Mindful Monkey.

Wellbeing tips from our students at Cumbria University

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Earlier this year as part of University Mental Health day we asked students to tell us their Mental Health and Wellbeing tips.

Thank you to everyone who took the time to share their thoughts. We had lots of really good ideas and wanted to share this wisdom with others (this is mostly in their own words, in a few places we’ve added a comment or a link). Here is what they told us:

Student tips on wellbeing included getting out for some exercise and fresh air

Self-care

  • Enjoy the little things
  • Take time for yourself, even when you “don’t have time”
  • Set aside some time in your day to do something for yourself that makes you happy… take the time to recharge your batteries and clear you mind for the next day
  • Make time for things you love
  • Look after yourself and give yourself time
  • Watch you fave Netflix show
  • Make sure you always speak out if needed
  • Take a nice relaxing bath, (or shower if no bath available)
  • Selfcare Sundays
  • You are the number one priority! Put yourself first and worry about others later, self-care before anyone else
  • Listen to music and relax (here’s a breathing exercise to do just that)

The company of friends, it’s good to talk

  • The most important thing is to talk to a family member or trusted friend about what’s worrying you. Let them hug you and give you a shoulder to cry on
  • Spend time with people you love! (You’d be surprised how much evidence there is that kindness is good for us!)
  • Talking to people always helps
  • Keep very social with your friends so you’re never lonely
  • I walk my dog, and talk to family and friends about my worries
  • Talk about it, have a cup of tea and a nice chat (with biscuits)
  • Do things that make you happy and spend time with people that are supportive
  • Make sure you always have a date with a friend booked in the diary!
  • Having a good balance between finding time for yourself, and socialising with peers and friends
  • No topic is taboo, even if it is hard, talk as much as you can about your mental health
  • Be around people who care and they will help bounce you out of any bad feelings/moods
  • Just talk about it, people will listen and it’s a weight of your chest
  • Do not keep toxic people in your life, even if they are on your course

Mind your thinking, and learn to meditate

  • Take every day as it comes. If you’ve got things on your mind, switch off at night, write them down and put them aside, come back to them when the time is right. Don’t overthink every little thing, it will seem worse and spiral out of control
  • Practice mindfulness as a normal thing (Excellent idea! As well as lots of other benefits, mindfulness has been shown to help develop skills in stepping back from rumination (negative-overthinking) here’s a practice to get you started)
  • Think of a positive thing you’ve done today, even something small counts
  • Download the ‘headspace’ app. Take advantage of the sleep music and exercises
  • Accept yourself, there is only one of you

Small steps and a good balance

  • Start writing, rather than facing assignments as whole, less stressful, less full on
  • Get organised, and reward yourself with each step (this fits very nicely with suggestions in our post on procrastination)
  • Make sure you plan time well, so that you make time to step back and take time for yourself
  • Social life and studying should be evenly split
  • Take deep breath, get a cup of tea and make a plan, and start again

Get out in in the fresh air

  • Get some activities that are not to do with the university, like walking through the park or going to a place that calms you
  • Go for a walk whatever the weather!
  • Go for a nice walk
  • Walking with headphones
  • If you can take a break and get outside, even just 5 or 10 minutes away from a screen, getting some fresh air can clear a foggy mind
  • Spend time outdoors in nature
  • Go to the hills

Sleep well

  • Make sure you get enough sleep. Have a good regular amount of sleep
  • Give yourself time to relax and do a self-care routine, e.g. bath, read a book, pamper yourself
  • Have 20 minutes off your phone before bed every evening to help sleep. Try reading, drawing, knitting, sewing, talking to friend or yoga instead (yes definitely better than too much screen time)
  • Use headspace stories to fall asleep

The Mystery of Post-Assignment Blues and How to Recover the Joy

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I wrote this post for our University of Cumbria Wellbeing Blog, please feel free to pass it on to anyone you know that might find it useful. Even if you are not a student, the ideas apply to any situation where you have been under a lot of pressure and have been in a state of heightened alert or nervous activation, working on something really important.

You’ve got to the end of the semester or the academic year, and you’ve submitted your assignments, survived your exams… it’s all done, phew!

Wait what! Where’s the elation, the euphoria? This is very confusing!

During the stress and struggle of the days leading up to deadlines, we imagine how wonderful life will be after the work is done! The relief, the joy, the freedom!

