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Avalon news and views

Returning to School - the impact on child and adolescent mental wellbeing

With children returning to school, parents and children are facing new pressures. Many have returned or changed their working practice, and along with services reopening, we start the transition to our new normal. During this period of adjustment and social re integration you may notice levels of anxiety and stress increase. You may also notice that the initial lockdown frustration of not being able to engage in enjoyable activities has been replaced with little motivation or desire to start back up.  Why is this? 

Many anxiety disorders expose themselves when we receive an environmental trigger. For example, social anxiety may be activated when entering a shop or giving a presentation, separation anxiety may become apparent when leaving for school or going to stay with a relative. Without these environmental trigger’s anxiety may appear temporarily reduced. Obsessive Compulsive Disorder (OCD) may be a constant challenge but with the lockdown there was more freedom and time to complete compulsions uninterrupted. With the emerging reality that we will need to resume our normal activities this underlying anxiety may start to increase.  Another element of stress for adolescents is the fear of missing out (FOMO). In lockdown all social events were cancelled, appearance become less important and we enjoyed the freedom of many pyjama days. As social opportunities resume there will be a pressure to take up social invitations and resume the competitive grooming.

For some young people, the reduction in social interaction and physical exercise may had promoted a cycle of inactivity and low mood.  Time to ruminate, continuously thinking the same unhelpful thoughts can intensify depressive feelings.  Sleep routine may have been lost and the thoughts of having to be up and ready in the morning may feel impossible.  Low mood affects motivation and concentration, when you do find the energy to start a task it may be hard to focus, reducing enjoyment, confirming unhelpful thoughts that it can’t be done.

So, what can we do?

  • Listen, if your child comes to you feeling distressed, don’t be tempted to dismiss or problem solve. Allow them to talk freely often people will generate their own insight if given a safe space to express themselves.
  • Structure the day with a loose timetable. Ensure this includes physical activity, selfcare and time to connect with others.
  • Establish a good sleep routine of going to bed and waking up at the same time each day.
  • Create a list of the activities they would like to resume doing. Break each activity down into small steps, gradually increasing time and energy spent, for example start with a 10 min workout video and increase by 5 minutes a day.
  • Track mood. Get into the habit of rating mood on a scale of 1-10. This can help identify moments of low and elevated mood. This enables you to schedule meaningful activities when its needed most.
  • For those of working age, if you are returning to work, be honest with your employer about what you can do. If you need to reduce hours or continue some working from home, let them know.
  • Encourage all family members to write down worries and separate them into real and hypothetical. Real worries can be problem solved and hypothetical ones can be discussed and then let go.
  • Test out fears a little at a time. If your child is worried about leaving you, start by encouraging them to do some self-guided activity. Have them separate from you for a short period of time for example letting them undertake an activity whilst you take a 10 min walk around the block.
  • Encourage social interaction. If you or your loved one has isolated themselves, the idea of social interaction may be overwhelming. Have them reconnect - this can be in writing a letter, messaging or calling someone, and then meeting face to face.
  • Practice social skills. They may feel unsure what to say and worried it will be awkward, practice come conversation starters and have them think about what they would feel comfortable talking about in advance.
  • Have rewards in place, have these pre agreed and make sure they are appropriate and achievable. They need to feel rewarding but not so big they are a bribe.


It is important to remember that lockdown has been a different experience for everyone. Many young people found themselves isolated and for some, home was not a safe haven. There is concern that some services, such as Child and Adolescent Mental Health and social care, may receive an unmanageable volume of referrals. Looking at what your family needs are, and taking action early, will help ease the pressure on the system. The good news is there are many sources of national support such as Off the Record, The Samaritans and Young Minds; alternately you can look at options for private services.

Above all show each other patience and compassion during this difficult time, this includes towards yourself.

Hannah Byrne

Accredited Child and Adolescent Cognitive Behavioural Therapist

Posted 30-09-20

Resetting my goals ..

To be honest, the past few weeks have been rather strange, hence my delay in blogging. After a rather stressful 2 years of a masters’ level course, I took my final exam – a huge relief to the whole family as it’s been quite tough on all of us. I thought I’d take the weekend off, maybe start my diet again by the middle of the week.

I began by enjoying a break from the usual routine, but then I found myself struggling to re-start the disciplines I had been enjoying and benefiting from. My Pilates Class had a break at half term and then both my dogs had to be quarantined due to illness. Unable to fulfill my key sources of weekly exercise, it led to an excuse of drifting into 10 days of inactivity – totally lacking motivation to do anything, especially exercise.

