Compass Magazine | Your Health & Wellbeing Guide | Spring 2022

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Your Health and Wellbeing Guide

In s s e n i l e n o L ce a l p k r o W e Th


. . . S U L P Fibromyalgia A Hidden Condition


Breast Cancer – Get Aware

Alcohol how is it HOW TO – SIT WITH THE SKILLS GAP LOWER BACK PAIN really affecting us?

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Training Programmes at PAM Group We deliver quality, organisation and people – focused services with a vision of being the best and not the biggest.

We believe in innovation, agility and quality and to achieve that, our colleagues are supported to be the best they can be. We have over 50 colleagues attending PAM funded University courses. We deliver over 40 training, development and awareness sessions every month to our colleagues on a range of different topics.

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The world of occupational health and workplace wellbeing is constantly developing. Encouraging our colleagues to keep abreast of developments, means our clients and their employees get the best and most up to date advice.

Our colleagues are supported in developing their writing skills and getting published is part of the achievement. Our e-learning platform is going from strength to strength, with a wealth of on-demand webinars for our colleagues from every avenue in the business.

PAM Academy facilitates the growth and development of all colleagues at PAM Group and supports the wider management team with evidence based learning, client focussed insight and delivery of recognised industry acceditations. 2

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Spring 2022

Your Health and Wellbeing Guide


What Is That Ringing In My Ear? Page 4-5 How To Sit With Lower Back Pain – A Posture Guide Page 6-7


Loneliness in The Workplace Page 8 The Skills Gap Page 9 Domestic Violence Page 10-11


Resilience – What Is It And How Do We Get It? Page 12-13




Fibromyalgia – A Hidden Condition Page 14-15 Anxiety Page 16-17 The Benefits Of A Home Workout Page 18

Compass Magazine is published by PAM Group Ltd Contact us 73-75, Sankey St, Warrington WA1 1SL All rights reserved - Reproduction is strictly prohibited - Copyright 2021 © For more information visit Compass Magazine 3


What is that ringing in my ear? Last month was Tinnitus awareness week, and for those who are unaware of or don’t understand the condition, it may seem strange that a whole week is dedicated to this condition! However, the British Tinnitus Association tell us that it affects 7.1 million people or approximately 1 in 8 in the UK and the numbers are growing. The word Tinnitus comes from the Latin ‘Tinnire’ meaning “to ring”, causing sufferers to hear sounds such as ringing, buzzing, whooshing, humming, or any other similar sound in one or both ears. For those who have never experienced tinnitus, it is hard to imagine. Add this to the perception that hearing loss, with tinnitus, is an age issue, and you can see why Tinnitus Week.

Most people associate tinnitus with hearing loss affecting the older population, age-related hearing loss, but the incidence is growing in the younger population, possibly due to exposure to high levels of noise through earphones, earbuds (2019 Canadian study) and live music as demonstrated in this case study. 23-year-old pool attendant attends Occupational Health for her hearing test. As part of her assessment questionnaire, she declares a hobby of attending heavy metal concerts although she states she is careful to wear hearing protection. Her hearing test shows a 20-decibel hearing loss compared to the expected hearing of her age group. Hearing loss from exposure to extreme or high levels of noise over time can occur at work. The HSE Noise at Work Regulations came into force in 2006 and included the entertainment and music industry in


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2008. This legislation aims to ensure that workers’ hearing is protected from excessive noise, which could cause them to lose their hearing and/or to suffer from tinnitus. Levels of noise exposure are set at 80 to 85 decibels with protection being advised at the former level and mandated at the latter. Employers are required to control the noise or exposure, bringing levels below these parameters, and providing protection when they can’t. There is also a need to regularly assess workers’ hearing to ensure any early deterioration, with or without tinnitus, is picked up quickly. Occupational Health (OH) teams usually undertake this testing, leading to the controls being revisited, if concerns are noted. Education is provided to workers by OH on how to protect their hearing, both in and outside of work as noise exposure for all areas causes accumulative damage if protection is not worn. Another cause of tinnitus you may be surprised at is mental ill-health like anxiety and depression, but you won’t

be surprised to hear that severe and disruptive tinnitus can cause mental ill-health. Tinnitus can also be caused by a variety of factors over and above hearing loss such as a head injury, disease of the inner ear like Meniere’s disease, but also diabetes, thyroid disorders, or Multiple Sclerosis. Some medications for example chemotherapy, types of antibiotics, anti-inflammatory medication, and aspirin, can lead to tinnitus as a side effect. All these factors are considered when OH assess individuals. For most people, the condition is minor and manageable but for those where it is intrusive, it can affect all aspects of their lives including relationships and work. The biggest impact seems to be on the ability to concentrate, exclusion from conversations as sounds are missed and the impact on mental health. Unfortunately, some people don’t disclose to their employer for fear of affecting their job prospects.

On occasions, the more severe effects of tinnitus such as lack of sleep, difficulty concentrating plus mental ill health can lead to poor behaviour. It can be known as a silent but violent condition, caused by extreme strain leading to a lack of tolerance and ability to regulate emotion, from rage at the sound which permeates all thoughts. Individuals are advised to seek help if they experience tinnitus regularly, is deteriorating, affecting sleep, concentration, or mental health or it beats in time with their pulse. This latter condition is called “Pulsatile tinnitus” and is caused by disorders of the blood vessels or arteries with further investigation needed. Generally, the GP will look for wax build-up, infection, or hearing loss for tinnitus that is not pulsatile.

The NHS make these suggestions to sufferers: DO • • • •

Relax using deep breathing or yoga exercises Find ways to improve sleep by using sleep hygiene methods Avoid stress or loud background noise if these issues cause symptoms to become worse Try self-help techniques such as those advised by the British Tinnitus association including exercise, diet, meditation, visualisation, and relaxation Joining support groups as knowing others are in a similar situation can be very helpful

DON’T • •

Have total silence, sound therapy such as music can be helpful Focus on it, utilise hobbies and activities as distraction techniques.

