Blog

This piece in The Guardian caught my eye: “Children’s lack of sleep is ‘hidden health crisis’  – NHS statistics for England show sleep disorder admissions for under-16s was almost 10,000 last year” (here).   The Guardian analysed NHS data, revealing that admissions with a primary diagnosis of sleep disorder among those aged 16 and under has risen from 6,520 in 2012-13 to 9,429 last year.

So – what is causing this increase in children presenting with sleep problems?

“Sleep issues are a huge problem … it’s a hidden public health crisis,” said Rachael Taylor, a child sleep consultant at The Sleep Sanctuary, quoted by The Guardian. “There is a lot of sleep anxiety being diagnosed at the moment; it’s a new area that we are looking at, dealing with more children who have anxiety and it is coming out in sleep issues.”

Vicki Dawson, the founder of the NHS Doncaster-funded the Children’s Sleep Charity, suggested the rise was partly down to technology and the fact that the blue light from screens suppresses the production of the sleep hormone, making it harder to fall asleep. “We are increasingly seeing families where both parents are out working and this can mean that bedtime becomes later, bedtime routines may be rushed or abandoned all together,” she said. Dawson added: “A good sleep routine is key in supporting a better sleep pattern. Diet can play a role too. We see children and young people who are consuming a lot of sugar and even energy drinks to try to compensate for the sleep deprivation that they are experiencing. This then has an impact on night-time sleep.”

Sleep issues are significant: in the USA between 15% to 28% of  adults have a sleep disorder; 10% have chronic insomnia.  Of these 48.0% report snoring; 37.9% reported unintentionally falling asleep during the day at least once in the preceding month and 4.7% reported nodding off or falling asleep while driving at least once in the preceding month!  A major cause is obstructive sleep apnoea effecting 9-21% of women  and  between 24-31% of men. While many are not getting enough sleep: 37% of 20-39 year-olds and 40% of 40-59 year-olds report short sleep duration.

But what about mental health? 

 Chronic insomnia can increase a person’s chances for developing anxiety disorders and depression, according to a study conducted by Dag Neckelmann, MD, PhD, of the Department of Psychiatry at Haukeland University Hospital in Bergen, Norway  (published in the July 1, 2007, issue of the journal SLEEP) demonstrated  that  Chronic insomnia can increase a person’s chances for developing anxiety disorders and depression.

The study collected date from 25,130 adults from two general health surveys conducted over a 10-year period. Compared to the group of participants without chronic insomnia in both surveys, the group with chronic insomnia had increased associations with anxiety disorders and depression. Those subjects who reported that they had insomnia during the initial survey had a higher risk of developing an anxiety disorder during the second phase of the study conducted 10 years later.

Yet there is a “chicken and egg” issue here – insomnia seems be a contributing cause of mental health issues… yet mental health issues can cause insomnia.

“Focusing on chronic insomnia as a symptom of both anxiety and depression may result in the early detection of a mental disorder, as well as the detection of other illnesses or conditions that may be present,” says Neckelmann.

So wherever you start… it’s a  “vicious circle” – stress. anxiety and depression can cause insomnia… yet insomnia can expose children to mental help problems… and so on. So doctors must take note: insomnia may be an early or even the first symptom of depression and anxiety.

Which brings us back to the children –  of course we should have good bedtime routines… yet I believe we should be  looking at mental wellbeing of children with insomnia… stress, anxiety and depression are each a potential cause of the rise in such cases.

Impostor syndrome is where a person doubts that they are good enough… and so fear being exposed as a fraud:  A voice inside your head tells you that you are not as good as your colleagues, or, that you do not have the skills, ability or experience to be doing your job.  You start to believe that you have no right to be doing what you are doing; that you do not deserve success;  and that sooner or later you will be exposed.. as a fraud… as an impostor.

Last month a survey by Access Commercial Finance revealed that 66% of women have experienced impostor syndrome – men are 18% less like to experience it.  The survey showed that just over half (56%) of women say they have experienced impostor syndrome in the last 12 months.  The common triggers were criticism, having to ask for help and the use of jargon by colleagues. The research found that employees working in creative arts and design are most likely to experience imposter syndrome, with 87% of those in the sector experiencing it in the past 12 months.

HR Magazine quoted Cary Cooper, professor of organisational psychology and health at the University of Manchester’s business school.  Cooper says that impostor syndrome can have a long-term impact on an individual’s career. “Impostor syndrome can inhibit productivity and seriously limit an individual’s career progression. Self-doubt can also hold a highly-qualified person back from taking the chances that propel them forward,” he said.