What I think happened was a build up of expectation, that once the exams were over, I would feel relief. However, as I won’t get the results until mid-March, I’m feeling bereft and I’m experiencing feelings of being directionless and lacking purpose – why aren’t I enjoying doing nothing? 

I’ve mostly kept to my diet but slackened off during this period which resulted in me gaining 4lbs, as I wasn’t bothering to monitor my points. Not disastrous, but in combination with the lack of other activities, it was evident that having no structure to my week really wasn’t good for me.

My usual reaction to this is frustration, which as we know, is always counterproductive, so this time around I have tried to embrace it by looking at the positives to come out of this “downtime” period. Firstly, I’ve decided to try something new this year and learn to ski, and have already had 2 lessons with a third booked next week. Secondly, as you can see from the picture above I have bought a few items to create my own make-shift gym in the garage; a bench, a few kettlebells and a suspension training system, all for under £70.

So, I’m going to set a new goal of 10 minutes in the gym a day, 5 or 6 days a week. Either some load bearing exercise based on the 7-minute workout or a short Pilates routine my instructor gave me before half term. If you’re interested in finding out about the 7-minute workout idea, google it, there’s plenty of information out there and it’s quite basic so the information is pretty reliable.

It’s all been a very useful experience. What surprised me most was just how long it took me to work out what was happening, but once I had, it was quite fast to change. When you expect relief and instead get a sense of loss, it’s disorienting. It’s ok to feel this lack of motivation and sometimes you don’t have the energy to fight against it, but there’s a fine line between going with it for a short time and allowing yourself to get caught up and ending up wallowing in it. Luckily this time around, I managed to catch it before it took hold. 

Posted 26-02-19

Reframing failure as success…

Something that didn’t really go to plan over the past month, was my attempt to carve a wooden spoon from a block of wood cut from a friend’s eucalyptus tree. I’d been enjoying the process but had put it to one side for a couple of weeks as I was beginning to get irritated with the fact it wasn’t turning out as I had expected.

It turned out, that I had made some fundamental errors. In the book I had read, called “Spon”, the author talked about using soft, wet wood (ie, freshly cut), as it’s easier to shape with a sharp knife. As it turns out, eucalyptus is a hard wood and over the 2 weeks I was handling it, it had become very dry, hard and quickly blunted my knives.

Feeling quite disappointed, I was going to abandon this piece of wood until I inadvertently broke one of my old wooden spoons (shop bought) whilst mixing sourdough. One of the advantages of making sourdough is that it doesn’t require kneading, you just mix it and time and chemistry do the rest. It looks like this and is very stiff, sticky and requires robust mixing.

It then dawned on me that what I, actually, needed was a dough ‘paddle’, hence resurrecting my abandoned spoon. If I couldn’t finish it off with my knives, I could use a sander to finish the job. Rather than seeing this as a catastrophic failure of my hand carved, meditative ethos, I accepted and embraced it - half an hour later I had this.

Ok, it doesn’t have the same rustic look, but I like the asymmetry. I decided to leave the handle part rough as I think it’s pleasingly tactile and it’s really very functional. The smoothness stops dough sticking into it, the sharper edge helps with mixing and the rounded edge helps scrape the bowl. It’s really strong and doesn’t have a concave bowl (which is what makes a spoon a spoon) as it doesn’t need one.

In a way, what I’ve done is fail at my original intention and inadvertently ended up with something that I really needed without knowing it. I think this only happened because I didn’t beat myself up over my lack of progress, or just throw it away and start again.

This is only a tiny thing, but it fits in with what I’m trying to do overall. One of the reasons I started this process of reflection and change, was out of frustration with myself after I kept moaning aloud to my family about being overweight. Then one day my son asked me if he was overweight and at that point, I decided to shut up about it or take positive action as it was giving out a negative message to my son’s idea of body image.  It’s about taking action and doing something about it, whilst not beating oneself up when things aren’t going to plan. We’re often quick to focus on our shortcomings but find it difficult to celebrate successes. Doing that and being open to the possibility of changing direction, in this case, brought me to something new.

The next thing I need to address is exercise. My weight loss, 11lb or 5% of my body weight, has gone well but seems to have plateaued. As the original changes now feel like I’ve adapted to them, it’s time to build on this and add something new that will improve my fitness and help burn calories.

Posted 05-02-19

My journey so far!

Although it hasn’t been that long since I started, this seems a good time to look at my experience so far, and to answer a few questions about what I’m doing and why.

