Transcript from Edge Talk on Resilience

KATE POUND:
Good morning everybody, welcome to this month's edge talk.
The Edge talks are delivered by the NHS Horizon team. We are a small team who
support large-scale change and build energy for change throughout the system. You
will know some of the work we do for the School of Health and Care Radicals and in
the recent Hackathon. We have also delivered the Edge, which you can join through
the internet.
Just to let you know, there are several ways you can contribute in this session. You
can get involved in the chat, and that is on the bottom right hand side of your screen.
Just type in and be part of the discussion.
You can also get involved via Twitter, using the #EdgeTalks.
We'll be feeding back throughout the session on what is happening in the chat and on
Twitter. You can also get involved in the discussion after the session, and that can be
through the School for Health and Care Radicals' and the NHS Edge Facebook
groups. For the School of Health and Care Radicals, you must send a request to join.
As you can see, there has been a slight change of plan. The teams had to be resilient
to change. Unfortunately, Jodie, one of our presenters has been unable to join us. So
Pip has taken up the reins today.
Our presenters today are Rosanna Hunt, Pip Hardy, myself chairing the session and
Hannah will be our Twitter monitor today.
How resilient are you feeling today? As we did in the School of Health and Care
Radicals, we have an icebreaker. We thought we would see how you are feeling today.
We have images where you can see how you are feeling. Are you ready to hide away?
Are you feeling overwhelmed? Are you coming out? Are you able to grow despite how
rough the territory is? Or are you ready to run this race? Are you on top of the world?
How are you feeling today?
If you look on the left-hand side of your screen, there is an arrow or pen, so you can
take either of those and Paul should have released your pencil, so you can make a
mark when you are feeling today.
Most people seem ready to run and take on the world. That is fantastic. I think I will put
myself… This is where I am. I am feeling on top of the world. I am ready for action
today. Really excited about this session.
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I love the icebreakers. It is great to see how different people are feeling. OK, Paul, if
you want to take the pens off and then we will move onto the next slide.
What I will do now is hand it over to Rosanna. I just have to go down the list.
Thank you. Thank you, Rosanna. I believe you have presenters right now.
ROSANNA HUNT:
Thank you. It is really nice to be here and talking about resilience. I work in the Horizon
team as a research associate. My work has been building new approaches. I have a
background in psychology and 11 years in the NHS, so I have some experience of
developing my own resilience.
This morning, what we would like to cover is some definitions of resilience, and also
looking in some more detail at the biology of resilience. What is happening in the brain
when fear is ignited.
We will keep this very practical as a session. There is some theory and evidence, but
mostly it is very practical. We have uncovered some approaches for developing
individual resilience. For example, I will be handing over to Pip to talk about how you
can develop individual resilience, but also to Ashok who is joining us from India and
has expertise in using mindfulness and meditation for developing resilience, and lots of
research to share this morning.
We will end the session with practical approaches for developing team resilience.
I see there's a number of attendees today from the School for Health and Care
Radicals, and you might remember Helen's session, where she touched on resilience
and mentioned the importance of connectedness for one's own resilience.
Developing our resilience as a group is something that can really help to build our
energy together. Do keep contributing to the web chat. Carol will keep an eye on that
and we will get some summaries on what you are talking about throughout the
session. Have a go if you have not already.
I picked up this definition of resilience. It will be interesting to see what words actually
jump out at you from the page. What do you resonate with from this description? This
is from Robertson Cooper and it highlights two elements of resilience. Being able to
achieve successful performance, and achieve positive well-being when there was
adverse conditions. But also when there is misfortune, change, or unexpected events,
to be able to respond to that and to adjust.
It is very much about being flexible. So, positive well-being has been picked out by
somebody already. Just put a note in the chat box to say which of those phrases really

sticks out for you.
I think one of the… "Recover," says Francesca.
I think I will go onto resilience and reframing. There is a lot of mounting evidence now
that shows some nations are actually populated with happier and more resilient
people. One nation in particular is Denmark.
Studies have shown that the Danish have a particular approach to raising their
children, which leads to more resilient adults. The key is teaching them to reframe
events, which at first might seem frightening. Take the encounter with the spider, for
example. Or with a dog. Do you go "Eek!" and protect the child for their imminent
survival, or do you help the child reframe the event and investigate the spider?
Eeyore is one of those characters who is constantly depressed, but is resilient at the
same time. He is able to reframe events and look for the positive.
Part of resilience is reframing and managing that tendency to leak into fight or flight
mode, when really, often the threat isn't actually to our survival. It is really just a primal
reaction in our brains that causes us to react in a fearful way. We will look at how that
affects the brain in a moment.
I think a common misconception about defining resilience is that it is about this Rocky
Balboa definition of resilience. It is about being able to be hit and keep standing, being
tough and immovable. It is not about being tough or immovable, it is about being
flexible.
Particularly when we have to react to change, it is about what Robertson Cooper
called bouncebackability. How quickly can you bounce back from a negative event? I
might go further and say it is about how you deal with that change in the moment, and
just notice your reactions to that event.
We do have this tendency as humans to catch fear from each other, or we feel, for
example, compelled to act quickly in a flight or fight situation. For example, that email
you wrote that maybe should have been left overnight before reviewing and sending it.
Resilience is about being able to adapt to change. I think many of us are actually
operating in an environment of perpetual change at the moment, and uncertainty.
I do not know if we have got the poll available? If it is available, it would be good to
hear. Or just write in the web chat some responses to that! How many of you are
operating in an environment of perpetual change and uncertainty in work at the
moment?

