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Taylor Swift’s world-famous Eras Tour arrives at the Wembley Stadium in London tonight. While I am a ‘Swiftie’ (A Taylor Swift fan), I unfortunately wasn’t able to buy tickets, which sold out in a matter of minutes when they were first released, following a protocol whereby only individuals with a ‘ pre-sale code ’  were able to purchase tickets. But, I have been following this concert virtually, and for those who, like me want to get the concert experience, I have linked a trailer to the Eras Tour movie, available on Disney+. Why is the Eras tour such a phenomenon? Most artists typically go ‘on tour’ when they release an album, performing songs mainly from that album. What sets the Eras tour apart, is that Taylor Swift performs songs from all the albums she’s ever recorded, spanning a career over two decades. It reflects different circumstances in her life, from love (the Lover era), heartbreak (the Tortured Poets Department Era), slander and reputation (the Reputation era) sharing with her fans the evolution of her personal and professional life (you can learn about each Era here ). The Eras tour has become such a phenomenon, that in 2023, she was recognised at Time Magazine’s Person of the Year . For context, this title in the past has been held by Popes, Presidents, and now, a Pop Star. My personal favourite part of the Eras tour is the tradition of the ‘22 Hat’. Part of her ‘Red’ era, she performs her upbeat song 22, wearing a black hat. One special fan is chosen from the audience to personally receive the hat from Taylor during the performance, and most of these fans have been young girls who have dreamt of seeing her perform all their lives. At one of the first shows, that is featured in the Eras tour film, the hat was given to the late basketball legend Kobe Bryant’s daughter, Bianka Bryant . One of the other recipients at one of the Australia eras Tour shows was 9 year old Olivia Scarlett, who bravely fought a brain cancer diagnosis,  and unfortunately lost her battle in April 2024 (you can watch this moment here ). Taylor Swift has sung about mental health and societal issues Taylor Swift has never shied away from talking about mental health. One of her songs, the ‘Anti-hero’ talks about her low mood and depressive symptoms, with lyrics such as “ When my depression works the graveyard shift ,  all of the people I've ghosted stand there in the room ”. In her documentary “Miss Americana” on Netflix, she also opened up about her experience with disordered eating habits . She is not one to shy away from politics and societal issues either. Her song “Miss Americana and the Heartbreak Prince” referred to the tumultuous US political climate of 2018. In fact, the song has been heralded the “Great Protest Song of Our Time” . From the same album, her song “The Man” tackles issue of gender inequality. She talks about how, if she was a man, people wouldn’t question her talents, and success success, nor would they judge her every outfit and action. The central lines of the chorus are: “ I’m so sick of running as fast as I ca n Wonderin' if I'd get there quicker if I was a man ” “You need to calm down” is yet another song  from the Lover era, which essentially claps back at haters who anonymously post rude and hateful comments online. In one of the verses, she promotes LGBTQIA+ rights: " And control your urges to scream about all the people you hate 'Cause shade never made anybody less gay " The controversies around the Eras tour Whilst I have addressed the stardom of Swift and magnitude of the Eras tour, it is important to also talk about issues that have risen ever since the tour was announced. From an environmental perspective, Taylor Swift has made headlines due to the sheer amount of carbon emissions caused from flying the world over. For example, when she flew in her private jet from Toyko to LA in time for the Superbowl (in which her sportsman boyfriend Travis Kelce was playing), she is likely to have produced more than 50 tons of carbon emissions . While some argue that her carbon emissions are disastrous for the environment, others defend her, citing that someone’s plane travel is a private matter, and should not be tracked, as this violates the privacy of those in the limelight. In fact, in 2022, she was reported to be the number one celebrity CO2 polluter , with emissions estimated to be over a 1,000 times those of others. However, in response, her publicist has mentioned that Swift uses carbon offsets, referring to investment in environmental activities to balance her carbon footprint. You can learn more about this here. One glaring problem is the excruciatingly high prices of tickets, set by Ticketmaster, a ticket sales and distribution company . A number of additional problems were then associated with the platform, such as cancelled sales due to the website crashing, those with presale codes being in virtual queues for hours, and skyrocketing resale prices. In fact, this fiasco has now become a legal matter being heard in the US Senate .   Some of these controversies have also been discussed in the academic setting. On the 12th of June, ahead of Swift’s performance in Liverpool, the University of Liverpool’s Department of Music hosted ‘ Tay Day ’,  an academic conference dedicated to “ discussing and debating all things Taylor Swift ” . They essentially took a balanced stance on this worldwide topic discussing her role as a feminist and LGBTQIA+ rights activist, as well as the problems she has been criticized for, such as her carbon emissions. To sum, Taylor Swift and her tour have undoubtedly made the headlines for both good reasons as well as some concerns. While I am a fan of her music and applaud her success and concern for social issues, I am also aware of the controversies I have discussed in today’s piece. As with supporting any celebrity or artist, it is important to be aware of both their positive, as well as negative qualities, so that we can apply critical thinking and ensure that we don’t blindly idolise them. I am now ending with a fun fact for all our readers from within KCL: did you know that Taylor Swift’s first ever show in the UK was held in the Vault at the Strand Campus in 2008?

Have you ever signed up for something, knowing it was a bad idea then worried about it for months on end only for your fears to be totally well-founded? My advice: if you are worried don’t do it! I’ve learned this the hard way, crashing into a wall of rocks at speed.   Last October, I was happily having lunch with a couple of friends from university. We all met at Queen Elizabeth College in Kensington back in 1983 (now King’s College London- I haven’t moved very far!) - it was great to catch up and reminisce. Someone (I think it may have been me) said something like “ hey -do you realise it was was exactly 40 years ago this week that we met?” The conversation then turned to how we should mark this momentous occasion. One chap, a very keen cyclist said “ are you guys up for cycling in the alps next summer? I’ve been thinking of doing this ride from Courchevel to Antibes .”   I had taken up cycling during the covid years having bought a bike under the ‘cycle to work’ scheme just before lockdown when bikes became as rare as hen’s teeth, so, spurred on by the Chablis, I agreed enthusiastically. Our other pal did too but said he would only do it on his electric bike. It was a done deal. The route was planned with a professional company that provide back up (a man in a van and a guide), flights were booked, and the date (Sept 2024) was set.   At first, I was excited about the prospect. What a great way to get fit, lose some weight, and keep me occupied throughout the winter. I had been looking for a challenge as I was entering my 60th year so this seemed to fit the bill. I already had a turbo trainer and Zwift subscription, so I planned to ramp up my training through the winter months. Things ticked along, friends I told thought I was mad, but as it was far in the distance, I didn’t start to worry about it until around May. At that point my fears were mostly about getting up the mountains - I changed the gearing on my bike and bought all sorts of new kit in the hope that I was fully prepared. By this time other people had been recruited to the challenge and we agreed to a couple of training rides out in Berkshire, at which I was hopelessly outclassed.   Even so, I pushed on with the training, gave up drinking in a bid to lose 7kg so I would have less to ‘carry’ uphill, and started to panic. In July that panic shifted from fear of going up to fear of coming down. We had been sent the route by the company - Day 1: Le Col de Madeleine . Basically, uphill for 25 km then 25km down the other side. Add in another 40km to and from the hotels and that was the gentle introduction. Day 2: Two mountains; La Croix de Fer  followed by l’ Alpe D’Huez . And so, it continued for 7 days. I was showing my son the route when he said rather unhelpfully, “ Dad, you’re probably going to die on the way down ”. This, though obviously said in jest, did not help. He saw the panic on my face. Later he had a quiet word with his mum saying he was worried because he thought I was terrified.   