Matt Haycox, a consultant at Access Commercial Finance, encouraged employers to provide more support for their employees to help tackle impostor syndrome. “Self-doubt can be the biggest obstacle to overcome, as our findings show, but employers can do more to help. More than one in 10 UK adults said not understanding technical language and industry jargon in the workplace made them doubt their own competence. This is easily tackled with a commitment to plain English and inclusive language,” he said. “Having to ask for help caused a lot of people to deal with impostor syndrome. Again employers can pre-emptively deal with this by ensuring their people, especially younger employees and new hires, are briefed clearly and given ongoing support as they learn.”

So on the one hand we can see that women,  particularly those returning to the workplace after maternity leave or those pursuing a career in a male dominated culture, may well be more prone to such thoughts; yet I expect that the lower score from men may be down to their denial!  So the gap may be closer than we think.

Impostor syndrome has be known about for quite a while – yet as an employer I can’t ever recall any initiative to try to reduce it and hence avoid demoralising a significant percentage of staff …and thereby failing to get the best from them.  Psychologists Pauline Rose Clance and Suzanne Imes first investigated ‘Impostor Phenomenon’ in the 1970s, and it came to widespread public attention through Clance’s book on the topic in 1985.

Helpfully, there are practical suggestions for that experience impostor syndrome – such as keeping a list of achievements – so that you can see that you are making progress.  Accepting that there is jargon and not being afraid to ask for explanations; and perhaps keeping a list of resources that will help you to progress.  You should talk about your feelings with colleagues and with your manager; and ensure that the company has the right induction training in place.  Exclusion is form of bullying

Yet a mindfulness based approach is also very effective.   Tell yourself that you are gaining skills, experience and knowledge – and that there is no reason why you cannot be as effective as your colleagues… and probably better.  It is just a case of effort and practice so that you will learn how to be the most effective member of the team.  When you are criticised or when make errors then you should show self-compassion – accepting that your cannot instantly know everything and that you will make errors sometimes…  but that you will learn from such experiences so that you will not repeat such errors – everybody learns and develops in this way.

Yet there is another aspect of mindfulness that you should also practice.  The workplace is competitive.  Promotion can be a zero sum game.  If the team leader leaves then many members of the team will want his or her job… and so they are in competition.  In some companies the pay budgets are capped across teams – so that a bigger the raise for one member will mean a smaller the raise others.  Again this is a competitive environment.   [NB: Of course companies should recognise the negative effective of this mechanism as well as the  impact of too much jargon that may sap the confidence of new joiners.]

So it may be that some colleagues are keen to show their relative dominance or performance in comparison with their colleagues.  Indeed they may fear being usurped by a teammate who may start to overtake and outperform them.   Given the survey results, it may be that some workplaces develop cultures of longer hours or after work drinking that can exclude parents or those have to other responsibilities after 5pm.

So again mindfulness can help with these situations. When a colleague is seeking to put you down – or to be unhelpful or unnecessarily competitive you can look at their behaviour objectively – it is not your problem… it is their problem.  You can say: “Wow… this person must be really frightened or they may be insecure if they have to behave in that way.”  When you notice such behaviours, then rather than see it as highlighting your own flaws, you can observe it; and tell yourself that you are improving in your work and that this poor behaviour, by a colleague, is driven by their emotional reactions and insecurities .

In some cases you might feel able to say “I am making progress – yet I don’t want compete with you. Better that we all improve together” – and even if you don’t say it out loud, I guess it will help avoid your own emotional turbulence.

You are good enough –  set aside emotional reactions that may chip away at your confidence and cause you to develop imposter syndrome.  I would love to hear about how you may have overcome such experiences.

I have been in two minds whether to post this piece or not – I was going to do it last week.. but I put it off.  Yet I am not alone in such behaviour…

Procrastination – putting off a decision or putting off some task – even finding other stuff to do (aka displacement activity) so that we can kid ourselves we are too busy to take on the issue we are putting off.  Sound familiar?

A study in “Psychological Science” of both proactive folk and procrastinators (…I wonder how they categorised them?) looked at scans of their brains.  It found that the amygdala – an almond-shaped structure in the temporal lobe which processes our emotions and controls our motivation – was larger in the procrastinators. “Individuals with a larger amygdala may be more anxious about the negative consequences of an action – they tend to hesitate and put off things,” says Erhan Genç, one of the study authors, based at Ruhr University Bochum.

Worse, the procrastinators had poorer connections between the amygdala and a part of the brain called the dorsal anterior cingulate cortex (DACC). The DACC uses information from the amygdala to decide what action the body will take. It helps to keep a person on track by blocking out competing emotions and distractions.  The researchers suggest that procrastinators are less able to filter out interfering emotions and distractions because the connections between the amygdala and the DACC are not as good as in proactive individuals.

So it’s a double whammy – the procrastinators have a large amygdala ensuring that they are awash with emotional responses; and the lack of connections to their DACC mean that it is unable to set these emotions aside… thus leading to feelings of unease relating to the event in hand.  And so the event is dismissed… or a displacement activity (without such effect) is found.