I think certainly there are certain aspects of resilience that are particularly important for
us to pay attention to, such as having a personal sense of purpose. Those are the
things that can help us to adapt to change.
Revisit those things and remind ourselves of what it is we are wanting to do. The poll is
available. I can start it. Polling notice!
So, to what extent do you operate in a state of change and perpetual uncertainty at
work? Your options are all the time, most of the time, sometimes, or never.
You have a minute in which to respond and we are starting to get some answers
already, which is fantastic. I have never done this before.
We have 50%, all of the time, 40% most of the time, some are in the lucky environment
of sometimes being in an environment of perpetual change, and absolutely nobody is
never in that situation. That is very reflective of the times in which we live.
Let's have a look at the impact of change on the brain. I find this interesting. This is
scientific evidence of where the energy comes from in our brain when we are
presented with an unexpected event or change.
There we go. When we do something fairly mundane, the activity is happening in the
basal ganglia. We take in new information, and we carry on with the example of driving
a car. When something comes into the road that is unexpected, we take in that new
information, match it against the old, and that happens in the prefrontal cortex, which is
where we are doing a lot of our thinking.
The prefrontal cortex is the whole front area of our brain. It is the most evolved area of
our brain. It is the rational thinking area. If something unexpected comes in then the
orbitofrontal cortex comes in. Thinking moves away from the rational areas to the
primal areas of the brain. And if there is a reason to be fearful, the amygdala is
activated. This area enables us to react quickly and emotionally to new and
unexpected information that poses a threat to us and drains all the energy from the
prefrontal cortex.
When you are in a fear zone, it is not possible to think rationally, and the emotions are
associated with fight or flight. We will not respond to this, we will just think emotionally.
So when we are confronted with a threat to our survival, we find it harder to think
rationally. We have to activate some individual strategies for developing our resilience
and moving the energy back into the rational thought area.
Let's share our strategies for getting into the rational thought zone. Use the web chat
to share your strategies.

While you are having a think about that, I will share a little recent story – it was about a
few years ago now. I was confronted absolutely with the awareness that I was going
out of the rational thought zone and into the fear zone and had to have a strategy for
thinking rationally.
I was threatened with redundancy and put at risk for several months, but then one day
a letter arrived and said, "Actually, no, you are not going to be made redundant, you
are going to have another year of funding."
I immediately thought of all the threats to my survival and couldn't think rationally about
how I was going to handle that year. I realised quite quickly that this reaction was
actually going to affect my own health, and it was not going to be helpful to my future.
I decided to sit down to work out my short-term goals and come back to my purpose –
what does this new environment sent to me in terms of opportunity?
Literally within weeks, I found a secondment opportunity that enabled me to achieve
the purpose that I felt was right for me at that time.
Wonderful comments coming through about reframing in the moment and sharing with
trusted friends, building social energy, I suppose.
Thank you, everyone, for sharing. I'm going to hand over now to Pip.
PIP HARDY:
Thanks, Rosanna.
It is really nice to be here this morning.
I thought I would start off – I know that Rosanna has already spoken about how we live
in a world of change, but I was thinking that it is not really just a feature of our times.
Change is pretty much constant.
The Greek philosophers talked about everything being influx and the Buddha spoke
about needing to reduce suffering by accepting change.
As Ben Franklin said, there are a couple of things that are definite. One is death and
the other is taxes. Set in the context of those things, we can think about change.
This is a lovely picture. Carol, you might appreciate this. I noticed your comment about
photo walks. It reminded me of how the leaves fall from the trees in order for the trees
to rest and regenerate in order for there to be blossom in the spring and perhaps fruit
in the summer.

We need change. It can sometimes be scary and unpredictable and uncertain, but
actually it is just there, all around us. Sometimes it can be really helpful to think about
the positive aspects of change.
I work a lot with stories, as some of you may know, and I think this is a lovely quote
from Tolstoy. He talks about the great literature that we all love is only one of two
stories – either somebody goes on a journey or a stranger comes to town. My
interpretation of that is that either we go in search of change, so we take a vacation
always start a new job or move to a new town or we begin a new relationship, or a
stranger comes to town.
It may be a welcome change. The person could be the love of our life. Or it may be
less welcome, it could be illness, redundancy, or any of the other challenges we face.
I think those are some of the things we are talking about, certainly in the School for
Health and Care Radicals.
There is something about trying to balance the good changes with the changes that
are often imposed upon us.
This is quite a famous model of change and transition, and I think it is quite a useful
one to help us understand how we actually deal with change. If something is changing,
we are in one situation, and at some point that one situation or state of mind or state of
being is going to finish and we are going to have to make an ending and let go of the
past situation.
I find it quite helpful to think of this like a river that you have to cross, and only when
we have actually gone through the feelings, which may be feelings of shock or anger
or despair, denial or disbelief that a change is happening, and it may take time to
become accustomed to the new state of affairs, to the new job, to the new baby, to the
new house, to the new town.
But at some point we do actually cross over this neutral zone and we find ourselves
able actually to make a new beginning.
There are various ways we can do this. I don't know, many of you may be familiar with
cognitive behavioural therapy, which is a common way of helping people address
issues they may face in terms of if people are feeling anxious or depressed or
concerned.
I had the good fortune to have some CBT a few years ago when I had had a really
challenging couple of years both personally and professionally, and this was one of the
things I found most useful. It is the A&E activities monitoring sheet.