Am I giving advice? Do I expect others to try the same things? Absolutely not, this is not a wellness blog or meant to be suggestions for others. I’m not selling anything, and I don’t think using any type of wonder ingredient can change your life.

I’m trying to change certain aspects of my life - you may feel there are changes you’d like to make to your life, but they will be different to mine. I’m analyzing and documenting my process and experiences. Your process and experience will be different.

The process of writing a blog is far outside my comfort zone (I’ve never even kept a diary) but it is a useful tool, forcing me to analyse my experiences, as well as making me learn more about myself.

You can read books for advice or self-help, but only you can make the change happen and I think that each of us is best placed to work out how to go about it. This does take effort and willpower, however you’re more likely to succeed if you begin with easily achievable goals and then extend yourself gradually – only you understand yourself and difficulties involved.

Hence my starting point of three things that are achievable:

I’m not really concerned about my weight as much as I am about the amount of body fat I’m carrying, and in particularly, visceral fat. This is internal body fat that is not visible which can be stored around organs and is being linked to a variety of risk factors to health. I haven’t set a weight goal or time limit, as failing to meet them causes disappointment.

I’m not promoting WW Team either. I chose them partly as solidarity with my wife so we can eat the same things and to be honest, if you’d told me a year ago that I’d be doing this, I’d have laughed! But here I am losing weight and surprisingly I’m enjoying it. I’m learning that I can lose weight and eat carbohydrate (obvious to most perhaps, but a revelation to me!) and eating a more balanced diet as a result.

Pilates has proved to be a good decision as I’ve forced myself to start at the very bottom and I’m learning a lot. My ego felt that as I’d done yoga for many years, surely I should start at an intermediate level! No one likes to feel like they don’t know anything, but my approach to yoga has not prepared me for my pilates experience so far. I’ve learnt how weak my core is, and the fact that I may have felt like I was doing yoga well, I was in fact, really relying on my strength to achieve this.

Wood carving I’ve found enjoyable, but I don’t feel it’s going to be a viable alternative to meditation. I’ve stalled slightly as it’s difficult to find enough free time to devote an hour at a time which, for me, is what it takes to progress reasonably. As you can see from the picture, 4 hours work has produced something that’s still a way off being a spoon and a lot of kindling!

So, I’m sticking with the diet and I’m going to use Pilates as my base to build more exercise into my week. I’ll finish the spoon, then have a think and try something new. What I’m finding exciting about this process is not knowing what I’ll be doing when the year’s up.

Posted 23-01-19

Breaking old habits

The element I’ve decided to write about first is my diet, mainly because that seems to be my biggest challenge at the moment. However, it has also brought an unexpected bonus too.

It’s been just over a week since I started and I’m starting to refine the rules I’ve set myself. I’ve lost some weight as the point system is easy to track and is really highlighting where my excessive calories are coming from. I’m still eating the foods I want, but the quantities and proportions have changed a lot.

I believe that pretty much any diet will work if you don’t cheat, so I’m going to stick to my points’ limit of 34 per day. For some reason I’m allowed 45 extra points a week which I’m going to try to avoid using.

It’s easy to play the points system by having a lot of zero-rated foods (e.g, a banana is zero points but if you enter fifty bananas into the app, it still counts as zero) so I’m going to keep portion sizes normal.

Ever since I used the Atkins diet, I’ve avoided carbohydrates as much as possible, however I’m trying to mix things up a bit, as this has to change. For example, I’m going to eat more fruit and make my own bread wherever possible. I’m going to use wholegrains as I think they taste better.

I won’t eat anything that is ‘low fat’ but I will limit the quantity to keep the points down. My belief in this is that some things, e.g. cheese, are inherently high in fat, as the products that produce them contain a lot of fat. To me, low fat cheese interferes with the taste and texture and possibly uses additives I’d rather avoid.

So, this was my dinner last night, it wouldn’t look great on Instagram but it’s miles away from my normal meals. Plus, I need to add that my wife was supposed to be bringing the vegetables from the grocers on Gloucester Road, close to where she works, but as she was delayed this is what I had to work with… 

Salmon fried in a pan with very little oil along with microwaved brown rice and a store bought plum sauce. In total, this comes to 9 points and is tasty in its own way,  but quite bland compared to what I’m used to. It was. however, much less calorific, very quick to cook and for the first time in a while, I sat down with my son to eat the same meal together.

