Getting an Autism or ADHD diagnosis as an adult woman can bring up quite mixed feelings. On the one hand, there can be enormous relief and validation. Things that have felt confusing or that you have blamed yourself for suddenly have another possible explanation. On the other hand, it can open up a whole new set of questions. You might start looking back at your childhood, your friendships, your relationships or your working life and thinking, “Was that my ADHD? Was that autism? Was I masking? Why have I spent so much of my life feeling like I’m slightly out of step? Why did nobody notice?” And sometimes the answers aren’t particularly straightforward. I think this is particularly complicated for women because many of us become very good at adapting. We watch other people and work out what we're supposed to do. We learn to be sociable, capable, organised and accommodating, even when doing those things takes considerably more effort than people realise. So you can get to adulthood having achieved quite a lot while also feeling exhausted, overwhelmed or somehow different. You might be very capable in one part of your life and completely stuck in another. You might have spent years thinking you are too sensitive, too intense, too disorganised, too much, or simply not trying hard enough. A diagnosis can bring relief, but it can also bring grief. You may grieve for the support your younger self didn't have, or for how much energy you've spent trying to understand or change yourself. You may also start questioning what is “you” and what has developed in response to your experiences. I don't think diagnosis gives us all the answers. Nor does everything need to be explained by neurodivergence. But it can give us another, often much more compassionate way of understanding ourselves. And perhaps that is where some of the useful work can begin; not simply learning that you are autistic or have ADHD, but working out what that actually means for you and your life.

A Quick Overview The Five Areas Model is a simple CBT framework that helps us understand how five parts of our experience are connected: what is happening in our life our thoughts our emotions physical sensations in the body what we do These systems influence one another all the time. If we feel anxious, for example, we may notice threatening thoughts, changes in our body and an urge to avoid or seek reassurance. If we feel low, we may have less energy, think more negatively and withdraw from people or activities. Many of these responses make sense from an evolutionary perspective. Fear, sadness and other emotions are not simply “bad” feelings; they are part of systems that developed to help us respond to threat, loss and important social situations. Difficulties arise when these responses become too intense, persistent or begin to keep themselves going. The useful part of the Five Areas Model is that we do not have to change everything at once. A small change in one area — such as approaching something we have been avoiding, becoming more active, or responding differently to a worrying thought — can begin to influence the whole system. Understanding the Five Areas Model The Five Areas Model is a simple way of understanding some of the processes that influence how we feel. It comes from cognitive behavioural therapy (CBT) and looks at five interconnected areas: what is happening in our life or environment our thoughts our emotions physical sensations in the body what we do These areas continuously influence one another. Understanding these connections can help us recognise why we may become caught in unhelpful cycles and where we might be able to make changes. Human emotional systems have developed over a very long evolutionary history. Emotions such as fear, sadness and guilt are not simply unwanted symptoms. They are part of systems that help us notice and respond to things that may be important to us. Difficulties can arise, however, when these systems become particularly sensitive, remain activated for long periods, or lead us into patterns of thinking and behaviour that inadvertently maintain distress. Situations and Life Circumstances How we feel does not occur in isolation. What is happening around us matters. Relationship difficulties, pressure at work, illness, bereavement, uncertainty, loneliness and many other experiences can influence our thoughts, emotions, bodily responses and behaviour. The same situation can also affect different people differently because we interpret events in the context of our previous experiences, expectations and beliefs. Thoughts Our minds are constantly interpreting what is happening around us, predicting what might happen next and remembering what has happened previously. This ability is enormously useful. Being able to anticipate possible difficulties, learn from previous experiences and plan ahead has obvious advantages. However, thinking can sometimes become caught in repetitive patterns. We might repeatedly anticipate things going wrong, focus our attention on possible threats or spend long periods going over events that have already happened. Importantly, having a thought does not necessarily mean that the thought is accurate or that we need to act on it. Emotions Human beings experience a wide range of emotions, including fear, happiness, sadness, anger, guilt, shame and surprise. Emotions provide information and influence our attention and behaviour. Fear draws our attention towards possible danger. Sadness commonly occurs following loss or disappointment. Guilt may arise when we believe that we have acted against our values or harmed a relationship and can motivate us to repair things. Emotions therefore have functions. The difficulty is not usually that we experience emotion at all, but that an emotional response may become particularly intense, persistent or poorly matched to the situation we are now in. Physical Sensations in the Body Emotions are also experienced physically. When our threat system is activated, for example, the body prepares us to respond. We might notice a faster heartbeat, changes in our breathing, tense muscles, sweating, shaking, nausea or butterflies in the stomach. Some people experience light-headedness or dizziness. These responses make sense in the context of a system designed to help us respond quickly to possible danger. The same threat system can be activated by psychological and social threats as well as immediate physical danger. Sadness and low mood may be accompanied by reduced energy, heaviness and a desire to withdraw, although people's physical experience of sadness varies considerably. Social emotions such as guilt can also have a physical quality. There may not be one particular bodily sensation associated with guilt, but many people recognise an uncomfortable physical feeling that accompanies it. Behaviour What we do is another important part of the system. If we are frightened, we may instinctively want to escape or avoid the thing that frightens us. From an evolutionary perspective, moving away from danger is an entirely understandable response. The difficulty is that our brains can sometimes identify something as threatening even when avoiding it is not necessary or helpful. Avoidance can then prevent us from discovering that we are able to cope or that the anticipated danger does not occur. Our behaviour can change in many other ways depending on how we feel. When we are sad, we may withdraw from other people or stop doing things. When we are worried about our health, we might repeatedly check our body or seek reassurance. When we feel stressed, we might drink more alcohol. When we feel lonely, we might contact a friend. When we are worried about an important relationship, we might seek reassurance or affection. Some