I'm sorry this is so small. When I put it into PowerPoint, it insisted on doing this tiny
thing. Hopefully you can see across the top the days of the week, and next to each day
a small A and a small E, and down the side, the vertical axis, there is just morning,
afternoon and evening.
The idea is that for a week you monitor your activity. In the morning, for example, you
might get up and have a cup of tea and a shower and then you may drive to work. You
can rank those things on a scale of one to 10 in terms of their enjoyment or your sense
of achievement.
Generally, having a shower and brushing your teeth, you may have a great sense of
achievement or accomplishment, but they may not be particularly enjoyable. Later in
the day you may be able to go for a walk and that could be a lovely thing to do in terms
of enjoyment but maybe not high on achievement.
By the end of the week you can notice how many things you do that you enjoy and
how many things you do that you have a sense of achievement. When I was doing this
in my first week I took it back to the CBT therapist and he said, "You don't seem to be
spending much time doing things you enjoy. Next week, come back with many more
high scores in the enjoyment ranking."
Just having somebody say that made a great difference. The result was that I also
ended up feeling a greater sense of accomplishment or achievement by doing things I
enjoyed, and gradually I felt better.
It seemed like a really practical thing that people might enjoy spending some time
doing at the end of each day.
Another one of the things you can do to actually build resilience is to develop or
cultivate a sense of gratitude or appreciation.
If I can stop myself and change my mindset to something that I feel grateful for, it could
be a beautiful spring morning or an unexpected daffodil… This is my little
granddaughter, who was staying with us last weekend. It is very easy to feel a sense
of gratitude for the little people in our lives.
I have often found that a really helpful way to develop resilience.
This is another thing Kate and I were talking about last night. She said she always
finds it useful to have a 'heart sing' project on the go. I like gardening so that is a
project that always makes my heart sing.
Another project I have enjoyed being part of over the past three years is the School for
Health and Care Radicals.

In among all of the other things you do at home and work, try to find a project that will
really did you joy and a sense of accomplishment.
This is something that was said to me by a Vietnamese acupuncturist. She said to me,
"You need to think of your work and think of how you do your work, and think about
your heart as a muscle that needs to contract but also needs to relax. If it doesn't relax,
it can't continue to do its work." She said, "between every patient I take 5 minutes to
walk around the garden, and that allows me to relax before the next patient."
Even if it is just a few moments, give yourself, your mind and body an opportunity to
relax a little bit so it can do the next bout of work more effectively.
We had a storytelling workshop here this week, and one of the participants told a story
about the challenges that she faces as a change agent and how she often ends up just
taking everything on and then becoming exhausted and burnt out and realising she
can't do it all herself.
It can be a really helpful thing to ask for help, to muster your resources, get your
networks, surround yourself with the people who can help you to accomplish your task.
This is a picture of a barnraising in America. If you try to build a barn by yourself, it will
take weeks, months, possibly years, but if you gather the community around you, you
can often do it in days.
An American colleague of mine says that "every day, I only have three or four things
on my to do list, and one of those things is to eat lunch." That's another really good
principle to follow when you are trying to build your own resilience. Make sure you take
a break, have some lunch, and try to limit the number of things on your to-do list.
It would be lovely, I think, at this point, if you could take a bit of time and put some of
your thoughts in the chat box about what you do to build resilience and share some of
your own experiences with us, with the rest of us.
Put a few things in the chat box about what you actually do to build your own
resilience.
I'm sure some of you must be doing something to be resilient.
Small to do lists – yes, a good thing.
Focusing on how lucky we are – that's a lovely way of expressing gratitude.

