Mental Wellbeing and Positive Psychology for Veterinary Professionals E-Book

Laura Woodward

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 490

Veröffentlichungsjahr: 2023

Beschreibung

Explore practical strategies for mental wellbeing across the veterinary professions

Mental Wellbeing and Positive Psychology for Veterinary Professionals: A Pre-emptive, Proactive and Solution-based Approach delivers a practical, hands-on guide to mental health and resilience for individual members of the veterinary professions and for those managing entire practices. Divided into 6 sections, the text offers valuable tools, including meditation, mindfulness, and positive psychology, to help readers grapple with the mental challenges presented by veterinary practice. The author has also included a series of case studies and anecdotes from her experience in counselling members of the professions, including a new-graduate vet, a specialist surgeon, and a head nurse, as they encounter issues like anxiety, compassion fatigue, fear of failure, imposter syndrome, and grief. By learning in advance about the common hurdles they will face during their careers, the reader will discover how to prepare for these in positive and proactive ways.

Readers will also find:

• A thorough introduction to effective strategies for dealing with the difficulties of the veterinary professions, including mindfulness, empathy, and emotional intelligence
• Comprehensive explorations of meditation, including body scan meditation, breath meditation, imagery, and mini-meditations
• Practical discussions of specific challenges faced by veterinary practitioners, including moral injury, client complaints, burnout, imposter syndrome, and a loss of confidence
• Fulsome case studies, including a veterinary nurse’s journey to mental wellbeing

Dr. Laura Woodward is well positioned to write on the topic, as both a working veterinary surgeon and an accredited counsellor and has crafted a text that is perfect for veterinarians, veterinary nurses, and practice managers. Mental Wellbeing and Positive Psychology for Veterinary Professionals will also benefit veterinary students, student veterinary nurses, and teaching staff seeking a comprehensive resource for veterinary mental health.

Leseprobe

Table of Contents

Cover

Table of Contents

Title Page

Copyright Page

Dedication Page

Foreword

How the Book and Ideas Were Developed

How to Use This Book

Part 1: Strategies

Mindfulness

What Does ‘Mindfulness’ Mean?

Paying Attention to the Present Moment

Non‐judgement

Mindful Living

Mindfulness: How to Do It

An Introduction to Mindful Meditation

Mindful Meditation: Paying Attention, on Purpose

Mindful Meditation: Non‐judgement of Emotions

The Case for Mindfulness versus I'm Already Too Busy

Mindfulness in the Veterinary Practice

Mindfulness and Management

Emotional Intelligence

The Five Competencies of Emotional Intelligence

Self‐awareness

How Do I Become More Self‐aware?

Motivation

Empathy

Social Skills

Empathy

The Three Types of Empathy

Leadership and Empathy for Line Managers

The Evidence‐based Case for Leadership: Empathic Concern versus Empathy Alone

Acceptance and Proactivity

How Do I Do It?

What's Not Helpful

What Is Helpful

The Empathy–Profitability Link

Secular Buddhist Concepts

Basic Elements of Secular Buddhism

Reference

Part 2: How to Meditate

How to Meditate: Part 1

Introduction

Gain Control of Your Mind

Mindful Drinking

Mindful Breathing

Mindful Body Scan

Loving Kindness Meditation

Hand‐on‐Heart Meditation

How to Meditate: Part 2

Observe an Emotion

Anger

Anxiety

How to Meditate: Part 3

How to Meditate: Part 4

Opening Shutters Meditation

The Fortress

The Heavy Bucket

Climbing Up the Branches of a Tree

Conveyor Belt Meditation

Part 3: Difficulties and Applying Strategies

Anxiety

Fear of Failure

The Dalai Lama Advises

How Do I Stop Fearing Fear?

Disputing Irrational Beliefs and Doing Our Cognitive Homework

Change Your Language in Order to Change Your Thought Process

Exercises for Attacking Shame

Imagery and Role Play

Desensitisation

Loss of Confidence

Perfectionism

Imposter Syndrome

Feel Like a Fraud?

What Can I Do?

Recognise Your Expertise

Remember What You Do Well

Talk About It

Compassion Fatigue

What are the Symptoms of Compassion Fatigue?

How Do I Prevent or Recover from Compassion Fatigue?

References

Lack of Assertiveness

Empathy

Motivation

Social Media and Doom Surfing

How Do I Stop Doom Surfing?

References

Yearning, Striving and Wishing Things Were Different

‘Letting Go’ of Striving

What is Striving?

Blissful Happiness

Moral Injury

What Can We Do About Moral Injury?

Moral Courage

References

Identity

When Being a Veterinary Professional is Your Whole Identity

How Do You Know if Your Identity Has Become Enmeshed with Your Career?

Start Small

Bullying

Cancel Culture

How to Refrain from Punitive Actions

Conflict and Client Complaints

Team Dynamics

Team Dynamics and Difficult Colleagues

Team Dynamics and Helping Colleagues

Depression

Anger

What's Normal?

Knowing How and When to Express Your Anger is a Skill Worth Developing

Sleep on It

Grief

How to Grieve Mindfully

Competitive Grief

Comparative Grief

The Emotional Burden of Error

Guilt

Fear

Isolation

Guilt

I Feel Guilty

What is Guilt?