of these responses help us; others can unintentionally keep a difficulty going. Anxiety and Fear Fear and anxiety are particularly good examples of how the different areas interact. Fear is generally a response to an immediate perceived threat, while anxiety is more concerned with possible or anticipated threat. If we believe that something dangerous may happen, our attention becomes drawn towards signs of danger. Our thoughts may become increasingly focused on what could go wrong. At the same time, the body's threat system becomes activated. We may notice changes in our heart rate, breathing, muscles, stomach or temperature. Our behaviour also changes. We may avoid the situation, escape from it, check for danger or seek reassurance from someone else. In the short term these behaviours may reduce anxiety, which makes them very understandable. But repeated avoidance or reassurance seeking can sometimes reinforce the brain's belief that the situation really is dangerous. Therapy can therefore involve gradually learning to approach situations differently and discovering, through experience, what actually happens rather than relying entirely on the brain's prediction of danger. Sadness and Low Mood Sadness often arises in response to loss, disappointment or circumstances that matter to us. When our mood is low, we may have less energy and motivation. Our thinking can become more negative, and we may be more likely to withdraw from people and activities. This can create another cycle. The less we do, the fewer opportunities we have for enjoyment, connection and a sense of achievement. Our mood may then fall further, making activity feel even more difficult. One way of interrupting this cycle is to make small behavioural changes even before we feel motivated to do so. Getting out of bed, having a shower, going for a short walk or contacting another person may not transform our mood immediately. But each action can alter another part of the system and gradually begin to change the cycle. Using the Five Areas Model The important idea behind the Five Areas Model is that these different aspects of our experience do not operate independently. What happens to us influences what we think. Our thoughts influence our emotions and bodily responses. How we feel influences what we do. What we do then affects both our circumstances and what happens next. This also gives us several possible points at which change can occur. We can learn to notice and respond differently to thoughts. We can work with physical arousal. We can change patterns of avoidance or withdrawal. We can gradually approach things that frighten us. And, where possible, we can make changes to difficult circumstances in our lives. We do not have to change the entire system at once. Sometimes a relatively small change in one area can begin to influence the others.

Demystifying the Physical Symptoms of Anxiety Anxiety can produce very real physical sensations: a racing heart, dizziness, sweating, trembling, nausea, tightness in the chest or a feeling that something terrible is about to happen. Understanding why the body responds in this way can make these sensations feel less mysterious. Our Threat Response Human beings have evolved systems that help us respond rapidly to possible danger. When the brain detects a threat, the body can prepare for action. This is often described as the fight-or-flight response, although defensive responses can also include freezing or becoming more vigilant. These responses would have been particularly useful when our ancestors faced immediate physical threats. If danger appeared, quickly mobilising energy, increasing alertness and preparing the muscles for action could improve the chances of escaping or defending ourselves. The same basic threat systems remain with us today. What Happens in the Brain? There is no single “fear centre” in the brain. Instead, several interconnected brain systems are involved in detecting and learning about threat, interpreting what is happening and coordinating the body's response. The amygdala plays an important role in recognising and learning about potentially threatening information, but it works alongside areas including the hippocampus, prefrontal cortex and insula. Importantly, threat responses can begin very quickly. We do not always have to make a deliberate, conscious decision that something is dangerous before our body reacts. This is useful: if we had to carefully analyse every possible danger before responding, we might sometimes respond too slowly. What Happens in the Body? When the threat system becomes activated, the sympathetic nervous system helps prepare the body for action. Our heart rate may increase, our breathing may become faster, our muscles may tense and we may begin to sweat. Hormones including adrenaline help mobilise energy so that the body is ready to respond. At the same time, processes that are less immediately important may change. Digestion, for example, can be affected, which is one reason anxiety may produce nausea, stomach discomfort or “butterflies”. Breathing can also change. Some people begin to breathe faster or more deeply than their body requires. This can reduce carbon dioxide levels in the blood and temporarily alter blood flow to the brain, contributing to sensations such as dizziness, tingling, light-headedness or feeling detached. Although these sensations can feel alarming, they are common features of anxiety. Why Does the Alarm Sometimes Go Off When We Are Safe? One useful way of understanding anxiety from an evolutionary perspective is to think of the threat system as being rather like a sensitive smoke alarm. For our ancestors, failing to respond to genuine danger could carry a very high cost. Responding unnecessarily was often much less costly. Evolution would therefore favour a system that sometimes produced a false alarm rather than one that regularly failed to respond to real danger. Modern anxiety can work in a similar way. Our threat system does not respond only to immediate physical danger. It can also react to uncertainty, memories, imagined future events and social threats. What About Social Anxiety? For humans, relationships with other people have always mattered. Throughout our evolutionary history, belonging to a group provided access to protection, cooperation, resources and support. Social rejection, exclusion and loss of status could therefore carry significant consequences. It makes sense that humans developed a strong sensitivity to signs that our relationships or social standing might be threatened. Today, this system can become activated in situations such as: speaking in front of other people meeting someone new being criticised worrying about making a mistake feeling judged experiencing rejection believing that we have embarrassed ourselves. There may be no immediate physical danger, but our brain can still interpret the situation as important enough to activate a threat response. Culture, previous experiences and learning also influence the situations in which we experience shame, embarrassment or social threat. Why Understanding This Can Help The physical symptoms of anxiety are therefore not random. They arise from systems designed to protect us. Sometimes those systems respond appropriately to danger. At other times, the alarm is triggered when the situation is uncomfortable or uncertain rather than genuinely dangerous. Understanding this distinction can be important in therapy. Rather than treating the physical sensations themselves as evidence that something terrible is happening, we can begin to recognise them as part of an activated threat system. With practice, we can learn to respond differently to both the sensations and the situations that trigger them.

