I was 5 years old when I first moved, and whilst I remember very little of the move itself, crossing countries in the search of a new home is an incredibly familiar feeling. Since then, I have lived in 6 places across Europe and have called 12 houses my home. Moving has become part of my identity. Through it, I have accumulated languages, cultures, and ways of living, and today, at 23, I see myself as a diary of experiences. I am, as they say, a ‘Third Culture Kid’. Being “the friend that always moves” is part of my identity. There is something so freeing about never being attached. I believe that being an expat is an opportunity that not many are lucky enough to experience. However, the truth is, it’s a very two-faced experience. The thrill of being knee deep in boxes and ready for new adventures, is a familiar feeling that I often chased. Whilst many people fear change and live the ‘small town life’, I could never understand the commitment. In my mind, it came hand-in-hand with boredom and a sea of deja-vues. I have family that never left the street they grew up on, and friends who moved back home after their studies. Yet, whilst growing up, I often found myself thinking about my next discovery, the next place I would call home. And to this day, I still remember asking my parents about the details of our next move, once everything started becoming a little too familiar. On one hand, being a TCK (Third Culture Kid) means that new experiences and adventures always await you. It’s a great time for personal growth. Kids like me often grow up studying at international schools, where we make lifelong friends that understand the feeling of not really belonging anywhere, and who are all part of that narrative. It’s at international schools that the campus becomes a little island of likeminded individuals who create a community without attachment. People come and go, and at the end of the day, everyone is welcome to our safe space. It’s actually because of the other TCK’s I met, that my mind has developed in a unique way. Today, I still mostly listen to German songs, I still do my multiplications table rhymes in Italian, I talk to myself in English, and I mostly dream in French. This is quite a common phenomenon for international kids, as we are not bound to a specific culture, or language. Some of us even use a multitude of languages to express ourselves differently. For example, I tend to use the German language when I am describing something that has upset me, whereas I am more likely to use French words when I am happy. This has nothing to do with my upbringing, and rather to do with the fact that some languages are more emotional and expressive than others, so we use them differently, to fully express our range of emotions. Just like the various languages I speak; I like to believe that my playlists are the perfect representation of who I am. The blend of cultures, emotions, and thoughts portray my passport of experiences, which give me a great advantage at winning the in geography-category at trivia nights! On the other hand, however, being a TCK can be really challenging. The feeling that you never really belong anywhere is a hard one to overcome. This feeling can take various forms, but for me it went a little like this: in Switzerland, I never felt Swiss enough because I couldn’t speak the jargon, in France I didn’t fully resonate with the lifestyle; Germany felt like my home, but I am not German. And Italy has always been somewhere in-between. Similar to what Kristi Ferguson wrote in her article, I have experienced the dilemma of ‘becoming one with the host country’, and share Camila Ribiero’s anxiety of losing a mother tongue. With this also comes culture shock and cultural identity. Many TCKs, like myself, don’t feel like they belong to one single group, and we often find ourselves performing balancing acts between what we know best, making us internalise a new identity. In all this change, the mundane daily routines can start becoming desirable again and I have often found myself clinging on to very specific things that remind me of where I last was, maybe in the form of food, like a perfectly baked loaf of bread or songs that bring memories back to life. Think about your favourite bakery, maybe a cafe you go to often, that park you love to walk through. Having to build a new life at every move can be incredibly daunting and takes a lot of effort. It’s often overwhelming to create a new routine, find new hangout spots and meet new people. The never-ending goodbyes and the guilt of ‘being the one that left’ can make the overseas life a challenging one at times, as there are moments I wish I didn’t have to feel emotions as strongly as I do. The bittersweet feeling of an airport goodbye is a sensation I know all too well. Excited for my friends to greet me on the other side, but sad about the current “goodbye” of missing milestones and watching your siblings move on and grow older without you. I am lucky enough to have been able to spread my wings, but part of being a TCK is living with the tiniest bit of guilt, hoping parents, grandparents and cousins don’t blame you for missing family events and holiday meet-ups, and letting them know that you are always just a FaceTime away. There are also some repercussions that come with moving so often. Lately, I have been asking myself questions like: where will I live next? What language will I speak to my children? What lifestyle will I teach them? What cultural traditions will I follow? And, after all the anxiety that comes with making these decisions, my answer often lands on: “The ones I choose to”; and I hope it will make a beautiful blend. So, all in all, where is home? Well, I like to think that home is where you belong and where you feel comfortable enough to be your true self.  So, for me, I choose to belong with my family, with my friends, and with my partner. I might not have a long-term place to call home just yet, but I have a great entourage, and to me that’s just as meaningful as an old building, because at the end of the day… they are all my versions of 'home'. So home or no home, I belong with the people that make my life a great one. “Home, the story of who we are and a collection of all that we love” - Nate Berkus

“When Frank Met Mary?” is inspired by personal experience and navigating double dementia divorced parents. Hopefully, it offers a humorous perspective of a common issue affecting millions as our parents age.  By creating a light-hearted environment, it seemed to help everyone cope with a sad and fraught situation. Frank and Mary married in 1955. He was a bebop jazz musician, and she was in teacher’s college. They met at a jazz club on 52nd Street, known as Swing Street in New York City. They were deeply attracted to each other, although Frank had concerns. “Mary, you’re not hip.” Frank would complain. “Face it, Frank. I’ll never be hip.” Mary would respond. By the 1960s, the couple ended up in New York area suburbia when Frank’s career shifted to sales and Mary taught kindergarten. Their house became the scene of all night bop jam sessions with the accompanying drinking and smoking wacky weed. In the morning, Mary would flush all the remaining marijuana down the toilet, terrified of getting raided and losing her teaching job. Along came two daughters, Anna and Laura, four years apart. While Frank would have liked a son, he stuck around for the ride. He treated his eldest, Anna, like she was the son he wanted, and then later, as a surrogate wife once Mary checked out emotionally from the marriage in the late 1960s. Frank often dragged twelve-year-old Anna out for a Chinese dinner after ten pm to talk about his work and life in general. Frank and Mary’s marriage deteriorated alongside Richard Nixon’s presidency and the 1970s economy. Frank’s gambling, womanising, and untreated bipolar disorder only accelerated the inevitable break-up. Their divorce in 1975, after twenty years of marriage and two daughters, was contentious. Mary was filled with rage over his philandering and gambling away their future at the racetrack. Frank, usually an elegant dresser, showed up at divorce court in a shabby suit and his psychiatrist’s declaration that he was too unstable to hold a steady job and pay child support. Mary’s attorney, who became her boyfriend, forced teenage Anna to testify that her parents had no carnal relations for the previous two years. “Why bother? She’s frigid” Frank piped up at the court hearing. The judge ignored him. Frank blamed daughter Anna for the divorce. “It’s your fault,” but provided no rational reason. He complained bitterly to both daughters about his now failed relationship with Mary. “I was a kindergarten student for twenty years! Never treated me as a husband. She’s a cold bitch.” The girls would be subject to an incessant diatribe on Mary’s mental health. “Your mother needs treatment. Get her to therapy.” Frank would insist to his daughters. Mary was incensed that Frank found love again and married shortly after the divorce. His new wife, Veronica, had just turned thirty and was fifteen years younger than Frank. Anna, at eighteen, hoped a new wife would take the pressure off her. Despite being newly married, Frank continued to berate Anna over the divorce in person and by phone. In desperation Anna called her new stepmother. “Veronica, can you make Frank stop calling me at work." It worked for a time, but Frank then continued calling Anna until she moved to Asia in her twenties. At that time, international phone calls were very expensive, so Frank’s calls stopped. Mary began dating even before the divorce and had a series of relationships. Strangely, they all ended with the guy cheating on her. She survived three cancer battles but carried on with her long-standing resentment against Frank. Mary felt Frank didn’t deserve having a new wife and life. After Mary’s third battle with cancer and chemo in her early eighties, she underwent a personality change and was clearly entering dementia. Frank faced his own cancer battle in his late eighties. After chemo, radiation, and multiple surgeries with anaesthesia, it tipped him over the edge into dementia as well. Watching both parents sink simultaneously into the alternate reality of dementia was heartbreaking for Anna and Laura. Veronica missed her charismatic, although hard-to-handle, husband of forty-five years. The old Frank was gone. Both Mary and Frank had been vibrant characters but were now descending into their own worlds and alternate realities. Their former selves, bright and quick-witted, would have been horrified had they been aware they would one day both face such mental decline. Anna and Laura tried to maintain a fun and