Misuse of Guilt

Helpful Guilt

Misplaced Guilt

When Your World Falls Apart

References

Euthanasia and Suicide

References

Chronic Pain

References

Burnout

The Three Dimensions of Burnout

Emotional Exhaustion (Focus, Language and Posture)

Depersonalisation

Disconnection from Purpose

Summary of Strategies to Combat Burnout

Neuroplasticity and Reversing Burnout

The Evidence Base

Suicide, Burnout and Chronic Stress

Recognising Burnout

Mindfulness and Burnout

References

Management and Mindfulness

Mindfulness as an Evidence‐based Tool to Prevent Stress, Burnout and Depersonalisation

How Do We Promote Mindfulness Training in Our Practices?

Reference

Suicide in the Veterinary Professions

The Perfect Storm in Vets

How Do We Increase Our Production of Oxytocin?

Understanding the Steps Towards Suicide

References

Part 4: Therapy

Cognitive Behavioural Therapy

Rational Emotive Behavioural Therapy

Mindfulness‐based Stress Reduction

What is MBSR?

Evidence Base for MBSR

Aims of MBSR

References

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy and Cancer

Animal‐assisted Therapies

Communication

Collaboration

Respect

Reference

Part 5: Case Studies

Introduction: The Counselling Process

Ann (A New Graduate Vet)

First Session

Acceptance

Second Session

Homework

Third Session

Summary

Ben (An Experienced Vet)

First Session

Second Session

Third Session

Summary

Darren (A Specialist Vet)

First Session

Second Session

Third Session

Summary

Claire (Head Nurse)

First Session

Second Session

Summary

Part 6: Positive Psychology

Gratitude

What Gratitude Isn't

Grateful for Nothing

Reference

Kindness

Small Acts of Kindness

Random Acts of Kindness

Reference

Mindful Gift Giving and Receiving

How to Practise Mindful Gift Giving

Mindful Receiving of Gifts

Pride and Profitability

Self‐focused Pride and Other‐focused Pride

Positive Psychology

Enhancing Self‐focused Pride

How Do I Notice the Mini‐victories?

References

Stubborn Optimism

What Can

I

Do?

Resilience

Mindfulness and Resilience

Positive Emotion

Engagement

Relationships

Meaning

Accomplishments

References

Two Ways of Looking

How Mindfulness Can Improve Cardiac Health

References

Self‐compassion Versus Self‐care

Mindfulness

Loving Kindness Towards Yourself

A Sense of Common Humanity

Being Ready for Some Good News

Why We Tend to Ignore the Good Moments

Three Practices to Help Us Notice the Good News

The Use of Language

Internal Monologue

External Words to Self

External Words to Others

Exercise and Work–Life Balance

Mindful versus Mindless Exercise – Your Call

Lacking in Motivation? Find an Exercise You Actually Like

Reference

Learning from Our Pets

Lesson One – The Importance of a Good Routine

Lesson Two – Feel What I Need to Feel When I Need to Feel It

Lesson Three – How to Truly Be Present

Resolutions and Intentions and Mindfulness-based Eating Awareness Therapy

New Year Intentions

Postponing Mindfulness and Self‐compassion

Index

End User License Agreement

Guide

Cover Page

Title Page

Copyright Page

Dedication Page

Foreword

How the Book and Ideas Were Developed

How to Use This Book

Table of Contents

Begin Reading

Index

Wiley End User License Agreement

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Mental Wellbeing and Positive Psychology for Veterinary Professionals

A Pre‐emptive, Proactive and Solution‐based Approach

Laura Woodward

This edition first published 2024© 2024 John Wiley & Sons Ltd.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of Laura Woodward to be identified as the author of this work has been asserted in accordance with law.

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Limit of Liability/Disclaimer of WarrantyThe contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Library of Congress Cataloging‐in‐Publication Data

Names: Woodward, Laura, 1967‐ author.Title: Mental wellbeing and positive psychology for veterinary professionals : a pre‐emptive, proactive and solution‐based approach / Laura Woodward.Description: Hoboken, NJ : Wiley‐Blackwell, 2024. | Includes index.Identifiers: LCCN 2023016988 (print) | LCCN 2023016989 (ebook) | ISBN 9781394200627 (cloth) | ISBN 9781394200634 (adobe pdf) | ISBN 9781394200641 (epub)Subjects: MESH: Veterinarians–psychology | Animal Technicians–psychology | Mental Health | Psychological Well‐Being–psychology | Burnout, Professional–prevention & control | Psychology, Positive–methodsClassification: LCC SF745 (print) | LCC SF745 (ebook) | NLM SF 745 | DDC 636.089092–dc23/eng/20230724LC record available at https://lccn.loc.gov/2023016988LC ebook record available at https://lccn.loc.gov/2023016989

Cover Design: WileyCover Images (front and back): Courtesy of Zoe Barr

To my Dad, who loved and believed in me through thick and thin, who proof‐read my articles for years, and who laughed with me until the day he died.

To my children Theo and Zoe. Thank you for your encouragement and enthusiasm for this book, your insights and the numerous cups of tea you made for me while I wrote it.

And to Bhante Samitha, who introduced me to mindfulness and meditation, who taught me with compassion and wisdom, and who shares laughter and joy with me at every available opportunity.

Foreword

Psychological happiness is the ability to maintain a state of peace and contentment whatever life throws at us. It gives us an anchor and a moral compass.

This is not another self‐help book for when you are in crisis. This is not something to hand out to your staff like a Band‐Aid when they have difficulties. It’s designed to be a book for the individual, not a book to be lost amongst the other books on the dusty, groaning practice library shelf.