If the effects of tinnitus remain severe then the GP or ENT specialist team can refer for tinnitus counselling or CBT (Cognitive Behavioural Therapy) to help individuals understand, cope and change the way they think about tinnitus to reduce the mental health impact. In some cases, tinnitus retraining can be provided which uses sound therapy to tune out the sound. There is also technology that can What about work? 38% of tinnitus sufferers feel that it affects their concentration and mood at work. Not everyone has the same level of impact but those with a moderate or severe impact are likely to note an effect on their productivity. Several people report that they do not feel confident in informing their employer (RNID, Hearing Health Foundation (HHF). Considering these figures, it is well worth employers opening the conversation about health and discussing with individuals what impact tinnitus may be having for them. There may be simple measures that could be put in place to support the individual, which could be agreed upon locally. Or consider a referral to OH where a more in-depth discussion can be held to provide information to the individual and advice to the manager. In some circumstances,

a workplace assessment is ideal as bespoke solutions can be put in place for that individual. This could include technology that may be reasonable or funding support could come from Access to Work or if the person is a veteran, RNID. In many cases, a stress risk assessment is advised to ascertain what, if any, workrelated stress could be impacting the individual or whether their condition impacts their tolerance of usual work stressors so these can be managed where feasible. In some circumstances, OH may suggest a WRAP (Wellness Action plan) to assist with self-management and workplace support. Finally, a reminder that any noisy environments need to be risk assessed by monitoring the noise levels and reducing levels wherever possible. This is especially important if they reach the HSE guide of 80 decibels over time or there is a one-off loud noise over 135 decibels. If they do, consider a hearing monitoring program with OH which will help identify early any noise-induced hearing loss (NIHL) and anyone at a higher risk of losing their hearing. OH provide much-needed education to the workforce exposed to noise

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How to Sit with Lower Back Pain – A Posture Guide Many of us find ourselves sitting for large portions of the day, whether through work or through hobbies. While this may be a necessity, staying seated for long periods can lead to back pain and especially pain in the lower back.

You may have good standing posture but this does not equate to a good sitting posture. And if your posture is poor when seated then this can create pain in your back that will persist when standing, especially if you have been sitting poorly for long periods of time. The best advice for seated posture has been updated over the years so the advice that you might have heard when growing up may not be the best advice according to the experts today. However, the most recent advice from ergonomic specialists is accepted by most and is proven to reduce back pain.

Proper sitting position A proper sitting position is one that reduces compression on the spine and promotes good circulation and blood flow throughout the body and the legs.

While some advice may be adapted according to your height and desired seating position, there are a few golden rules that you should always follow to avoid lower back pain when seated:

Do not cross your legs – this disrupts your circulation and is especially bad for people with sciatica

Keep your feet flat – this can be on the floor or on a footrest if needed

Your knees should be slightly lower than your hips and bent at around 90 degrees

Keep your back pressed against the backrest of your chair rather than slouched forwards – this is important as it provides support on your spine

Your shoulders should be relaxed and your arms should be bent in an L shape at the elbows

If there is a gap between your lower back and the backrest of the chair then introduce a lumbar support to bridge this gap and keep your spine fully supported

By following these rules, you will be keeping your body neutral and exerting as little pressure as possible on your spine.


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How to sit at your desk to avoid back pain If you regularly sit at a desk then you should have a set up that meets your needs. This means personalising the height of your desk, chair and monitor, and also the placement of your keyboard and other accessories. Here are some tips when working at a desk to avoid back pain:

Your monitor should be in line with your natural level of eyesight, or at least no higher than two inches above this

Your monitor should also not be further than an arm’s length away to discourage leaning

Your forearms should be straight and bent at the elbows, with your keyboard easily within reach

Keep all of your equipment directly in front of you to avoid needing to twist or rotate your spine

You can also consider alternating between sitting at your desk and working at a standing desk if you have the option to. If not, then be sure to take regular standing breaks to prevent experiencing back pain.

FAQs Where should lumbar support be on your back? Lumbar support should be placed at the curve of your back. Sit back in your chair and place your lumbar support in the gap that is found between your back and the backrest of your chair. Not everyone has this gap and some chairs will naturally provide lumbar support whereas others will not. How to sit with QL pain?

100 or 110 reclined angle In the past, it was thought that sitting with a 90-degree angle between your legs and your spine was the best way to sit. However, this is no longer the most advised method by ergonomic specialists. Instead, you should now sit with your chair in a slight recline at an angle between 100 and 110 degrees. Be sure to always keep your spine straight, shoulders relaxed, and your back pressed against the backrest of your chair to maintain support on your spine. You should still keep your spine straight and your hips neutral with no slouching between your hips and your back. By doing this, you will drastically reduce the pressure exerted on your spine and prevent experiencing pain.

Ergonomic chairs for lower back pain Some chairs make sitting correctly easier or more comfortably than others. At PAM Health, we stock a wide range of ergonomic chairs that are suitable for individuals with lower back pain or for people who want to prevent themselves experiencing back pain in the future. Check out some of our best chairs for back pain and make an informed decision before making your next chair purchase.

Quadratus Lumborum refers to the muscles between the ribs and the pelvis on either side of your spine. Pain in these muscles can be caused by slouching to either side or twisting your spine. Sit straight and keep the best practices for seated posture in mind to avoid aggravating your QL muscles further. How to sit on a sofa with lower back pain? You should keep the best practices for sitting in mind even if you are sitting on a sofa rather than an office chair. This means to keep your spine straight, not twisted or slouched, and keep your knees below your hips and bent at around 90 degrees. How to fix lower back pain when standing for too long? Lower back pain when standing can actually be caused by your seated posture. You should try to correct your seated posture by sitting in a neutral position and taking regular standing breaks. By doing this, you will reduce the pressure on your spine and this can prevent back pain from occurring when you stand or walk. If back pain still persists, then seek advice from our medical professionals.