Anxiety is something that all humans experience. In fact, if you did not experience any anxiety you would be considered to be abnormal! Our anxiety system developed in Hunter-Gatherer years and at that time it was a very useful system in helping us to survive and thrive into this day and age. The problem with the anxiety system is that although it was useful in hunter-gather times it really is not very useful today.

We often imagine that when life becomes less demanding, we will automatically feel better. Work slows down. We go on holiday. The children finish school. We finally have a weekend without plans. And yet, instead of feeling immediately relaxed, some people find themselves feeling unusually tired, irritable, anxious or emotionally unsettled. Sometimes people tell me that they were coping perfectly well while life was very busy, and it was only when they stopped that they began to feel how exhausted they actually were. This can be confusing. If the stressful period is over, why don’t we simply feel relieved? Part of the answer lies in the way our nervous system responds to sustained demand. We can function remarkably well under pressure Human beings are very good at mobilising when something needs to be done. When there are deadlines, responsibilities, people depending on us or simply too many things happening at once, the body can shift into a state that helps us keep going. Our attention narrows. We become more task-focused. We may notice our tiredness or emotions less because there is something more immediate requiring our attention. This is not necessarily unhealthy. It is part of an adaptive system that has helped human beings respond to challenge for a very long time. The difficulty comes when that state continues for weeks or months. We can become so accustomed to functioning under pressure that being busy begins to feel normal. We may not realise quite how much effort is involved because we are still managing to work, look after our families, answer messages, make decisions and do all the things that need doing. From the outside, we may appear to be coping very well. Internally, it can be rather different. Stopping gives us space to notice When the external demands finally reduce, the nervous system does not always move instantly from mobilisation into relaxation. Instead, there can be a period of adjustment. It is often only then that tiredness becomes apparent. Emotions that have been pushed slightly to one side may become more noticeable. Thoughts that were drowned out by activity can suddenly feel much louder. For some people this shows up as exhaustion. For others it may be restlessness, low mood, anxiety or irritability. And because we expect ourselves to feel relaxed, we can then become worried about the fact that we do not. You might find yourself thinking, I’m finally on holiday. Why can’t I switch off? Or, Nothing is actually wrong. Why do I feel so anxious? The secondary worry can sometimes become almost as difficult as the original feeling. Relaxation is not an on/off switch We often talk about “switching off” as though the nervous system were a machine. But psychologically, it rarely works like that. If your mind and body have spent a long time responding to demands, monitoring problems and anticipating what needs to happen next, it makes sense that they may continue doing this for a while after those demands have reduced. The absence of work does not necessarily create an immediate internal sense of safety. This is one reason people can find the first few days of a holiday surprisingly difficult. The environment may have changed, but internally the system is still running at roughly the same speed. Given enough space, it may begin to settle. But sometimes what emerges first is the fatigue that being busy allowed us not to feel. Why doing nothing can feel uncomfortable There is another part of this which I think is easily overlooked. Being busy can serve a psychological function as well as a practical one. Activity gives our attention somewhere to go. It provides structure and a sense of forward movement. For some people, it also keeps more difficult thoughts or feelings at a manageable distance. When the activity disappears, that space can initially feel uncomfortable. This does not mean that somebody has been deliberately avoiding their feelings, or that there is necessarily something deeply wrong underneath. It may simply mean that the mind has more capacity to notice things that were already there. People are sometimes surprised by this. They may have spent months longing for some time off, only to discover that slowing down leaves them feeling strangely exposed. Again, that response is often much more understandable when we stop interpreting it as evidence that we are doing relaxation badly. Rest does not always feel restful at first We tend to judge rest by how it feels. If we sit down and immediately feel calm, we conclude that it is working. If we sit down and feel restless, guilty or anxious, we may assume that it is not. But the experience of rest and the effect of rest are not necessarily the same thing. Someone who has been operating under prolonged stress may need time before stillness begins to feel comfortable. The nervous system is learning that it no longer needs to remain quite so mobilised. That transition can feel unfamiliar. And unfamiliarity itself can sometimes be interpreted by the brain as something to be wary of. There is no correct way to decompress One of the problems with the way we talk about wellbeing is that even rest can become something we feel we have to succeed at. We can start comparing ourselves with people who appear effortlessly relaxed, or become frustrated because meditation, holidays, exercise or time away have not transformed the way we feel. But different nervous systems settle in different ways, and they do so at different speeds. For one person, a quiet afternoon may feel restorative. For somebody else, gentle activity, routine or being around people may make it easier to begin slowing down. And sometimes a period of rest simply reveals that the level of stress or exhaustion has been greater than we realised. That information can be uncomfortable, but it can also be useful. Perhaps the first task is simply to understand what is happening If you notice yourself feeling more tired, anxious or emotionally unsettled when life becomes quieter, it does not automatically mean that taking time off has made things worse. It may mean you finally have enough space to notice how you have been feeling. And rather than asking, Why can’t I relax?, a gentler question might be: What has my mind and body been carrying while I’ve been getting on with everything? Sometimes understanding that is a more useful place to begin than trying to make ourselves feel relaxed. Because slowing down is not always an immediate feeling of peace. Sometimes it is simply the point at which we begin to hear ourselves again.

