The Fathom Trust – health and healing through Green crafts

Back in 2020 Jess Tanner worked for Brecon & District Mind as an Ecotherapist leading the Green Minds Ecotherapy Project. Jess now works for the Powys charity The Fathom Trust as an Ecotherapist and Community Gardener.

We spoke to Jess to find out more about The Fathom Trust, and how coming together as a community to craft and connect with nature can enrich lives.

Jess Tanner, Ecotherapist

What is your role with The Fathom Trust?

I lead the six week “Making Well – Health & Healing through Green Crafts” course at The Fathom Trust. Located in Bwlch, Making Well runs four times a year and is centred around the kitchen and cut flower gardens and outdoor craft workshops. We work alongside a local, visiting craft practitioner on every course.

Crafts taught at Making Well have included willow weaving, horticulture, pottery, green woodwork and cob building. Our sessions are rooted in the seasons and our craft practice is very much guided by nature and the growing gardens that surround us.

We’re currently working to build stronger referral partnerships through our local GP surgeries, Brecon & District Mind as well as Credu, who we are welcoming to Making Well for the first time this summer for series of day-long craft and nature-connection workshops. We welcome referrals from mental health teams in the community, and self-referrals are also welcome if people feel the course will benefit them.

Tell us more about The Fathom Trust 

The charity, which is based between Brecon and Crickhowell in south Powys, was founded three years ago by Dr William Beharrell, formerly a trainee psychiatrist and NHS Manager, with an interest in health innovation. Its mission is “to promote physical, mental and spiritual wellbeing using traditional crafts to restore life-giving connections to body, soul, nature and society.” It has lots of new projects developing.

Craftsmanship, Conservation and Contemplation – how do these three aspects work together to support healing?

It's about tending and coming into relationship with all three of these aspects – how we tend to ourselves, others and the landscape around us. By working with our hands; with willow, wood and earth, and through gentle mindfulness and movement practices we come into a practice of noticing ourselves and the world around us. At Making Well we hold nurturing and healing spaces in which to come together as a community to share our individual and collective experience.

How can The Fathom Trust support people who are struggling with their mental health?

We support participants to improve their current health and wellbeing by cultivating skills, friendships and a deeper connection to nature. Our team of experienced practitioners provide a nurturing space for groups to come together, and are on hand to offer the compassion and guidance needed to meet people at their own pace. Our practitioners come from a diversity of backgrounds within wellbeing and craft-making and there is a real sense of collaboration within each Making Well course.

We offer a taster day ahead of each course which gives people chance to meet the team and each other and get a sense of whether the course is something they'd like to take part in. We feel that the taster days are a really important aspect of the course and help people to see what might be possible for them and what they might be able to achieve over the 6 weeks, especially after any long periods of ill health or feelings of isolation. If throughout the day participants find taking part in the group activities a challenge, we have a therapeutic practitioner at Making Well that is able to offer 1-1 walk and talks if needed. Each Making Well course is a closed group which we find helps build a stronger sense of community over a short period of time, and provides a fertile space in which to develop new skills and meaningful friendships.

What happens on the course?

Each session follows the same rhythm of coming together for a morning grounding and contemplative nature-connection practice, followed by small group morning and afternoon craft sessions. Halfway through our day we stop for a seasonal, nutritious lunch which is cooked onsite in our outdoor kitchen. We also weave in time throughout the day for time to reflect and share in our different experiences of crafting and being in nature.

Welcoming new craft practitioners keeps our work growing and evolving. It's great to be able to come into contact with so many different natural materials which often bring about a different set of experiences for those taking part. There are different challenges and moments of insight that can be discovered within each material and craft-making process.

Can 6 weeks make a big difference?

From my own experience of the healing and restorative potential held within nature, and from the privilege I have of guiding and witnessing others through their own experience throughout the 6 weeks, I do believe so. I am reminded of a Mary Oliver poem “When I am Among the Trees” and the constant source of reconnection and sense of belonging that she speaks of that is never too distant, and that through a slow crafting of tending to each moment within us and around us, we can begin to see and experience life in new ways.

We are in the process of creating a new digital story bank at Fathom with the intention of weaving together the many and diverse experiences of the way participants have valued their time at Making Well. Once these are published we will be able to draw upon a much wider range of the depth of experience each course can offer. It's really important for us to keep growing and to know that what we offer here is always in service to our community and to the landscapes we inhabit, so these story sharing opportunities are vital for our continued practice of being able to respond to, and be malleable, within times of change and uncertainty that many of us are constantly adapting to.

Although everything that we offer at Making Well is invitational, it is through participation that we can experience the most benefit, so we encourage and support everyone to take part wherever they can. We don’t see Making Well as an isolated experience and we hold and nurture a space together as a community over the 6 weeks that might help to cultivate new ways of thinking, feeling, and experiencing that we hope will offer little seeds that people will continue to tend to. Tending is a big theme of what we cultivate – tending to the garden, one another and ourselves and the realisation that we are all part of this world. We all share similar stories around our struggles, our fears and feelings of isolation. At Making Well we create a space to share and support one another, and that can offer a huge sense of relief and respite to those that join us.