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Loneliness In The Workplace It is Mental Health Awareness week from 9th May to 15th May and the topic this year is Loneliness. Given the impact that measures to counter the Covid Pandemic has had, Loneliness is a very appropriate subject to be raising awareness of. We know that feelings of loneliness and social isolation can have a profound impact on both physical and mental health. For example, physically, loneliness increases the likelihood of mortality by 26% [1] and the effect of loneliness and isolation on mortality is comparable to the impact of well-known risk factors such as obesity and has a similar influence as cigarette smoking [2].

In terms of mental health, Loneliness puts individuals at greater risk of cognitive decline and dementia [3] and Loneliness and low social interaction are predictive of suicide in older age. Bearing these facts in mind it is worth considering what can we do in the workplace to help minimise and mitigate the impact loneliness may have on ourselves, and our colleagues. [4]

Looking back at how the pandemic affected levels of loneliness among employees, Gallup conducted polls which saw that, at the start of the pandemic, as millions of people shifted to working from home those who worked remotely 100% of the time reported higher percentages of “loneliness a lot of the day yesterday.”

As time passed, and as vaccines became more available and people began to socialise again, loneliness for fully remote workers dropped to levels indistinguishable from hybrid and fully on-site workers. To some this news was surprising; surely those working from home would be reporting higher levels of loneliness? There are at least two possible explanations; one, that remote workers adjusted to the conditions of working from home and two, that the surplus of lonely remote employees in 2020 were among the first to return once offices started to open up. By early 2021 those who work from home and those who are on-site report similar loneliness at 18%, whereas hybrid workers report just 14%. This suggests that, regardless of whether employees were working at home or in an office, a significant number were experiencing loneliness. So what can be done to try and reduce levels of loneliness that employees may experience?

There are many factors that could feed into solutions – the culture of the organisation; the make-up of individual teams not to mention the circumstances and experiences of each individual employee, amongst many other factors. Certainly, as a very general answer, the culture of the organisation can impact massively on the behaviours and attitudes of its employees, and their attitudes towards each other.

One recommended way to try to reduce loneliness at work is to encourage friendship in the workplace. As you will all be aware, friendship is - along with loyalty, teamwork, enthusiasm, hard work and improvement - one of PAM’s encouraged behaviours. Friendship in the workplace has been shown to can bring cooperation, innovation, inclusion, and belonging. Happier workers are more productive [5] so encouraging a culture of friendship is a win-win situation for the organisation and the employee too. Please remember this when interacting with colleagues that it’s in everyone’s best interest to feel part of the team.

[1] Holt-Lunstad, J., Smith, T.B., Baker, M., Harris, T. and Stephenson, D., 2015. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on psychological science, 10(2), pp.227-237 [2] Holt-Lunstad, J., Smith, T.B. and Layton, J.B., 2010. Social relationships and mortality risk: a meta-analytic review. PLoS medicine, 7(7), p.e1000316. [3] Holt-Lunstad, J., Smith, T.B. and Layton, J.B., 2010. Social relationships and mortality risk: a meta-analytic review. PLoS medicine, 7(7), p.e1000316. [4] O’Connell, H., Chin, A.V., Cunningham, C. and Lawlor, B.A., 2004. Recent developments: suicide in older people. Bmj, 329(7471), pp.895-899. [5] 8

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The Skills Gap The gap is getting bigger. Widen your scope The skills gap is widening and recruitment teams throughout the UK are struggling to secure the right candidates for their available positions. According to research by The Open University, in Scotland alone, 65% of businesses surveyed are struggling to recruit individuals with the correct skillset. Of particular concern, is entry level talent. As we move further into 2022, many organisations remain fully aware of the negative impact that the skills shortage is having on recruitment efforts. Without considered processes and a clear understanding of how to widen the pool of available candidates, mitigation of this recruitment issue will continue to prove challenging. The report also identified that 57% of businesses surveyed recognised the importance of apprenticeships and work-based learning, for the long-term success of a business. What about the other 43%? Perhaps the question remains.

What steps can organisations take to effectively and sustainably widen the talent pool? 1. Recognise the value of neurodiversity: Acknowledging the benefits that neurodivergent thinkers bring to an organisation is an important component

in talent attraction. Understanding and embracing these differences enables your organisation to tap into a vast set of unique skills and abilities that can set your business up for success. Research has shown that approximately 15% of the population has one or more neurodiverse characteristic. Positively, many organisations are acknowledging the talents and strengths of these individuals and are actively seeking to recruit them through targeted campaigns. Invest in education and training to better understand how the strengths of these individuals can positively impact your business. 2. Develop an inclusive recruitment process: This important step encourages not only neurodiverse applicants to feel confident in applying for a role, but those with disabilities too. An inclusive process can be achieved in a variety of ways. For example, be clear in each job description that your organisation is willing to undertake workplace needs assessments, as necessary. In addition, offer a variety of application and interview options. This will further support equal opportunities and assist in encouraging a diverse selection of applicants. Importantly, place your ‘disability confident employer’ logo at the top of each job advertisement. This demonstrates a commitment to offering an interview to disabled candidates who meet the criteria of the role and declare their disability.