I phoned my mum - not a good idea. I told her about the trip. “ You’ll be careful coming down the mountains, won’t you? ” Not what I needed. This request was repeated every time I spoke to her in the lead up to my departure, and by now I was in full ‘anticipatory anxiety mode’. My son Seb came up with another pearl of wisdom “ Dad, why do old men (note not middle-aged men!) feel the need to take up cycling? ” A good question. I said something along the lines of “ we all get fat so some of us take up exercise- running hurts our knees so cycling seems a better option ”. There’s obviously a lot more to it than that, and that’s probably another blog in itself. I denied I was having a mid-life crisis on the grounds I was beyond ‘mid-life’. Throughout this, I mentioned ‘anticipatory anxiety’. I have suffered from this before. When I was 22, I went to the US, and I was convinced I was going to die. I was plagued for months - I left sealed ‘goodbye’ messages to my family. I even ‘knew’ the day on which it would happen - a day I was flying from Chicago to Los Angeles. Turns out, I got so drunk the night before I left Chicago that I was horrendously sick on the plane but at least I’m here to tell the tale. Since then, I would never describe myself as a worrier. Day 1 – Le Col de Madeleine By the time I left for France with all the ‘be careful’ messages ringing in my ears, I was a nervous wreck. As soon as we got to Courchevel we built the bikes and went on a short test ride over to Meribel . I felt much better to get going and my legs felt great. The next day we left the chalet at 8.30am and dropped down into the valley before tackling the Col de Madeleine. We all got up okay and had a nice lunch at the top before dropping down the other side. Most of the gang took off at great speed, I was more conservative. I was so tense gripping the brake hoods that my neck was soon in agony. I knew the problem but just couldn’t relax on the bike. I was so glad to get to the bottom in one piece and the pain eased as we rode on the flat. That night, I got so much conflicting advice on how to descend my head was in a whirl. Day 2- Le Col de la Croix de Fer This mountain is a brute - it’s 28km up to a height of 2067m. The first 2km have an elevation of 8% so it’s immediately tough. There’s a relative respite between 12-20km (4-5%) and ramps up for the last 8km (8-9%). I experienced a huge sense of achievement and relief when I finally got up there. There was a well-earned lunch at the summit, but we were soon back on the bikes for the descent to Le Bourg-d'Oisans. The descent starts with long sweeping curves, and you can see a good few kilometres into the distance. It then gets tighter with more switchback chicanes. Again, I was gripping on for dear life but strangely enjoying the first 10km. The roads were busy in both directions- about 10 Porsches came past at speed – all in a line and groups of motorcyclists hammering down the mountain. I was constantly talking to myself, concentrate…concentrate. We were hitting speeds of between 50-70km/h on the open stretches. I remember slowing for a double chicane, congratulating myself for negotiating it safely - then it happened. I was accelerating after the chicane (I reached 40km/h according to my Garmin), the next corner arrived quicker than anticipated and I hit the brakes. My back wheel slid, and I managed to keep upright but now I was heading for the rocks. The front wheel hit the first one and I went over the handle-bars. It is a cliché to say it all happened in slow-motion, but I really did have time to think- ‘ oh, this is going to hurt .’ I slammed into the rocks, my ribs on right side were the first point of contact then my left hip and head. I lay there stunned and motionless for an indeterminate length of time. A German couple got to me first. They helped me extract myself from the rocks and I explained I had friends behind me on the mountain who could call the support van, which by this stage was waiting at the bottom. I was lifted into the van having refused a trip to hospital.   As we drove down 3 ambulances were on their way up - one of the Porsches had hit a motorcyclist knocking him down the mountainside, and a young girl in a cycle race had come off at the corner after the one I hit and lay unconscious. It is a crazy, dangerous place! We got to the hotel, but I couldn’t walk. I shuffled to the bar and called my wife. My wife is a consultant physician, so I got a practical and unemotional assessment.  Once she was happy that I didn’t need to go to hospital (i.e. she was happy my hip wasn’t fractured) she said, “ well, you have to try to get back on the bike tomorrow- you don’t want to spend the rest of the week in the van ”. The guys were quite stunned at this, especially the next morning when I asked two of them to lift me on to the bike. I rode 60km that morning before retiring to the van after lunch. It was agony for the most part – upper body suffering but although I couldn’t walk very well, the pedalling motion was fine. From there I didn’t look back. Although, in constant pain, I tackled one more big mountain, Mont Ventoux. The last 5km of Mont Ventoux is fairly bleak- well it was on the day we were there. About 1 km from the summit is a memorial to British cyclist Tom Simpson who collapsed and died there during the 1967 Tour de France. We stopped at the memorial on our way down. It is a stark reminder to respect the terrain. The weather closed in and after coming down the first 5Km on the bike, I refused to go down any further so got in the van. I’d completely lost my nerve on the descents After Ventoux, we were into Provence so the big hills were behind us.The sun came out and  we cycled through the incredibly scenic Gorges du Verdon . At last, I was able to enjoy the ride (almost). On day 7 , we made to the beach at Antibes!   I have never been so pleased to reach anywhere else. Looking back, was it a coincidence that I crashed, do I have insight or was my anxiety about crashing the root cause making it inevitable? I’ll never know but I do know I’m not very good at predicting future outcomes.

I distinctly remember my first introduction to One Direction, when I was 11 years old. It was the “What Makes You Beautiful” music video , with Liam Payne singing the opening lines. Little did I know that from this moment on, supporting the band would shape a key aspect of my pre-teen and teenage years. A little over 10 years later, on the 16th of October I woke up to a one-word message from my best friend. Under that, was a BBC announcement that Liam Payne had tragically lost his life, aged 31 in a hotel in Buenos Aires, Argentina. I spent much of yesterday re-living all my memories of when I was a Directioner (a One Direction fan). I grew up in Mumbai, and sadly, the band never performed in India. Merchandise was not available either, and I distinctly remember my father buying me a few t-shirts and books from one of his work trips abroad, which, as it happens, I have to this very day. My time after school, when not doing homework, was dedicated to listening to their newest music, watching their famous “video diaries” , and dreaming about the day I would finally watch them live. I am aware that recently, before his passing, Liam had been in the news because of a fictional book published by his ex-girlfriend based on her relationship with him. It discussed aspects of their relationship such as abuse, harassment, and details which might be triggering to some readers. Eventually, she issued a cease and desist against him last week due to harassment from him. Further, after the band split up, stories about Liam being violent with his mates emerged. So,  like many other celebrities, Liam too had negative qualities about him. On my commute yesterday, I started scrolling on X, where my timeline was all about his passing. Sadly, I saw a few tweets that said he ‘deserved to die’ because of everything he put his ex-girlfriend through, and others which trolled his fans for mourning his death. And this made me very upset.  It is rather complicated to deal with these conflicting feelings, when someone who I have respected so much as an artist in my teenage years has then done horrible things. When he was part of One Direction, he was young; but, as he grew, he became quite a different person, who caused harm to others. This brings me back to what I discussed in this article a few months ago, where I said that we cannot wear rose-coloured glasses when we support celebrities, . We need to be aware of their negative qualities, and, when they do bad things, we do not need to defend them. Liam was part of a band that broke records and made history. He was a great musician, who, according to reports , was making a conscious effort to mend his life, such as his relationship with his son. He was an important part of so many of our lives growing up. Seeing that pictures of his body had been acquired by TMZ , and the fake videos circulating, at a sensitive time when his family was coming to terms with his loss, infuriated me. Where is the empathy? Just because he was a celebrity, no one has the right to violate his privacy, especially in death. In 2019 , he opened up about his experience with loneliness and poor mental health, often resorting to alcohol and other substances as a coping mechanism. In relation to his death, news reports said Argentinian police was responding to reports of ‘an aggressive man who may have been under the effects of drugs and alcohol’ based on a phone conversation with the Manager of the hotel where Liam was staying. As I reflect, I realise that so many stars who rose to fame in their teenage years or early twenties, fell victim to alcohol and substance abuse as adults. like Amy Winehouse , and Demi Lovato . Coping with fame can be a challenging experience anyway - coping with the pressures of adolescence coupled with constantly being in the limelight can undoubtedly affect mental health. Liam is one such celebrity who sadly fell victim to this. My fondest memories of One Direction One of the reasons why I have written this article is to reflect on the amazing memories I have made because of One Direction, and to celebrate the life of Liam. If you, like me, grew up with them, I’m sure some of these will bring a smile to your face. I am currently writing this piece as I listen to “Night Changes”, feeling particularly emotional. Here is a photograph of 12-year-old me, proudly posing with my newly acquired One Direction book. As I mentioned earlier, merchandise in India was unavailable. I distinctly remember my dear dad, in between a jam-packed day of meetings on a work trip, went to a pop-up store in New York city, just to buy his tween daughter merchandise of this boyband she loved so much. I can just imagine how he might have been the oldest in the shop by many years, in a suit and tie, surrounded by other tween fans. I remember when their This is Us movie was released, and how my best friend and I were two giddy girls off to the theatres like grownups. Now that I think of it, not even the Taylor Swift Eras tour film instils the same feeling in me. Just like every other Directioner, when I hear words like “Kevin” and “No! Jimmy protested” my mind automatically plays the infamous video diaries in my head. Back then, we didn’t have streaming services like Netflix and Prime. When music awards were scheduled, due to time differences, I could never watch them live. So, I’d record them onto my tv and watch them so passionately when I got back from school the next day. As I think about all these memories, I can’t help but be emotional. I never expected that we would lose someone from the band so soon. I always imagined a potential reunion decades later, when I would be a grown woman, perhaps a mother, telling my child about all these amazing memories. But, for now, I can only say, “Just how fast the night changes” . Last evening, all the members of the band put out a joint statement honouring Liam, and it was so sad to see that they had reunited under such sad circumstances.   Rest in peace Liam, you will forever be remembered.