Yet strangely sometimes we don’t feel as ecstatic as we had imagined. We expected to feel just great. What happened to all those good feelings, what a disappointment!?

Time and time again I hear students describe this as an anti-climax, a feeling of emptiness; sometimes even feelings of anxiety, as if you’re standing on the edge of a precipice.  

But since submitting my dissertation last month I’ve been in a weird limbo. My executive dysfunction has got quite bad because I have no urgent deadlines, so I can’t even bring myself to do the things I really want to do and instead just daydream about them all day. So trying to get myself unstuck has been a bit of a struggle.

Anonymous student

Please don’t beat yourself up about not feeling as you expected to. Let’s consider what might be going on, and what you might do about it:

The crash in mood is a comedown from all that adrenalin. This is a very real phenomenon; it happens all the time. If you’ve been in a heightened state of excitement and alert for a while, you’ve been pushing out that adrenaline (and dopamine), you’ve been using up your resources, the batteries can get pretty flat. The higher you were and the longer you stayed there, the more intense the comedown.

Solution: That flat feeling is your system recharging, and the neurotransmitters, particularly dopamine, are restocking. Don’t fight the feeling, accept it, rest up, pamper yourself, sleep. It will pass, and you will soon feel much better. I call this ‘cognitive override’, you might say to yourself:  I’ve been working my socks off, and achieved so much, I’ve made it through. This feeling won’t last – it’s just my nervous system recovering, I will feel better once I’ve recharged.

You’ve got used to having all your time structured around the work you had to get done, you’ve had a purpose, now you’ve got all this empty space and that feels weird. Life feels empty – you don’t know what to do with all this time on your hands, the days ahead feel like a vacuum.

Solution: You’ve got so used a particular state of alert and focus. When the situation changes your nervous system doesn’t know how to come out of that, just yet. You need a bit of time to get used to the new situation and become convinced that there really is nothing to do but chill for a while. And then when you’re ready, to begin to discover what you want to do next.

There’s a feeling of anxiety, you’re on a cliff edge, about to step into the unknown. This fear of the future is understandable – suddenly there’s more uncertainty than you’re used. You’ve been in a place where you always had the next goal in front of you, the next task. Now it all seems more uncertain.

Solution: Accept the feelings, as natural, give yourself space, time to think about the future, accept that uncertainty is a part of this major transition in your life. So maybe the uncertainty of not knowing is the feeling you get just before you discover something new.

So, what next? Once you’ve had a chance to recharge those batteries, give yourself permission, a bit of space, to be uncertain. Take a bit of time, to reconnect with yourself, and your surroundings; rest, take a walk, talk to friends, meditate. In this space of not knowing exactly what will happen next, let yourself rediscover the sense of freedom, the excitement of new possibilities…


Kindness is the New Rock and Roll

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I wish I’d come up with this aphorism, because it nicely sums up an important piece of wisdom (credit goes to the band that used it as the title of their last album, and a song on that)

We recently had the Mental Health Awareness Week – hosted by the Mental Health Foundation. The theme is kindness. They rightly say that: in times like these when the world feels upside down, Kindness is the way to turn things the right way round.

“We all know that being kind is the right thing to do but did you know that kindness is good for you? A little act of kindness can boost your mental health, reduce stress and it can cheer you up to think of someone else – not forgetting, of course, to be kind to yourself. It is a path to a society that better protects our mental health”

https://www.mentalhealth.org.uk/campaigns/mental-health-awareness-week

They point to research evidence for the positive impact of kindness on protecting and improving mental health. Their survey has shown that almost three quarters of UK adults say it’s important that we learn from the coronavirus pandemic to be more kind as a society. Also almost two-thirds of UK adults say that being kind to others has a positive impact on their mental health.

Psychologists have long shown that kindness to others (altruism) also has a positive effect on the giver (Fehr & Fischbacher, 2003; Kurzban, et al., 2015; Wang, et al., 2020).

There is evidence that accessing states of caring and compassion have a profound healing effect on us (Gilbert, 2010) and there appears to be a evolutionary neuro-biological basis for this (Porges, 2011).

Based on ancient wisdom, a growing body of research suggests that kindness & compassion meditations activate these healing systems within us. These meditative practices can be effective as part of the treatment of a wide range of mental health conditions and promote physical and emotional wellbeing (Graser & Stangier, 2018; Hofmann, et al., 2011; Shonin, et al., 2015).

