Absolutely, your physical health can affect your mental health.
I think when we step back and think about this it makes absolute sense that a patient
who is suffering or adjusting to a long-term condition is going to be affected emotionally as well.
And we can lose sight of that when we get quite clinical and we narrow down
and try and fix discrete problems for patients.
But it's really important to keep quality of life in mind.
And that's why looking after people's psychological health is really very important.
Luckily, I'm part of a very forward-looking clinic at the London Cardiovascular Clinic;
who really recognise this that the quality of life is really important;
and that patients need their psychological health to be supported at all aspects of their health journey.
So, for example, before diagnosis we often need some support with the anxiety that comes up
with the fear of what might be around the corner and to manage that well.
A lot of symptoms can be made a lot worse by anxiety as well.
So perhaps if we're experiencing palpitations or dizziness or even pain,
if we're very anxious that can really amplify them and make things worse as well.
And there's a lot of adjustment that needs to happen once we have a diagnosis and
we're learning to live with a long-term condition.
Because it's very important to realise that we can still live life well and how to achieve that.
So looking after relationships, making sure that we still keep doing things that we love
and that we're passionate about are really important.
But to get there, sometimes we do need the help of a professional as well.
So, I really look forward to a time when actually a psychologist working alongside a physical
health care team is routine. And that really helps us keep patients' quality of life
at the centre of care.
At a very simple level I think our emotional health affects our physical health.
Because if we feel more optimistic and resilient, we can really step up and take control of our condition.
And we do know that patients who feel in control and have an understanding of their physical health condition
really do better as a result.
In terms of the biology and the physiology of what's happening, we're only really beginning
to understand this whole area. But we know, for example, from the placebo effect: the
fact that our body can respond to dummy pills or to intervention which is imaginary, if you like,
that our body really does have a capacity to heal itself.
We also know for example that even quite inexperienced meditators can affect their blood pressure,
their heart rate, their blood glucose levels, and amazingly even their survival rates after cancer
as a result of meditating and pulling in the power of all the feel-good chemicals that
come with the parasympathetic nervous system, that cascade of feel-good chemicals that come
when we're really relaxed.
So, there are a lot of ways that we're only beginning to understand around the physiology of all of this.
I think it's also really important that we're learning a lot about how social connection is very important as well
for affecting our physical health.
Being part of a team or feeling supported it seems can have as strong an effect on our
health outcomes in terms of how long we're likely to live as (in some cases) smoking or obesity.
So, there's a lot we're understanding about our psychology and our relationships
and the really strong impact that that has on our physical health.
There are many ways that a clinical psychologist can help with a physical health problem.
Often by the time patients come to see me they've been given a wealth of different advice and information.
And it can feel a little bit overwhelming.
So often a really important part of the work I do is having the time to sit down
and pull all those strands of advice together and to help patients make the lifestyle and cognitive changes
that they need to make to really be looking after themselves well.
There's also really important work to do helping patients to adjust to a new identity
and to live well with a diagnosis and with the struggles,
the daily struggles that come from living with long-term conditions.
It's really important to make it very clear that life doesn't have to be miserable or compromised,
but there are many ways that we can still live a really valuable and positive life
and still do the things that really matter to us whether that spending time with
friends and family, and adjusting those interests and passions so that they're achievable
even with the compromises we need to make.
So, adjusting exercise in a way that's workable,
spending time with friends in a way that we can still achieve
is very important to maintaining quality of life and living a meaningful and vital and joyous life.
There's an awful lot that I want to achieve in a first session.
And very importantly a lot of the patients that I work with haven't seen a psychologist before.
So, there's some important work to do to demystify the whole approach.
And to make it really clear that really, we're here as a team to work together
to identify what you're struggling with at the moment and how we can move towards
helping you live the life that you really want to live.
Often by the time patients come and see me, they've seen a lot of other professionals
and consultants and they've had to tell their story many times and that can be a little
bit frustrating. So while it's really important for me to hear directly from the patient what
it is that they want to achieve and what they're struggling with and what our goals are going
to be, I also think it's really important to spend some time really working on a plan
helping a patient have a sense of where it is they want to go and what they want to achieve
and to leave the room with a few new tools to try out a few strategies to put into place,
so that when we meet the second time we can already start to talk about what's working
and what isn't.
I also spend some time really establishing what approach it is that
the patient would like us to use together.
We have a few different therapeutic approaches that we can use,
but it's important that we agree and talk about that
so that we both know the way we're going to be working going forward.
But the most important thing really is that the patient walks out of my door feeling
confident to come back and with a sense of hope and optimism
that we're on the right path to making life as good as it can be.