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Things You Can Do to Stay Mentally Healthy During Self-Isolation

These past few months have been wild, and not in a good way. 

On February 4th I partially dislocated my knee while playing basketball in Port Vila, Vanuatu. It hurt. A lot.

On the 8th of February, I was medically relocated back to Australia, where an MRI confirmed the extent of the damage. I had ruptured my ACL, torn my meniscus, injured my MCL and fractured my tibia. Surgery was recommended, but the waiting list to see a specialist was lengthy. I worried that I would need to terminate my volunteer role as a Mental Health Specialist at Vanuatu’s Ministry of Health early. Fortunately, a private medical specialist said that I could go on a public waitlist for surgery and medically cleared me to return to Vanuatu to finish my role. I was still in pain, but I could walk and work, and the surgery could wait. 

On March 7th I returned back to Port Vila and was super happy to see everyone again and put my psychological knowledge and skills towards reducing mental illness in Vanuatu.

Around this time, the number of Coronavirus cases began to escalate worldwide. Quickly. Before I had even re-adjusted to life in Port Vila again, the Australian Volunteer Program informed us that the program was being suspended worldwide, and all volunteers would be sent home in the next one to three weeks. 

On the 16th of March, we were told that we would need to pack up all our stuff and book a flight to return to Australia before the 31st of March. On the 19th of March at 6:30pm, we were told that we needed to leave the following day. After living in Vanuatu for 18 months, I did not even have a full day to pack and say a proper goodbye to everyone there, including dear friends, coworkers and patients. It was extremely tough, and something that I am continuing to try and process both cognitively and emotionally. 

architecture buildings clouds daylight

Now that I am back in Melbourne and self-isolating, I suddenly have a lot of free time, no job and no demands except to stay on my property and away from other people.

A lot of the things that we are all being asked to do during the pandemic is almost the exact opposite of what psychologists would normally recommend for people to do. This is especially the case for people with a diagnosable mental illness, such as depression or anxiety. 

For depression, not doing things that we have previously enjoyed and isolating ourselves from others are two of the biggest traps that we can fall into. For anxiety, the biggest trap is continued avoidance of the things that we are afraid of. 

A common psychological intervention for depression with a lot of scientific evidence supporting it is behavioural activation. This means that we push ourselves to try to do the things that we know are likely to be good for us, even if we don’t feel like doing them. For anxiety, the most empirically supported intervention is gradual exposure, or slowly challenging ourselves to face our fears, especially with situations that feel like life or death situations to us but are actually pretty safe. Once we begin doing these things again, we realise that they are actually more enjoyable and less scary than our minds were telling us, and over time it can become easier and easier to do these (and other) activities.

person holding covid sign

What about Coronavirus?

Regardless of where you are in the world, the most important thing that we can do for our physical safety of ourselves and our loved ones is to follow the directives from your government about COVID-19 and the trusted health organisations that are helping to determine these directives in your area. If you are being asked to self-isolate, don’t go outside your property. If you are being asked to work from home and you can, please do, unless you are considered an essential service and you are needed out in the community. Wash your hands with soap and warm water for 20 seconds regularly, or use hand sanitizer if you have access to them. Don’t touch your face and cough into your elbow and away from others. Practice social distancing and stay at least 1.5 metres from others. Don’t hang out in groups or touch or shake hands or hug and kiss others. Wear a mask if you are worried that you have any symptoms. Call the emergency numbers or hotlines in your region if you are concerned about your symptoms and ask medical professionals about what you should do rather than just turn up to clinics or hospitals unannounced. 

Hopefully, most of you know the relevant recommendations in your area by now and why they are important to help flatten the curve. If we can all do our part, it will help to reduce how overwhelmed our medical facilities become with severe or critical COVID-19 cases, which will reduce the overall fatality rate.

don t panic sticker on sign

How Can We Mentally Cope?

The current Coronavirus pandemic does seem to be having a huge psychological impact on people across the globe. Many people were in denial initially or trying to minimise the seriousness of the virus or the impact that they thought it would have. However, once it began to spread more, people began to feel scared, afraid, fearful, anxious, worried, nervous, panicky and overwhelmed about what is going on in the present and what may come in the future. Others report feeling sad, shocked, despondent, hopeless, helpless, or in grief about what they have already lost and what they can do about it at the moment. Or they feel annoyed, frustrated, mad, or angry about what has happened, how it has happened, and the decisions that governments and others are making to try and slow down the spread of the virus.

It is a very difficult time for everyone. 

During my first few days of self-isolation, I think I was still recovering from the panic associated with trying to pack up my life and leave Vanuatu in less than 24 hours. I was in shock maybe, or denial. For the first three days, I didn’t even unpack my bag. I just communicated with friends and family, read some books, worried, played video games, watched Netflix, ate and slept. 

By day four, which was yesterday, enough was enough. I pulled out a notebook, and decided that I would try the Ivy Lee Productivity Method. This 100-year-old method to boost productivity is quite simple, with only five steps:

wly_infographic-01

By figuring out what my top 6 priorities were and writing them down, I managed to already feel a lot better and more in control, even before I started actually doing the tasks. I also managed to fly through the tasks and feel productive again for the first time since being back in Melbourne. I resumed my daily meditation practice using the ‘Waking Up’ app. I unpacked my bags and tidied my room. I switched over my SIM card in my phone back to my Australian one. I did some much-needed paperwork online and did a weights workout while watching some TV. It was a good day. 

If you are feeling overwhelmed or unproductive at the moment, try the Ivy Lee Productivity Method. Just make sure that you only put six items on the list, and do the most important things first.

Having a schedule or consistent routine is also something that I would highly recommend during this pandemic. Work and school often provides this for us, but if you are at home 24/7, you need to create this yourself. A helpful routine might consist of: 

  • trying to sleep and wake at relatively consistent times,
  • not spending too little or too much time in bed (7-9 hours for adults, more for children),
  • eating regularly with lots of vegetables and not too much junk food or sweets,
  • staying hydrated by drinking enough water and minimising consumption of alcohol, nicotine and illicit drugs,
  • communicating via phone or the internet with at least one friend or family member daily,
  • doing some form of strength training or cardiovascular exercise for 20-30 minutes a day, even if you are confined to a single room,
  • having some daily tasks that give you a sense of achievement, engagement or mastery, and
  • getting fresh air and sunlight regularly if you can do this without breaking any restrictions in your area.

The more that you can build these things into your daily routine, the greater chance there is of maintaining or improving your mental health. Having some activities that we enjoy each day and look forward to doing can also really help.  

lego toy in clear glass container

Which Activities Can Help?

If you still aren’t exactly sure what you can do from day to day at the moment, a pleasant activities list or pleasant activity schedule can help. There are many different ones available online for free, but the one I will use for this article is the ‘Fun Activities Catalogue‘ by the Centre for Clinical Interventions in Western Australia. 

Out of the 365 activities listed, there are some that I can definitely not do while in self-quarantine, including going ice-skating, going out to dinner, socialising in person, flying a plane, scuba diving, going on a tour or to the zoo or movies, or playing sport. 

What is surprising though, is just how many items I still can do. Read the list of self-quarantine friendly activities below, and rank on a scale from 1 to 5 how much you think you would enjoy doing the task if you were to do it. If you can’t do that particular item where you are living, just skip it. For this exercise, 1 = I would hate to do this activity, 2 = I wouldn’t really like doing this activity 3 = doing the activity would be okay, 4 = it would be pretty fun to do this activity, and 5 = I would love to do this activity!

  • Spending time in my backyard
  • Watching the clouds drift by
  • Debating with someone online or over the phone
  • Painting my nails
  • Scheduling a day with nothing to do
  • Giving positive feedback about something (e.g. writing a letter or email about good service)
  • Feeding the birds
  • Spending an evening with good friends online or on the phone
  • Making jams or preserves
  • Getting dinner delivered by a restaurant and having them drop it at your doorstep
  • Buying gifts online
  • Having a political discussion online or over the phone
  • Repairing things around the house
  • Washing my car
  • Watching TV, videos
  • Sending a loved one a card in the mail
  • Baking something
  • Taking a bath
  • Having a video call with someone who lives far away
  • Organising my wardrobe
  • Playing musical instruments
  • Lighting scented candles, oils or incense
  • Spending time alone
  • Exercising
  • Putting up a framed picture or artwork
  • Looking up at the stars at night
  • Birdwatching from my backyard or window
  • Doing something spontaneously in the house
  • Going on a picnic in the backyard
  • Having a warm drink
  • Massaging hand cream into my hands
  • Fantasising about the future
  • Laughing
  • Clearing my email inbox
  • Getting out of debt/paying debts
  • Looking at old photo albums or photos on my computer or Facebook
  • Exploring Google Earth
  • Walking around my house and yard
  • Researching a topic of interest
  • Redecorating
  • Donating money to a cause I support
  • Smelling a flower
  • Opening the curtains and blinds to let light in
  • Doing jigsaw puzzles
  • Sorting through old clothes or items that you could donate to a charity eventually
  • Lying in the sun
  • Learning a magic trick
  • Talking on the phone
  • Listening to a podcast or radio show
  • Noticing what I can see in the neighbourhood from my house or yard
  • Doing arts and crafts
  • Sketching, painting
  • Mowing the lawn
  • Doing the dishes
  • Sitting outside and listening to birds sing
  • Watching TED talks online
  • Planning a holiday for the future
  • Playing cards
  • Putting moisturising cream on my face / body 
  • Re-watching a favourite movie
  • Gardening 
  • Going camping in the living room or backyard
  • Entering a competition
  • Doing crossword puzzles
  • Patting or cuddling my pet
  • Cooking a special meal
  • Putting extra effort in to my appearance
  • Doing a favour for someone online
  • Building a bird house or feeder
  • Looking at pictures of beautiful scenery
  • Talking to family members online or over the phone
  • Listening to music
  • Learning a new language using the app Duolingo
  • Taking a free online class
  • Working on my blog or seeing clients via telehealth
  • Washing my hair
  • Singing around the house
  • Creatively reusing old items
  • Stretching
  • Maintaining a musical instrument (e.g. restringing guitar)
  • Buying clothes online
  • Snuggling up with a soft blanket
  • Listening to an audiobook
  • Watching an old stand-up comedy show on Netflix or Youtube
  • Writing down a list of things I am grateful for
  • Teaching a special skill to someone else online (e.g. knitting, woodworking, painting, language)
  • Playing chess using an app
  • Playing video games
  • Jumping on a trampoline
  • Sending a text message to a friend
  • Doodling
  • Putting a vase of fresh flowers in my house
  • Participating in an online protest or campaign I support
  • Baking home-made bread
  • Walking barefoot on soft grass
  • Watching a movie marathon
  • Skipping/jumping rope
  • Wearing an outfit that makes me feel good
  • Cooking some meals to freeze for later
  • Hobbies (stamp collecting, model building, etc.)
  • Talking to an older relative over the phone and asking them questions about their life
  • Listening to classical music
  • Photography
  • Watching funny videos on YouTube
  • Doing something religious or spiritual (e.g. praying)
  • Making my bed with fresh sheets
  • Lifting weights
  • Early morning coffee and news
  • Planning a themed party for next year (e.g. costume, murder mystery)
  • Wearing comfortable clothes
  • Shining my shoes
  • Trying to act like the characters in my favourite movies or TV shows
  • De-cluttering
  • Arranging flowers
  • Working on my car or bicycle
  • Juggling or learning to juggle
  • Contacting an old school friend
  • Calligraphy
  • Sleeping
  • Playing with my pets
  • Listening to the radio
  • Doing Sudoku
  • Planting vegetables or flowers
  • Surfing the internet
  • Doing embroidery, cross stitching
  • Buying books from Amazon or bookdepository.co.uk
  • Meditating using Smiling Mind or Headspace or Calm or Balance or Waking Up apps
  • Training my pet to do a new trick
  • Planning a day’s activities
  • Waking up early, and getting ready at a leisurely pace
  • Organising my home workspace
  • Writing (e.g. poems, articles, blog, books)
  • Dancing in the dark
  • Reading classic literature
  • Putting on perfume or cologne
  • Reading magazines or newspapers
  • Calling a friend
  • Sending a handwritten letter
  • Reading fiction
  • Meeting new people online by joining groups that you are interested in
  • Doing 5 minutes of calm deep breathing
  • Buying new stationary online
  • Turning off electronic devices for an hour (e.g. computer, phone, TV)
  • Buying music (MP3s, Spotify premium subscription)
  • Relaxing
  • Watching an old sports game (rugby, soccer, basketball, etc)
  • Doing woodworking
  • Planning a nice surprise for someone else
  • Saying “I love you” to someone important in your life online, over the phone or in a letter
  • Making a playlist of upbeat songs
  • Colouring in
  • Doing a nagging task (e.g. making a phone call, scheduling an online appointment, replying to an email)
  • Shaping a bonsai plant
  • Planning my career
  • Reading non-fiction
  • Writing a song or composing music
  • Having a barbecue
  • Sewing
  • Dancing
  • Looking at art online
  • Making a ‘To-Do’ list of tasks
  • Having quiet evenings
  • Singing in the shower
  • Refurbishing furniture
  • Exchanging emails, chatting on the internet
  • Knitting/crocheting/quilting
  • Napping in a hammock
  • Making a gift for someone
  • Having discussions with friends
  • Trying a new recipe
  • Pampering myself at home (e.g. putting on a face mask)
  • Reading poetry
  • Savouring a piece of fresh fruit
  • Eating outside in my backyard
  • Making a pot of tea
  • Using special items (e.g. fine china, silver cutlery, jewellery, clothes, souvenir mugs)
  • Doing a DIY project (e.g. making homemade soap, making a mosaic)
  • Taking care of my plants
  • Telling a joke online or over the phone
  • Discussing books online
  • Watching boxing or wrestling online or on TV
  • Giving someone a genuine compliment
  • Practising yoga or Pilates
  • Shaving
  • Genuinely listening to others
  • Tidying-up
  • Rearranging the furniture in my house
  • Blowing bubbles
  • Buying new furniture online
  • Watching a sunset or sunrise from the balcony
  • Watching a funny TV show or movie
  • Recycling old items
  • Boxing a punching bag
  • Cleaning
  • Daydreaming
  • Learning about my genealogy/family tree
  • Setting up a budget
  • Writing a positive comment on a website /blog
  • Eating something nourishing (e.g. chicken soup)
  • Taking a class online (e.g. Masterclass, Udemy, Coursera)
  • Combing or brushing my hair
  • Writing diary/journal entries
  • Scrapbooking
  • Cooking an international cuisine
  • Reading comics
  • Trying new hairstyles
  • Watching a fireplace or campfire
  • Whistling
  • Working from home
  • Playing board games (e.g. Scrabble, Monopoly)
  • Savouring a piece of chocolate
  • Hunting for a bargain online
  • Buying, selling stocks and shares
  • Buying myself something nice
  • Solving riddles
  • Watching old home videos
  • Making home-made pizza
  • Origami
  • Doing something nostalgic (e.g. eating a childhood treat, listening to music from a certain time in my life)
  • Joining an club online (e.g. film, book, sewing, etc.)

