How to improve mental health in 2020 - What’s the difference between a top down and a bottom up approach to wellbeing?

By Richard Fryer

Top down performance psychology

If you’re feeling stressed, anxious or depressed at the moment – you aren’t alone. It’s a difficult time for many of us, but fortunately there are practices we can integrate into our lives to enhance our sense of wellbeing. By learning to use bottom up and top down approaches, and to find the ones that work the best for you, you can maintain and perhaps even improve your mental health into the future.The World Health Organisation describes mental health as a state of well-being that enables a person to realise their full potential. Mental health is a fundamental building block of human performance – not something separate or somehow less important. Yet how many organisations have their wellbeing programs separate from their performance initiatives? In my experience, the answer is ‘most’.

We sometimes neglect the importance of wellbeing while focussing on the day-to-day of “living our lives”. So, how do we nurture more mental health and well-being? There are many different ways proven to help people increase their levels of wellbeing which can be broadly grouped into two types of activity.

The first set are ‘top down’ approaches – thinking and talking techniques. These might include talking with a psychologist, socialising with friends, learning new skills and some types of mindfulness meditation. Talk about your experiences with the people you’re close with, immerse yourself in learning new skills, spend time non-judgementally noticing what thoughts and feelings arise for you. You could spend a moment writing down all the feelings that arise for you. Often our inner thoughts are very tumultuous, and it can be surprising how much we’re feeling at any given moment. By taking a moment to name those thoughts and feelings we can make some space for them. Naming difficult thoughts and feelings won’t make them go away, but it can help us to carry them lightly.

The second set can be called ‘bottom up’ approaches as they work through the body to improve the mind. The body and the mind work together to shape our experiences, by using a bottom up approach we can improve our sense of wellbeing through physical experiences. Bottom up approaches to wellbeing include exercise, yoga, diaphragmatic breathing, music and other forms of play. Schedule some time to do things that make your body feel at peace.

You may notice that some activities are a combination of top down and bottom up – for example mindfulness practise that uses breathing as a way to connect with the present moment non-judgmentally.So which mix of approaches is best for me? The answer is likely to be ‘the one that you enjoy doing the most’ – which you’ll discover with expert psychologist help and encouragement! The most important point is that investing time in our mental health is an essential foundation for flourishing in our lives – not something that we should put off because of seemingly more “urgent” work or life priorities.

This is why expert ACT therapist help in building your psychological flexibility can really enhance your life performance outcomes – they have the skills and training to integrate mental health and wellbeing work with valued living improvement work, recognising that everyone needs a bit of everything from time to time.

Richard Fryer is a general and sport and performance psychologist at Brisbane ACT Centre. He works with a broad range of clients, whatever their struggle to help people realise their life performance potential – and live more rich, full and meaningful lives – during the Covid-19 crisis and beyond!

FACE COVID

FACE COVID – how Acceptance and Commitment Therapy skills can help you to respond effectively to the Covid 19 crisis – with thanks to Dr Russ Harris for the text, and the worldwide ACT community for the wonderful animation and infographic!

‘FACE COVID’ is a set of practical steps you can take to respond to the Corona crisis, using the principles of acceptance and commitment therapy (ACT). Here’s a quick summary of the key steps, and in the linked animation, infographic and e-book you can explore them all in more depth:
F = Focus on what’s in your control


A = Acknowledge your thoughts & feelings


C = Come back into your body

E = Engage in what you’re doing

C = Committed action


O = Opening up


V = Values

I = Identify resources


D = Disinfect & distance
= FACE COVID! Let’s now explore these, one by one...

Focus on what's in your control
Fear, anxiety & worry are normal reactions. You can’t magically control them. Nor can you control the Corona virus or the world economy. But you can control what you do – here & now. So focus on that!

Acknowledge thoughts & feelings
Silently and kindly acknowledge your thoughts and feelings, With curiosity, notice what’s going on in your inner world. You might say to yourself, 'I’m noticing feelings of anxiety' or 'There's my mind worrying' or 'I’m having feelings of loneliness'.

Come back into your body
Find your own way to connect with your physical body, For example: Slowly press your feet hard into the floor, or slowly press your fingertips together, or slowly stretch your arms or neck, or shrug your shoulders, or take some slow breaths.