Yet there is evidence that mindfulness can help – previous studies have shown that mindfulness allows people to avoid “unconscious emotional responses”; and also to be able to focus much better and so avoid distraction.

Prof Tim Pychyl, from Carleton University, Ottawa, who has been studying procrastination for the past few decades, believes procrastination is a problem with managing emotions rather than time.

In fact mindfulness can reduced the size and impact of the amygdala:  “This study provides physiological evidence of the problem procrastinators have with emotional control,” Pychyl says. “It shows how the emotional centres of the brain can overwhelm a person’s ability for self-regulation.  Research has already shown that mindfulness meditation is related to amygdala shrinkage, expansion of the pre-frontal cortex and a weakening of the connection between these two areas”.

So if you’re a procrastinator then don’t put off the mindfulness training – it could be your best hope yet!

Each week The Sunday Times publishes list of  the top ten selling books in the non-fiction and fiction categories (…hard and softback).  This week the total week’s sales for the top 10 fiction titles (hard and softback) is 187,000 while for non-fiction it is  about of third of that… 65,000.  Yet each week there are many more pages devoted to reviews  of non-fiction books than for fiction – this week non-fiction reviews cover 8 pages while fiction reviews only get 3 pages.

I’ve no idea why this is…  it doesn’t make sense.

Yet now we have audio books also – and it turns out that many books are selling more in audio format that in the combined hard and software back sales.  We are seeing renowned authors writing to go “straight to audio” – and audio rights  are often sold separately to the print rights… and for much larger sums.  Now this does make sense.  Generations Y and Z are  busy and on the move – and have never developed the habit of reading from the page.  They carry their phones… and so the audio library is always available to them. In a piece within the Sunday Times Review, Francesca Angelini writes that US audio book sales have risen by over 250% over the last three years.  The figures show the main group of consumers contributing  to this rise are men aged 25-44 who are tech savvy but not traditionally big print readers.

At Carina Sciences we are launching our self-help app to develop resilience thought mindfulness based cognitive therapy: REZL.  It delivers tutorials and guided meditations from your smartphone to your ears… when and where you wish.

When setting out on this journey I was wondering about the effectiveness of such self-help courses in comparison with attending  face to face sessions.

I was encouraged by  the following paper from 2014: “The effectiveness of self-help mindfulness-based cognitive therapy in a student sample: a randomised controlled trial.”  (by Lever Taylor, Billie Lever, Strauss, Clara, Cavanagh, Kate and Jones, Fergal) published in “Behaviour Research and Therapy”( 63. pp. 63-69. ISSN 0005-796).  This study measured  the impact of “self-help” mindfulness based cognitive therapy intervention – up on measures of anxiety, depression, stress, life satisfaction, self-compassion and mindfulness in comparison with a control group.

The study showed: “significant decreases relative to controls in anxiety, depression and stress symptom severity and significant improvements in life satisfaction, mindfulness and self-compassion.”

In fact the study showed improvement effects in every measure that were greater than those which would be expected from therapist-led interventions.   And the effects were persistent – the improved levels were maintained at the subsequent follow-up measurements.

Now, all other thing being equal,  having a human tutor  probably isn’t a bad thing – although there will be some variance in the quality of your tutor and I suppose you have to like them – but I suspect this finding is  about participants being more able to find the right time and right place to properly engage with the training material… and to practice.  Who wants to reduce their stress by having to rush across London for a 18:00 meeting with a therapy group? Further… some people may find face-to-face sessions to be awkward and inhibiting … especially when in the presence of work colleagues (either familiar or not).

So, if you don’t have a good therapist… or if you’re on the move … or more likely, if you find committing to the lessons (or the time to come to town and travel to the sessions) a  problem ….then maybe an app REZL is better for you.

So the convenience of self-help  trumps the therapist,  Yet there are self-help programmes that provide a book and CD… but how many under 40’s will read a book or are able to listen to a CD?  I guess that just like the audio book phenomenon, it seems that self-help is more accessible if it is provided by audio… and on demand – so that busy people can engage within it when they are free from distractions and without introducing more hassle into their lives.

This week the UK media has been full of the disclosure by James O’Shaughnessy (a “health minister”)   that hospital admissions of teenage girls for self-harming have nearly doubled over the last 20 years – up from 7,327 in 1997 to 13,463 in 2017; the figures for boys were about static (2,236 in 1997 to 2332 last year).