Breaking big things down to little ones.
Taking breaks.
Going for walks – I'm with you, Tony, on that one, definitely.
Doing things like tai chi. That is a great opportunity for relaxing and developing your
strength and your flexibility and your balance.
OK, so, people are obviously finding physical activity and doing exercise of different
sorts… Those are really helpful suggestions.
Just a final slide from me. Do keep on putting your ideas in the chat box, please.
I have to briefly talk to you about the last slide, which is about your five-a-day building
resilience. First of all, making connections. Connecting with people who are your
friends, loved ones, your family.
You are active. A lot of you have talked about the need to be active, go for a walk, do
dancing, take exercise, do circuit training, run 10K. Whatever it is you do to get
yourself out of your chair and doing something outside.
Take notice of small things. Be curious and investigate the little things. Look at flowers
and start to smell the roses. Try and be curious about your friends and colleagues, and
what they are doing. Notice how things change. Try to pay attention to each moment
and savour the moment before each one comes.
Then the next one of your five a day is try to keep learning. It can be incredibly helpful
in terms of building your resilience to take a course, do something different, push
yourself outside your comfort zone. Learn to do ballroom dancing or computer
programming or coding or a new kind of cooking. Maybe you want to learn to do Thai
cooking or learning to cook at all. Anything at all that will keep your mind active and
engaged in a new opportunity to do things and look at it differently.
Finally, the last of the five a days is to practice giving and generosity. It may be giving
of your time, your money, or your skills. But try to find somebody who will benefit from
something you have to offer. You will discover or rediscover how lovely it can be to be
generous with your time and talents.
That is all from me. Thank you for listening and for your comments in the chat box. I
am now going to pass the presenter's rights over to Ashok.
ASHOK GUPTA:
Hello, everybody. You can all hear me clearly now? Thank you so much to Kate,

Rosanna and Jodie and Pip for inviting me to talk about resilience. I have enjoyed the
presentation so far. It has been fascinating. It is great to be with you all.
I am here in India at a large gathering of people meditating together. I am about to go
to a big airfield with 3.5 million people meditating, so it will be great. It has been a
really eclectic day today.
I run a clinic specialising in treating stress illnesses. ME, fibromyalgia and anxiety. I
myself suffered from ME and chronic fatigue syndrome when I was at university. I got
myself into quite a mess. I had to degrade one year at university. It was a very difficult
time.
I went on a journey of trying to understand what this was about. I am sure some of you
as practitioners in the NHS will have come across patients who suffer from the
disorder. It is very difficult to treat. I did a lot of research myself into the brainology of
the illnesss, and I got myself well. I opened up a clinic to help others with the condition.
I published a couple of papers on the brain neurology of chronic fatigue syndrome.
In 2007, we published a home study course, so now we have patients all over the
world who have DVDs and videos on how to get better from the condition. We also
have webinars. We have practitioners all over the world to treat the patients.
We have had a couple of small research studies which have had positive effects on
the tools I am about to talk about. That has been very positive. We are looking to raise
$200,000 for a large-scale clinical trial either within the NHS or outside. We are looking
for partners.
That is the background to myself. I will now talk about some of the research around
mental health problems people currently face which reduces their resilience, and some
tools and techniques that can practically help us develop that resilience.
It is like Rosanna said - what are the issues in the mind and brain and how do we
focus the tools and techniques to target those particular issues? I will share with you a
couple of interesting studies.
The first one was by the BBC in association with the University of Liverpool. One of the
largest studies on anxiety and depression, which is the two most common mental-
health conditions people experience. In fact, the World Health Organisation estimates
that by 2020, depression will be the biggest illness in the world that people face. That
is shocking.
This study looked at 42,000 participants, looking at the life events, experiences, etc.
The study found that the biggest predictors of anxiety and depression or any kind of
mental conditions was to firstly dwell on negative thoughts, and secondly self-blame.

Which is really fascinating. Whatever we have been through in life, and the common
ones were trauma, childhood abuse, bullying, etc, it was not the events or
circumstances in our lives, or even current circumstances which determined levels of
mental health. It was dwelling on negative thoughts and self-blame. This was such an
interesting and definitive study, because it was such a large number of participants. It
did back previous research.
Essentially, we are saying the nature of the mind is by default to dwell on the negative.
That is one of the aspects of our mind. A default setting of our mind. The mind keeps
going into the past or the future. When the mind goes into the past, it dwells on things
we're angry about, things we regret, things we're sad about.
When our minds dwells on negativity about the future, it tends to go into fear and
anxiety about the future. Generally, our mind goes to negativities about the past or the
future. That is the biggest predictor. If we can understand that and control that, that
would be the holy grail of mental health.
The second aspect is self-blame. Self-blame is looking at actually how we put
ourselves down and we are negative on ourselves, and that can be a big predictor of
mental health issues. Low self-esteem, or what I like to term "low self-love", which can
be different.
Sorry, someone is just asking about 'understand and control'. Understand and control
the dwelling on the negative thoughts that go into the past and the future.
That is an interesting start for us. The second study which I would like to share with
you was a study which I think should have made international headlines. I think, once
again, it's a landmark study. This was a study that was missed in the journal Plus One.
It was 5000 participants going through a stress resilience training course.
The first bullet point, and I don't normally like having lots of words on a slide, but this
was fascinating to me. Stress-related illnesses, such as anxiety and depression, is the
third-highest causes of health expenditures in the US.
This shows us this is not small things we are talking about. This is large-scale
expenditures in the health services.
The second point. "Over 90% of people suffering from stress seek help from primary
care, and these can comprise 70% of a physician's caseload. In 80% of patients
presenting to general practice they lack evidence of resiliency to psychological stress."
This is an incredible statistic. It shows that the vast number of illnesses that present
themselves to the GP, the GP cannot do much about it. They can give treatments to