What impact does this course have on participants?

There is some really interesting evaluation work that has been done on this by the Wales School of Social Prescribing Research in conjunction with several universities. You can read more on our website here.

Heather Dickens, willow weaver

How can people and communities contribute and benefit from The Fathom Trust?

The Trust is trying to grow wellbeing and craft hubs – and also to grow the network of landowners and practitioners taking part across Powys. We have a Crafters’ Café at Brecon Cathedral which is part of Making Well – it’s a drop-in craft café in the Tithe Barn every Tuesday within term time run by Heather Dickens our willow weaver.

The Trust is also looking for other sites to set up more Making Well programmes – with a vision to link each cluster of GP surgeries to a 6 week course, so that the referrals are held much more within our local communities. Currently some people travel from a fair distance and we want to limit that where we can within Powys.

Long-term, funding permitting, we hope Making Well courses will pop up throughout the county. They might be shaped a little differently according to the surrounding landscapes and local need, but each will be anchored in our approach to craft, conservation and contemplation.

Which other organisations are you working with this summer?

We’re also working with Credu (Connecting Carers) over the summer holidays for the first time offering sessions for young and adult carers’ groups.

What are the main challenges of your role?

It’s getting the message out there and reaching people, it takes time but we are starting to build momentum as we strengthen our local partnerships. 

By working outdoors, we also work with the changing weather and terrain, we want Making Well to be as accessible to as many people as possible, so we are constantly looking at ways that we can adapt our offer to suit everyone’s mental and physical strengths and limitations.

We will be inviting professionals to come and join us for an open day to see how Making Well can support those they are supporting. Some of the PAVO Community Connectors have taken part so can then speak about it which is especially useful for those referring in. That’s worked out to be a very natural partnership that we hope to keep growing.

What do you get out of working for The Fathom Trust?

So much. I am always reminded how important it is to come together as a community and how much we all need that and the space to come and share and express who we are in a supportive environment. I get huge joy in sharing the many nature-connection activities we offer, gardening together in groups, skill sharing, and holding space for people – it feels a real honour to do that. Also seeing the difference in people from a taster day to the end of the course is wonderful and the ways that people slowly unfurl themselves and open out to the world around them as the course goes on.

It's such a joy to see how participants on Making Well make each invitation to explore nature and craft-making their own, and take time to tune into nature and themselves in ways they might not have done or had the time to do so before. It's just a great privilege to see the growth that can happen over such a short period of time and the friendships that blossom and how people begin to trust in their own capacity for becoming and being well. We work with the natural world to create a rhythm and a nurturing environment for people to come into, but it’s always about the unique constellation of participants that join us that make each course the healing and regenerative experience it becomes.

When you are not working for The Fathom Trust, how do you enjoy spending your time?

I love to potter, grow and make things. I like to write songs and take long walks with my hammock. In the garden, or under the night’s sky, is where I find my sense of sanctuary.

If you want to find out more about The Fathom Trust, 

you can contact Jess by emailing: jess@fathomtrust.com

The next Making Well session starts with a taster day on 14 September. 

You can sign up on the online referral form here.

‘A place to just be’ - Forest Bathing for everyone

Lucy McQuillan is a Forest Bathing Guide (Mindfulness in Nature) based in West Wales and has been guiding a wide range of groups since 2021. She has a background of 25 years working for National Parks and Wellbeing Projects in community engagement, health and wellbeing in the Inner Hebrides of Scotland, the Lake District National Park, and Exmoor National Park. 

Lucy’s final move has been to the beautiful Cardigan Bay, at Aberystwyth, her partner Dave’s childhood home. She started as an Activity Leader with Tir Coed (a charity that connects people with land and woods (tir, coed) by delivering outdoor training, learning and wellbeing programmes across Mid Wales) last year and was asked to run a forest bathing session at Y Plas Garden at Machynlleth this March. We heard about the event and decided to find out more about forest bathing from Lucy.

What being out in nature means to me

Being out in nature is my favourite place. It grounds me, reminds me of what is important in life and generally maintains my sense of wellbeing, for both my mind and physical body. Recognising the massive benefits of Forest Bathing, and loving being in nature, I decided to train as a guide with Nature and Therapy UK in 2020, gaining my diploma in 2021.

What is Forest Bathing?

Shinrin-Yoku, translated as Forest Bathing, is a practice that originated in Japan in the 1980s as part of a national health programme designed to reduce population stress levels. Shinrin-Yoku literally means ‘bathing’ all the senses whilst immersing yourself in the forest atmosphere.

What happens during a session?