I’d never really thought about this, but we very rarely sit down together and eat the same meal. I think the lessons I’ve learned are, that I’ve been quite snobby about my food without realising it (considering what I eat it’s no surprise I’m overweight) and if I spend less time in the kitchen preparing and cooking, I can spend more time sitting down with my family, eating more simple food. All of which is quite obvious when you think about it, but the point is, I had never stopped to think about it, I was just carrying on with my normal habits wondering why nothing was changing. 

Posted 15-01-19

Stretching out

So, these are my starting points, there’s nothing too dramatic as my aim is to find achievable goals. I have a whole year to build up to stronger challenges…

Stretching out

I’ve long been an advocate of yoga or Pilates as a useful baseline activity suitable for pretty much anyone. People tend to gravitate towards one or the other, but my choice was always yoga.

Whilst I don’t often recommend something unless I’ve experienced it, I felt I could recommend Pilates, as many people, whose opinion I respect, vouched for its effectiveness. To mix things up and have a new experience, I’ve signed up for an introductory Pilates course which runs for 6 weeks. As I do with yoga, I’ll do some background reading about its philosophy too.

Celebrating the ordinary

I received this book as a Christmas present, as whittling and wood carving are something I’ve been interested in for a while but haven’t really found the time for.

It’s a beautifully written book (and is much more interesting than you’d think a book on spoon carving could be) and in it, the author talks about the act of carving as a way of celebrating the function of simple objects, focusing concentration and developing manual dexterity.

I used to have a daily meditation practice which I’ve allowed to lapse, and for some reason I’m finding it difficult to sit quietly and meditate. Rather than continue being frustrated about this, I’m going to try wood carving as a mindful action, to see if this can be considered a form of active meditation.

Changing the way, I eat

The third element I’m addressing relates to my diet, and I never thought I’d say this, but I, seemingly in conjunction with Robbie Williams, have signed up with WW Team (formerly, Weight Watchers). As my wife kindly pointed out, my own diet system hadn’t produced any weight loss, so I had to try something new. The points system used is straightforward and doesn’t disallow anything, however, it does penalise highly calorific foods by awarding them a high point score.


I’m going to struggle with this the most. I love to cook, I really love to eat and, as I taught myself to cook using a 70’s classical French cookbook called Modern French Culinary Art (an amazing book that has the recipes for probably every dish you’ve ever eaten in a classical French restaurant), my cooking relies heavily on fat or rich stock for flavour. Some of the diet methods I’ve followed in the past rely heavily on protein and fat, with minimal carbohydrate, so I’ve really got to unlearn a mindset and retrain my taste buds.

I shall be sharing my experiences in all three….

Posted 11-01-19

We all make choices….

All of us. If we’re saying we can’t find time to exercise or eat properly because of work, or ferrying children to weekend clubs, what we’re effectively saying is that we prioritise something else over ourselves. Yet, if we’ve found time to unwind with a glass of wine or to watch an episode of Black Mirror, we’ve found time for something that we feel nourishes ourselves.

What this year is about for me, is examining those choices and making some new ones. My diet, fitness levels and the way I choose to spend my time are all areas that I feel need to be addressed because my old patterns aren’t working for me anymore. This is my 50th year on earth so I’m over halfway through what I can reasonably expect to live and I don’t want to sleepwalk into old age.

Listening to my body

What I mean by this is, that I know there’s a point in my life coming where something will happen and perhaps, I won’t be able to prevent or change it. I don’t want to get to that point and think “I wish I’d done something sooner”. I want that something to be done now.

The three areas are my body, my mind and using a word I’m always cautious of, but can’t find anything that works better, my spirit. I use the word spirit to mean that part of you that can’t be measured but has a huge impact on how you feel as a human being.

I’m going to do this by creating space in my life where I can pay attention to all of those areas, and most importantly, get my ego out of the way of the decision-making process. Like most people, I feel I know what’s best for me but if that were true, I wouldn’t be here writing this. I’m going to question everything and try new things, and this means asking what do my body, mind and spirit need NOT what do they want.

Posted 08-01-19

Not sleepwalking into old age...

The reasons for starting this blog were that I’d suddenly found myself in the same position as a lot of my patients – time poor, under exercising and overweight.

I’m 50 next year so should probably consider that I’m over half way through the time I’ve got on the planet.

From experience, I know that everything gets a little bit more difficult as you get older, you lose fitness and muscle tone faster, weight is easier to gain and harder to lose.

One thing I’ve never been very good at is finding balance, I tend to get fit and then lose motivation, I lose weight and then it drifts back on. I think a lot of people will recognise this as a common pattern.

