All posts by Frances Coleman-Williams

What is World Autism Awareness Day about?!

Since I’ve started raising awareness about autism, you would have thought it would be the ideal opportunity to jump on the band wagon and publish a post on World Autism Awareness Day but I thought I’d, instead, spread some education, from the autism community about what’s really going on…

People are aware of autism, so what is the meaning of the day? What are we actually raising awareness of? While it makes sense to raise awareness of rare diseases, it would make more sense to bring acceptance of autistic people, understanding of autism.

The awareness day didn’t come out of the autistic community, it was created by the United Nations for the community—while it’s well meaning, as often happens when autistic people aren’t consulted on things that are for them, a few things don’t quite add up…

Unhelpful puzzle-piece representation

For example: the puzzle piece is often used to represent autism, suggesting that autistic people are a puzzle, have something missing, or they don’t quite fit—it’s not exactly the most positive representation. Another, less than favourable, “light it up blue” campaign from the abhorrent Autism Speaks organisation is based on damaging stereotypes.

Many members of the autistic community feel ambivalent about the day because it makes no difference to them and their everyday life. What would make far more difference would less ableism, more reasonable adjustments at work, less stigma and discrimination in the world—is this day really achieving this?

The way the autistic community works is to share our stories. We’re an accepting community for people who’re searching for answers. Often people have been feeling lost and disconnected for years. Belonging is a fundamental human need.

I try to use my blog has a positive effect in getting my story out there and perhaps helping people feel less alone. Autism awareness day doesn’t really work because it’s another example of the disability community being done to… When it comes to anything disability related, it’s best to stick to the moto “nothing about us without us”.

For further thoughts on these subjects read this article “An Autistic’s Perspective” is a great read!

Checkout my thoughts about how awesome it is to be part of such an accepting community in this post!

female holding seated yoga pose

How yoga has totally transformed my life

Having recently discovered yoga, I’ve found far more benefits than I could have imagined. My mind, body and overall health have improved in layers.

1. Physical health—strength , flexibility and balance

Depending on the type of yoga practiced, incredible strength is needed to obtain some of the poses and movements. During vinyasa flow yoga practice, you’re encouraged to breath in a particularly way with each movement. Regular yoga practice builds strength and flexibility across your whole body. While holding the poses, even simple ones, your balance is improving each time.

Healthier blood flow around the body, in turn helps with blood flow to the brain which can help with clearer thinking. On a personal note, yoga can help with chronic conditions such as chronic pain—most (if not all) of the movements and poses can be modified if disability prevents the full posture being achieved. To start with I found, even, upward and downward facing dog difficult but I soon mastered a full sun salutation.

2. Mind-body connection

2 women, 1 with Down syndrome, doing yoga together

For all sorts of reasons, I struggle to understand the experiences of my body; I’m not sure what signals it’s giving me. It’s taken me a long time to understand hunger (for example) and when I experience pain, I’m not sure how to respond. Proprioception is the awareness of the body and its movement in space, yoga has really helped me be more aware of my body and to be more connected with it. A good yoga teacher will help you be aware of how far to push your body, to listen to its cues and to this has the huge benefit of having a better overall awareness of what your mind and body need.

3. You time—self compassion

As soon as you make the decision to do something for yourself, you’re showing yourself compassion. How many of us think we don’t have time to do something for ourselves? Think we’re too busy, have other priorities or put other people first? Carving out some you-time isn’t a bad thing, it’s not indulgent to look after yourself, after all, you can’t look after others if you in poor health… Treating yourself well has all sorts of knock on benefits, including: eating better, a calmer mood, more motivation, better confidence and self esteem, overall better mental health!

4. It’s not limited

A woman and young boy doing upward facing dog together

There are so many different types of yoga you’ll be able to find something that can work for you. You can do it with a child, in groups, on your own, while you’re pregnant, you can find work outs that make you sweat or that help you meditate, harder poses if you need something to motivate you to work harder over a period of months/years and there are simple movements if you body needs a break.

Yoga can help with specific issues such as bloating and digestion or headaches but it’s also great for overall fitness and health. You can do a 5 minutes routine in the morning or evening (to help you wake up or wind down) or a full blown intense hour long workout.