entertaining attitude for them and found surprising advantages to their condition. The dark comedy environment they had had as children continued, albeit with a different spin. When Anna announced she was dating a new beau named Joe, Mary was convinced there were wedding bells in the future. “I’m not going to your wedding!” She announced, “I threw away all my mother-of-the-bride dresses after your last wedding to the bipolar angry Italian and your sister to that other horn player, what’s-his-name.” This was not entirely unreasonable as Mary and Frank had had two daughters and six sons-in-law over four decades. That didn’t even count Anna’s common-law marriage to a socialist playwright from Liverpool. He was older than Frank. Laura had made the snarky comment, “Daddy issues?” to her sister. Anna, in turn, teased Laura about marrying two jazz musicians in succession, “Who has the daddy issues, now?” Frank continued to deteriorate physically and mentally, displaying processing issues in his late eighties. Wife Veronica became, “that lady.” His daughters were also strangers. Frank grilled Anna on her residence, religion, where she was born, and marital status. He broke into laughter when Anna told him she had been married three times. All the answers to Frank’s questions seemed to amuse him so Anna played along with the idea they had just met. Frank and Mary continued to play piano with the same skill as before. He played his original compositions, sweeping cocktail piano and 1960s Mancini-like movie themes. She favoured pop music, Broadway, and Christmas tunes in July. Mary often sang during meals and remembered all the lyrics. There were many positives about Frank and Mary losing their memory. Frank would no longer give unsolicited advice and get angry if his daughters didn’t follow it. There were no more political rants and only small amounts of his pension disappeared at the racetrack. Eventually he couldn’t figure out how to make bets but just enjoyed the racetrack ambience of fellow gambling degenerates and the hot dogs. Decades post-divorce, Mary had been resentful of her daughters spending any time with Frank and Veronica. For years, Anna and Laura concealed any mention of visits to their father and his wife. Now, they didn’t have to hide visiting them as Mary didn’t remember they existed. Mary held a grudge for over forty years and hated Frank until her dementia took away memories she even had of an ex-husband. Frank also ceased rants over Mary’s mental health and had no recollection of who she was. After Mary’s married divorce lawyer boyfriend of thirty-five years died, she barely reacted. A few hours after reading his obit in the local newspaper she announced, “I think I’ll call his wife and ask for my house key back.” The decades long affair was there somewhere in her brain. Mary couldn’t remember having three kinds of cancer and the gruelling treatments. When Anna or Laura pointed out they were her daughters, Mary replied, “Impossible. You’re just making that up.” Yet both Mary and Frank easily recognised actors in old classic movies. “That’s Myrna Loy, Barbara Stanwick, Clark Gable,” It was a clean slate for Anna, Laura, and Veronica as they became strangers to Frank and Mary who were now 92 and 90 respectively. No longer did the parents push any buttons for the daughters, and all interactions reduced to light conversation. The fights, confrontations, and resentments vanished, replaced with small talk and fleeting recollections of people and places. A long proponent of healthy eating, Frank was an amateur gourmet chef who banned soft drinks and fast food when his girls were young. One day, they watched him scarf down a McDonalds burger and a large Coke after a chemo infusion. His former self would have been shocked and would have probably said to, “just put a bullet in my head.” Frank called Laura one day while she was dressing Mary. “I went to bed with twenty grand in my pocket and when I woke up it was gone!” Frank sounded frantic. Mary, naked on the bed after a shower and refusing to get dressed, asked who was on the phone. Laura replied, “Frank” and put him on speaker phone as he ranted about the missing money. “Did you check under the pillow?” Mary asked, and he responded, “Good idea.” When Veronica overheard this interchange, she had an epiphany. Why not house Frank and Mary together with one caregiver? It would save all of them money as they were both paying for daily helpers. “What if they kill each other?” asked Laura. “Do they have the strength? He weighs 115 pounds at six foot two. And sounds like Mary can barely walk.” quipped Veronica while the two daughters shrugged. At this stage, neither Frank and Mary remembered being married to each other or anyone. Frank would quiz Veronica at three am, “Are you married?” Then Frank wanted to drive home to his daughters but couldn’t remember their names. He repeated this nightly for a week. Veronica took that as a sign that he should be together again with Mary for their final years. Veronica had grand plans for her widowhood. It helped her cope with Frank as he declined, became belligerent, and obsessed with his Korean war memories. After Frank’s passing, she planned an around-the-world cruise first, followed by having horses on her property. Laura and Anna could not begrudge her. If it wasn’t for Veronica, Frank would have been a homeless war vet.  They lived on her pension. Frank’s full-time caregiver was a big expense and Veronica wanted something left for herself. Anna and Laura couldn’t begrudge Veronica as she had put in over four decades dealing with Frank. Veronica had also helped the girls out with their educational expenses when Frank couldn’t. And who knows what Frank would have been as a divorced bachelor and no one to rant at? They were more than grateful that Veronica was Frank’s “minder” for decades and dealt with his bipolar behaviour and now PTSD from the Korean war. Mary had always been frugal but sharing costs would allow her to stretch out her savings and have quality care for another decade if needed. It seemed like a great idea, but Veronica felt she had to warn her stepdaughters of Frank’s desire for intimacy. What would Mary do or say if Frank tried to have relations? “Separate bedrooms.”  Laura suggested. “And cameras we can monitor remotely,” piped up Anna. It made sense to move Frank in with Mary as she lived in the same house that they bought and furnished together sixty years prior. She still had most of the original furniture and the same artwork on the walls. It included a large oil painting of a sad clown painted by Tony. He was Frank’s boyhood heroin addict friend who had tried to destroy his painting with a knife. Frank took the knife out of Tony’s hand after one slice at the top and gave him fifty dollars for the painting. Frank may feel at home or that he never left. They moved his armoire into the spare room and the wood cabinet he kept his jazz vinyl records. The cabinet still had the round stains of his martini glass. They hung the sad clown painting by Tony, long overdosed, over Frank’s bed. Anna sent photos of the bedroom set up to Veronica and she thought it was perfect. Veronica was convinced this plan would work so she placed a down payment on the 110-day round-the world cruise. She would wait to finalise her plan when they settled on a caregiver. They had a short list of two women and a spry sixty-year-old Filipino man named Manoy. Veronica pointed out the women were probably not attractive enough for Frank to be interested in. They weighed the pros and cons, and liked Manoy the best. He seemed to be very easy going and was cheaper than the women. Although they would need a female aide to bathe Mary or do it themselves as Laura and Anna had been for the past few years. They installed Manoy in Mary’s home so he would get used to the house and her routine. Manoy had physical therapy training and envisioned the couple doing exercises together. He thought it was so romantic that these two divorced people would spend their last days together. He assumed, and no one corrected him, that Mary and Frank wanted this arrangement. They transported Frank with several suitcases, a CD player, and boxes of jazz recordings to Mary’s house. Their daughters re-introduced Mary her to the ex-husband that she hadn’t seen since the many weddings of thirty plus years before. “Frank meet Mary” Anna said. “Mary this is Frank, he’s going to stay in the spare bedroom for a few days.” Laura added. Mary didn’t react to that news but remarked later, “He looks a little familiar.” Anna and Laura blanched; would Mary realise she was living with the ex-husband she loathed for decades? Frank looked at Mary. “I know exactly who YOU are, that broad that stiffed me in Vegas.” Neither Laura nor Anna knew anything about the Vegas incident and said nothing.  Everyone ignored Frank and Manoy changed the subject to food. Manoy found Frank and Mary mostly entertaining but a lot of work to coordinate their eating and sleeping schedules. While Frank told his Korean war stories, Mary reminisced about her kindergarten students and old lovers. Very soon after the cohabiting, they had one big problem. Frank insisted on playing the piano and would shoo Mary off the bench. At first, Mary recognised Frank’s playing. “I’ve heard those chords before,” she noted.  Frank tended to play the same chords and tunes for decades.  He berated Mary for playing Burt Bacharach music. “Why are you playing that garbage?” Frank asked and approached the piano to examine the sheet music. "I like this song. Go home.” Mary suggested. Manoy sided with Mary as he too liked Burt Bacharach tunes. He had a nice voice and would sing along when she played. Frank admitted Manoy sounded good and suggested he get a job as a hotel lounge singer as a second career. Anna and Laura were informed about the piano situation. They apologised to Manoy as they had forgotten about Frank's habit of hogging the keyboard. They moved a second piano into another room. That didn’t stop Frank from encroaching on Mary’s piano time. Frank sat next to Mary on the piano bench and banged out his favourite chords. “See the difference. These are hip chords.” Frank said. “I don’t want to play hip chords.” Mary insisted. Frank shook his head as Manoy cajoled him to return to his piano in the other room. The cohabiting arrangement didn’t last long as Frank had a major stroke and died a few days later. Mary didn’t notice Frank was gone or remember he had ever been there. She carried on with her life with Manoy singing Burt Bacharach tunes while she played the piano. One day Manoy was overcome with emotion after singing a love song and declared, “Frank was wrong. You’re very hip, Mary.”