In this blog, I’m sharing a few ideas from what may be one of the earliest self-help books: The Art of Loving, published in 1956. Some of the language now feels dated, and the book reflects a limited view of relationships and identity. Even so, I think Fromm offers a thoughtful and still relevant perspective on love within committed relationships. Fromm takes a surprisingly dim view of romantic love, seeing it as an immature form when compared with what he calls mature love. For him, love is not primarily a feeling or a possession; it is an action. Love is a verb rather than a noun. He is less interested in the idea of “falling in love” and more interested in the practice of “standing in love” — a steadier, more intentional form of connection that feels quite different from the way love is often described in contemporary culture. He argues that love is expressed through four key attitudes, which I’ve outlined below. 1. Care For Fromm, care is an active concern for the life and growth of whatever or whoever we love. We often stop at love as a noun – the deep affection we feel for someone or something. But love as a verb is different. It is expressed through what we do: the effort, attention, and care we offer. Whether it is directed towards a partner, a child, or even a rose garden, love is made visible through action. It can be as simple as bringing your partner a cup of tea in the morning, helping with a task, offering support, or taking a genuine interest in how they want to live and grow. It means asking what they need, what they want, and how you can help. These small, practical gestures are not separate from love; they are expressions of it. The same is true elsewhere in life. A child cannot thrive without care; without it, they may struggle to communicate, connect, and develop the capacity to care for themselves and others later in life. A rose garden left untended will choke with weeds or fail to flower. Love, then, is care in action rather than care as an idea. “The essence of love is to labour for something and to support its growth; love and labour are inseparable.” – Erich Fromm In adult partnerships, care means actively supporting one another’s growth – both individually and together. This is part of why relationships require work. Love is not passive; it asks something of us. 2. Responsibility This is not responsibility in the sense of duty. It is better understood as responsiveness. Fromm suggests that responsibility, in its truest sense, is a voluntary readiness to respond to the needs of another person, whether those needs are spoken or unspoken. In parental love, this is visible in the way a child’s physical and emotional needs are recognised and met, often through attentiveness, instinct, and trial and error. In love between adults, responsibility means being willing to respond to the needs of a partner’s mind, heart, and inner life. It asks us to be present, attentive, and capable of care. 3. Respect Respect is not about placing someone on a pedestal. It is about seeing them as they are and recognising their uniqueness. In practice, it means allowing the other person to grow into themselves rather than trying to shape them around our own needs. It asks us to loosen our grip on ego and possessiveness, and to let the other be fully themselves. 4. Knowledge “To respect a person is not possible without knowing them; care and responsibility would be blind if they were not guided by knowledge.” For Fromm, knowledge is what gives depth and direction to love. There is a paradox here: he suggests that the deepest knowledge of another person, and of ourselves, is realised through intimacy. For that reason, these four attitudes of love are inseparable. Care, responsibility, respect, and knowledge are intertwined, and together they form the labour of love. This may not align neatly with the archetypal romance of falling in love, or with the intensity and chemistry we often associate with it. Fromm’s view is quieter and more demanding: love is not only something we feel, but something we practise. The people who truly love you know who you are. They respond to your needs, care for you, and respect you – not in an idealised way, but in the ordinary, consistent ways that matter most. In that sense, love is not only about romance. Love is labour, and labour, in its best form, is an expression of love.

