Thursday, February 19, 2015

Did you know there is a good type of stress? The secret ingredient is HOPE!

It’s SLC exam time in Nepal. The pressure on the students as they stare down the barrel of the “Iron Gate” exams of which less than half of the students will pass, is substantial. I have been teaching MindBody Wellness to the 29 class 10 students at our model school, Riviera. The last few weeks we have been focusing on stress – its impact on our bodies and our minds as well as ways we can manage it. As I told the students, I can’t take away the stress – the exams are coming whether we like it or not and the pressure of the expectations on their shoulders from their schools, their teachers, their friends, their families but mostly from themselves, is settled in for the long haul. What I can do is to provide them with some tips and tricks to enable them to handle the stress as well as possible.

We did an anonymous “brain dump” – “What effects is the stress having on you both emotionally and physically?” Everyone had a heart shaped sticky note (it was Valentine’s Day after all!) to fill and we stuck them all on the door. As we stood around reading them all, I could hear the murmurs of “me too”, “yes definitely” accompanied head nods as they realised that their classmates were all feeling the exact same things. We talked about the physical effects of stress (yes we talked about tummy upsets, nausea, sore shoulders and backs, feeling tired, lack of appetite) and the emotional ones (easily irritated, fast to anger and yes some of the boys admitted to feeling teary sometimes). We discussed some people preferring to be alone when they are stressed and others craving company. This new awareness enabled a conversation about being respectful of others’ preferences – if you are one who prefers to be around others when you’re stressed, note which classmates share this approach and spend time with them. If someone likes to be alone when they are stressed, leave them alone and don’t take it personally. One of the boys said to me, “Thanks, Bec. I was worried something was wrong with me because I keep getting sick and feeling like vomiting all the time. Now I know it is just the stress, I won’t worry anymore and now I can use that energy for my exams!”

Having worked through what’s normal stress symptoms, I gave them the good news. There are 2 types of stress – distress which, as it sounds, is a negative type of stress; and eustress which is a more positive type of stress. The difference hinges on HOPE and comes down to how we frame the event. If we see the SLC as exams designed to make us fail and that if we don’t get good results our lives will be ruined, this will cause distress and hopelessness. However, if it is reframed to be seen as an opportunity to showcase our hard work and to give us the necessary piece of paper to enable us to go on to achieve our dream futures, then our body and mind react to the hope and respond accordingly, motivating us to study hard and clearing our minds to focus on achieving the best we can do in the exams. We practised reframing our responses to the question they get asked multiple times a day “How are you feeling about your exams?” and responding with an answer reflecting either distress or eustress. One of the girls remarked on the immediate difference in body language between the 2 responses. It was true – a distress response saw the student acting the role with his shoulders dropped, head down, wringing his hands. The same student’s response when he responded with an answer containing hope and opportunity (a eustress response) saw his shoulders thrown back, his head up, hands wide open and a significant confidence in his voice which had been missing before.

By the end of the session, the students had developed a new sense of connection with their classmates, an increased awareness of the fact that they are all facing the same challenge and experiencing the same symptoms of stress, that what they are feeling is normal. They had a new language to discuss with each other how they are coping and they had a reframed view of their exams as an opportunity, full of hope for their futures, leapfrogging the stress of the exams and giving them a glimpse of the hope waiting for them.

The same strategies apply to you. The reality is that we cannot escape the stress in our lives. But we can reframe it to give it hope, to place it in the camp of eustress rather than distress, to be kind to ourselves during the process. And be aware of the effects, both physical and emotional, that stress is having on you. You owe it to yourself to address these. The long term consequences of prolonged stress are huge. There are ways to reduce the impact and face stress with a renewed strength.

We ended the session with a great laughter yoga session. Yes, stress can be contagious. But the best news is that laughter is even more contagious! Thanks, class 10, it is always a pleasure learning with you!

With gratitude always
Bec

Thursday, January 15, 2015

The Rwandan Approach to Depression - Community, nature and joy

Neha was feeling out of sorts. Exams were looming and the pressure was intensifying. The Iron Gate of the SLC (final school exams) seemed to get taller every day. Her will to go on had disappeared. I hated seeing her under this amount of pressure, wished I could do something. The Nepalis I spoke to said it was simply exam pressure and everyone had to go through it. But it was more than that. Her appetite had gone, she couldn’t sleep. She had started talking about suicide. Her soul was giving up. I sought advice in Australia. I was told she needed counselling and to be put on anti-depressants, that she was clinically depressed.
 
I returned to the psychiatrist in Kathmandu to ask his advice. “It’s normal exam pressure, but if you think it’s more, then here are some anti-depressants and sleeping tablets.” Um, no thanks. Sleeping tablets for a suicidal teenager didn’t seem logical. And counselling in Nepal generally consists of telling them to get over it and study harder.
 
All options seemed counterintuitive. Talking about what was making her stressed and drumming it further into her mind; medicating her so she wasn’t able to feel the stress; telling her to get over it; removing the stress entirely by telling her not to sit her final SLC exams, effectively limiting her future options. There had to be a better way; one which was more positive, which would build her resilience against future stress as well. Not one which seemed to compound the problem.
 
Then I came across this quote about the Rwandan approach to dealing with depression. It was an aha moment for me.  
 
"We had a lot of trouble with western mental health workers who came here immediately after the genocide and we had to ask some of them to leave. They came and their practice did not involve being outside in the sun where you begin to feel better. There was no music or drumming to get your blood flowing again. There was no sense that everyone had taken the day off so that the entire community could come together to try to lift you up and bring you back to joy. There was no acknowledgement of the depression as something invasive and external that could actually be cast out again. Instead they would take people one at a time into these dingy little rooms and have them sit around for an hour or so and talk about bad things that had happened to them. We had to ask them to leave."
 
As I reflected on this as well as the elements of wellbeing and the research surrounding resilience, I felt like we needed to inject some fun into Neha’s routine, some laughter and positive experiences. So we started with a “Love Bomb” – a burst of one on one attention doing something she enjoys. Often these have the effect of giving a boost of energy which enables the person to grab onto the first rung of the ladder to help them climb out of the pit of depression. We combined this with a number of other strategies – spending time in nature, allowing our bare feet to connect with the earth; hanging out with the kindergarten kids (there is something uplifting about enjoying the company of young children with few inhibitions and a wonderful curiosity for life); a crazy hour of dancing to all her favourite songs. We also taught Neha the impact that stress was having on her body, allowing her to identify the symptoms and giving her some tools (breathing exercises, mindfulness techniques) to minimise these. Then we added some memory boosting foods such as almonds and tuna.
 
Of course, the tension and pressure of exams continued. We can’t remove this. But by adopting the Rwandan way, giving her a package of positive boosters, we hoped to allow her to climb out of the depressive pit and to allow her to feel confident she could handle things herself in future.
 
As Neha’s final exams near, she is in a great place. Stressed and terrified, understandably yes; but no longer feeling hopeless and sad. Now she sees the opportunities to learn from the experience and is excited about her future. And her cheer squad is right here to give her boosts of fun and love along the way.