Engage in what you’re doing
Notice where you are, and refocus your attention on the activity at hand. Notice what you can see, hear, touch, taste and smell. Notice what you are doing, and give your full attention to that activity.
NOW!

Committed action
Take effective action. Follow official guidelines to protect yourself & others. Ask yourself often ‘What can I do right now - no matter how small it may be - that improves life for myself or others?’

Open up
Make room for all those painful feelings - and be kind to yourself. What kind things would you say to and do for a loved one in this situation? Apply those same kind words and deeds to yourself.

Values
What sort of person do you want to be? How do you want to treat yourself and others? Your values might include love, patience, courage, kindness … or numerous others. Look for ways to live them.

Identify resources
Identify resources for help, assistance, support, and advice. This includes friends, family, neighbours, health professionals, emergency services. Make sure you know the contact phone numbers.

Disinfect & Distance
Disinfect often & physically distance - to care for yourself, your loved ones, and your community.

Please share all these resources – the animation, infographic and more detailed e-book as widely as you may choose. This is a global time of crisis and need for effective action – let us do all we can to FACE COVID – and care for yourself, your loved ones, and your community.

Check out Russ' full ebook on FACE COVID here.

ACT at the time of COVID-19

By Marcela Costanzo

I woke up this morning with the unsettling feeling of finding a new and scary world out there, this is how much change has happened in so little time. It brought home to me what has been emphasized to us ACT practitioners at every training we have ever done: the value of applying skills on ourselves, not only to develop mastery, but also to truly experience the benefits of what we as therapists suggest to our clients.
This morning I had to make a conscious effort to follow that advice closely. The last few weeks have seen a rise in anxiety levels for everyone I know, and I am not an exception to that. Like many people, my mind alternated between disbelief and bleak scenarios; getting caught up in assumptions, rules and judgments that quickly became unhelpful.

Of course, being an ACT therapist, I understood that my anxious mind was trying to be my friend, save me from potential danger and alert me to treacherous situations. After all, that is the duty of the human mind!

And then I grounded myself, putting both feet on the floor and asked myself: ‘What is important for me right now?’ I noticed how my mind tried really hard to pull me out of this exercise. However, I realized I still have some choices and focused on those things I still some control over, like writing a blog for our clients at the Brisbane ACT centre.

I noticed the uncomfortable emotions that showed up: frustration, impatience, fear and anger just to name a few. Readers may be experiencing those emotions as well. It is totally understandable! After all, I would have preferred to be writing about something else right now, and things may get worse before they improve. How can we not feel anxious at this unprecedented time? And yet, remember that you still have some control over your actions.

You can still choose to act kindly and compassionately towards family and friends, colleagues, and fellow shoppers at the supermarket.

You can still spare a compassionate thought for the countless people who have lost their jobs and are struggling to pay their rent, and for all of us who have to spend more time at home. In these circumstances, some may be more lonely and others may be experiencing the stress of spending long periods with an abusive family member.

Personally, a commitment I made early this morning is to catch myself every time I say ‘Now I can’t ….’ And replace it by ‘How can I ..? So I would love to invite you to join me in being creative in asking this question. When you face the reality that you can’t socialise with your friends, I would love you to ask yourself: ‘How can I keep in touch with my friends in this time of physical distancing?’ ‘How can I look after an elderly family member in the time of physical distancing?’

I realized this morning how much we all need the psychological flexibility that is the ultimate aim in ACT. Remember that when you feel overwhelmed or close to despair, your ACT practitioner will be there for you and do not hesitate to reach out. We are in the process of starting to deliver psychological services remotely, using the great technology at our disposal. We are confident that ACT will help you in the challenging times of COVID-19!

About the Author

Marcela is a clinical psychologist and ACT clinician who is passionate about using modern cognitive behaviour therapies, in particular Acceptance and Commitment Therapy (i.e. ACT!), to help ease many common human struggles. She has expertise in helping clients with a range of presentations including but not limited to anxiety, depression, life transitions, acute stress, relationship issues, change of careers, adjustment disorders, grief and loss, sleep difficulties, self-esteem, chronic pain, body image (all ages) and substance abuse.

The Ostrich Effect

Have you ever found yourself putting off something important? Something that you knew you needed to do but found reasons to avoid. Maybe you avoided checking your email for fear of what was inside, maybe not checking a debt balance or a bill or maybe you avoided going to the doctor for fear of unpleasant news.