As you can imagine there were many quotes about the inadequacy of the UK’s Child and Adolescent  Mental Health Services  (CAHMS) – and a government spokesperson was quoted as saying that they were putting in an extra £300 million to provide such help in schools. [Yet as a governor of a school myself, I know that that there are many initiatives to ask schools to spot children who are struggling with problems – but the school staff themselves are completely unqualified to provide the support the children need…]

“Heart-breaking,” was how the statistics were described by the charity, the National Society for the Prevention of Cruelty to Children (NSPCC).  “These heart-breaking figures are sadly unsurprising. We know from contacts to Childline that many children are being driven to self-harm as a way of dealing with the pressures and demands of modern-day life,” an NSPCC spokesperson said. “Young people are crying out for help and more needs to be done to prevent them from reaching crisis point.” The NSPCC said it gave 15,376 counselling sessions about self-harm last year, the equivalent to 42 per day.

So CAHMS and the admirably proactive NSPCC are struggling to keep up – buy why has there been such a rise?

Well I am pleased to say that the most thoughtful piece in this debate written by Lauren Bell and published in The Sun: https://www.thesun.co.uk/fabulous/6952830/teenage-girls-self-harming-doubled-online-sites-tv-shows-glamourising/

Here Ms Bell highlights the “normalisation” and even the “glamorising” of self-harm: Fashion brands have used models with self-harming scars; and TV shows have made self-harming  seem a reasonable choice – almost as if “everyone is doing it”.  Worse, some online resources (…Tumblr and Instagram posts) can provide first hand accounts of how self-harming  feels – or even secret codes (- sounds exciting) for the sharing harming pictures.  One self-harmer has spoken of how a TV “teen soap” was “triggering” for her – as, like the character, she came to see self-harm as  an antidote to problems, a way of asserting control or even a method to gain relief for “pain”.

Netflix recently paid for research to show that their programme with a self-harming plot  might provoke empathy rather than encouraging girls to self-harm; or to be  “triggering”.  So TV makers may argue about “triggering” (- being directly responsible for precipitating acts or causing copycat acts etc) – and I am sure their script editors will take measures, and seek out advice,  to ensure their output is responsible.

Nevertheless it seems that the “normalisation of self-harm” means that it is seen by many teenage girls as “an option”– and the availability on the internet of “how to” information, plus the self-representation to be gained by sharing such thoughts or even pictures, seems to be supporting the rise in figures.

I think we have to acknowledged that web services that allow the promotion of self-harming – the sharing of justifications, of “how to guidance” and even testaments or photographs should be irradiated.  Similarly advertising should avoid the promotion of self-harm.

Yet, the figures cause me to believe that responsible programme makers of material aimed at teens have a real dilemma  – as even with even best intentions,  plotlines involving self-harming  can suggest that the behaviour is commonplace… and for some, a normal response to the pressures of life.  The usual reason for running such plots is that they help to gain understanding for those involved… and these plots often introduce the issue to a wider audience who may not be aware of the issue. However, these plots can also normalise the behaviour and even encourage interest from teen girls seeking ways to gain control in their lives or to redirect themselves  from other painful issues.  I think we have to be more concerned with the reduction of self-harming rather than providing community support for harmers.  It seems that even educating teens about the dangers of self-harming… or where they might seek help… can be counterproductive! Support for harmers must come  from the government funded services (which must improve)  –  the rest of us should work on reducing the problem.

Jesse Sostrin is a director at PwC’s U.S. Leadership Coaching Center of Excellence – I enjoyed reading his piece about developing your “adversity quotient” here.

Jesse suggests that people can progressively become resilient though “personal acts of defiance”:

A moment of resilience is your chance to face adversity and say: “No, not today. You will not stop my momentum or reduce my potential to make the most of this opportunity.”   Unfortunately, for many leaders besieged by the constant change, rising ambiguity, and intensifying complexity of today’s business world, it is adversity — a big or small problem rising from your experience — that does most of the talking: “Yes, I will change your plans. I will undo your progress. I will cause you to question your goals and I’ll be sure to mess with your confidence along the way.”

He suggests that to become practiced it is important that we should “Leverage every micro-adversity”:  

The big issues often grab the spotlight. E.g. “Our company was just sold… Our competitor landed the client… A close colleague was diagnosed with a serious illness”. Although these major adversities have the potential to reshape the landscape of a life, they aren’t necessarily the best starting point to build resilience. The better strategy is to leverage everyday micro-adversities to steadily increase your resilience and place yourself in a stronger position to respond when the big one shows up. E.g. “I shared an idea during a conference call but it didn’t get the response I wanted… My boss just assigned me a project that I’m not excited about… I tried to give a colleague some feedback, but it backfired and now there’s tension between us”.

These are examples of micro-adversities. They’re not a big deal — except for the fact that they kind of are. … Such micro-adversities can weigh on your mind, making you feel powerless or stuck and tilting the inner game out of your favour by stealing attention from other important matters.

In his piece,  Jesse introduces the concept of  Adversity Quotient (AQ).  So what is AQ?