Hopefully there are at least a few items in the above list that you would find fun or would love to do. If so, put them on your to-do-list or build them into your routine somewhere over the next week, and see what happens. If it’s been a long time or you have never done it before, it may be even more fun than you expect once you get started. Just make sure that you give the task a proper go for at least ten minutes before stopping and trying something else. 

people walking near train

Conclusion

In the 21st Century, our lives have become extremely busy, full and fast-paced. With the COVID-19 pandemic, we are now being told that the most helpful thing we can do is stay at home and remain physically distant from others. Unless you are in an essential profession, this could be a time to slow down. To check-in with those that you care most about. To chat for longer and to connect emotionally. To reflect on your life and rediscover what really matters to you. To hope and dream and plan for a better future. And to try things that you otherwise may not have had the chance or the time to do.

 

Feeling Fatigued? What Would Happen if We Worked Less?

Throughout a lot of my life, I have struggled with fatigue. Growing up, I played a lot of sport and never really rested. I was always on the move, playing games and competing with my siblings or friends when I wasn’t at school or playing organised sport.

I remember in grade 6, begging my mum not to have to go to swimming training anymore four mornings a week before school because of how exhausted I was. She obliged, but it didn’t stop me from playing sport all weekend. I would play Basketball Friday nights, Tennis Saturday mornings, Basketball Saturday afternoons, and then train for Basketball and Volleyball all day Sunday. That’s not to mention the training and games that I also had during the week.

I would often fall asleep in class and struggled to pay attention for 50-minutes straight without getting sleepy or nodding off. It was tough to stay awake for the hour-long train commute to school too, and a few times I’d sleep through my destination and have to get off and jump on another one coming back the other way.

Once I got to university, I continued to work hard and play hard. I played sport at least five times a week. I studied full-time, worked night-shift stacking shelves at the supermarket and tried to spend time with family and friends in-between. I was productive when I needed to be thanks to energy drinks and No-Doz, but would sleep whenever and wherever I had the chance.

Things began to change after September 2013 once I started working full-time as a Clinical Psychologist. I wanted to keep pushing myself as hard as possible. Still, I realised how important it was to be able to fully concentrate on all of my sessions every day across the whole week. If I wasn’t careful, my concentration could lapse, and I might miss something important and potentially cause real harm to the clients that I was seeing.

So I tried to learn more about how to manage my fatigue. It wasn’t as easy as I imagined it would be. If you looked at the pace I was living my life at, most people would have described it unsustainable, but it was pretty enjoyable. I also liked being able to fall asleep within 5 minutes whenever I wanted to.

To begin with, I tried to do less. I played less sport, especially after I tore some ligaments in my right ankle and broke my left hand playing Basketball. But this didn’t seem to make me less tired, and sometimes the days where I did the least exercise were the ones where I felt the most tired.

I caught up with my friends less. I wouldn’t recommend this either, but it did help me to stay more on top of my workload.

I then cut down my working days from five days to four. Even with this cut-down, I was still feeling exhausted by the end of end work week and taking at least a full day to recover on the weekend before I felt normal again. Then it was only two days before it started all over again.

By mid-2018, after nearly five years of private practice work, I was burning out. I accepted the role of volunteering as a Mental Health Specialist in Vanuatu for the next two years. I packed up my life in Melbourne to head off on a new adventure.

In Vanuatu, my working hours were from 8 am to 5 pm Monday through Friday. Initially, I was feeling quite worried about this and how I would cope when I couldn’t even manage four days of 9 am to 5 pm back in Melbourne.

Working on Paama island, Vanuatu

Vanuatu was different though. It felt a lot like living in California, which I did for my second last year of high school back in 2002-2003. The pace of life was a lot slower, and I could take the pressure off myself to always be on the go in a way that I never really felt that I could when I was living in Melbourne. Living on “island time” in Vanuatu meant that there was never a rush. And if no one else was rushing, then I didn’t need to either.

Initially, I wanted to make a good impression on my co-workers, and did work hard, but never outside of the scheduled 8 am to 5 pm working hours. I also made sure that I took my full hour for lunch every day.

Once I had settled in, I began to realise how much healthier the Ni-Vanuatu attitude to work was. Maybe not for the Government or work output, but definitely for psychological and emotional well-being. I noticed that people didn’t mind coming in late, or leaving early, especially on paydays (every second Friday). Long lunches weren’t too problematic, nor was leaving to go to the bank or pay bills or attend weddings or funerals or their kid’s performances or school assembly.

A health centre visit on Malekula island, Vanuatu

Eventually, I began to take the pressure off myself too. I tried to adapt my approach to work to what everyone else was doing there. For the first time in my working life, I was getting to the end of a workweek, and I wasn’t feeling tired or experiencing fatigue. I was coming up to a two-week holiday to return to Australia for my sister’s wedding, and I didn’t even feel like I needed a break. Compare this to how I’d been only a few years earlier, and I would fall sick as soon as I took a holiday. Like, every single time. Now I was feeling refreshed and was able to concentrate. I was not stressed or anxious about anything. Most importantly, I now had the energy to exercise and connect with the people I wanted to outside of work too. I was even falling asleep at an earlier time. 

Do We Need to Work Less?

Back in the 18th Century, employees worked up to 16 hours per day. Everyone knew this was unsustainable, and that it led to severe fatigue and a horrible quality of life for most of the working class. Then in 1856, the 8 hours movement began in Victoria.

The Labor unions fought hard for the idea of 888. They wanted 8 hours for sleep, 8 hours for work, and 8 hours for family, rest and play. This statue was erected at the top end of Russell Street in Melbourne in 1903, meaning that they had achieved this goal for most people sometime between 1856 and 1903 in Victoria.

Eight Hour Day Monument (Melbourne): UPDATED 2020 All You Need to ...
Eight Hour Day Monument (Melbourne): UPDATED 2020 All You Need to ...

In the US, the railroad workers began to work eight-hour shifts in 1916. Ford Motor Company followed suit in 1926 when they cut the working hours of their employees to 8 hours per day while doubling wages. The reduced work hours and better pay led to a happier and more committed workforce, and productivity increased. More leisure time and money also led to more workers buying more stuff (including Ford cars), which the government realised was better for raising GDP. Other companies also began to realise that workers were more focused and productive when they worked less. An eight-hour workday subsequently became the new norm.

Since then, the working hours have begun to creep back up again, especially in the US. Among people employed full-time, the average employee works 47 hours per week. 40% of full-time employees now work over 50-hours per week, with only 8% working less than 40 hours. So much for 8-hour workdays being the standard. 

The Negative Consequences of Long Work Hours

Research has shown:

  • Working more than 10 hours per day can increase your risk of cardiovascular issues by 60%
  • Regularly working more than 10 hours a day can also increase your risk of stroke by 29%.
  • Working more than 11 hours of overtime a week leads to increased depression risk.
  • Working 12 hours days increases your risk of making mistakes at work by 23%.
  • In companies where the average weekly work time is under 43.5 hours per week, barely any fatigue-related problems are found.
  • In companies where the average weekly work time is between 43.5 hours and 46 hours, minor fatigue problems are detected.
  • In companies where the average weekly work time is over 46.5 hours, severe fatigue-related issues are seen.
  • The rate of relationship problems in those working 50-60 hours per week is 10%
  • The percentage of relationship problems in those working more than 60 hours per week is 30%.
  • Long working hours are linked to poorer mental health and sleep quality.
  • Long working hours are also linked with increased smoking, excessive alcohol consumption and weight gain.
  • Long working hours are related to lower job performance, as well as less job satisfaction and lower overall life satisfaction.

What if We Did Work Less?

Six Hour Workday infographic

The above infographic by Ohio University highlights why we need to work less. If the top 10% of employees in terms of productivity work in 52-minute blocks followed by 15- to 20-minute breaks, they can only do seven 52-minute work block in a day. That is 7 x 52 = 364 minutes of work per day. That means we really shouldn’t be putting in more than 6 hours and 4 minutes of work per day.

We also should be taking 1 hour and 56 minutes of breaks spread out across the day if we want to be at our most productive too. That’s six breaks that are 19 minutes and 20 seconds long, or five 15-minute breaks and one 41 -minute lunch break. Like they say in the infographic, eight-hour days are only productive when we take sufficient breaks, and few people do.

An alternative for the people or organisations that don’t want to take regular breaks is a shorter workday. The average person is only productive for 2 hours and 53 minutes every day. What do you think would happen if we reduced the workday to only 6-hours per day and paid people the same amount?

For a 6-hour workday to be effective, it would be necessary for companies to make it harder for their employees to waste time. Just putting a block on news websites and social media sites would give the average person 1 hour and 49 minutes of their typical workday back. With the extra time after work, these employees could check the news and social media then if they wanted to. If the average employee is 20% happier and healthier with six-hour workdays, they are going to be less likely to look for other jobs too.

Microsoft has also recently experimented with four-day work-weeks in Japan. When workers took the Friday as well as the weekend off, productivity went up 40%. Only 10% of the staff who tried this weren’t more productive overall. They also cut meeting times down to a maximum of 30-minutes each. I’m sure that this helped as well.

When other companies have tried four-day work-weeks, they manage to produce 25% more output with the same size staff. They also find it easier to fill vacant positions when they arise, as more people are enticed by the four-day-a-week full-time job than a typical five-day-a-week role.

Conclusion

Since coming back to Melbourne and returning to full-time work, I have noticed that a lot of my stress and fatigue has returned. Finding the right work/life balance isn’t easy, especially with all of the uncertainty and anxiety created by the COVID-19 pandemic. I’m grateful to have full-time work doing what I love to do, but working in a way that isn’t harmful to my health and well-being is still a work in progress for me.

However you decide to manage your workload, please understand that working long hours without regular breaks is not sustainable. We can address this by working fewer hours in a day or fewer days in a week. Or we can merely get up from the desk and walk around a bit more when you notice that your productivity and energy levels are dropping. Getting outside for lunch and away from screens can also help. As can taking some pressure off of ourselves.

Working hard and being busy are still seen as status symbols in Western society on too frequent a basis. Stepping out of this culture and into “island time” for 20 months was one of the best things I could have done for my fatigue, happiness and overall well-being.