relieve pain or other aspects of the conditions, but most GPs realise that those
emotions are the underlying consequences of stress, anxiety, and depression. They
cannot target them in a five-minute consultation.
The most important statistic: those 5000 participants had an average reduction of 43%
in their use of healthcare services in the year after participation.
Imagine there was a pill that could reduce general healthcare use by 43%. It would be
the miracle cure of the century. And now we have the clinical evidence that supports
that. We have this landmark study.
What were the two aspects of this resilience training? Number one was relaxation. The
second was resiliency training. I will skip forward a few slides here.
This shows us that the way we develop resiliency, I see it as the wings of a dove.
There are many practitioners focusing on one or more of these. When we bring them
together, they can work powerfully together.
One of the wings of the dove is what Pip was talking about. Developing cognitive skills
and positive psychology. Normally, we are engulfed with our mind and moving around
with our mind. It is controlling us. But if we can take a step back, we can consolidate
our awareness within our prefrontal cortex and observe what is going on in our
emotional minds. We will be able to temporarily dissociate, observe what is going on,
and refrain those experiences. We will shift perspective. The second aspect of
resiliency training is meditation and mindfulness. Stimulating the deeper relaxation
response. If we have one of those things, certainly we can reduce our stress, but I do
not think it is the whole story. When we combine together, it is incredibly powerful.
If a dove was using both wings, sure it would be able to fly, but it would not have
direction. The tail feathers represent purpose. Giving our lives purpose. Engaging our
minds with a positive activity of being of help and service to people around us.
Expressing gratitude through a sense of purpose in life. That is also something we can
develop.
But in primary and secondary healthcare, those two wings of the dove, if we were to
develop themselves across ourselves as practitioners, but also to the wider
community, what an impact we would make.
I will go back to this lead. A reduction of 43% in the use of healthcare services. This
backs up the positive results of meditation and mindfulness.
Looking at some of the positive clinical effects of meditation, we know that people who
regularly meditate have reduced stress, anxiety and depression. We will know that just
as I showed you that analogy of that diagram Rosanna showed us, our prefrontal

cortex, when we regularly meditate, is better able to control the responses of the
amygdala. The rational thinking brain becomes stronger and decreases activity in the
amygdala. That is very exciting.
Secondly, we know there are physiological brain changes. Increasing grey matter
volume and other changes we can detect. Meditation is not just a nice thing to do. We
now notice the exact effects it has on the brain. It changes gene expression and
boosts the immune system. It reduces inflammation. We know a lot of modern
conditions are being triggered by too much of an inflammatory response in the body.
And that last statistic - heart attacks, strokes and cancer are the biggest killers. We
know people who regularly meditate have a 66% decrease in heart attacks and
strokes.
Meditation and mindfulness has a huge amount of research behind it. It was a joke, we
would see it as a miracle drug. But it is available to us for free and has very few
negative effects, if any.
So we are mentioning that we love how plastic the brain is. This idea of neuroplasticity,
we used to think the brain was very fixed. But we know that the cognitive processes
and regular meditation, we can take advantage of this idea of neuroplasticity to rewire
our brains.
I have been excited. If we can somehow distil all this knowledge and research into a
kind of pill, the aspects of a pill that it is easy to access, consume, and we know it has
the clinical effects.
What I have developed is an app. This part of my business is a social enterprise. This
is a not for profit app. It is called the Meaning of Life Experiment. Within this app, there
are 30 meditations and short mind exercises. A lot of 10-20 min meditations, as well as
30 videos.
There are lots of engaging videos, and the idea is it is a 30-day experiment. Every day
you take a 10-20 minute meditation. You watch a video and you answer some of those
questions. It takes around half an hour each day.
"I can't do 10 minutes." Within the exercise, there are 3 minute meditations, 4 minute
meditations…
This is just my clinic giving back. We wanted to create an app that was easily
available, that was free, and could take all the different mind tools that we need for a
calm and happy mind.
We thought we could create an app that was a nonbranded app that any organisation

could take and present to their employees.
Something I have been speaking to Rosanna and Jodie around is could we create a
beta app for NHS staff? Could we put it out there and see what people's experiences
are? Could we create a study where you take 1000 nurses and doctors might test
them on various aspects of their lives and visiting healthcare, get them to use the app
for a few months, and then test them again to see what research evidence comes back
to support the use of this app.
If we test this with actual NHS staff and they start noticing the benefits, they are more
likely to share that with patients. From then on, because we have the clinical research
around meditation and mindfulness anyway, could we actually create an app that we
can give to patients? Could we, in the longer term, reduce NHS costs by bringing
resiliency training to the mass population?
NHS costs, as we know, are skyrocketing. We as a society can't afford the healthcare
costs of the next 20 years, because of an older population as well as increases in
levels of stress and depression in the populations. Can we create a tool that can
actually reduce healthcare costs?
Other aspects of resilience – sleep research is an important part of that, and within the
app we have different meditations that can help you to get back to sleep. We have got
people who have never been able to meditate because they think their mind is too
anxious. When they have used these, they have been able to get back to sleep.
I specialise in creating meditations for people with busy minds who thought they could
never meditate. Obviously physical exercise is something that we know can help with
resilience as well.
Somebody is mentioning staff sickness. Absolutely. We know that within social
services, within the public sector, the levels of absence, of sickness are actually higher
than the private sector. The levels of stress are higher. That is why all of these tools…
First and foremost, they could have a massive effect on current staff.
Certainly I would encourage you to download the app and have a play with it and give
me your feedback, because that would be really interesting for us as a starting point
because we're looking to take the app to the next age. We have got about 7000-8000
people using it so far, but the current version is available.
Or there is a facility where it asks you how you are feeling. You might say you are
feeling happy or sad or stressed. Depending what you click on, it then presents you
with a short or long exercise you can do to help you with that particular mood.
For me, this is all about putting this out there. There is not a profit stream on this. That