This is a book designed to help the veterinary workforce to enjoy life with all its twists and turns, using evidence‐based methods. This is a pre‐emptive and proactive book for when one is happy and wants to help others to thrive. It is for those amongst us who are in difficulty. It is for students prior to qualification, mental health first aiders, for line managers who want to lead with emotional intelligence in a productive way, as well as for those who want to learn about self‐care in a career which will definitely challenge them.

This is for people who are happy and want some tools to help others, for people who want to lead from within the team and for those who are contemplating leaving the professions.

Why Are We Here?

Seventy‐five percent of vet students wouldn't want anyone to know if they were suffering from a mental health problem, compared to 41% of the general population.

Nearly 39% of vet students have experienced suicidal thoughts.

(above figures from Vet Futures BVA)

Forty‐two percent of vets and veterinary nurses have considered leaving the professions.

Vets have four times the national rate of suicide. The suicide rate of veterinary nurses has not been widely reported (the figures shocking in their absence).

There's a pattern here from student to experienced professional.

Until recently, mental health concerns were taboo in the veterinary world. We have such a ‘can do’ attitude which we're proud of. It's fantastic that we are physically resilient. We don't take a day off because of a cold, a broken leg or even when we go into labour early.

But is that taking it a bit too far?

‘Powering on through’ is the way I have worked for decades. If we continue this way, how on earth can our colleagues be open about having depression, anxiety or compassion fatigue?

It is nearly impossible to imagine what depression feels like unless you have suffered from it. Now, as a therapist, I am only just about able to comprehend how debilitating depression and anxiety are. It is harder to get out of bed and go to work when you are depressed than it is to go to work with a broken leg or when in early labour.

If you have never been depressed, you are lucky. Lucky enough to have the strength of mind to realise that you just don't understand how hard it is for some of your close colleagues.

It's okay to not be able to understand. The important thing is to accept that you can't imagine how hard it is.

Doing a literature search for hypotheses as to why our professions are in such a state proved fruitless. The reasons will be multifactorial and there will be many differing opinions. My hypothesis is born out of what I have experienced through counselling scores of vets and vet nurses.

Many people in our professions grow up in families that place a big emphasis on achievement, in particular with parents who send mixed messages, alternating between overpraise and criticism. This can increase the risk of fraudulent feelings when we become adults. There can be a lot of confusion between approval and love and worthiness. Self‐worth becomes contingent on achieving in these families.

So, as parents, it is our duty to attach our children's self‐worth to more than just good grades or medals at football. Kindness is an achievement in kids too. So are empathy, self‐regulation, resilience and the ability to be self‐aware of our strengths and weaknesses.

Such ‘soft skills’ fly in the face of ‘powering on through’.

But until we realise that true happiness is not solely reliant on social and professional status, we are doing ourselves and our young people a disservice.

I hear similar stories time and time again. Small person is praised for being clever because they can add up two dice in a board game or because they can count to a hundred. They are applauded for being clever, their parents are proud, their grandparents are proud. They get good grades throughout school and their teachers praise them for working so hard.

Achievements follow with maybe a few grade 8s in piano and violin along with grade 9s at GCSEs and A*s at A‐level.

They get into vet school or medicine, dentistry or vet nursing and the applause continues.

They are seen as a whole and complete person because of their achievements and they believe it themselves.

But at no stage has anyone stopped to ask if they have good social skills? Do they have empathy?

Do they know how to fail? Or how to fail without falling apart? Do they even know what it feels like?

How are their coping skills for when things go wrong? Have they learnt resilience?

Then comes the workplace. Every day we will all fail to some degree. Usually it's tiny and not to the detriment of our patients. We aim to get it perfect, but we don't always achieve perfection. We have to cope with inexperience and the prospect of getting it wrong and failing. That prospect is paralysing to some new grads.

We need the best social skills of pretty much any profession I know. Loving animals isn't enough. If we don't love people, we'll get stuck because nearly every patient comes with at least one person attached.

We have to have the empathy and social skills to work with these owners, our receptionists, our vets, our nurses, our PCAs, vet students, work experience kids.

New graduate nurses and vets tell me about crippling fear of failure and insomnia. Then they get some more experience and suffer from imposter syndrome: a lonely place to be.

It's exhausting learning social skills and empathy on the job and they suffer from depersonalisation and compassion fatigue. If only they had been taught these soft skills as a child or as a student.

To the leaders and managers, you weren't there when your employees were growing up. But you are there now when the new grad turns up or when your student nurses start. Open pre‐emptive discussions about mental health, difficulties which will arise, positive psychology, coping tools and tools for joy will be the best welcome gift you can give these employees to help them form cohesive teams and take our professions forward with a determination to be happier and change our god‐awful statistics.

If we were doing enough, doing the right things or doing enough of the right things, our suicide rate would be going down.

What are the major stressors at work?

Survey of 40 members of BVOA (British Veterinary Orthopaedic Assoc.) Survey Monkey 2016.

This is a typical day at work for many of us; it's busy or chaotic, our pet owners are understandably stressed or sad and they may pass that onto us, not everything will proceed without complication, there may be people you have to work with who you don't like.

However, it is possible to have the crazy busy day, the difficult clients, the surgical revision and the grumpy colleague and still be happy and joyful. It takes effort and the knowledge of where to place that effort.