In a way doing what I do for a living makes it harder for me to change. I understand a lot about how the body works and understand nutrition and psychology, so feel that I know best when it comes to myself.

However, I started to try to change things about 3 months ago and in that time have lost exactly zero weight and am no fitter than when I started.

Then someone (my wife) suggested that maybe I didn’t necessarily know what was best for me as I was hardly objective.

So, I’ve spent time thinking about where I am, what I want to achieve and most importantly, how I can make a lasting change.

I’ve set myself the goal of not putting on any weight over the Christmas period, while this may not seem like much, this is a holiday and should be enjoyed.

However, I’m going to try to be a bit disciplined and not overindulge. Psychologically, it’s easy to think “I’ll just start after the holiday and to hell with it now”.

In terms of what links the three foods above, they have roughly equal calorific value... which one would you rather have? I'll be picking this up in the new year, and exploring it in more depth. Blogs will start in the new year but until then, have a lovely holiday! 

Posted 24-12-18

Encouraging the young to take care of their health

I think most parents would agree that the pressure on our children nowadays is quite different to what we experienced in our own school years. The demands of coursework, homework, P.E and extracurricular activities can put a lot of strain on a body that is still growing and developing.

One of the main things I’ve learnt whilst working in a specialist Children’s Osteopathic Centre in London, is that children and adolescents are not simply small adults. Although teenagers can be emotionally mature beyond their years, physically, their hormonal, muscular and skeletal systems are still developing. One of the things we try to do as Osteopaths is to balance the forces on the growing skeleton in the hope that when they reach adulthood, their bodies are in the optimum condition.

Recently I’ve worked with a teenager whose sporting schedule amounted to 20-25 hours of training and matches a week, on top their normal academic work. This required an impressive amount of dedication and we used this passion to achieve our goal. My approach with children and adolescents is for treatment intervention to be minimal but to educate and give advice, in this case we produced a personalised stretching routine, and encouraged sufficient rest time to aid recovery.

This approach allows them to take charge of their own health and hopefully they get to appreciate taking care of their body at an early age. I feel this is important as I meet many adults who wish they’d looked after themselves better when they were younger.

If you and your children would like to find out more about how osteopathy can help, we offer free consultations

Posted 04-05-18

Working from home - are you sitting comfortably?

Working from home - are you sitting comfortably?

As homeworking continues to be increasingly popular, allowing flexible working, there needs to be an awareness of how this can affect your health. The most obvious being the effects on your body.

According to the Health and Safety Executive, musculoskeletal disorders are the most common form of ill health related to work. They recognise that spending long hours in a poor seating position can cause back pain or make existing pain worse. There are also a range of neck, shoulder, arm and hand disorders, that can range from short to long term, that are linked to activities at work.

As a rule, if you feel uncomfortable at your desk or feel stiff after working for a while, it’s worth checking how your equipment is positioned. Most of the homeworkers I treat have a set up that is designed to fit a space rather than designed for the task, ie, using a laptop at the kitchen table or at desk crammed into a small space. In the workplace, your employer is obligated to provide you with suitable space and equipment, why shouldn’t you apply the same standards?

Most people understand the importance of a good mattress, but you can easily spend equal time working as asleep. It’s worth considering your working environment to be a similar investment as your mattress.

My first step when assessing a homeworker is to have a photo taken so we can review their home set up to see what may need improving. This can be as simple as decluttering to create space or adjusting a chair for more comfort. Laptops can be placed on a stand, so the screen is at eye level, relieving pressure on the neck. Whilst adding a plug-in keyboard and mouse relieves strain on the wrists and shoulders.

Often, I make a home visit and we work out how to get the most out of your equipment so changes (and cost!) can be kept to a minimum. I also give you a set of stretches that can be done at or away from your desk.

Here are some simple solutions which only cost a few pounds (and some are free!), yet they make a big difference to your body.

Your chair should support your lower back and you should sit comfortably upright.

The desk and chair height should be set so your forearms are roughly horizontal.

Your knees should be below the level of your hips.

The top of your screen should be at eye level.

If you mainly use a laptop, consider using a docking station, external monitor, mouse and a full-size keyboard.

Ensure wrists are comfortable when using a mouse or keyboard. Use wrist rests if possible.

Avoid clutter where possible. Document holders that place paperwork near the same level as the computer are ideal.

Take regular breaks. Regular short breaks are better than occasional long ones.

In addition, ensure you have adequate lighting.


Posted 23-02-18


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