3. Identify the skills-gap: Conduct a mini-audit and review the skills you currently have within your organisation, as well as those you expect to need in the future. This will allow your organisation to be more strategic in the hiring process. 4. Invest in your current workforce: By investing in your current workforce and committing to professional development, your organisation will enjoy increased retention and higher productivity. Whilst this doesn’t alleviate the current skills shortage, it enables you to secure a more solid foundation as your organisation move into the future. 5. Embrace apprenticeship programmes: Apprenticeships offer organisations a cost-effective opportunity to not only develop core skills but, create passionate business ambassadors in the process. Through an apprenticeships scheme, organisations can attract home-grown talent and nurture individuals in a direction that offers progression, whilst at the same time, future-proofing the business. At Concept Northern, we can work with you to not only support your apprenticeship programme, but your entire workforce. This will ensure that your organisation achieves increased productivity and retention through early disclosure and workplace adjustments. For further information contact us at:

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Domestic Violence has been defined as “any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence, abuse, rape or homicide between those aged 16 or over who are, or have been, intimate partners or family members regardless of gender or sexuality.” For the majority of people, home is a roof over their heads, a warm loving place where safety & comfort allows freedom of expression. Women and men who live with domestic abuse have a different perspective of home. It is a roof over their heads but also a place of fear, humiliation, intimidation and isolation, a prison and the place where they are more likely to be abused. Women and men find ways to manage their safety and the safety of their children. Statistics show that two in four women live with domestic abuse and for them, it is what they know.

Domestic abuse is about power and controls some of the characteristics are: • • • • • • •

Fear of being judged Fear of repercussions Losing the home and becoming homeless with children being taken away Walking on eggshells and being in a state of hypervigilance Being submissive and not able to be themselves, scared of talking to the opposite sex Coercive control Physical, verbal, financial, spiritual abuse and emotional abuse

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Domestic abuse can happen to anyone from any socio-economic background, race, age, gender, culture or religion. It is a hidden form of abuse where victims tend to minimise what they have been through. During coercive control, the victim is under a constant stream of criticism eventually leading to the victim losing their sense of personal integrity, confidence and self-respect. Victims also believe what they are told by the abuser, leaving them with a sense of guilt, shame, hopelessness and unworthiness. The concern is that no one will believe their experience because the perpetrator may seem to be a kind and caring person to everyone, on the outside of the family unit. The fear and anxiety that comes from being uprooted from your family home and the uncertainty of where the family will live, especially if they have children or have a disability are some of the barriers to leaving an abusive relationship. Once the barrier of keeping silent has been broken, there is help for victims. Finding help can be difficult particularly when a person has been constantly belittled, undermined and manipulated into believing it is their fault for the abuse. It might be difficult for them to leave home.

Disclosing an abusive relationship is the most dangerous time for victims. Women and men are having to manage their own safety to find a safe time to leave home to get the help they need. UK Says No More has created safe and discreet spaces for women and men experiencing domestic abuse to contact specialist support services or reach out to friends and family at these shops on local high streets. Boots, Superdrug, Morrisons and Well Pharmacies all have safe spaces. An abused person can go into any of the shops and ask to be taken to the space. This might be the first step for a man or woman being abused to get help (https://

When a person is at high risk of harm, or they have children a Multi-Agency Risk Assessment Conference ( MARAC) can be put in place to stop the abuse. A MARAC consists of local police, health visitors, midwives, child protection, housing practitioners, Independent Domestic Violence Advisors. The MARAC aims to share information to increase the safety, health and well-being of victims/survivors, adults and their children. There are also Independent Domestic Violence Advisors (IDVAs), providing independent practical support and assistance to people who have experienced sexual violence or abuse whether a crime has been reported to the police or not. They make sure victims have the best possible advice, information, access to services and support that they need and can act as an advocate when dealing with other agencies.

Two issues that can arise once a person has left or ended an abusive relationship is stalking and harassment. Stalking is a pattern of repeated, persistent and unwanted behaviour that is invasive and can generate fear, including stalking through social media - Stalkers can be male or female.

Women’s aid/men’s advice line provides emotional support, counselling and the Freedom program. The followon program Own My Life Course, empowers women/men to heal from their abuse to rebuild their lives. The organisation Men’s Advice line supports men living with Domestic abuse.

Harassment occurs, when a person, is placed in a position of, fear of violence and is a serious offence, whether a violent act has been committed or not. The Domestic abuse bill 2019 means that when a case does go to court. The perpetrator cannot cross-examine the victim in person in the family courts.

Moving on from Domestic abuse can be terrifying. Now, anyone can find out if a potential partner poses a risk to them or family and friends, by using Clare’s Law. Clare’s law was introduced in 2014 and a Domestic Violence Disclosure Scheme (DVDS) application can be made if someone is at risk of Domestic abuse ( publications/domestic-abuse-bill2020-factsheets/domestic-violencedisclosure-scheme-factsheet). One of the ways a victim can protect themselves is by applying for a nonmolestation order, which is used to stop an abuser from using threatening, violent, intimidating, harassing, pestering behaviour. It can also prevent the abuser from coming within a certain distance of you, your home address or even attending your place of work. If a non-molestation order is breached, it is an arrestable offense.

Stalking occurs when the person becomes fixated and obsessed with another. Stalking is a devastating crime, and its impact can result in major life changes for the victim, e.g.:

• • • • • • • •

Living in constant fear Invasion of privacy Threats of violence Loss of employment Having to move Isolation, unable to go out Depression, Anxiety & PTSD Potential physical injuries

Increasingly men are disclosing Domestic abuse.

An estimated 7.5% of women (1.6 million) and 3.8% of men (786,000) experienced domestic abuse in the last year Domestic abuse in England and Wales overview Office for National Statistics ( Members of the LGBT community are asking for help from specialist organisations such as Galop (https:// People living with disabilities are targets for Domestic abuse. The organisation Safelives has specialist support workers who help people living with disabilities ( spotlights/spotlight-2-disabled-peopleand-domestic-abuse). Once the silence has been broken, counselling services can help survivors heal from their experiences.