is why, for the NHS, it would be interesting to take some of the content we have spent
the last couple of years developing and actually creating one that is NHS branded and
saying, "This is a beta test, let's see what people's responses are."
If you want to access this online, we have also got a website –
www.themeaningoflife.tv.
The life purpose videos are there at the end of the experiment. If people are not feeling
a sense of purpose, these videos really help them to reconnect with that.
Somebody mentioned the idea of 'dementis'. Resilience is our ability to cope with
stresses, people and situations that present themselves. With people, it is all about
developing that sense of stillness and centredness and strength, to not allow their
negative energy to affect us, and with situations, as people have said, it is the ability to
take a step back from the situation and, for instance, to understand that it could be for
our growth or some other kind of reframing around that.
Just to end my session, I thought it would be useful to give you a couple of takeaways.
I could take you through a five-minute guided meditation, but I know that meditation is
something which now is very easily accessible to most people, and if you download the
app, there's tons and tons of meditations on there.
Rather than that, I thought I would take you through a tool I have developed. It is called
the new groove technique. It is a very short technique that can help us reframe a
particular person or situation that we are going through in our lives right now that easily
gets us into a positive state.
I thought I would give you a very practical tool to take away, and hopefully you will
have a chance to experience the guided meditations on the app.
First of all, I want you to think about a particular situation in your life right now that is
causing you a lot of stress. It might be that you feel unfulfilled in your career or it might
be a particular difficult person you are working with right now or a difficult personal
problem that you are experiencing.
The new groove technique – each aspect of the four stages we will go through begins
with S. They are 'stop', 'surrender', 'shift perspective' and 'substitute'.
If you like, we can do this with our eyes closed.
If we just close our eyes and let's take a slow, deep breath in.
Then breathe out.

Once again, I would like you to think about that particular situation, that negative
situation that you are finding difficult in your life right now, whether it is something small
and local like a difficult personal situation or a person you are finding it difficult to get
along with, or whether it is a difficult problem in the longer term. But something that is
causing you stress or anxiety or sadness right now.
The first step of the new groove technique is first of all, in your mind, to take that
moment to just stop and take a slow, deep breath in. If we just do that, if we just
imagine the word "stop" in our mind, take a deep breath in… With a smile…
And as we breathe out, the second letter S is "surrender". Breathe out and imagine
you are surrendering and letting go, which means bringing your mind to the present
moment and releasing the stress and surrendering it.
Some people find it easier to surrender to somebody they see as love. It is letting go to
something that represents love and gratitude.
Keeping our eyes closed, we will repeat that process. Imagine, after this webinar,
something is really stressing you out. You just imagine interrupting that flow of thought
by saying, "stop" in our mind, take a deep breath in with a smile, a big breath in, hold it,
and then we breathe out with a smile and just imagine surrendering it to a sense of
love and gratitude.
Keeping our eyes closed, the third S is "shift perspective". Looking at this personal
situation or problem we are facing, how could we change that problem into a challenge
instead? How can we shift perspective to look at this situation differently, from a
positive perspective? What is the positive in this situation? What is something positive
that could come out of this situation? How could we reframe it in a positive way?
Just spend a few seconds thinking about how you can shift perspective on this
experience.
We can be really creative in how we think about shifting our perspective and looking at
it differently.
Once we have now got that new perspective, if you haven't got a new perspective, one
of the global perspectives we can take is that every challenge that comes to us can be
seen as helping us to grow in some way.
Nobody ever became more resilient by having a happy, easy life. We develop
resiliency and grow when we meet those challenges because it forces us to become
more resilient.
How could this challenge actually help us to grow in some way? Where is the growth in