How the Book and Ideas Were Developed

This book has been developed over about six  years. For my entire career, I have spent most of my time at work ensconced in the operating theatre with one other person for hours at a time. This ‘other person’ changes all the time.

As most vets and vet nurses know, there's something about theatre that brings out the deepest of conversations. Maybe it's because the surgeon and the anaesthetist are both masked up and focused on their different tasks rather than facing each other straight on, and we are therefore a bit oblivious to each other's facial reactions to us.

As therapists, we are trained to not face the client directly but rather to sit at an angle to them. It's easier to speak truthfully to someone if you can comfortably avoid eye contact and if you feel you aren't being interrogated. It's the opposite of the interrogation room in any TV cop drama.

Or maybe it's because there's an unwritten rule that what's said in theatre stays in theatre.

I became fascinated with human thoughts and behaviours out of a genuine interest in my colleagues' differing stories.

Then I had children. Their developing minds blew my mind, and their learnt and innate behaviours mesmerised me.

I also had adults in my life with difficulties, personality disorders and misbehaviours, as well as other adults who were resilient, compassionate and fun.

This gave me a passion for psychology and I studied to become a counsellor over several years while working.

Because of my children, I specialised in child and adolescent therapy. I then went on to study Buddhist psychotherapy because of the way it looks at our cognitive, energetic and physical being. I love its holistic approach. I also qualified as a mindfulness practitioner and a positive psychologist.

I have been writing for Veterinary Practice magazine for over six years and I am very grateful to them for allowing me to use some of the materials I wrote for them in this book.

I still wanted to do more to help to change the mindset of our professions. We are not doing the right things, or enough of the right things, to improve our horrific statistics of mental health crises, burnout and suicide. If we were, the statistics would be improving.

It was after the publication of an article I wrote in Vet Times in 2022 on the neuroscience of suicide that Wiley contacted me to ask me to write this book, and for this I’m also indebted. I have tried to collate all the knowledge I have gleaned from my many mentors, lecturers, leaders and counselling patients over the last decade and place it here in your hands.

I have designed the book to be portable enough to carry around with you, comfortable enough to read in bed, and concise enough that you don't have to go trawling through the internet for some help specific to our professions.

I hope that you will dip in and out of it many times, each time finding something new which applies to you or which you can use to help someone else.

Happiness is not something ready made. It comes from your own actions.

Dalai Lama

How to Use This Book

This edition is designed to be carried around with you, read first thing in the morning and at night‐time, dipped into on the bus or train and while at work.

An essential part of any mental health first aider's reading, this book tackles multiple difficulties specific to our veterinary world, and also many others which are part of our often tumultuous life outside work.

Nothing is taboo in this easy‐to‐follow, gentle but firmly proactive guide to investigating your own emotions and learning to deal with them in a way that works for you.

In between a stimulus and our reaction there is a space. In that space lies our freedom to choose our response. Therein lies our freedom.

Viktor Frankl

This book will teach you how to recognise the stimulus and how to pause to make the space large enough to choose your own reactions, both internal and external, in order that you'll be happy with your choices. Instead of continuing on autopilot, reacting reflexively and regretting your actions, you will learn to react reflectively in a way which will ultimately make life more enjoyable for you and for those around you.

Part One: Strategies explains effective strategies for dealing with frequent and not so frequent difficulties in our lives, with our multiple roles being taken into consideration and being a reality.

It covers the basics of Mindfulness, Emotional Intelligence, Empathy and so much more, but explained so that we can understand them in a logical fashion and actually apply them in real life today.

This area provides many tools which we will refer to throughout the book. You can skim over it or study it in depth or both. In any case, I hope that you will flip back to it frequently. Some strategies will ring true with some people, and other strategies with other people. You may use one strategy one day and a different strategy with the same situation another time. You are in control of this.

Part Two: How to Meditate: I wrote this in order to demystify the whole process of meditation. Meditation is, of course, another strategy but deserves a whole section to itself.

Meditation can be done at any time, for any length of time, in any place in any clothes. I explain in sensible, effective ways how to incorporate meditation into any hectic life. I understand the many hats we wear as vets, nurses, managers, counsellors, parents, students and family members. Multitasking is part of life. Meditation can also become part of our lives without being the chore at the bottom of the list, and in this section I show the many varied forms which meditation can take.

Part Three: Difficulties and Applying Strategies: this is the section to dip in and out of.

Numerous difficulties are discussed here such as anxiety, fear of failure, imposter syndrome, compassion fatigue, grief, burnout and suicide. No one strategy applies to all and so I have suggested tools for you to use in whatever way they work for you here with each difficult topic.

One day, one strategy may help you. Another time, you might want to try a different tool or both. This part is self‐help. This often makes it more valid for you, and therefore more effective than if you were just doing as instructed.

The greatest weapon we have against stress is our ability to choose one thought over another.

Part Four: Therapy: Mindfulness is not a panacea and neither are the other strategies. Many of us will benefit from therapy beyond the scope of this book. Part Four explains some of the many therapies available to us and what they entail. It's a minefield until explained. There are differences between CBT, MBSR, ACT, psychotherapeutic counselling, animal‐assisted therapy, etc. Here, we simplify and demystify again. Nobody, especially somebody who is overwhelmed and in crisis, should have to blindly figure out the best type of therapy for them.