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BY ToHealth

What Is It And How Do We Get It? Resilience is often described as the ability to bounce back, being able to cope and be strong through adversity. Whilst these are attributes related to resilience, these sentiments are also largely reactive. Given the frequency with which we face challenges in life, should resilience not be best practiced on a proactive basis? The better prepared we are for life’s inevitable challenges, the less affected we will be by them. Resilience is commonly associated with extreme scenarios. Immense displays of heroism on the frontline, in the line of duty or in front of an 80,000 strong partisan crowd. We credit others as being blessed with having the innate gift of resilience. We often long to be as mentally strong as they are. But consider this, resilience is relative. It is very important in our own day-to-day lives, but it isn’t something we are born with. Our lives are big contributors to our resilience and therein lies a key point of difference between those who are resilient and those who are not. When you are presented with adversity in life, what do you do? Perhaps you actively engage with, try to problem solve, learn from your mistakes or ask for help. Maybe, you shy away and hope that it will all blow over, you might even

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blame others and find yourself believing that bad things only happen to you and that life seems unfair. If we are not reflecting on and studying an experience, we are likely bottling up some negative thoughts and feelings. These can begin to inadvertently damage our wellbeing. After all, it is not the case that resilient people do not get sad or angry, they do. They are just better able to recognise and understand their emotions. This allows them to engage with their emotions and try to upregulate themselves to a more positive state.

Why is resilience important? Resilience plays a key part in shaping our mindset. Our mindset is really a conscious decision, made unconsciously. Our default mindset will either be positive or negative and this autopilot will kick in when we are presented with adversity. If a default negative mindset occurs, then expect negative behaviours to follow suit. This isn’t a life sentence. Once we have identified that we possess a default negative mindset, we can take action. Self-improvement is a good way of actively building resilience. With a positive mindset, we will display positive behaviours that are going to be critical in forming a response to overcome adversity. In reality, the adversity may well pose some threat to

you, but that threat will only manifest if you do nothing about it. When you think positively and actively try to do something productive and constructive, good things tend to happen and threats within the adversity, are reduced. Being resilient enables us to maintain a healthy lifestyle. Resilient people are unperturbed by challenges. This allows them to avoid wasting time, energy and emotion on things outside of their control. This preserves time for them to honour their commitment to regular exercise and good nutrition, social interactions and adequate rest. These lifestyle habits serve as a reminder that they are not defined by their challenges. Creating boundaries helps to avoid burnout. These positive health behaviours also enhance energy levels, which further aids resilience. Life can be challenging sometimes. How can we expect to thrive if we are regularly giving ourselves a hard time and putting ourselves down. In doing this, we subconsciously chip away at our self-confidence, self-esteem and self-efficacy. We need to learn to love our flaws and idiosyncrasies, knowing that in spite of these, we possess many strengths and wholesome characteristics too. If we want to be the best, most resilient version of ourselves, we can of course try to develop our weaknesses, but we must also be our own cheerleader and champion our strengths.

How can we develop resilience? To comprehensively develop resilience we must look beyond the mental side of things and consider a holistic approach. The United States Air Force implores its personnel to achieve a complete state of resilience through nurturing the ‘four pillars of resilience’:

• • • •


The mental pillar refers to our ability to be flexible in our thinking. To learn to adopt an open and positive mindset where we are curious to let situations unfold and see what we can learn and achieve from then. This pillar also involves developing emotional intelligence. This can be done by spending more time with others, fostering empathy and reflecting on what different emotions really mean, what they are trying to tell us and how to control them. Whilst the things under our control may appear small and insignificant, they offer stability and reassurance that we are competent and capable. It is important to be aware of the things in life that are of concern, but only so that we know not to waste too much time, energy or emotion on them. The physical pillar of resilience involves performing behaviours and activities that will enable recovery and promote energy. If we want the brain to perform at its best, we must give it the right fuel. Consuming carbohydrates for energy, as well as for aiding serotonin release and good healthy fats to improve cognitive functioning and processing, is important. Much like a car without or with the wrong fuel, it will splutter its way to a halt and cause us problems. Performing regular exercise helps us to burn off excessive levels of







Core Values









Positive Thinking


Social Support



Given the high stress environments that these individuals operate in, it is important for them to harness the four pillars and translate their meanings into their own lives.

The Four Pillars


Resilience Provides Balance to Life

unwanted stress hormone, cortisol. It also causes a release in endorphins, helping to lift our mood and generate optimism. Life is very much a contact sport, so it’s essential that through exercise we also build up a physical capacity to withstand the rigours of life. Remember to prioritise sleep. When we are tired, our amygdala portion of the brain (responsible for informing you of danger) becomes hyper-reactive. This makes us more likely to interpret situations as threatening and invoking symptoms of anxiety. Stick to a routine so your circadian rhythm works with you. Knowing to give you helpful hormones in the morning to get you up and ready to tackle the day, and essential sleep hormones in the evening to encourage a restful and regenerative sleep, to recover from the demands of the day. The social pillar of resilience involves drawing on support networks. Having a social network in place acts as a safety net. It gives us the confidence to be bold and attempt challenges knowing that we have family, friends and colleagues who love us and who will continue to love us, regardless of any failures we may have. Our network also serves as a way to ensure our deep-rooted psychological survival needs are being met. We need to feel a sense of belonging, security and love. Being around others, gives us that.