Many people are noticing that they feel more anxious, more irritable, more tired, or less able to cope than they used to. Often, they assume this means something is wrong with them. They wonder why they are not managing better, why small things feel harder, or why they can no longer push through in the way they once could. But it is worth asking a different question. What if your mind and body are responding quite understandably to the world you are living in? Over the last few years, many people have been dealing with a steady accumulation of pressure. The cost of living has affected basic feelings of security. The news cycle brings a constant stream of conflict, political tension, climate concerns and uncertainty. Work has become faster, more demanding and, for many, less predictable. Artificial intelligence is changing how people think about their jobs and future security. Social media means we are exposed not only to our own worries, but to everyone else’s fears, opinions and crises as well. This matters psychologically. Human beings are not designed to process unlimited threat. Our nervous systems evolved to respond to danger that was immediate, concrete and time-limited. A threat appeared, the body mobilised, and then the system could settle again. Modern stress is different. Much of it is abstract, ongoing and difficult to resolve. You may not be facing a physical threat, but your brain can still register uncertainty, financial pressure, work instability or constant negative news as something that needs monitoring. This is one reason anxiety can become so persistent. The mind keeps scanning: What if things get worse? What if I cannot cope? What if I fall behind? What if I make the wrong decision? What if my job changes? What if my children struggle? What if the world is becoming less safe? The problem is not that these concerns are silly. Many of them are based on real pressures. The difficulty is that when the brain stays in threat-monitoring mode for too long, it starts to cost us. Sleep becomes lighter. Concentration becomes poorer. The body feels tense. Small decisions take more effort. People withdraw, become snappier, procrastinate more, or feel emotionally flat. This can look like a personal failing, but often it is an overloaded system. One of the most important shifts is to stop treating anxiety and exhaustion as signs of weakness. They are information. They tell us something about the level of demand we are under and the amount of recovery, support and control we currently have. This does not mean we can control everything happening in the wider world. We cannot. But psychologically, we do need to create boundaries around how much threat we consume and how much responsibility we take for things beyond our control. For example, staying informed is useful. Constantly refreshing the news is usually not. Thinking about your career is useful. Mentally rehearsing every possible future threat at midnight is not. Caring about the world is human. Carrying the emotional weight of every crisis every day is not sustainable. A helpful question is: “Is this something I can act on, or is this something my mind is looping around because it feels uncertain?” If there is an action to take, take the smallest useful step. That might mean reviewing your finances, speaking to someone at work, booking an appointment, making a plan, learning a new skill, or having a difficult conversation. Action helps the brain register agency. If there is no action available, the task is different. The task is to help your nervous system step out of threat mode. That may involve reducing news exposure, moving your body, getting outside, returning to routine, connecting with someone steady, writing worries down rather than mentally rehearsing them, or deliberately bringing attention back to what is happening today rather than what might happen in six months’ time. This is not avoidance. It is psychological regulation. There is a difference between being informed and being flooded. There is a difference between planning and catastrophising. There is a difference between caring and absorbing more than your mind and body can process. Many people are also finding that work has become a major source of psychological strain. The pace is relentless, expectations are high, and the boundary between work and home is often blurred. For some people, AI has added another layer of unease: a sense that the rules are changing quickly and that they need to keep up, adapt and prove their value all at once. In this context, it is understandable that people feel pressure to be constantly productive. But high performance without recovery eventually becomes depletion. The mind becomes less flexible, less creative and less able to solve problems. Rest is not the opposite of effectiveness. It is part of what makes effectiveness possible. A psychologically healthier response to this period is not to pretend everything is fine. It is to become more deliberate about where your attention goes, what you allow into your mind, and what you do when your system starts to show signs of overload. That might mean asking yourself: What am I repeatedly consuming that leaves me feeling worse? What am I trying to control that is not actually within my control? What small action would help me feel more capable today? What does my body need before I ask more from my mind? Who helps me feel more grounded rather than more alarmed? These questions sound simple, but they matter. In uncertain times, people often try to think their way into feeling safe. But safety is not created only through thinking. It is also created through rhythm, connection, movement, sleep, boundaries, meaningful action and moments where the nervous system is allowed to stand down. If you have been feeling more anxious, overwhelmed or emotionally worn down, it may not mean you are failing. It may mean you have been carrying too much for too long without enough space to recover. The aim is not to become unaffected by the world. That would not be human. The aim is to stay connected to the world without being consumed by it. To care without collapsing. To plan without spiralling. To remain informed without living in a constant state of alarm. In a period where so much feels uncertain, protecting your attention, your energy and your nervous system is not indulgent. It is necessary.