Part Five: Case Studies: sometimes it's helpful, and also fascinating, to see how others react and behave in different situations with which we are familiar. Part Five uses cases from real counselling sessions (anonymous and altered to protect identities) and sees how they applied different tools to help them navigate the difficulties they brought to the counselling room. We are complex creatures and these cases are brought to life by demonstrating that any crisis is multifactorial. I've never met a client in counselling who had only one problem or only one cause of their problems. These case studies are from vets and vet nurses examining their journeys and the various life‐hurdles they met along their paths.

This section can help students, new graduates and recent graduates to see what may lie ahead of them, as I often see these patterns recurring. If we are prewarned of common difficulties, we are less likely to feel shocked and alone when they happen to us. If we are prearmed with a selection of tools to deal with life's difficulties, we won't burn out, leave the profession or take our own lives.

Part Six: Positive Psychology: ‘Life is for living’ may sound like a meme, but it makes so much sense. Positive psychology is all around us. We no longer buy alarm clocks, we have gentle lights which gradually awake us and then a burst of birdsong greets us to start the day. It's the experience we want, not just the functionality.

My friend's new car greets her when she hops in with a customised seat position and preheated steering wheel. This is the fun world of product design, realising that we want to have pleasant experiences, not to just ‘get through it’.

Mental wellbeing can learn from this, and this last part of the book suggests ways for us to promote our experience from okay to good, from good to great or from great to fantastic. This is not beyond our reach, nor is it selfish. If we achieve a level of bonhomie which we can spread around us, and create an aura of calm and wellbeing even for just a few minutes of each day, we make the world a better place.

Just one breath, taken mindfully, can change the course of our day. A few days like that and we can change the course of our life, if we choose.

Part 1Strategies

Mindfulness

Emotional Intelligence

Empathy

Secular Buddhist Concepts

Mindfulness

What does ‘mindfulness’ mean?

Mindful living

Mindfulness: how to do it

An introduction to mindful meditation

The case for mindfulness versus I'm already too busy

Mindfulness in the veterinary practice

Mindfulness and management

What Does ‘Mindfulness’ Mean?

Jon Kabat Zinn, a very well‐known mindfulness teacher and advocate, defines mindfulness as ‘paying attention to the present moment on purpose, non‐judgementally’.

Paying Attention to the Present Moment

It's so hard to make ourselves aware of ‘just now’ for an extended period of time. Our minds naturally wander to tasks that need to be done, things we need to sort out, what happened last night, what may happen next weekend, who just walked in, the cat needs feeding, my phone's beeping, etc.

Non‐judgement

Begins with awareness of your own thoughts and stopping yourself from labelling any of them as good or bad. But how can we do this?

Everything can be taken from a man but one thing: the last of the human freedoms – to choose one‘s attitude in any given set of circumstances.

Viktor E. Frankl

Take a moment to examine whether you are the type of person to see an event and then reflexively judge it as ‘right’ or ‘wrong’? Or do you hear about someone, see their Facebook post and jump to a ‘good’ or ‘bad’ conclusion? It's okay if you do. Most of us do just that.

People bitching about other people is designed to sway our judgements of the person being talked about. Do you side with the slanderer? Are you easily swayed? Do you feel obliged to pass judgement even if you don't act upon it? It's human nature.

Politicians try to sway us into judgement as their full‐time job. Celebrities, news channels, Instagram all ask us to judge. And we do.

Now imagine what it would be like if you consciously chose not to judge any more. What a weight is lifted off your shoulders if you decide you don't have to take sides, pass judgement, make decisions about who's right and who's wrong.

It starts off as a conscious decision. With a little time, it becomes part of you. It is the most liberating feeling of relief when you make a conscious decision to not get involved in all the judging of others. I advise you to try it for one day or even one hour and then spend some time contemplating how it feels for you.

Mindful Living

This can be done literally anywhere, at any time, for a few seconds, for a whole day, or as a permanent thing. It still involves focusing on the present moment on purpose non‐judgmentally, with curiosity and awe as if we had never noticed it before. It can also include time sitting on the cushion. The point is that it really is attainable for anyone. With practice, it rapidly becomes your personal way of being.

And all of this can be incorporated into your hectic daily schedule without losing any of your time.

In the book Skills Training Manual for Treating Borderline Personality Disorder, Marsha Linehan describes one such way of bringing yourself to the present moment by using the mindfulness skill called ‘observe’. Observe is about merely noticing what is happening right now. It is just noticing – nothing more. Often it can be more powerful to just notice the present rather than think about the present. Seeing with fresh eyes in a non‐judgemental way like a child can be liberating and a breath of fresh air for your frazzled mind. You can try that right now. It really is just a snapshot commentary of ‘now’ to bring you into the present moment. For example “I’m sitting on the bed reading a book on mental wellbeing”. What's the point of this? Probably the easiest way to answer that is to recommend you try it a few times today and see what it feels like for you.

George de Mestral was a Swiss engineer in the 1940s. He was known to be a bit of a genius. What is less known about him is that he kept his mind sharp by taking regular breaks in nature, walking mindfully. So, while many of us might walk the dog while catching up on Facebook, or go for a run to clear our heads, get some steps in and get fitter, only to be disappointed that our minds are still cluttered at the end, George would walk painstakingly slowly, noticing all the different shades of green (42 apparently), the shape of the trees, the shape of the leaves on the trees, the shape of the veins on the leaves on the trees, and so on.

Well, George noticed the hooks on the seeds of the trees so closely, with awe and wonder, that he invented Velcro and never had to work again.

