How hypnotherapy can help us make positive changes in our lives As an occupational therapist, my focus is on doing. It may seem strange, then, that I have recently trained in cognitive behavioural hypnotherapy, which is more likely to be associated with thinking, or even entering a state of trance. In this short piece, I will explain why I believe that self-awareness, and using our imagination to practice new ways of thinking and feeling, can help us to do the things we want to do, make changes in our lives and be the best versions of ourselves. Photo by Milad Fakurian on Unsplash In the hot summer of 2022, I cured my arachnophobia and wrote about my experiences here. Terror of spiders had been a long-standing issue for me, so when I was able to overcome it at the London Zoo, Friendly Spider Programme I became curious about the methods that had been used. The programme incorporated a special blend of cognitive behavioural therapy (CBT), hypnotherapy, and exposure therapy, all bolstered by some excellent peer support from volunteers. As a result of this, I decided to undertake training in cognitive behavioural hypnotherapy, an approach that integrates these methods, at the UK College of Hypnosis and Hypnotherapy (UKCHH). I’m an occupational therapist and researcher, so it was important to me that this was an evidence-based approach, that focuses on enhancing CBT with hypnosis. There is a strong body of research showing that those who have hypnosis added to their CBT will generally have better outcomes than with CBT alone. Various articles have summarised what hypnosis is and where it is supported by evidence. A final-year medical student writing for Inspire the Mind described their experience of shadowing an Irritable Bowel Syndrome (IBS) hypnotherapist here. Peter Whorwell, a prominent medical doctor and researcher, conducted research which found that of 1,000 people with hard-to-treat IBS, 76% experienced a positive effect with hypnotherapy, with symptom severity reduced by half. I found that there was a lot of overlap between what I have learnt over the years about successful rehabilitation and the keys to successful hypnotherapy. In my professional training, I was influenced by Bandura’s concept of self-efficacy, which emphasises that our belief in our ability to do something is a key factor in whether we will be able to do it successfully. Self-efficacy can be improved by receiving positive feedback or observing others doing the task in question, but a more powerful way of improving self-efficacy is to have the opportunity to master the task by doing it ourselves. In rehabilitation, this concept is applied by educating people to understand their conditions, and empowering people with opportunities for ‘mastery experiences’. Although there are many models and approaches to hypnotherapy, the cognitive behavioural hypnotherapy approach encourages self-management and self-awareness, with self-hypnosis encouraged as a tool for clients to sustain positive changes that have been identified and agreed in the initial meeting. A key feature in cognitive behavioural hypnotherapy is an initial assessment that spends time gathering information about the problems a client is facing and understanding them in a cognitive behavioural model – which then helps identify how specifically the client can begin to solve those problems. At each stage, the client is highly involved in the process  - including the hypnosis part which is not a passive experience for a client but an active directed involvement. Learning to use self-hypnosis enhances self-efficacy further, due to the sense of accomplishment gained by guiding oneself to develop a skill or manage challenges. Photo by Jr Korpa on Unsplash Real-life experience is always the best way to develop mastery and self-efficacy, but hypnotherapy is an excellent way to practice for the real thing. The second most potent way of developing self-efficacy is ‘vicarious experiencing’, which could be through observing others or through our own imagination. Far from the stereotype of a hypnotist embarrassing people by turning them into chickens or making them do silly dances, the reality of hypnotherapy is that it strategically uses the imagination to powerfully increase self-efficacy, as we imagine coping with and mastering our challenging situations. After an in-depth assessment to find out about a person’s issues and goals, hypnosis can be used to mentally rehearse situations, using the imagination to experiment safely with different thoughts, feelings and actions. This is where the cognitive behavioural part comes in. Many people will be familiar with the principles of CBT as it has strong research evidence and is widely used, including in the NHS. It enables us to increase our self-awareness of the connections between our thoughts, feelings and actions. Once we can understand how these factors interact, we can test and challenge unhelpful assumptions and break unhelpful patterns. When I mentioned cognitive behavioural hypnotherapy to a retired psychologist friend, he was surprised. ‘Sounds a bit counterintuitive,’ he said. ‘CBT is all about awareness, so why would you send someone to sleep?’. Actually, the idea that hypnosis is the same as sleep or trance is a myth. It requires focused attention, imagination, absorption and positive expectation. It may not even involve relaxation, for example where the goal is to improve performance in sports. Whatever the goal, hypnosis is always something the person involved should be actively engaging in, and it does not require any relinquishing of control. Photo by Chris Briggs on Unsplash An example might help here. Jane (not her real name) had a fear of flying. It ruined holidays for her. She avoided travelling by plane, and if she knew she would have to fly home from a holiday the anxiety about this preoccupied her throughout the holiday. She had the opportunity to take a cruise to her holiday destination but would have to fly home afterwards. We spent a long time unpicking what the fears were about. I probed Jane about what sort of thoughts went through her head relating to the flight, and how she felt when she boarded a plane. We talked about what sort of things she would usually do in response to these thoughts and feelings. Then we used hypnosis to allow her to get into a relaxed, receptive mindset so that she could mentally rehearse the things that she feared in the knowledge that she was perfectly safe. We repeated the experiment until her anxiety lost its grip. Occupational therapy came in too, as we problem-solved different activities Jane could do on the flight to occupy her and bring a sense of pleasure and relaxation. Incidentally, Jane had no intention of making a habit of flying as she was also concerned about the environmental impact, and it is really important to consider a person’s wider values when setting goals together. She just wanted to be free of her phobia and able to enjoy the occasional holiday with flying involved when necessary. This is just a little taster of how we can combine approaches to increase our self-awareness, desensitise ourselves to the things we fear, achieve a new sense of mastery (self-efficacy) and make positive changes in our lives. So far, I have successfully worked with people to overcome fears, break habits, build confidence and manage pain. I use self-hypnosis regularly to manage period pain, reset my motivation, rehearse situations or just to go to a positive place in my imagination. The evidence for hypnotherapy depends on what you are using it for. It has been found to be effective in helping people manage anxiety, asthma, irritable bowel syndrome, and pain. When combined with cognitive behavioural therapy it is effective for treating phobias and obesity. Other suitable goals include overcoming fears and inhibitions and improving self-esteem and self-confidence. The Royal College of Psychiatrists has published information about the conditions hypnotherapy can help, according to research evidence. Although in theory, anyone can respond well to hypnosis, it helps if you are motivated, have a good imagination and have the patience to persevere. If you would like to see someone having significant dental work using only hypnosis to manage the pain, take a look at this video! It may seem inconceivable that the power of the mind could be so effective, but why should it? Have you ever had a thought that makes you feel sick, or causes you to flush or have a wave of sadness or fear? Our thoughts lead to physical responses all the time, sometimes on an obvious level and sometimes much more subtly. When you think of it that way, it’s only sensible to pay attention to the messages we give ourselves, take control, and re-programme any unhelpful patterns. Now, on the count of three, you will take a deep breath and feel ready to stop reading, smile to yourself and get on with the rest of your day. One… two… three! Photo by Yuyang Liu on Unsplash

“Queer silliness offers purposeful strategies to playfully engage with the present, insisting on frivolity, mundanity, and fun, despite and even because of violence. It demands the concrete possibility of a hopeful future…” - Dr Joe Parslow Over the past few years, I have watched in awe as my cousin George’s drag career (performing as ‘That Girl’) has skyrocketed, and as the colours, outfits, and make-up looks get more fabulous with every Instagram post. But, around this time last year, my admiration of him turned into fear with him, as he suddenly became the target of far-right smear campaigns and protests at his Drag Storytime events. As well as being a concerned cousin, I am also a researcher interested in stress and mental health, with a particular interest in art in this context (as I have written about before). But despite this, it was only when the protests against George began that I realised how naïve I had been to the troubled political and social context of drag performance. Over the past year, following his experiences, George has become a prominent voice in the UK drag community, having even been invited to Sadiq Khan’s Pride reception, and recently won Pink News’s ‘Drag Artist of the Year’ award. Now, in honour of February’s LGBT+ History Month, I sat down to learn more from him about the delight and darkness of drag performance. George first got into drag performance while he was studying for his Master’s Degree in Musical Theatre. One of his assignments was to create a solo show; it could be anything he wanted. As a big fan of RuPaul’s Drag Race, a popular reality TV series in which drag artists compete to become the next drag superstar, George decided to give drag a try. Paired with Dr Joe Parslow, an academic expert in drag performance, and whose husband is a drag queen, George’s eyes were opened to the world of drag beyond RuPaul. That first production was the start of his passion and career in drag. From the beginning, George became aware of the political aspects of drag, and reflected that for many, getting into drag was (and still can be) dangerous and “radical”, and resulted in people being attacked or arrested. Despite drag roles like pantomime dames being a traditional part of British society, some forms of drag performance are much more contentious. As part of her many performance types, That Girl participates in ‘Drag Storytime’ events, in which she is “a colourful