Many of us are familiar with Intelligence Quotient (IQ) and Emotional Quotient (EQ), yet in 1997, Paul Stoltz introduced a new yet interesting and intriguing concept – Adversity Quotient (AQ), which tells how well one withstands adversity and his ability to triumph over it… and research has shown that measurement of AQ is a better index in achieving success than IQ, education or even social skills.  By understanding the concept of AQ we can better understand how we and others react to challenge and adversity in all aspects of our lives. In fact, how people respond to adversity is a strong indicator of ability to succeed in many endeavours.

Dr. Paul Stoltz defines Adversity Quotient as “the capacity of the person to deal with the adversities of his life. As such, it is the science of human resilience.”

There is lots of great information about AQ on Dr Stoltz site here… and  I have borrowed much of the following explanation from the excellent piece “Adversity Quotient (AQ): An Emerging Determinant of Success and Superior Performance” on stitchesm.blogspot.com here:

To summarise: A person’s AQ can be measured. It is comprised of four CORE dimensions –

C for Control  – To what extent can you influence the situation? How much control do you perceive you have?  Those with higher AQs perceive they have significantly more control and influence in adverse situations than do those with lower AQs.

O for Ownership – To what extent do you hold yourself responsible for improving this situation? To what extent are you accountable to play some role in making it better?  Those with higher AQs hold themselves accountable for dealing with situations regardless of their cause. Those with lower AQs deflect accountability and most often feel victimized and helpless.

R for Reach – How far does the fallout of this situation reach into other areas of your work or life? To what extent does the adversity extend beyond the situation at hand? Keeping the fallout under control and limiting the reach of adversity is essential for efficient and effective problem solving. Those with higher AQs keep setbacks and challenges in their place, not letting them infest the healthy areas of their work and lives. Those with lower AQs tend to catastrophize, allowing a setback in one area to bleed into other, unrelated areas and become destructive.

E for Endurance  How long will the adversity endure? Can you see a time beyond the current situation?  Those with higher AQs have the uncanny ability to see past the most interminable difficulties and maintain hope and optimism. Those with lower AQs see adversity as dragging on indefinitely, if not permanently.

Of course our ability to feel empowered and “in control”… to be confident to take up ownership…. to be able to control our emotions so that current stresses and pressures do not impact on other parts of our lives… and our ability to see beyond the current “temporary situation”…. are all dependent on being able to avoid allowing previous difficulties or emotions or panics from influencing our performance today… and to be skilful to manage our instinctive emotions and our responses so that we can focus on the immediate solutions to be identified and implemented.

I guess that most of us would identify a “mindful approach” as assisting in limiting the reach of such problems.  Yet re-reading the above paragraph it seems that a mindful approach has much to contribute to improving each of our core dimensions in time of need.

So if you are working on your core responses – or if you are facing down micro adversities … or even if you are encountering  significant adversity… it important to remain objective and to be comfortable with pausing to consider the options available and their consequence… and then to  focus on the actions to be taken rather than reacting emotionally.  A knee jerk reaction may make things worse!

A more mindful approach will help you to become more resilient and who wouldn’t want that?

Last week The Times has published a report showing that last year 7.3 million people were given at least one antidepressant prescription in England. This figure includes more than 70,000 under 18s and almost 2,000 children of primary school age. Yet some experts think that such pills rarely work in children – with one saying that doctors were “medicalising adolescence”.   There was also a bias towards giving such pills to the elderly… and this was termed  “prescribing pills to combat loneliness”.

This Times piece led to media discussions suggesting that GPs were either “lazy” in giving out such pills… or that they had no option given the wait for “talking therapies”.  At least two doctors wrote to The Times to explain that such drugs are mostly effective… and that 70,000 out of about 15 million children was not a big number (e.g. Asthma prescriptions were given to over 100,000 children.)

The BBC covered the follow-on news here  saying  – “The number of antidepressants prescribed to children in England, Scotland and Northern Ireland has risen over the past three years…In England, there was a 15% rise. Scotland saw a 10% increase. And in Northern Ireland the number rose by 6%.  …Experts have linked the rise to waits for specialist mental health services”

Now, it may be that that other therapies including Mindfulness Based Cognitive Therapy (MBCT) could offer a chance to reduce the level of prescribing (and addiction) – and ironically, the NHS often advises suffers to read the Mark Williams and Danny Pennman book “Mindfulness – a practical guide to finding peace in a frantic world” while waiting their turn for talking therapies;  yet such services are very stretched.  My advice to sufferers is to find a therapist and pay to get help asap… especially when it is your own child.  It is not right… but it is pragmatic to do so.

(In the interest of openness, I point out that we at Carina Sciences  are shortly to launch our REZL app to build resilience in all of us – so that we are better able to meet life’s challenges – by  using Mindfulness Based Conative Therapy.)

 

But, let’s go back and think about the 70,000 children given antidepressants last year. My own belief is that this number is, in fact, on the low side!