Jon Kabat Zinn asks in a famous interview with Oprah, ‘When you're in the shower, are you actually in the shower?’ It's a poignant question. I shamefully put my hand up and say that I'm usually not in the shower when I'm ‘in the shower’. I'm triaging the day's tasks, I'm planning my surgical list, I'm thinking about what the kids need for school and what I'm going to make for dinner.

But I know for sure that if I left this plethora of thoughts outside the shower, it would be so good for me. If I, or you, spent 10 minutes getting up earlier and doing our triage list, then hopped into the shower and focused on the present moment, the temperature, the sound and feel of the water, the scent of the shower gel and the gratitude we feel for having all these luxuries, we would benefit enormously from it.

And we wouldn't even have started meditation yet. Try it once. It will be difficult. Don't judge yourself if your mind strays. Then try it again.

Habituation

Our brains are designed to stop us paying too much attention. This is well demonstrated by the optical illusion called Troxler fading (named after the nineteenth‐century Swiss physician who discovered the effect). If presented with a steady image in the area of our peripheral vision, we actually stop seeing it after a while. This phenomenon – the general neuroscientific term is habituation – probably points to an efficient way in which the brain operates. Neurons stop firing once they have sufficient information about an unchanging stimulus. But this does not mean that habituation is always our friend.

We can consider the effort not just to think differently but also to see differently as a way of countering our built‐in tendency to habituate – to sink into the familiar way of seeing and experiencing. By running on autopilot, we are in danger of missing out on the sheer, unadulterated pleasure we can get from the fact that a seemingly mundane, boring thing is actually running to plan. It may be an unchanging stimulus and yet be a potential source of joy for us if we allow it to be noticed.

It's all too easy to divert our attention to problems or malfunctions and miss out on the times when everything is actually and beautifully okay.

The great French mathematician Blaise Pascal said: ‘Small minds are concerned with the extraordinary, great minds with the ordinary’.

Mindfulness: How to Do It

Mindfulness can be anything from taking a moment to appreciate a beautiful view, to taking a few deep breaths, to mini‐meditations, to full meditation in cross‐legged posture for an hour or more every day.

No act is better or worse than the others. What matters is that you choose what works for you.

Incorporating mindfulness into your life can be done in any way you choose.

Formal Mindfulness Practices

Formal practices might be an easy way to start if you want guidance at the beginning. When I go to the gym, I love classes where the teacher does all the motivation and I just have to do what I'm told as energetically as I can. Similarly, guided meditation or other guided practices teach and motivate us.

Unguided meditation and other practices often have a more powerful effect and you can tailor them to your own needs. So while mindfulness apps and YouTube meditations are a fantastic place to start, I urge you to move on to unguided as your norm or as an adjunct to your practice as soon as you feel you can.

Sitting meditations can be for three minutes or three hours and anything in between. Sitting upright is important; this is not about being in a daze, it's about being more acutely alert and awake than ever before.

Movement meditation is a very serene mindfulness practice. Mindful walking involves walking so slowly that you notice every part of your foot as it gradually takes one step and then every part of the other foot as it gradually moves through its step, all the while feeling gratitude for the solid ground, our ability to move and having the time to appreciate what we normally take for granted through habituation.

Group exchange in Buddhism is called Sangha, where a community of friends gather together to practise the dharma (the teachings of the Buddha) together, to bring about and maintain awareness. Being in a group talking about mindfulness, or the dharma, or in Alcoholics Anonymous, gives people strength and encouragement to persevere towards their common goals. Knowing that you are amongst like‐minded people, even if there is only one thing you all have in common, is comforting and opens us up to new ways of thinking.

Informal Mindfulness Practices

Informal mindfulness practices may include a mindful activity. There is a bottomless list of opportunities to do this every day. Mindful cooking involves taking more time than I want to make a meal. I'm usually aiming for the best meal in the shortest time possible. However, on the days where I decide to do this task slowly and mindfully, it's a pleasure. Lots of people glean enormous amounts of pleasure from cooking. Others adore cooking programmes and there is a plethora of cooking and baking programmes to watch on TV. So there has to be something in this mindful cooking lark.

Taking the ingredients and noticing things about them which we haven't taken the time to notice before is a good place to start. Feeling the ingredients, smelling them, listening to the sound of them being cut might sound comical and we can have so much fun with this. It is comical and therein lies the humour because mindfulness isn't about being straight‐faced and strait‐laced sitting cross‐legged on a painful cushion.

Noticing aromas, textures and flavours, feeling grateful that we have a fridge, home delivery and the cash to enjoy both is a simple gratitude practice we can use while cooking.

Mowing the lawn is one of my favourites. The smell of freshly cut grass means that spring or summer is here. I love growing a lawn. I'm grateful to not have hay fever. I can take this hour out of my weekend to make geometrical parallel stripes on my lawn with a roller. I can look out of my window and admire those stripes several times a day afterwards in all types of changing daylight.

Mindful activity is about being present in the moment and noticing in a child‐like wondorous way using all of our senses. It is the opposite of mindless activity and distraction techniques.

Mindful reading usually involves a carefully chosen text which is designed to provoke thought. For example, it may be a text which we can dip in and out of, read a short passage and then sit in quiet contemplation about that passage and what it means to us personally. It could be this book or another book with many small thought‐provoking passages, etc.

