What Abi Taught Us (18 page)

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Authors: Lucy Hone

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Get out and get moving

I've long been motivated to exercise for my mental health more than for my physical health. I know how cranky I am if I don't get outside and move each day and I know, from the research and the empirical studies I've conducted, that exercise is the key to living a long and healthy life. I often quote Tal Ben-Shahar, former lecturer at Harvard and author of several books,
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who says that not exercising is akin to taking a depressant. That is, if you're not exercising you may as well be taking a pill that makes you depressed—that's how much difference not moving makes to our lives. The research is incontrovertible: exercise
is
medicine.
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‘Physical exercise contributes a great deal to happiness; in fact, there is research showing that regular exercise, three times a week for 30 to 40 minutes of aerobic exercise—could be jogging or walking or aerobics or dancing . . . is equivalent to some of our most powerful psychiatric drugs in dealing with depression or sadness or anxiety. We've become a sedentary culture where we park our car next to our workplace or take the train and we don't walk like our foreparents used to. Thousands of years ago
our foreparents walked an average of eight miles a day. How far do we walk today? Well, it depends on where we park our car. And we pay a high price for it because we weren't made to be sedentary. We were made to be physically active.'
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After Abi died, and with Ben-Shahar's words foremost in my mind, I knew that moving daily was more critical than ever. But, I was also fortunate enough to have studied exercise psychology, which is an entire field dedicated to the science of making exercise happen. That's right: while sport psychologists focus on how to make professional athletes be faster, quicker and stronger, exercise psychologists are chiefly concerned with how to get the rest of us off the couch and moving a bit more often.

I knew from exercise psychology that humans are designed to live outdoors in nearly perpetual motion. As Stephen Ilardi writes in his great book
The Depression Cure
, ‘human beings were never designed for the poorly nourished, sedentary, indoor, sleep-deprived, socially isolated, frenzied pace of twenty-first-century life'.
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Mechanisation has effectively removed the requirement for daily movement from our lives: we push buttons and flick switches to transport us from A to B, to wash our clothes, vacuum our floors, knead our bread, roast our food and even to switch TV channels. All of our clever inventions have engineered movement right out of our lives, so that our average energy expenditure per unit of body mass is now less than 38 per cent of that of our Stone Age ancestors.
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While Paleolithic man walked five to ten miles on an average day just to find food and water, very little in our 21st-century lives requires us to physically move, push or pull, hunt or gather. As a consequence of this, we are struggling mentally and physically and, just to make it harder
still, physical activity has become something of a choice. We have to opt in rather than opt out. For most of us, opting in is hard work; it's just not the obvious choice, particularly when we are grieving. But when we are stressed, we need to get out and get moving more than ever. Regular physical activity really is a magic bullet for mental health.

I'm not talking about running marathons—the type of physical activity that I'm talking about won't require you to don Lycra or join a gym. Just to get outside and move, for half an hour a day, in three ten-minute blocks is good. The research is undeniable: aerobic exercise physically transforms our brains and engaging in physical activity is the natural way to prevent the negative consequences of stress. What's more, while the evidence is relatively new, the psychological benefits of exposure to sunlight are also starting to emerge. Ilardi is big on green exercise: ‘Although simply going outside on a sunny day can brighten your mood, an even deeper link exists between light exposure and depression—one involving the body's internal clock. As it turns out, the brain gauges the amount of light you get each day, and it uses that information to reset your body clock. Without enough light exposure, the body clock eventually gets out of sync, and when that happens, it throws off important circadian rhythms that regulate energy, sleep, appetite, and hormonal levels. The disruption of these important biological rhythms can, in turn, trigger clinical depression. Because natural sunlight is so much brighter than indoor lighting—over a hundred times brighter, on average—a half hour of sunlight is enough to reset your body clock. Even the natural light of a grey, cloudy day is several times brighter than the inside of most people's houses, and a few hours of exposure provide
just enough light to keep circadian rhythms well regulated. But people who are inside from dawn to dusk often find their body clocks starting to malfunction.'
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But given that exercise is a choice, I'll be the first to acknowledge that it's not always the easiest one to make. People who don't know me well suppose that I love exercise. In some ways I do, but I also firmly, utterly loathe it too. I hate the moment the alarm goes off to tell me it's time to get up in the dark; I am full of self-pity as I go to bed and set that alarm; I'm often cross as I lace up my shoes; and if, for some glorious reason, I cannot locate my car keys in the morning, I'm only too happy to call the whole thing off and go back to bed.

REGULAR PHYSICAL ACTIVITY REALLY IS A MAGIC BULLET FOR MENTAL HEALTH.