Here is a short introductory guided meditation to help cultivate this state of self healing. Please read the guidance below before you try it.

Please read the important guidance below before you begin
  • This guided meditation requires active engagement and participation, so while it can be calming, it does ask for some mental effort
  • A bit of perseverance is likely to pay off, with a bit of practice the positive effects of meditation increase
  • If you find it difficult to settle and follow along with the guidance, then you might need a bit more brain-training with a breath practice
  • By using the meditation, you are taking responsibility for your wellbeing. It is not a substitute for counselling or treatment. It is an educational and self-development resource
  • Meditative practices have been shown to offer powerful tools for mental health and wellbeing by helping to develop enhanced emotional and thinking skills. They are not a quick fix and require effort and practice
  • Meditation is not usually suggested as mental health first aid. It can be very helpful in managing difficult emotions, yet this skill takes time to build. I think when you’re feeling anxious or unsettled, there are lots of other helpful things you can to do first, for example here is a calming exercise which I have used with many people (link opens in dropbox where you can directly play the file or download it for offline use)
  • Of course if you are acutely unwell then please get appropriate support, make yourself safe, and come back to this practice when you are feeling stable enough to engage with it
  • I hope you find this meditation helpful, feel free to get in touch with any feedback

References

Fehr, E. & Fischbacher, U., 2003. The nature of human altruism. Nature, Volume 425, pp. 785-791.

Gilbert, P., 2010. Compassion Focused Therapy. Hove: Routledge.

Graser, J. & Stangier, U., 2018. Compassion and Loving-Kindness Meditation: An Overview and Prospects for the Application in Clinical Samples. Harvard Review of Psychiatry, 26(4), pp. 201-215.

Hofmann, S. G., Grossman, P. & Hinton, D. E., 2011. Loving-kindness and compassion meditation: Potential for psychological interventions. Clinical Psychology Review, Volume 31, pp. 1126-1132.

Kurzban, R., Burton-Chellew, M. N. & West, S. A., 2015. The Evolution of Altruism in Humans. Annual Review of Psychology, Volume 66, pp. 575-599.

Porges, S. W., 2011. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, Self-Regulation. New York: W. W. Norton & Company.

Shonin, E. et al., 2015. Buddhist-Derived Loving-Kindness and Compassion Meditation for the Treatment of Psychopathology: A Systematic Review. Mindfulness, Volume 6, pp. 1161-1180.

Wang, Y. et al., 2020. Altruistic behaviours relieve physical pain. Proceedings of the National Academy of Sciences (PNAS), 117(2), pp. 950-958.


Breathe

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During the current lockdown there is a lot of good advice out there. Our contribution here is just a small practical thing that you can do to help reduce stress and increase wellbeing. There is strong evidence that stress levels can have a significant impact on our immune functioning.

This is a short guided meditation. The visual element is just to add flavour, it is OK to close your eyes during the practice, if you like. At just under 8 minutes you can pop this on anytime you have a bit of time to spare.

Mindfulness isn’t the same as relaxation, but is a very good way of building wellbeing if practiced for a time. A very common misunderstanding is to expect to have an ‘empty mind’ or feel more relaxed (which may or may not happen). So if there is agitation or lots going through the mind, then there is no need to suppress anything, just observe what’s there.

Meditation is not first aid for anxiety. It can be very helpful in managing anxiety (and other difficult emotions) yet this skill takes time to build. I think when you’re feeling anxious or unsettled, there are lots of other helpful things you can to do, for example here is a calming exercise which I have used with many people (link opens in dropbox where you can directly play the file or download it for offline use).


Managing Exam Stress

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Image by kmicican from Pixabay

(You can skip straight to the breathing exercise if you like)

Needless to say, one of the key things in managing exam stress is the actual study you do. So of course, starting early and preparing well is going to be very helpful. Once you’re at or near the actual exam the challenge is more about optimising things as much as you can, with whatever your level of preparation.

Another important area is specific study, revision and exam skills. You will be developing these throughout your time of study, together with your academic confidence generally. At the time of the exam there are a number of recommended strategies around the specifics of dealing with the exam paper: for example, read the exam questions carefully, make sure you understand the question. Make a few rough notes or brainstorm just to get some initial ideas and to get that inner process started. Start with a question you feel the most confident in, to get as many marks in the bag as you can, and get things going. Here are some tips on exam preparation.