This New Year, I fell victim to one of those prevailing social media trends. This one: 2024 ins and outs. If you haven’t seen it, the idea is essentially a fresh outlook on New Year’s Resolutions. A list of smaller, more manageable things to bring into 2024, or leave in the past of 2023. New Year’s Resolutions are likely not going anywhere, but there’s certainly a case to be argued for the pressure we often put on ourselves trying to transform under the weight of big and often reaching ambitions. While the start of a new year is the perfect time to embrace the opportunity of a fresh start (even scientifically speaking), lots of us inevitably fall short of our resolutions and leave ourselves open to disappointment. The 'ins and outs' lists are instead a new and light-hearted way of embracing the inspiration and implementing change through more manageable and attainable actions. Like many, my ‘outs’ list was full of little things like saying goodbye to unnecessary spending and avoiding high-screen time, but I found my ‘ins’ to be far more interesting. Rather than a big resolution to reach, I had inadvertently added little things to incorporate into my existing routines which, would ultimately help me to reach a larger goal of mine, sans pressure. And, all by complete coincidence. The current (I am mindful that we are still only in January...) success of my new-and-improved daily routine, and seeing others around me revamp their own, really led me to think about the benefit of routine. Digging deeper, I discovered there was far more to it than I initially knew, and routines actually have some incredible implications for our mental well-being, particularly when it comes to stress reduction. Perfect, really, given that another of my 'outs' was unnecessary stress... Morning routines, skincare routines, workout routines, night routines. Our routines come in all shapes and sizes and are ever-evolving throughout our lifetimes. Some, called ‘primary routines,’ are essential for making sure we meet our essential needs like sleeping, eating, and maintaining hygiene. These primary routines help us to regulate the structure of our daily lives. Others are, well, less essential. I can’t say that my daily skincare routine is particularly crucial to my survival but, routines like this do still help us to add a certain level of control to our every day. And some just make us feel good. As humans, we are habitual creatures, hence why we thrive with routine. Routines make things so that, with enough repetition, we do not need conscious thought or effort to complete the individual parts of our routine. It’s not too often that you have to make a conscious decision on whether to brush your teeth before or after you shower. You just do it in whichever order you usually do. It seems very simple, but this is more helpful than it may appear. No matter the size, decisions are decisions. Of course, some are far less important than others, but they all require a certain level of thought and brain power. Having routines in place for the things we do frequently, removes the need to make quite so many decisions thus leaving us with more capacity to handle decisions we need to make which aren’t part of everyday life. How to respond to that scary work email, for example. It all comes back to a sense of control. The more we feel we can control things, the more we reduce our stress. During particularly stressful times, the familiarity of routine can be especially helpful. During the COVID-19 pandemic, a stressful time for everyone, advice from the World Health Organisation implemented by several governments encouraged people to keep regular routines and schedules as much as possible due to the buffering effect that continuity can have on our mental health. As an added bonus, sometimes the things we incorporate into routines have their own stress-busting benefits. While it is possible to get into unhealthy routines, most intentional routines are actually encouraging us to build healthy habits. Sleep and exercise being big ones. Your sleep routine is probably one of the most important in day-to-day life. Whether it's trying to go to sleep at roughly the same time each night, trying to get a set number of hours, or doing things before bed to help improve your sleep quality, it is all-important for well-being. There's an awful lot of synchronicity between sleep and stress. When you feel more stressed you may notice your sleep suffer - it can take longer to fall asleep, or it may be a more restless night. This is because we have higher levels of stress hormones, such as cortisol, working to prepare us to tackle our stressors. But, in true fashion for such a reciprocal relationship, not getting enough good quality sleep can subsequently increase feelings of stress, as when we do sleep, our brains are busy restoring our bodies' balance. Part of this is reducing certain hormones such as... you guessed it, cortisol. This is all a very long-winded way of saying that any routine aimed at improving or regulating our sleep is wonderful for trying to make the potentially vicious cycle between stress and sleep a more positive one. Similarly, many people have daily or weekly routines to incorporate exercise and movement. Not only do you get into the habit of movement, making it easier to continue, but there are obvious benefits for health. Having a routine to get moving regularly has particular perks for also bringing down those cortisol levels, similar to sleep, helping to reduce feelings of stress. As a bonus, physical activity has also been shown to increase the brain's production of endorphins, which are essentially our happy hormones. But again, it's not always that simple. When you feel stressed or are experiencing low mood or motivation, exercise can be the last thing you want to do which is why it can be helpful when it becomes part of your routine. It's important to recognise that just because routines can be very helpful, it doesn’t mean they’re always easy. Our ability to create and adhere to a routine can ebb and flow just like many things in life and it isn’t always in our control. Important factors such as your working hours, financial situations, and even your mental and physical health can have huge impact on your ability to have and stick to routines. Ironically, times of high stress can become a barrier to maintaining routines. We've already seen that our routines can be held back by stress as much as they can help it. Like most things when it comes to well-being, we are all individuals with our own sets of circumstances; adapting to what you can and want to do is the most important thing. Routines aren’t for everyone and that’s ok. The important thing, as with most things in life is to do what works best for you. Maybe you didn’t start a new routine at the beginning of the year but the beauty of it is, routines aren’t resolutions, and we can start and update them at any time. It’s not necessarily easy to form routines and our ability to do so varies between us, but to do so can be very fulfilling and may help to reduce those stress levels. It is, however, important to take it with a grain of salt. I think part of the reason I enjoyed embracing the 'ins and outs' list was that it was a low-pressured set of changes. Resolutions are more cutthroat. By the end of the year, you were either successful in meeting your goal, or you failed. Routines do not hold such high stakes. Occasionally missing a day or skipping a step in a routine likely won’t have such rigid implications. The goal isn’t to achieve perfection, but rather to have enough consistency to get all the added benefits. So, for now, I will try and keep up with my new and improved 2024 routines and see if that stress-related 'out' takes care of itself.

“Reality is that which, when you stop believing in it, doesn't go away.” Philip K. Dick In 2022, an article published in a psychiatry scientific journal questioned the role of the neurotransmitter serotonin in the pathophysiology of depression. Despite multiple methodological criticisms by international clinicians and scientists, conclusions from the article were indirectly used to kindle the latest wave of media flame on the alleged (f)utility of antidepressants, which are supposed to target serotonin and other similar neurotransmitters. I am a clinical psychologist, certified psychotherapist, and researcher in psychiatric epidemiology. I have seen several of these media-amplified flames criticising antidepressants outbursting cyclically. Nevertheless, in the current age of social media, where the news cycle is mainly oriented toward enhancing the polarization of opinions, the resulting crude oversimplification of the arguments has completely lost touch with the clinical reality, its complexities and imperfections. The clinical reality In international clinical guidelines, antidepressants are listed among first-line treatments for depression. This indication is supported by research data: large meta-analyses (a type of study that combines and analyses data from multiple clinical trials) showed that, on average, patients on antidepressants had a higher likelihood of responding (reducing by more than half the severity of their depressive symptoms) as compared to those on a placebo. Of course, there is complexity hidden in this reality: antidepressants do not produce significant response in all subjects (⅓ do not respond after different combinations of drugs); they have side effects; and their discontinuation needs to be carefully planned and require careful handling in certain categories of subjects (e.g., adolescents, or older subject with somatic multimorbidity and using multiple medicines). Nevertheless, the mentioned issues are a common aspect of the reality of all pharmacological treatments for all conditions, psychiatric and somatic. What could be an alternative to antidepressant medication? We know that certain psychotherapy approaches work: large meta-analyses showed that psychotherapy and pharmacotherapy have comparable effects (and their combination is more effective than either psychotherapy or pharmacotherapy alone) in the short term. I am a psychotherapist and I have seen the improvement in patients applying tools from cognitive behavioural therapy for instance. However, this type of approach requires a level of engagement and active work that may be difficult to achieve in the acute phase of depression. For this reason, I often collaborated with psychiatrists initially prescribing antidepressants to fend off the most severe symptoms and regain some energy to start the psychotherapy work. Furthermore, evidence-based psychotherapies are not accessible to all persons struggling with depression. In the country where I live, The Netherlands, more than 80,000 persons are currently on waiting lists for mental health care; the long waiting time is one of the first things to be discussed with a depressed person opting for psychotherapy. While in a parallel ideal world we are certainly going to train legions of psychotherapists to match immediately this unmet need, what are we going to do in this real world for those who are suffering now? Any argument against antidepressants that does not contextually address this practical question is merely ignoring (the clinical) reality. Osheroff v. Chestnut Lodge: a legal battle for medications In this period of anti-antidepressant media flame, it was interesting for me to re-discover the story of Osheroff v. Chestnut Lodge, a landmark (legal) case in American psychiatry involving a patient suing a psychiatric hospital for failing to treat him with antidepressants. Dr. Raphael (Ray) Osheroff was a nephrologist who at age 41 started to develop severe depressive symptoms. In 1979, he decided to seek care at a prestigious private psychiatric hospital, the Chestnut Lodge in Rockville (Maryland), which was strictly proposing a psychoanalytic approach not contemplating the use of psychopharmacology. Over several months after his admission, Ray's mental and physical condition alarmingly deteriorated, causing concern among his friends and mother, who repeatedly asked the hospital to give him antidepressants. Eventually, Ray’s mother decided to transfer him to another hospital where he was treated with medications and was able to regain his functionality. The legal dispute that followed, which involved eminent civil rights attorneys and psychiatrists, profoundly impacted American psychiatric culture with multiple ramifications that goes beyond the scope of the present brief piece. Here, I just wanted to mention a historical case in which a patient fought hard to have his right to be treated with antidepressants acknowledged. The clinical reality that does not go away The reality of depression treatment (either with psychopharmacology or psychotherapy) is not perfect. The endless cycle of media-amplified flames on antidepressants terribly oversimplifies the clinical reality, its complexities and imperfections. This crude attitude unfortunately unfairly hits persons struggling with depression who could benefit from this treatment. I tend to agree with the perspective proposed by Dr. Joseph F. Goldberg (Mount Sinai, New York): “To paraphrase Winnicott, a “good enough” psychopharmacology often means coming to terms with the reality of imperfection. It serves no one’s interests to pretend that psychiatric problems hold an immunity from that reality in ways that are somehow different from other chronic nonpsychiatric medical conditions.”