Many of us engage in self-development to become better in some way, feel happier, or simply grow as people. Human growth can bring many benefits to our wellbeing and support our relationships with family, friends, romantic partners, and colleagues. At the same time, I have noticed a huge increase in self-development content across social media. It is encouraging that so many people want to grow and become the best version of themselves. However, much of this advice offers little guidance on how to decide what is actually worth trying. The volume of information can feel overwhelming. How do we know what is best for us? With so much content online, it can be hard to know which practices are most likely to help, and easy to jump from one shiny new idea to the next. Practice is exactly that: practice. We need repetition for a new habit or behaviour to become useful, just as we do when learning to drive, dance, or swim. The same is true in self-development. Qualities such as kindness, patience, and courage can be practised and strengthened over time. We need to stay committed, then review whether a practice is working for us, rather than moving on too quickly to something else that seems more exciting. When we constantly switch approaches, we may miss the full benefit of our efforts. As a clinical psychologist, I naturally prefer self-development practices that are grounded in science and supported by evidence. Psychology offers many useful tools and insights, and here I want to share two of my favourite approaches to wellbeing and personal development. One source I often return to is the work of Bronnie Ware, who wrote about common reflections she heard while working in palliative care. Although these insights are observational rather than findings from a formal peer-reviewed study, they have resonated with many people because they speak so directly to what matters most in life. Learning from others’ regrets: death as a tool for the living What might you learn from other people’s reflections about the end of life? If you looked back on your life today, would you do so with gratitude? Here are five reflections that Bronnie Ware says she heard repeatedly from people nearing the end of life: 1. I wish I'd had the courage to live a life true to myself not the life others expected of me 2. I wish I hadn't worked so hard 3. I wish I'd had the courage to express my feelings 4. I wish I'd stayed in touch with my friends 5. I wish that I had let myself be happier These reflections invite us to pause and ask what we might want to change while we still have time. What do you regret, and can you repair it? Can you make a change, work towards a life that feels more meaningful, or create more space for happiness and rest? What would it be like to share your feelings, even when that feels difficult? Could you reach out to the friend you keep thinking about? Many people reach the end of life feeling that they did not fully honour what they needed or wanted. So do not wait. Start now by building a life with more of what matters to you, even in small and simple ways. Very often, what stays with us most are meaningful experiences and time shared with people we love. These memories can become a lasting source of fulfilment. Above all, remember that the present is a gift. Treasure it. If you would like to explore this idea further, Bronnie Ware speaks about these reflections in the video below. https://www.youtube.com/watch?v=tAcQfn96yFk Gratitude There is good evidence of a positive relationship between gratitude and wellbeing. A 2023 systematic review and meta-analysis of 64 randomised clinical trials found that gratitude interventions were associated with better mental health, fewer symptoms of anxiety and depression, and more positive mood and emotions. Gratitude can also support your relationship with yourself and others. It helps us refocus on what we already have, rather than constantly reaching for something new in search of quick gratification. Gratitude can be a helpful antidote to dissatisfaction and fear. Our minds are naturally more alert to problems and threats, which is part of how we stay safe. Practising gratitude can gently shift our attention towards what is good, steady, and meaningful in our lives. This does not mean ignoring difficulty; it means making space to notice what is also supporting us. Ways to practise gratitude 1. Write a letter to someone important to you, even if you are out of touch or they are no longer alive. You can still feel grateful for what they meant to you. It is the process of gratitude that matters most. 2. Keep a gratitude diary in a format that works for you. It can be very simple. What matters is repetition and consistency. 3. Write a short summary of a good day and what made it meaningful. 4. Spend time remembering good experiences and allowing yourself to revisit them warmly. 5. Notice the small things in life: a smile, a kind touch, a quiet moment, or a call with a friend. These, too, are worth celebrating. https://pmc.ncbi.nlm.nih.gov/articles/PMC10393216/ https://www.sciencedirect.com/science/article/abs/pii/S0167494322000267

When people come to therapy, writes Dr Megan Patterson, they are often looking for ways to make sense of difficult experiences, overcome challenges, and create meaningful change in their lives. While therapy often focuses on thoughts, feelings, and relationships, I also draw on ideas from community psychology to understand the wider contexts that shape our wellbeing. One of the key ideas in community psychology is power. Power influences our opportunities, relationships, sense of belonging, and how we experience the world. Factors such as workplace culture, social expectations, discrimination, financial pressures, and access to support can all have a significant impact on mental health. This means that when we explore difficulties in therapy, I am interested not only in what is happening within you, but also in what is happening around you. Sometimes people carry a sense of self-blame for struggles that are connected to wider social or systemic issues. For example, difficulties at work may be shaped by organisational cultures, unequal power dynamics, unrealistic expectations, or experiences of exclusion. Within families, long-established roles, patterns of communication, cultural expectations, or caregiving responsibilities can also influence how people feel about themselves and relate to others. Recognising these influences can create space for greater self-compassion and a clearer understanding of the challenges you are facing. A community psychology perspective also encourages curiosity about difference and identity. We are all shaped by aspects of ourselves such as our culture, ethnicity, gender, sexuality, social class, disability, age, faith, and life experiences. These identities can bring strengths, resources, and a sense of belonging, while also influencing how we are seen and treated by others. In therapy, there is space to explore how these experiences have shaped your story, relationships, and sense of self. A focus on power also shapes the therapeutic relationship itself. Rather than positioning myself as the expert on your life, I aim to create a collaborative space where your experiences, values, and knowledge are respected. I also recognise that difference exists within the therapy room. We may share some experiences and identities while differing in others. Being open to these conversations can help create a relationship built on trust, respect, and genuine understanding. Bringing together community psychology and individual therapy allows us to hold both personal and social perspectives at the same time. We can explore patterns, emotions, and relationships while also considering the broader influences that may be affecting your wellbeing. This often helps clients develop a deeper sense of agency, identify sources of support, and make changes that feel both meaningful and sustainable. Therapy does not take place in a vacuum. By understanding the role of power, identity, relationships, and social context, we can work together to develop a richer understanding of your experiences and support the changes that matter most to you.