During my clinical training as a psychiatrist, I had access to the emotional worlds of my patients in every aspect. This could be challenging, as the person may not always recognise what they have, emotionally, going on. In this article, I will try to explain what it means for some people to be unable to recognise or express their emotions, a diagnosis called ‘Alexithymia’. One of the most common questions psychiatrists ask their patients is "How are you?" . This question may appear trivial, but when we ask a person how they truly feel, we attempt to gain access to their daily life and emotional world. As much as we try to tiptoe into this dimension the “how-are-you-question” can sometimes be a source of distress, especially when someone struggles to access their feelings. Not having access to their emotions frequently leads to a lack of words to express what is happening. Therefore, the response to the question “How are you?”  might be “I don’t know” . This inability to grasp what they are feeling or why they are experiencing certain feelings can lead to somatising the emotions. This means feeling emotional states through bodily symptoms. For example, when asked: "How are you?" , they may respond with: "I always have headaches" . This difficulty in recognising and expressing emotions can become a persistent condition: alexithymia. So, what is alexithymia? Alexithymia , or emotional blindness, is a term coined by John Nemiah and Peter Sifneos in the early 1970s to describe a set of characteristics found in "psychosomatic" patients – i.e. patients whose organic pathology (e.g., headache, difficulty swallowing) is a symptom of unexpressed psychological distress. The word alexithymia comes from the Greek “a-“ (“lack”), “lexis” (“word”), and “thymos” (“emotion”), which literally means “lack of words to express emotions”. Alexithymia is the inability to recognise and verbally describe one's own emotional states and those of others, as well as to distinguish emotional states from physiological perceptions. People with alexithymic traits often struggle to identify their emotional states, express their feelings, or comprehend the emotional condition of others. Failure to characterise emotional states can result in a decline in imaginative, dreamy, and introspective capacities. For this reason, people with alexithymia tend to have behaviours that conform to the masses. They mirror the emotions of the crowd and experience these emotions physically in their bodies. Experiencing an emotion purely on a physical level prevents its cognitive processing, making it difficult to articulate or fully understand. As a result, the emotion is perceived, but not recognised, which may loop back around to further feeling emotions through physical symptoms.   Not a disorder, but a personality trait… Alexithymia is a common personality trait in conditions where the expression of mental pain and discomfort also passes through the body, such as post-traumatic stress disorder, eating disorders, dyspepsia (a feeling of fullness or bloating during and after meals), dysphagia (difficulty in swallowing), certain sexual disorders (e.g., erectile dysfunction), anxiety disorders, and substance abuse. Another aspect of alexithymia is the difficulty in showing empathy toward others. The less a person is aware of their own emotions, the less they will be able to be empathetic. This should not be confused with the clinical deficit of empathy, which could be present in other disorders. In fact, alexithymic individuals can sense empathy. However, they understand empathy through physicality and, thus, cannot directly recognise it.   Is alexithymia spreading in our generation? From a broader, more global perspective, it's hard not to notice how recognition and expression of emotions have changed dramatically in the age of the internet. In the presence of a screen, and the possibility of starting or interrupting communication at any time, people are less concerned about how they are perceived – in other words, they are more likely to establish superficial relationships. Additionally, interactions often only occur between two persons, displacing people from group dynamics which have differing emotional loads. Considering these factors, the quality of online connections differs from that of connections formed offline.   The importance of “reconnecting” with ourselves Alexithymia may have significant impacts on the lives of those experiencing it. Therefore, therapeutic interventions geared at recognising and improving emotional processing may be powerful tools. A first step towards emotional recognition could be to start being mindful of physiological responses (for example, to concentrate on the heartbeat and recognise its variations during different situations). Psychological treatments such as cognitive behavioural therapy (CBT), group therapy, and psychoeducation can aid the recognition and verbalisation of one's emotions, resulting in increased emotional awareness, more meaningful relationships, and a higher quality of life. For example, a study on a psychoeducational intervention  found that teaching adolescents in a school environment to recognise their emotions can assist in reducing bullying, racism, and homophobic behaviours and attitudes. One suggested reason for this is empathy; when kids are taught to experience and recognise emotions, they gain different perspectives on reality and a greater understanding of the consequences of their actions, particularly how they impact others. Furthermore, several factors have been identified to assist clinicians in supporting individuals in exploring emotional themes . Psychotherapy incorporating specialised strategies to promote emotional awareness and use symbolic components of emotional systems could help reduce alexithymic features. Changes in alexithymia appear to be connected with assigning meaning to emotional experience, relating feelings to events, or accessing new perspectives. A message to keep in mind: "negative" emotions are just as important as "positive" ones. So, learning ways to identify emotions doesn’t mean working against "negative ones" but working with them to live a life we can feel (and recognise) in every aspect. So, how are you?

Like catching up with an old friend or, during a spontaneous deep clean of the entire house, stumbling upon a trinket that you thought you’d lost lifetimes ago, there’s such a sweet comfort in rewatching one of your favourite TV shows or films years later. This past Christmas, my brother – the youngest of the three of us – gifted me nostalgia in the form of a 23-disc box set. Doctor Who, Series 1-4. Not unexpected, given his out-of-the-blue “btw do you guys like the 11th doctor? Or just 10?”  text in our siblings' group chat in early December. For two nerds who spent their early teens charmed by David Tennant’s performance as the time-travelling spaceman, the answer from my sister and I was a no-brainer and an immediate “obviously, 10”. Not long after gifts had been opened and Christmas dinner devoured, we three made plans to rewatch this beloved show from our childhoods together. My TV, my sister’s PS4, and my brother’s snacks all made their way to our parents’ room to take over the space. Three overgrown children squished together on the bed for a Christmas movie night, popcorn and drinks in hand. Right away, my sister and I began our excited whisperings, pointing out foreshadowing and throwaway lines that would come back to haunt the characters, and practically cheering at iconic quotes. Thankfully, our brother is a patient man and paid no mind to our incessant yapping, instead focused on the story unfolding before him that he had been too young to understand the first time around. Although I genuinely love exploring unfamiliar worlds in new stories, I can’t deny how thrilled I am when a loved one tells me “Oh, I’ve never seen that. Would you want to watch together?”. And I’m hardly alone if all the nostalgia talk and endless reboot after remake after sequel is anything to go by. But why is that? Why do we enjoy revisiting the stories – the “old friends” – we love so much, instead of just seeking out the new? What is Nostalgia? Nostalgia is a concept I’m sure you’re all too familiar with – the bittersweet ache of memory, the moment of melancholy, the wave of familiarity and ensuing mourning. Often paired with a wistful sigh, nostalgia is “a feeling of pleasure and also slight sadness when you think about things that happened in the past” . When it comes to stories, one of the most entertaining aspects of rewatching a favourite show or film is the fun of noticing details that you missed the first time around. The foreshadowing and “how on earth did we not notice that?” hidden-in-plain-sight Easter eggs. With every revisit to a beloved “old friend”, there are new truths discovered and depths revealed. In a well-crafted piece, it’s a chance to find a greater appreciation for the artists and their artistry. Research shows that we are comforted by familiarity and expectedness compared to the unpredictability and perceived risk of trying something new. This is also true for the stories we read and watch. How many times have you felt down and leaned on a romcom or classic for comfort? It’s comforting and familiar stories are far less cognitively demanding in times we already feel overwhelmed. In a world of unpredictability, the predictability of our “old friends” can provide that much-needed sense of escaping and stability. Sometimes it helps to just have an episode of a show you’ve seen countless times playing in the background as you think and deal: a small consistency during moments of turbulence. Alongside escapism, in particularly high-stress times – like the first year of the pandemic – nostalgic thinking can promote optimism and act as a buffer for deteriorating mood . Nostalgia as a Social Experience We are all sentimental about something. Whether it be the “good ol’ days” or chocolates we had as children. This missing what once was is a shared feeling allowing us to feel closer connected to those around us . In this way, nostalgia is a social experience  and more than just a yearning but also a way to strengthen our sense of belonging, identity, and self-regard. This collective nostalgia is often utilised in politics , particularly in more conservative groups, in which the dissatisfaction with present-day events motivates a mission to turn nostalgia from just reminiscing into a world necessary to return to. In contrast, studies in the United States shortly after Donald Trump’s election into office found that “Obama nostalgia” predicted political engagement and voting intentions . Though nostalgia and how we engage with it can certainly be a form of avoidance, research also suggests that nostalgic thinking regulates avoidance and motivates action . Of course, the world of politics is by no means the only way collective nostalgia is utilised... Nostalgia as Marketing In advertising, relatability and sentimentality are exploited. Our nostalgia is targeted as a marketing  strategy every day – and sometimes, nostalgia for times we weren’t even alive for . And it works! People will heavily dispute the quality and necessity of the Star Wars sequel trilogy, but we all spent the money on cinema tickets and saw those films. Why? Because it’s Star Wars! Of course, you’re going to watch the ‘nth new show for the chance they’ll throw in a cameo or line about a character you’ve been attached to since you were a child . It’s a story you grew up with, that so many love, you’d be a fool to miss out on seeing something this important together, right? As cynical as it sounds, targeting your love for the story and the childhood attached to it worked and the goal of the production was met: to make as much money off an established brand as possible. For better or for worse, trust that you and your grandkids will be seeing new Star Wars films and TV shows  until the end of time. And what does this tell us, as audiences? Nostalgia sells – originality just doesn’t. Of course, there are always exceptions to the rule but generally, this seems to be the stance taken by production companies. Look, for example, at the rate of cancellations of new series  over the years. Netflix is becoming increasingly known for how soon after a first season is released, they announce its cancellation . This isn’t an exaggeration and Netflix isn’t the sole culprit; just recently, Amazon Prime received criticism for its similar response to the series My Lady Jane , released on June 27th and cancelled just over a month later on August 16th . More often, audiences are asking ‘What’s the point of starting something new if it’s going to get cancelled before I get a chance to even finish watching the 8 episodes they have out?’. Instead, we then turn to shows that concluded years ago and, conveniently, paying for licences to host these shows rather than paying for full original productions ( except reality shows ) is far more cost-effective for streaming services like Netflix and Prime. And so, we end up trapped in a nostalgia-fed time loop. Nostalgia and You This doesn’t mean we should stop seeking new stories ourselves or that we should feel bad for nostalgic thinking or enjoying the latest remake reboot sequel. As with most things, there is nuance to the topic and no distinct right or wrong answer. Revisiting “old friends” is also a chance to reflect on how we and the world have changed in the years since that first watch. However, in cases where that change may be upsetting or uncomfortable, studies have shown that nostalgic thinking can positively impact self-continuity , which in turn can promote "meaning in life" (i.e., that the events in one's past connect them to who they are today, providing coherence). As we mature, our perspectives shift, as do our interpretations of the same story. To younger-you, what once was a simple comedy may now, to adult-you, reveal profound bittersweet insights into what it is to be human. Or perhaps a theme that went right over your head as a child now hits like a ton of bricks, leaving you an emotional wreck for hours after. Revisiting “old friends” is more than a nostalgic trip down memory lane. It’s finding new appreciation for the craftsmanship, finding solace in familiar stories, connecting with loved ones, or reflecting on how you’ve changed. It’s a timeless joy. So, the next time you find yourself in need of a pick-me-up, why not dust off that old box set and embark on a journey back to the stories and worlds that captured your heart years ago?