The 2014 UK Adult Psychotically Morbidity Survey  showed that 1 in 4 of us will suffer from a common mental disorder  such as anxiety and/or  depression in our lifetimes… and that in 3 out of 4  cases these problems begin in childhood or adolescence (<= 18 years).  So this suggests that 3/16 (about 18%) of children under 18 years old will have experienced the start of such problems.  Indeed the government’s statistics show that 10% of school children have a diagnosable common mental disorder .

So if we assume that these problems are entirely developed linearly between say 14 and 18  of which there are around 3.6 million young people in UK  ( – as the Times said only 2,000 of the 70,000 were of primary school age) … then we might reasonably  expect that there are about 350,000 under18s who have a “common mental disorder” problem.

Yet the piece in The Times says that ONLY 70,000 are being given drugs  in England …which can be scaled to about 80,000 across the UK… So we are using antidepressants for ONLY 80,000 of the 350,000 suffers. 

The real questions this raises are:  why are 18% of our children developing these problems?  What are we doing to help them? And, what are we doing to avoid such problems in the first place?

The simple answers are that:

• Ignorance and stigma  (…in parents as well as children) mean that many children will soldier on and fail to get early  help as their problems develop – and  it may be that domestic breakdown,  pressure from exams, unrealistic materialistic expectations or social media pressures are all making things worse for our children.
• We are doing little to help – the CAMHS (child and adolescence mental health services)  is a “silent catastrophe” say the Association of Child Psychotherapists (see The Guardian piece here)
• There are no preventative initiatives in place in UK.

So everyone is worked up about 70,000 children  and young people being given antidepressants – yet I am astonished the figure is not 5 times higher…  70,000? …it is the tip of an iceburg.

 The Guardian goes on to point out that not only are the CAMHS services scarce but they are often very poor: “This year, the NHS watchdog, the Care Quality Commission, rated 39% (26 services) of specialist Camhs as requiring improvement. Those surveyed by the Association of Child Psychotherapists were asked whether they could see any evidence of the government’s claim of making “one of the biggest expansion of services in Europe” – 93 % of respondents said they saw no evidence of this.”

…

Of course it is good that everyone is getting concerned about mental health problems in childhood…. (I wrote last month about the denial and lack of leadership shown by our  universities in failing to take responsibility for supporting students with problems  …yet it seems there is a similar lack of support for the under 18s.

IMO we should expect more from our government… we are long way from having CAMHS of the right scale and quality…  so sadly I expect we will have to wait until antidepressants are prescribed to our children at  a level where minsters will finally have to sort this out.

When an organisation  accepts that sticking to “what has worked in the past” is no longer an option,  it  will seek to re-organise, to adopt new strategies, systems and working practices and/or to radically change its culture. It is seeking “transformational change”. 

Yet such change will produce substantial “ambiguity”  – causing uncertainty – as there may well be many interpretations as to what the future will look like.  It is this “ambiguity” that causes employees to feel anxious about jobs, roles, organisation and hierarchy;  and it disempowers them as they foresee changes that will wash way the processes in which they  have invested  or that will eliminate the need for the skills that they have mastered.

 This negativity can undermine the whole project.  A recent study by IBM suggests that 41% of such change programmes are subsequently described as “unsuccessful”!

 So how should leaders prepare… and how should they behave through such a transformational change – if they are to  ensure that the programme is successful and that the business gains the advantages sought?

 Here’s a great 2017 paper by  Professor Julie Chesley and Avonlie Wilson of Pepperdine University – “Ambiguity: the emerging impact of mindfulness for change leaders”. [NB There is an excellent free summary of the key content here .]

This study of organisations undergoing “radical organisational change” has looked at the level of mindfulness of the leaders involved and to understand the ways in which the leaders built resilience within staff in order that they embrace such change.

The study shows that in successful programmes:

·         The leaders themselves took time out to be mindful and to reflect; and to be engaged in their own therapy and coaching

·         The leaders were prepared to reach out to coaches, mentors and colleagues for advice or support in the face of challenges

The “less successful leaders” were more likely to seek support from family and friends and to seek wisdom from educational books (– I wonder if this reflects an unwillingness to be open about the issues that they are troubled by; and a reticence to admit that there are things they don’t know…  IMO: it may come from a lack of self-confidence or an fixed self-image, I suppose?).

 Yet, an absolutely key trait was the leaders’ attitude to “ambiguity”.  The effective leaders used methods to “reframe ambiguity” – removing bad connotations and reframing it as “a challenge” for staff; or by introducing it as an opportunity to “be curious” – to investigate and imagine – with a flexible and open mind; thereby encouraging staff to be objective and non-judgemental – and to ask questions.  In this way the leaders were building resilience within their staff.  This was accompanied by a willingness to involve employees in the change process and, more importantly, in the discussions around the search for the right approaches to the areas of ambiguity. At minimum, this creates “buy-in” and ownership; yet the culture of openness and curiosity seems to reduce apprehension and anxiety also.