The biggest question I still have is whether or not we can learn from our experiences and from what the research says. It seems counter-intuitive, but working less could help us to be a healthier, happier and more productive society going forward. We just need COVID-19 to go away so that we can enjoy the free time we have doing the things we enjoy and connecting with the people we love.

Motivation: Tips for How to Improve it

People often ask me how they can improve their motivation. Generally what I tell them is that there are two big motivators in life. One is your values, or what is most important to you in your life. The other is fear, or trying to prevent the worst from happening.

Research by Tversky and Kahneman found that losses loom much larger than gains. This means that fear is usually better for motivation than values, because we are more willing to put in effort to avoid something bad happening than we are to create something good. This bias is one of the main reasons that all of your direct ancestors survived long enough to reproduce. So without their loss aversion, you may not be here today.

The problem of just using fear for motivation is that it triggers our fight-or-flight response. It increases our cortisol levels if we trigger this response too often, so in the long run it isn’t so great for our mental and physical health.

Being motivated by our values on the other hand is very rewarding. We aren’t just in survival mode. We are creating the life we want and it feels very rewarding.

Intrinsic vs extrinsic values

Values are not the same thing as goals. You cannot just achieve them and then move on. They are guiding principles for life. They help you identify whether you are on the right track in your life or not. If you are not sure which values are most important to you, this clarification exercise can help.

The biggest problem with values is that it can be hard to know why your most important values are important to you. Is it because society says they are, or movies, or marketing companies? Or is it because your family or religion says so? Or just because it feels really important deep down?

Research has found that we are much more likely to experience motivation when we are being motivated by our intrinsic rather than our extrinsic values. Extrinsic means something outside of us. Intrinsic means something within us.

I remember back when I was doing my Doctoral studies. For the first six months I was not on a scholarship and was studying for free. Then I was placed on an academic scholarship, and was being paid to study. There was something about being paid to study (an extrinsic factor) that diminished my intrinsic motivation to study and made it harder overall. Before I received the scholarship, I thought it would have been the opposite, and that getting paid to study would have helped me remain focused and finish my research even quicker. It did not.

Professional sports players who start getting paid to play can feel the same way. Growing up you couldn’t keep them off the court. They just loved the game. But now it’s a business, and some people in the NBA refuse to play unless they are getting paid more or playing for a team that is contending for a championship. Their intrinsic motivation has become overshadowed by their million dollar salaries.

Volunteering in Vanuatu was the opposite. Because I was no longer getting paid to do any of the Mental Health support that I was offering the country, I could fall in love with psychology and therapy all over again. I was simply helping people to improve their mental health and the overall quality of their lives. I felt connected with my important values and experienced lots of motivation as a result.

Three Intrinsic Ways To Build Motivation

In his excellent book ‘Drive: The Surprising Truth About What Motivates Us’, the author Daniel H. Pink says that there are three major ways to increase your intrinsic motivation:

1. Autonomy

  • What do you want to do?
  • Why do you want to do it?
  • Is it for others or for you?
  • If it is for others, do you feel forced to do it or is it because it is important to you?
  • If it’s important to you, what personal value is being highlighted as very important for you:
    • Dutifulness?
    • Obedience or Loyalty?
    • Altruism?
    • Empathy?
    • Sympathy?
    • Being supportive?
    • Being kind or compassionate?
    • Not being indebted to others?
    • Equality or fairness?
    • Something else?

2. Mastery

  • What skills do you want to build?
  • What do you enjoy learning?
  • What areas interest you?
  • What comes easily to you that doesn’t come easily to others?

3. Purpose

  • What are you passionate about?
  • What is personally meaningful to you?
  • If you didn’t have to earn money, what would you do?
  • What would you want your epitaph or tombstone to say?
  • What would you want to hear someone say at your 80th birthday during a talk about you and the person you have been?
  • What do you want your legacy to be?
  • What do you want to add to the world?
  • How would you like to be remembered?
  • If the world was going to end in 2 years, and you couldn’t do anything about it or tell anyone else about it, would you do anything different to what you are doing now?
  • If your kids didn’t listen to what you said, and only looked at what you did, would you change you actions or what you do on a daily basis? If so, what would you do differently?

Is FEAR Holding You Back?

Let’s say you know what you want to change, but are still struggling to do it. Perhaps FEAR is holding you back from making the changes you want to. FEAR is an acronym Russ Harris created in his books’ The Happiness Trap’ and ‘The Confidence Gap’.

FEAR stands for:

F = fusion with unhelpful thoughts

If you are fusing with unhelpful thoughts, you need to practice defusion skills to let go of unhelpful thoughts and increase your motivation. Defusion techniques involve recognising thoughts, images, and memories for what they are. They are just words and pictures. You then allow them to come and go as they please, without fighting them, running from them or giving them more attention than they deserve. Google search Acceptance and Commitment Therapy (ACT) defusion exercises and try some until you find one that allows you to let go of unhelpful thoughts. My personal favourite is on the app ‘CBT-I coach’ in the section called, ‘quiet your mind’ where you can find an exercise called ‘observe thoughts – clouds in the sky’.

E = expectations that are unrealistic

If you have unrealistic expectations, review your goals and write the new ones down to improve your motivation. Break these goals down into smaller steps, give yourself more time to achieve them and allow yourself to make mistakes. Let’s say you are hoping to obtain seven hours of sleep per night, and you only sleep five hours currently. Start with trying to improve your total sleep time by an average of 10 minutes over the next week. Once you achieve this, you can then aim for another 10 minutes. Within 12 weeks, you could get to where you want to be, so try to take the long-term approach instead of looking for a super quick fix. If you do not reach your sleep goal on one night, that is okay. Just stick to the plan you have set, and do not give up until at least two weeks have passed. Everyone has a terrible sleep from time to time, so it is important to keep realistic short and long-term goals to ensure that your motivation remains high.

A = avoidance of discomfort

If you are avoiding discomfort, challenge yourself to improve your motivation by taking action. Remember that gradual exposure is the most effective intervention for any anxiety disorder, including post-traumatic stress disorder. With anxiety, we want to avoid, but this only keeps the fear alive as our brain tells us that what we are avoiding is dangerous. We need to challenge ourselves to do what we want and make room for the emotions that we feel in these moments. By doing this, we will generally realise that doing the thing we were afraid of was not nearly as bad or uncomfortable as we imagined. To increase your ability to sit with painful or difficult emotions, try expansion ACT exercises, or a body scan meditation. The CBT-I coach app has a body scan meditation under the ‘quiet your mind’ section that I would recommend checking out.

R = remoteness from values

If you are not living consistently with your most important values, reconnect with them to increase your motivation. Then see if your plan or desired outcome will help you to live more consistently with your most important values. If your plan will, write down your most important values and put them in a place that you will often see to remind yourself of why you are currently doing what you are doing. If your plan will not, change your plan so that it is more consistent with what is most important to you.

Remember, change is generally always hard, but worth it if it will help us to live the life that we want to be living in the end. Keeping in mind why you are doing something is also the key to improving your motivation so that you can push through when things get tough.

Good luck with improving your motivation, and do let me know if these strategies help!

How Can We Improve Our Sleep During Uncertain Times?

Well, that was chaotic.

I was volunteering as a Clinical Psychologist on the Australian Volunteer Program for the past 18 months in Port Vila, Vanuatu. It was meant to be a two-year role, but unfortunately due to the Coronavirus pandemic, the Australian Government suspended the entire volunteer program worldwide and we were forced to come back to Australia on the 20th of March 2020.

Let’s have a look at how my sleep was during this stressful and uncertain time using my Fitbit data:

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By the 15th of March, I had really started to realise how big of an issue Covid-19 was going to be. I had spent most of the Saturday reading up on what was going on around the world and why we should be concerned, and my sleep started to suffer as a result. I spent nearly 9 hours in bed, which is more than usual, but didn’t sleep well. I was asleep for 7.5 hours, which is more than enough, but my sleep efficiency (percentage of time in bed spent sleeping) was only 83%, much lower than my usual 89% average over the prior 30 days. I also obtained less deep sleep and REM sleep than usual, and my overall sleep had 12% more light sleep than I typically obtained.

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My next night of sleep was a bit better, but I slept less as I needed to get up at 6am for work while I was volunteering in Vanuatu. I had a greater percentage of deep sleep and rapid eye movement sleep than the night before, and both were within the recommended ranges for men my age. Not falling asleep until after 11:25 was likely to be caused by my sleep in on Sunday. I tried to enjoy my day, and I think my partner and her daughter and I went swimming at a pool at a local hotel. This would have helped me to get a decent sleep too.

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Monday was the day that the Australian Volunteer Program informed me that they would be suspending the program and that we would all need to book a flight back to Australia before the end of the month. My overall sleep score dropped from good to fair, my total sleep time decreased to under six hours, and my sleep efficiency, REM sleep and deep sleep were all less than my previous 30-day average. Notice the frequent awakenings between 3:30am and 5:40am when I got out of bed. That is not normal for me.

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On the 19th of March at 6:30pm, we were told that we needed to book a flight back to Australia the very next day. I was not prepared for this and did not take it well. After talking with a good friend who worked from Air Vanuatu, I decided to book a ticket on the last flight out of Vanuatu to Brisbane before the Australian borders shut at 9pm. This decision meant that I would have less than 24 hours to say goodbye to my incredible girlfriend and her amazing daughter, and we wouldn’t be able to see each other again until who knows when.

I also had to pack up my life from the past 18 months, tie things up at my work at Vanuatu’s Ministry of Health and at the Mind Care Clinic at Port Vila Central Hospital, and say goodbye to my friends, colleagues and patients if possible. It was too much, and my sleep paid the price. My mind was racing and my chest felt like it was exploding out of my chest. I was very close to experiencing a full-blown panic attack and had some alcohol before sleep to try and calm myself down when slow and deep breathing didn’t work by itself.

The result was my worst sleep score since beginning to use my Fitbit at the end of December 2019. The 61 is considered fair by Fitbit, but it was poor. I didn’t fall asleep until after 11:30 and had a sleep efficiency of 76%, which isn’t good. Being awake for a quarter of the night means that the night can really drag on. I slept less than 5 hours for the first time in over a month. My REM and deep sleep were also less than usual, with my REM sleep being less than recommended for men my age.

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This night was spent in a hotel in Brisbane near the airport and was really restless because I knew that I needed to be back at the airport in the morning to fly to Melbourne at 7:10am. I also had to try and calm down from everything that I had just been through. I rushed around, packed, said goodbye to loved ones, and jumped on a flight in Vanuatu with a very heavy heart. I knew that I could not stay with my volunteer position and visa and insurance being cancelled, but I also didn’t want to go. Not yet. I was meant to finish in mid-August. Instead, I was heading back to Melbourne with no money and no job and lots of uncertainty. I was also heading from a country with no confirmed cases of Coronavirus to a state of emergency in Victoria.

I spent less time awake during the night than the night before, but my sleep score of 64 was quite poor. I had a decent amount of deep sleep, but lots of light sleep and not much REM. It left me feeling pretty tired the next day, but I also knew I was heading into self-quarantine for the next 14 days and would be able to wake and sleep whenever I felt like it.

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My very next night of sleep was my first night of self-quarantine down at my parent’s house. They live near the beach at the start of the Great Ocean Road, and there isn’t much noise at night except for the faint crashing of the waves in the background. No matter how grown-up I usually try to feel, it was also nice to see my parents again and to see that they were fit and healthy. I knew that they would be helping me out over the next two weeks with shopping and cooking and everything else that I wasn’t allowed to do, and I could just calm down and relax and wait for the two weeks to pass.

My sleep score went from my two worst nights ever to my best night, with the Fitbit telling me I achieved a 91 or an excellent rating. Even though my percentage of time awake was the same as the night before, I slept 2 hours and 39 minutes longer, and my REM and deep sleep were both over 20% and well above my monthly average. It was a pretty amazing turnaround.

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The next night, or my second night of quarantine, was exactly the same, with an equal best sleep score of 91. I spent even less time in bed awake and the same percentage of time in REM and deep sleep (21%), which were both at the upper end of the range recommended for men my age.

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The third night of quarantine was nearly exactly the same, with over 20% REM and deep sleep. The main differences were that I slept later and had a little bit more time awake during the night. It was still considered excellent with an overall sleep score of 90. I’ve never had over 90% three nights in a row, and yet I did it here, despite all the stress and upheaval that I had just been through and during the midst of an escalating COVID-19 pandemic.

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How did I improve my sleep so quickly?