When anxiety becomes intense, the body can feel as though it has taken over. Your heart may race, your chest may tighten, your breathing may become shallow, your thoughts may speed up, and you may feel a powerful urge to escape, fix something, seek reassurance, or make the feeling stop immediately. This can be especially frightening during panic. Panic is not simply “feeling anxious”. It is a full-body alarm response. The nervous system behaves as if there is immediate danger, even when there may be no actual threat in the present moment. The body prepares to protect you. Adrenaline rises. Blood flow changes. Breathing shifts. The mind scans for danger. And because the sensations can feel so strong, many people then become frightened of the anxiety itself. One simple strategy that can sometimes help in these moments is the use of freezing cold water. This does not cure anxiety, and it is not a replacement for therapy, medical care, or longer-term psychological work. But used carefully, it can be a powerful way of helping the nervous system change gear when anxiety or panic feels overwhelming. Why cold water can help anxiety Freezing cold water works because anxiety is not only a thinking problem. It is also a body state. When you are panicking or intensely anxious, it is often very difficult to reason your way out of it. You may already know that you are not in danger. You may already have told yourself to calm down. You may already understand that the panic will pass. But the body may still be in alarm mode. Cold water gives the body a strong physical signal. It interrupts the spiral. It pulls attention out of racing thoughts and into immediate sensation. It can help slow the body down and create a sense of reset. When cold water is applied to the face, particularly around the cheeks, eyes, and upper face, it can stimulate what is sometimes known as the diving reflex. This is a natural physiological response that can help slow the heart rate and shift the body towards a calmer state. It is one reason that putting your face into cold water, holding a cold wet cloth over the face, or using an ice pack wrapped in a towel can sometimes help during panic. The key idea is not that cold water “solves” anxiety. It is that it can help reduce the intensity of the body’s alarm response enough for you to regain a little space, choice, and control. How to use cold water during panic or intense anxiety If you are feeling overwhelmed, try using cold water in a simple and safe way. You might run cold water from the tap and splash it over your face several times. Let the coldness be noticeable. Try to keep your breathing steady and allow your attention to rest on the sensation of the water against your skin. Another option is to fill a bowl with cold water and briefly place your face into it for a few seconds, then come up and breathe normally. This should not be forced or extreme. The aim is to create a strong sensory reset, not to push yourself into discomfort or prove anything. You can also hold a cold, damp flannel or towel over your face, especially around the eyes and cheeks. This can be useful if you are at home, in bed, or feeling too shaky to stand at the sink. Some people prefer holding an ice pack, a bag of frozen peas, or an ice cube wrapped in cloth against the face or neck. Avoid putting ice directly onto the skin for long periods, as this can cause irritation or damage. The cold should feel intense but manageable. Once you have used the cold water, pause. Let yourself notice what has changed. You may not feel calm straight away, but the panic may have dropped by 5 or 10 percent. That matters. In moments of high anxiety, even a small reduction can make it easier to breathe, think, and choose your next step. Cold water is most helpful when paired with psychological skills Cold water can be useful, but it works best as part of a wider anxiety management plan. After using cold water, it can help to say something steady and realistic to yourself, such as: “This is panic. It feels horrible, but it is not dangerous.” “My body is having an alarm response. I do not need to fight it.” “This will pass. I can let the wave move through.” The aim is not to talk yourself into instant calm. The aim is to stop adding fear to the fear. Panic often escalates when we interpret the sensations as dangerous. We feel the racing heart and think, “Something is wrong.” We feel dizzy and think, “I’m going to collapse.” We feel unreal and think, “I’m losing control.” These thoughts are understandable, but they intensify the alarm. Cold water may help bring the body down slightly. Then psychological skills help you respond differently to the experience. Together, they can reduce the cycle of panic. Using cold water for general wellbeing Cold water is not only used during panic. Some people find that brief cold exposure helps them feel more alert, grounded, and emotionally steady. This might mean ending a shower with a short burst of cold water, splashing the face in the morning, or using cold water after a stressful day to create a clear transition. From a wellbeing perspective, cold water can help because it brings attention into the body. It can interrupt rumination. It can create a sense of vitality. It may also build confidence in tolerating discomfort, which is psychologically important. Much of anxiety is maintained by avoidance. We understandably try to move away from uncomfortable sensations. But when we repeatedly avoid discomfort, the brain can learn that discomfort is dangerous. Gentle, intentional cold water exposure can teach the opposite: “I can experience strong sensations and remain steady.” This does not mean forcing yourself into extreme cold exposure. You do not need ice baths, endurance challenges, or dramatic routines. For many people, small and consistent practices are more helpful than intense ones. A simple cold water routine A helpful routine might look like this. At the end of your usual shower, turn the water cooler for 15 to 30 seconds. Keep your breathing slow and steady. Let your body feel the cold without tensing against it too much. Then return to warmth if needed. Or, in the morning, splash your face with cold water and take three slow breaths before starting the day. Or, during a stressful workday, run cold water over your hands and wrists for a minute while deliberately slowing your breathing. These are small practices, but small practices often matter because they are realistic. They fit into ordinary life. They can be repeated. They can become cues to pause, reset, and return to yourself. When to be careful with cold water Cold water is not suitable for everyone. If you have a heart condition, uncontrolled high blood pressure, fainting episodes, a history of seizures, breathing difficulties, or any medical condition that could be affected by sudden cold exposure, it is important to seek medical advice before using more intense forms of cold water practice. You should also be careful if cold water triggers distressing memories, panic, breathlessness, or a sense of being unsafe. The aim is to support regulation, not overwhelm the nervous system further. Avoid extreme cold exposure, prolonged ice baths, or holding your breath for long periods. More intense does not mean more therapeutic. For anxiety, the goal is not toughness. The goal is regulation. The bigger picture Freezing cold water can be a very useful short-term tool for managing intense anxiety and panic. It gives the body a strong signal, interrupts the anxiety spiral, and may help the nervous system shift out of high alarm. It can also support general wellbeing by helping you feel more grounded, present, and able to tolerate discomfort. But it is only one tool. If panic attacks or intense anxiety are happening regularly, it is worth looking at the patterns underneath them. What is your nervous system responding to? Are you under chronic stress? Are you avoiding certain sensations, places, responsibilities, conversations, or emotions? Are you becoming frightened of anxiety itself? Are you stuck in cycles of reassurance, checking, overthinking, or escape? Longer-term change usually comes from understanding the anxiety cycle and learning how to respond differently. This may involve CBT strategies, breathing retraining, behavioural experiments, compassion-focused work, acceptance-based approaches, lifestyle changes, and careful attention to sleep, stress, relationships, and health. Cold water can help you get through the wave. Therapy can help you understand why the waves keep coming and how to relate to them differently. Used wisely, cold water is not a gimmick. It is a practical body-based strategy that can help you create a pause when anxiety feels too big. And sometimes that pause is enough to remind you that although panic can feel powerful, it is temporary, survivable, and something your body can learn to move through.