It is ADHD Awareness Month , and I often find myself reflecting on my own diagnosis of attention deficit hyperactivity disorder (ADHD), and the challenges and strengths it's brought to my life. However, what I have frequently found is ADHD is often discussed in terms of its impairments.    Struggling to concentrate. Forgetfulness. Emotional dysregulation, and a predisposition to depression. Problems with sleep. Difficulties meeting potential at school, work and beyond.   The list goes on and on, and when I was diagnosed with ADHD in my second year of medical school, I quickly found that we rarely balance it with anything positive. I am now in my seventh and final year of medical school and will graduate next year. However, at the time of my diagnosis in my second year, I was on academic probation and already very aware of my weaknesses. Although I now have a diagnosis that explains some of my difficulties, the D for “deficit” in ADHD overshadowed all the other letters for me. Before my diagnosis, I was already worried I wasn’t suited for a medical career. However, reading online about ADHD after my diagnosis made me feel like I had been officially labelled as unsuitable.   Most importantly, I struggled to find examples of doctors who succeeded with ADHD.  Some people with ADHD do make statements online such as “ADHD is my superpower”, but that has always felt a bit unbalanced and too far in the other direction for me. I had heard that some people with ADHD claimed it made them more creative or spontaneous, and I wondered if there were any strengths of having ADHD as a doctor.   I figured that ADHD must have some strengths – otherwise, why would it still be genetically pervasive, if it was 100% disadvantageous? I’m now coming to the end of my time at medical school, and going into my seventh and final year, I think I’ve finally found some of those elusive positives to having a neurodevelopmental condition.   My impulsivity has got me into trouble at times - rushed work at school, booking flights to Paris on a whim, and once famously catching a hot iron with an outstretched palm. However, ADHD traits of impulsivity and distractability are thought to be partially due to novelty-seeking and exploratory behaviours also seen in ADHD.   To highlight the positives of these features, novel, stimulating experiences can help those with ADHD learn and increase memory . As medicine is an ever-evolving field, with a clinical environment that is constantly changing, this experience is beneficial for my ADHD brain. A medical career involves constant learning, and this abundance of new experiences and knowledge keeps me engaged.   For example, the variety of moving between different patients and performing different tasks on a ward shift is appealing to me, particularly as I dislike being stuck on one task at a time.  On the other hand, ADHD makes learning things that don’t relate to my interests, such as anatomy, much harder, as I frequently lose concentration and find it hard to focus. However, I find studying things that relate to my interests, such as psychiatry, much easier to study and thus often spend hours engaging in this.   Whilst it is true for all people that it is easier to focus on things you are interested in, those with ADHD can sometimes feel this to a much stronger effect. This experience is called hyperfocus, ‘ a phenomenon that reflects one’s complete absorption in a task, to a point where a person appears to completely ignore or ‘tune out’ everything else ’ . For example, I can hyperfocus on an area of interest for hours at a time, often forgetting to do things like eat or drink. Looking at the positive side of this experience, ADHD can help me learn about things I’m interested in deeply, and this can translate into better competency for my future career.   Another strength I have found is having insight into the lived experience of neurodivergent patients, which can lead to increased understanding and improved care. Neurodiversity is a model which originally arose from the autistic community, with the term neurodivergent serving as an identity for those who considered themselves as neurologically “different”, often due to conditions like ADHD, dyslexia and autism. Doctors with lived experience of neurodivergence could have an understanding and empathy for their neurodivergent patients, which is different to those without this experience.   For example, some parts of accessing healthcare, such as phoning to make an appointment or sitting in a waiting room, can seem straightforward to neurotypical doctors. However, these seemingly straightforward tasks might be overwhelming and create barriers for a patient who is neurodivergent. I have spoken to several patients with ADHD who have been discharged from a service after forgetting one appointment, something I too can relate to. Recognising barriers is important for implementing change to better serve this patient group. Doctors with lived experience have unique insights and, therefore, may feel more motivated to make changes that improve care for neurodivergent patients.   So, how many doctors could potentially be bringing these neurodivergent strengths to the medical profession?   Whilst there isn’t any reliable data on the prevalence of neurodivergence in doctors, 3-4% of adults are estimated to have ADHD, and this number is likely to be an underestimation due to difficulties in accurately identifying ADHD  in some populations, such as women. Additionally, some studies   have suggested that neurodivergent people might actually be overrepresented in STEM fields, including medicine, precisely because of these skill sets. However, stigma is unfortunately also likely to prevent doctors from sharing that they have ADHD. In a 2020 survey   by the BMA, only 36% of respondents felt comfortable disclosing their disability at work, whilst a troubling 77% were fearful of discrimination. A recent review  found that over half of medical literature on ADHD contained stigmatising language, and in the UK Doctors subreddit , I have sadly read disparaging comments about neurodivergence.   Would you feel comfortable disclosing that you had ADHD, if there was a chance your colleague next to you had stated “ADHD is a fake diagnosis” online?   I have had to learn to be resilient to comments on placement like “Why would you want to scrub in? You’re always distracted in teaching, so you probably won’t concentrate on the operation.” Comments such as these indicate a lack of understanding about ADHD.   Whilst there are strengths of having ADHD in medicine, I have experienced two main barriers to these strengths being more widely recognised.   The first barrier is recognition and understanding of ADHD in the workplace. Greater recognition and staff knowledge of ADHD is something we all would benefit from - whether you have ADHD or not. The second barrier is recognising ADHD in ourselves, and understanding what this means in terms of the positive traits it brings, and the areas where one might struggle.   In a positive step forward, it was announced in March this year that the NHS is launching a  cross-sector ADHD task force  to boost care for patients living with ADHD. The new taskforce will bring experts together from a wide range of sectors, including the NHS, education and justice, to “ better understand the challenges affecting those with ADHD, and help provide a joined up approach in response to concerns around rising demand ”. I greatly look forward to seeing the outcome of this new taskforce.