These, according to exercise psychology, are my ‘barriers' to exercise. Others are: I just can't be bothered; I hate running, I'd rather have an extra hour in bed; I'm not fit enough to keep up with the others I run with; it's raining/cold/dark/too hot; I'm too hung-over; or, currently, I'm just too plain weary with grief. Yes, there are multiple barriers to exercise.

Just as there are barriers to exercise, there is also what is known as ‘enablers' to exercise—the things that motivate and enable us to get out the door. Running, for instance, is cheap (costs nothing aside from a new pair of shoes each year), it's efficient (all you need is half an hour to accrue a long list of positive physical and mental health benefits), it's social (the friends I run with can very often become the only friends I get to spend time with each day). In my case, it also involves being
outdoors. Best of all? All of the above apply to walking too. It's cheap, efficient, social and, ideally, outdoors.

Walking is my favourite exercise; it ticks so many boxes. Mostly I go with Trevor and Jack The Dog, but there are times when our circle of grief, the two of us, feels too small and claustrophobic, and I instinctively know we need the support and energy of others. That's when I'll text or call a friend, knowing we need company. There are other times, though, when I relish walking alone; it gives me the opportunity to think, to cry, and reflect on what's happened, what I'm feeling and how I'm coping. I use it as an opportunity to check in with myself.

If developing a regular exercise routine has been hard for you in the past, identifying your enablers to exercise is vital. Knowing your barriers, and finding solutions to them, or the enablers that outweigh them, is equally important. Consider what your personal barriers and enablers might be by answering the questions in the exercise below.

Embarking on an exercise routine when you are grieving might seem initially like adding to your burden, not helping. But remember I'm talking only about three bouts of ten-minute walking each day. Social support is also likely to be key when you're starting out. As Stephen Ilardi writes: ‘The depressed brain actually has an impaired ability to initiate activities, so those battling depression usually have a difficult time starting anything new. But they typically do just fine with a new activity if someone else can help them get going.'
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My friend Kate helped me get back into swimming. By driving me to the pool, understanding that there are days when I might only manage ten lengths, and turning it into an enjoyable activity rather than
a chore, she made this activity possible for me once or twice a week. I would never have kept it up without her.

If developing and sticking to a habit of daily physical activity has been a challenge for you, James Prochaska's change model may help you understand why you've previously fallen off the wagon and what you can do to stay on it. Prochaska and his colleagues identified that in order to develop a habit of any kind, people have to travel through five steps from 1)
precontemplation
(when we have no intention to change but the inkling of a thought is recognised) to 2) actual
contemplation
(when we first seriously consider changing a habit) to 3) progressing through
preparation
(when we consider the difficulties involved and perhaps crystallise goals) to 4)
action
(when the new behaviour begins) and finally to 5)
maintenance
(which involves us working out relapse-prevention strategies).
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SOCIAL SUPPORT IS LIKELY TO BE KEY WHEN YOU'RE STARTING OUT.

Their research also revealed two key pieces of evidence informing the successful adoption of an ongoing and ingrained habit of physical activity: first, that our readiness for making that habit occur is the vital indicator of success (that is, no one can be convinced to become a routine exerciser while they are still in the precontemplation stage); and, secondly, that before we can truly adopt a new habit and make it a permanent feature in our lives (i.e. reach the maintenance stage of the model) many of us have to pass through some of these stages many times. But—and here's the promising bit—each time we do so, we learn more about what successful change looks like for us individually. ‘Most self-changers
will recycle several times through the stages before achieving long-term maintenance,' says Prochaska,
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explaining that the development of a fully ingrained, sustainable new habit does not happen in one steady linear progression. His model resembles an upward spiral like a corkscrew. It is well worth spending some time considering which stage of Prochaska's model you currently sit at, and what it would take for you to move through to the next stage.

Exercises for boosting daily physical activity

In the professional development workshops I run, aimed at helping employees become more resilient, I use an eight-pronged strategy for boosting daily physical activity:

1. Work out what motivates you to move more by asking yourself the following questions:

•
Who do I want to do this for?

•
What difference will it make?

•
Why do I/they care?

•
How will I feel if I do manage to move more?

•
What is the consequence of not moving more?

2. Plan each week. This involves working out in advance the 4Ws of activity:

• W
ho are you going to exercise with this week?

• W
hen are you going to do that?

• W
hat activities are you actually willing to commit to?

• W
here will this happen?

3. Don't be put off by the word ‘exercise'. If it helps, stop thinking about exercise and focus on just moving more often.