During a Forest Bathing session I take you through a number of invitations between 3 minutes to 20 minutes long (simple mindfulness activities). We follow a framework - a beginning, middle and ending - that makes forest bathing 'a practice' and not a general walk in the woods (which of course is lovely too!). 

As with any practice, repetition helps to build a deeper understanding and ability to 'drop in' to your inner self and connect with nature. I intuitively shape the session to reflect the needs of the individuals in the group and the nature setting we are in. No two sessions are the same. An introductory session can be up to 90 minutes long with longer sessions being 2 to 4 hours.

What are the benefits of Forest Bathing - to you and to our natural environment?

You will experience the health and wellbeing benefits from simply 'just being' in amongst the trees and nature. Benefits of this scientifically proven practice include: reducing blood pressure; lowering stress; lowering blood-sugar levels; improving concentration and memory; lifting depression; increasing anti-cancer protein production; improving pain thresholds; improving energy levels; and boosting the immune system with an increase in the count of the body’s natural killer (NK) cells.

…………And leave us with a deep sense of calm that follows us home…..

By experiencing the ‘awe & wonder’ of being in nature this can lead us to an appreciation of the natural world, and our place within it. And this in turn leads us to have a desire to protect and nurture nature.

Machynlleth Forest Bathing 23rd March at Y Plas

5 people were booked onto this session at Y Plas Gardens, Machynlleth. Fresh April showers, interspersed with sunshine and blue sky, set the scene! My helper Carys and I wondered if the weather would put people off…. We waited at the main entrance. People can tell it’s you waiting for them and one person, two and another two soon turned up and introduced themselves. All were new to forest bathing and all were not bothered by the weather one bit and were intrigued to find out what we’d be doing.

As a guide my role is to slow you down and help you stay in the moment and to open the door to your senses. We started by walking to a start point under some trees, dodging another shower.

After a brief introduction of names, and what had brought people to the session, I started with an invitation to leave worries, tasks, ‘to do's’ at this threshold and to enter the woodland/nature space with no expectations, nothing to accomplish, to just lean into what was being offered and see what unfolds. After some simple breathing and sense awareness we went into the first invitation ‘Slow Walking’ taking time to look, touch and listen to what was around us.

After gathering together again, to share what we experienced, (to share is entirely optional) we moved into the second invitation, by the garden, of Human Camera, working in pairs. One partner led the other, whose eyes were shut, to different photo points. By having your eyes closed, when you do open them, to take your photo, the frame before you is intensified and the sense of awe and being in the moment are nurtured.

We then walked over to a woodland area near the garden, which had a completely different, hushed and atmospheric feel, of which all the participants commented on. Here we finished with a 15 minute ‘Sit Spot’ gently focussing on a chosen focus point – a leaf, a piece of moss, bark on a tree – gently bringing our minds back to this simple activity, when they inevitably wandered. The more you look the more reveals itself to you….

By experiencing the ‘awe & wonder’ of being in nature this can lead us to an appreciation of the natural world, and our place within it. And this in turn leads us to have a desire to protect and nurture nature.

Some feedback from the participants included:

“I enjoyed exploring the different ways to immerse yourself in nature and learnt some great new techniques to share with my children and for myself.”

“A great experience to share with others.”

“Lucy’s experience and calm nature and skill share were a real treat – thank you so much.”

The general feedback on the feedback forms was that everyone strongly agreed that they enjoyed spending time in nature and felt connected to nature, and left with a sense of wellbeing.

Many thanks to Lucy for telling us more about Forest Bathing. You can find out more on her website - Forest Bathing & Mindfulness and Facebook page.

If you have a positive experience of interacting with Nature in Mid Wales, please let us know in the comments section below. We love to hear from you!

How can a Compassion Focused Model help Felindre Ward?

by Baz Van de Vegte – Wards' Psychology Student

The Felindre Ward is an acute facility in Bronllys Hospital perched on the hills of Brecon’s countryside. The ward welcomes patients to its beds who maybe experiencing a significant crisis in their mental health. The staff who dedicate their time to supporting the patients vary from nurses, doctors, occupational therapists, health care support workers, domestics, clinical psychologists and students. Time and care go into interventions such as nursing assistance, community support, psychological therapies and engagement with activities towards the improvement of well-being.

The Journey of Psychology on Felindre

Felindre introduced its first dedicated psychologist on the ward in September 2021. I was fortunate to be given the opportunity to join the psychologist within Felindre Ward in October 2021. At this point we were just starting to build relationships across the teams and establish the potential role for psychology on the ward. It was clear from the start that staff and patients alike were tired and weary from the ongoing Covid-19 pandemic, which drastically impacted the processes in place for patient and staff safety.

Getting to know the Team

We wanted to find out what staff most appreciated whilst working on the ward. We shared a survey with staff, asking questions such as ‘what do you most like and dislike about your role on the ward?’. The overwhelming response was that staff mostly loved spending time with patients and caring for their needs. 