A Holistic Approach for Workers, Organisations, and Communities My name is Gillian Brooks, and I am a Senior Lecturer in Marketing at King’s Business School, King’s College London. In recent years, mental health and well-being have emerged as critical aspects of a healthy and productive workplace. As awareness around these issues grows, more organisations are recognising the importance of fostering an environment where employees' mental health is prioritised. This is not just a matter of social responsibility; it's a strategic investment that benefits workers, organisations, and even the broader communities they serve. It is for this reason that focusing on work-life balance makes a profound difference. So to celebrate this year's World Mental Health Day (WMHD), I would like to share with you a holistic approach to addressing wellbeing in the workplace for workers, organisations, and global communities. For employees, mental health challenges such as anxiety, stress, and burnout can have a significant impact on their personal and professional lives . According to the Mental Health Foundation , mental health was the 5th most common reason for sickness absence in 2022, and 857,000 workers suffered from work-related stress, depression, and anxiety in 2023 in the UK alone. When workplaces ignore these issues, the consequences can be severe : reduced productivity, increased absenteeism, and a decline in overall job satisfaction. On the other hand, a workplace that actively supports mental health creates an environment where employees feel safe, valued, and motivated. Implementing mental health initiatives — such as access to counselling, stress management workshops, or mindfulness programs — can reduce stress levels and help employees cope with challenges. Additionally, promoting work-life balance ensures that workers have time to recharge outside of work, fostering resilience and enabling them to bring their best selves to their jobs. And by creating a culture of openness around mental health, companies can help reduce stigma, encouraging workers to seek support when they need it. Looking at Business Benefits Investing in mental health and well-being is not just the right thing to do—it’s also a smart business move. 17.1 million working days were lost due to work-related stress, depression or anxiety in 2023 . And since then, organisations that have prioritised their employees' well-being have seen a range of benefits, including improved productivity, higher engagement, and greater employee retention. This includes: Enhanced Productivity : Employees who feel supported are more likely to be engaged and focused. They have the mental bandwidth to be creative and solve problems efficiently, which contributes to better performance and innovation. By reducing stress and creating a supportive work environment, companies can enhance productivity across the board. Higher Engagement : When workers feel that their well-being is valued, they are more likely to be engaged with their work. Engagement drives commitment, enthusiasm, and a sense of belonging. This, in turn, translates to better teamwork and a more positive workplace culture, where individuals support each other and align with the organisation's goals. Reduced Turnover : High turnover rates can be costly for organisations, both in terms of recruitment expenses and the loss of institutional knowledge. A focus on mental health and well-being helps retain talent by creating a more satisfying work experience. Employees who are healthy and supported are less likely to leave, reducing turnover and maintaining a stable, experienced workforce. Looking at Community Benefits The impact of prioritising mental health and well-being in the workplace extends beyond the office walls. When organisations take care of their employees, it creates a ripple effect that benefits entire communities. In fact, it can promote healthier family dynamics. Employees who maintain a healthy work-life balance and manage their mental health effectively are more present and engaged in their personal lives. This means they can be better parents, partners, and friends, contributing positively to their social circles. The reduced stress levels help them engage more meaningfully with their loved ones, creating stronger, more resilient families. Businesses who take a lead in promoting mental health, help normalise conversations around these issues, not only within the organisation itself but also in the broader community. This can encourage other businesses and local institutions to adopt similar practices, creating a culture where mental health is openly discussed and supported. Communities also thrive when their businesses are strong and stable. By reducing absenteeism and turnover, and by maintaining a productive and motivated workforce, businesses contribute to the economic stability of their communities. According to the Centre for Mental Health , the long-term economic impact of prioritising mental health can actually be seen in more resilient local economies, where businesses are equipped to weather challenges and continue to provide employment opportunities. One of the most effective ways to support mental health and well-being is through a focus on  work-life balance . When employees have time to disconnect from work and enjoy their personal lives, they can recharge, preventing burnout and long-term stress. Here are a few ways organisations can support work-life balance: Flexible Work Arrangements : Remote work, flexible hours, or compressed workweeks can give employees more control over their schedules, allowing them to balance their personal and professional responsibilities. Flexibility helps reduce stress and allows employees to adapt to their unique life circumstances. As noted in a recent article by The Guardian , enhanced rights to request flexible working arrangements have been implemented in the U.K. as of 2024, further emphasising the importance of adapting work environments that support employee well-being. Encouraging Time Off : Promoting the use of vacation days and mental health days allows employees to take the time they need to rest and recover. It’s important for organisations to actively encourage this, ensuring that taking time off is seen as a positive aspect of the workplace culture. A recent study highlighted by Forbes found that 47% of workers feel guilty for taking a vacation, underscoring the need for organisations to foster a culture where taking time off is encouraged and normalised. Creating Boundaries : Encouraging boundaries between work and personal life, such as no email expectations outside of working hours, can help employees fully disengage from work when they are off the clock. This allows them to return to work refreshed and more capable of handling challenges. As highlighted by Sky News , giving workers the right to switch off could not only enhance their well-being but also potentially boost the economy, demonstrating the broader benefits of maintaining work-life boundaries. This incentive that has also been supported by the U.K.'s labour party. To make a meaningful difference, addressing mental health and well-being must become a core part of a company’s culture. This means more than just having policies on paper — it requires a commitment from leadership, managers, and employees to create a supportive environment. Training managers to recognise signs of stress, providing access to mental health resources, and fostering open communication can make a big difference. And involving employees in these efforts can ensure that initiatives are tailored to their needs. Whether through anonymous surveys, focus groups, or simply open conversations, gathering feedback helps create programs that truly resonate and make a difference in the lives of employees. So, let’s remember the power of conversation in shaping a supportive community. This year’s WMHD focus on workplace mental health underscores the need for organisations to prioritise the well-being of their employees, creating environments where everyone feels valued and heard. By checking in with friends, family, and colleagues, we can foster connections that help us navigate life's challenges together. Let’s not confine this important dialogue to just one day; instead, let’s make it a continuous effort to advocate for mental health awareness. Together, we can create a culture that not only acknowledges mental health but actively supports it, benefiting individuals and communities alike.

A Reflection on Robert Frost’s “The Rose Family” What do I have to be to prove that I am a rose? Hello everyone! My name is Isabella Molnar, and I recently completed my Master’s degree at King’s College London. Having had some time to reflect on my past achievements, I began asking myself: What truly defines me? How do I determine my own worth, and is it shaped by external validation, or does it come from within? These reflections led me back to one of my favourite poems “ The Rose Family ” (1928) by Robert Frost (1874–1963). In this article, I will share my personal interpretation of the poem and explore my thoughts on the unconditional nature of human worth. So, let’s begin… “The rose is a rose, And was always a rose. But the theory now goes That the apple’s a rose. And the pear is, and so’s The plum, I suppose. The dear only knows What will next prove a rose.   You, of course, are a rose – But were always a rose.” What is Frost Trying to Tell Us? In his poem, Frost begins by affirming that the rose – often a symbol of beauty – has always been a rose, suggesting that its beauty is timeless. He then extends this metaphor to other fruits in the rose family, implying that they too can be considered roses, though only “the dear” knows what will next be classified a rose. Frost’s direct address to the reader, reassuring them that they are and always have been a rose, introduces the deeper message: human worth (symbolised by the beauty of the rose) is intrinsic ( “belonging to the essential nature of [something]” ) and constant, regardless of external definitions. This hidden message reflects Frost’s style of writing , using nature and simple language to explore important social and philosophical ideas. The poem can be interpreted through both naturalist and idealist philosophical stances, which often intersect in his work. Essentially, naturalism claims that reality is grounded in nature and physical causes, while idealism argues that reality is shaped by our thoughts and mind. So, from a naturalist perspective, we might say that no matter how society tries to redefine or categorise the rose, its natural structure remains unchanged. On the other hand, the idealist perspective suggests that the beauty of the rose is not rooted in physical attributes, but rather in how we perceive it. If society renamed the rose, its essence would remain the same, as beauty exists in our perception. Nevertheless, in my opinion, both perspectives lead to the conclusion that external labels do not alter the beauty of the rose. While Frost’s dualist approach and the crossroad between naturalism and idealism has faced criticism for not taking a definitive philosophical stance, seemingly creating an epistemological dilemma , I view this as a strength, given that poetry is naturally open to diverse interpretations. My personal interpretation is that Frost’s key message is that, much like the rose’s enduring beauty, our intrinsic worth remains constant despite external influences. Indeed, just as the rose remains beautiful despite how it is categorised, we too are worthy, regardless of external labels, societal standards, or judgement. This idea aligns with the transcendental concept of human worth, suggesting that our intrinsic worth is unconditional and thereby not dependent on external validation, such as achievements, social status, or appearance. Our worth consequently does not depend on what society next proves a rose, which is particularly significant considering society’s shifting standards of beauty and worth and the random nature of such judgements, symbolised (and criticised) by the phrase “the dear only knows what will next prove a rose”. The poem exemplifies a recurrent theme in Frost’s poetry: the tension between the individual and society . So, what do I have to be to prove that I am a rose? “The Rose Family” reminds us that we do not need to prove ourselves to anyone as our worth is already within us. Human worth is not tied to external validation; we are all the same and thus all worthy of acceptance and love. Why is This so Important for Mental Health? I believe that the concept of unconditional intrinsic worth is key for mental health. When we tie our self-worth to external validation, we make ourselves vulnerable to a cycle of stress, perfectionism, and dissatisfaction . This reliance on external measures often leads to feelings of worthlessness and inadequacy , making it difficult to find genuine contentment and self-acceptance. Moreover, what society proves valuable, or worthy can shift rapidly, creating an unstable foundation for self-worth that is prone to collapse under pressure. However, when we truly believe that we are all roses – intrinsically and unconditionally worthy – such external pressures lose their power over us. A large body of evidence supports the idea that individuals with a strong sense of self-worth are more resilient and better equipped to cope with stressful life experiences . They are consequently less likely to experience mental health issues , such as anxiety and depression, and are more likely to maintain emotional resilience through life’s ups and downs. Why is This Relevant for Us Today? Although written in the 20th century, this poem is more relevant than ever, as the tension between the individual and society has become even more pronounced in today’s world. Social media, professional pressures, and societal standards constantly bombard us with ideals of success, beauty, and happiness , often making us feel that we must conform to these external standards to be worthy. This creates relentless pressure to adapt, leaving many questioning their own worth when they “fail” to meet these shifting standards. Moreover, societal expectations have become increasingly unrealistic and unattainable, keeping us endlessly chasing an ideal that is perpetually out of reach. Particularly with the rise of social media, comparison culture has made it more and more difficult to feel content with who we are, consequently exacerbating feelings of self-doubt and insecurity .   Perhaps, by embracing the concept of intrinsic worth, we can live our lives for ourselves, rather than constantly seeking approval from others. Frost’s poem captures this mental freedom. The idea that “you, of course, are a rose – but were always a rose.” encourages us to look within for our worth. This shift would allow for a more liberated existence, less impacted by the weight of constant pressure. In this regard, “The Rose Family” is a powerful reminder that our intrinsic worth is constant and unconditional, no matter what the outside world tells us. So, the next time you find yourself doubting your worth, remember: You are, of course, a rose—but you have always been a rose.