Think about how you can diversify your network. Joining more clubs or involving yourself more in your local community are both great ways to establish new connections. Meeting new people helps to develop a more sophisticated emotional intelligence through sharing interactions and experiences. You may find a resilient role model for you to model your behaviour on. You might even find that you give more of yourself to others and gain a wonderful sense of reward and contentedness when you are able to reciprocate or ‘pay forward’ kindness. The spiritual pillar of resilience does not necessarily refer to religion, but for some people religion is a source of strength. It’s more about having faith and belief in a higher purpose. Trying to establish your reason for being. It could be following a particular set of values or principles, fulfilling a vocation or simply wanting to be the best version of yourself. An easy way for us to remain focused on a purpose is to set goals. A resilient person will set goals and understands that the inevitable challenges along the way are part of the journey. When the goal is completed, the sense of accomplishment and satisfaction is ever sweeter, knowing that it is the product of hard work and obstacles overcome. This induces a confidence and self-belief for future tasks, knowing that with the right application and mindset, anything can be achieved. Compass Magazine 13


Fibromyalgia A Hidden Condition Fibromyalgia is a poorly understood condition. We do not fully know yet what causes it or how to treat it. While medication can help some people, self-management is the mainstay of care and the key to living well with Fibromyalgia. The main symptoms of chronic widespread pain and extreme fatigue can vary in intensity. Because the symptoms of Fibromyalgia are not visible to the observer and change so much from day to day, it can be hard for others to genuinely appreciate the impact they have. I hope this article will help to raise awareness and understanding of this hidden condition. There is no simple test for Fibromyalgia, with a diagnosis being based on the symptoms and history given. Many wait a long time and see several specialists before getting a diagnosis. This makes it harder to work out how common it is. Some studies suggest between 2 in 100 people have Fibromyalgia (Croft 2002). While the NHS website states it may be as high as 1 in 20. Fibromyalgia is diagnosed in women more often than men, but the reason for this isn’t clear. It may be because the condition is not as well recognised in men or because they are less likely to see their GP.

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Symptoms of fibromyalgia. As well as widespread pain, people with fibromyalgia may also have:

• • • • •

• •

increased sensitivity to pain extreme tiredness (fatigue) muscle stiffness difficulty sleeping problems with mental processes (known as “fibro-fog”), such as problems with memory and concentration headaches irritable bowel syndrome (IBS), a digestive condition that causes stomach pain and bloating w(Source NHS)

While having the ability to affect the quality of life, Fibromyalgia is not life-threatening. We do not really understand what causes it. Rather than being an inflammatory or autoimmune disease, we now think it is a condition of the nervous system. Studies suggest there is a gene that increases the risk of Fibromyalgia. But this alone does not seem to cause the illness. We think there also needs to be a triggering factor, such as physical or emotional stress. Many people link the start of their symptoms with a period of illness, pregnancy, or an emotional event such as bereavement. This may trigger a change in brain chemistry and how our nerves and brain process pain. The American College of Rheumatology describes Fibromyalgia as a “Central Pain Amplification disorder”.

Fibromyalgia is a long-term condition for which we do not currently have a cure. The nature and degree of symptoms can vary both from person to person and day to day. The pain experienced can be widespread, affecting just specific areas of the body or changing locations. The strength and type of pain can change too. Those with Fibromyalgia describe it in varying ways, including it being a deep ache, shooting pain, tenderness, burning, or pins and needles. Unfortunately, painkillers do not always help manage this type of pain. Extreme tiredness or fatigue is also a common feature, again the levels experienced can change and vary daily. One moment you can feel well and the next struggle to function as if someone has “pulled the plug”. Most people with the condition also have problems with poor sleep. We now think that this may be linked to the hormones serotonin, noradrenaline and dopamine, as people with Fibromyalgia tend to have lower than average levels. The relationship between these hormones, the quality of sleep and fibromyalgia appears complex. Poor sleep may reduce levels, while low levels may also cause problems with disturbed sleep. Treatment with medication can help some people. However, others find they experience side effects that outweigh the benefits and decide medication is not for them. Physical or emotional stress appears to make symptoms worse. Common triggers include illness, overexertion or “doing too much”, feeling stressed, depressed or anxious. They may also experience increased sensitivity, with exposure to hot or cold temperatures, touch or pressure, loud noise, bright lights or even strong smells triggering pain.

We think that these factors make symptoms worse by increasing the level of stress hormones, which influences how we experience pain. We do know that dealing with long term fatigue and pain can result in difficulties with depression and anxiety. This, in turn, can make it much harder to stick to the routine and self-care measures that help people with fibromyalgia function at their best.

Pacing – The three Ps Plan your activity to be use the least amount of energy. Prioritise the most important or demanding tasks to when you feel at your best. Pace your activity to your available energy. Carrying out short periods of activity but taking a rest, or alternating to a less demanding task. Rest should be to prevent exhaustion, not because you are tired. Therefore, taking regular short breaks can sometimes be better than pushing on and taking a long break. Remember that tasks that require you to concentrate and focus also require energy. Pacing isn’t just about physical activity.

Self-care is the main method of managing fibromyalgia with pacing being a key part of this. Pacing involves managing your activity, balancing rest and activity so as not to drain your energy completely. Instead taking a break to rest or carry out an easier task before the battery is flat, rather than only stopping once it is drained. The principle of pacing sounds simple, but can be tricky to stick to. It can be hard to plan activity or judge when to take a break. People also tend to do as much as they can on a “good” day, not always appreciating, that doing so may help trigger a “bad” one. The good news is that once mastered, pacing can smooth out the peaks and troughs, helping to reduce flare-ups and the impact Fibromyalgia can have on daily life. Gentle exercise, mindfulness and Cognitive Behavioural Therapy (CBT) can also help manage the condition. This is not because, as some people mistakenly think, the symptoms of fibromyalgia are not real. These techniques can help people to understand and accept their symptoms, learning to live with them in a way that reduces the impact on their physical and mental wellbeing. The charity, Fibromyalgia Action UK highlight “People with fibromyalgia tell us that their work is important to them, even though they have this condition and that an understanding, supportive employer can make a world of difference in enabling them to cope”. Because you cannot see pain, fatigue or the other symptoms of Fibromyalgia, it can be helpful for managers to listen to their employees. Having a better understanding of how Fibromyalgia affects the individual makes it easier to help them function at their best.