To assess anyone’s sleep, I ask them the following three questions:

  1. Is your sleep pressure high enough when you are going to bed for sleep? YES, especially the first night that I scored a 91. On the other night’s I stayed up progressively later each night, which meant that I was still waiting before I felt sleepy before going to bed.
  2. Are you regularly sleeping at the right time for your body clock? SOMEWHAT. I have usually had a delayed body clock, so sleeping between 12midnight to 8am is probably ideal for me, especially when I am living in Melbourne. The last night of sleep was probably a bit too late, and I could be a bit stricter with not spending time looking at screens in the last two hours before bedtime so that it doesn’t keep getting pushed back further.
  3. Are you doing things to lower your stress levels and make sure that they are low enough when you go to bed at night? YES. As soon as I got back to Melbourne I could breathe a sigh of relief. I wasn’t going to be stuck anymore. I didn’t have to travel. Mum and dad were helping me with accommodation, shopping, meals and entertainment. I also began doing meditation and heart rate variability training and just relaxing and taking it easy, watching shows or movies or talking with friends and family. I went from being panicked to being bored in less than four days, which is a big indicator that my stress levels had dropped a lot.

If you are not doing one or any of these three things, it could explain why you aren’t sleeping so well at the moment. I’d recommend trying any of the following, depending on which of the three things you aren’t currently doing.

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Tips to improve your sleep pressure:

  • Aim to be up for at least 16 hours each day
  • Spend a maximum of 8 hours in bed each night
  • Do not nap during the day
  • Keep naps to under 30 minutes and before 4:00 pm each day
  • Consume as little caffeine as possible
  • Exercise at least 30 minutes every day
  • Participate in physical activity for at least 30 minutes five times per week
  • Engage in a new or cognitively challenging task each day
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Tips to better regulate your internal body clock:

  • Wait until you feel sleepy before you go to bed each night
  • Go to bed as soon as you feel sleepy each night
  • Avoid all bright screens in the last two hours before bed each night
  • Get up at the same time each day, seven days a week
  • Get outside for 20 minutes within the first hour of arising from bed every morning
  • Buy re-timer glasses and wear them for 30 minutes every morning
  • Use f.lux if using the computer during after sunset and night-shift or similar features if using a phone or tablet after sunset
  • Use blue-light blocking glasses if using a phone, tablet computer or watching TV in the last two hours before sleep
  • Install Phillips Hue Smart Lights in your home and use them like you would your regular lights
  • Try to deliberately eat your breakfast, lunch and dinner earlier than you usually do
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Tips to lower your arousal or stress levels:

  • Do less during the day
  • Lower your standards
  • Take more breaks during the day
  • Get out into nature during your lunch break
  • Go for a walk during your lunch break
  • Practice meditation 10 minutes a day using an app such as Balance or Calm or Headspace or Waking Up or Smiling Mind
  • Practice cognitive restructuring skills every time you notice an unrealistic or unhelpful thought – ask what is a more helpful way to think about this situation?
  • Engage in one enjoyable task every day – here are some ideas for during the Covid-19 pandemic
  • Do a random act of kindness every day – here’s 101 ideas for what you could do
  • Live more consistently with your top five values – do a values clarification exercise
  • Live more consistently with your top five signature strengths – take the VIA character strengths survey
  • The two-minute rule: if something takes less than two minutes to do, don’t put it off until later – do it then and there
  • The ten-minute rule: If you do not feel like doing something that would be helpful; start doing it anyway. If after ten minutes of doing the task, you still aren’t up for continuing the job, stop
  • Journal for five minutes about two hours before you go to bed
  • Write down three things that went well that day or that you were grateful for or appreciated
  • Spend more time with friends, family or people that you feel calm around and accepted for who you are (online or over the phone if you can’t see them in person)
  • Do not try to force yourself to sleep and find a good distraction instead
  • Paradoxical intention: try to see how long you can stay awake lying in bed with the lights off and no distractions. Remind yourself that if you are awake, you are succeeding, and say to yourself, just a little longer
  • Autonomic suppression: In bed, mouth the word ‘the’ to yourself every one to two seconds until you fall asleep
  • Listening to stand-up comedy in bed, with a sleep timer on if possible
  • Listening to the podcasts or the radio in bed, with a sleep timer on if possible

Good luck with improving your sleep, and please feel free to ask me any sleep-related questions that you have. If you want to book in for a online video session to discuss your sleep issues in more detail and get more personalised help, please contact me for more details.

Are You Trying to Sleep at the Optimal Time for Your Internal Body Clock?

Our internal body clock (also known as our circadian rhythms) is one of the three major things that influence how well we sleep. This article will teach you all about your circadian rhythms, why they matter, and how to change them if you want to sleep better. The other two underlying mechanisms that you need to learn about for consistently great sleep are your homeostatic pressure and stress levels. If you want to learn tips for changing these aspects, I recommend checking out those articles too.

What Are Circadian Rhythms?

The figure above shows normal circadian rhythms in a human. The word circadian simply means approximately one day, and many things fluctuate in line with these rhythms, including our appetite and how well we perform on cognitive and physical tasks.

Melatonin is closely related to sleep. It usually begins to increase about 2 hours before bedtime to help us fall asleep, and increases its release during the night to help us to remain asleep or get back to sleep when we wake up. Growth hormone spikes during the first half of the night to help promote growth, repair of cells, and restoration of energy for the next day. Body temperature decreases throughout the night, and this drop can help us to fall asleep more comfortably, which is why it can be hard to get to sleep on sweltering nights. Cortisol spikes just after waking in the morning to help increase our arousal levels and get moving for the day. It also tends to drop in the first half of the night to help us sleep more deeply.

How do circadian rhythms work?

We regulate our circadian rhythms through the suprachiasmatic nucleus (SCN) in our brains. We have light/dark receptors in our eyes alongside our cones and rods. The only role of light/dark receptors is to take in the light wavelengths from our environment, and then send these signals to our SCN about what time it probably is based on these light wavelengths. White, blue and green wavelengths have typically signalled the middle of the day, and orange and red wavelengths have indicated that it was either first thing in the morning (dawn and sunrise) or nearly night time (sunset, dusk and campfires).

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The role between our light-dark receptors and our SCN worked really well for thousands of years, but then humans invented electricity and lightbulbs, and then TVs and now bright LED screens for smartphones, tablets and computers. Suddenly this super trusty relationship wasn’t so trustworthy anymore. The light/dark receptors began picking up blue wavelengths of light from all these devices first thing in the morning or last thing at night, and our poor SCN found it very difficult to know what time of the day it actually was. As shown in the graph above, the SCN would receive bright (and blue) light cues at night, and tell the pineal gland not to produce melatonin yet, because it must still be daytime.

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Researchers have only relatively recently begun to understand the full negative impact that inappropriate exposure to bright light at night can have, especially blue wavelengths of light. In June 2019, the IARC (International Agency for Cancer) classified night shift work in Group 2A, which indicates that it is a probable carcinogen to humans. This is because of the negative impact of trying to sleep and work at different times to most people’s internal circadian rhythms. Remember, our SCN not only helps to regulate our sleep/wake cycle but also how we feel, how we think and how we behave. It influences our appetite, our hormones, our body temperature, our blood pressure, our blood glucose levels and more, so it’s not something that you want to mess around with if you can help it.

Light exposure, either too early in the morning or too late at night, can lead to two big problems. Our internal body clock begins to stop working as well (circadian disruption) or our body clock keeps working, but much later than we want it to (circadian delay).

How Can Knowing This Help Me To Sleep Better?

When all of our circadian rhythm variables are in-sync with our social and working routines, it becomes much easier to make the transition to sleep at night, to wake up in the morning, and to function well during the day.

The ideal time to sleep based on circadian rhythms varies for each person. Between 10:30 pm and 6:30 am is common in many countries. Problems arise when people disregard their circadian rhythms, and try to sleep at different times for social reasons, such as going out late at night with friends or staying up late with their partner. People may also have to sleep at different times for technical reasons, such as rotating shift workers and night-shift workers.

Individuals that are “morning people” tend to have an advanced circadian rhythm, and may sleep best when they go to bed early and wake up early. If they go to bed at 9:00 pm and wake up at 5:00 am every day they feel great, but they struggle to stay up late at night or sleep in later in the morning. Conversely, individuals that are “evening people” tend to have a delayed circadian rhythm, and may sleep best when they go to bed late and wake up late. If they go to bed at 1:00 am and wake up at 9:00 am, they feel great, but struggle to get to sleep earlier than that or wake up at earlier times in the morning. I was like this back when I was in my teens and 20s, and it is more common for people during their adolescence.

Most people’s internal body clocks do shift forward a little bit as they get older, and you would benefit from adjusting your sleep schedule to these new ideal times if this has happened to you. I now generally sleep between 10:30 pm and 6:30 am, but 11:00 pm to 7:00 am is probably suitable for me. I need to get up a bit earlier for work, however, so I use some of the tips below to help bring my internal body clock forward a bit.

If you are a morning person that goes out until 1:00 am, remember that your circadian rhythms will still be trying to wake you up at your usual rise time of 5:00 am. Any sleep that you get after this time will be inferior quality than usual. Likewise, if you are an evening person that wakes up at 6:00 am for work, your body is still going to want you to sleep until 9:00 am, so there’s a good chance that you’ll be quite tired and perform at a lower level until after 9:00 am.

Individuals with chronic insomnia are often not aware of what their natural circadian rhythm is. They tend to make their problem worse by trying to sleep when their body is trying to keep them awake and trying to stay awake when their body is trying to help them to sleep.

If you want to sleep well, try to tune into when your body is feeling sleepy rather than just tired. If your homeostatic sleep pressure is high, you will feel tired and not feel like doing too much. However, this does not mean that you are necessarily ready for sleep. If you feel sleepy, this is a better predictor that you are prepared for sleep and are likely to fall asleep quickly once you go to bed.

Good indicators of sleepiness include regular yawning, your eyes feeling heavier or blinking more slowly, your body feeling heavier and sinking more into your chair, or missing parts of a TV show that you are watching. If you are driving and you notice these signs, you need a power nap, so pull over as quickly as you can, as long as it is safe, and have a short nap before continuing to drive. If it is happening around your usual bedtime, do not try to fight it, get up, and go to bed. It will make it easier for you to fall asleep quickly once you are in bed.

How can you figure out your ideal sleep times?

If you are not sure what your ideal bedtime is, or you tend to feel sleepy at different times from day to day, ask yourself the following question:

If you were on holidays for two weeks and had no commitments that would force you to go to bed or wake up at a particular time, what 8-hour period in a 24-hour cycle would lead to the best sleep for you?

  • 8:00 pm to 4:00 am?
  • 9:00 pm to 5:00 am?
  • 10:00 pm to 6:00 am?
  • 11:00 pm to 7:00 am?
  • 12:00 midnight to 8:00 am?
  • 1:00 am to 9:00 am?
  • 2:00 am to 10:00 am?
  • 3:00 am to 11:00 am?

Your answer to this question is likely to be your current best bedtime and rise-time based on your circadian rhythms or internal body clock. If you are still not sure, find and complete the morningness-eveningness questionnaire (MEQ) online. It can help you to identify if you have an advanced circadian phase (colloquially known as a “lark”) and should aim to go to bed and wake up earlier than most people. If this is you, try to go to bed to begin between 9:00 pm and 10:00 pm as long as you feel sleepy and set your alarm to get up 8 hours later.

The morningness-eveningness questionnaire can also help you to identify if you have a delayed circadian phase (colloquially known as a “night owl”) and should aim to go to bed and wake up later than most people. If this is you, try to go to bed between midnight and 1:00 am initially as long as you feel sleepy and set your alarm to wake up 8 hours later.

If you are neither a lark nor a night owl, aim to go to bed around 10:30-11:00 pm as long as you feel sleepy and set your alarm to get up 8 hours later. By tuning into signs of sleepiness around these times, you should find where your natural circadian rhythm is, and this will help you to fall asleep faster, stay asleep longer, and have better quality sleep.

There are a few other ways that we can determine what the optimal times are for us to go to bed based on our internal body clock. We can monitor our sleep for 1-2 weeks using a sleep diary or sleep-tracking device and then look at your average to-bed time and average rise time across this period. Then aim to go to stick to these bedtimes and wake times as closely as possible over the next two weeks, and continue to monitor your sleep. If it helps you to get to sleep more quickly, improves your sleep quality, and you feel better and function better during the day, you are definitely on the right track.

The most accurate and scientific way to determine your natural circadian rhythm timing and optimal sleep times are by analysing your dim light melatonin onset (DLMO). Your DLMO can be collected at specific sleep laboratories and in sleep research looking at the impact of light exposure or melatonin tablets. You get your saliva taken at several periods across a night as you sit in a very dimly lit room. The researchers put saliva into test tubes and then sent away for analysis. Your melatonin onset is then determined. The only problem is that you cannot obtain the results immediately, and our circadian rhythms are sensitive to certain factors in the environment, especially light. Therefore, by the time you get your results back in a few weeks, your DLMO may have already shifted, and your ideal bedtimes may have moved too. I, therefore, wouldn’t recommend doing a DLMO test until doctors or researchers can give us our results within 24 hours.

