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Mental health and wellbeing: Looking after yourself

There are a range of simple steps that you can take to improve your overall wellbeing. Different approaches can help different people. Some you may love, some you may hate but they are worth a try, and may surprise you.

Sometimes being able to take a helicopter view of your life can help bring perspective (try the Wheel of Life or Wheel of Wellbeing described below). Taking proactive steps to wellbeing may be helpful (try NHS Moodzone). These might include trying different approaches to self-reflection (such as journaling or the 55-word story).

Our blogs, written by doctors, explore different areas that may help you to stay well, such as increasing your physical activity and paying attention to how you sleep.

Wheel of Life

A Wheel of Life example, adapted from Real Balance

Used by life coaches, the Wheel of Life can help you to take a ‘helicopter view’ of your life. This simple exercise gives you a visual representation of how you currently live your life. It can help to highlight which areas of your life may be out of balance, in need of more attention or some additional support. It can be done as part of an iterative self-assessment process, revisiting it after taking action in one or more domain, or as a stand-alone exercise to provide a snapshot of how your life looks at the moment.

Importantly, this tool also allows you to identify and celebrate the areas of life that are balanced or even thriving and subsequently draws attention to the actions that may be necessary to maintain this. The Mind Tools website includes a guide on how to use the Wheel of Life and has a downloadable template.

Keeping this bird's-eye view of life can help to maintain perspective when ups and downs are experienced in the different dimensions of life. Being aware of the way in which the domains are interconnected can minimise the impact that stressors and challenges can have on your overall wellbeing.

Why not try it?

The Wheel of Wellbeing (WoW)

www.wheelofwellbeing.org is an online resource providing tips and strategies for exploring and improving wellbeing with separate sections for ‘yourself’, ‘community’ and broader policy development. The WoW reiterates the holistic nature of wellbeing and allows you to explore different dimensions one at a time.

5 steps to mental wellbeing

The NHS Moodzone describes simple steps that you can take day-to-day to improve your overall wellbeing. Exploring this website leads to resources and links related to the 5 steps to mental wellbeing described below, including signposting to helpful services.

  1. Connect with the people around you (inter-connectedness). A growing body of evidence suggests that time spent developing relationships with the people in your life contributes to overall better wellbeing.
  2. Be active. Being physically active benefits overall physical health, but is associated with lower stress levels, sense of community, improved self-esteem and accomplishment.
  3. Keep learning. Learning something new can help to develop skills potentially transferable to work, provide a sense of achievement and opportunity to meet new people.
  4. Give to others. The World happiness report 2019 explores the importance of pro-social behaviours while at the same time recognising there are some important limitations to the benefits on individual mental wellbeing particularly relevant to those of us working in large-scale healthcare systems.
  5. Be mindful. Mindfulness involves focusing on and living in the present moment, acknowledging and accepting the associated range of emotions. Apps such as Headspace and Calm can help you to develop these habits.

Encouraging reflection

Any form of journaling/self-reflection can be extremely valuable.

Think about different ways to do this, such as:

  • writing a letter to your childhood self
  • writing down positive affirmations of what you would be doing if your life looked better. For example, I am walking my dog on the beach. I am joyfully walking my dog on the beach

55-word story

Noticing, reflecting and healing – writing as a contemplative practice.

The 55-word story is a thoughtful and simple reflective exercise you can use to capture the essence of an experience – when a moment touches you, surprises you, inspires you, worries you.

It can be used for self-care, journaling, team support, debriefing etc.

Dr Emma Vaux said, 'I discovered this recently at a workshop at the ICRE and was very cynical of its application. By the end of 45 minutes I was captivated by this approach. There had been something worrying me about a patient and I was having difficulty processing it. I used this experience to write my 55-word story.'

The process: Take 25 minutes to write – write as many words as you like for 15 minutes without editing; then take 10 minutes to remove any unnecessary words until you get to 55 words. Take notice that there is a difference between the narrative form and the 55-word story.

Here’s Emma’s 55-word story:

A time to stop

‘I’m going to stop haemodialysis’. ‘My wife has left’. His brain tumour operation may mean he cannot work anymore. He is a proud man. I have nothing. I feel a sense of helplessness. How do I give this man hope, a sense of future beyond platitudes? I find I can’t; just to say he’s loved.

Narrative form

On a Monday evening I visited a man with a brain tumour on haemodialysis. He told me that he was going to stop dialysis.

Emma summed up her reflections on the process: ‘I found writing a 55-word story extraordinarily powerful. It allowed free thinking, I liked the creativity, not worrying about sentence structure, it evoked vivid images, it was not easy but it was cathartic. I was not expecting it but the process of doing it gave me a sense of release and closure. Try it!'

Big book of blobs

Another recommendation to help aid reflection is the Big book of blobs by Ian Long and Pip Wilson. This is a collection of blob pictures that can be used as prompts to explore feelings. One reviewer said:‘This can be a very quick and visual way of focusing on how you feel NOW at this moment, in comparison with how you would like to feel. I discarded it as 'silly' cartoons when I first came across it. However, I was shocked to find that it gave me an immediate representation of realising that I was not where I wanted to be at that moment.’

Schwartz rounds

Schwartz rounds are a group reflective practice forum which provide an opportunity for staff from all disciplines to reflect on the emotional and social aspects of their work. The Never too busy to learn report published by the Royal College of Physicians in 2018 outlines how useful these structured forums can be in affording opportunities to learn about the emotional and relational aspects of care, and develop understanding of staff experience from a human perspective.

How you can thrive

Even if you are not thriving, but feel balanced and steady, it is important to proactively maintain this.

Reflecting back to your existing coping strategies will help to identify behaviours that have overall positive impacts on your wellbeing. Learning to make time for these is important.

It may help to write down:

  • the behaviours you already have that are helpful and want to continue
  • behaviours that you don’t currently have, but might find helpful to develop.

Using your wheel of life, or even dividing the domains of your life in a way that is most appropriate to you, we recommend making a note of your answers to the following questions in each of the domains:

  • What is working well?
  • What can I do less of?
  • What would I like to spend more time on?
  • What would I like to do more of?
  • What would I miss if it didn’t happen?
  • Who can I ask for support?

The website Connecting with People can help you identify a self-care maintenance plan, or when going through or anticipating a stressful period, an emergency self-care stress plan.

Find out more

The RCP’s Mental health and wellbeing resource aims to support physicians to stay well and seek help when needed by opening up the conversation about mental health issues and their impact.