I would highly recommend finding a teacher who has the ability to modify postures and poses to individuals. Even online teachers can do this quite easily. It’s also important that they don’t make you feel as though you’re a failure for needing to do the modified moves, our bodies are all different and that’s ok.

During lockdown I started following YouTube videos daily and have found this to be incredibly beneficial for keeping a routine. My recommendation would be Boho Beautiful, she has a huge range of videos and has the option to join a community to get longer workshop video (I’ve never felt the need for this as her YouTube videos are enough for me!).

stethoscope and pen on medical chart

An Explanation of Moral Injury

Moral injury is defined as the profound psychological distress which results from actions, or the lack of them, which violate one’s moral or ethical code.

All in the medical profession sign up to a moral code that promises beneficence and non-maleficence. To not only do good for those in their care but to do no harm. The covid-19 pandemic as called on many frontline workers to push themselves to the brink. Previously called burnout, it is now recognised that when clinicians are asked, repeatedly, to act in a way, in a top-down administration, that is in opposition to their moral compass, it can cause untold damage.

Lack of resources such as beds, ventilators or medicines can mean frontline workers are unable to give the care they know can save lives, having to self-isolate while colleagues are stretched beyond capacity, knowing you’re not able to provide care for those with life limiting conditions because you’ve been re-deployed to give life-saving treatment or being involved in any keyworker roles under extreme pressure may lead to unnecessary risks being taken.

Ambulance technicians sitting in a queue instead of taking the next call, palliative care nurses preventing relatives from sitting with their loved ones as they die, admin staff sending out letters to push back patients’ outpatient appointments/surgery or any staff trying to follow policies set out by management that don’t appear to be patient centred are all events that could be considered potentially morally injurious. While in themselves, the worker may manage each individual event, it might be the build up or it might be the lack of support that can cause the most damage.

Man in scrubs looking depressed

Experience of potentially morally injurious events can lead to negative thoughts about oneself such as “I’m a terrible person” or “I’m not good enough” which can lead to shame and guilt. Although moral injury itself is not a mental illness, it can lead to symptoms of post-traumatic stress disorder when the sufferer can have flash back, lack of sleep and anxiety.

There is an increased risk of moral injury if the following occurs:

  1. Loss of life to a vulnerable person (e.g. child, elderly);
  2. Leaders are perceived to not take responsibility for the event(s) and are unsupportive;
  3. Staff feel unaware or unprepared for emotional/psychological consequences of decisions;
  4. The potentially morally injurious event occurs concurrently with exposure to other traumatic events (e.g. death of loved one);
  5. A lack of social support following the potentially morally injurious event.

Moral injury may not be restricted to frontline healthcare workers but can also be experienced by shop workers, teachers, social workers or prison staff for example. A lack of clear guidelines, training and resources mean they feel their own health is at risk and their unable to adequately care for those entrusted to them.

Man in scrubs sitting on the floor

Guilt or shame surrounding this issue can mean staff are reluctant to talk about it. Lack of support and a belief that it’s “all in a day’s work” means staff can turn to unhealthy coping mechanisms to manage the impact of moral injury.

It has been found that psychological screening or de-briefing is ineffective but the following may be beneficial for anyone exposed to potentially morally injurious events:

  1. Education and being made aware of the thoughts and feelings that could arise from the events and discussing the topic in advance to ensure staff are psychologically prepared;
  2. Seek informal support from colleagues, peer supporters, chaplains, managers etc as early as possible;
  3. If informal support doesn’t help and the events appears to be impacting the individuals daily life, professional help should be sought early. Sources of confidential support should be advertised within organisations so that it’s easily accessible.
  4. Those in leadership should have psychologically informed conversations upon checking in with their staff regularly. If they don’t poses the skills, trained peer-supporters could take on this role. These “check-ins” should involve encouraging staff to seek help whenever necessary.
  5. Frank discussion of events and team cohesion can help. It’s important to understand the impact on mental health as well as being aware psychological growth can be expected if staff do their best.
  6. Limiting exposure to media and unreliable news outlets and instead seeking information from trusted sources such as public health England and finding evidence-based coping resources (i.e. https://www.nhs.uk/oneyou/every-mind-matters/).

Experiencing moral injury and/or needing informal or professional support doesn’t make one person stronger or weaker than another.