Needles and Pins

Needles and Pins

I had a lovely conversation with a client this week. To be honest, I enjoy all of my conversations with clients. There’s discipline and deliberate effort in the Solution Focused approach that means I always find something to admire, but this session was especially good. There was a lot of laughter.

Mary* had been for her first COVID vaccine a couple of days before our meeting. It’s something we had talked about in the previous session, and it’s fair to say Mary had had some trepidation:

She was happy with her decision to be vaccinated and didn’t have any particular fear of needles, but despite having worked, raised kids and run marathons (literally!) she had lost her confidence and enthusiasm for life. This had felt especially difficult in year trapped inside, with little social contact, and the whole process of going to the vaccination centre felt daunting.

‘Ok” I said “If, for some reason, the very best version of you were to show up on vaccination day… How would you know?” I love this question. I don’t think we very often need to be ‘the best version’ but the implication that it already exists, and just needs to be brought to the fore, is powerful stuff.

Like a lot of clients, Mary skipped straight to the problem itself, the vaccination centre, where she would be calm, composed, friendly, polite etc. I gently invited her back a few hours. “But what about when you first wake up?” I asked “What might you notice then?”

Mary described a morning where she woke up with energy and optimism that affected everything from what she chose to wear to how she made her coffee.

When she’d run out of things she might notice I asked her what her son, who lives with her, might notice. “Probably nothing!” she laughed. “I know what you mean” I said (I also have a teenage son) and we shared a few moments over the remarkable obliviousness young men are capable of at 9am! “But what if this time he did notice?” I asked “what do you think… ?” 

Mary came up with another lovely list of all the tiny differences her son might see, and the differences that might make. We ended the session there, with Mary saying it had been nice to hear herself talking about this version of herself.

So, on this most recent session, when I asked Mary “What’s been better since we last spoke?” I was completely unsurprised (although still delighted) to hear that ‘Vaccination Day’ had been a breeze.

Mary described a morning where she had noticed that she was calm, composed, able to focus, and even enjoyed the walk. Her son had, as is entirely reasonable, stayed in bed and not noticed any of this! Mary had been the first at the vaccination centre and been completely undisturbed by the bloke hanging around outside warning of blood clots, microchips and god-knows-what else. 

“A really funny thing happened though” Mary said. After she’d had the vaccination the Doctor handed Mary some papers that turned out to have a half-attached staple in them. The staple pricked her finger “I said OW, really loudly, and nearly jumped out of the chair. It made the Doctor jump too! Isn’t that weird?” she said “when I barely felt the needle at all” 

Now, I do know from my Occupational Therapy and NHS work, that this isn’t weird at all. The way humans create pain is pretty reliable. We don’t have any such thing as ‘pain nerves’ or ‘pain receptors’ we have nerves that recognise change (temperature change, pressure change, soft tissue stretch change, chemical change etc.) Our brains use this information to decide if pain would be useful to us. So when a Doctor injects us with a vaccine that we are hopeful will keep us well, and return some fun to our lives, it registers the needle and says “No need to panic, we were expecting this… it’s all fine, carry on” When we receive almost identical information, having been unexpectedly speared by a staple, it says “Holy moly… what on earth is that, it might be deadly, better create lots of pain” Essentially to make sure we pay attention and check!

Whilst I was thinking about this Mary carried on “I suppose” she said “you kind of get what you’re looking for. I was expecting to be injected and I’d already practised in my head that it’d be fine… and actually” she continued without me needing to ask anything at all “my whole day was a bit like that. It’s not like I woke up thinking, ‘I must do this and I must do that’ like I’d talked about with you, but it just kept popping into my head. I noticed when the good stuff happened.” She paused for a second “I suppose” she said (and although this was a phone conversation I could definitely hear a wry smile in her voice) “If you’re expecting it to be fine, there’s at least half a chance it might be!”

I’m expecting my clients to have strengths and resiliencies that are useful for them, and if I’m expecting that, there’s at least half a chance we might both notice them. Wise woman that Mary!

(* This story is written with my client’s consent. ‘Mary’ is not her real name)


If you feel like you’ve lost confidence and are struggling with anxiety or low mood, pop me a message, or book a free first appointment for a chat about it. I’d be happy to talk.

Same if you’re struggling with chronic pain. It’s an area I work in often.

If you do have a needle phobia, it can be surprisingly easy to sort out. My lovely colleague Hannah specialises in this.