Humans are inherently social beings, and our daily interactions with others – whether family, friends, colleagues, or strangers – shape our ability to understand the minds of those around us. I’m Bryony, a cognitive psychologist, and I’m interested in how the brain works and how we think about other people’s minds. In my latest research , my team and I found that people frequently misunderstand those who differ from themselves. In this article, I’ll explore why this happens, the consequences of these misunderstandings, and how we can improve the situation.   Where does it all start? People categorise each other  into different social groups. This helps us to make sense of the busy social world around us, and where we belong in it. One of the ways we categorise people is in terms of whether they are ‘in-group’ to ourselves (i.e., they belong in the same group as us) or whether they are different and therefore part of an ‘out-group’.   You may perceive someone to be different to yourself for many reasons. Perhaps because they hold different political views to you, speak a different language, or perhaps because they are of a different gender-identity (e.g., cisgender vs transgender), or neurotype (e.g., neurotypical vs neurodivergent). It may simply be because you’ve had different life experiences. This social categorisation is not , inherently, a bad thing.     However, we tend to spend more time with the people in the same social group (s ) as us. This allows us to develop a nuanced understanding – or representation – of the individuals within our ‘in-groups’. In other words, spending more time with people similar to us allows us to recognise the diversity within the group . This isn’t the case for out-groups though. Because we spend less time with out-group members, our understanding is often based on limited interactions or second-hand information from media or social networks. If that information is inaccurate or overly simplistic, then our representation of them will be as well. This is important because research  suggests that if we have a poor representation of people, we are more likely to make inaccurate assumptions about them. What did our research find? In our study , we asked 256 people from the US to predict the social and political beliefs of others. First, we asked participants their own view, i.e., how far they agreed or disagreed with statements such as “my own race is not superior to any other race”. We then showed them the responses of other people who had been asked the same question.   If the participant said they strongly agreed  that their own race is not superior, they would be presented with someone who said they strongly disagreed  with this. This would make them “out-group” to the participant.  Now aware that the other person disagreed with them on one belief, we asked participants to predict this other person’s view on a different topic, such as “immigrants are good for society”. The participant might assume that someone who believed in the superiority of their own race, might also be anti-immigration.   Each time, we asked participants how confident they were that their prediction was correct. We found that people were consistently very confident that their predictions were accurate (75% confident) but they were wrong more than 60% of the time. In fact, the more confident they were, the more likely it was that their prediction was wrong.     How does this affect our day-to-day lives? The consequences of this are vast and wide-ranging, manifesting at the individual level and on a societal level. For instance, imagine you are interviewing someone for a job and they suddenly leave the room without explanation. You might assume they are rude or uninterested, leading you to question their suitability as a colleague. However, if your representation of them included the knowledge that they had an anxiety disorder and suffered from panic attacks, you’d probably interpret their behaviour – and the type of mind they have – very differently. A broader range of experiences with diverse individuals allows us to form a more complete understanding of others, making it easier to interpret their actions and intentions accurately. Without that diversity, we may mistakenly assume that everyone’s mind works like ours, or like the other minds we have been exposed to. For instance, children who have experienced abuse or neglect may be more likely to represent other peoples’ minds as ‘nasty’ . That is, they may overestimate the likelihood that others are aggressive, deceitful, and lacking in empathy because of their prior experience . In such children, who may be later diagnosed with Conduct Disorder , their incorrect assumptions about what other peoples’ minds are like may make them more likely to react with suspicion or aggression towards others. Thus, the previous experience one has of others may reduce their ability to understand people who have minds that deviate from what they’re used to. People’s lack of awareness about their proneness to misjudge differential others can have wider impacts at a societal level . For instance, in the UK riots this summer, we saw far-right protesters targeting asylum seekers and Muslims, as well as those who were helping or housing them. The riots were started after an attack on children in Southport , in which the p erpetrator was wrongly identified as a Muslim asylum seeker via social media posts. Thereafter, it is likely that many of the  people comprising the far-right in-group took their understanding of this single ‘asylum seeker’ as wanting to intentionally harm children, and attributed the same intention to all asylum seekers and Muslims. This led to wide-spread violence against swaths of people in the UK, the vast majority of whom had no such intention.   What can we do to help? The good news is, it seems that when people are made aware that their assumptions about other people are incorrect, they do reconsider. In a second study (which is still in progress), we asked participants to complete the same task, but this time told them when their initial prediction was incorrect. Receiving this feedback helped participants to make their predictions more accurate. Further, participants learnt that they were more likely to misunderstand the views of out-group members than in-group members.   If people are aware that they are less able to understand out-group minds, they may become less likely to rely on their initial assumptions, and seek more information. Indeed, having conversations with people who hold different views, beliefs, and experiences could help challenge our incorrect assumptions about each other. This is why it is so critical that people are exposed to people who are different from themselves, and hear their real stories to gain insight into who they are as individuals. This helps us to understand that, like our in-group, the out-group is made up of many people with different personalities, beliefs, desires and emotions. Over time, this helps us to understand how their mind works and, hopefully, makes it likely that we will treat out-groups fairly and with humanity.

This June we launched the ASPIRE study, aiming to understand how we can use inflammation blood tests to identify people with depression who can be helped by anti-inflammatories. Led by myself at King’s College London, the ASPIRE study (‘Advanced stratification of people with depression based on inflammation’) brings together investigators from 8 countries (Australia, Belgium, France, Germany, Italy, South Africa, The Netherlands, USA), including two associations of people with lived experience of mental health problems. As a psychiatrist dedicated to helping people with depression, the most frustrating aspect of my work is the difficulty in predicting who will respond to which antidepressant strategy. This is particularly relevant to people with “treatment-resistant” depression, who have not improved with two or more standard antidepressants. This study may change this. This is our aspir ation.     At Inspire the Mind, we have often discussed the clear evidence that 20-30% of people with depression , and even more people with depression who are not responding to antidepressants , have increased levels of inflammation in the blood. Inflammation is activated when we face a threat that could lead to infections, such as a physical assault, but it can also be activated by being stressed. Indeed, during depression, the increased inflammation is part of a general activation of the biological stress response system: ultimately, depression is, both psychologically and biologically, a condition of chronic stress.   From a clinical point of view, this activation of the inflammatory system directly affects the brain , making the person more likely to stay depressed (for example, by changing how brain cells and brain areas communicate between themselves) and less likely to respond to antidepressants (for example, by changing the brain chemicals that are the target of antidepressants). As such, dampening this inflammation with anti-inflammatory medications – drugs such ibuprofen, celecoxib or aspirin, used for inflammatory disorders such rheumatoid arthritis – should have beneficial antidepressants effects, by rescuing the brain changes induced by the inflammation.   Indeed, some studies , including ours , have demonstrated that adding an anti-inflammatory medication to an antidepressant improves depressive symptoms in people who had not previously responded to antidepressants – but only if their levels of blood inflammation are measurably high. Other studies in people with low levels of inflammation have shown no such beneficial effects .   And this where ASPIRE steps in to try to address exactly this question: what is the best blood inflammatory biomarker(s) that accurately predict successful response to an anti-inflammatory? And, connected to this question, are there clinical features that accurately predict the response to anti-inflammatories: for example, the type of depressive symptoms a person experience, or physical health abnormalities such as obesity and excessive sugar levels in the blood? Moreover, are there brain changes induced by inflammation that accurately predict the response to anti-inflammatories and that could be measured by taking pictures of the brain via brain scans? We will then put all of this information together in a “decision tool” and test our ability to predict the response to anti-inflammatories using this decision tool in a new clinical trial.   