How do we deliberately shift our internal body clock or circadian rhythms if they are different to when we would ideally like to wake and sleep?

Circadian rhythms do tend to stay relatively constant from day-to-day. Still, things that can shift the timing of our internal body clock include light exposure, melatonin supplements or medication, and to a lesser degree, what we eat and when we eat. If your ideal sleep times based on your circadian rhythms are different to your usual sleep times based on your current work schedule and lifestyle, there are specific things that you can do to change it.

If you want to advance your circadian phase and go to sleep earlier at night or get out of bed earlier in the morning, try the following:

  1. Get as much light exposure as you can shortly after waking in the morning.
    • Even 20-30 minutes of being outside in natural light in the morning can make a big difference in helping you to feel alert during the day, as it signals to your brain that the day has begun and helps to switch off melatonin production and release.
    • If you combine sunlight exposure with some exercise each morning, your mood is likely to improve too, as regular exercise can be as effective as an antidepressant for depressive symptoms.
    • Morning light exposure shortly after you awaken also helps to bring forward the timing of your melatonin onset the following night. It will help you to feel sleepy earlier, as long as you do not get too much light exposure in the evening and before bed.
    • Inside light doesn’t have as much lux as natural light, but looking at computer screens, tablets or phones or sitting by a window in the morning may give you some benefit if it is too cold outside or not possible to get outside each day.
    • If you have delayed sleep phase disorder, seasonal affective disorder or cannot spare the time to get regular morning sunlight, it may be worth buying Re-timer glasses. They cost a little bit, but you can just put them on as soon as you wake up and wear them for 30 minutes while you get ready for your day and eat some breakfast. The blue-light from this will help you to feel more alert during the day, may improve your mood and should bring your circadian rhythms forward a bit for the following night.
  2. Minimise light exposure after sunset.
    • Our melatonin onset is usually two hours before we typically fall asleep. Light exposure to our eyes, especially blue wavelengths around or after this time suppresses our melatonin production. This can lead to a later sleep onset time, reduced sleep quality and less total sleep time.
    • Smartphones, tablets and computers all emit a lot of blue light from their screens, and they are often pretty close to our eyes, which means they can suppress melatonin quite a lot. If you can stay off them in the last two hours before bed and do not use them in bed, this is ideal.
    • If you want to use bright screens in the last two hours before bed or in bed, try to change the light that they emit so that it is dimmer and warmer. If you have done this successfully, it will make the screen look orange or red in comparison to usual. On the iPhone, it is called night shift and can be turned on through going to Settings > Display and Brightness and clicking on Night Shift. Mine changes from Sunset to Sunrise. On the computer, there is a free plugin that you can download called f.lux. It also makes the screen a warmer colour from sunrise to sunset or for whichever hours you choose.
    • If you like to watch TV at night, this can suppress melatonin onset. The bigger the screen is and the closer it is to you, the more it will affect your circadian rhythms and sleep. To offset this, wear blue-light blocking glasses if you want to watch TV in the two hours before bed. Optometrists can make fancy personalised glasses for you, or you can buy cheaper ones as I did, which block out all of the blue wavelengths of light. UVEX is the brand that I purchased online, and they are inexpensive and effective.
    • Recent research coming out of the Monash Sleep & Chronobiology Research Team even suggests that the lights we have in our house can delay our melatonin onset and suppress how much our brain releases. Phillips Hue Smart Lights aim to solve this problem by also changing to warmer colours after sunset, potentially making it easier to feel sleepier earlier and sleep better and longer at night. I have not tried these yet. Wearing blue light blocking glasses around the house would also have a similar effect for a lower price.
  3. Take melatonin tablets at least two hours before you go to bed.
    • Most young, healthy people produce enough melatonin internally, so taking more melatonin will not necessarily help you sleep better, especially if you are minimising your evening light exposure.
    • If you have a delayed circadian phase, taking melatonin earlier in the evening can help you to bring your body clock forward and go to bed sooner so that you can wake up earlier the next day.
    • Melatonin is available over the counter in the US, but you need a prescription from your GP in Australia, so talk to your doctor about if this is a suitable medication for you and the best times for you to take it.
    • If you are sleeping at 1:00 am, but want to sleep at 11:00 pm, first try taking your melatonin at 10:45 pm. By consuming melatonin at this time, it may help you to get to sleep by 12:45 am. Get up no later than 8:45 am the next morning. After a few (2-3) days, take your melatonin tablets at 10:30 pm. It may help you to get to sleep by 12:30 am. Get up no later than 8:30 am the next morning. Keep taking the melatonin tablets 15 minutes earlier every few days and getting up 15 minutes earlier in the morning every few days until you consume melatonin at 9:00 pm, sleep by 11:00 pm, and arise from bed at 7:00 am.
    • If you have jet lag and are not feeling sleepy until too late at night, taking melatonin and getting light exposure at the right time can help shift your body clock forward by about 1 hour every night. The phone app ‘Jetlag Genie’ can tell you the best times to do this depending on where you are travelling.
  4. Deliberately get up at your desired wake-time, seven days a week, no matter what.
    • This strategy is hard, as it is fighting against your natural circadian rhythm instead of working with it, but if you are naturally waking up at 9:00 am but want to wake up at 7:00 am, set your alarm for 7:00 am and keep this wake time every day. Because you will not be getting enough sleep, your homeostatic sleep pressure will increase over the subsequent days and help make it easier to fall asleep before what is natural for your circadian rhythms. However, if you do this alongside getting morning sunlight and minimising light exposure after sunset, it is likely to bring your body clock forward too. You might feel tired and struggle to function during the day until your internal body clock shifts forward to your new routine.
  5. Eat breakfast, lunch and especially dinner earlier than you usually do.
    • Our circadian rhythms do respond a little bit to the timing of when we eat. If you eat earlier than usual, it may help you to feel sleepy before you usually do. Some foods are also natural sources of melatonin, such as cherries. However, do not overly focus on what you eat if you want to bring your body clock forward, and try not to overeat too close to your usual bedtime.

It is generally easier to delay our body clock than advance it, especially if you have travelled around the world and have jet lag, which is when your circadian rhythms are out-of-sync with the time in your new environment. While we can realistically advance our body clock by an hour each night with appropriately timed light exposure and melatonin administration, we can delay it up to two hours each night. This means that it is harder to fall asleep earlier than you usually do, and easier to go to sleep later than usual.

If you want to delay your circadian phase and go to sleep (at night) and get out of bed (in the morning) later than you usually do, try the following:

  1. Seek less sunlight in the morning.
    • If you have to go outside before noon, wear sunglasses. If you use your phone, tablet or computer before noon, put on f.lux or night shift to change the colour of your screens to orange or red. If watching TV in the morning, put on blue-light blocking glasses, and use blinds to reduce the light coming into the house.
  2. Seek more sunlight or blue-light exposure in the afternoon, early evening, and before bed.
    • Go outside without sunglasses on in the afternoon. Or turn on plenty of lights in your house in the afternoon and evening. Lastly, watch TV, or play on your phone, tablet or computer before bed. It will help you to stay up later but may lead to less sleep and worse sleep quality.
  3. Force yourself to stay up later each night.
    • The increased sleep pressure when you go to bed may help you to sleep in later the next morning.
  4. If you do have jetlag, follow the advice of when to get light exposure from apps such as ‘Jetlag Genie’ or ‘Jetlag Rooster’.
    • If you have Re-timer glasses, putting these on at the designated times that you need to seek light exposure can help.
  5. Take melatonin at a specified time.
    • I cannot recommend a time for when to have melatonin if you want to delay your circadian rhythms. Please seek advice from a qualified Sleep Physician about when is the best time for you to take it.
  6. Eat breakfast, lunch and dinner later than you usually do.
    • It may or may not help, but try this if you have tried all the other items already.

I’d love to hear if reading this has taught you anything or helped you to see just how important it is to understand your circadian rhythms if you want to have a consistently good night’s sleep. I’m also interested to hear if you will make any changes to your sleep schedule after reading this, and how much it helps if you do!

Is Your Sleep Pressure High Enough Each Night When You Go to Bed for Sleep?

Unless you are a sleep expert, you probably haven’t heard much about homeostatic pressure (sometimes referred to as sleep pressure). However, it is one of the main three underlying mechanisms that are essential to understand if you want to have consistently good sleep.

Homeostasis is a principle that explains how our body tries to maintain balance and equilibrium within all of our systems so that we can live a long and healthy life.

Homeostasis is both fascinating and annoying. Fascinating because it means that as humans, we are surprisingly resilient to the bad things that happen in our lives. Annoying because we get used to the good things in our lives rather quickly too. The excellent book by Dan Gilbert called ‘Stumbling on Happiness’ explains this well, as does his viral TED talk video ‘The Surprising Science of Happiness’.

Examples of Homeostasis in Action

TEMPERATURE REGULATION: Suppose we move somewhere that is hotter or colder than our natural environment. Our body will eventually adapt or acclimatise to this. In 2009, I spent four months working in London and saw people sunbathing in Hyde Park with very few clothes on during a 17 degree Celsius day. Then in August 2018, I moved to Vanuatu and saw people wearing jackets and beanies when it was 22 degrees Celsius in the evening. I never thought that I would have to wear a jumper in Vanuatu because of how much I was sweating initially, but sure enough, eight months later in Port Vila I was also reaching for extra layers to stay warm at night.

PAIN SENSITIVITY: Now let us imagine that you have a chronically painful back. If you have never taken any pain medication before, one Paracetamol or Ibuprofen tablet may be enough initially. However, very quickly, you may need two pills a day, and then four, then six, until it is no longer alleviating your pain or you are taking such high amounts that it becomes dangerous for the health of your internal organs. You switch to a stronger analgesic, maybe something with codeine in it, until you get used to that, and then turn to an opiate medication such as Tramadol or even Morphine. Eventually, either you are taking potentially life-threatening doses, or you are in excruciating pain. Through the process of homeostasis, you adapt and develop a tolerance to whatever you consume until it no longer has the desired effect that you want. Your brain is happy because it was trying to send you the pain signals for a reason, but you and your pain doctors are probably not.

PHYSICAL FITNESS: Exercise is the same. If we want to get fitter over time, we cannot just keep doing the same exercise routine week after week. We need to keep increasing the frequency, variation and intensity of our workouts over time so that our body does not fully adapt and continues to increase our strength and aerobic capacity. Our body’s drive for homeostasis means that eventually the same workout will require much less effort, burn fewer calories and fail to improve our overall ability.  We must change things up and challenge ourselves more and more.

METABOLISM: To lose weight, we cannot just reduce our caloric intake. Restrictive diets like these may lead to weight loss initially, but eventually, through the process of homeostasis, our metabolism slows, and the weight loss stops. If we then go back to eating what we used to, our weight climbs back up, usually to more than what it was before the diet initially began. Then homeostasis kicks in and increases our metabolism again, and our weight remains relatively stable unless we start eating a lot more or less. Things like intermittent fasting or the 5:2 diet have become the latest fads in weight loss because the variability makes it possible to lose weight over time without your body’s drive for homeostasis wrecking it or slowing down your metabolism. It gives your digestive system a much-needed rest at times too.

Homeostasis in Sleep

Our sleep system is similar to our temperature regulation, pain sensitivity, physical fitness and metabolism in that our brain and body’s drive to maintain homeostasis helps to regulate it. Homeostatic sleep pressure works to help us remain alert enough during the day to function and survive, and tired enough at night to sleep well, help process what we learnt that day, and restore our other bodily systems too. Just as it is possible to be too hot or too cold sometimes, or to eat too little or too much, it is also possible to spend either too little or too much time in bed.

Homeostatic pressure for sleep rises from when we get up in the morning to when we go to bed at night. The longer that we are awake for, the less quickly this pressure rises, but it does make it harder and harder for us to remain awake over time unless we get some sleep. When we nap during the day or fall asleep at night, our homeostatic pressure for sleep declines, with deep sleep (Stage 3 non-REM sleep) reducing the pressure faster than light sleep (stage 1 and 2 non-REM sleep and REM [rapid eye movement] sleep).  

If we spend too little time in bed, say under 6 hours regularly, we will not obtain enough sleep to erase our homeostatic pressure for sleep. As a result, our homeostatic drive for sleep increases over subsequent days to try to help us spend more time in bed so that we sleep longer. If we do not spend longer in bed, our brain instead works to help us sleep deeper and better, so that our pressure can drop more quickly each night. As a result, people who spend less time in bed are more likely to fall asleep quickly, have a good quality of sleep, and remain asleep during the night.