 So it is clear that processing an  understanding the strategies to effectively manage ambiguity is important – given that ambiguity commonly arises during organizational change; and building reliance though mindfulness – and through “mindful leadership traits” – is a key to preparing for any transformational change programme. 

 Then, going forward, it is clear that “managing ambiguity and being more able to adapt” is essential for an organisation’s survival; and will avoid the possibility of being surpassed by a competitor that really can deal with ambiguity.

Many newspapers covered the recent comments by Sam Gyimah the UK’s Universities Minister.  The guardian (30th June 2017  see here) wrote:

With as many as one in four students seeking help from counselling services at some institutions, the universities minister, Sam Gyimah, is calling on vice-chancellors to prioritise student mental health and take a personal lead on the issue.

It seems Gyimah is unconvinced that the Universities are talking this issue seriously… and he is right!

 With around half of all young adults now going to university it is peverse that we are packing our kids off to face the stresses and challenges of university life… making new firiends, worrying about their ability to cope…. to face these challenges alone – without the support of their families … and without any proper support from the universities.

 Indeed– it does appear that Universities are not up to pace in relation to dealing with these problems – more worrying is that the Minster suggests that the Universities seem to see mental health challenges as some sort of  “character building service subsid”:

Gyimah says “There are some vice-chancellors who think that university is about training the mind and all of these things are extra ….that they don’t have to deal with. They can’t do that, they’ve got to get behind this programme. It can’t be something that belongs to the wellbeing department of the university. This requires sustained and serious leadership from the top.We want mental health support for students to be a top priority for the leadership of all our universitie. Progress can only be achieved with their support – I expect them to get behind this important agenda as we otherwise risk failing an entire generation of students.”

Wow… it does sound like he thinks the Universities are failing to engage with this issue and are failing to provide the leadership required to put the right support in place.  Yet on this occasion, all Gyimah is asking is that the universities back a proposal to enable colleges to contact the parents of any students experiencing difficulties – while this is  good idea… it doesn’t get close to the sort of prevention initiatives and support initiatives that our children deserve.  If this small step is a such a struggle then making real progress will be a very long battle.

 So is Gyimah  right to be concerned about the leadership from the universities?   Well, the Guardian article also quotes Prof Steve West, the vice-chancellor of UWE and chair of the Universities UK mental health in higher education advisory group, who said:

“Universities cannot address these complex challenges alone. Partnership working with students, staff, government, schools, colleges and employers, the NHS, local authorities and third sector organisations is vital if we are to help students and staff to thrive.”

 IMO Professor West’s leadership on this issue  is very worrying – he seems to be saying that the responsibility to solve the problem lies all over the place.  He seems to suggest that many others should be addressing this issue. Reading between the lines he seems to be ducking the responsibility.

 It is high time for Prof West and his colleagues to step up to the plate.  This is his moment to say – “Each  university must take up this responsibility and we will be relentless in drafting in the appropriate agencies to ensure we have the right support and healthcare interventions that students deserve”. Now that would be leadership!

As you may be aware , at Carina sciences,  we are shortly to release our REZL app which employs mindfulness based CBT to build resilience… and declaring an interest… we are focusing on both corporate citizens and also upon young adults in higher education …who really do need to build up their resilience to help them to face the academic and personal challenges of moving to college. (NB: in fact we are seeking socially  responsible organisations who may be will in sponsor the deployment of REZL with FE colleges).   

So let’s look at the issues faced by young people in further education. Here are some finding from a yougov poll in 2017:

·         Over 1 in 4 (27%) of students report a Common Mental Disorder (CMD) higher than in whole pop – 19% male v 34% female

·         Of these 77% have symptoms of depression and 75% have symptoms on anxiety (– about 50% have both)

·         6 in 10 students (63%) say they experience stress interfering with their daily life and  performance

·         Causes of stress: 77% “fear of failure; 71% course work; 39% employment prospects; 35% family, 23% relationships and 23% friends

·         31% of students say they are lonely

and

·         At 16 years:  70% are regularly sad or anxious; 22% everyday (Barnardos)

·         16 years  stress factors: school (83%); future (80%) (then home, bullying, weight) (Barnardos)

·         FE Students: only 9% confident about their exams (PushOn/Ryman)

·         FE Student stress factors: themselves (70%); teachers (68%); parents (39%) (PushOn/Ryman)

 So, we can see that coming to college can be a difficult time:  perhaps moving away from supportive structures; feeling stressed by course work and feeling like they are struggling in comparison with others who look to be doing fine (whatever they are feeling inside); finding new friendships; and dealing with their own expectations and the expectation of others… it looks like these are all draining the pools of resilience within even the most self-confident and positive students.

 These figures  suggest that many will be struggling to learn (or continue) throughout their course  and to  perform well in exams.