When our mental health is not in a good place, it can feel scary and hopeless. Poor mental health can be brought on by a significant life event such as a loss, break-up, or an unexpected and unwanted change in circumstance. Other times, there may be no obvious reason at all. When this happens, it can be hard to know how to make ourselves feel better, as we don’t know what is causing the problem. When we feel bad, we may stop taking care of ourselves, and this leads to a vicious cycle that is hard to break free from. Making some small life changes can have a drastic impact on your mental health, even if they appear insignificant at first. Here are some suggestions that can help improve overall mental wellbeing and make it easier to get through the tougher times. Disclaimer: Whilst some of the information in this article includes supporting evidence from scientific journals, the information is primarily obtained from my own lived experience. Get some exercise When you feel low, exercise might be the last thing on your mind. Summoning up the energy to move when you feel depressed, or convincing yourself to go outside when you feel anxious can be incredibly hard. However, exercise has been proven time and time again to be an effective tool to improve mental wellbeing. Even something as simple as a thirty-minute walk can boost our mood. A 2018 paper published in The Lancet journal studied the effect of exercise on mental health, with data from over 1 million people from the US. They found that those who exercise had 1.5 fewer days of poor mental health over a month than those who did not exercise Large amounts of scientific evidence, such as that covered in this review, has shown how exercise boosts our endorphins and reduces our stress hormones, leading to a happier mindset. Photo by Emma Simpson on Unsplash If you prefer to be alone, you could walk, jog or ride a bike. This can be an effective way to get outside, practice mindfulness or experience a change of scenery. Team sports can be a great way to incorporate exercise into your life at the same time as socialising with friends or meeting new people. If you don’t feel up to exercising, don’t feel the pressure to do it every day, or to do exercise that is more vigorous than you’re comfortable with. However, try to make exercise a part of your routine whenever you do feel up to it. It might surprise you just how much it can help. Engage in positive self-talk We are all guilty of being negative towards ourselves from time to time. Negative self-talk can increase anxiety, depression and lower our self-esteem. Identifying when you are being negative to yourself and putting a more positive spin on things can do wonders for your mental health. Telling yourself something like ‘I’ve been feeling low for four days with no reason. I will never get better,’ is an example of negative self-talk. Persistent negativity about ourselves can lead us to believe it as fact, making it harder for us to break out of the cycle. If you notice yourself being negative towards yourself, reframe your thoughts to be more positive. ‘I will never get better,’ can become ‘I’ve felt this way before, and I felt better after a few days. I can get through this, even if it’s hard. If I need to seek help, I will.’ In cognitive behavioural therapy, a CBT therapist works with clients to identify these negative cognitive distortions and helps the client to come up with a more positive alternative thought. If you find yourself engaging in negative self-talk too frequently and struggling to stop, consider speaking to a therapist. Photo by Katrina Wright on Unsplash Get a good night’s sleep, and have an early morning There have been a lot of studies on the relationship between sleep and mental health, and many medical professionals advocate for a good night’s sleep to improve our mental health. A 2021 meta-analysis published in Sleep Medicine Reviews journal is one example of this evidence. The paper included 65 trials comprising of various types of sleep interventions, and findings showed that improved sleep quality reduced levels of stress, anxiety, and depression. Making sure you get the recommended eight hours of sleep a night is a good way to improve your mental health. Furthermore, some studies have identified that waking up early can also impact your mood. This 2021 study found an association between waking up early and a reduced risk for major depressive disorder. Waking up early and using that time to exercise, relax and enjoy your hobbies or get a head start on your to-do list can start the day off on a positive note and may encourage longer-term healthy habits. Photo by Sandra Kaas on Unsplash Do things that bring you happiness Read a book. Play video games. Go for a walk. Watch a film. Paint. Write. Cook. Whatever it is that brings you some joy, that allows your mind to focus on something other than how you’re feeling, do it! It can be hard to motivate ourselves to do things that make us happy when we are feeling low, but it can do wonders for our mental health. Make time for yourself and for the things you love. If you’ve been working or studying a lot and are stressed out, try to ensure you have a healthy balance between working and doing things that make you happy. Photo by Steve Johnson on Unsplash Connect with others Call up your friend or relative and have a conversation, or meet up with friends for a coffee or a meal. Even the most introverted of us need to socialise on some level. You could even join an online group to talk to others, such as mental health support groups or groups related to a specific hobby or interest. We don’t always have to speak about our mental health. Socialising can be both, a distraction from our troubles, or it can be used to help us work through them with someone who cares about us. Photo by Ola Dybul on Unsplash The chances are you’ve heard all these methods before. Exercise, be kind to yourself, get a good night’s sleep – they are the most recommended methods for improving our mental health. But why are they so often repeated? Because they work! Motivating yourself to treat yourself kindly can be difficult but take small steps every day to do something kind for yourself. Whether it’s time to focus on your hobbies, going for a walk or picking up the phone to talk to a friend, every small positive step can lead to better mental health in the long run.

This November marks my 11th year living in England, a momentous milestone in my life journey. When my parents broke the news that we would be moving to an entirely new country one of the first things they did was enroll my sister and I in English classes. At the time, as a nine-year-old, the thought of navigating the world in a foreign tongue was daunting and triggered a wave of anxiety within me; “Would people mock my foreign accent?” “Will I be able to communicate and make new friends?” These questions flooded my mind as I embarked my first day of school in England. Over the years, my initial feelings of anxiety began to fade, replaced by a growing sense of pride as people around me pointed out how impressive it was that I learned and embraced English so quickly. However, what I did not anticipate was that eleven years later, I would find myself experiencing a familiar feeling of unease towards speaking a language. What surprised me the most was that, this time, the anxiety was directed toward speaking Spanish, my mother tongue. The irony of the situation was not lost on me. I had conquered the fear of speaking a foreign language, only to be confronted by a resurgence of anxiety when speaking my native tongue later on in my life. At home, my mother insisted we only spoke Spanish. However, beyond speaking Spanish with my family, the majority of my everyday life remained and continues to be, immersed in the use of English. I speak to my friends in English, received most of my education in English, and consume most of my media in English. Therefore, my proficiency in Spanish has gradually waned over the years. This has made engaging in conversations with my family, using my native tongue, somewhat challenging. I often stumble over my words, struggle to maintain fluency, and have at times felt a profound sense of frustration and embarrassment when people would point out mistakes or express concerns over me losing my native accent. This concept can be described using the term “first language attrition”. This term signifies the shift in linguistic behaviour resulting from the frequent use of a second language, which has now become dominant, ultimately leading to the deterioration of one’s native tongue. Research has shown that there is in fact a correlation between self-perceived lower language competency and pronunciation skills, and elevated levels of anxiety. Moreover, an individual’s anxiety tends to be greater when they perceive their native language abilities as inferior compared to others. Together, these factors contribute to a distinct form of anxiety known as social anxiety, defined as the fear of negative evaluation and constant worry about saying or doing something that leads to them feeling embarrassed. For me, this constant fear of being judged and feelings of anxiety, when speaking my native tongue, has reached a point where I unconsciously shy away from conversations with fellow Spanish speakers. Currently, I am pursuing my undergraduate degree in psychology at Kings College London and have recently become a member of the CELEBRATE project team as part of my placement year! With this big change in my routine came a lot of reflection about my life. I realised that losing my mother tongue has elicited a sense of shame within me. Spanish is not just a tool I use to communicate with my family and friends back home; it’s an integral part of my identity. Slowly losing it has made me feel like I have lost a part of myself. Therefore, I made the conscious decision to not let anxiety define my relationship with my languages. Instead, I am determined to rediscover the sense of pride that comes with being bilingual. To achieve this, I have immersed myself in Latin American music, started reading more books in Spanish, actively engaged in conversations with others, as well allowing others to help me when I make linguistic mistakes. Growing up bilingual has its share of challenges, including the anxiety associated with losing your mother tongue. However, it is more prominently a journey of self-discovery and a celebration of the richness and sense of pride that comes with mastering multiple languages, even if one surpasses the other in proficiency. Let this be a gentle reminder that the languages you speak, and how well you speak them, do not define who you are or where you are from. Instead, they represent a collection of your life experiences, cherished memories, and your own personal growth on this life journey!

I am Stan Popovich, the author of A Layman’s Guide to Managing Fear, and I struggled with fear and anxiety for over 20 years. During these times, my anxieties and fears were so powerful that I had trouble getting through the week and there were times I felt like giving up. I learned numerous lessons from my struggles, which I will share in this article. To get through these trying times, the first thing I did was admit that I had a problem. I then took the steps to find a mental health counsellor who could help me with my situation. I also made the effort to learn as much as I could in dealing with various anxiety disorders and depression by reading a lot of books and doing a lot of personal research. I knew that the answers I was looking for were out there and all I had to do was try to find them. Over time, I learned how to deal with fear and anxiety which helped me in the long run. It was very tough — however, I did not lose hope. With time, I became better able to conquer my fears and anxieties, and I applied the techniques I learned from professionals and my own research when I encountered such situations. I tried to find out which techniques worked for me. I would then write down this information in a small notebook. When I encountered a similar situation, I could better face my fears by reading these notes. This prevented me from repeating the same mistakes I had made in the past. Instead of looking at my struggles as a problem, I tried to look at each situation as a learning experience. For example, I remember when I first learned to ice skate. Initially, I fell all the time, but I kept getting back up even though it was very difficult. Over time, I did not fall as much and eventually I was able to skate without falling. How I Got Through Each Week Dealing with My Fears and Anxieties Whenever I struggled, I made it a habit to take things one day at a time. I tried to not dwell on my fearful thoughts which were telling me that I was not going to make it. I also realised that you just can’t predict the future. A person may be 99% correct in predicting the future, but all it takes is that 1% to make a difference. There are factors and circumstances that you can’t predict or anticipate that can make a difference in your current situation. What I Learned About Happiness When it Comes to Mental Health Happiness is not from seeking one joy to the next, and research indicates that happiness involves times of considerable discomfort. Our intrinsic genes, environmental interactions, achievements, and social connections all influence how happy we may feel. Therefore, taking small steps to create pleasurable situations, undertaking various tasks or challenges, and setting and meeting goals can all increase life satisfaction. The key is to pursue activities which make you happy. How I Maintained a Positive Outlook I found it can be very challenging to remain optimistic when dealing with depression, fear, and anxiety. Depression is often associated with overwhelming feelings of loneliness, despair, and hopelessness. Here are a few tips I used in my personal life when I struggled with my mental health: 1. Socialise With Others It can be tempting to confine yourself to solitude when you are struggling with depression. Unfortunately, this can simply exacerbate the negative feelings that you are experiencing. Reaching out can go a long way toward supporting you during your more difficult stages. Experiencing depression can certainly make socialising feel exhausting, but there are many benefits to engaging in social activities when you are struggling with depression. 2. Exercise Regularly Physical activity helps to produce hormones, such as β-endorphins, in the body that are great at lifting the mood and fighting feelings of depression. Though improving your health can certainly help with depression, it doesn’t require substantial exercise and exertion to provide ample benefits. If you don’t exercise regularly, it can be particularly beneficial to simply invest some time in walking around the block. Sunlight, for example, provides many positive benefits to your mental health. It has been shown to boost levels of serotonin, which can substantially improve mood and feelings of well-being. 3. Reduce or Avoid Drinking Alcohol can affect your brain chemistry, increasing the risk of depression. Many people turn to substance abuse as an alternative to facing the extreme negative emotions associated with depression. Though they may provide a numbing effect, they are certainly not helping with the symptoms of depression. If you drink regularly, reducing the amount you drink, or even quitting altogether, can substantially help you handle the struggles of depression. 4. Implement a Routine Those who struggle with depression often find that their sleeping patterns deteriorate and become unhealthy. Sticking to a routine can help to prevent you from falling into these habits. In addition, a routine will help to ensure that you eat regularly and obtain the nutrition that you need to stay healthy and manage your mental health issues. 5. Seek Help For Your Mental Health It is important to seek help when handling mental health issues. Regularly visiting a therapist can go a long way toward providing you with the tools and mental strategies that you need to find happiness while living with mental health issues. 6. Practice Meditation Meditation has been shown to provide a multitude of mental health benefits. When you incorporate meditation into your routine, you can often manage stress more effectively and ensure a more positive mood. In addition, meditative practices can help you to focus on gratitude and positive feelings to minimise your negative emotions. In summary, the key is not to give up, and to seek help from professionals. You are not alone when it comes to your mental health challenges. There are many support groups in your area where you can get assistance and where you can meet others who can relate to your circumstances. Your situation is not hopeless and by making the right decisions, you will eventually be able to get your life back on track.