The work is divided across seven work packages. Work Package 1: Systematic Reviews and Meta-Analyses of Inflammation Related Clinical Predictors. We aim to gather a large amount of data by thoroughly reviewing previous research investigating anti-inflammatory medications in depression. We will also perform additional analyses to see how factors like age and sex-at-birth affect treatment response.    Work Package 2: Laboratory Analyses of Inflammation Related Blood-Based Biomarkers.  We will focus on well-known blood-based inflammatory biomarkers, which are biological molecules measured in the blood and used to assess a person’s levels of inflammation. We will re-analyse biomarkers from over 1,200 participants across many clinical trials using anti-inflammatory medications in people with depression.   Work Package 3: Meta-Analysis of Blood-Based Biomarkers. We will combine all the data gathered from work packages 1 and 2, including data from other collaborators, that focus on biomarkers measured in blood and that are related to the immune system and metabolism.   Work Package 4: Meta-Analysis of Inflammation-Related Neuroimaging Markers. We will look at alterations in the brain's structure (structural data) and how different brain regions function and interact with one another (functional data), from clinical trials using anti-inflammatory medications in people with depression.   Work Package 5: Generating a Machine Learning Tool. We will use a machine-learning approach to develop a decision tool that identifies individuals with depression who will respond to an anti-inflammatory and thus benefit from accessing these drugs.   Work Package 6: Feasibility, Proof-of-Concept Study to Test Decision Tool. We will run a 12-week study to see if we can use the decision tool to identify the people with depression who will improve using an anti-inflammatory.   Work Package 7: Views of People with lived experience and Dissemination Findings. The views of people with lived experience (PWLE) are at the core of the ASPIRE project. In this work package, we will explore opinions on the notions of using anti-inflammatories to treat depression. We will also focus on sharing all the research we have done in ASPIRE with the wider public, for awareness and education. And indeed, at the heart of the study are people with lived experience. Alongside playing a crucial role in the conception and design of ASPIRE, the study will amplify the voices of those affected by depression and advocate for better treatments and understanding.   The study aims to change public perception of the role of inflammation in mental health and, in general, on the importance of mind-body interaction in mental disorders.   Further information on the study can be found at www.aspirestudy.org , @aspireresearchstudy on Instagram and @theaspirestudy on X.   Members of ASPIRE Consortium King's College London, UK: Carmine Pariante, Anthony Woods, Caitlin Pentland, Courtney Worrell, Giulia Lombardo, Lea Schmid, Luca Sforzini, Melisa Kose, Naghmeh Nikkheslat, Nicole Mariani, Zuzanna Zajkowska, Valeria Mondelli Amsterdam University Medical Centre, The Netherlands: Brenda Penninx, Femke Lamers, Yuri Milaneschi Cardiff University, UK: Neil Harrison   Charité University, Berlin, Germany: Christian Otte, Julian Hellmann-Regen, Deniz Dogan, Stefan Gold Deakin University,  Australia: Jane Meier, Michael Berk, Olivia Dean Emory University, Atlanta, USA: Andy Miller, Jennifer Felger Foundation FondaMental, Paris, France: Federico Cevoli, Marion Leboyer, Bruno Aouizerate IRCCS Ospedale San Raffaele,  Milan, Italy: Alessandro Mioli, Benedetta Vai, Camilla Monopoli, Francesco Benedetti, Sara Poletti   IRCCS Fatebenefratelli, Brescia, Italy: Floriana De Cillis, Annamaria Cattaneo Libera Virginia Cavaliere Istituto Superiore di Sanità, Rome, Italy: Claudia Delli Colli, Igor Branchi GAMIAN Europe, Brussels, Belgium: Erik Van Der Eyken, Fanni-Laura Mäntylä, Nigel Olisa South African Depression and Anxiety Group (SADAG), Cape Town, South Africa: Cassey Chambers Ofentse Hanyana University of Antwerp, Belgium: Céline Wessa, Livia De Picker, Manuel Morrens, Violette Coppens University of Bristol, UK: Golam Khandaker, Eimar Foley University of Cape Town, South Africa: Dan Stein, Nadia Hoffman, Shuretta Thomas   University of Melbourne, Australia: Ben Harrison, Christopher Davey   University of Muenster, Germany: Bernhard Baune

On the 13th of March, 2023, a one-year and six-month journey of strike action began for junior doctors, involving 11 individual rounds and totalling  44 days  of strikes.   However, on 16th September 2024, these strikes have finally come to an end, with an agreement having been made between the British Medical Association (BMA) and new government.   So, let’s break down why doctors were striking, and what the new deal means.   Junior doctors have voted to accept a pay rise which will average 22% over two years, in a constructive step towards pay restoration.   The pay deal is a positive step forward for doctors, and a particularly positive change for myself and my colleagues, as after 8 years of studying, I am due to graduate as a doctor and start work next year. Why were junior doctors striking? Since 2008, junior doctors have had an approximate  35% decrease  in salary, due to below-inflation pay rises. The image below illustrates the current pay of junior doctors in 2024, and was captioned by the BMA : "The junior doctors operating on your appendix are paid just £66.55 between them. For a potentially life-saving procedure, which lasts about an hour". When a junior doctor with 1 year’s experience is referred to, this means they have already completed 4-7 years of medical training at university, and are in their first year of working as a doctor. The image highlights how a doctor with one year of experience is earning £14.09/hour, which has been compared to a rate  less   than that of a Pret A Manger Barista , whilst a trainee surgeon with 10 years of experience is earning £28/hour.   The BMA posted a photo further highlighting the junior doctor and Pret A Manger barista's similarity in salary, leaving many doctors feeling undervalued due to the years of training they have undergone, and the level of responsibility they hold for people's lives. This salary decrease has taken place on a background of junior doctors experiencing workplace burnout at the highest level ever recorded , high-pressure workloads, inadequate resources , poor support structures, and a cost-of-living crisis. In fact, junior doctors are now facing higher levels  of burnout than during the pandemic, with 63% of doctors feeling ‘at a high or moderate risk of burnout. I have written previously about burnout in the NHS which you can read more about here .   Additionally, 65% of doctors have experienced the feeling of ‘moral distress’ as a result of working in the NHS. Moral distress  refers to the psychological unease felt when professionals identify an ethically correct action to take but are constrained in their ability to take that action.   It is therefore unsurprising that 19,000 doctors were estimated to have left NHS England prematurely between September 2022 and 2023. This equates to 1 in 7 of the NHS doctors in the workforce.   Doctors enter the profession wanting to help people, however when resources don’t allow for this, it is devastating. When you then also feel undervalued due to factors such as a salary decrease, it exacerbates the challenges already faced by doctors.   Therefore, the strike action was called to advocate for pay restoration, and one and a half years on, a new pay deal has been accepted.   What does the new pay deal mean? The pay deal  offers an average of a 22% pay increase over two years, which results in an average 4.05% uplift on existing 2023/24 junior doctor pay. For a first-year doctor, this will result in earning approximately £16.06/hour compared to the previous £14.10/hour. This offer shows progression in the journey to reverse the past decrease, and moves doctors about one third  of the way towards full pay restoration.   The new deal will hopefully provide a renewed sense of optimism for doctors, and a belief that a more positive work environment can be achieved.   What about other healthcare professionals? Some frustration has arisen for other healthcare professionals such as nurses, midwives and physios, some of which similarly underwent strike action last year . After the Royal College of Nursing’s (RCN) negotiations with the prior government, their pay deal was a little more than half  of the new junior doctor deal as a percentage increase.   The leader of the RCN has said “We do not begrudge doctors their pay rise”, “What we ask for is the same fair treatment from government.” The RCN has now opened up communication with its members to understand the views of nursing staff on their current pay, which is yet to be announced.   What other changes are happening alongside the doctor pay deal? The junior doctor pay deal announcement also comes alongside a change to the title of doctors, with junior doctor being removed and replaced by the term resident doctors .   Over the course of the pay dispute, there have been large amounts of misinformation and confusion over the term junior doctor. The previous governments Health Secretary, Victoria Atkins, was accused of belittling Junior Doctors  by calling them “doctors in training” on national television. This may suggest to some that they are not qualified doctors, or are undergraduate students.    However, the definition of a junior doctor is ‘a qualified doctor practicing at any stage between graduation and completion of specialist postgraduate training’. Junior doctors could have a decade of experience working in a field such as neurosurgery, however, have not yet finished training due to the length of time it takes to complete. Therefore, the new term 'resident doctor' will be a positive change to better reflect the skills and responsibilities of these doctors.   Overall, the pay deal is a step towards pay restoration and will hopefully provide positive news to doctors working on the frontline, alongside the change in terminology from junior to resident doctor.