Sleep needs vary, but people who only spend 6 hours in bed each night will probably still feel both tired and sleepy during the day because their homeostatic pressure is likely to remain high. By spending more time in bed, say 8 hours regularly, they could still have good sleep quality and not feel as tired or sleepy during the day, because their sleep pressure is minimal in the morning and high enough at night.

It is hard to obtain enough good quality sleep if we spend too long in bed, say over 10 hours regularly. Most people with chronic insomnia do not realise this and spend longer in bed to try to get more sleep. However, all this does is reduce their homeostatic drive for sleep, resulting in a lighter and more fragmented sleep.

If you are already in bed for more time than you need to sleep, your homeostatic pressure is unlikely to be high enough, and your brain will not help you to sleep as much as you would like. By spending less time in bed, or looking at other ways to increase your homeostatic drive for sleep, you can ensure that it is high enough when you go to bed each night.

How can we ensure homeostatic pressure for sleep is low when you get out of bed in the morning and high when you go to bed at night?

If you want to increase your homeostatic pressure for sleep so that you sleep better at night:

  1. Aim to be up for at least 16 hours each day. You should maintain a regular wake time, even on weekends, and spend a maximum of 8 hours in bed each night.  
    • If you want to increase your sleep pressure even faster, increase your time awake each day even more (17 hours) and reduce your maximum time in bed further (7 hours).
    • The more extreme you make it, the faster your sleep pressure will rise, but try not to reduce your time in bed too far below your actual sleep need.
    • To figure out your sleep need, determine your average amount of sleep that you obtained over the past week. Then add 30 minutes to this for your initial maximum time in bed prescription.
      • If you have been sleeping approximately 6 hours a night for the past week, setting your maximum time in bed initially to 6 hours and 30 minutes is good.
      • If you have been sleeping under 5 hours per night over the past week, do not set your initial time in bed prescription any lower than 5 hours and 30 minutes per night, as this is likely to be unhealthy and unsustainable.
      • If you are not sure what your sleep need is, start with 8 hours in bed as your maximum, and aim to be up for at least 16 hours each day.
    • For every hour that you are up past your usual bedtime, you can sleep in beyond your ordinary wake time by 30 minutes the next morning. It will ensure that your homeostatic pressure is still high enough the next night when you go to bed.
      • If your regular to bedtime is 11:00 pm and rise time is 7:00 am, but you are out of bed until 1:00 am, do not panic. Just sleep from 1:00 am to 8:00 am.
      • If you are out until 2:00 am, make sure that you are up by 8:30 am. Out until 3:00 am, sleep until 9:00 am. Out until 4:00 am, sleep until 9:30 am. Out until 5:00 am, sleep until 10:00 am, etc.
      • The later you are out of bed past your usual bedtime, the more tired you will feel the next day. You will feel tired because you have slept less and not at your ordinary time, but following this rule will help you to get back on track with your sleep more easily the next night. 
  2. Do not nap during the day.
    • Napping reduces our homeostatic pressure for sleep, making it harder to get to sleep at your usual bedtime that night.
    • If you have to nap, keep it to under 30 minutes and before 4 pm, and set the alarm if you choose to have a nap so that you do not sleep more than 30 minutes.
    • If you do nap for longer than 30 minutes, go to that amount of time later than you usually do to ensure your pressure is still high.
      • If you nap for 1 hour, go to bed at 11 pm instead of 10 pm. If you nap for 90 minutes, go to bed at 11:30 pm instead of 10 pm. If you nap for 2 hours, go to bed at midnight instead of 10 pm, etc.
  3. Consume as little caffeine as possible.
    • Caffeine targets adenosine receptors, which reduces our homeostatic pressure for sleep.
    • If you have to have caffeine, make it weak, drink tea instead of coffee, or have it early in the day.
    • Caffeine has a half-life of approximately 4.5 hours, so 100mg (a regular cup of coffee) 9 hours before bed means that you will still have 25mg in your system when you go to bed that night. It will reduce your sleep pressure a little, or increase your arousal levels, which can also negatively affect sleep.  
  4. Engage in regular physical exercise and challenge yourself cognitively during the day.
    • The more we do physically and cognitively demanding tasks, such as exercise or practising new skills, the higher our need for sleep will be that night.
    • Because exercise and learning new skills places a certain amount of stress on our body and brain, do not do heaps more than usual. It is better to gradually build up over time and slowly do more and more than we have previously done.
    • It is also crucial that we do not engage in rigorous exercise or hugely demanding tasks too close to our usual bedtime. Aim to finish anything too cognitively or physically demanding at least 3 hours before your bedtime, or go to bed a bit later than usual if you have to do these things later than you would like to. Having effective strategies to wind down and relax quickly can also assist if you need to do these tasks shortly before your usual bedtime.

If you want to reduce your homeostatic pressure for sleep in the morning or during the day so that you feel more alert or energetic during the day:

  1. Sleep longer.
    • A good rule to remember is that 1 hour of sleep reduces approximately 2 hours of homeostatic pressure. If we sleep longer, our sleep pressure will be lower, and we are likely to feel more alert and more capable of functioning. I recommended this only if you are currently not spending enough time in bed to meet your sleep needs.
    • Be aware of sleep inertia, though. It is normal to feel a bit tired or drowsy when you first wake up, especially if you have been in a deep sleep. It can take anywhere between 1-3 hours before someone feels fully alert in the morning, so if you have already reached your maximum allotment of sleep for that night, try to get up and see how you feel a bit later, rather than hitting the snooze button or turning off your alarm and going back to sleep.
    • The more you sleep in beyond your usual time, unless you went to bed later the night before, the later you will need to go to bed that night to ensure that your sleep pressure is high enough for a good night’s sleep.
  2. Have a power nap.
    • If you are feeling sleepy and not functioning well, have a short 15-20 minute nap.
    • It could increase your alertness and productivity for the rest of the day and is unlikely to cause sleep inertia when you wake up because you have only had a light sleep.
    • It is also unlikely to lower your sleep pressure to the point where you will not be able to get to sleep that night.
  3. Have caffeine at the right time for you.
    • Our body naturally produces cortisol at higher levels in the morning shortly after we wake up to help us become more alert and get going for the day. Caffeine also boosts our cortisol levels. Often known as the stress hormone, cortisol helps if our stress levels are too low and we feel apathetic, unmotivated and unproductive.
    • If our cortisol is already high, adding caffeine at this time can make us overstimulated, anxious or irritable in the short-term, or reduce the natural levels of cortisol that our brain releases in the long-term (because of our brain’s drive towards homeostasis), making us more reliant on caffeine to be productive.
    • Rather than having caffeine at the same time every day, have it only when you are feeling sleepy, as it can reduce homeostatic sleep pressure by acting on adenosine receptors in the brain. The times when you may most need it are around 9-10 am to help you make it through to lunch, or about 2-3 pm, to help you make it through the post-lunch dip and up until the end of the workday, assuming you work a regular 9 am- 5 pm job.
    • Shift workers and night shift workers also need to realise what times it is best to take caffeine so that they can function during their shift and get home safely without it negatively disrupting their sleep.
  4. Other substances could assist with alertness and energy during the day, such as Guarana, Ginseng, Gingko Biloba, Taurine, B vitamins, especially vitamin B12 if you do not regularly eat meat. So could prescription medications such as amphetamine-based medications (Ritalin), Modafinil or Armodafinil.
    • I do not recommend or prescribe any of these substances and do not know how they act on our homeostatic drive for sleep. For more advice, please see a medical doctor.
    • Modafinil and Armodafinil do seem to reduce people’s need for sleep based on self-reporting that I have heard, but the Pharmaceutical Benefits Scheme in Australia only endorses these prescription medications for the treatment of Narcolepsy. In the USA, you can also get these medications if you have excessive daytime sleepiness associated with OSA or shift work.
    • If you think you may have excessive daytime sleepiness due to OSA or another Primary Sleep Disorder or may suffer from RLS, Idiopathic Hypersomnia or Narcolepsy, please seek a referral to a Sleep Physician from your General Practitioner for a full assessment. The Sleep Physician can then determine if these medications could be useful for alleviating your daytime difficulties without negatively affecting your sleep at night.

Although it may be difficult to sleep well with all that is going on around the world at the moment, good sleep is still possible. This article goes into one of the three main things that you need to know to sleep well on a regular basis. Managing your stress or arousal levels effectively is another aspect that you really need to learn how to manage if you want to sleep well consistently. I will introduce the third element to you soon. Stay tuned.

The Pro Athlete’s Checklist for Optimal Performance: Part Two

This is the second part of a two part series exploring a checklist that professional athletes can go through to ensure that they are performing at their best.

Part One covered the mental aspects that are important to consider while training for an upcoming competition and preparing yourself right before an event. If you haven’t read it yet, I recommend checking out that article first.

Part Two will now cover the aspects you need to consider to perform at your best during a competition, and how to reflect and learn the most after the event has finished.

woman jumping with ball

When Competing in an Event

  1. Do you know how to get into a state of flow? [_]

The flow genome project has a 10 question survey that helps you to understand how you best find flow or get “into the zone”. My flow profile result said that I was a hard charger:

A hard-charger: You’re a focused go-getter. You thrive in intense situations, both personally and professionally. You seek out challenges. You lead a high-impact lifestyle. When you set out to learn a new skill, you look for training from the best and brightest in that field. If such training is not available, you hunker down and focus until you’ve figured it out yourself. Either way, “slow and steady” progress is not what you’re after.

The same intensity that fuels your drive and focus also feeds a relentless inner critic. One that ceaselessly pushes you to raise the bar. For you, the Flow State offers a rare escape from the relentless tallying and scoring of yourself against your own ideal goals and past performance. When you find activities that allow this blissful calm and relief, you make them a priority in your life.

Flow Hacks: Hard chargers gravitate towards adventure sports. Skiing delivers the intensity you seek. You favour non-traditional, off-the-beaten-path travel. You’re less interested in itineraries than you are in cultural immersion.

Pro-Tip: As a Hard Charger seeking flow, you may lose sight of the trade-off between risk and reward. Make sure you always stay on the recoverable end of that equation. Rather than pursuing bigger and faster, try going more in-depth. Slow down. Take time to develop discipline and to understand all your pursuits have to offer. It’s typically a lot more than thrills. Develop skills instead of seeking challenges. If you’re already hucking off 20-foot cliffs on Alpine skis, try a different approach, like telemark skiing. If you’re surfing big waves, try stand up paddleboarding. You might also benefit from mindfulness training.

Check out the website, take the quiz, and see what can help you to best get into a flow-state on a more regular basis.

  1. Do you have a clear objective? [_]

A clear objective is something that you can focus on that is within your control that if you do well will help you to win. In the excellent book ‘The Inner Game of Tennis’ by Timothy Gallwey, he said that tennis only has two requirements for success. The first requirement is to hit each ball over the net and the second is to hit each ball into the court. What are the requirements for success in your sport, or the essential things for you to keep your focus on during a game or performance?

  1. Are you able to observe what is going on so that you change things if they are not going right? [_]

How do you know if things are not working for you while competing? Is it that you are not focused on your objectives or you are easily distracted or irritated by less important things? Is it that you are in your head too much and not in your body or the zone enough? Is it that things don’t feel quite right? Is it that you feel too physically tense or your worries are getting the better of you? Is it that you are making mistakes or losing?

To me, being able to observe well is to first become clear of what my point of focus or objective is going to be during the game, then notice as soon as possible when my focus is no longer on this objective, and then gently bring my attention back to this without getting frustrated with myself for becoming distracted.

  1. Are you able to let go of judgment so that you are in your body and connected with your senses rather than caught up in your head or lost in your thoughts? [_]

Being non-judgmental of your performance and having trust in yourself and your body and your capabilities are some of the keys to staying in the zone or getting back into it during competition.

The more that you are caught up in judgmental thoughts, the more you will worry, the tenser you will become, and the more your performance will suffer. If you notice yourself being judgmental or self-critical, treat these thoughts just like you would any other unhelpful thought – challenge them, or try to let them go.

  1. Can you keep your focus on what’s most important and know how to minimise or block out distractions or worries? [_]

Whenever you find that you are distracted or worrying too much about things during a game, first take one slow, deep breath. Then accept that you have been distracted or worried without judging yourself. Remind yourself that these things are traps and are not helpful, then put all of your focus back onto your clarified objectives from #2 above. Try to be patient and trust that things will be better the more you try to immerse yourself in your movements and the game rather than worrying about what others are doing or saying, including your own mind.