Ostriches are famous for burying their heads in the sand to avoid predators, although this is a fictitious belief – ostriches don’t really do this. Like the apocryphal story of the ostrich, many of us will commonly bury our heads in the sand to avoid unpleasant experiences, even if those experiences are vital to leading a full, rich life.

The ostrich effect is a tendency to ignore important information when we feel overwhelmed, stressed or worried. In particular, people may delay acquiring information, even when doing so may improve their situation. One study even found that investors check their portfolios growth more frequently in a growth market than one that’s receding. It may be easier to pretend that the problem doesn’t exist than to deal with it, especially if we don’t feel like we have the cognitive resources or emotional capacity to be able to cope with the challenge ahead. We may be in a job that doesn’t fulfil or satisfy us, we may feel that we’re in a relationship with the wrong person, we may regret living in the city we move to, or maybe we’re questioning our sexuality or whether we are studying the right degree? Maybe we’re lacking meaning or purpose in our lives but we don’t know what to do so it’s easier to power on and “just get on with it” and pretend that we’re just doing “fine”.

These types of “problems” we have in life are difficult to talk about and finding the right person to have a discussion with can sometimes be challenging. We all fear people’s judgments, and we prefer to show the version of ourselves that is our “best selves” rather than admitting that things aren’t the way we expected.

In our society today, we are taught to think that we have “control” over our lives. When things go “wrong” or when we have “problems” we have a tendency to overestimate how much influence we have over outcomes. People who are self-critical believe that they got themselves into the mess that they are in, and therefore has the responsibility to get themselves out. When we feel like we are the problem it is more likely that we are going to bury our heads in the sand, to save “face” for as long as possible. However, what if we don’t actually have as much control over our lives than we think we do? What if sometimes stuff just happens and what we need to do is talk about it so that we can overcome our challenge?

If we think about it, businesses are run with groups of people, each person has a different task to do, people have meetings to talk about how each member is going on their particular task and each person is able to get help and feedback from other team members if they are struggling with their project. What if we were to have regular meetings with ourselves and the people we have in our lives? To check in and ask “what’s currently working for you?”, “what do you think you need to improve on?” “what are you finding most challenging”, “Is there anything you’re finding difficult to approach right now?”, “are you missing some important information”, “how can we get through this together?”. Checking in with others and getting and receiving feedback about our personal problems with the right people, can open up new doors to feel differently about our situation. Doing this regularly will decrease stress and prevent problems from getting worse.

When it’s an external problem that has guidelines to follow, objectives to meet and outcome to measure, it’s much easier to talk about because the problem is “out there” rather than something “inside” of us. But when it’s an internal problem, personal situations, difficult thoughts and feelings about life, work, relationships and our future, it’s much harder to articulate and express the issue in words, especially when we haven’t taken the time to process what’s going on for ourselves.

People have a tendency to “avoid” problems. Therefore use different types of methods to help them get rid of them. Some methods include:

-Over productivity: taking on too many new projects, excessively cleaning or exercising, having a regimented routine.

-Suppression: pushing difficult thoughts away, pretending that everything is okay.

-Numbing or Withdrawing: drinking more alcohol than usual, taking drugs, over eating, restrictive dieting, sleeping too much or too little.

The first step to change is to identify what avoidance strategy you are using. Once we admit that something is not working out we usually feel much better about ourselves and our situation because most of the time it’s not half as bad as we think it is. When we open up and talk to a trusted friend, colleague or professional a huge weight is lifted off our shoulders because we are actually dealing with the problem instead of pretending that it doesn’t exist. We all have problems, but most of us don’t like to admit or talk about. If we can stop burying our heads in the sand, open up and be honest to ourselves and others then maybe our lives will be filled with less stress, and only then we can truly experience a life filled with meaning and purpose.

It’s very common to ignore information to avoid unpleasant thoughts and feelings, but by burying our heads in the sand we do ourselves no favours, in fact we only deny ourselves the chance to grow, to be brave, and to be vulnerable with ourselves and others. Talk to those around you about the things you’re avoiding, and do your best to open up and accept that it might be unpleasant, but it’s in service to living your values – and being the kind of person you’d like to be.