Mindful reading might be reading poetry slowly and noticing how we see different things each time we read it, looking at photo books or books about paintings.

I have a book by my bed with 365 different mindful practices, one for each day of the year. When I am having trouble focusing during meditation, one passage from this book rescues me and gives something to contemplate.

An Introduction to Mindful Meditation

This will be a recurring theme in this book and I've dedicated a whole section to how to meditate (see Part Two).

Mindfulness and meditation are inextricably linked so it's worth demystifying meditation briefly at this point, especially as we'll be dipping in and out of the book in random fashion as you please.

Mini‐meditations are what we're doing often without realising. Mini means as small as you want. If you take three deep breaths while waiting for an elevator to arrive, that is a mini‐meditation. So you're probably doing this already in some shape or form. It isn't hard and it doesn't take up any valuable time in our hectic veterinary roles.

Only you can meditate for you.

Mindful meditation is only one part of living mindfully. Meditation can have profound effects on those who subscribe to doing it habitually. If we can make it part of our daily routine, the results can be life changing.

I was sceptical too. And yet almost as soon as I discovered how powerful mindful meditation is (and it works immediately), I was sold.

Although mindfulness as a concept has been around for thousands of years, its application in Western psychology is relatively recent.

Meditation will help you discover an understanding of how thoughts and feelings influence your behaviour.

A word of caution from personal experience: although the beneficial effects are immediate, which is very rewarding and incentivising, if you skip a morning or two, there are no residual benefits from the meditation you did last week. It has to become a daily habit to change every day for the better.

And I suppose that is a no‐brainer. If we are truly living in the moment, on purpose, then it is fitting that the meditation we do today affects us today.

Also, there is a huge difference between non‐guided meditation, which we are aiming for here, and guided meditation which can be done using apps, etc. While any meditation is better than none, the benefits of unguided over guided meditation are enormous. It takes so much more time to achieve the same results with an app than it does if you are your own guide.

Mindful Meditation: Paying Attention, on Purpose

If you've been meditating for some time already, well done. Sometimes it can be useful to bring yourself back to the basics of pinpoint concentration on ‘nothingness’. See how long you can manage that for. It takes enormous focus and discipline to be able to maintain this clarity of mind. It is so important to start any meditation session clarifying the mind like this.

For those embarking on meditation for the first time, it may be too difficult to focus on nothing. I advise beginners to focus on ‘something’ instead. For example, try focusing on your breath and nothing else. It doesn't have to be deep breaths or shallow. It can be any breaths you take. Notice it. See if you can maintain focus on your breathing and on nothing else. If that's not working for you, some people find it useful to count the breaths to maintain focus.

All thoughts that try to enter your mind at this stage, you need to gently push aside. Right here, right now, you are clearing your mind and all thoughts can wait until another time. By ‘creating extra time’ in your day, you deserve these moments to not be organising/sorting/thinking. If you hadn't set the alarm to meditate, you wouldn't be sorting them out either, you'd be asleep, so they just have to wait until later.

If you do find that your mind has wandered, it isn't failure. Rather, it's useful that you notice it. Each time you gently push those thoughts to the left or to the right, you are getting better at clearing your mind. It takes training to become good at maintaining the focus.

Some people imagine a narrow slit of light in front of them. This light is the clear mind they are aiming for. As each thought enters their mind, they push it to the left or right as if pushing back the shutters to open their mind and make this slit of light wider and wider until it becomes a window of light to focus on.

One practitioner I met started his meditations with reciting the words ‘just’ at every inhalation and ‘now’ at each exhalation until he achieved total focus.

Whatever works for you is great.

So my mind is clear. Big deal. Now what?

It's hard for me to describe just how much maintaining clarity of mind for extending periods of time can make an average day feel fantastic. Our worries about the future and past can negatively influence our behaviour in the present. Mindfulness potentially counters this process by teaching us to focus on the current moment.

For this month, achieving a clear mind each morning for as long as you possibly can is enough.

Observe if you find it easier as the weeks go by.

Notice if some mornings it's easier than others.

Instead of waiting endlessly for the perfect time to start a daily mindfulness practice, we could instead just start.

Mindful Meditation: Non‐judgement of Emotions

So during your morning meditation session, now that we are au fait with achieving clarity of the mind for extended periods of time, it's a perfect time to allow our emotions to envelop us. It takes discipline and inner strength to allow the emotions which have previously been overwhelming to come to the forefront of our mind one by one.

Self‐awareness means being acutely alert and aware of what we’re feeling. This is not about burying emotions in a box and ignoring them. It is about being actively aware of these emotions, however distressing or otherwise they may be, and feeling them one by one, so that the full force of the emotion is there. Then, and only then, can we defuse it, if we wish.

Give one emotion a name, look it in the face, allow it to envelop you and accept that you are feeling what you are feeling. The more you accept and embrace that emotion, the more you defuse it and decrease its power over you.

Now the non‐judgement… Non‐judgement begins with awareness of your own thoughts and stopping yourself from labelling any of them as good or bad. They just are. Accept your thoughts and feelings as natural and allow them to come.

Non‐reacting is the skill of allowing your thoughts and feelings to be, without resorting to the need to behave reactively in the same way you have reacted before. No one ever healed from a blow to the head by hitting themselves there again.

Pause for a moment to reflect on your inner experience. Don't act hastily and emotionally.

Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.