It also highlighted that staff mostly disliked it when tasks got in the way of this time with patients. This told us that interacting with patients played a vital role in staff wellbeing and role satisfaction. However, it felt as if we were all on autopilot and somehow that core passion was worn out from the ongoing tiredness of the pandemic. We wondered ‘how we could reintroduce that important sense of connection between staff and patients?’.

Introducing Mindfulness

Shortly after our research, we developed daily mindfulness sessions that are now being run for patients and staff to explore breathing techniques, notice bodily sensations and engage in group activities. 

Mindfulness is a way to focus one’s mental state on the here and now and away from memories in the past or anxieties in the future. It expands awareness of what we are doing, how we are feeling and what’s going on around us. By practicing techniques that helps ground oneself to the present, anxiety levels can reduce creating feelings of calm and wellness. Daily mindfulness sessions have proven to be well received by patients who started to practice calming techniques when under stress. 

However, whilst staff also engaged in the sessions we noticed that they some seemed to struggle to allow themselves this luxury on their shifts.

A Compassion Focused Model enabled us to understand why this could be.

Baz Van de Vegte – Wards' Psychology Student

A Compassion Focused understanding

We used a Compassion Focused Model to help us understand why staff showed some resistance to practicing mindfulness. According to a Compassion Focused Model, there are three systems in the brain that are in sync helping us makes sense of how and why our brain triggers the arousal of emotions - we call these the threat, drive and soothe systems.

Our drive system is what we depend on to keep ourselves motivated to achieve, complete that short-term goal or stay active with our hobbies. We then get rewarded for such activities by the release of dopamine which in turn drives us to keep motivated. 

The soothe system is what we rely on to keep relaxed when we get overstressed or full of anxiety. The system regulates any feelings of threat and keeps us relaxed so that we can think rationally to reduce levels of anxiety. 

Our threat system tells us when we feel under threat so that we can try and self-protect from a given situation. It’s closely linked with our flight, fright and freeze responses when under stress - causing hormones like adrenaline to be rushed through the body. As a result, this activates as a safety mechanism to help us avoid any immediate danger.

How does this apply to Felindre Ward?

Ideally for our emotions to be regulated efficiently, all three systems need to be evenly active in our everyday lives. As staff go through ongoing stressors, the threat system can grow out of proportion and tower over the soothe and drive systems. The threat system can be activated by perceived threats as well as actual threats. Therefore factors such as staff shortages, environmental noise, too many demands, could act as possible threats. 

Prolonged periods in threat mode can result in burnout, reducing energy and motivation. In order to reduce the threat system it is essential to increase the soothe system. This can be done by mindfulness for example, which can increase self-compassion and rekindling energy for the drive system. 

We knew that if staff were able to increase their own self-compassion and self-care, this could have a direct influence on patient care. The idea of introducing the Compassionate Focused Model to Felindre could be an opportunity to establish compassionate thinking and keep an evenly balanced soothe, drive and threat system amongst our fantastic team.

Our Pathway to Compassion

Now that we are starting to understand how compassion has an incredibly important role in the lives of our patients and staff alike, we can start to build towards a more compassionate focused direction. By allocating tasks to staff members which are closer in line with their interests and values, tasks could be more rewarding than stressful. 

Introducing staff training to help with these tasks could help drive our team to expand their knowledge and bring the best services to their patients. More time spent on reflecting with patients and staff would also help us understand ongoing changes in attitudes and passions so that we can adjust to accommodate all. Taking the time to join mindfulness sessions would also really ground staff members who may benefit from a moment of self-compassion or who generally need to destress from a busy morning. 

By introducing the more compassionate focused practices to the ward, we could help guide our patients and staff to think and reason compassionately by behaving caringly and kindly to themselves and others.

Psychology Notice Board – Felindre Ward

“Compassion is the courage to descend into the reality of human experience.”

Paul Gilbert - founder of Compassion Focused Model

Green Minds Ecotherapy Project - South Powys

by guest author Jess Tanner

Green Minds is Brecon & District Mind's new Ecotherapy project which launched this winter. As a fledgling project we are in the process of developing a range of nature-based initiatives that are rich in social and therapeutic value, and aim to reduce social isolation and increase the quality of life for our group members and the local community.

Our project's aim is to help our members to build a stronger connection and sense of belonging to the local environment by exploring the local landscape through mindfulness and nature-connection walks. The project will also help people to create new links within the local area through volunteering roles, and provide opportunities for our members to build self-confidence, self-reliance and new skills.

Our activities are currently taking place at Brecon Cathedral where our project is working towards the design and development of more wildlife friendly planting within the garden areas of the cathedral grounds. We have also started work within a walled garden in Brecon this month, preparing the polytunnel for the seed sowing ahead.

We also have lots of woodland mindfulness walks and craft activities coming up over the next few months. These include willow weaving workshops led by a professional basket maker as well as a bird box making session as part of February's national bird box making month.

We are now open to receive new referrals from within the community for those that feel being part of the Green Minds project will be of benefit to them. Please get in touch for more details.