4. Be flexible: there will be days when your greatest intentions are thwarted, and days when you just can't bring yourself to get out of bed. What small thing can you do on those days to keep the habit alive?

•
Walk to a local coffee shop mid-morning instead of driving.

•
Ask a friend to join you walking their/your dog.

•
Climb the stairs at work instead of taking the lift (when you've done it once, you're more likely to repeat that success).

•
Park as far away from the supermarket as you can, then walk.

•
Get the bus instead of driving to work.

5. Be kind to yourself: grief is exhausting and not the time to set yourself strenuous and unrealistic exercise goals. Do what you can: something is better than nothing, every time.

6. Sign up for an event to increase your motivation: find something that appeals to you and is manageable (perhaps a sponsored walk or cycle).

7. Buy a dog! I've long considered dogs one of the best wellbeing promoters there is: offering love, requiring walks, making us laugh, our dog has been such a compassionate friend and a fantastic antidote to grief.

8. Use a Fitbit to monitor your daily activity patterns. Using goalsetting and feedback software is a great way to boost motivation.

FUSING PHYSICAL ACTIVITY WITH SOCIAL CONNECTION

Dr Elaine O'Brien has for more than 20 years run her FitDance movement class based around her academic research into the importance of social fitness. Based on the principles of Positive Enjoyable Exercises Promoting Strengths (PEEPS), she has built and sustained a thriving community of exercisers aged 71–81 years old. When I first met Elaine, I imagined how much this vital, energetic woman must give to her group of aging movers and shakers. But, digging deeper for this book, I realised just how much of a win–win this class has been for her too as she watched her father die and tackled her bereavement.

‘That class has helped give my life meaning, purpose and has sustained me during my lowest times of bereavement and grief,' she explains. Based on the ‘moai' (an Okinawan practice whereby a group of good friends support each other, share life's fortunes and woes, and meet for a common purpose), FitDance is aimed at helping increase cardiovascular health, strength, balance, flexibility and core development. But, just as importantly, the social fitness underpinnings are expressly aimed at building and promoting kinship, camaraderie and support among attendees. ‘The moai is a safe place to laugh, cry, gain strength and give support. The moai in our FitDance programme offers an opportunity to confer, care and create a sense of purpose for each member of the group,' explained Dr O'Brien.

‘Many of the wonderful women in my dance/fitness programme have been widowed, some for many years. These vibrant, active older women have meaningful lives that connect
them to the larger world. I fully recognise that the relationships we have with others, our environment and our selves are a truly important part of the bereavement process. The women in my classes know that I love and care about them. Each . . . has been there for me, and has helped me through some of the darkest hours of my life. Many group members have been participating in the FitDance programme for from 5 to 15 years, and new members are always heartily welcomed into this whole fitness training. It has evolved into a loving, social support network.'

Dr O'Brien is passionate in spreading the word about the importance of PEEPS—physical activity as a positive strategy for life, making it enjoyable so that her participants want to return—and for building therapeutic relationships, and thriving individuals, workplaces and communities. ‘Being strong in mind, body and spirit offers a beautiful framework for resilience, helping lift us up, and cope through tragedy, bereavement and grief,' she concludes.

She also has these tips for people struggling to start and maintain a regular routine of being physically active:

• Ideally, exercise should have a fun factor to keep up the enjoyment, offer some challenge and encouragement, leaving participants wanting more. Making exercise play, and fun, will increase the possibility that you will continue on with building an enjoyable exercise habit.

• Practise self-care and self-compassion. Get rest, exercise, eat well, go out and breathe in fresh air, and take care of yourself. We need to care for ourselves, and then for others. Think
of the law of the oxygen mask on an airplane—fit your own mask first, then attend to your children.

• One of the best ways to sabotage an exercise habit is to start too fast or hard. Ideally, new and experienced exercisers need to listen to their bodies, take it at a comfortable yet challenging pace, be given appropriate movement modifications, build progression each time, apply a variety of forms of movement and consider balanced movement, of varying intensities (again building progression), for different time durations, at frequent intervals during the day.

• Make a date to walk, even better if it is with friends. When you walk, mix it up. Start with an easy warm-up, giving you and your friends time to visit, and after a set time period (five minutes), pick up the pace. You can start with even five seconds of higher-intensity walking—a faster, longer stride, with focus on posture and alignment. After higher-intensity walking for a bit, go back to a more moderate pace. Changing the movement packs a powerful punch, lifting up physical, cognitive and emotional benefits.

• Think of the activities you enjoyed as a child and see how those might be modified for you to enjoy right now.

• Remember that physical activity is at least as relevant to the mind as it is to the body—that might just motivate you more!
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