 In his letter to The Times (Saturday 30^th June 2018) Nick Forsyth, Head of Wellbeing at Kingston Grammar School,  points out that “Recent research into brain development suggests that our brains only fully mature at the age of 25”.  Forsyth goes on to say “In recent years, schools have made great strides in their provision of pastoral care and, in particular,  supporting children and young people suffering from poor mental health.  For may students this support has evaporated overnight on entering higher education.  If we are serious about tackling poor mental health in adolescence, universities must begin to catch up”.

 All this adds up to a real need for solutions that will reduce the possibility of common mental health problems and also to support those experiencing such difficulties.

 However, if the Universities are going to take up their responsibility to seek out such solutions and to provide the support necessary then they must to stop regarding stress as some kind of “tempering or character building” and start to engage with the problem… and they must demonstrate ownership of the issue…. and they must show some  leadership.

“Disruptive times call for transformational leaders with a knack for addressing complex problems. To navigate effectively, we must learn to let go–and become more complex ourselves. “

This quote is from the fascinating piece form McKinsey & Co “Leading with Inner Agility” By Sam Bourton, Johanne Lavoie and Tiffany Vogel.

It is an article about how to manage in the face of change.  (You can read it here .)  It shows that our ingrained reactions… to fall back onto old maxims… can be counterproductive and will fail to find the right response to the developing situations we face:

“We live in an age of accelerating disruption. Every company is facing up to the profound changes wrought by digitization. Industry boundaries have become permeable. Data, algorithms, and artificial intelligence are changing the nature of forecasting, decision making, and the workplace itself. All this is happening at once, and established companies are responding by rethinking their business models, redesigning their organizations, adopting novel agile-management practices, and embracing design thinking.”

The authors go on to suggest some rules of thumb to help leaders to navigate such waters….

• Pause to move faster. Pausing while remaining engaged in action is a counterintuitive step that leaders can use to create space for clear judgment, original thinking, and speedy, purposeful action.
• Embrace your ignorance. Good new ideas can come from anywhere, competitors can emerge from neighboring industries, and a single technology product can reshape your business. In such a world, listening–and thinking–from a place of not knowing is a critical means of encouraging the discovery of original, unexpected, breakthrough ideas.
• Radically reframe the question. One way to discern the complex patterns that give rise to both problems and windows of emergent possibilities is to change the nature of the questions we ask ourselves. Asking yourself challenging questions may help unblock your existing mental model.
• Set direction, not destination. In our complex systems and in this complex era, solutions are rarely straightforward. Instead of telling your team to move from point A to point B, join them in a journey toward a general direction. Lead yourself, and your team, with purposeful vision, not just objectives.
• Test your solutions–and yourself. Quick, cheap failures can avert major, costly disasters. This fundamental Silicon Valley tenet is as true for you as it is for your company. Thinking of yourself as a living laboratory helps make the task of leading an agile, ever-shifting company exciting instead of terrifying

But to adopt these ideas will require you to control your reactions and emotions and thereby avoid a “rush to judgement”.  You will be required  to counter the ingrained desire to act immediately;  so that you are more able to create a pause… to seek out  a more profound or radical approach to the challenges. Further, it requires more openness and objectivity… and the ability to be comfortable with your own ignorance and uncertainty rather than being panicked by it (which can lead to a rush to devise a quick fix). This takes take a lot of emotional energy and control.

Here’s where it is essential to possess resilience to deal with the pressure to rapidly adopt a position; and mindfulness to control our gut reactions so as to remain objective and calm.   These skills will help us to be able to listen with a deeper focus rather than allowing our ingrained reactions and emotions to cause us to fail to accept the full picture or even to discard alternative strategies.

The piece goes on to give details of how meditative techniques can support leaders to accept the situation without panic and to accept that they themselves may need time to explore and listen rather that rush to act in support of their own self-image or from a perceived need to have all the answers.

“Claiming this space is hard, and there are no silver bullets. Some CEOs like daily meditation. We know one CEO who takes a ten-minute walk through the neighbourhood around his office—leaving his cell phone on his desk. Others regularly catch a minute’s worth of deep breathing between meetings. The repetition of such practices helps them pause in the moment, interrupt well-grooved habits that get triggered under duress, and create space to practice something different.”

“…if you don’t start the journey of learning how to decouple from your context and the immediate response it provokes, you’ll find it harder and harder to be open to new ideas, or to become a better listener—both traits that are critical at moments where your own vision is clouded.”

At Carina we are close to launching our REZL app that provides a foundation course to use mindfulness to increase resilience.  We are seeking to work with groups of users at all levels within organisations… This piece from McKinsey suggests that REZL will be of particular value to senior managers within larger corporations when facing disruptive change.  If you are a senior leader and would like to try REZL then please get in touch with us…we would love to work with you.