Here, let’s focus on what you can to do to manage your emotional state (anxiety, wellbeing): Getting your state right will optimise everything else. Being in a good state has longer term and short term factors. There are things you can do in the time leading up to your exam, and on the day.

General self-care: Looking after yourself, investing in your wellbeing will pay off and be a more sustainable strategy. There’s lots of good advice on improving well being on this blog and elsewhere. Here’s a brief reminder of some of the practicalities for getting the best out of yourself:

Regular exercise: in any shape will help. Little and often, doing something you like doing. There is lots of evidence to suggest a strong positive impact on mood and cognitive functioning.

Eating & Nutrition: This includes the usual advice, eating plenty of vegetables and fruit. Avoid high sugar and highly processed foods, complex carbohydrate (Low GI, sustained release is better). Avoid excessive caffeine. Alcohol in moderation, avoid drugs. Drink plenty of water.

Some kind of meditative activity: this can include things like mindfulness or yoga. Mindfulness is a great way to build resilience and develop emotion management skills as well as enhance cognitive processes. It tends to work cumulatively, rather than as first aid in an anxiety situation.

Sleep hygiene & Routines: sensible use of screen time (avoid excessive use, avoid at bedtime and definitely not in bed!), avoid caffeine in the evenings. Read, listen to music, relaxing sounds, or an audiobook at bedtime.

The night before: Staying up late (or all night!) can sometimes work as a short term solution when you have to hit an assignment deadline (most of us have done this at some point, hopefully got away with it, and vowed not to leave things to the last minute again!). But This is not a sustainable strategy for studying. And for exams it will not be helpful at all, even if you manage to cram lots of knowledge into your head, you probably won’t be in a fit state to deploy that effectively. So be kind to yourself, and get some rest the night before.

Let’s talk about managing anxiety: The days before and during the exam can be challenging for most of us. On a very practical note: Get organised and show up early, get things ready the night before, and get up early so no there’s no need to rush around getting more wound up.

Anxiety is a normal response to stressful situations. In fight or flight mode our adrenalin system kicks in and is there to provide additional resources when there is a perceived danger situation. This works really well where we need to deal with situations of physical threat, but is less effective when we have complex tasks to deal with (studying, thinking, writing assignments, exams, job interviews, first date etc.).

A small amount of adrenalin can be helpful in giving us a bit of alerting energy. However, too much of it will cause a drop in productivity. There is an optimum range for this. So as adrenalin levels go up, initially performance increases, however it soon tapers off and begins to drop as adrenalin increases.

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Yerkes and Dodson, Hebbian [CC0] *Derived from the Yerkes–Dodson law)

Here are some tips to manage your state during the period leading up to and especially on the day. With performance anxiety there is usually a cycle: feeling anxious – negative thinking – more anxiety – more negative thinking. Interrupting this at both points (thoughts and feelings) is a good strategy to manage anxiety, stop it spiralling further, and even begin to turn it into a positive cycle (feeling calm – increasing confidence).

Manage unhelpful thought patterns. Watch out for catastrophising thoughts. Remember: thoughts are not facts. Thoughts with a negative bias amplify stressful feelings. Instead, try saying something like: “I’ll do my best, staying calm and focusing on the task will help me to get the best out of myself”. If you think you should have done more, earlier on, then there is not point in beating yourself up. Better to approach this with self compassion: “OK I could have done better, I can learn from this, and improve things in future”.

Learn to use calming strategies. There are a range of good ways to settle anxious feelings, using the breath is a powerful way to calm things. Here is a breathing technique that you could try. This audio file is a breathing exercise which lasts 6 minutes, the link opens in Dropbox where you can directly play the file or download it for offline use. We are very interested in getting feedback so please feel free to let me know how you get on with it.

This image has an empty alt attribute; its file name is img_20200105_165326.jpg
Learning to Breathe

Selye, H. The Stress of Life. New York: McGraw-Hill, 1956 (2nd Revised edition 1978)

Yerkes, R. M. & Dodson, J. D. (1908). The relationship of strength of stimulus to rapidity of habit formation. Journal of Comparative Neurology and Psychology, 18, 459–482.