References Croft, P. (2002) ‘The Epidemiology of Chronic Widespread Pain’. Journal of Musculoskeletal Pain [online] 10 (1–2), 191–199. available from: Fibromyalgia (2017) available from Fibromyalgia (n.d.) available from: Fibromyalgia Action UK (n.d.) available from:

Compass Magazine 15

BY ToHealth

What is it, why is it so relevant and how do we overcome it? Anxiety can create feelings of dread, butterflies in the stomach and an increased heart rate. It is a word that more and more people are becoming familiar with. The media - be it social, news networks or the newspapers and tabloids, often portray anxiety as the jittery sibling of depression. Both are thought to be the main mental health conditions experienced by individuals, today. It isn’t quite as ‘all or nothing’ as that. Anxiety can be defined as “multiple mental and physiological phenomena, including a person’s conscious state of worry over a future unwanted event, or fear of an actual situation. Anxiety and fear are closely related.” (Foa et al, 2017, p.189 1) It is an umbrella word given to the different subtypes of anxiety.

Some commonly diagnosed anxiety disorders are: • • • • • • • •

Generalised anxiety disorder (GAD) Social anxiety disorder Panic disorder Phobias Post-traumatic stress disorder (PTSD) Obsessive-compulsive disorder (OCD) Body dysmorphic disorder (BDD) Perinatal anxiety or perinatal OCD

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(For more information about the above, visit the mind A-Z page https://www. In England, in any given week, 6 in 100 people will experience GAD, 4 in 100 will experience PTSD, 2 in 100 will have a phobia and 1 in 100 will experience OCD. These are only the reported figures, it is likely much higher (McManus, 20162). Many factors can contribute to the development of anxiety. Genetics, life experiences, drugs (even alcohol and caffeine) and our everchanging circumstances, are just a few. Each day, we can move through different states of feeling anxious. It can become a mental health problem when it impacts our ability to live our life as fully as we would like. Our mental health and wellbeing is fluid and dynamic. It changes all the time. Someone who has a diagnosis of GAD, may not always experience it. It can come and go, depending on different situations in their life. Gordon Allport (19373) mentioned in his studies that mental health and illness are not two independent constructs. Rather, he suggested that they are two poles of a linear continuum that keeps changing throughout the lifetime. This can be seen as the starting block of what is now referred to the Mental Health Continuum.

Depending on the variation of the continuum being considered, there are several distinct markers.

• • •

The healthy point The problem point The disorder point.

Some may argue that this use of language does not promote positivity and simplifies what is the complexity of psychology. Let’s fast forward a few years. We now include language such as ‘languishing’ and ‘flourishing’. Within this perspective, a mental health disorder or an overall distressed state is referred to as ‘languishing’. A more positive and content state is called ‘flourishing’. Similar continuums use words like ‘struggling’ and ‘thriving’ to describe such states. ’Surviving’ is labelled a middle ground. It is important to remember that we all are capable of moving from one end of the continuum to the other. Being in a red zone does not imply that we cannot get to the green zone again, and vice versa. Being mentally ill does not mean that there is a complete absence of mental health. It suggests that a person, at a particular point in their life, is experiencing the negative end of their continuum (Chowdhury, 20214). The truth is, we all have moments of anxiety. We can all find ourselves on the not so nice end of the continuum.

Figure 1. Mental health continuum. From an evolutionary perspective, the signs and symptoms of anxiety, our emotions and our physiological reactions, helped to keep us out of danger, away from predators. They protected what was important to us for survival. Our modern world doesn’t seem to have much of a place for these feelings. Our primitive fears no longer play that fundamental role in our lives but remain an important part of them. Having the right tools to cope with anxiety can help us to view it in a more accepting way and allow us live with it but not let it take over our lives.

Here are our top tips to managing mental health: 1. Question your thought pattern Negative thoughts can take over your mind and distort a situation. Challenge your fears. Ask if they’re true, or based on emotions and feelings. Identify where you can take back control and write down your thoughts. Writing down what is making you anxious takes it out of your head and can make it appear less daunting.

2. Identify and learn to manage your triggers - Sometimes triggers can be obvious, like caffeine, drinking alcohol, or smoking. Other times they are less obvious and more situational specific. Long-term problems, such as financial or work-related stressors, may take some time to figure out and problem solve. They may necessitate extra support. This could be through therapy, with friends or accessing other specific services. 3. Exposure and response prevention (ERP) - This is used for a range of anxiety disorders. It is particularly effective for helping with obsessivecompulsive disorder (OCD). ERP therapy encourages you to face your fears and let obsessive thoughts occur without ‘putting them right’ or ‘neutralising’ them with compulsions. Exposure therapy starts with confronting items and situations that cause anxiety, but anxiety that you feel able to tolerate. After the initial exposures, you will find that your anxiety does not climb as high, nor last as long. 4. Adopt cognitive behavioural therapy (CBT) - CBT helps people learn different ways of thinking about and reacting to anxiety-causing situations. A therapist can help you develop ways to change negative thought patterns and behaviours before they lead to a downward spiral.

5. Commit to something that you find calming and relaxing - This could be focussed deep breathing, meditation, going for a walk, yoga, different forms of mindfulness, etc. Whatever you choose, set time aside to work it into your week with the aim of making it a daily habit. 6. Ask your doctor about medication - If your doctor or mental health practitioner believes that your anxiety is severe enough, it may be beneficial to discuss the use of medication. There are a number of options available, depending on your symptoms and how your body may react. In addition to the above tips, eating healthily, staying active, having a great routine, prioritising sleep and keeping a journal or diary, are all positive ways to manage your mental health. If you require further information on how ToHealth can support you, please get in touch at For more information on the topic of anxiety, please take a look at the anxiety UK website - https://www., alternatively, you can take a look at the mentalhealth UK website for helpful information around anxiety and many other mental health conditions treatment/.

References 1. 2. 3. 4.