When asked what mattered most to our members after the Green Minds' sessions their responses were:

“Working with other people and being able to see the end result. I feel less worried, being outside helps clear your mind.” - Sarah

“I felt uplifted when we took a step back and looked at the results of our graft. It's good to interact with others and be outside doing something good.” - Rich

Jess Tanner - Project lead biography

As well as working for Brecon & District Mind as a Community Wellbeing Support Worker, Jess leads the new Green Minds Ecotherapy Project, delivering horticultural therapy and community gardening activities for adults. 

Her background includes working within the creative arts therapies, outdoor education and life long learning. Jess undertook her horticultural training over a one year WRAGS placement (Women retraining as a gardener scheme) in the Black Mountains and also holds an Award in Social & Therapeutic Horticulture with Thrive. 

Jess is passionate about facilitating opportunities that help people to access gardens and green spaces and build stronger relationships with the local area and surrounding landscapes.

Emma Charles - Co-project lead biography

Emma is a Nature Based Facilitator offering ecotherapy and social and therapeutic horticulture in and around the Brecon Beacons and Black Mountains. 

Her background is in social care provision, having worked in the third sector for over 10 years. Emma has recently joined the Green Minds Ecotherapy Project and her hope is to raise awareness of the importance of the natural world on our mental and physical wellbeing, and to bring people into a closer relationship with their natural selves whilst cultivating a deeper sense of appreciation for the beautiful environment they live in here in the Brecon Beacons.

You can find out more about the Green Minds Ecotherapy Project by contacting Jess Tanner at Brecon & District Mind, email: Jess.T@breconmind.org.uk or ring 01874 611529. Jess works Wednesdays and Thursdays.

Wellbeing - our PAVO staff day

Earlier this month the Health & Wellbeing team at PAVO organised a Staff Wellbeing day for colleagues in the organisation. In Britain, most of us don’t tend to cultivate our minds in the same way we give to our bodies. We agreed it was important to give space to colleagues to consider their wellbeing and how they might look after it.

There are various definitions of “wellbeing,” from that promoted by the World Health Organisation to the Buddhist definition of Tibetan monk Matthieu Ricard:

"Wellbeing is not just a pleasurable sensation, it is a deep sense of serenity and fulfillment. 

 A state that actually pervades and underlies all emotional states 

and all the joys and sorrows that can come one’s way."

The day, which took place at an amazing venue - the Mid Wales Arts Centre in Caersws - was totally dedicated to experiencing activities that might impact on people’s wellbeing. No presentations. No policies. No papers. Instead people could choose from the range of activities on offer, or they could just enjoy being in an inspiring place. 

Freda Lacey, Senior Officer Health & Wellbeing, introduced the day

So I’m just going to give you a little bit of context around “wellbeing” and what that means. I think you all had the email about the Five Ways to Wellbeing – this has been promoted for many years across Wales and beyond. If I was to ask you to shout out those five ways to wellbeing to wake you up a little bit:

1. Exercise (Be Active).
2. Keep Learning.
3. Connect.
4. Be Creative & Give.
5. Taking Notice.

Mindfulness could be another, but I can see someone counting! That’s more than five! There are probably many others. In fact, in doing some of the research for today you can just get lost on the web in the amount of information about wellbeing. There are the Twelve Pillars. The Four Constituents. But it was really interesting to delve into that.

So those five key themes are what underpin lots of information around wellbeing.

It’s been a real team effort today – that sense of coming together around a theme and / or something that really means something to the team. I think it’s what unites us. In terms of PAVO, as well, it unites us in terms of our work. We hear about the wellbeing of people and organisations. There isn’t one organisation that isn’t about wellbeing on some level.

Even from providing freshly made smoothies this morning it was all about – how can we set people off in the right way in terms of really feeling that sense of wellbeing – even about what you’re taking into your body. Even the food today has been really mindfully considered in terms of local ingredients, where it’s come from, how it’s been put together. The venue has also been carefully considered in terms of what that brings for us, and hopefully it allows us to be creative and indulgent, just to be in this beautiful space.

I just wanted to talk a little bit about the day. We have had some colleagues feel a little bit uncomfortable about today. We can all put our hands up and say we are uncomfortable about some things when we head into areas we haven’t explored before or experienced before. And one of the things about today was to move away from the theory of wellbeing, ie: the words, to being more able to experience an activity and / or activities and what that looks like.

Again, we all have ways of enabling or working with our wellbeing. Today was just to give you a flavour of what could be and what different activities could augment or give you a sense of wellbeing. And most of these activities have an evidence base behind them. So they are known to lead to wellbeing. Walking, for example, or, indeed, meditation. 