Author's Note: This piece was originally written in response to a flash fiction contest on the theme of Daylight Savings Time. It's loosely inspired by the goings-on in my own neighborhood, and as often happens in writing, the character revealed to me the depth of what actually needed to pan out in the plot. What began as a story about a grumpy elderly man strolling through his neighborhood soon became a heart-wrenching look into the life of someone living with dementia. ​ The doctor told me I should take walks for my health. Ridiculous. Apparently sitting at home made me rust, and walking would put oil back into my hinges. My cholesterol and blood pressure were getting higher, my mobility was getting lower, and my blood sugar was up and down every day. Depression seeped in, and he warned me Alzheimer’s would be close behind if I weren’t careful. But as I saw it, Yvette was gone, my family didn’t care about me, most of my friends were gone (or worse: senile), and the world was getting more and more horrible every day. Why would I want to live anymore? Why would I want to become healthy and prolong this existence? I just wanted to rest. But the doctor and I agreed on one thing: I didn’t want to lose my mind. If I was on the way out of this world, I wanted to at least be myself. So I listened to the doctor. I started walking. There was no way I was buying a treadmill or investing in a gym membership, so I decided to take a lap around the neighborhood every day. Plus, the doctor said the bit of sunshine was good for the depression and the fresh air was good for my lungs. He suggested I go in the cool of the morning, but I liked to sleep in. He couldn’t rob me of that. So in the afternoon, between my nap and my dinner, I took my medications, put on my hat, slipped on my shoes, grabbed my cane, and slammed the front door behind me. From the time I walked out that door to the time I sat back in my chair, all I could think about was how much I did not want to be outside walking. But at my first follow-up appointment, the doctor did say all my high numbers were going down and all my low numbers were going up. So I reckoned I might as well keep doing it. I had to hire a landscaper long ago when the doctor told me I shouldn’t be doing yard work anymore. But I watched that landscaper like a hawk. He was just a kid too, and he didn’t know much about grass at all. So my yard that once looked so green and clean now looked rag-tag and messy. But on my walks, I noticed that some of the neighbors’ yards were even worse. One house two doors down had a willow tree–trashy trees, if you ask me–that was dead at the top. It really just needed to be chopped down. Another neighbor had problems with moles, the little unmistakable brown tunnels breaking through the grass. I hoped they wouldn’t make their way to my house. They’d be sorry if they did! These feet are good for stomping! And one house had a basketball hoop pointed out in the street for some of the neighborhood kids to play in (and be loud around, with their terrible music and foul language and yelling), but the trees and bushes behind the goal were looking worse and worse every day from wear and tear. I didn’t like that kid landscaper much, but he kept things looking okay at my house, I suppose. This neighborhood was one of those cookie-cutter subdivisions thrown up in a frenzy to meet housing demands. I didn’t really want to live here; I wanted to stay in the house that Yvette and I raised the kids in. But when the kids moved out, they went to the four winds. This area was closer to them and the grandkids, and we downsized to a one-story ranch house. Surrounding neighborhoods were much higher quality, and as long as more “for rent” signs kept going up in our neighborhood, that price divide would keep increasing. I would walk and see house designs nearly all the same: mid-century ranch-style houses with more contemporary components added on, with a one- or two-car garage, a small covered front porch, and mostly brick exterior. And to think these houses were over four hundred thousand now! What was the housing market coming to?! I had to keep my wits about me because the neighborhood was near a high school, and the teenagers drove wild in their rush to get home. They weren’t experienced enough behind the wheel to know how dangerous it could be. There was in particular one black Charger, with one of its windows covered in saran wrap, that always went way too fast and peeled out at the stop sign. “Slow down!” I yelled. “You’re going to get someone killed, you idiot!” Of course, he never listened. I’m sure he thought he was much more knowledgeable than me in the ways of being smart, but he had another thing coming. And the trash! Walking on garbage day was awful because the garbage company would just leave the trash cans in the middle of the road! Sometimes trash would fall out, too, and they didn’t even have the decency to pick it up. The trash, of course, stank. I couldn’t understand why people just didn’t seem to care about their things and their jobs anymore. I had to weave in and out of rank trash cans and keep my head on a swivel for those high school drivers. We paid for the Homeowners Association, didn’t we? Why couldn’t we get a better trash pickup service? Or sidewalks? Or speed bumps, a gate, or an agreement for buyers only? My walks kept me vigilant of changes like these in the neighborhood, and if it weren’t for me, who knows? Maybe there would be a lot more problems in the neighborhood. People just didn’t seem to care anymore. But I cared, and I let people know I cared. When I spotted something that shouldn’t be, I let them know. “Your dog should be on a leash!” I said to a jogger one day. “Remember to pick up your newspapers as soon as they arrive or else the rain will make them decompose on your driveway,” I called to a young man bleary-eyed in his pajamas. “You kids keep the noise down!” I said to a group of teens standing around their car. “There’s a noise ordinance, after all. Don’t want someone calling the police on you.” Of course, I didn’t want to be known as the grumpy old man who just complained about the neighborhood. I noticed improvements too. One young man built a nice fence around his backyard. I asked him if it was up to code, and he assured me it was. It was good handiwork. Another house recently planted wildflowers around their mailbox. Yvette would have loved that. I just hoped they kept the flowers cared for. Weeds could spread easily. And this led me to notice something: hardly anybody talked to me. When did neighbors stop talking to each other? I realized I hardly knew any of my neighbors, and when I thought about it, I discovered that it was always me who needed to start a conversation–not them. So many of us were what Yvette would call “waving neighbors”: we didn’t know their names, their families, their histories … but we were kind enough to wave when we saw each other. Whatever happened to respecting your elders? What if something were to happen to me? Would I just be left for dead in my house? Would no one come looking for me? With the end of Daylight Savings Time in the fall, I thought the walks would get even worse. Yes, it got colder, and that made my joints hurt more, and it was darker, which made it harder to see, especially against the blinding headlights. But actually, despite these changes, I found the most enjoyment in taking a walk during this time. With the sun going down around 4:30, right when I was out for my walk, people remembered to turn on their lights but forgot to close their blinds. I didn’t mean to look at first. I was walking, watching the ground so I wouldn’t stumble, and a light caught my eye. A young woman had flipped on the light in her living room. It was the house with the wildflowers around the mailbox: black-eyed susans, milkweed, and coneflowers this time of year. It appeared the young woman was just coming home from work. She wore scrubs, her badges all still clipped to her. She must have been a nurse of some kind, maybe coming home from a shift at the clinic or hospital. She looked exhausted, her hair frazzled and hands full. She happened to look up and see me walking past. I was scared maybe she would think me some sort of peeping Tom, this old geezer limping through the neighborhood and peeking into her life as he walked by. But instead, she waved with a small smile. I tipped my hat before she turned and went somewhere else in the house, and I continued on my walk. I passed by the wildflowers and could smell their aroma. They reminded me of Yvette, and I was a little less grumpy. I began to lift my eyes more as I walked, and I noticed I could see just about everything. It was easiest to see TVs and computer screens. Not only were they the most prevalent–nearly every house had a screen on – but the glow from the screens made for easy viewing because it was in such contrast to the dark. I was amazed at how much negativity I saw on those screens: violence from video games, scenes from war and mugshots from the news, indecency, and lewdness – and with the blinds open! “Turn off that smut!” I yelled, but of course, they couldn’t hear me. I saw lots of animals, too, because they would be there at the windows looking right back at me. It was fast to spot dogs because I could hear them too, scratching and barking at the glass like they were trapped. Cats often silently supervised from up high, staring at me like I didn’t deserve to live. But I also saw the occasional fish tank illuminating the window, and one neighbor even had a cockatoo that squawked as I walked by! The animals were often the only living creatures that acknowledged me on my walks. I would always stop to say hi to the cockatoo. Sometimes the rooms were empty but the lights were left on, and I would be able to see how people decorated or how the layout of their house compared to mine. Why did they paint their kitchen that color? Who would want a staircase there? My house wasn’t the best in the neighborhood, but I seriously questioned several neighbors’ choices in design. I could also see more ways people weren’t caring for their property: broken blinds, trashy furniture, clutter in the yard, packages left on the front porch for days …. It was just asking for criminals to come, which was an endangerment to us all. Of course, I also saw many people. I often saw a young boy jumping on the living room couch while watching cartoons. He reminded me of my boys when they were little, pretending like they were superheroes themselves. I saw older children helping to set the table for dinner and was happy to see that wasn’t a lost art. I saw many men come into the