  1. Do you know how to cope with adversity if you are not playing as you hoped or you are losing by more than you expected to be? [_]

When things aren’t going how you have planned, call a time out if possible and re-centre yourself. Select a focal point in the distance below eye level. Form a clear intention of what you aim to do, whether that is stick to the plan or make needed adjustments if the plan isn’t working. Breathe slowly and deeply, and release your muscle tension if you feel tight anywhere. Then find your centre of gravity and ground yourself with where you are and what you are doing. Have a process cue that you can say to yourself in these moments to re-focus on your objectives, and then try to channel all your remaining energy into these objectives and inspired performance.

  1. Do you know how to peak under pressure and still perform at your best when the game is on the line? [_]

Try not to overthink things too much. Although this is easier said than done, remember how much hard work you have put in during practice, and trust that your muscle memory will know what to do in the crucial moments. If you worry that you tense up or worry too much under pressure, remind yourself of times that you performed at your best in the past and visualise how your body was during these times. Try to channel this and see if you can have fun, enjoy the moment, and give 100% to the performance. You won’t regret it if you know that you have applied yourself as much as you could towards the important things that were within your control.

grayscale photo of man at the finish line of a marathon race

After the Competition or Event

  1. Have you spent some time reflecting on how you felt your performance was? [_]

How do you normally feel after an event? Relieved? Disappointed? Happy? Sad? Whatever it is, spend some time just sitting with your feelings about your performance, all the hard work that you put into the lead up to the event, and how you prepared for the event. Do you feel grateful and appreciative of all the hard work you put in, or dissatisfied, knowing that you could have done more or better or pushed yourself harder?

  1. If you performed at your best, do you know what was it that you did that helped you to perform so well? [_]

If you managed to get into a flow state or were in the zone while competing, even if it was only for part of the time, do you know how you did it?  If you smashed your opponent and felt super confident and unbeatable, how did you do it? Do you know how you could replicate these things again next time?

  1. If you did not perform at your best, are you aware of what triggered the poor performance, or what traps you fell into? [_]

Let’s say you under-performed and did much worse than expected. What happened? Was it an issue with your training or your preparation, or was it purely what went wrong during the competition? Do you know how to make sure a similar outcome doesn’t happen again next time?

  1. Are you reflecting on your performance too much? [_]

Reflection doesn’t need to take any longer than 30 minutes, so if you find yourself continuing to stew over what has happened, especially in a self-critical way, you might be ruminating rather than reflecting.

  1. Regardless of how well you performed, have you written down three things that went well, either for you or the team? [_]

Writing this down will help you to remember that it wasn’t all bad and reinforce the positive. Even if you are bitterly disappointed, what did you or other people in your team do that went according to plan or better than expected? If it is what you did, give yourself some acknowledgment or a pat on the back.  Even though it didn’t quite work out how you wanted it to, you still put in so much hard work and effort and deserve some acknowledgment for that. If it’s what your teammates or coaches did, make sure you let them know when it is appropriate.

  1. If you made any mistakes, have you written down up to three things that you could do differently next time to overcome these mistakes and improve your performance next time? [_]

Even if you performed amazingly or won the event, was there anything that you could have done better? What will help you to shave an extra-millisecond off your time, or turn the ball over less, or take higher-percentage shots? Whatever it is, write it down so that you don’t forget what you can do keep improving and growing and getting better over time.

  1. Have you written down anything else that you would like to focus on that is in your control that you think will increase your likelihood of success next time? [_]

Things that you may want to write down include:

  • a different plan for training?
  • a different plan for pre-competition?
  • a different plan for during the next performance?

If you are not sure of what else to write after the 30 minutes of personal reflection, make sure that you also talk to your teammates and coaches about your performance. Others may be able to pick up on different things than you could. Maybe they saw things that you did not. They might also be more objective than you were about your performance too, especially if your emotions were high in the heat of the moment. If someone filmed your performance, watch it back with your teammates or coaches if possible. Ask for feedback, and then write down the essential points that you know you could improve. Only give your teammates honest feedback if they ask for this too. Then come up with a plan with everyone for how you can all address these issues together before the next event.

How many checklist items do you usually do? If it’s not many, are you willing to try and implement a few more of these steps by your next competition? If you do, I’d love to hear about how much it helps. Keep up the great work, and all the best in your athletic endeavours!

 

Dr Damon Ashworth

Clinical Psychologist

 

 

 

The Professional Athlete’s Checklist for Optimal Mental Performance: Part One

My last sports psychology article covered 21 strategies that you can apply to improve your sporting performance. If you struggle to cope with adversity, remain free from worry, tend not to peak under pressure, get offended by what your coaches say to you, or struggle to focus as much as you would like to, I highly recommend checking that article out first.

One question that I had when I shared these skills with the Vanuatu Women’s Beach Volleyball Squad was “What skills do I try to learn first?‘ Another question was “When exactly do I try to apply them?” These are both great questions, as I don’t want anyone to overthink what they are doing too much, especially during a significant competition.

This article and the next one will try to answer both of those questions. Firstly, if you already cope well with adversity or peak under pressure every time, don’t even bother trying to learn new skills. Just keep doing what you are already doing, because it is working. If you have poor concentration and goal setting skills, however, then do focus on learning the strategies that I have recommended and see if they work for you.

Now onto when to apply these skills. Below is a checklist that I have created to see if you are already doing everything that you need to do for optimal performance. This article goes into training for an upcoming event and before the competition. The next blog post will cover what is helpful to know how to do both during competition and afterwards.

woman holding two ropes in gym

Training for an Upcoming Event

1. Are you training/ practising enough to improve as quickly as you would like to? [_]

If you notice that you are not growing as much as you hoped, it is important to look both at the frequency (how often you practice), duration (how long you practice for) and the intensity (how hard you practice when you do) to know if one or all of these variables need to change. You can assess this yourself or figure it out with your coach or trainer.

2. Is your practice deliberate enough? [_]

You must have specific objectives for each training session and each week. It is also essential that you have particular skills that you are trying to improve with each activity you do that aims to help you to meet these objectives.

3. Do you have baseline measurements of all the key things you want to improve and are you tracking your progress with these measures? [_]

If you have not conducted a baseline assessment of your skills or the things you want to improve, it will be tough to know how much progress you have made. Baseline measurements could include your weight, vertical jump, flexibility, 40m dash, reaction time. Whatever aspects you and your coach want to improve, figure out a way to assess them and keep track of your progress concerning these things as you train and prepare for a competition. Then you will know if you are on the right track with your training or will need to switch things up.

4. Are you over-training and not giving your body enough time to recover between practice sessions? [_]

Load management is all the rage in the NBA these days. Wilt Chamberlain used to play 48 minutes a night for a whole season at his prime, never subbing out. Now some of the stars will sit out the second night of a back-to-back set, as teams have realised that playing two nights in a row increases their risk of injury. Signs of over-training may include mental exhaustion, muscle fatigue, impaired motivation and concentration and reduced performance. If you are experiencing these things or are concerned that you are overdoing it, talk to your coach, reduce your workload for a bit, and see what happens. If your symptoms go away and your performance improves again, you will know that you are on the right track.

5. Are you eating healthily and enough for your training objectives? [_]

Fresh vegetables and fruit and good sources of protein (fish and lean meats) and fats (eggs, nuts, avocado, some oils) and whole-grains are generally considered healthy. Anything processed or deep-fried or too sugary or salty is not considered very healthy, and having too much caffeine and sugary drinks isn’t recommended either, but there are sport-specific recommendations that nutritionists can provide also. If you are burning an extra 3,000 calories of energy a day in your workouts, you will need to eat more and may require more carbs than an athlete who is only burning an extra 200-500 calories a day.

6. Are you getting enough sleep and rest? [_]

The average adult needs 7-9 hours of sleep, with more sleep than usual needed after strenuous and extended training sessions. In between training sessions, try not to always be on the go either. Give yourself enough downtime for leisure, fun, socialising, relaxation and recovery.

7. Are you practising mindfulness meditation daily? [_]

Even 10 minutes a day can significantly improve concentration abilities during practice and competitions. Some people prefer doing it first thing in the morning. Others prefer last thing at night. Whenever you think you could consistently do it, set a reminder on your phone, have a meditation app (e.g. headspace, smiling mind, calm, buddhify etc.) that can guide you through a meditation, and then do it at the same time every day for at least three weeks. Once it becomes a habit, you won’t regret that you have started to do it and built it into your daily routine.

8. Are you aware of unrealistic and unhelpful thoughts, and do you practice challenging them or letting them go? [_]

There are two ways that we can successfully manage unhelpful thoughts. Firstly, we can try to challenge and change them, which is a CBT (cognitive behavioural therapy) strategy. To do this, notice what you are thinking. Ask if it is a realistic or a helpful thought? If it not practical or desirable, ask yourself what ideas might be more useful to have. Then every time you have the initial thought, try to remind yourself of the more suitable replacement thought instead. Secondly, sometimes it is not the thought that we have that is problematic, but how much we get caught up in the idea or fuse with it.  Each time you notice you are too fused with a thought, aim to create some distance or let it go using defusion skills, which is an ACT (acceptance and commitment therapy) strategy. Imagine the belief in a different colour or font, or said in a funny voice, or put it on a cloud and let it float away. Both thoughts challenging and defusion can be helpful for people, so see which strategy you like best, and then apply it whenever your thoughts are impairing your performance during training sessions.

9. Are you practising in ways that simulate the conditions and pressure you will experience during the event? [_]

Andre Drummond was an awful free throw shooter in basketball games in his first few NBA seasons, making much less than half his shots. Yet, in training, he could make 9 or 10 out of 10 regularly. If this is similar to you with a skill that you do well in training but poorly during events, experiment with the stakes during practice to make it more game-like or have more on the line. Every missed free-throw at training might equal two laps of running around the court or 20 pushups.  It would mean that the athlete may tense up a bit more, meaning better preparation and more practice for tense in-game situations.

10. Are you also allowing yourself to have fun, experiment with skills and play games? [_]

Extreme athletes like skateboarders and freestyle skiers don’t always practice deliberately, especially not the athletes who started the field. They improved their skills by doing what they loved, playing around with their friends, and challenging each other to push their boundaries and see what is possible. So even though deliberate practice is the best way to improve specific skills, getting into a flow state and not thinking about things too much is the best way to improve performance. Don’t forget to have fun, play around, push yourself just outside your comfort zone, and see what happens.

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Before a Competition

1. Do you have a consistent pre-competition ritual? [_]

Before games, I try to have a low-GI carb-heavy meal the night before, get 8 hours of sleep if possible, get up at my usual wake time, eat protein shortly after waking, and not have too heavy a meal too close to competition. I pack my bag with all the things I need, arrive at the stadium about an hour before the game. I then warm up a little bit by myself. After this I stretch and listen to music that helps me to get pumped up and focused. I then discuss the game plan with my team and coach. We then all go out as a team and warm up together before the introductions and the game begins.

2. Does it help you to perform at your best regularly or allow you to get into the zone quickly? [_]

If your pre-game ritual doesn’t help you to perform at your best, see what you can do to shake it up. Maybe get there earlier than you usually do. Find a quiet spot. Bring headphones and do a 10-minute meditation. Practice a few easy skills to fire up your muscle memory and boost your confidence. Listen to music and focus on your objectives for the day. Visualise yourself doing the moves you want to do and being successful doing this. Add something in that you don’t usually do, or take something out that you don’t think is helping, and see what the result is. Over time, you’ll know what helps and what doesn’t, and what to do more before a competition.

3. Do you know what type of environment is most helpful for you to prepare yourself before the competition? [_]

Some people are more extroverted and like to be around people, socialising and connecting and laughing and having fun. Others are more introverted and like space from others and quiet. Experiment with this before competitions, and soon you’ll know what environment is best for the significant events.

4. If the ideal environment is not available, do you have a back-up plan of what you can do? [_]

Let’s say you prefer space and quiet, but there are no change rooms around, and you need to remain by the side of the court. You may need noise-cancelling headphones or other things that can still take you away from where you are a bit so that you can focus and do your pre-game ritual and get into the zone for when the competition begins,

5. Are you aware of your arousal level before a game? [_]

Think of this as a scale from 0 to 10, where ten is overwhelmed, anxious and panicky, and zero is as relaxed as you can be. Check in to your physical symptoms and give yourself a score from 0 to 10.

6. Do you know what arousal level is ideal for you at the start of the competition? [_]

If you compete in a sport where precision is critical, you may want to be at three or a four. If you need to be aggressive and reactive, like in boxing or American football, it may be better to be at eight or nine. Once you know what number you are at, determine if you need to increase it or decrease it for it to be ideal for the event.