Foa E. B, Franklin M, McLean C, McNally R. J, Pine D, Costello E. J, Kagan J, Kendall P, Klein R, Leonard H, Liebowitz M, March J, Ollendick T, Pynoos R, Silverman W, Spear L (2017). Treating and Preventing Adolescent Mental Health Disorders: What we know and what we don’t know (2 ed.). Oxford University Press. McManus, S, Bebbington P, Jenkins R, Brugha T. (eds.) (2016). Mental health and wellbeing in England: Adult psychiatric morbidity survey 2014. Allport, G. W. (1937). Personality: A psychological interpretation. New York, NY: Holt. Chowdhury, M.R. (May, 2021). What is the mental health continuum model? Compass Magazine 17


The Benefits Of A Home Workout The past couple of years we have been thrown into a whole new reality, in which every aspect of our usual routine had to be re-adapted. Our home has suddenly been transformed into the main setting of our whole life: it became the place where we would be working, studying, home schooling our children and also spend our free time working on our hobbies or exercising, often with rooms dedicated to each one of these activities. Particularly, many carved out space in their living rooms or terraces to make room for fitness equipment and with no surprise, stuck to them even once gyms reopened. In fact, home workouts can offer an array of advantages, and many were not willing to give them up to go back to their pre-pandemic gym routine. In this blog post, we will list you the main benefits of working out from home and I am sure by the end of this article you will be tempted to give it a go. FLEXIBILITY TO WORK OUT WHENEVER AND WHEREVER YOU WANT Having your own workout set up gives you a lot of flexibility as you can train when it suits you best, without time limits, and without the need to take the car or the bus to get to the gym. You can work out during your lunch break, before picking the kids up from school, or if you like, even in the middle of the night! There are no opening and closing times to stick to, as you are the one setting up your own workout schedule. YOU WILL HAVE MORE TIME FOR YOURSELF This point links to the one above, as being flexible with your workout times and schedule, then enables you to have more free time, as you can fit it anytime throughout the day, it cuts out all the travelling time and also, once you finish exercising, you can jump into your shower to get ready for the day without having to carry a heavy gym bag full of clean clothes and toiletries. But also, 18 Compass Magazine

you will avoid having to stand by and waste time waiting for machines to be free, making your workout not only more effective, but also more concise. IT WILL MAKE YOU SAVE MONEY Some people think that buying gym gear can be expensive, and although this may be true for some pieces of equipment, it is definitely not the case on a general note. Although upfront costs may seem overwhelming, there are no other expenses involved in setting up a home gym as there is no membership or fee to pay for. In fact, in the long run, you may even be saving money! LESS DISTRACTIONS THAT HINDER YOUR RESULTS When exercising at home, you don’t have to worry about your surroundings or people interrupting your workout. And even if you may find some distractions within your home gym, you have full control over them and can eliminate them if necessary, whilst this is not possible at the gym. This means that you can concentrate entirely on your workout without the fear to lose focus. KEEP YOURSELF COMFORTABLE Some of us are conscious when working out at a gym full of other people, and this can negatively impact our fitness journey. However, you don’t have to worry about this when working out in your own home, as you can feel free to do any exercise you like or wear what you want, without the fear of being the target of judgement and unwanted attention. VERSATILITY IN TRAINING STYLE Yes, home workouts can be extremely versatile! You don’t need to buy heaps of equipment, just a few right ones. With a few and cost-effective fitness tools, you will be able to create efficient and new workouts to stimulate your

passion and keep you enthusiastic. By creating innovative workouts, you will also reduce the risk of getting bored of performing the same exercises, hence allowing you to constantly upscale your fitness journey. IT CAN BECOME A FAMILY ACTIVITY As mentioned earlier in this article, one of the benefits of working out at home is the lack of distractions, including people, who could take your focus away from your training session. However, it is also true that setting up your home gym can also be a good way to organize a family workout and spend quality time together. This way you will not only help your loved ones stay healthy and strong, but you will also create exceptional family memories. There are plenty of group activities that can be done with only a few pieces of equipment, and that are also child friendly. These are our main reasons why you should get into home workouts. If you were uncertain whether to set up an exercise-dedicated area in your home, I hope this article helped answering your concerns and made you want to give it a go!

Compass Magazine wishes to thank its contributors from PAM Groups businesses:

PAM OH Solutions is a national Occupational Health provider. We work with clients across all industry sectors, delivering a flexible range of high quality, pro-active and cost-effective services. Combining the traditional values of professional integrity and good customer service with a modern progressive approach to service delivery.

We deliver efficient and fit for purpose Occupational Health solutions to improve attendance and reduce absence in full compliance with legislation. Our approach extends beyond simply providing a reactive management referral service, we aim to forge strong working relationships with our clients, working in partnership to deliver tailored absence management solutions.

PAM Wellbeing was born out of a need to support our customers and their employees from a holistic health and wellbeing perspective in 2009, expanding on the physical health and rehabilitation services that our occupational health sister company has expertly provided since 2004.

a strategic wellbeing partner to support their employee’s whole health and wellbeing needs, and for their employees to benefit from the multidisciplinary expertise of our extensive team.

Our suite of mental health, psychological and wellbeing solutions enables organisations the option to engage with

PAM Health is one of the UK’s leading healthcare-product suppliers. Based in Liverpool, providing a wide range of solutions to workplace-health challenges including:

• • • •

Posture and musculoskeletal problems Chronic neck and back pain Carpal tunnel syndrome Headaches and migraines

We work strategically to implement proactive workplace mental health and wellbeing solutions, to help organisations and their people thrive.

• •

Injuries to employees Hygiene and infection control

Working in partnership with all of PAM Group, we provide a range of products to assist with continued occupational health processes. From ergonomic chairs to sit/stand desks and everything in between.

Compass Magazine 19

Holly House, 73-75 Sankey Street, Warrington, WA1 1SL

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