And something I explored earlier this summer with Academi Wales was the concept of moving into your ‘negative capability’. If you look up the words ‘negative capability’ it’s actually been around for quite a long time, it was the poet Keats who came up with it. He talked about exploring the edges of where your comfort levels are or what you think are the things you should be good at. And what he was talking about was moving into that negative capability, about understanding perhaps those areas where you might explore which might give you a sense of capability or, indeed, wellbeing that you might not think would give you that.

And so part of today was also about exploring that, about offering new opportunities such as Laughter Yoga. How many people here today have experienced Laughter Yoga before? Okay, a couple. Even I had a particular viewpoint of Laughter Yoga which turned out not to be the case! Because I said, “we’re not going to do that are we?” And then the team said, “No, no, it’s not like that at all!” 

So I think it’s just about really exploring that edge of where your comfort level is, to risk maybe today, in terms of doing things you wouldn’t ordinarily do. And it’s also really about looking after yourself. So if there’s something you’re doing, or you’re indulging in something, and you really feel uncomfortable, and you don’t want to do it… Let’s say in meditation I’m asking you to close your eyes or to be silent and you don’t want to do it – you don’t have to do it. This is not about forcing you to do something that you really don’t want to do.

And if you’re in an activity where you think – argh, I just cannot get into this, this is not what I want to be doing – don’t do it. Just leave or sit and be observant. Be mindful if you’re sitting on the outside what that might feel like to the group, but it’s not about forcing you to do something you don’t want to. It’s really about your wellbeing and your responsibility, your ability to respond to that yourself. 

I was speaking to S earlier, something that came up about that sense of moving into something you’re uncomfortable with. When we were talking about the day S said – “Oh, I’d like to do ALL of those things, apart from meditation. It’s not really for me.” So I laughed and I said, “oh, that’s interesting because I’m actually leading the meditation.” And she said to me, “Well, if you can be quiet for that long…!” 

And I think it’s really important to add that S said that she doesn’t feel that it’s the right thing to do this morning because she’s had a family upset and she’s really looking after herself in that way because she feels that being in that environment – maybe being quiet, closing your eyes or whatever might come up – is not what is comfortable for her today and I really honour that – that you’ve looked after yourself in that way. And that you’re vulnerable and saying that I’m not in that good space today. Again it’s really about saying if that’s the place you’re in then that’s OK.

OK, so the aim for the team today is that you have fun! And that you explore different things that you’ve maybe not indulged in before. That you in essence flourish. That there’s a sense of wellbeing when you walk out this afternoon. So we’re hopeful that that is going to be the case. 

Feedback following the activities:

• I really enjoyed it.
• I loved doing the Dabble with Art. It was a new thing to try.
• The singing, that was fab. Really good. I didn’t expect that to be so professional! We just sounded good from the start!
• It’s discovering those hidden talents of colleagues. We’ve just come out of a jamming session and again just aware of colleagues’ talent.
• I think the whole day, the venue itself is really interesting and thought-provoking – just a pleasant place to wander round and kind of absorb things. And first time Tai-Chier – loved it. Fab.
• I think that jamming session was fantastic. I didn’t realise we had so many musicians in PAVO. Loved it.
• I’ve had a really nice day spending time with my colleagues in a different context – not working.
• It’s actually been nice seeing colleagues that you don’t normally see, and speaking to people you don’t normally speak to on a regular basis.
• There was one session that was definitely out of my comfort zone – that was Dabble with Art – and I deliberately went for it. And Sue was brilliant, and even I came out of that session having both enjoyed it and benefited from it.
• Seeing people with smiles on their faces – quite often we’re all quite serious at work. I know we all smile from time to time! But people have been generous with their smiling. 

Going forward

Freda rounded off the day by suggesting how colleagues could link with community organisations to pursue activities they may have enjoyed:

We’ve experienced quite a lot of different things today and the opportunity is there to use our Community Connectors to connect ourselves with our local communities for those of us who would like to go forward and maybe take opportunities to do classes / activities, whether it’s pottery or Tai Chi, meditation, or anything really.

If you have any thoughts about wellbeing, and how to encourage it to flourish, let us know in the comments’ box below.

To DBT or not to DBT? That was the question...

This was the intriguing title of one of the key presentations at the recent Powys Research, Therapies and Health Sciences Conference: Inspiration and Innovation to Drive Patient Centred Care. I attended the conference last November and subsequently wrote How is telehealth working in Mid Wales? The day was packed full of inspiring talks and workshops on all aspects of innovative health work and research going on in the county – do go this year if it’s on again and you get chance.

Anyway, Dr Kathryn Walters, Consultant Clinical Psychologist and Dr David Pyle, Associate Specialist Psychiatrist, told us all about a relatively new service that has been developed in South Powys, to deliver Dialectical Behaviour Therapy (DBT) for the first time in the county. They were joined by Richard, who has been through the programme in Powys and was able to tell us what it was like for him.