Viktor E. Frankl

So now, you can make this space as large as you like. And you can literally choose how you want to react to this emotion internally as well as externally. What you choose to do in your morning meditation, you will do subconsciously later in the day.

Let's consider a couple of frequent emotions we can approach in this way with an open mind. We will use anger and anxiety many times in this book.

Anger

For example, if I feel angry, I feel angry. Having the emotion is not good nor bad. It is what it is.

There may be many reasons why I am angry and the causes of how I'm feeling right now are in the past. Maybe the causes will never stop but the way I feel right now is a result of what has happened up to this point, and the past cannot be changed or undone.

Right now, while allowing the anger to envelop me, I have a choice to make. Would I like the internal reaction to be ‘to feel less angry’? Is it a sign of weakness that the same things/people which caused the anger will remain the same and I am changing to be less reactive?

Does that mean that I'm allowing them to ‘win’? Or, in choosing to suffer less, am I indeed being responsibly selfish enough to be the ‘winner’?

That's for you to answer.

Pain is inevitable. Suffering is optional.

Dalai Lama

But if your motivation is to feel less hate, less hypertension and less pain, then maybe you will choose to simply feel less preoccupied and less consumed by the anger when the stimulus occurs next time. It is genuinely a choice.

Or maybe the cause of the anger is gone, in which case it's even easier to simply feel less anger about the past from now on. If that's what you choose.

No matter how justified your anger is, if you choose to let the feelings of rage go, then you may feel more empowered and more free than the perpetrator if you choose to defuse it.

Once the internal reaction has been chosen, what do I want my external reaction to be? Again that's your choice. Maybe you want to send an eloquent email. Maybe you feel that throwing furniture is appropriate. Maybe you want to try something new if the previous external actions haven't achieved an optimal result. Maybe you want to try (dare I suggest it) showing compassion towards an adversary.

It may be that, once the internal rage has become so weak that it's way down your list of priorities now, your external reaction is naturally one of calmness and physical non‐reactivity in the face of what would have previously enraged you.

Holding onto distressing and painful emotions disempowers you. Letting go of them, if that's what you choose, relieves the stress and burden on you to feel responsible for everything, especially those things that you cannot change.

Anxiety

Anger is just one emotion which can be looked at in this way. Anxiety is a great emotion to work with in a similar step‐by‐step fashion. Fear, grief and regret may be on your list also. When embracing anxiety and feeling it to its full extent, it can be quite nauseating and stressful. You may find your stomach sinking, your pulse increasing, your breaths becoming gasps. ‘Letting go’ of anxiety is simply too difficult and impractical for most people due to its biochemical aspects as well as the external causes.

Spending extended periods of time focusing on ‘nothingness’ can help with anxiety, as can breathing meditations where you focus on your breaths and nothing else for as long as possible (ideally 20 minutes at a time). It's so hard but it's so effective.

However, probably the most powerful tool I have used with my clients, along with the above, is learning to accept that anxiety is not going to go away any time soon. Acceptance of anxiety as a part of your life (if it is), which contrasts so profoundly with trying to make it go away or cure it, can feel like lying down passively and succumbing to the horrors of it all. However, if fighting against anxiety hasn't worked this far, and ‘letting go’ of anxiety is simply too difficult, maybe allowing it to just be, to play along in the background and be accepted for what it is, will decrease its hold over you.

Hans Selye said: ‘It’s not stress that kills us. It’s our reaction to it’.

The Case for Mindfulness versus I'm Already Too Busy

Paying attention to the present moment on purpose, non‐judgementally.

It's so hard to make ourselves aware of ‘just now’ for an extended period of time. Our minds naturally wander to tasks that need to be done, things we need to sort out, what happened last night, what may happen next weekend, etc.

At work, we focus on problem lists, the consults coming in next, the ops list, the bad debts, the complaints not yet dealt with. Rarely do we take the time to focus on the here and now. It's a luxury enjoyed by few. We don't have the time. I never focus on the surgeries that went right. They don't need my energy and attention any more so why should I? The hundreds of happy clients don't take up as much headspace as the one complaint letter or surgical complication.

But mindfulness isn't all about sitting cross‐legged on the cushion in a meditative state focusing on the present for an hour. Maybe you're a member of the early morning lot who wake up at 5 a.m. to meditate. Maybe it suits you to be mindful while in a yoga session.

What isn't helpful is for you to berate yourself for not managing to find the time to ‘be better’ at mindfulness. It's about being non‐judgmental, remember?

No Time to Meditate

In its purest and most effective form, deep meditation is often pinpoint concentration on nothingness for a period of time to calm the chaotic mind.

You need to literally ‘make time’ for this. Usually, the best time for meditation is upon waking. How often is frantically scrolling through your phone the first thing you do in the day? On top of this rapid input of information needing to be processed, our minds usually are at their most chaotic and disorganised the moment we wake up. What a stressful way to start our days.

For those embarking on meditation for the first time, it may be too difficult to focus on nothing. I advise beginners to focus on ‘something’ instead.

For example, try focusing on your breath and nothing else. Notice it. See if you can maintain focus on your breathing and nothing else. If that's not working for you, some people find it useful to count the breaths to maintain focus. If it's still too difficult, try putting your hand over your heart and feel your chest rise and fall with the breaths. This is very much in the present moment.

All thoughts which try to enter your mind at this stage, you need to gently push aside. Right here, right now, you are clearing your mind and all thoughts can wait until another time. By creating extra time in your day, you deserve these moments to be spent not