that situation? That is the global shift.
Finally, the fourth S is "substitute". Thinking about a person, situation or challenge.
Armed with this new perspective you have got now, how do you choose to feel in
relation to this personal situation?
You might have some personal affirmations, such as "I feel calm and relaxed in the
presence of this situation. I choose to feel calm around this situation. I choose to have
a new perspective and a positive attitude to this situation."
Now, we will install that into our bodies and really imagine what that feels like. Imagine
you have fully taken on this new perspective and new way of thinking about the
situation. Take a slow, deep breath in.
And with a smile, as you breathe out, relax your whole body. Keeping that gentle smile
on your face, imagine holding on to how you choose to feel in that situation. How does
your body feel, how does your mind feel?
Say in your mind those affirmations, such as "I feel relaxed in this situation. I know I
can handle this situation now. I choose to look at the opportunities for growth."
In your mind, say those affirmations. Remember the smile.
OK, great. Keeping our eyes closed, we will repeat those four steps of the new groove
technique, all beginning with S.
We might think of the same problem again. Imagine you are having those lost,
negative thoughts about that problem, situation or person. A lot of negative thoughts
running around. In our minds, we say "stop". Take a deep breath in.
With a smile, just surrender and let go of all those worries and cares to a
representation of love and gratitude.
Now with the third S, reflect on how you can think about this situation differently.
And the fourth S, take a deep breath in. As you breathe out, physically and matching
your whole body and mind has taken on this new perspective and, out loud or in your
mind, you can say some sentences and affirmations that summarise how you want to
feel in relation to this personal situation. Really imagine feeling like that. With, "I am", "I
feel" statements.
Good. So, let's take a slow, deep breath in. And let go.
And when you are ready, you can just gently open your eyes.

OK. Great. Just to finish off, I hope you will get an opportunity to have a play around
with some of the videos and meditations within the app. I am very excited to speak to
anyone who would be interested in white-labelling it, creating it for a particular group of
people or NHS staff, and offering these tools to the masses. This would not have
worked 20 or 30 years ago. It would have been seen as far too alternative and strange.
But the time right now is ripe. Ideas around meditation have become mainstream.
People are open to it. These tools and techniques can create a change in the way we
deliver care and shift emphasis to preventive health care.
People on the planet will produce more resiliency, reduce their stress, and reduce their
spiralling healthcare costs. It has been exciting to share this information with you.
Unfortunately, I have to leave very shortly. But if there were any questions people have
around resiliency or meditation or anything else I have shared... Kate, I don't know if I
have time to answer questions or if you need to move on?
KATE POUND:
Thank you, I think we will take the questions if you have to go. If you can pass the
globe over to me, we can certainly keep a record of any questions if you have already
left the room by then. Thank you, Ashok, for that.
I was reminded of that phrase, "Change starts with me." I wonder how many people
were able to work through that new groove technique without having a quick, sneaky
look at the emails coming in.
We work in an environment that is very much about multitasking. It is the complete
antithesis for us. And I think that, across the organisation, to stop and do one thing is
something we do not necessarily have practice at.
It strikes me that so many organisations are investing in this. Warwick University now
runs guided meditation for staff and students. Dame Carol Black did a review of health
at work in 2008, and found that being invested in employee health and well-being is on
the rise. We are more productive when we are in good health. The Department of
Health has shown that productivity is 20% higher when that is the case. Organisations
are beginning to see, and have been for some years, that it is worth this kind of
investment.
I would absolutely love if, as John said, just imagine this happening at every trust. You
have already said, Ash, staff sickness is high in the NHS. It would be a great place to
start with NHS staff.
I will move onto practical approaches for developing team resilience. I will refuse to
approaches. But I am sure those of you who are working with the app team has

employed various approaches. I would love you to be able to share those.
We need our resilience to change the world. If we can build resilience together, we will
achieve greater connectivity than before. Plus, it makes it more socially acceptable, I
think, to focus on resilience and take this as a priority in our lives. Not just something
we do when we finish work, or the alarm clock goes off in the morning. We do some
meditation before we goes to work.
Let's look at a couple of approaches. The energy for change approach is a way to
measure a team's energy when a new event or change comes our way.
I have put some instructions here just to keep this very practical, in terms of how you
would access this as a group. So, the five images that are measured are
psychological, spiritual, social, intellectual and physical. Those of you who are in the
School will have had some exposure to this through the School for Health and Care
Radicals in February.
The central energy is about resilience. When psychological energy is low, we are in
that sphere. We think that change poses a threat to us. But when psychological energy
is high, we're feeling safe in the environment.
In terms of spiritual energy, we need to make sure that we have a sense of purpose,
and what Ash has suggested is we look back at our life purpose and so on. But this is
also about developing that in a team way. Looking at how you can develop spiritual
energy and how you can develop your sense of shared purpose. Maybe that is about
being honest about your purpose, and adjusting the change and integrating change
into our shared purpose.
'Social energy' is very much about doing this as a group and building a sense of
connectivity and solidarity. 'Intellectual' is developing what is the reason for doing this
change?
'Physical energy' is about putting the energy behind it, but also managing physical
energy and making sure we are taking those lunch breaks that are needed and we are
also taking the time to do physical exercise and to look after our nutrition.
I think people have made comments about physical exercise and nutrition as a way of
maintaining resilience as well.
A team can measure their energy as a group. Use a questionnaire that is available
online.
Just as becoming aware of physical energy, you can start to address those things. As
a group, if our energy is low because we have social energy, then we can put some

