promise I will respond. So Yeah, interesting session, wasn't it, this one, Beginning to look at how we communicate, how we use our empathy and warmth, and how we look after ourselves as first responders.

So, yeah. Dawn's just put her, her contact there for everybody. So once again, thank you all so much for being so responsive again.

It just does make such a difference and I'm hoping that our course is helping you all, hoping that you find it interesting and rewarding, and our final session is next week. And so, it gives us a real opportunity to have a think about anything you may want to ask for next week, and I really look forward to seeing you all next week. And enjoying your company once more.

So I don't, oh, there's a couple of, some have just come in. Oh, there's a lovely thanks. Thank you all.

Oh, lots of thanks coming in there. That's great. And yeah, that's so sweet of you all.

Thank you so much. Have a brilliant week. Look after yourselves and your colleagues.

A friend of mine always signs off with, take care and give care. I rather like that. And so take care and give care.

Good night, everybody. Good night.