*The Yerkes–Dodson law suggests that there is a relationship between arousal and performance. originally developed by psychologists Robert M. Yerkes and John Dillingham Dodson in 1908. The law dictates that performance increases with physiological or mental arousal, but only up to a point.
This law states that a relationship between arousal and behavioural task performance exists, such that there is an optimal level of arousal for an optimal performance. Over – or under-arousal reduces task performance.
This graph shows a version of the Yerkes–Dodson law, it leaves out that hyperarousal does not seem to adversely impact simple tasks.


Procrastination!!

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procrastination

Part 1

Procrastination is a delay in doing an intended and important task, despite being aware of the negative consequences of not getting it done.

We all procrastinate. Mostly we think of this tendency as an annoyance and just live with it. At other times it can become a hindrance to success, and can cause considerable distress, especially if it becomes chronic.

Remember, you are not alone, and there are things you can do to help yourself. This is the first in a series of blogs on the topic.

The good people at BBC Radio 4 have produced an excellent episode of ‘All in the Mind’ which looks at this issue and makes some interesting points: https://www.bbc.co.uk/sounds/play/m0005t4x

Here are some of the key things I thought were useful:

Don’t rely on negative emotions to to motivate you: feelings like fear, shame, guilt can sometimes provide a kick. We’ve all heard ourselves say something like ‘Oh I work well under pressure’. However, we are not at our most productive when we are in a negative emotional state. Cognitive functioning: our ability to think, focus, reason, remember things is diminished when there is anxiety, or we feel low. Even if this strategy works, there are emotional costs, it doesn’t feel good, is stressful and impacts on wellbeing.

It is better to engage with positive emotions. Here are some ways of doing that.

Make it fun: One way to engage motivation is to find a way for the task to become more enjoyable. Is it possible to make some element of the task more fun? To find something positive in the process of the task itself?

Engage your identity: using language like: I am a runner, I am a learner, a teacher, nurse, geographer, conservationist…

Remind yourself of the bigger picture: why is this important? how does it fit with what’s important to me?

Be kind to yourself: The worst thing you can do is be hard on yourself. Have you noticed that beating yourself up doesn’t really work. Rather than getting the job done, it just makes you feel worse. Better to have compassion and forgiveness for yourself when procrastinating. Ask yourself what would you say to a friend or loved one who was struggling to get going with something. Would you berate them, wag your finger at them? Or would you say something kind, supportive, tell them it’s OK to struggle sometimes, and is there anything you can do to help?

The myth of a different future you: We say things like “next week I’ll be less tired… have more energy… be more focused… clearer headed… I’ll be a better person… the writer’s block will be gone”. As if next week you’ll become this cape wearing superhero. The reality is: I won’t, I’ll still be little old me, pretty much as I am now, with pretty much the same resources and limitations, and this is what I’ve got to work with.

So I will take one small step that fits with the resources I have I’ve got right now, and do something (however small) right now. I can do just one part of the task that I can manage right now, and see how I get on.

I recently came across this quote (from Zig Ziglar) which sums up this last point:
You don’t have to be great to start, but you do have to start to be great.



Screen-time and Your Eyes

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Smartphones are now ubiquitous, and can be a very useful tool for learning and communication. There are however a number of potential issues from a wellbeing perspective, these (and how to minimise problems) will be considered in a few separate blogs. Here I want to focus on eye health.

LED/LCD/AMOLED screens are everywhere, (TV, desktop, laptop, tablet computers, smartphones, and gaming devices). We know that there are potential problems with overuse of these screens. Spending too much time staring at a screen can lead to eye discomfort, eyes feeling tired or strained, dry itchy eyes, difficulty focusing and headaches.

These screens also produce blue light which is associated with additional issues. And with phones, the closer proximity and length of time looking at them adds to the potential problems. There is emerging evidence of damage to retinal cells and increased risk of macular degeneration. It seems that these risks can be significantly increased by looking at your screen in the dark. Many people report using their screen device in bed at night. Of course there are multiple things to consider with this pattern of use, for now just from an eye health perspective, this might of particular concern.

Here are some things you can do to reduce eye problems.

