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Change

Mental Health

5 January 2024

11 min read

Resolutions: the addict’s guide to making a change

Don’t give up on giving up something. Lauren Windle explains how to arm yourself best for success.

Lauren Windle

Lauren Windle is an author, journalist, presenter and public speaker.

Three signs attached to a fence read: Don't Give Up, One Day At A Time, and Your Mistakes Don't Define You.

Road side encouragement in Lehi, Utah.

Ann Schreck on Unsplash.

I remember the talk we had on ‘giving things up’ every year in my primary school. The same doddery old vicar from a local church tottered down to tell two-hundred children what it meant to sacrifice something we enjoyed in order to feel better down the line. He explained that he could give up kippers, but that would be no sacrifice, as he didn’t even like kippers! How we laughed.

We were young for a lesson on restraint, but down the line, it would prove to be the biggest challenge of my life. The concept is huge for 4-11-year-olds but, as adults, we all know that sacrifice comes with rewards – although many of us resist the idea. It’s very unsexy in a world of ‘you do you boo’, but the fact is, discipline is making a comeback. I read plenty of self-development, smart-thinking and spiritual books, and am gob-smacked by some of the wisdom on offer. The greatest minds of our day are now suggesting taking a full day of rest every week. They are extoling the virtues of honesty to our neural pathways. And they are encouraging fasting as a route to greater mental and physical health. This advice is so sage that it almost sounds biblical.

The world is finally catching up with what the birthday-boy Jesus has been saying for so long. A life of prayer, meditation, bounded connection, outward-focused living, honesty, non-judgement and discipline will lead to the peace and sense of fulfilment that so often eludes us.

We’re not so different you and I. We are all weak. We all live in a world tailored to give us short-sharp dopamine hits when our soul yearns for sustained, hard-earned rewards.

As an active drug addict, I had none of this peace. I didn’t want it. Live fast, die young. The highest of highs faced by the lowest of lows that could be chemically rectified. My assumption was that everyone was miserable, I had just found something to get me through. If anything, I was the one who was winning. But from the cage I had built around me, there was no way to see the freedom I could be enjoying.

It was on 22 April 2014 that I finally gave up cocaine and alcohol after handing over every good thing in my life in service to their attainment. I thought I was trading the misery of addiction for the misery of abstinence. But, what I would slowly learn was that the incredible weakness I had exhibited could be transformed into a strength of such magnitude, it exceeded any dream or hope I had for myself. I had decided to deprive myself for long-term good of my life and unlike Father Brown and his kippers, the cost would be great.

I have a degree in neuroscience. This surprises both people I meet at dinner parties and other students who were on my course – one of which asked if I was lost on my way to beauty therapy. Since getting sober I have added a Master’s in Addiction Studies from King’s College London to my resumé and five years of heading up a recovery programme for people struggling with all sorts of addictions. I have mentored, coached and sponsored scores of people to freedom. In the process I’ve learned a thing or two about ‘giving things up’.

The best time is right now. Before you’ve had one last ‘treat day’, one last party or one last flutter. The best time to make a change is the moment you realise you need to.

There are two points I’d like to address before we get into the nitty gritty. Firstly, yes this is relevant to you. This isn’t an addict’s sob story where you get to voyeuristically bask in my pain before returning to your cushty life safe in the knowledge that you’ll never sink so low. Addiction is at the top end of a scale of idolatry that we all teeter on the brink of. If you think you can’t relate to my story, turn your phone off for three days and note how you feel every time you go to reach for it. We’re not so different you and I. We are all weak. We all live in a world tailored to give us short-sharp dopamine hits when our soul yearns for sustained, hard-earned rewards. We all have something we could afford to give up or moderate.