character”, who reads picture books to children and their parents, often choosing stories with positive messages to teach children about kindness, sharing, and that it’s okay to be different. As well as the fun of hearing stories being read aloud, Drag Storytime provides the added benefit of creating a safe space for children, promoting inclusivity and self-acceptance. George hopes that him sitting there in a dress might just make a child feel comfortable wearing whatever they want to wear too. Drag Storytime seemed like a great fit for George, as he is passionate about books and getting stories to children from a young age. He has always loved books himself, has worked in children’s publishing, and has even written his own book for young adults about drag. In fact, his belief that storytelling is important for child wellbeing and development has been supported by a review in 2020. From a research perspective, not much is yet known about the impact of Drag Storytime programmes. However, one study in America surveyed caregivers at these events, and found that the majority enjoyed the programme themselves, said that their children enjoyed it, and in general felt that the event was age appropriate. Even such organisations as the American Library Association have expressed their support for the events. However, despite the positive intention of these Drag Storytime events, they have attracted a lot of negative attention across the world, and, back in February 2023, that attention unfortunately found That Girl. A right-wing political group started posting about George and That Girl on their social media pages, drawing attention to protests they were planning at the South London venue where That Girl’s Storytime took place. To incite community disapproval of these events, they used footage of That Girl lip-syncing swear words and performing burlesque, and of her fellow drag queen Copper Topp’s ‘Drag Brunch’, all of which are targeted at adult audiences, to argue that the content created by drag artists is not suitable for children. Of course, it is common in the performance industry for artists to create a range of content to suit their range of audiences — actors such as Tom Hardy and Regé-Jean Page have starred in ‘CBeebies Bedtime Stories’, a TV programme in which they read stories to children, while also being allowed to star in adult scenes in adult-targeted movies, with no backlash. However, drag artists are seemingly not allowed the same freedoms to tailor their performances to their audiences. So, what’s the difference? George argues that it “exposes the fact that, broadly, this is homophobia and they are using the “think of the children” rhetoric to get people riled up. And, to some degree, it has worked.” Before the first protested event, George told me he was terrified. He said “I had no idea what was going to happen and despite the outpouring of love online, I didn’t know how that would translate to in person. [The far-right group] appear to have a huge online following, and the people in their comments are loud and angry. On the day, I didn’t want to do it. I wanted to run and just leave the event in the dust.” Thankfully, the local community turned up in large numbers to refute the views of the protesters, and have done so at every protest since. To George, “it’s a reminder that we are doing the right thing, and that these people won’t win.” I wanted to find out more from George about the joys of drag, and how it can have such a positive impact on his mental health. In short, he told me that he loves performing; it makes his “heart sing” when he is bringing joy to people with something that brings so much joy to him. Having recently attended his show ‘That Girl vs The World’, in which the first half comprises George going through the process of transforming into That Girl, and the second half starts with That Girl exploding onto the stage in her full glory, I was struck by how much George lights up and gains confidence when he embodies the ‘That Girl’ persona. He tells me of the “unrestrictive” feeling of performing in drag. With That Girl’s outfits, voice, and song choices, he doesn’t feel limited by gender expectations and can sing songs from whichever artists he likes, rather than feeling the need to “stay in his lane”. Over a difficult year, it is clear that George’s relationship with That Girl has been complicated — his love for drag performance risked having its joy overshadowed by his fear of the protests and loud opposition. When asked what has been important to help him cope during the challenging moments, he said, “No drag is an island.” His support network is very important, and his drag family rally around him and help him to carry the load on heavy days. This is not only true for him — a study found that the most protective factor in the mental health and resilience of drag performers is social support from friends (despite a very high 68% of them reporting feelings of depression). But more broadly than that, the drag community, like any marginalised community, needs support from anyone and everyone who is able and safe to provide it. I’ll leave you with George’s powerful final message: “We are but a small part of the population, and it is allyship that will carry us through this. We can’t do it alone.”

Trigger warning: The following article contains discussion on sexual assault, which some readers may find distressing. Recently, I heard a story in the news which horrified me, as I’m sure it did you. A 20-year-old woman was sexually assaulted on a London Tube, in broad daylight and in plain sight of other passengers. However, the presence of these witnesses did not stop the attack from occurring, and no one on the tube did anything to stop it from happening. While the sole responsibility for this attack lies with the perpetrator, the incident left me questioning how it could have possibly occurred in the presence of numerous passengers who could have intervened. I have always been taught and believed in the concept of safety in numbers and feeling more secure when surrounded by people. However, this story has challenged this belief. It has left me questioning whether there is ever a time when we can confidently leave the house alone and not be checking over our shoulders, worried that something might happen, and no one will help. And I am by far not the only one asking these questions — the story has ignited outrage on several social media platforms, with the term ‘bystanderism’ or ‘the bystander effect’ being the focus of conversation. In trying to understand how this event could have been allowed to unfold, I decided to do some research into the bystander effect and took to writing this article to help myself, and hopefully our readers, learn why people behave this way, and what we can do to overcome it safely and effectively. Understanding the Bystander effect Bystanderism is defined as a scenario in which individuals do not help people in critical situations due to the presence of other people observing the same situation. It can occur in any situation where people are in danger; however, for the purpose of this blog, I will be focusing on the bystander effect in the context of women’s safety. This is not only because of the story which ignited me to write this piece, but also because proactive bystanders play a pivotal role in shifting the narrative surrounding the prevention of sexual violence. Promoting bystander intervention can move the focus from victims feeling a need to defend themselves, to recognising it as a community issue that demands collective action. According to the bystander effect, people are less likely to intervene in emergency situations when they are surrounded by bigger groups of people than if they were the only person on the scene. Psychologists Latane and Darley (1970) have offered a couple of explanations as to why this is the case: Diffusion of responsibility — Consider that you are the only person witnessing an emergency. In such a scenario, 100% of the responsibility to help falls on you. Whether you help or not, that burden will only be yours, making you more likely to intervene. However, if there are several other people around who could help, the share of the responsibility is spread, and the psychological cost of you not intervening is reduced. Social influence — When we are unsure of what scenario is unfolding, we look to other people for reassurance of what needs to be done. If you are in a crowd of people who are not intervening in a dangerous situation, you may begin to wonder if you are in fact witnessing an emergency and are likely to go with the crowd and believe that everything is okay, encouraging a state of mutual denial. In an interesting article from The Guardian, it’s noted that individual bystanders may also choose not to intervene based on their distinct characteristics and obligations. Some men might hesitate, fearing they could inadvertently escalate the situation and be perceived as a threat. Those accompanied by loved ones might grapple with the risk of their safety, while younger individuals might feel powerless, doubting their ability to make a meaningful difference. This research has allowed me to understand why people might hesitate to intervene in emergencies, prompting me to reflect on my own potential actions. While I’d like to believe I would run to someone’s aid, the reality is that when faced with such circumstances, the stress, hesitation, fear of repercussions, and uncertainty can influence one’s immediate response and decision-making. However, if we don’t step in to help, it raises the unsettling question: When can women feel truly safe in public? While the ideal scenario would be to prevent such attacks altogether, given the rising rates of sexual harassment and normalisation of sexual assault against women, it is important that we learn to become proactive bystanders, so that if a situation arises, we can act quickly. Further, silent bystanders inadvertently signal acceptance, leading perpetrators to believe their harmful behaviour is acceptable. How can we be proactive bystanders? In situations where someone needs help, it can be incredibly frightening and anxiety-provoking to know what the best, and safest, thing is to do. In light of this, an anti-harassment group, Right To Be, have designed a checklist for bystanders in order to raise awareness of the safest way to intervene without escalating the situation or putting yourself in danger. The checklist, entitled ‘The 5D’s of Bystander Intervention’ encompasses: 1.     Distract — diverting attention away from a potentially harmful situation 2.     Delegate — where one seeks assistance from others or authorities 3.     Direct — directly intervening or confronting the situation, if safe to do so 4.     Document — the collection of evidence or information about the situation for appropriate action or reporting 5.     Delay — wherein one checks on the individual after a potentially harmful incident has occurred, offering support. Ultimately, while bystanderism remains a pressing issue, it is crucial to recognise that it is not the root cause of violence against women in public spaces. It is important that we encourage ourselves to act when we can, but also to redirect our focus from a need to defend to a need to change men’s behaviour so we never find ourselves in a situation of needing to intervene.