things in place to build up our sense of solidarity. And also psychological energy, you
might look at doing some team exercises around strength, for example. I will go on to
that in a moment.
With the energy index, you can pick it up and it is free, as Ashok's app is free.
The second tool I would suggest is the Strength Finder from the Gallup organisation.
They say 33% of people are engaged at work. I'm sure you are all hearing similar
kinds of statistics. There is some evidence from the Gallup organisation that if we look
at, as a team, at developing and understanding what strengths we bring to the team,
then we can build our resilience to the future and to changes.
These strengths finder measures individual strengths on individual categories. I will
pick up a few to describe to you. A few are particularly pertinent to us.
One is the achiever, which is people who are exceptionally talented in the achiever
theme work hard and produce a great deal of stamina. They take immense satisfaction
in being busy and productive.
I think quite a few of us are also connecting with the connectedness definition, since
we are working together on the School for Health and Care Radicals and taking part in
webinars together to extend our learning.
People who are exceptionally talented in the connectedness theme has faith in the link
between all things. They believe there are few coincidences and almost every event
has meaning.
That is a couple of examples. There is one which does not show up on here, which is
on the bottom, which is the 'Woo' one. I wanted to describe it because Kate is
particularly interested.
Woo stands for something. It is about loving the challenge of meeting new people and
winning them over. We derive satisfaction from breaking the ice and making a
connection with someone.
These are all strengths that individuals hold that they can bring to work, but you may
not even necessarily be getting an opportunity to exercise this strength. So, using
these measures and engaging in some team exercise where you share what your
strengths are, you can look at how you can build up your strength. The opportunity to
use your strengths at work, as I am sure is obvious, if we are going to build up our
strength and resilience together at work and build up our energy and passion for the
work, we have got to be able to be in a position where we are using our strengths and
getting some kind of recognition from others as well, that our strengths are
appreciated.

So, I note we are nearing the end of our webinar this morning. We will go over to Carol
in a moment to summarise some of the web chat and let us know what has been going
on on Twitter over the last hour or so. But before that, it would be good to hear from
participants about whether you have any team initiatives you have undertaken to build
resilience together.
If you could use the web chat again to share that.
The Strength Finder is from the Gallup organisation. You can find the questionnaire
online. I think it costs 10 American dollars or Australian dollars.
I think it is called the comfy chair exercise. Members of the team will take turns being
in the chair.
Then talk about in what situations at work you get to use your strength and where you
might get more experience.
Then you go to the other group members and they say what specific occasions they
have seen you use your strength in the workplace. You can also go around and say,
"What cheeses this person off?"
Then you get to say, "Are you right? Are those the things that annoy me?" And you can
take turns being in the comfy chair.
You can also do a little bit of brainstorming as a team. Sometimes environments are
not conducive to our strengths, but what can people do to create a work environment
that enables them to use your strength?
That really is very powerful way of creating a vibrant and resilient group, and also
helps to get to know each other better, because we are confined in our professional
roles and yet we have so much more to bring to the workplace.
Thank you for contributing some suggestions here for building resilience.
We have got some coffee and cake suggestions and recognising achievements within
the team. I totally recognise that one, Rosanna. We had a team development session
where we had a book – I still have mine on my bookshelf, and it is lovely. Everybody
wrote three things they appreciated about me. That helped to build personal resilience
and it is a great exercise to see why you appreciate your teammates.
"Recognising achievements within the team helps build resilience." Absolutely.
Lots of focus here on using achievements and remembering everyone in the team a

little and often.
We are all on John's team because he is a freelancer! Thank you for including us on
your team.
Before we close, and I will hand back to Kate in a moment, could we hear from Carol,
a summary of what has been happening on the web chat and Twitter?
Oh, look, lots more comments coming through. I hope you are reading, Carol!
I think we are having some trouble getting Carol off mute. Just reading through some
of these, improvising is a good team game and a skill that is not always valued.
HANNAH:
Can you hear me? I could just read out a couple of comments that have come through
on Twitter.
It has been quite quiet this morning. We have had a small but perfectly formed group
who have been listening intently to what everybody has been saying and contributing
in the chat box. We have had some comments on Twitter, really positive comments.
"Loving the stuff you said in the case study."
Michael Goody, a dear friend of Horizons, he said at the beginning that he is needing
some help at the moment, so this is obviously very timely for a lot of people.
Louise says a personal thanks to Pip, saying she enjoyed the presentation.
Patricia says that dwelling on negative thoughts are the most common mental health
problems.
I think there are some really thoughtful reflections going on from everything that has
been said this morning and some useful tools and techniques that people have been
considering for use going forwards. So, yeah, all good, Rosanna. Thank you.
ROSANNA HUNT:
I will hand over to Kate now.
KATE POUND:
Thank you. It has been a really enjoyable session. We have learnt much more about
the understanding of the physiology of resilience and what goes on, and we have also
learnt new skills, which I certainly will be looking at more.
I have been looking at the app. I am sure there will be lots of us downloading it later.

I just reflected a bit on the session today and how it links into all of the learning that we
learned in school.
We learned that change starts with me. That is the first, taking care of ourselves,
looking after ourselves, but then also moving further and taking care of our team and
learning how to build team resilience.
But really maybe think about the fact that we can't be rebels alone and we need to
work together to develop resilience as a team to support each other, but then to lead
on change together.
As we lead on change together, we become stronger as a team and then develop our
personal resilience.
So, thank you, all, for todays's session and we have all enjoyed having you here today,
and that is the end of the session today.

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