Second, New Year’s Day is not the best day to give something up. Neither is the first day of the month, or next Monday, or even tomorrow morning. The best time is right now. Before you’ve had one last ‘treat day’, one last party or one last flutter. The best time to make a change is the moment you realise you need to. That said, I do know plenty of people who gave up smoking for Stop-tober and never looked back and there are plenty of resolutions that have resulted in lasting change. Also - we are conveniently placed at the start of a new year, so let’s strike while the iron is hot.

If you have decided to give something up this year, here is how I, a recovering addict, believes you can arm yourself best for success.

Set clear goals

Leave the shades of grey to E. L. James. When it comes to making a positive change in your life this is a black and white business. ‘To be on my phone less’, ‘to read more’, ‘to drink less’… these are too vague to be achievable. Instead try: ‘to turn off my phone at 9pm and not turn it back on until 9am’, ‘to go to bed half an hour earlier and read 10 pages of a book’ or ‘to only drink on two days a week and have no more than three drinks.’

I once worked with a woman who set herself some simple goals around food: not to eat while she was cooking, not to eat in the supermarket, not to eat in her car and not to eat in her bedroom. This is far easier to attain than just a generic diet.

If you want to change your clear goals, you absolutely can… after a three-day cooling off period. If you want to up your drinking days to three per week, do it. But it will start next week, not this one when you’ve already drunk on Wednesday and Thursday and someone brings round some beers on Saturday night. You want to turn on your phone an hour earlier every morning, definitely do. But that will start in three-days-time, not on a low day when you’re fighting in bed and decide ‘what’s the harm?’

It's half about the lower screen time/alcohol consumption etc. and half about your ability to play by the rules, to exercise discipline and to make a decision today that will benefit you tomorrow. This is about looking after yourself as you would someone else who was your responsibility. You must enforce boundaries to help your charge develop well. Only this time, your charge is you.

Tell people

Social pressure is a helpful tool. Did you know those flyers that they drop through your door saying: ‘90% of your neighbours have completed their tax return by now’ are far more effective than the ones saying: ‘File your tax return’? How others perceive us matters to us.

Research shows that the more people you tell about your new resolution, the more likely you are to keep it. If you’ve announced to the Jones’ that you won’t be drinking and then pour yourself a cheeky snifter, you don’t just disappoint yourself but you run risk of a loss of respect from those you informed of your decision. Keeping up with the Jones’ can be a powerful motivator.

Expanding on that premise, and taking it from a threat to an encouragement, there’s also evidence that doing things in a group greatly increases everyone’s chances of success. If you’re reducing phone time, why not set up a WhatsApp group where you drop a message to your comrades just as you turn off your phone. That way everyone will have a record of the time each person logged off, you could then catch up in the morning and say how you used the time instead. If your plan is to exercise more, head to the same class every Tuesday morning with a friend and grab coffee afterwards. If you’re making pledges around food or alcohol patterns, why not agree them with your partner as you’re likely to share many meals together?

For the sake of your friendships though - make it clear to whoever you tell if you expect them to challenge you if you fall short or if you want them to leave you to it. Don’t expect a friend to police you without their prior agreement. Equally don’t expect them to stand by as you break your resolution without saying anything, unless you’ve made it clear you don’t want their intervention.

Observe yourself

There will be times when sticking to your resolution is easy (usually the firs two days of January). But unless you’ve gone for the kippers option, there will be times when it is incredibly hard. Observe yourself in those moments, ask yourself questions and understand what it is about those times that present a challenge.

Many people reach for their comforts when they’re happy, hungry, angry, lonely or tired. How do you respond when you feel these emotions? What brings you most comfort? Is there a healthier option that could support you instead?

You see, if you’re giving up something that has become an idol, that takes your attention and satisfies that dopamine craving when you most want it, you’ve left a vacuum. The void could mean you are more drawn to your crutch of choice than ever. Or it could mean that you select something equally unhelpful to get you through. Identify these crevices as they arise and come up with a plan to protect yourself in those moments.