  • Pause now and again and look into the distance or stare out of the window
  • Blink your eyes now and again
  • Stretch your head and neck
  • You should also take frequent short breaks away from the screen.
  • Make sure you’re working in well-lit conditions but without light reflecting off the computer screen.
  • Completely avoid using screens in the dark
  • Use blue light reduction settings if available (but this doesn’t solve all the problems so don’t rely on this as your only measure)
  • Reduce overall screen time

Sources

www.nhs.uk/live-well/healthy-body/eye-safety-at-home-and-work/#

www.ncbi.nlm.nih.gov/pubmed/21600300?report=abstract

www.preventblindness.org/sites/default/files/national/documents/fact_sheets/FS104_BlueLight_1.pdf

www.nature.com/articles/srep11325

www.theguardian.com/technology/2016/jun/23/smartphone-users-temporarily-blinded-looking-screen-in-bed

utnews.utoledo.edu/index.php/08_08_2018/ut-chemists-discover-how-blue-light-speeds-blindness



The Mindful Workplace

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Mindfulness is commonly associated with spiritual (and particularly Buddhist) traditions, but over the past 40 years these practices have been combined with modern psychological theory and developed into a secular training that has been the subject of extensive scientific research.

Mindfulness is about learning to focus and quiet the mind. This is done through simple guided exercises, attending to the breath, and observing what is happening in the mind and body, moment by moment. A kind of ‘mind gym’ which is about paying attention to what is happening right now with kindness and curiosity[i].

Mindfulness practice helps us to learn how to feel contentment in the present moment and manage our emotions more effectively. This has knock-on effects in lots of ways. Research shows that regular practice can bring about a wide range of benefits in physical and emotional health, and social functioning[ii].

A majority of GPs think that Mindfulness should be made widely available[iii]. The Mental Health Foundation – ‘Be Mindful’ Campaign pointed to extensive research pointing to wide ranging benefits[iv].

In 2015 the Mindfulness All-Party Parliamentary Group (MAPPG) published the ‘Mindful Nation UK’ report[v] .  It recognised mindfulness as a major contributor to the nation’s health and wellbeing: “better health and flourishing, improving mental health, and boosting productivity and creativity”. It went on to recommend mindfulness the key area of public policy: criminal justice, healthcare, education and the workplace[vi]. In 2016 the MAPPG launched a new publication: Building Mindfulness in the Workplace[vii] which looked specifically at the impacts of mindfulness at work[viii].

We spend a good proportion of our lives at work, yet for many people these hours are the least happy. Stress related problems at work account for a huge loss of productivity. Organisations are concerned about the increasing cost of employee stress and mental health problems, which account for 70 million sick days, more than half of the total every year

Success in most organisations relies on the very things that unhappiness and stress erode:  collaboration, creativity, cognitive flexibility and effective decision-making. Clearly the cognitive and emotional resources of the workforce will determine the health, resilience and future performance of our businesses and institutions. So forward thinking organisations see that enhancing employee health and wellbeing are just as important as skills training.

Mindfulness in a work context

A recent roundup of the scientific evidence for the potential benefits to business from mindfulness concludes that it can have an impact on many aspects of workplace functioning, including the 3 key areas: Wellbeing, Relationships and Performance[ix].

Wellbeing

A number of studies of workplace mindfulness courses have found positive effects on wellbeing and a reduction in stress and burnout[x]. There is strong evidence of Mindfulness having a positive impact on Anxiety and Depression[xi]. It has also been shown to reduce stress, anger, rumination, and physiological symptoms, while improving positive outlook, empathy, sense of cohesion, self-compassion and overall quality of life[xii].

Working relationships

Positive relationships at work lead to effective collaboration and increased productivity. Research into workplace mindfulness has pointed to improved relationships, collaboration and employee resilience[xiii].

Work Performance

Mindfulness has been shown to have a wide ranging impacts on cognitive functioning, workplace performance, leadership and decision making[xiv].

Introducing mindfulness into your workplace:

We have been delivering mindfulness training to individuals and groups around the country. Here are some of the ways we can help you to bring the benefits of mindfulness into your organisation:

  • A one day course which introduces staff to mindfulness practice
  • A longer mindfulness course which takes place over a number weekly sessions and aims to help participants deepen their practice and bring that into their working life
  • An ongoing program of mindfulness within the organisation
  • Training and developing champions within the organisation that can take mindfulness forward within their organisation

References

 

(more…)


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