Dr Kathryn Walters

First things first. What exactly is DBT? Over to Kathryn and David: 

“DBT is a cognitive behavioural treatment that was originally developed in the United States to treat chronically suicidal individuals diagnosed with borderline personality disorder and is now recognised as the gold standard psychological treatment for clients with this diagnosis. In addition, research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post traumatic stress disorder and eating disorders.” 

Apparently 20% of mental health inpatients have been diagnosed with BPD/ Emotionally Unstable Personality Disorder.

And so this is my next question: what is borderline personality disorder? 


We’re not very keen on psychiatric labels on this blog, but this one is used routinely by the mental health services in the UK, including here in Powys. Kathryn referred to the DSM V definition (the Diagnostic and Statistical Manual of the American Psychiatric Association) which is extremely detailed. There is a good description on the mental health charity Mind’s website, where people have also posted about what it feels like for them: “having BPD is like the emotional version of being a burn victim. Everything in the world hurts more than it seems to for everyone else and any 'thick skin' you are supposed to have just isn't there”. First thing on a Monday morning and probably most people would meet the criteria for BPD… but for those where difficulties continue and go on to become very extreme, and when people self harm often or attempt suicide, then they are very likely to come into contact with mental health services.

Kathryn explained more about the biosocial theory of BPD – that some people are born experiencing emotions more acutely, and have difficulties managing their emotions. This could be reinforced by the responses of family, friends and services, and ultimately it can be very difficult to change behaviours.

So, why DBT? Dialectics is about balancing opposites: balancing acceptance and change. It incorporates elements of mindfulness and radical acceptance, and helps people to accept the world as it is rather than battle against it. In other parts of the UK it had already been shown to be successful as a kind of “mental health gym” to improve the lives of people with a BPD diagnosis. A study in South West Wales where DBT is provided by Hywel Dda Health Board highlighted that financial savings could also be achieved. So, three years ago, in recognition of the fact that there was at that time no DBT service available to Powys residents, a bid was submitted to charitable funds to train six multi-disciplinary members of staff in order to set up a DBT service in South Powys.

Dr Kathryn Walters leads this team, which comprises Psychologists, Community Psychiatric Nurses (CPNs), an Occupational Therapist (OT) and a Psychiatrist. If, following assessment, someone is referred for a course of DBT they will join a rolling programme and be offered individual and group therapy, skills training, and phone consultations. (People in secondary mental health care with a care co-ordinator and a diagnosis of BPD can be referred. Care co-ordinators generally make referrals for DBT assessment). Feedback from people who have received DBT indicates that there is a general trend of improvement in people understanding and managing their difficulties better, and most are greatly satisfied with the programme.

Richard was in one of the first cohorts receiving DBT in Powys and spoke very favourably of his experience on the programme. Prior to joining he described his life as very difficult: “meds, meds, and more meds”, and not much support. It was rare for him to think through his thoughts – they were automatic and he would react to them. He was experiencing difficulties with his personal life to the extent that he self-harmed a lot. But this all changed once he started the 14 month DBT course. At first Richard felt that the programme went completely over his head. However, he committed himself to DBT and to the group, and he bonded quickly with fellow participants. It was reassuring to be with others who knew how he was feeling so that he didn’t have to explain all the time.

A third of the way through the DBT programme Richard had an experience which really changed his life. Everything suddenly became clear, and he felt changes within himself. He started to discuss his thoughts. By the end of the course he felt that he was a completely different person from when he had started. It is now 2 years since Richard completed the DBT programme, and he has not tried to self-harm or “do anything crazy” since. In fact, he is now into the third year of running his own business, has a good relationship with his partner, and a new baby.

Kathryn explained that people are encouraged to meet up as a “graduate group” once they have finished the course. There is also an open door for participants to get back in touch if that is what they want. The team stay in contact with annual Christmas cards. Meanwhile, demand for the South Powys DBT service has grown and there is currently a waiting list of 20 clients and three further members of staff have been trained to join the team.

So, in conclusion, it looks like the answer to the original question was definitely: “To DBT”. Which is perhaps not surprising, as much has been written online about the positive effects of DBT, such as: “DBT is not just a form of psychological therapy but a life-programme which patients use, initially to prevent serious self-harm or suicide and ultimately to build fruitful, satisfying lives”.

Do you have any experience of DBT? Whether you have or not, let us know what you think in the comments box below.

Terrible things happen to other people

This week's guest post is from PC Owen Griffiths of Dyfed Powys Police. I met Owen in May during Mental Health Awareness Week, where he spoke to colleagues and partner organisations about his own experience of mental distress. He kindly agreed to share his story with a wider audience. Over to Owen.

Bad things always happened to other people - faces on the news and names in the paper - or so I thought. My life was good and right and nothing was going to change that, of that I was sure. All that changed for me on the 22 May 2004. Let me tell you about it.

My name is Owen Griffiths. I am a 43 year old serving Police officer who currently works in the training department for Dyfed Powys Police. On the 22 May 2004 I was involved in an incident whilst on duty - one which I was very lucky to leave with my life intact. I can clearly remember being quite badly injured and standing at the side of the road. I was bruised and bleeding badly and although these injuries hurt me greatly they were nothing compared to the pain that hit me in my mind.