house and sit in the living room, wondering how sad it was that they wouldn’t engage more with their families but also knowing how dog-tired they were at the end of the day. I saw women cleaning or cooking, often looking at those husbands with disdain. “Get up and help her, you lazy bum!” I sometimes grumbled, wishing I could speak to my past self. I saw teenagers on their phones – always with the phones! - or, less likely, doing homework. I even saw my landscaper working on someone’s yard one day. I didn’t realize he had other customers, though it wasn’t surprising. “Laying down seed for the spring?” I asked, and he looked up at me inquisitively, pointing at his headphones. “Oh, nevermind.” When I looked up at the house, I saw that the nurse come home. So it was her house. I often saw her, and we would always wave. She was definitely a waving neighbor. But she was the exception; most of the people didn’t notice me as I walked by. I began to form my own stories in my head as I walked. I started naming the animals and guessing about the people. The black Charger, for instance, was owned by a young man named Joseph. He had three older brothers, so he always felt like he needed to compete against them. He paid for the Charger himself and intentionally took off the muffler. He hated school and couldn’t wait to get out of there and begin a career in automotive work. Of course, he needed to pay more attention in school if he was going to succeed. The landscaper’s name was Stephen, and he was fresh out of college, with a new wife and a baby girl. He studied entrepreneurship and hoped to run his own business one day, but he didn’t expect it to be lawn care. It was an honest living, though, and he was learning about the dos and don’ts of good business. He still had a lot to learn, though, and he hoped to have a career that would send him home a little less physically exhausted – though it did feel good to get his hands dirty. The garbageman’s name was Darius. He liked watching the garbage truck since he was a young boy and hoped to get into city planning. For now, being a garbageman allowed him to see the ins and outs of small government management, and he reminded himself: it was a dirty job, but someone had to do it! The noisy teens were cousins who all lived in the neighborhood. Their parents were away at work when they walked home from school, so they used their free afternoon hours to play basketball, dance to music, and hang out before the watchful eyes of their parents, aunts, and uncles came home. The young man with the new fence and the power-washed driveway was named Miguel. He was the oldest of five children, and his parents were both hard workers. They taught him respect and the value of responsibility, and he used those lessons in his own family life now, to pay respect to the ones who raised him well. The house that always had a shoot-em-up video game upstairs had a bunch of college bachelors. The house belonged to the father of one of the boys, and he rented it out to his son and his probably-too-many-subleasing buddies. They were all high school buds who stuck around each other in college, and they’re all part of the same fraternity. They play violent video games as a safe way to release their aggression and frustration in a messed up world. That little Yorkie that always barked at me from inside the storm door was Frisky. He belonged to an old woman who spoiled him rotten. Though he was small, he sure was as dangerous as a police-trained rottweiler. The house with the purple wall in the living room had an opinionated wife named Charlotte and a tool of a husband named Daniel. Though she was a stay-at-home wife and mother, she resented him for getting to work outside of the home, and that jealousy leaked into the way she treated him. She was a micromanaging control freak, though she would never admit it. Daniel, on the other hand, knew that a happy wife made for a happy life. The boy who watched Spiderman was named Jimmy, and he wanted to be a superhero. He had a severe nut allergy that always kept his parents on edge, so they were often scared to let him play with other kids. They stuck him in front of the TV most of the time, where he dreamed of being invincible. The nurse was named Tiffany, and she was a fresh graduate making her place in the professional world of medicine. She had a boyfriend named Ezekiel who she hoped would commit soon; she was tired of waiting. She went into medicine because her father died young from a congenital heart defect that made him progressively weak. She was raised by her mother, along with a younger brother, Nathaniel. I felt like I knew these people because of the stories I imagined about them. It was fun to wonder what made them tick and why they did the things they did. I often tried to give them the benefit of the doubt and see the best in them, despite the difficulties they were probably going through. I reminded myself that we were all just trying to make our way through life. We all had shortfalls, dreams, fears, and passions. It helped me feel more connected with my neighbors, though I was lucky to get so much as a hello from any of them. I formed my own neighborhood – one that was more forgiving and friendly than what it really was. When spring came and Daylight Savings rolled around again, yes, it was warmer, but people’s windows became darker. Their homes and their lives inside them became a mystery again. It became harder to keep the stories going, and I felt alone again in a treacherous, noisy, isolated mass-produced suburb. It was actually the first time I missed what my ridiculous walks had become. One day in March, I walked toward Tiffany’s house and noticed she was outside already getting her mail. Rhododendron, columbine, and bloodroot were blooming now around her mailbox. “Stephen’s done a good job on your yard! He’s improving, I reckon.” “What’s that, Mr. McClain?” she asked with a polite smile. “Oh, the, uh … the landscaper.” I realized I had let my story slip. She probably didn’t know who I was talking about. “Wait, you– you know my name?” Her expression melted into a smile filled with pity. “Yes, of course I do. And do you remember my name?” “Oh, uh … it’s Tiff—“ My eyes caught her badge. “Oh. Amaya. That’s … that’s right.” A strange feeling of realization filled my mind, and even though it brought some clarity, it also made me more confused. “Yes sir, that’s right. And, yes, Landon is doing a good job to make sure Yvette’s wildflowers look nice. You must be very proud of your grandson.” The words Amaya said felt like a foreign language that I learned a long time ago. My brow tightened as I tried to understand. “I’m sure your walks are more enjoyable now that it’s lighter out, aren’t they?” I blinked a few times, still processing what she said. “Y-yes, they’re … they’re all right.” She put her hand on my shoulder and led me toward the driveway. “Are you ready to come in for dinner now? I’ve almost got it ready for you.” “Oh, uh … thank you. That’s … very kind of you.” As she helped me up the porch steps, I saw a sign next to the door: “George and Yvette McClain.”

Photo by Westend61 on Adobe Stock Throughout the week, our thoughts often gravitate towards the approaching weekend, or we eagerly anticipate the holidays that loom on the horizon. Especially now, as the holiday season approaches, it’s natural to look forward to these periods of relaxation. However, for many, taking time to relax is accompanied by a nagging sense of guilt, and our minds begin racing with thoughts like: Why am I not being productive? I’m wasting my day! Why am I so lazy? This phenomenon, aptly coined “stress-laxing”, can cast a shadow on our ability to truly unwind. If you’ve ever experienced this before, rest assured, you are not alone. With the work-focused attitudes of today’s culture, it can be easy to associate our productivity with our self-worth, compelling us to feel the need to elaborately justify ourselves when we take a moment to rest. This can be especially true with the blurred lines of work-and-home life that have arisen since the introduction of hybrid working. I’m Maddy, a PhD student here at the Stress, Psychiatry and Immunology (SPI lab - the team that brings you Inspire the Mind), and I aim to uncover the reasons behind relaxation guilt, and how we can overcome it to ensure our time for self-care is used to its greatest potential. Understanding relaxation guilt and its triggers “Stress-laxing” encapsulates a phenomenon that researchers have been investigating for years: relaxation-induced anxiety. It’s contradictory, as people who need to relax and de-stress end up in a self-perpetuating cycle where they cannot alleviate their anxieties by switching off. To add to the irony, individuals who are more susceptible to experiencing relaxation-induced anxiety tend to be those with anxiety disorders, despite the fact they may need this relaxation more than those without such disorders. The importance of relaxation Here at the SPI lab, a core component of our research is the negative impacts that stress can have on our health. While there is limited research directly examining the effects of relaxation guilt on mental health, studies exploring the impact of chronic stress and guilt on well-being indirectly shed light on this issue. High levels of stress can increase levels of the hormone cortisol. When cortisol levels are continuously high, it can affect our mental state, leading to poor concentration, irritability, and, in some cases, depression. Further, chronically high levels of cortisol have been linked to negative effects on our physical health, impacting our immune and digestive systems. When we engage in relaxation but end up feeling more stressed for doing so, cortisol levels will only get higher. Indeed, failure to relax and chronically high stress can lead to burnout, a topic which has been covered here on Inspire the Mind by Dr. Mia Eisenstadt. Photo by Nataliya Vaitkevich on Pexels Moreover, it’s important to note that guilt, in its essence, is a negative emotion which arises when we believe we are doing something wrong. When we experience guilt, it often gives rise to self-doubt, anxiety, and diminished self-esteem. Consequently, feeling guilty for prioritising self-care can send us into a negative cycle, amplifying self-criticism and undermining our self-worth. The importance of quality relaxation reaches beyond reducing stress. I’m sure many have experienced the occurrence of dedicating hours to a task, grappling with it without a breakthrough, only to return after a break to experience that ‘eureka’ moment. As it happens, there is a scientific explanation