7. Do you know how to pump yourself up if you are feeling apathetic, lazy or tired? [_]

Let’s say that your arousal level is at a one or two and you need it to be at a six, what can you do to pump yourself up? Do you need some caffeine or sugar or an energy drink? Do you need to jump around to get your lymphatic system flowing? Do you need to watch motivational videos or listen to a pump-up music soundtrack? Do you need to remember your values or goals, or why you put in all the hard work at training or why you love the sport? Whatever you decide to try, give it a go, and if it works, repeat it next time. If not, move onto something else.

8. Do you know how to relax if you are feeling too overwhelmed, worried, stressed or anxious? [_]

Let’s say you are at nine or ten and want to be at five or six. There are thousands of spectators ready to watch you. You start to worry that you are feeling too anxious and tense and won’t perform well as a result. Try to re-frame this anxiety as excitement. Remind yourself that being pumped up means more oxygen to the limbs, which can help you to run faster, jump higher, put in more effort. Then if your arousal level is still too high or you are worrying too much, ground yourself. Look at what you can see, hear, touch, taste and smell. Remind yourself that you are safe and there is no danger. Take some slow deep breaths and put your focus on one thing at eye level in the distance. Tense your muscles, breathe in, then release the tension as you breathe out. Stretch nice and slowly. Remember the objectives that you want to focus on that are within your control and think back to times when you have successfully done this. Remind yourself that you can do this, exhale all the air, and then go out there and give it all. People don’t tend to regret losing as much when they know they have given it their best!

part two is now up

 

Dr Damon Ashworth

Clinical Psychologist

My 8 Easy Guidelines for Improved Sleep

My Sleep Research

Being part of an innovative sleep research team was what led me to do my Doctorate of Clinical Psychology at Monash University. Professor Shantha Rajaratnam is a world-leading expert in Chronobiology and has received major grants for his research. His results have been published in excellent journals, and I knew that I wanted to learn from his expertise.

Given the difficulties that I had faced with my sleep, I wanted to help people function as effectively as possible during their waking hours, and sleep as efficiently as possible at night. Shantha encouraged me to look at the relationship between insomnia and depression, and see how we could help individuals who were suffering from both conditions.

Up to 90% of individuals with Depression suffer from sleep difficulties, and 67% have significant enough problems with their sleep to warrant an additional diagnosis of Insomnia. Insomnia is considered a chronic problem after only one month and unfortunately doesn’t tend to go away on its own without treatment.

Interestingly, Insomnia usually precedes the onset of Depression, and can actually bring on Depression or trigger a relapse if it persists. Sleep difficulties, therefore, need to be directly treated for optimal Insomnia and Depression outcomes.

This is what our research found. By targeting sleep through four sessions of Cognitive Behavioural Therapy for Insomnia (CBT-I), we were able to significantly reduce both Insomnia and Depression severity across the treatment and by three-month follow-up in comparison to a control group. The control group were given the same information about how to improve their sleep but were unable to talk with a qualified therapist trained in CBT-I about their personal sleep difficulties. CBT-I participants were ten times more likely to be in remission from both their Insomnia and Depression by the follow-up, indicating a much lower risk of relapse.

Other research shows that CBT-I consistently reduces the time taken to get to sleep, decreases the amount of time spent awake during the night, and improves sleep quality and efficiency, with improvements persisting after treatment finishes. This is unlike sleeping pills, which typically lead to rebound Insomnia and ongoing sleep difficulties once they are discontinued.

CBT-I is similar in effectiveness to sleeping pills for Insomnia in the short-term and much more useful than sleeping pills in the long-term. It is, therefore, concerning to see that nearly 90% of individuals who go to GPs with Insomnia complaints are given sleeping pills over a referral for CBT-I. Sleeping pills (typically Benzodiazepines such as Temaze or Valium) are not recommended for use beyond 2-4 weeks at a time, and recent research even links long-term Benzodiazepine use with a higher risk of premature cognitive decline.

Hopefully, the awareness of CBT-I as an effective alternative to sleeping pills will continue to increase, but please pass the message on to whoever you know that may be suffering from Insomnia. Even one session of CBT-I was recently shown to significantly improve Insomnia that had been occurring for less than one month. The more people ask for CBT-I referrals, the more doctors will become aware of this effective treatment and/or feel more comfortable in referring patients for this treatment, and the less our society will be impacted by Insomnia, Depression, and dependence on sleeping pills.

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What I Did to Improve My Sleep

By learning what I did through my research and CBT-I treatment, I began to make the following changes to my routine. These steps slowly started to make a huge difference in my sleep, fatigue, alertness and concentration:

#1: I reduced the variability in my sleep from day to day.

I now sleep consistently between 11:30pm and 6:30am, give or take an hour on each side (sleep onset usually between 11-12 and rise time between 6-7am), even on weekends. There are some rare exceptions when I stay up later, but I always make sure that I get out of bed no later than 8:30am, so that I don’t push back my circadian rhythm further. I also never spend more than 8 hours and 30 minutes in bed, and usually, find that 7.5 hours in bed is more than adequate to feel energised and refreshed during the day.

#2: I cut down on caffeine, especially in the afternoons.

Anything under 300mg daily is fine for me, and usually doesn’t noticeably impact my sleep at night. However, it is still much better for me to eat healthily, drink plenty of water, take regular breaks, and get outside and exercise if possible when I am feeling tired. By drinking caffeinated beverages or eating high sugar or high-fat foods and pushing through my fatigue, I was elevating my arousal levels during the day and making it more difficult for me to switch off and sleep well at night.

#3: I stayed away from bright screens in the last two hours before bed, and stopped doing work if I had any at this time too.

By doing this, I helped my brain identify that it was night-time, and my melatonin production began earlier and helped me feel sleepy and transition to sleep more effectively. Looking at bright screens before bed can suppress melatonin release by as much as 22%, and lead to later sleep onset, reduced sleep duration and poorer sleep quality.

#4: I tried to seek sunlight exposure when possible in the mornings.

This helped my brain identify that it was daytime and helped increase my energy levels and alertness, which meant that I could concentrate better during the day. For individuals with DSPD, timing is everything, so it is essential to discuss with a Sleep Physician the exact times that light exposure should take place for optimal alertness and phase-shifting benefits.

#5: I exercised regularly during the day, but not in the three hours before bed when possible.

By doing this, it increased my energy levels and alertness during the day, lifted my mood, reduced my stress and anxiety levels, and improved my sleep pressure for that night. I then felt more tired and ready for bed at around 11:30pm when I wanted to go to sleep.

#6: I made sure that I did things to wind down and relax before bed each night.

This typically took place in the last two hours before bed. Activities varied between chatting with friends or family that I felt calm around, reading a book, engaging in a creative task, listening to a podcast or music, having a hot bath (but not right before bed), or practising relaxation exercises or mindfulness meditation. It is essential to do anything that can reduce arousal levels before bed and can help bring on feelings of sleepiness earlier. As soon as I experienced these signs of sleepiness (eyes or body feeling heavy, losing focus, yawning), I went to bed, assuming that it was around 11:30pm.

#7: Once in bed, I didn’t force myself to sleep.

I allowed it to occur on its own and tended to focus on positive experiences that went well for me during the day or things that I was grateful for instead. I sometimes practised imagery and imagined myself lying on a beach or hiking in the mountains. If that didn’t work, I returned to mindfulness meditation or relaxation exercises and focused on keeping my breath slow and deep and exhaling all of the air with each breath. Before I knew it, I was usually asleep. I sometimes woke up occasionally during the night but had minimal difficulty in returning to sleep if I did.

#8: I ignored sleep inertia.

One of the biggest traps for individuals with DSPD is judging how they’ve slept or if they need more sleep immediately upon awakening. Given that I was typically waking up before my body clock wanted me to, I almost always felt tired immediately upon awakening in the morning and would have no difficulty hitting the snooze button or resetting my alarm for later and returning to sleep. I used to do this a lot before I knew about sleep inertia, and even after two more hours of sleep I would still feel the same way upon awakening. Now I get up no matter how I feel when the alarm goes off, shower and have breakfast or go to the gym, and then review how I’m feeling. By delaying my judgment, it becomes a much more significant indication of how well I’ve actually slept and how I’m likely to function for the remainder of the day. I typically feel energetic and less fatigued during the day and am able to pay attention to whatever it is that is most important to me in each moment. Even without the extra sleep.

I hope that you find some of my personal strategies helpful. If you are struggling with sleep difficulties, change one thing at a time where possible, try it for a week or two, see if it makes a difference to your sleep or how you feel during the day. If it helps, keep it up, and then introduce another change if needed.

Once your sleep is better, it is vital to introduce some flexibility so that you don’t become too preoccupied with needing all of the right conditions to be able to sleep. Good sleepers will tell you that they do nothing to sleep well and could sleep almost anywhere under any circumstances if needed, so it is essential to try to relax where possible and not over think it.

If you have tried many things, but your sleep isn’t getting any better, please seek a referral to a Sleep Physician or a Psychologist who is trained in CBT-I. They will be able to help you understand your sleep difficulty more, let you know if there is any possible underlying condition that may be making your sleep difficulties worse, and give you individualised instructions based on validated research. By putting into practice the strategies that have been shown to be the most effective treatments for the sleep condition(s) that you have, you are giving yourself the best opportunity to become a good sleeper (again, or for the first time). It has worked for me and thousands of others, and it can work for you too!

Thanks for reading! If you would like a personalised sleep report and the five things that you could do to best improve your sleep, please check out our services.

 

Dr Damon Ashworth

Clinical Psychologist

20 Fascinating Paradoxes About Life

What is a Paradox?

According to the Oxford dictionary, a paradox is a noun that has two meanings:

1. A seemingly absurd or contradictory statement or proposition which when investigated may prove to be well founded or true.

2. A person or thing that combines contradictory features or qualities.

I love paradoxes because they are sometimes funny and usually also quite insightful. Listening to the audiobook version of the Tao Te Ching by Lao Tzu was like listening to one paradox after another. This was especially surprising to me, because it is an ancient book of wisdom. So a great paradox is much more than just a cliche, even though it can appear like that over time.

Below is a list of some of my favourites, starting with one from the Tao Te Ching:

  1. New beginnings are often disguised as painful endings” – Lao Tzu

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2. “Who you are speaks so loudly I can’t hear what you’re saying.” – Ralph Waldo Emerson

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3. “I’d rather be hated for who I am, than be loved for who I am not” – Kurt Cobain

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4. “I refuse to join any club that would have me for a member.” – Groucho Marx

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5. “You know what the issue is with this world? Everyone wants a magical solution to their problem, and everyone refuses to believe in magic.” – Alice in Wonderland

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6. “I am the wisest man alive, for I know one thing, and that is that I know nothing.” – Socrates

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7. “Yesterday I was clever, so I wanted to change the world. Today I am wise, so I am changing myself.” – Rumi

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8. “We judge ourselves by our intentions and others by their behaviours.” – Stephen Covey

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9. “If you don’t risk anything you risk everything.” – Mark Zuckerberg

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10. “The more we do, the more we can do; the more busy we are, the more leisure we have.” – William Hazlitt

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11. “Only you can take responsibility for your happiness…but you can’t do it alone. It’s the great paradox of being human.” – Simon Sinek

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12. “If you try to fail and succeed, which have you done?” – George Carlin

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13. “Seek freedom and become captive of your desires. Seek discipline and find your liberty.” – Frank Herbert

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14. “Nowadays most people die of a sort of creeping common sense, and discover when it is too late that the only things one never regrets are one’s mistakes.” – Oscar Wilde

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15. “Whatever you do will be insignificant, but it is very important that you do it.” ―Mahatma Gandhi

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16. “He who fears he shall suffer, already suffers what he fears.”― Michel de Montaigne

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17. “A lot of people never use their initiative because no-one told them to.” – Banksy

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18. “If someone doesn’t value evidence, what evidence are you going to provide to prove that they should value it? If someone doesn’t value logic, what logical argument could you provide to show the importance of logic?” ― Sam Harris

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19. “Let go of certainty. The opposite isn’t uncertainty. It’s openness, curiosity and a willingness to embrace paradox, rather than choose up sides. The ultimate challenge is to accept ourselves exactly as we are, but never stop trying to learn and grow.” Tony Schwartz

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20. “If you don’t get what you want, you suffer; if you get what you don’t want, you suffer; even when you get exactly what you want, you still suffer because you can’t hold onto it forever. Your mind is your predicament. It wants to be free of change. Free of pain, free of the obligations of life and death. But change is law and no amount of pretending will alter that reality.” – Socrates

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Dr Damon Ashworth

Clinical Psychologist