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Talking Mental Health: Reflections of a PWP

By Jordan Thomas

Image Description: The background is a light blue. At the top there is the text “A LUNA project series on the intersection of physical health and mental health”and the LUNA logo. There are then three polaroid style infographics, the two on the right and left have images of the buildings, light, and water within them and are kind of cut off. The one in the centre has an image of Jordan, who is stood smiling on a bridge,  with the text underneath reading “Talking Mental Health: Reflections of a PWP”. End of Description. 

Defined by the World Health Organisation (WHO) health is; “a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity”. Now, with this definition in mind let’s look to that that bruised arm from that drunken fall you had on the weekend, I’m willing to bet every copper penny down the back of my sofa you could coherently explain to me how it feels to have that bruise, summarising it with the use of the odd simile or metaphor. I’m also 99.9% sure that if I asked who in your life makes you happy outside your immediate family unit, one of those people that pops in to mind would be your best friend (it’s too late for you to cover your webcams and put on your tin foil hats…I’m in your heads now…it is literally my job). Now, my next point is going to be a question, and before you continue reading, to answer the question, I want you to think about a situation in the past two weeks that has spurred on feelings of anxiety or depression.

You ready for my question?


“What was it about that situation that made you feel anxious/depressed?”.

Now be honest, how long did it take you to come up with an answer to that? Or better yet, did you come up with an answer at all? Let’s revisit that definition; “a state of COMPLETE, physical, MENTAL and social-wellbeing”. Now don’t be alarmed by my use of caps lock, I’m not suggesting that for those of you who couldn’t answer the question you have severe mental health difficulties. All I’m trying to get across here is that when we really attend to our internal cognitions/thoughts, it can be difficult and we can come up empty handed. Factor in that we often make conscious decisions to ignore how we feel mentally AND don’t seek help when we’re experiencing psychological distress, it puts into relatively simple context why suicide is the second biggest killer of those aged 15-29 (according to WHO).

So now some of you might be thinking “yeah sound Jord thanks for reading my mind, who the hell do you think you are!?”. Well me, I’m a Psychological-Wellbeing Practitioner or PWP for short. My role is to treat people who suffer from mild to moderate symptoms of anxiety and depression using a principle called “Cognitive Behavioural Therapy” or CBT. And for some reason, Ross Tanner asked me to write a blog…so you don’t like it…you know who to speak to. He did ask me to explain what it is I do, how/when to reach someone such as myself and how seeking help ISN’T, and I cannot stress this enough, ISN’T a sign of weakness or compromise to your character.

So first up, a bit of general knowledge, as a PWP I work for a service in the NHS known as Improving Access to Psychological Therapies or “IAPT” for short. IAPT is an NHS initiative designed to provide more psychotherapy to the general population. As I mentioned previously, we treat those who predominantly present with symptoms of depression and anxiety. It may be important to note for some of you who are not too familiar, anxiety is an umbrella term and it’s presentation is not just irrational worry but also identified as conditions such as OCD, social anxiety, agrophobia etc. the difference being they have exceptional characteristics to that of generalised anxiety that need a more specific form of treatment. However, these are all treatable within this service too.

As I mentioned, IAPT services work on a principle called cognitive behavioural therapy which prioritises a situation and we explore how our thoughts, emotions, behaviours and physical symptoms interact in that particular situation and then we focus on restructuring the behaviour and thought responses, hence “cognitive” and “behaviour”. We work on a “stepped care model”. As a PWP I work at step 2, where I am responsible for the assessment of a client’s symptoms and deciding on whether they are appropriate for the service (Step 1 is an agency that might refer you to us so a GP for example). Should I believe that you, the reader, yes you (take the smile of your face this is important), are suitable for treatment, my next clinical decision is to see whether you are fit to be seen by myself, a step 2 therapist, or maybe you’d need a more intense approach with longer sessions with a step 3 therapist. But we don’t need to go that far right now...I just want to make sure you have an understanding of how to find us and give you the basic idea. So, “how do I get in contact with you as I feel I’m struggling with my mood”. Well first things first, if you’re over the age of 18 reading this…you don’t need to tell mum and dad, heck you don’t even need to go to see your doctor. The beautiful thing about all IAPT services is they’re self-referral. All you need to do is hop onto google punch in the name of your county or town followed by the word “IAPT” and there you go.

“When can I contact this service”, Sir/Madam…we’re like batman…you get on that hotline and we’ll answer your call. If you are struggling with low mood, if you cannot stop worrying about a hundred and million one things CALL US! It’s never a bad time to talk, if we can’t help you we’ll signpost you to someone who can. But pick up the phone and call in the hours advertised by your local service.

Before I end, I want to really break down to you how complex the brain is with a little anecdote and potentially try and remove the stigma attached to mental health and it being a “its me I’m crazy” conclusion. You’re not, the brain can get it wrong and I hope the following examples how in the case of generalised anxiety. I’m going to discuss with you the “fight or flight” mechanism in our brain. *Clears throat* Actually, while I’m thinking about it, open google images and I’ll take you through it without even being there but technically I’m there…but im not…you get what I mean.

Right. Deep in our brain there is a part called the “Amygdala” and it sits in the “Temporal lobe”. Now the amygdala is responsible for our emotional response. The temporal lobe as a whole is responsible for making sense of the day to day stimuli we see, hear, taste, smell and touch and put it into context for us to understand. Now when we receive stimuli that our brain perceives as a “threat” blood rushes to this area to make us consciously aware we’re in danger, the brain will then send signals to your heart to start pumping harder so it can supply blood to your bigger muscles preparing you to “fight” or run (“Flight”), some people may begin to feel nauseas or have a sensation of needing to pee, this is your body actively trying to remove unnecessary weight to make you more agile. All sounds pretty horrific right but in the context of a threat such as a lion chasing us all its actually very appropriate, pat your brain on the back, well done brain.

NOW, when your brain decides to initiate these protocols as it see’s being around a group of people as a threat, has you constantly worrying your house is going to burn down when there is absolutely no factual evidence to back this up. THAT’S when getting in contact with your local IAPT service is necessary, because your brain for one reason or another believes that there is potential for threat or harm in environments where actually this is not the case. Doesn’t mean you’re going crazy, doesn’t mean when you speak up we’ll cart you off in a white van and your loved ones will never see you again. All we need to do is conceptualise the worry, understand its origins and work on your thoughts and behaviours to teach your brain that it is in fact causing you unnecessary feelings of distress. To conclude it is very normal to experience sadness, worry and stress in some capacity (ask your mum, you’ll be there for a week, particularly around the topic of stress). But look at these emotions more as a prompt if you will, and as a result of these prompts, most of the time you will problem solve and put into action a task that would relieve these negative emotions. Now sometimes we can’t do that, sometimes we need assistance, and just like putting your hand up for help with the answer of a math test that’s completely okay and expected. If there is one message I would like to leave with you now in my final paragraph is that a problem shared is a problem halved. Speak up, you wouldn’t leave a broken arm to “sort itself out”. You’d go to a doctor so you could return to “a state of physical wellbeing”. Do the same for your mental wellbeing and begin a dialogue with how you are feeling. I wish you, the reader of this entry, all the best with your future endeavours. ☺

(Originally published 22/11/20)

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