My grandfather passed away with dementia in the Commonwealth of Dominica when I was 16. I was raised with him, my grandmother, and my mum. I remember my grandfather as a supportive grandparent, attending every graduation, school meeting, and church event I was a part of. We went fishing, played dominoes and cricket together. These are my fondest memories. He was a reserved individual but was able to brighten up anyone’s day. My grandad was a classy man and held strong values of being kind and spending time with family. The warning signs began with my grandfather notifying us about a leak in the house, which is quite normal. There are always leaks in the house. But it was quite frequent, and we kept checking in, and there wiuld be no leak. The significant warning sign for me was when we almost ended up in a car accident with him at the wheel. We were unaware that he was developing dementia at this stage, but my grandfather had a clean driving license, so I knew something was wrong. We needed to seek professional help. My grandfather was then diagnosed with dementia and Parkinson’s Disease. He lost the ability to walk and talk. He also experienced stiffness, particularly in his hands, and difficulty swallowing, so he also needed assistance with eating and drinking. During his dementia diagnosis, I spent my time at the hospital with my grandad. This experience highlighted to me the lack of understanding of dementia in public health facilities, the cultural stigma towards dementia, the lack of access to support for young carers, and insufficient research and resources for treatments for dementia. I felt a bit hopeless at some point of this experience, my friends didn’t understand what I was going through, and I wasn’t too far from their level of understanding either, so I started doing my own research to learn more about dementia. I brought pictures of the family to the hospital as I read that this is a good reminiscing activity to do with someone who has dementia. I started going to therapy for the first time in my life, to cope and further process what I was feeling. I would attend sessions between classes at school. This was helpful for retrospection, and I felt lighter speaking to someone who has a deeper understanding of dementia. My grandfather regained his memory, but it was 3 days before his death. By the age of 18, I founded a youth-led dementia charity in 2016 in memory of my grandfather, with aims and objectives based on personal experiences. We are the only dementia organisation in Dominica. This allowed me to develop my leadership and advocacy skills by building key relationships with Government officials, regional and international non-governmental organisations, and key beneficiaries, including care homes and families with someone who has dementia. I grew a community of Dementia Advocates in the UK and Dominica. I'm hoping to create psychosocial interventions for people with Dementia by conducting further research into Dementia through the Dominica Dementia Foundation. Her Majesty the Queen Elizabeth ll awarded me the Queen’s Young Leaders Award in Buckingham Palace for my commitments to Dementia. Since starting the foundation, I’ve also explored different disciplines such as film, using it for social change in this area. Dementia: The Island Journey is a feature film and an eco-friendly production that focuses on dementia, culture, and my personal journey in creating an impact in the lives of older people in Dominica. Living well in a cultural context is something the film highlights, creating a realistic as well as a positive approach to older people in the media. I also explored holistic treatments for dementia and engaged in traditional experiences in a quest to understand the recipe for the meaning of quality of life. This film project has allowed me to fall in love with Dominica all over again, seeing it through a film director’s lens. I’ve also been able to connect with my grandfather’s siblings and cousin as we share memories of him since the film launch. In 2017, I started my journey of achieving a bachelor's degree at the University of Kent. I was a recipient of the Queens Young Leader award for the work I do in dementia, and I was also selected to speak on the BBC's The One Show with Prince Harry. This September, I’m pursuing a master’s degree in dementia at University College London (UCL). My grandfather’s passing has given me a sense of purpose, it has been the journey of a lifetime contributing to this cause. I feel connected to my grandfather, it has been personally healing for me to support other family members navigating this new life change. I am who I am because of my grandfather and my upbringing. The foundation is my way of honouring a great man who is dearly missed. The Dominica Dementia Foundation aims to raise awareness of dementia, raise funds for families affected, provide emotional support to families and caretakers as well as facilitate research towards dementia.