for this. As mentioned in Psychology Today, this is rooted in the concept that the frontal lobe of our brains, a region responsible for decision-making and planning, can operate creatively during moments of rest rather than when you are overly using mental capacity. In other words, our brains require intervals of rest to effectively consolidate knowledge and operate optimally, allowing us to come up with solutions. Therefore, taking breaks from work can lead to accelerations in productivity. Strategies to overcome relaxation guilt While we can force ourselves to take time out of work and engage in relaxation, diminishing feelings of guilt and stress is a more difficult task. Strategies to overcome these feelings will differ between individuals, depending on their personal responsibilities and coping mechanisms. Nevertheless, I have pulled together some suggestions that have personally helped me: Photo by Formatoriginal on Adobe Stock Incorporate relaxation into your to-do list: While work tasks are concrete and contribute to our progress, relaxation can seem like an unproductive use of time. Overcoming relaxation guilt may be as straightforward as reshaping your priorities to recognise that relaxation, in itself, can be productive. By intentionally scheduling moments for relaxation, we can shift our perspective from viewing it as a hindrance to success, to something which enhances our potential. Acknowledge your stress: If you’re feeling stressed while relaxing, it can be easy to force yourself into a state of denial. However, feeling stressed is our innate way of warning us of potential danger, and when we ignore these feelings our bodies continue to send stress signals to prompt us to take action. Indeed, research has shown that consciously recognising your stress allows you to stop your automatic reaction, allowing you to opt for a more beneficial response. Plan your relaxation activities: Personally, I often find myself deciding to take a short break and take to mindlessly scrolling on social media. Half an hour later, my break is suddenly over, and I feel no more rejuvenated than when I was working, but I feel bad about wasting my time. Planning activities during your breaks from work can help us feel as if we have accomplished something, especially if this is something we really enjoy like reading, walking, or even watching your favourite TV show. As a new PhD student, where my new position is exciting and I want to showcase my abilities, it can be difficult to remember to take time to relax, and even more difficult to do so without feeling guilty. Nevertheless, with the holidays just around the corner, it is vital to offer yourself the invaluable gift of unwinding and fully embracing relaxation, by reminding ourselves that: “Sometimes the most productive thing you can do is relax” – Mark Black

A playful exercise to make peace with the roots of our suffering Have you ever felt stuck in a rut with a negative emotion? Caught in a whirlpool of rage? Slumping in self-pity? Sometimes when I am feeling despondent the opening lines from The Merchant of Venice come to mind: In sooth, I know not why I am so sad: It wearies me; you say it wearies you; But how I caught it, found it, or came by it, What stuff 'tis made of, whereof it is born, I am to learn; And such a want-wit sadness makes of me, That I have much ado to know myself. I am very open minded when it comes to trying new practices for self-development, and I had only really stumbled across this one by accident. I grew up very averse to anything remotely monstrous or demonic, and never even watched horror films. It was partly my own time in Tibet that taught me that the scary looking demons on temple walls can be our raging, roaring advocates. I’m intrigued by shadow work, and think it is useful to get to know ourselves better. As I had not come across ‘feeding your demon’ previously, but found it a helpful tool, I decided to share it with you. We read about the mood boosting benefits of getting out in nature and doing physical activity, but today I am sharing a quirkier exercise that you might like to try if you feel weighed down by doldrums that you can’t shake off. ‘Feeding your demons’ is a meditative exercise that involves visualising your demon, imagining it leaving your body and sitting opposite you, and engaging with it in dialogue. You ask the demon questions, and swap seats to give the responses. You can do it on your own, or with a trusted friend or therapist. I first came across it at a retreat run by Charlie Morley, who combines a love of Tibetan Buddhism with expertise in lucid dreaming and integrative shadow-work. Shadow work Shadow work, or shadow integration, is associated with psychologist Carl Jung, but has been widely adopted. The idea is that we all have a shadow side, the side of ourselves that we try to hide or ignore altogether. It is beneficial to shine a light on our shadows so we can work with them and have more integrated and well-rounded self-concepts. Getting to know our shadows is a way of getting to know ourselves, and if we can bear to face the things we hide behind our outward-facing masks, then we will find we can release repressive feelings of shame and guilt. It is important to note that darkness does not equate to evil or badness, it’s just not yet illuminated. Our shadow might include the parts of ourselves we are afraid of, ashamed of, or don’t love. It might also include any other aspects of ourselves that we don’t know. It might include things we could have been proud of but learnt to repress, for fear of standing out or being bullied. Why would you feed your demons? Looking away from things we are afraid of only gives more power to the fear, but getting to know ourselves can be transformative. The demons we are talking about here are not external gremlins or forces of evil. They are parts of us, but as we suppress them or look away, they cause us to suffer. We struggle with our demons, pushing them down and away and preferring not to see them as parts of ourselves. The idea of ‘feeding your demons’ is to pause and take a moment to listen to yourself. By allowing our imaginations to play with the idea of a dialogue with our demons, we can gain an understanding into what is at the root of our suffering. We can pay attention to it, reconcile ourselves with it, and let it go. How to feed your demon – a step -by-step exercise (safe to try at home!) I have tried this exercise a few times. Sometimes it has felt profound, but not always. If you would like to try it, choose a time when you can be undisturbed, and go to the trouble of setting up two seats or floor cushions opposite each other. Have some pen and paper to hand to write down your revelations, whether they are deep, funny or mundane. Lama Tsultrim Allione, a practitioner, author and teacher of Tibetan Buddhism, outlined the five steps of embracing and nurturing the parts of ourselves that we usually struggle with, in her book Feeding Your Demons: Ancient Wisdom for Resolving Inner Conflict. First, sit quietly, close your eyes, and notice your breath. Once you have settled, start to imagine your demon. Visualise it leaving your body and going to sit on the seat opposite. Imagine its shape and colour, and allow it to become more intense until it is personified. The first time I did this exercise I identified my demon as my indecision when I was at a crossroads in life. I wrote afterwards; “the energy came out of my chest and slimed across to the opposite stool. It was brown and male with sucky feety hands coming off stick think limbs that kept moving; push me pull you. Sticky, clingy, pulling away.” Next, you are going to start a dialogue with your demon. Ask your demon: What do you want? What do you need? How will you feel when you get what you really need? Give time and space to this, and then swap seats to your demon’s place, to answer the questions. In my notes about the demon of indecision, I wrote: “It wants to keep me safe, protect me, and show me the risks so I don’t go down the wrong path. It was moving all the time, and its restlessness was suffering. When it got what it needed it would feel happy, safe, and still.” The next step is to swap back into your original place and feed the demon! Now we visualise dissolving our own body into nectar and allowing it to pour into the demon until it has had enough. We give our demon the positive things it needs to feel safe, happy or peaceful. We notice as the demon morphs. It might change colour and shape. It might disappear completely. Give it time. The demon is fed, but there is another lovely stage to this meditation. Now it is time to invite an ally to come into the place of the demon, if they have not already appeared in the seat opposite! After noticing details of your visualised ally, you ask it: How will you help me? How will you protect me? How can I access you? In my notes about that first experience I wrote: “First I saw a burning torch, then I thought it needed a person so Syd, the gardener, appeared to carry the torch. He said ‘I will help you by guiding you, lighting the way and making sure the path ahead is safe. I will protect you by flashing my torch on the road ahead so you can move forward fearlessly. You will summon me by moving forward. I will always be ahead, clearing and lighting your path.’ Playful imagination I see this exercise as a focused, imaginative, playful meditation, that can also be deeply revealing and comforting. If you don’t think this would be a safe experiment for you to try, then give it a miss. But if you feel like trying something new to break a mood cycle, you could give it a go. At the end, Lama Tsultrim Allione invites us to imagine the ally dissolving into light, and then to feel it dissolving into ourselves and integrating this luminosity into every cell of our bodies. My favourite ally came in a more recent go at this exercise, when I was fretting about something mundane. Instead of Syd the gardener, my ally was a beautiful, winged horse, who said “These material, earthly things are like rocks in your shoes weighing you down. Come on my back and fly with me up into the air, looking over the whole, beautiful, wide world.” I asked, how will I find you? “Look up! Look up at the enormous sky. Not so much looking down. Look up, remember the sky, and we can fly.” Now, when I find myself in a negative rut, I sometimes remind myself to picture that beautiful winged horse and our flight above the fields and forests. Perhaps it is a mental trick, but I think it’s a harmless and uplifting pick-me-up, reminding me to break a pattern and look up. And it’s free! I wonder if you’ll try it.