There are times when it seems that hope is beyond our grasp. Times when sadness or disappointment, loss or hurt seem too strong and consuming to allow space for hope. When we have lost a loved one, we can feel lost and terrified, stuck in grief with all its emotions, the ‘frozen present’. We can feel challenged to the core – who am I if I am not, a partner, daughter, son; who am I without that friend; how can I live, if my child dies? It can feel impossible, as well as disrespectful to their memory, to look ahead, to consider the possibility of a future without them, to engage in life and hope for joy and happiness once again. When we have felt rejected by a partner, a boss, or a friend, it can feel like the rug has been taken out from under our feet. How can we feel anything positive when they have rejected us, betrayed us, devalued us? How do we believe in ourselves when it doesn’t seem others do? It is easy to feel defeated. When we have never experienced self love, the concept can seem illusive, even ridiculous. The idea of hoping for something better, a better feeling inside, a better response from others can seem unimaginable. And at a macro level, when the world seems so out of control, when our trust has been broken and ethics seem so absent, cynicism can seem the natural response. When we are bombarded everyday with news of hostility, hate and brutality; when the world seems such a frightening place, hoping for a better future can seem nonsensical. Hope is an act of will, a little act of resistance to negativity, a determination to take that step that seems so difficult, or to allow yourself to believe you could turn a corner. Hope is a feeling we carry inside, but its also active. It can be deciding not to have that piece of chocolate, or setting the clock to get up and go for that run, making that long overdue phone call to an estranged relative, believing that you will, in time have success with an audition, a job application, your search for a publisher; or it can be simply getting up out of bed, and engaging with the day. We humans are ‘intentional beings’; we are hard wired to look to the future. That can feel very frightening and daunting, but it can also feel exciting. We can decide to feel a glimmer of hope. We therapists are sometimes described as ‘hope merchants’; we hold the fundamental belief, that although loss and tragedy, disappointment and struggle are a part of life, we, you and I, each of us, have the capacity and resources to heal, to strengthen, to gradually allow in new possibilities. As Leonard Cohen so aptly tells us: “Ring the bells that still can ring Forget your perfect offering There is a crack in everything That’s how the light gets in”

World Meditation Day: The Quiet Revolution Inside the Human Mind By Dr Sarah Jane Khalid In a world addicted to noise, speed, and constant stimulation, silence has become rare. Yet science suggests that within silence lies one of the most powerful tools for psychological healing: meditation. Every notification, deadline, and unresolved thought places the brain in a continuous state of alertness. Over time, this chronic mental overload increases cortisol which is the body’s primary stress hormone. Cortisol affects sleep, focus, emotional stability, and even physical health. Meditation interrupts this cycle. Neuroscientists have discovered that regular meditation can calm the amygdala, the brain’s fear and stress centre, while strengthening neural pathways responsible for emotional control and self-awareness. In simple terms, meditation trains the mind not to react impulsively to every worry, fear, or distraction. Psychologically, this creates a profound shift. Instead of being controlled by stress, people begin to observe their thoughts with clarity. Anxiety loses some of its intensity. Emotional resilience grows. The mind becomes less crowded, less reactive, and more present. Perhaps the most remarkable finding is that meditation can physically reshape the brain through neuroplasticity. With consistent practice, areas linked to memory, compassion, and attention become stronger. Thus, proving that inner peace is not just a spiritual idea, but a measurable biological process. This World Meditation Day on Thursday 21 st May 2026 is more than a reminder to sit quietly for a few minutes. It is a reminder that the human mind was never designed to live in constant chaos. Sometimes, the most powerful transformation begins with a single breath. If you would like more information on mindfulness and meditation practice, please contact myself, Dr Sarah Jane Khalid, at Hampstead Psychology practice where I can support you to get started.