Author's Note: This story depicts grief and social anxiety, and how taking care of others can sometimes help you take care of yourself. The events are fictional, but I hope you enjoy and that it brings you comfort if you need it. Photo by Simone Dalmeri on Unsplash Sarah sighed as she carefully pulled back a curtain just a smidge; just enough to look outside. She saw the shifting grey, just like the one that hummed inside her like an old box TV set with no signal and knew before the first drop fell that it was going to rain. "Of course," she said, quietly, to no one in particular. In fact, to no one at all. Sarah was 22 and lived alone. Some would say she was lucky not to have to exist alongside a gaggle of roommates, or with her parents. But they wouldn’t know, just by looking at her, that her only family was her Gran, and that she died a year ago, leaving her the house. And leaving her all alone.          Sarah supposed some people would still consider her lucky, having the house all to herself in this economy. They were right, in a way, but again, they weren’t to know that the last time she’d left the house - beyond the front or back doorstep - was to attend her Gran’s funeral. That she hadn’t brushed her teeth in about three weeks. That she could barely get out of bed most days. But how would they know, anyway? She never left the house - she just couldn’t - not with all the noise, and heat, and eyes on her, like laser beams. The one time she tried to go in her garden she couldn’t breathe and had to rush inside before she passed out, because if she did there would be no one to find her for weeks, maybe even months. Sarah sighed, imagining the raindrops falling against the windowpanes covered constantly by heavy curtains. She remembered, for a moment, the game she used to play as a child, how she would pick a raindrop and trace its trail down the window and wait to see if it was the first of the cluster of raindrops that reached the bottom. Sarah almost pulled the curtain back, just to see, but as she moved her hand towards the fabric, anxiety shot through her as though she'd been struck by lightning. It was then that she heard it, a strange scratching at her front door. The anxiety jolted, almost as if there was an aftershock. Sarah stepped away as if on impulse, and sat on her sofa, waiting, desperately, for that sound to go away. Unfortunately for Sarah, the sound continued for what felt like hours. And as the sound continued, the anxiety continued to reverberate through her, her hands and feet buzzing with pins and needles. And still, the scratching sound continued. In moments like this, she always tried to distract herself. What was that trick she read online? Five things she can see, four things she can hear… She tried her best, but she couldn't seem to focus on any other sound that wasn't the scratching at the door - even the fierce rain that roared alongside the wind outside. She tried her best... "All you've got to do is try your best, love," Sarah suddenly heard her Gran's voice, as clear as day. It was something that she always said, especially when Sarah was struggling with things, like her exams or the school football team tryouts. It used to be something she would try and remember, after her Gran died, to help her get out of bed or find something to eat. But lately, she hadn't thought of it so much. She supposed she'd used it to get by so much that it had lost its magical effect. Just the idea of that made Sarah’s chest ache like someone had just punched it. She didn't want to stop remembering her Gran. Louisa Fielding had practically raised her. But on top of being her guardian and pretty much her mum, she was so incredibly kind - always baking enough treats to feed the streets, cheering everyone up during bad weather, and keeping plenty of cash on hand in case she passed someone homeless to offer some food and a night at the hotel. Of course, she also had her wild sense of humour - most of Sarah's memories involving her Gran involved the both of them laughing, or at the very least, smiling. Yes, Louisa Fielding was the best person Sarah ever knew. And the person with the biggest, funniest heart. Until it stopped. Sarah caught her breath as reality caught up with her. She was sat alone and anxious in her dead Gran's house. And there was still that damn scratching noise, going on and on by the front door. "All you've got to do is your best, love." Sarah wondered what her best would be, right now. Not being anxious? But it was that scratching that made her feel anxious in the first place… Alright, Sarah thought. I will. Her hands trembled as she reached to open the door, but she still managed to pull it open despite the wind roaring against it. Whatever Sarah thought would be there, she certainly didn't expect a tiny, soaking wet little bundle of fur. A gasp escaped her lips, and in that time, the bundle of fur rushed inside, as if the noise was inviting it in. Sarah shut the door, still shaking, and turned to see the wet ball of fur sat, dripping on the carpet beneath it. Under the wet, matted grey, Sarah could see two black pupils, looking up at her. They stared at each other for a moment, before the bundle of fur shook itself furiously, sending water everywhere as if it had suddenly started raining inside. "No!", Sarah cried, as she reeled from the cold water; she was soaked, and almost started trembling herself, if she wasn't so distracted by the small, furry dog that had just revealed itself. It turned its head slightly as if trying to decipher what she was saying. It had long, matted black fur, and two ears that stuck up on its head, that Sarah thought, at that moment, almost looked like antennas. "Sorry," Sarah said, quickly, and much quieter. The dog tilted its head back up as she spoke, seemingly understanding. It gave a soft bark, which Sarah thought, for a moment, almost sounded like the dog was saying hello. The absurdity of that thought made Sarah smile, and then the dog started gently wagging its tail. The sight of this made Sarah’s anxiety lessen, just a little, and she realised that the dog was still dripping wet - and so was she. Not that it mattered, really, as she hadn't changed out of these pyjamas in a few days. Weeks, even. But if she was going to dry the dog, she may as well change into a fresh set afterwards. "Shall we get us dry?" Sarah asked the animal who simply wagged its tail as though enthusiastically agreeing with her. *  It had been a few days with the dog before Sarah decided to see if he had an owner. Sure, it seemed happy enough - Sarah even let it sleep on the end of her bed - but she couldn't bear letting it stay if it was someone else's family. She couldn't just take it from someone. She wouldn't. But before she took him to the vet, she needed to make him more presentable. She didn't want anyone to think badly of her - she was anxious enough at the mere prospect of leaving the house as it was. Bathing the scruffy little thing was actually kind of fun. Sarah managed to rub soap into the dog's fur until it decided to shake again, covering her in soap, too. Instead of being frustrated or upset, it made her smile. She finished bathing the dog before jumping in the shower herself to wash off the soap and apply human soap and wash herself too - she was already in there, so she might as well, right? It was only when she was brushing the dog's long, matted fur afterwards, that she realised that was the first shower she'd taken in a while. The first time she'd even had the energy to consider going in the shower, let alone having one. And as the thought entered her mind, the small dog wrinkled slightly before licking her hand and bringing her back to the present. "Good dog," Sarah said, and she started to brush again, counting as she did so, and breathing easier with every new number.   *  Despite the positive steps Sarah had taken today, her hands shook as she went to open the front door. At just the thought of stepping out there - of being around other people - Sarah felt her breathing quicken, her chest hitching faster and faster as the reality of what she was about to do hit her like a slap in the face. As she turned away from the door, she felt a soft pressure against her legs. Sarah looked down to see the dog stretched up and resting its front paws on her legs, as if it was trying its hardest to reach her. It did a gentle, soft bark, before attempting the jump again. Eventually, what the dog was trying to do broke through her anxious thoughts and appeared in her mind: He was trying to leap up at her and into her arms. The dog did a soft bark again - "Pick me up," it seemed to be trying to say, "Pick me up!" So, Sarah obliged. But as soon as she picked the dog up, leaving its lead to dangle like a cord towards the floor, the dog stopped moving. Instead, it curled up in her arms and even nuzzled its nose into the crook of her elbow. Sarah stayed still, not wanting to wake him, and realised she could hear its heart beating, so softly, through its fur. Just listening to it for a few minutes, standing stock-still, was enough to steady her own anxious heartbeat until eventually, she felt okay again, and her anxiety was at bay. Not wanting to disturb the sleeping animal in her arms, Sarah impulsively decided to carry the dog to the vet, just as it was. While anxiety crackled through her as soon as she took a step away from the house, Sarah tried her hardest to just focus on the dog's steady heartbeat as it slept soundly in her arms. And somehow, that helped her keep putting one foot in front of the other, to the sound of the little dog's heart beating. Ba-bump, one step, ba-bump, two steps, ba-bump, three steps… Before she knew it, Sarah found herself at the vet, only slightly drenched in sweat, and she’d walked the whole way there without collapsing, and even without having an anxiety attack. The receptionist at the front desk smiled kindly as Sarah approached. "Do you have an appointment, love?" She asked. Sarah tried to ignore the worry bubbling up inside her as she replied. "Yes, in about 5 minutes," Sarah managed to say, before gesturing to the dog in her arms. "Aw bless," the receptionist said, still smiling. "Tired, is he?" Sarah just nodded. "And a bit scared." "Aw, don’t worry," the receptionist said, talking more to the dog now than to her. "Just do your best in there, alright? That's all you've gotta do." Sarah nodded, grateful, and rushed to sit down before the receptionist saw the tears that sprung into her eyes at her very familiar words.   * It wasn't long before they were called in by a vet with colourful tattoos of a cat and a dog on each arm, angled and etched as if they were greeting each other over the vet’s chest. "Hello," the vet said softly, more than the dog than to Sarah, which put her at ease. "Who do we have here, then?" The dog stirred in her arms and jumped deftly onto the steel examination table. "Um," Sarah said, suddenly realising that she'd never given the poor creature a name, "I..." Anxiety crackled in her chest, and she caught her breath in her throat, making her cough. God, maybe this whole thing was a mistake. "It's alright," said the vet, as if they could sense her anxiety. "It took me weeks to name my last kitten. Let's just start the examination and we can go from there, alright?" Sarah nodded and stepped back, grateful the focus would no longer be on her. The dog sat calmly and didn't object to anything the vet did during the examination and various bits of paperwork on the computer. When they were done, the vet even patted the dog on the head, saying "Good boy." "Boy?" Sarah asked. Gender hadn't crossed her mind either. "Yup," said the vet. "And he's not microchipped either, so unless you'd like us to take care of him until he finds a new home—" "No," Sarah cut the vet off with a quickness that surprised even herself. "He's coming home with me." At that, the dog started wagging its tail, and the vet smiled. "Alright then. Before I let you go, have you had any thoughts of a name for this little lad?" Sarah thought for a moment before a name appeared in her mind, as bright and clear as a summer's day. As loud and joyous as her Gran's laugh - the perfect name. "Lou," said Sarah. "His name is Lou." The dog kept on wagging his tail, quicker now, and licked her cheek as she reached out to pick him up. "Well, he seems to like it. And Lou - that’s a lovely name," said the vet, with a smile. It is, Sarah thought, both there and as she carried Lou home. Just the sound of it made her smile. Lou, Lou, Lou… Sarah would later realise that her trip home was the first time she’d left the house since her Nan’s funeral and she hadn’t focused on her anxiety, or let it consume her. Despite the brisk walk there and back, Sarah collapsed heavily on the sofa as soon as she got through the door. Thankfully, Lou happily jumped on her lap, settling as he rested his head on Sarah’s hand. She couldn't move it now, but she realised that when she could, she felt like she could brush her teeth, or even her hair, especially since Lou was so well groomed - she might as well be too, right? Or at the very least, she would try her best, she thought, shutting her eyes, just for a moment, as she listened to Lou softly breathing in and out, in and out… That's all she had to do - and it didn't seem so difficult now. She was no longer alone, after all. And for the first time in a long time, just as she was about to fall into a peaceful sleep, Sarah realised she might just agree with anyone who called her lucky - yes, because now she had Lou to take care of, and him to take care of her.