Trigger warning: This article discusses sexual violence and rape, which some readers may find distressing. Ever since Mark Zuckerberg announced the rebranding of Facebook to “Meta” in 2021, the 'metaverse' as a concept was popularised. But what exactly is the metaverse, and why has it been featured in the headlines lately for being a place of sexual violence? The metaverse has been described as “the next evolution in social connection and the successor to the mobile internet”, and essentially refers to the combination of virtual reality (VR), augmented reality, and other types of technology for people to have various experiences online. The metaverse has numerous applications, but the most common ones are for fitness, gaming, social interaction, and entertainment. Video: Guardian News via Youtube While the features of the metaverse sound incredibly exciting with the potential to do a lot of good, this has unfortunately not been the case for some young women. In January 2024, reports surfaced of a 16-year-old girl in the UK being virtually raped in the metaverse, which is now being investigated by the police. This attack occurred in an online immersive game, and the girl’s avatar was subject to a violent sexual attack by a group of men. While she did not experience any physical injuries, the nature of this attack left the child distraught, and investigators are concerned that she experienced the same level of emotional trauma as a victim of rape in the real world. Unfortunately, this is not the only report of sexual violence in the metaverse. In 2021, psychotherapist Nina Jane Patel shared her distressing experience of being sexually harassed in the Meta platform ‘Venues’. She described how, within minutes of joining, she was verbally and sexually harassed by male avatars, who then yelled out obscene things such as “don’t pretend like you didn’t love it”. Another report from 2021 shared the experience of a woman who experienced sexual harassment from a male avatar who simulated groping her and exposing himself as she used the Occulus Quest virtual reality headset.  When she asked the player to stop, he indicated that it was the metaverse, and that gave him the liberty to do whatever he wanted. In another VR based game QuiVR, a female avatar experienced a male avatar’s unwanted sexual advances, as he virtually rubbed her chest, chased her around, and even though she asked him to stop, his advances became more intense, only ending when she removed her headset. As is often the case in cyber harassment, the metaverse offers anonymity to its users, creating a challenge to identify real-world counterparts from their avatars. What are the effects of metaverse harassment and how have people reacted? The negative mental health impacts of cyberbullying and online sexual harassment have been widely investigated. Some of them include increased depressive and anxiety symptomology and suicidal ideation. Unfortunately, with the creation of the metaverse, online sexual harassment is likely to increase and take a different form. In fact, the National Society for the Prevention of Cruelty to Children (NSPCC) commissioned a poll among adults about children’s metaverse safety, and found that 75% of people believe that 6-12 year olds are at significant risk of sexual abuse in immersive VR space. One additional problem is that using virtual reality headsets to enter the metaverse can cause people to experience the phantom touch (wherein a person can feel interpersonal touch as a vibration through their headset, without any physical interaction). This immersive nature of the metaverse adds another layer to the impact of online sexual harassment, having severe effects on mental health. I wanted to understand how the world reacted to this January 2024 attack and had a look at social media platforms to get an idea. While most responses support the victim and call for more regulation, I came across a news channel’s TikTok account, which shared a video of one of their female TV presenters questioning whether this investigation was a ‘good use of police time’. In addition, a 2020 review of comments in response to another report of metaverse harassment found that many were dismissive of the user’s experience, and there was a lot of debate as to whether it was considered groping if there was no physical touch involved. In a recent interview, Dr. Verity McIntosh (Associate Professor of Virtual and Extended Realities), actually helps to answer these questions. She describes the ‘process of embodiment’ which means that online representations of us have connections with our actual selves. When using avatars in VR worlds that look similar to us and using our same voice, this process of embodiment is intensified. Therefore, traumatic experiences using VR can trigger the same emotional and behavioural responses as a real-life experience, elevating the importance of addressing metaverse harassment. Given the evidence of how ‘real’ the metaverse experience is, these dismissive responses to news reports are disappointing and worrying, and only reiterate that safety measures need to be put into place as a matter of urgency. People need to realise that sexual harassment is harassment, be it in a metaverse or the real world. What are the safety measures that can be implemented? As the metaverse continues to expand its reach globally, it’s important to understand the safety measures available to remain protected in this virtual world. The ‘Horizon Worlds’ application provides its avatars with a personal boundary function which is turned on by default. This prevents others from invading personal space, and if someone does try to enter, the system prevents them from moving forward (You can learn more about the function here), and is a helpful mechanism for both adults and children to keep themselves safe in the metaverse. The NSPCC has also shared tips for parents to help maximise their child’s safety in the metaverse. One of these is exploring the games/platforms themselves to understand functionalities and features. This can go a long way in being aware of potentially harmful and unwanted contact from strangers. Related to this, parents should also regularly check with their children about the people they are talking to in the virtual world, to make sure they are safe from online predators. NSPCC also recommends supervising their child and being available if they experience a negative experience, particularly when they are accessing the metaverse. Distressing experiences can come on suddenly and without warning, and having an adult present in the room can mitigate these unwanted stressful disturbances. Last but not in the least, with the rise in metaverse harassment cases, it is imperative to set strict legislations in place specifically for virtual world applications, to protect the rights of victims and ensure that perpetrators do not repeat this offence. If the metaverse is the future of the internet, that means it is here to stay. While it has the potential to make technological leaps for the good of humanity, these reports of sexual harassment are detrimental. If we don’t act on this now and make changes, this is only going to get worse, and we need to realise that it is the mental health of young children that is at stake.

Many people wish to have children but face challenges in doing so without medically assisted reproduction. This term encompasses all medical treatments aimed at achieving the goal of parenthood, such as intra-uterine insemination - a procedure in which semen is implanted in the uterus - or in vitro fertilisation that handles human gametes- oocytes and sperm- in a laboratory. While some individuals deliberately choose to remain childless, numerous situations result in involuntary childlessness. Are you a couple or a single individual in need of medical assistance? You are not alone. In Europe, over 12 million cycles of medical treatments for conception have been performed between 1997 and 2019. As a psychologist working with couples and families, I would like to share some insights learned during my three-year PhD research at the Institute for Maternal and Child Health “IRCCS Burlo Garofolo” (Italy), in the hope that this article may be beneficial to people trying to have a baby. Therefore, I will provide some clarifications and tips in the following paragraphs. Comprehensive information regarding these procedures and securing the support of loved ones and professionals at every phase - both before and after medically assisted reproduction - are important to ensure a more fulfilling experience, helping individuals to avoid unnecessary suffering. Secrecy and stigma surrounding conception treatments persist in many countries, and couples, as well as singles desiring parenthood, may feel lost and silently desperate after years of waiting. Nurturing Hope: An Informed Path Many of us may have come across stories about medically assisted reproduction in shows, web searches, or in online forums, but these can sometimes contain confusing or misleading information. These rumours can discourage many people from trying to have a baby or, on the contrary, give false hope to others. Don’t be influenced by misconceptions. You should know that there are plenty of techniques with varying levels of complexity, and only a doctor specialised in medically assisted reproduction can explain the risks and benefits of these procedures to you based on your particular condition. It is important to note that the availability of these techniques varies depending on your country’s policies. In Europe, some countries permit medically assisted reproduction solely using the couple’s gametes, while other countries also allow the use of donated gametes, embryos, and surrogacy. Furthermore, certain countries restrict access to medically assisted reproduction to different-sex couples only, whilst others adopt a more inclusive approach. I recommend checking the laws in your country with your family doctor. If you decide to seek medical assistance, you should be aware that attempting to conceive is a complex and subjective experience. During this process, you must navigate physical and/or psychological changes, so take care of your mental health and don’t be discouraged. Indeed, undergoing medical treatments could be very demanding due to physical discomfort, such as the side effects of medications, and time constraints of procedures which can be difficult to integrate with work and leisure activities. If you are part of a couple, relationship issues may arise, as medical procedures can put a strain on the relationship. Additionally, medical treatments can sometimes be costly, as they are not always covered by insurance according to local law. All these factors can exacerbate stress, potentially leading to discontinuing medical treatments and reducing the chances of conceiving a child. Finally, it’s essential to acknowledge that treatments may not always succeed. Coping with this reality can be emotionally challenging, so seeking psychological support is crucial to moving forward and finding fulfilment, even if you remain childless. If you are expecting a baby, you should keep in mind that the prenatal period can be stressful, and it is common to experience both positive and negative feelings. So, take even more care of yourself. Depression and anxiety are frequent conditions during pregnancy, and reaching out for assistance, such as through your National Health Service, is the way to feel better in the long run. This is vital not only for your well-being but also because mental health impacts pregnancy outcomes, such as preterm birth and low birth weight. Moreover, certain methods of conception may increase the risk of neonatal complications, impacting your emotional well-being. Additionally, your medical practitioner may advise rest or recommend limiting daily activities if they pose a risk, and managing this advice can sometimes be challenging. Also, the fear of losing the baby can be particularly intense after medically assisted reproduction, and seeking psychological support can help you cope with it. Families Through Medically Assisted Reproduction: Resilient Connections If you are concerned that medically assisted reproduction might create challenges in your relationships, research in this field provides positive insights regarding the well-being of families formed through this method. Parents who have turned to medically assisted reproduction typically maintain strong and positive relationships with their children, even when there is no genetic or gestational connection. Regardless of the family structure, the deep desire for parenthood and emotional investment drive parents to make significant efforts to establish close relationships with their children. Also, for couples undergoing this journey, it’s important to recognize that those who persistently pursue the dream of having a baby form a resilient group. These couples typically maintain a strong bond, demonstrating mutual support and cooperation. So, don’t be worried about the well-being of your family. However, bear in mind that the initial months with the baby can be overwhelming for every parent due to life adjustments and childcare responsibilities. These changes may increase stress levels and lead to social isolation. A valuable social network is very important for mental health; for this reason, don’t exclude family and friends, and ask your loved ones and your National Health Service for emotional and practical support throughout the perinatal period. Furthermore, transitional phases and stressful moments can negatively impact a couple’s relationship. So, if you are part of a couple, don’t forget it. Take care of your relationship through small daily gestures, such as emotionally supporting your partner during times of stress and dividing parental responsibilities fairly. By doing so, you will cultivate a shared identity as a couple and experience satisfaction in your relationship. When deciding to share the truth with the child, it's important to note that some methods of conception pose greater challenges in disclosure and asking for professional advice would help parents find the right disclosing way. Additionally, the age at which children are informed about their conception can impact the process, with professionals in this field often recommending early disclosure. What matters for a happy family are love and honesty. Being open about a child’s origins and fostering loving, supportive interactions between parents and their children, will positively influence family happiness.