How to Feel Happier

How to Feel Happier

If I told you there was a substance that would make you feel happy, like you were coping really well with life, calm, brave and (as an added bonus) was a fantastic pain reliever, would you be interested?

And if you found out that it was completely free and had no negative side effects? Even better, right?

And how about if it were something you could make yourself… no equipment needed? Perfect!

Well, it’s true. Serotonin is a neurotransmitter, that we all produce, that does exactly that.

Everything that we think, feel, or understand about the world comes from a chain of neurons firing across our brain. In the synapses, the gaps between the neurones, we produce chemical messengers… neurotransmitters, and serotonin is one of these. There are other ones, like dopamine for example. Dopamine is more reward driven, it is the big excited high of a great first date or winning a race. It drives us to look for that experience again and is the reason heartbreak feels so rough, and musicians have a notoriously hard time with their mental health. When we experience that ‘drop-off’ of dopamine our brains kind of go “hang on a second, where’s all that good stuff gone… find that again”

Serotonin is different. Serotonin is that lovely “I can deal with anything” optimistic, positive, calm feeling, and if there was ever a time when that might come in useful, I would say it’s about now!

If you have ever taken anti-depressants you have probably heard of serotonin before. Most modern anti-depressants are SSRI’s; Selective Serotonin Re-uptake Inhibitors (catchy!) They work by stopping the serotonin that we produce last a bit longer.

The reason we know that serotonin has been produced, and the reason we recognise that ‘feel good’ sensation, is because in the synapses (the gaps between the neurons) we have receptors for different messengers (neurotransmitters).

We also have neuroplasticity; the ability of our brains to ‘clean up’ bits that we are not using and use the energy somewhere else. So, if we go for a significant amount of time without producing much serotonin, our brains think that the serotonin receptors are just sitting around not doing much and will get rid of them. The bit of serotonin we do produce gets re-absorbed without having much effect.

SSRI’s slow down this re-absorption and our brain thinks there’s a bit more serotonin floating around and will start to put receptors back in. That’s the reason anti-depressants take some time to work. You don’t just take a tablet and wake up happier the morning after… It takes some time for the receptors to be back in action.

So generally, the more serotonin the better, but how to we get it in the first place. Well in three reliable and predictable ways.

Humans are essentially rewarded for behaviours that benefit us in some way, and we can class these into three groups:

1) Positive action. Humans are designed to hunt and gather, to feed themselves and their families. Now clearly, we don’t need to do too much hunting and gathering, because… well, supermarkets, but we do need positive action. We are rewarded for activity. My positive action won’t be the same as yours. Some people like crocheting, some skydiving and everything in between, but when we take part in meaningful activity, we produce serotonin. In its simplest example, going out for a walk around the block nearly always feels better than sitting on the sofa ruminating about a problem. When we fight with our families, someone taking a bit of ‘time out’ and doing something else often calms them down. It’s the serotonin.

2) Positive interaction. Humans are safer together than separately. We’re social, collaborative creatures because it’s nearly always in our best survival interests. When we spend time with people that we like, love, trust or respect in some way, then we produce lots of lovely serotonin. Tough at the moment I know, when we are all separated, but a text, a chat on the phone or a video call still produces that collaborative, safety response. And remember I said it was a great pain reliever? Well, it’s the reason that grandparents with arthritic joint pain can be engrossed in playing with their grandchildren with little, or no pain at all, for a period of time. It’s the serotonin.

3) Positive thinking. And I don’t say this lightly. Clearly there’s more to feeling happier (or getting over depression) than “Oh great, I’ll just think positively… everything will be marvellous then!” but it can be a really useful tool. I wrote a blog a few months ago about what happens when we think the worst or catastrophise We have these incredible brains that can produce physical feelings of fear or sadness when nothing difficult or threatening is happening. It’s a useful tool if you don’t want to forget where the snakes hang out in the jungle, not so useful at 3am when you’re awake and sweating with anxiety over a work deadline. Well luckily the reverse is also true. If I were to ask you to tell me in detail about some of the happiest moments of your life, something funny that happened at work, or a time that you felt really proud of yourself, you would feel good, smile and relax during your description. The same is true, even if you were to tell me about moments when things have felt a little better and you have felt a little happier. It’s the serotonin.

An exercise that a lot of people find really helpful is just keeping an eye on when these three P’s (Positive action, Positive interaction and Positive thought) show up. It can be challenging the other way around, like when you make New Year’s resolutions, if you start trying to shoe horn these behaviours into your life. Just keeping an eye open for them however, can have surprisingly effective results. Give it a try and let me know how you get on.

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