An interview with the new Executive Dean of the IoPPN “I grew up in a family talking about philosophy and psychology”. This is how the conversation starts with Professor Matthew Hotopf, the new Executive Dean of the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) King’s College London, in an exclusive interview for Inspire the Mind. His father was an experimental psychologist, and his mother was actively involved in social causes, working in a housing charity. Yet, his first passion was medicine, not psychiatry. “I always knew I wanted to be a doctor”, he continues. As a teenager, he was listening to the history of medicine in school, or watching the Body in Question, a formative TV series presented by Jonathan Miller in the late 70s. His passion for psychiatry began as a medical student at Barts during his intercalated BSc in Psychology at UCL, and was consolidated by being exposed to two brilliant minds of psychiatry, Anthony Clare (“charismatic”) and Peter White (“a true gentleman and a friend”). This is also the time when he developed his curiosity about the interface between mental and physical health, between medicine and psychiatry (many years later, this is still his overarching area of research and, as a liaison psychiatrist, his main clinical activity). “As a medical student I saw patients with non-cardiac chest pain, functional neurological disorders or post-viral fatigue”. He remembers that these conditions were very challenging both for patients, who felt stigmatised by the implication that their symptoms were not real, and for the doctors, who were frustrated by the lack of effective treatment for these symptoms. “How different is it today?”, I challenge him, mindful of the potential difficulties with patients with, for example, Long-Covid. “The rhetoric on the separation between mental and physical health is much better, but there is a long way to go”, he cautions. He is worried that the already existing gap in mortality between psychiatric patients and the general population – some say between 10 and 25 years – has worsened with Covid, and that the integration between psychiatry and medicine remains unsatisfactory. After medical school, Matthew started his psychiatry training at the Maudsley Hospital and the then-called Institute of Psychiatry. His teachers included the ‘who’s who’ of psychiatry: “Dinesh Bhugra, Stuart Checkley, Glyn Lewis, Alwyn Lishman, Anthony Mann, Robin Murray, Michael Rutter, Emily Simonoff, Simon Wessely…”. The famous MSc in Epidemiology at the London School of Hygiene and Tropical Medicine completed his training and opened the path for his career as a psychiatric epidemiologist, the study of the distribution and determinants of mental disorders in the population Before asking about the specific challenges he wants to address at the IoPPN, I ask him what he thinks is the biggest challenge in psychiatry . He answers with no hesitation. “Psychiatry has been forced to focus too much on risk”. He is worried that our clinical choices, for example, whether or not to accept a patient into services at all, or admit someone onto a psychiatric ward, are dictated by the risks posed by that person to themselves or others, rather than by providing something therapeutic. "You have to be pretty unwell to get any form of psychiatric care now – we have to ration access because resources are too thinly spread, and this means it’s difficult to intervene early. Often the trigger for a service to provide support and treatment only comes when someone is in real crisis.” The situation is even worse for inpatient care: “Only the most severe patients are admitted today”, he continues, “and because nationally beds have been so severely cut, virtually all patients are admitted using the legal framework of the Mental Health Act”. He does not doubt that the use of coercion is justifiable for most individual patients, but the effect of bed closures and a higher threshold for admission means that the hospital environment is stressful for both the patients and staff, and therefore the therapeutic relationship suffers. (I may add that, with 6,000 fewer hospital beds in psychiatry – a 25% drop – between 2010 and 2020, this situation will not be improving anytime soon). Another crucial challenge is the unacceptable racial disparity in the access, experience and outcomes that Black communities face which was highlighted in the national Mental Health Act Review in 2018. Our clinical partner, South London and Maudsley NHS Foundation Trust, has been doing sterling work with The Patient and Carer Race Equality Framework (PCREF) which we hope will significantly improve trust and confidence in mental health services. He is also worried by the “unhelpful” antipsychiatry narrative, which sometimes comes from members of the psychiatry community itself. This narrative centres around the notions that “mental disorders are socially constructed” and that biological approaches to their understanding and treatment are “inherently reductionist”. “The former view often feels stigmatising of people in genuine distress”, he continues. As to the latter, it’s as though there’s some “fear that biology necessarily squeezes out social or psychological explanations, as though there is some zero-sum game”. His view (which I share) is that ‘’there are likely to be many routes to mental disorders, and complex problems require serious thought and open-mindedness. One of the great things about the IoPPN is the diversity of disciplines available to understand these alternative routes” I push him on his ‘first 100 days agenda’ but he ignores the provocation. Instead, he lists the priorities that, as Executive Dean, he plans to address over the course of his mandate. First, integrate “psychiatry, psychology and neuroscience, more, as the Institute’s name says”. “The “brain can change in so many different ways and for so many different causes; this is not reductionism, it’s reality”. So, “we are bringing together the great efforts across mental health and neuroscience that are ongoing in our institution, by planning an overarching focus and improving collaborations and integrations between groups. “It’s a stretch to create meaningful models of mental disorders in animals to humans, but we can make it”, he says enthusiastically, before mentioning basic sciences approaches that I recognise immediately: “biomarkers, organoids, stem cells, optogenetics…”. As one of the few psychiatrists directly involved in basic science research in our institution, I am very happy that this is his priority number one. Second, we must do “research that improves mental health at a population level, starting with the local population” – the 1.3M people in South London served by the South London and Maudsley NHS Foundation Trust. He wants to engender a “renewed, supercharged” relationship with the Trust and to do research that improves “primary prevention” (that is, decreasing the risk that mental disorders ever occur) and “secondary prevention” (that is, promoting early detection, diagnosis and treatment to avoid poor outcomes which so often affect people with mental disorders). The IoPPN needs to create the evidence to promote “changes in education, fiscal policy, criminal justice, work environment”, responding to the “communal needs” and focussing on social functioning. Third, building on the imminent launch of the new Pears Maudsley Centre for Children and Young People, Matthew wants to address “the treatment gap for children and young people, with their enormous unmet needs”. He wants the IoPPN to provide the research that will distinguish those who will “benefit from an app or other digital intervention while on a waiting list” from those who “will require rapid access to the GP, psychological services or children and adolescent mental health services”. “Last but not least”, Matthew sees education as central in the success of the IoPPN. “We have Early Career Researchers and a Research Festival”, he says, referring to the established tradition of an annual event celebrating research success across the diverse workforce of the Institute, “but where are the Early Career Educators and the Education Festival?”. Teaching should receive the recognition and prestige it deserves. We are approaching the end of the interview. I have one more question. “What is your worst fear?” He smiles. “The IoPPN is such a great place, and it is daunting to think that things may fluctuate in the wrong way just by chance”. (He uses the expression ‘regression to the mean’, which is used to explain how things naturally move between peaks and troughs to reach a medium). “But”, he immediately adds, “I want to lead it exactly because it is such a great place, at a time in my life where I feel ready for this challenge”.

I am a Fujian White Crane Kung Fu & Tai Chi instructor, and I have been involved with Chinese Martial Arts for 40 years.  I teach and train in the UK using a Kung Fu style which was founded by a woman fighter in China in the 17th Century, Fang Qi Niang.  I am very proud of being the first non-Chinese woman to achieve the grade of 6th Dan as recognized by the Chinese National Wushu Association (People’s Republic of China). The problem with talking about violence As a martial artist, I teach and speak to a lot of men. Kind, gentle, loving men who are horrified at the prospect that any of the women in their lives should suffer violence. And I train them to deal with inter-personal violence because that is what martial arts are for. But over the years I have found that violence is difficult for men to talk about – it can be triggering, it can raise fears that they don’t want to deal with. So with the 2023 UN Campaign to Eradicate Violence Against Women approaching, I had conversations with the Instructors I teach with. An attack on a woman is an attack on all who love her, respect her, value her. Men are not immune to the impacts of violence a woman is subjected to. I am struck by the husbands, fathers, and brothers who are seen after the trial on the steps of the courthouse telling the world what it feels like to be the ancillary victims of a violent crime against a woman by another man. They are helpless in their suffering – living with bereavement, living with traumatized family members who may never be the same again, bringing up children without their life partner.  So, non-violent men need to understand and speak up about this issue because at any time it can affect them too, in ways they may never anticipate. The campaign – “What did she expect?” I felt that as a group of physically powerful men and women who teach martial arts we should speak up. Our social media campaign was based on answering the question “What did she expect?” This judgemental question is asked when there is a report of a woman being attacked in public spaces.  One of the first pieces of information in the news is often what the woman was doing – for example, walking home from the bus stop. We know the answer to the question, but why don’t we say it? In this example, she expected to walk home from the bus stop – it is as simple as that. 16 Days of Action So, we each answered the question and over the 16 days of the UN Campaign posted the answers every day on the Instagram accounts of our instructors.  The UN Days of Action are big sources of news and social media activity but this often dries up after the first day. It was important for us that we kept answering that question every day for the 16 days of action, because the problem does not go away with simple answers. We wanted to have a conversation, not a sound bite. The use of language - The Question When a woman is attacked in a public space, the first questions that often arise are “What time was it?” “What was she doing there?” “What was she wearing?” These all have factual answers. “What did she expect?” sums up the previous questions in a way that implies the woman made a bad decision. This is more than just victim-blaming (in the wrong place at the wrong time and somehow she should have known better). It implies that there is in fact no answer at all. This is wrong – we take actions to achieve expected outcomes all the time. When women go about their daily lives in frankly mundane situations their expectation is that they will achieve the outcome they anticipated. In other words, all the things we do, such as popping to the shop because we’ve run out of milk, are a need (no milk for tea), decision (buy milk) followed by an action (go to the shop), and an expected outcome (go home and have a cup of tea). Violence interrupts the outcome – it does not change the expectation. The use of language – The Answers We came up with 16 answers which reflect day-to-day situations where there are clearly expected outcomes for the woman.  A woman going for a run expects to get some exercise, to sweat a bit, to look after her health.  She does not expect to become prey for a violent predator – and neither do the men in her life. So in answering the question we used very direct language in the past tense.  This is important. Among the many messages following abductions and killings, there is often “She was just going home.” That is true – she was but she never made it. I wanted to use language that does not describe the process which was interrupted (going home) but the expectation that was not met (she expected to get back home). My hope is that this helps people to move mentally from a passive observational mode watching a process into a direct shared experience mode (when I go home, I expect to get there). Finally, we used direct quotes in the Instagram posts.  This was a conversation and the way that social media works means that we read someone else’s words inside our heads.  So I asked a person a question and then he answered it. He is telling you the answer. For example, one of Instructor Richard Wagstaff’s answers was “She expected to put down a blanket and enjoy the sunshine.” This is a shared experience that many people (men and women) can relate to. Realising that somebody else’s identical expectation was interrupted by violence is a starting point for moving to an understanding how violence disrupts people’s lives – and maybe how we can move towards disrupting the violence instead. Finally, when you hear the question asked again (as it will be) maybe you can just say the answer – “Well she expected (insert news story here).”