An interview with Anna Viduani, a Brazilian researcher in adolescents’ depression. “If you ask closed-ended questions, you are only going to get the answers to these questions,” says Anna, the research psychologist from Brazil who is interested in depression in adolescence, in particular adolescents’ perspectives on what it means, and feels like, to be depressed. Anna is conducting her research in Brazil, and she recently published two scientific articles – one focusing on adolescents’ experiences of depression, and the other on their experiences of receiving the diagnosis of depression. Having worked together with Anna on a research project in the past, Identifying Depression Early in Adolescence (IDEA), I was lucky to get a chance to talk to her about her recent work in qualitative research, which is the kind of research that asks open-ended questions in an interview-like format to explore and understand the depth and breadth of the topic – in this case, adolescents’ perspectives on depression. Similarly to Anna, I am a mental health scientist with a background in Psychology and I was always fascinated by this kind of scientific approach, because it integrates diverse perspectives, and is a great indicator of which way to go in research. And who is a better guide to understanding depression than those who have experienced it? “We were really interested in exploring in greater detail how Brazilian adolescents perceived and experienced depression”, Anna explains, “we interviewed adolescents with open-ended questions, trying to truly understand their experiences, perceptions, thoughts, and behaviours about depression.” She emphasises the power of giving a voice to those with lived experience if we want to understand “what is important and what really matters to those affected by depression”. Knowing this can point us in the right direction in terms of research, clinical practice, school interventions, and generally, in society to help open a dialogue and reduce stigma. “What did you learn from your group of adolescents”? I am curious. “One of the first things that we learnt was that many of the adolescents never had a chance to speak about their experiences before, and being part of our study, gave them this space to talk and think about it. We felt like they were using the space to make sense of something that they did not have the opportunity to express before, and to make sense of their symptoms.” When talking to Anna, I felt that this alone seemed like reason enough to conduct this study, it was offering something important to these kids. And whilst this space for open conversation was available, Anna learnt something new about how youth experienced depression, what was important to them, and where to go from there in terms of helping create an environment fostering well-being. “Adolescents felt like their voices were often not heard, especially by adults or other people in their lives, and they felt like they were not treated as experts of their own experiences”. This was an important piece of information as it showed the need to create spaces where adolescents could share how they felt. This was also something that was reflected in the interviews with parents who reciprocated the feeling that there was a lack of communication and understanding for them about what their children were going through. “I know what sadness means for me, but I have no idea what sadness means for my child”, one of the parents said. This statement really struck me as it was saying something powerful – you can really miss the point if you are not curious about the other. I wanted to know if Anna found the answer to this question – what did sadness and depression mean to adolescents in her study? The central theme that emerged was social isolation. When exploring it further, she found that two aspects were contributing to how adolescents experienced depression – an internal sense of loneliness and how it was reflected in the quality of relationships with others. Anna and her colleagues called it a relational model of depression. According to this model, isolating and withdrawing from social interactions also serves as a coping strategy for internal discomfort and difficulties relating. “We proposed this model because we felt like social isolation was at the core of the experience”, Anna says, and adds, “I feel like this is not an experience that is limited to Brazil and might be applicable to adolescents in different parts of the world”. Anna talked about opening a dialogue which really helped to normalise experiences where participants could understand and name what was happening to them. For example, adolescents who received a diagnosis of depression were able to think about it. However, adolescents who were not familiar with what depression was, and did not know anyone who had depression, found it more difficult to accept and understand the nature of it. There was a sense of confusion. For example, how can the condition that is rooted in biological changes be manifested in mood changes – “How can emotions be a disease?” This also meant that they felt more worried when they received a diagnosis and there was a sense of stigma associated with it - “Some adolescents really struggled to come to terms with having a diagnosis, feeling like it would bring up a lot of stigma because they had this idea of depression as something negative”. Listening to Anna, I felt like I learnt a fair bit about adolescents’ experiences, and I wondered, what’s next – how can we use this information to help address the gaps? “I feel like the biggest message that we wanted to convey to everyone is listening to adolescents, it's always a good measure when trying to identify what the main difficulties are and which direction to go next in terms of interventions. For example, based on what we learnt, we could start thinking about interventions that would focus on social connectedness, interpersonal relationships, opening spaces for communication between not only peers, but also different generations, reducing stigma and so on.” I couldn’t agree more. I think it is incredibly important that we create spaces and listen to those with lived experience and integrate this knowledge with that of researchers and health professionals. This way we can think together what is relevant and how we can make it work. And we are on the right track with new research projects emerging, such as CELEBRATE, which looks at co-producing a framework of guidelines for engaging young people in biological research in mental health. I hope more projects like this will follow and conversations will open. As, supposedly (although not scientifically confirmed), Fyodor Dostoyevsky said, “Much unhappiness has come into the world because of bewilderment and things left unsaid.” Let’s talk.