I’ll kick you off with a few examples:

You would usually pour yourself a glass of wine to mark the end of a working day? Get outside for a walk.
You would usually fiddle on your phone on the commute? Bring a book with you.
You get distracted during prayer/meditation time? Take a notepad with you, jot down any thought and then get back to your practice.
Connect with friends over booze at the pub? Host a games night.
Give yourself a little treat of chocolate or cake after a long day? Get a nice selection of teas and hot drinks.

Personalise the above as required.

Don’t beat yourself up

Lifestyle changes involve failure. Sadly, most things that are worth having involve accepting some level of failure. It doesn’t make you weak. It doesn’t make you evil. It doesn’t make you anything other than human. ‘The measure of a person isn’t how they fall, but how they pick themselves up.’ – said some over-quoted person like Gandhi, Theodore Roosevelt or Marylin Monroe probably.

Discipline is a muscle that needs work, and if this is your first time seriously embarking on something like this, you’re in the equivalent of the beginners’ Zumba category. Slipping up does not signal the end. It signals a slip. If I were cycling from London to Brighton and I fell off my bike around Horsham, I wouldn’t pick it up, walk it back to London and start again. I get to remount the bike exactly where I fell. I get the benefit and experience of the last 30 miles of road. It is an opportunity to strengthen my resolve and recommit myself, not to give up until next year.

Use the tools

There are an outrageous number of tools available to help you in your quest for progress. Don’t be too proud to use them. There are tracker apps, accountability programmes (like covenant eyes for those who want to cut out porn), books, podcasts, charities, anonymous meetings, medications, therapists, doctors, family, friends, churches and many others who can be with you. They can help while you mull on any challenges and strategize solutions that will help you grow.

Self-efficacy is key

There’s a study that I promise exists, even though in my in-between-Christmas-and-new-year haze I can’t find the reference for it. It was research on cannabis. Formerly cannabis was most commonly found as a secondary addiction for those whose primary focus was cocaine, heroin, Benzodiazepine or alcohol. But with the increased potency of street-level cannabis and the invention of synthetic-cannabinoids like Spice, more people are dying at the hands of marijuana, and therefore there are increasing budgets for research.

Unlike heroine, Benzos or alcohol, there is no medical intervention to support those coming off cannabis. So the study looked at the primary factors that supported long-term abstinence from the drug. The strongest predictor of successful recovery was self-efficacy i.e. participants who were most likely to get and stay clean were those who started the process by saying they believed they could.

You can make any positive lifestyle change you want but it takes time and perseverance. But if you make a declaration believing you probably won’t stick to it or that you’ll see how it goes – you’ve lost before you’ve started.

It won’t feel good

There’s an unspoken expectation that taking steps towards better, more nourishing clean-living feels good. Some people think that they will start waking up before their alarm, well-hydrated, with enough energy for a quick round of squash before a bracing ice bath and hearty breakfast. This is not my experience.

There are times when, in order to stick to my resolve, I had to just stay in bed. Not moving or facing the outside world. There were times when the agony of rejecting my crutches felt unbearable. Anything felt better than continuing on that difficult path of discipline. Achievement, to-do lists and even the notion of ‘a calling’ are reserved for those lucky enough to be functioning that day. The rest of us just have to survive.

The feeling of pain won’t last. It never does. For some it will be a few days of discomfort, followed by smug boasting that they ‘don’t even think about caffeine anymore’. While for others, the loss will sting and it will take time before they feel any benefit. But those benefits are coming. They are worth holding out for. In a world of 10-15 minute Deliveroo meals, let’s take an hour to cook ourselves a good dinner. In a world where every movie is a few remote clicks away, let’s read a book. In a world where you can plough on, getting things done, let’s boot one thing off our checklists and pause to pray instead. In a world of quick solutions, let’s take the long, restrained route. Let’s allow the process to run its course. Let’s become better, stronger people who are more equipped to carry life’s burdens and help others along the way too.

Article

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?"

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.