Before this incident I always believed that “stress” was feeling a little angry or perhaps snapping at people whilst being a little rushed or busy. I could not have been more wrong. The feeling that came upon me at that moment was something far more than this - it was a distinct all prevailing physical sensation that hit me as if I had run into a brick wall. At that moment I can clearly remember thinking “everything has changed”.

The next few days I spent recovering from the physical injuries I had sustained. My body was in pieces but it was my mind that was really hurting. Even though I was told to rest, it’s the last thing I wanted to do. I spent those early days walking around in a daze, my mind a constant stream of negative and anxious thoughts. It was at this time that I realised that I was very ill. No matter how much I tried I couldn’t concentrate on anything other than my own situation and what would become of me.

Because of the nature of the incident I had been involved in there was a procedure and as a Police officer I knew all too well that there would be an investigation into the events of that night and that my colleagues and I would be involved. Looking back now with the benefits of a clear mind and the comfort of hindsight it’s easy to see that I had done nothing wrong and it was just an unfortunate set of circumstances that would have to be looked into. Sadly this new me, a me tortured with racing thoughts, had thoughts that led to catastrophic conclusions with no possible endings other than my own imprisonment for the rest of my days. Again, looking back it seems silly that I even contemplated this happening, but what I didn’t realise is that I was now deep in the troughs of a severe episode of anxiety, one which would not leave me for over a year.

Days turned into weeks, and weeks into months, and all this time was spent in a haze of catastrophic thoughts. Sleep became almost non existent and I staggered from one horrendous fantasy of what my future was to another. I went to my GP on an almost weekly basis begging to be sectioned or given something that would relieve me of the torture that my life had become. Pills made me worse and I started to self harm and even contemplated ending it all but I kept going, unable to talk about anything other than my own problems or think about anything other than my own situation. There would on occasion be small windows of hope, perhaps I would get some good news or be cheered by the friendly words of family and friends. These moments of non worry became an incredible phenomena, a brief time when I felt for just a few moments like the “old me.” This feeling was more than just a lift of mood, more than a feeling of a weight lifted from my shoulder, it was like peering out of a cave on a summer's day. 

These were difficult times for my family. Having always been a big character I think it was difficult for them to accept this new me.  They gave their all to help me and I will be forever grateful. Like the pills that could not cast a spell and make me better I became frustrated and could not see any future for myself. Things looked really bleak. They had to change.

During the early days of my illness I had been referred by the GP to the local psychiatric services. Time had gone by and I had heard nothing (I would eventually get my first appointment almost two years to the day that I was referred). Seeking help but finding little I started to try different ways of helping myself. Of course getting myself out of the gloom and into helping myself was actually the last thing I wanted to do but little did I know it was actually the best thing for me.

Exercise was something I was sort of doing without realising it. Unable to sit and relax I was in the habit of walking miles, usually round in circles in my garden totally preoccupied. But when I started to give myself small goals like walking my dog to the old ruin a few miles from home, or cycling to Tesco to buy a chocolate bar or anything else that I may need, something started.  I would suddenly go, first seconds then minutes and then maybe ten minutes, without thinking of my problems. These little breaks from the pain became a lifesaver. Now I run regularly taking part in my local Parkrun every Saturday morning and being a regular runner in local 10k races. Exercise above any medication became a lifesaver.

Meditation and Body scanning. Helped by the force's occupational health department and counsellor I was steered in the direction of mindfulness and body scanning. This again became and has become an essential part of my day. I found it difficult at first to stop the swirling voices of doom but slowly over time I managed to shut them down for a few seconds at a time. This was priceless in the long run. 

My road to recovery was rocky and long and has taken a few detours along the way. I will be forever grateful to the Police rehabilitation centre in Flint House. The meagre amount deducted from my monthly pay could never hope to pay them back for the help they gave me. Even now I get my moments but it gives me great pleasure to talk to people who are going through a similar thing and sometimes can’t see that there is a way out. I can honestly say that at its worst it was the darkest time of my life. It affected me more than I could possibly imagine but I refuse to let it define who I am. From it I grew, I started to find my love for performing again and lost a lot of the inhibitions that were holding me back in life. Now under the name Owen Staton I can often be found performing and storytelling or acting all over the country. It’s not easy sometimes but Life isn’t a bed of roses and sometimes it's better for it I feel.

Mental illness can sometimes be a gift. It makes you appreciate being well, it helps you realise the battles that people are fighting and makes your victories ever sweeter. Do I wish I had never been ill? Yes I do, but I don’t for one minute regret being the person it made me. I am better and stronger and you can be too.

God Bless

Owen

You can follow Owen on Twitter @owenstaton

Many thanks to Owen for sharing his story. We love to hear from our readers, and welcome any comments in the box below.