Introducing tianeptine — an antidepressant with a dark side. Its mimicry of opioid effects, coupled with easy accessibility in the United States (US), has earned it the nickname “Gas-Station Heroin”. For individuals already grappling with opioid addiction, the deceptive marketing of tianeptine as a dietary supplement only escalates the problem, as it enforces the mistaken understanding that it may be a safer (and legal) alternative to street opioid drugs. Not just another antidepressant Tianeptine was originally produced in the 1960s by a group of French researchers for treatment of depression. To this day, it is approved at low doses for prescription use in parts of Latin America, Europe, and Asia, but not in the UK and the US. It can be effective for some people suffering with depression. Unlike classic antidepressants, which increase levels of ‘mood-boosting’ factors in the brain such as serotonin, tianeptine appears to reduce brain serotonin levels. It is believed that tianeptine’s antidepressant affects are underscored by its ability to prevent changes in brain structure and function caused by stress. The drug is recognised as safe and effective when used at the proper dose and under prescription. However, unlike classic antidepressants, high doses of tianeptine activate the same brain mechanism activated by Class A opioids like heroin and fentanyl (mu opioid receptors), and indeed people report that it can create a sense of euphoria. Unsurprisingly, this also means that after using tianeptine, the same withdrawal symptoms associated with classic opioid drugs arise — including nausea, insomnia, depression, agitation, and diarrhoea. Moreover, tolerance to tianeptine develops rapidly, requiring abusers of the drug to escalate their dosage in order to recapture the pleasurable effects. Indeed, it has been found that individuals are taking tianeptine at doses over 100 times greater than recommended for therapeutic purposes, equivalent to 200 tablets a day. However, this only increases the severity of the “dopesick” symptoms, leading to a destructive cycle where abusers feel the need to take more tianeptine as withdrawal symptoms kick in. Slipping through the cracks as a dietary supplement Clearly, tianeptine is a dangerous drug, so how has it managed to be so freely available? While tianeptine is not approved for prescription use in the US, it is here that it is raising the largest concerns. This is because it is easily and readily available as a nootropic agent — sold in small colourful bottles under names such as “Za Za”, “Neptune’s Fix”, and “Tianna”, at gas stations, liquor stores, smoke shops and even online. Manufacturers claim that these supplements can boost mood and improve cognition. In 2022, the Food and Drug Administration (FDA) did issue a consumer warning that tianeptine was being illegally marketed as a dietary supplement. Furthermore, they claimed that they do not approve it for any medical use and warn that it is harmful and addictive. However, they are unable to impart much regulation on dietary supplements. Indeed, under the Dietary Supplement Health and Education Act (DSHEA, 1994), the FDA “does not have any authority to approve dietary supplements for safety… or to approve labelling, before the supplements are sold to marketing”. Instead, they rely on companies taking responsibility to ensure their products are safe. In the case of nootropics containing tianeptine, the cracks in this system have become prominent. While the FDA are now taking regulatory action to prevent the marketing of tianeptine products, imparting a nationwide ban is not currently possible. Despite the FDA rightfully stating that "availability is no indication of effectiveness or safety", it should be considered that the average person, even if they see tianeptine as a listed ingredient, will not be aware that it could have opioid-like effects without the presence of informative or warning labels. Social media has also played a role in the rise of tianeptine usage, with several platforms facilitating misinformation and promoting tianeptine’s positive effects. However, with the rise of tianeptine misuse has also come a rise in people trying to spread word of its negative, addictive effects. Especially on social media platforms, like TikTok, people are trying to curb the narrative of tianeptine and produce public awareness videos to warn people of its harmful properties. Intersection with addiction A recent and interesting article for the New York Times describes the devastating effects this drug can have for people struggling with addiction. The article recalls a story of how a man who had recently come out of rehab was intrigued by the apparent mood-boosting properties of “Neptune’s Fix”, under the false pretence that it was being sold so openly in shops and thus it must be safe and non-addictive. However, the immediate positive effects and rapid onset of withdrawal quickly hooked him, and he was eventually using five bottles a day. Soon, he collapsed in a preschool car park, after suffering from an overdose. Sadly, stories like this have become all too common. People with a history of addiction are initially captured by the notion of a drug which gives them the same feeling as opioids, but is easily accessible and legal, leading them to believe they are safe. Maybe they start to feel they have found something which can help curb their addiction without destroying their lives. Devastatingly, a recent study reports on a case of a baby born to a mother taking these dietary supplements during pregnancy to mitigate chronic pain without knowledge of their harmful effects. Following birth, the child quickly developed symptoms of severe opioid withdrawal. For addicts, recovering addicts, or people who have never even tried opioids, these dangerous “dietary supplements” are incredibly damaging to both physical and mental health. The pervasive false marketing of tianeptine not only draws people with addiction into another hazardous cycle, but also contributes to an undeserved tarnishing of the reputation of legitimate antidepressants, obscuring their potential benefits for those who genuinely need them.

What are Brain-Computer Interfaces and How do They Work? This week, Elon Musk's Neuralink has captured global attention by successfully implanting their wireless brain chip, named 'Telepathy', into a human for the first time. This milestone marks a significant leap forward in the realm of neurotechnology, specifically the field of brain-computer interfaces (BCIs). BCIs are a technology that enables direct interaction with computers and devices solely through thought. They use advanced neuroimaging technologies and machine learning algorithms to convert brain activity into machine commands. Neuralink’s ambitious project aims to help people with motor impairments by allowing them to control computers with their minds, restoring previously lost functions and helping them live a better life. (For more information on current ethical considerations, see Lea Schmid's article here.) Musk recently shared Neuralink’s vision, stating, “Imagine if Stephen Hawking could have communicated faster than a speed typist or auctioneer. That is the goal.” This article will share the simplified workings of BCIs, their potential applications, and the pressing safety concerns as neurotechnology companies like Neuralink move swiftly towards human trials. How do BCIs work? Although the communication from thought to computers may sound like something out of a Sci-fi movie, the underlying logic behind it can be understood through a simple acronym, MIND: Measure, Interpret, Encode, Deploy. By the end of this article, you will hopefully understand the basics of this technology, using this acronym to remember the foundational steps in turning thought into machine action. Measure Understanding the science behind the brain’s 'language' system and learning to measure it has been pivotal in developing BCIs. Our brain's mode of communication involves transmitting electrical impulses along neurons, creating a measurable electrical charge. This electrical activity is the signal that BCIs capture. The foundation for measuring this neural 'chatter' was laid in the 1920s with the invention of the electroencephalograph (EEG). An EEG functions by utilizing a series of electrodes placed on the scalp or, in some cases, inside the skull. These electrodes are sensitive to the millisecond electrical charges resulting from the brain's neuronal communication. The unique electrical activity at different electrode points, captured by the EEG, is thus, indicative of specific cognitive states, processes or intentions. Today, EEG devices have evolved into complex tools that allow for a more accurate measurement of our brain's data. Advances in EEG hardware and neurosurgery are enabling the surgical implantation of extremely thin electrodes inside the brain, offering more precise brain information (picture below). Different types of brain-measuring tools enable us to customise BCI designs according to the specific thoughts or actions that need to be captured. Interpret and Encode After measuring the brain “data” using EEG - capturing the electrical activity for a specific brain state, we bring in the Machine Learning (ML) models for interpretation and encoding. These models act like computational translators, turning the complex language of brain waves into understandable actions or thoughts that can be sent out to a device. Here's an example of the steps of a basic BCI ML model. Feature Extraction: The ML model first identifies key features in the EEG data related to the action/thought we are interested in. These features might include specific electric frequency bands (like alpha or beta waves), event-related signals, or even more complex features such as connectivity patterns between different electrodes (brain regions) placed on the head. Sophisticated algorithms parse through the EEG data, extracting these features while filtering out irrelevant information. By zeroing in on the most informative aspects of the EEG signals, we set the stage for more precise and meaningful pattern recognition. Training the Model: We teach the model with a dataset where these patterns are linked to known actions or thoughts. Over time, the model learns to correlate certain brain wave patterns with specific actions or thoughts, so next time it sees that specific brain pattern, it will know the person is thinking about moving his left hand up, for example. Once trained, the model can interpret new EEG data in real-time. Deploy This is where the magic happens. The processed and encoded thoughts by the machine learning models are “deployed” to a computer or device to manifest the thought into action, whether this means moving a robotic arm or having a word appear on your screen after having thought about it. The method of transmission to the device varies, with some being done with wired connections, Bluetooth, or even Wifi. What can BCIs be used for? The potential applications of this technology are limited only by human imagination. For example, BCIs can interpret the brain signals of a person with paralysis, translate these into commands that a computer can understand, and then prompt a machine to move accordingly. Leading companies in this field, such as Neuralink, Blackrock Neurotech, and Precision Neuroscience, are demonstrating promising clinical applications for individuals with conditions like quadriplegia, paraplegia, upper spinal cord injuries, stroke, ALS, and muscular dystrophy. Some other creative commercial applications for BCIs include translating brain signals into text for computers for everyday use, identifying if you are in the right mental state to drive, or even the implementation of “passthoughts”, where one signs in to personal devices with their unique brain activity. Future Directions BCIs are exciting technologies that have the potential to significantly improve and change lives. People who haven't been able to speak, walk, move, or interact with technology can live more fulfilling lives by bridging our advancing devices with our thoughts. Scientific research in the BCI field is advancing rapidly, as evidenced by a more than 600% increase in publications featuring the keyword 'BCI' from 2005 to 2020 and a predicted 15% annual market growth from 2022 onwards. It's clear that BCIs are here to stay, and considering safety and data privacy issues, so contemplating where and how this technology could be applied is important. I recommend a new book by Professor Nina Farahany called Battle for Your Brain - Defending The Right to Think Freely where she emphasises the need for meticulous ethical considerations whilst approaching the age of neurotechnology. She states “Neurotechnology will soon become the ‘universal controller’ for our interactions with technology. This can benefit humanity immensely, but without safeguards, it can severely threaten our fundamental human rights to privacy, freedom of thought, and self-determination.” I agree with this statement and believe that, for the time being, whilst we research the psychological effects of this tech, BCI applications should remain limited to those who need it for clinical purposes. We want this technology to improve our well-being and our human experience at an individual level. The careless adoption of BCIs in the general population could further submerge us in a codependence on technology that we might not be ready for. Nevertheless, be on the lookout for advances and novel applications of these fascinating technologies. Below are some fascinating applications for BCIs from top neurotech companies, showcasing their immense potential to significantly improve people's lives. If curious, here are links to more information: Bi-directional BCI Movement with BCI Art with BCI Speaking using BCIs Elon Musk Neuralink A TEDX explanation

Hard reset, a phrase we use to refer to the action of starting over. A new beginning. Usually, resets happen intentionally, triggered by our own will to change something in our lives. In my case, the reset button was hit the minute I left my oncologist's office in May 2021, holding a letter with the words IN REMISSION on it. This came after 8 months of treatment, 6 cycles of chemotherapy and 15 days of radiotherapy, all to get rid of my rapidly spreading B-cell lymphoma. Just like that, I was cancer-free. This news was met with excitement and joy by everyone but me. I just stood there amidst the cheer, hugs and party music, smiling at everyone, but contemplating what my life will look like from now on. See, until that point, I had nothing in my mind but this: survival. Taking it day-by-day, surviving, staying alive. Being officially 'in remission' came with a new wave of anxiety, because although my cancer was gone, there was a deafening question in my mind: what am I meant to do now? Two and a half years later, I am still figuring it out. Now, don't get me wrong: I experienced genuine relief as I steered clear from the danger zone. I felt gratitude and wrote about it every day. But along with feelings of appreciation for my body battling through, I was constructing a new narrative in my head. One that wasn't easy to share with anybody. Because of this, I felt compelled to write this piece, in an attempt to dispel the shame and guilt I felt, and open up about feelings that are valid, especially after receiving intense, life-draining treatment. PATIENT Early on in my treatment, I realised that cancer is a sensitive, awkward at times, topic to talk about. I quickly realised who was a true friend and who hid behind the barriers of "politeness". I felt a clear distinction between myself and the rest of the people I knew. I felt distanced from the strangers I'd exchange glances with in the street. My cancer took centre stage, exerting a strong hold on my life, making me feel like a patient. Patient. I used that label to describe myself for the majority of my treatment. In my internal monologue, I always made sure to remember that I was a patient and everyone else lived a different life. It sounds obsessive, but walking down the street, I would try to imagine who else was in pain, had chronic illness, or was undergoing serious treatment. Even on days where I felt physically stronger, more capable of doing normal things like walking and reading, I still felt like I was existing at a different tempo and plane to everyone else. Upon hearing I was in remission, instead of feeling the expected relief and happiness, I felt lost as an internal loneliness grew inside. Throughout treatment, there was a general sense of care and consistent check-ins from my closest people. However, post-treatment, my friends' habit of checking in faded away unexpectedly. To them, I was cured, but within, a new battle emerged. The battle to understand my new life, acknowledging what had happened, and moving on. Life was supposed to go back to normal, but what is normal for me? Battling cancer was the one thing I had learned to live with, a treatment that defined my days, and now, not so suddenly, I found myself grappling with the process of making sense of my new body, being patient as my hair grew back, and allowing myself the time needed for processing and healing. I constantly felt guilty for not feeling grateful, frustrated for not being happier after a successful treatment. Life was scary, in the purest sense of the word. I felt mentally unstable, insecure and weak. The mind healing process seemed invisible to outsiders, it was only felt and experienced by me. So, I started from scratch. I journaled extensively to fill up my days but mostly to feel like I was expressing these feelings that would seem selfish and downright crazy to anyone that hasn't lived a similar experience. Writing down my thoughts, my outbursts and silly ideas, I felt I could regain some control and creative agency. I tried treating my journals as valuable archival material, fantasising that someday when I'd be a famous performance artist, "they'll want to use my journals to display this dark period in my life, and how I rose from the ashes like a creative phoenix". DANCER I don't want to talk about my life before cancer, but what you should know is this: before getting sick, (among other things) I was a contemporary dancer. Movement was my way of feeling confident, of making life meaningful. I used my body to express myself. For myself, and for an audience. When I got sick and my body couldn't dance, I felt defeated. I would break into improv sessions in my bedroom when my chemotherapy wasn't wearing me down, but beyond these subtle sparks of joy, the treatment couldn't allow for much more. My body is interwoven to my identity as a woman, as an artist, as myself, and this connection, albeit powerful, suffered its hardship the moment I got sick. One of my hard reset's biggest obstacles has been to come back to dancing. I dance occasionally, it is one of the most fulfilling experiences for my soul, yet it carries so much psychological weight. My insecurities, my body not being strong enough or up to the standards. So, I give it time; with time, I will learn to trust my body, seek its movement, listen to its flow, harmonise it with the rest of my life’s pieces. NOW I am by no means where I aim(ed) to be. But I learned through writing, by moving like nobody's watching, and with time, that I am where I need to be right now. That is enough. The present, my presence in the present, is enough.

Trigger warning: This article discusses suicide. Some readers may find this distressing. Over the past two decades, prevention efforts have helped reduce global suicide rates by a third. It does, however, still claim an estimated 700,000 lives worldwide each year (almost two thousand a day) although - with many countries under-reporting deaths by suicide coupled with issues of stigma, religion and illegality - there is a need to view statistics with caution. Globally, the rate is twice as high amongst men and, in the UK, suicide remains the biggest killer of males under 50. It’s one of those messages I shall never forget. It was May 2021; the UK was coming out of a second lockdown, and I was in Wales to collect a puppy. My phone vibrated on the hotel bedside. I turned it over to see a message from a friend asking, “Have you heard about Derek?”. I hadn’t. But I knew. The first time I met my friend I remember masquerading a sigh as my internal voice muttered “What an arrogant sod!”. We were at a boxing gym in Thailand and before class one sweltering afternoon he swaggered his way over. Shirtless in 90-degree heat, he was more than six feet with chiselled good looks, broad shoulders, a six-pack and looked as though he’d just popped across from a Men’s Health cover shoot. He walked over from chatting to the most attractive woman in the gym (of course) and said: “Hi, I’m Derek. Nice to meet you. Where are you from?” Along with mutual friends, I smile now because everything about this guy we should have disliked. His looks, his confidence, his effortless popularity. Most of the women probably wanted to date him. All the men wanted to go hang out with him over a beer. Well, as the saying goes - and it’s a lesson to which we should all heed (and on a daily basis) -“Never judge a book by its cover”. The person I met that day turned out to be one of the most naturally empathetic and intuitive people with whom I’ve ever crossed paths. It’s not an especially fashionable trait in these times but he exuded kindness – and did so by the bucket load. We became friends instantly. It was a friendship conducted across thousands of miles – and on the occasions, we’d meet up again in Thailand - but it was honest, deep, meaningful and we helped each other through some tough moments. I always remember smiling when I’d wake-up in the morning and – due to the time difference – see a waiting message from him illuminated on my phone. When my father died, Derek was in regular contact, checking in on me and doing that rare thing we all need to do way more when we ask someone “How are you?”. I’d say “Yes, I’m fine thanks.” And I’d get back: “No dude! How are you? Really?”. I didn’t know at the time quite the extent of the turmoil and torment he was going through which, with hindsight, made his inherent empathy even more remarkable. Sadly, our friendship wasn’t destined to span the decades for, in May 2021, my buddy took his own life. He was 35. I know that had he not, our friendship had every indication of being life-long. In the realms of loss, suicide is one of the most acute and visceral things those of us left must deal with on this journey we call “life”. Someone said to me recently that it “blindsides” you… and “it just keeps on blindsiding you”. More than two years have now passed and so often it’s the little things, the small reminders that dwarf the larger picture, the wider expanse of loss. It’s the chat about stuff and nonsense. It’s the banter; the guy talk. It’s the “Hey man, what do you reckon I should do about..?” And it’s the deeper conversations about life, relationships, and family. Yes, men do have those exchanges but clearly nowhere near as often as we should. Last year, I heard UFC fighter Paddy Pimblett recount the loss of his friend Ricky. He said: “I’d rather have a mate crying on my shoulder than go to his funeral next week.” I know I’d pay a princely sum now for one more chat with my friend. I’m no expert on bereavement by suicide and its turbulent aftermath but I have, as I learn more, come to understand that – in so many instances – those who decide they no longer wish to be a part of this world possess a certain “quality”. I’d watch my friend on numerous occasions and marvel at his ability to make whomever he was talking to feel, not just at ease, but like they were the most important person in that gym, bar or restaurant. And he did it with such natural charm, such honesty and by being so open and non-judgemental to whatever he got back. With any bereavement, time does heal. If not heal, then at the very least it does dull the pain. With suicide, it’s intertwined with all those regrets: those what ifs?, those “I wish I could have spoken to him/her on that day”. And then there are all those unanswered questions. But, as a counsellor said to me, “The reason it (suicide) is so hard is because we don’t know. We just don’t know. And we’ll never know.” My friend and I had shared passions for travel and for Muay Thai (Thai boxing) and it is in these, for me, the most painful of memories are stirred. I want to message him when I visit some new destination, or when I returned to his (and my) “happy place” in Thailand earlier this year – that was tough. Or when I’ve had an especially good or - more likely for me - bad session “on the pads”. It those moments that catch you unaware. But there are also moments that make me smile and make me feel that, no matter how fleetingly, I am honoured I met that swaggering, gentle giant that day in Thailand. And I’m proud that, albeit briefly, I got to call him “my friend”.

I took off my shoes and walked into a gentle stream with pebbles beneath its clear, shallow water. The tiny stones pricked my feet prompting me to step on the sandy soil on the water's edge. It was a nature trail, a symphony of trees. The melodies of birds and the gentle murmur of the nearby stream intertwined and formed a harmonious orchestra within the depths of the wilderness. A few paces ahead, my eyes widened not just in surprise but also in appreciation of the intricate choreography of existence — a kaleidoscope of butterflies fluttering all around. Common Mormons sitting in groups mud-puddling, wavering their wings at a shutter speed of three-thousand frames per second, some of them sipping nectar from the flowers. A few of them circled me as if asking me to be a part of their rituals. It was such an unexpected find – a little butterfly haven. I stood there, utterly captivated. I forgot about the waterfall I set out to see. It wasn’t important anymore. That was one of my prettiest glimmers. A core memory that I will revisit every time I see a butterfly. Glimmers are the opposite of triggers. It is a cue that brings one back to a sense of joy or safety. Think of it as a micro-moment of pure joy that instantly lifts your spirits. This word, ‘glimmers’, was popularised by Deb Dana in her book, The Polyvagal Theory in Therapy. I am a nature devotee and a writer with Inspire the Mind and other magazines. I've always felt that the seemingly little things in life are the most joyous ones. Science agrees. Glimmers Glimmers aren't supposed to be big events. They are tiny, little, micro-moments in life that bring calmness to our body and mind. Feeling sunshine on a cold day, basking in nature, petting your dog, rocking your body, humming your favourite tune, the smell of rain after hot weather, and more - all warm, fuzzy feelings that give rest to overwhelmed life and thoughts of existential crisis. Your glimmers can be different from my glimmers. While you might find joy in watching a cackling baby, I may not necessarily share the same sentiment. No offence to babies. My slice of heaven comes when I encounter a singing canary, a new flower in my garden or upon touching the bark of old redwood trees. Go ahead, here's your chance to roll your eyes at me. Our joys come from different sources, one has to discover what gives them that calming joy and moves the body and mind into that feeling of safety and connection. On the nervous system level, it is called moving into the ventral vagal state. We have a remarkable sensitivity to emotional cues around us, often responding instinctively to signals of safety or danger. Triggers signal a potential threat. The opposite, glimmers, are cues that signal safety. When we feel threatened, our bodies have two ways of reacting: fighting or running away (fight or flight), or freezing and shutting down (freeze). This can make us feel angry, want to escape, or just shut down. Glimmers activate our ventral vagal nervous system putting us in a relaxed state. Glimmers are like the bright spots that bring us a sense of peace and make it easier to feel close to people and the world around us. We hear "enjoy the little things" so often that it has reached the cliché phase status, but research suggests that this phrase is meaningful. A 2012 study showed a link between greater appreciation and increased life satisfaction. Taking time to appreciate the simple pleasures of life boosts satisfaction even when things don’t turn out how we hoped. These positive emotions lead to improved heart health, These positive emotions improve heart health, strengthen our immune system, and reduce pain and stress. The good news is that these glimmers are all around us. A penny found in old pants, stumbling upon a dried rose in an old book, your cat cuddling with you, a rainbow, a cotton-candy sky, a stranger dog greeting you with a wagging tail, a beautiful flower on your nature walks, an old song you loved and grew up listening to, unexpected kind words or a gesture. The list is never-ending. The task is to observe, learning the art of noticing. Savouring Noticing small things, and being mindful of the world around us, can be the answer to regulating our overwhelmed nervous systems. We are on a hedonic treadmill and missing so many joys that life has to offer. We are in a culture of multitasking. Everything is being accomplished in a hurry with stress over the impending gong of a looming deadline, even when there is no real need for it. Where is the time to pause, reflect, and enjoy? Mindfulness comes from cultivating it as a habit. Once it draws upon us, there is no need to compel our minds to return to the present moment from the futile, whirling thoughts that divide our attention. This enables us to appreciate the joy inherent in this singular moment. This focused attention is also called ‘savouring’. This term was coined by Bryant and Veroff in 2007, defining it as attending, appreciating, and enhancing positive experiences that occur in one’s life. It is the counterpart of coping. Savouring need not be only of the present moment. One can reminisce about the happy moments in the past or visualising the future. It is positively associated with higher levels of subjective well-being. When we know things are short-lived, we start enjoying them to the fullest. The last day of the vacation, the last bite of your favourite sweet, your last day of high school. And we forget that life is transient too; it passes us by so quickly and we just don’t know for how long it will last. So, why don’t we savour each moment each day? That’s what will turn us into the inherently blissful being one is supposed to be! What is your glimmer that you savour?