Why Has Nobody Told Me This Before? DR JULIE SMITH WRITE-ON PAGES Any references to ‘writing in this book’ refer to the original printed version. Readers should write on a separate piece of paper in these instances Contents Introduction 1: On Dark Places 1 : Understanding lo w mood 2 : Mood pitfalls to w atch out for 3 : Things that help 4 : Ho w to turn bad da y s into be er da y s 5 : Ho w to get the basics right 2: On Motivation 6 : Understanding moti v ation 7 : Ho w to nurture that moti v ation feeling 8 : Ho w do y ou make y ourself do something w hen y ou don ’ t feel like it ? 9 : Big life changes Where do I start ? 3: On Emotional Pain 10 : Make it all go a w a y ! 11 : What to do w ith emotions 12 : Ho w to harness the po w er of y our w ords 13 : Ho w to support someone 4: On Grief 14 : Understanding grief 15 : The stages of grief 16 : The tasks of mourning 17 : The pillars of strength 5: On Self-doubt 18 : Dealing w ith criticism and disappro v al 19 : The ke y to building con fi dence 20 : You are not y our mistakes 21 : Being enough 6: On Fear 22 : Make an x iet y disappear ! 23 : Things w e do that make an x iet y w orse 24 : Ho w to calm an x iet y right no w 25 : What to do w ith an x ious thoughts 26 : Fear of the ine v itable 7: On Stress 27 : Is stress di erent from an x iet y ? 28 : Wh y reducing stress is not the onl y ans w er 29 : When good stress goes bad 30 : Making stress w ork for y ou 31 : Coping w hen it counts 8: On a Meaningful Life 32 : The problem w ith ‘ I just w ant to be happ y ’ 33 : Working out w hat ma ers 34 : Ho w to create a life w ith meaning 35 : Relationships 36 : When to seek help References Resources Ackno w ledgements Spare tools Inde x About the Author DR JULIE SMITH has o v er ten y ears ’ e x perience as a clinical ps y chologist and w as the fi rst professional to use TikTok to gi v e insights on therap y A er running her o w n pri v ate practice , Julie launched her TikTok channel w ith the mission of making top - qualit y mental health education accessible to all During the COVID - 19 pandemic , her audience gre w astronomicall y to 3 million follo w ers as users related to the bite - si z ed self - help v ideos she w as sharing and put her ad v ice into practice Those v ideos ha v e clocked up around half a billion v ie w s across her platforms She w as named b y TikTok as one of its Top 100 creators Julie has appeared in t w o BBC fi lms as w ell as on CBBC , Good Morning Britain , BBC Breakfast and CNN International She is the BBC Radio 1 Life Hacks ps y chologist and has been featured b y Women ’ s Health , Bu zz feed , the Telegraph , The Times , the Mail on Sunda y , Glamour , CNN and more Julie li v es in Hampshire , England , w ith her husband and three children Dr Julie Smith , BSc ( Hons ), D Clin Ps y ch ., C Ps y chol Chartered Clinical Ps y chologist Registered w ith the HCPC and BPS @ drjuliesmith @ drjulie @ drjulie For Ma he w If mine is the ink then y ours is the paper Like all our ad v entures w e got here together Introduction I ’ m si ing in m y therap y room across from a y oung w oman She is rela x ed in the chair , her arms open and loosel y mo v ing as she speaks to me A transformation from the tension and ner v es of her fi rst session We ha v e onl y had a do z en appointments She looks into m y e y es and starts to nod and smile as she sa y s , ‘ You kno w w hat ? I kno w it ’ s going to be hard , but I kno w I can do it .’ M y e y es sting and I s w allo w The smile s w eeps across e v er y muscle in m y face She has felt the shi and , no w , so ha v e I She came into this room , some time ago , fearful of the w orld and e v er y thing she had to face Per v asi v e self - doubt led her to feel dread for e v er y ne w change and challenge She le therap y that da y w ith her head held a li le higher Not because of me I ha v e no magical abilit y to heal an y one or change their life She had not needed y ears of therap y that unra v elled her childhood In this situation , as in man y others , the major part of m y role w as as an educator I passed on insights about w hat the science sa y s and w hat has w orked for others Once she understood and started using the concepts and skills , a transformation began She felt hope for the future She started to belie v e in her o w n strength She started dealing w ith di cult situations in health y ne w w a y s Each time she did , con fi dence in her abilit y to cope gre w a bit more As w e re v isited the things she needed to remember in order to face the w eek ahead , she nodded , looked at me and asked , ‘ Wh y has nobod y told me this before ?’ Those w ords sta y ed w ith me , ringing in m y head She w as not the fi rst or the last person to sa y them The same scenario repeated itself o v er and o v er Indi v iduals w ere coming along to therap y belie v ing that their strong painful emotions w ere the result of a fault in their brain or personalit y The y did not belie v e the y had an y po w er to in fl uence them While longer - term , more in - depth therap y is appropriate for some people , there w ere so man y w ho simpl y needed some education about ho w their mind and bod y w ork and ho w the y could manage their mental health da y - to - da y I kne w the catal y st w as not me , it w as the kno w ledge the y w ere being introduced to But people should not ha v e to pa y to come and see someone like me just to get access to that education about ho w their mind w orks Sure , the information is out there But in a sea of misinformation , y ou ha v e to kno w w hat y ou are looking for I started campaigning into m y poor husband ’ s ear about ho w things should be di erent ‘ OK , go for it ,’ he said ‘ Put some v ideos on YouTube or something .’ So w e did Together w e started making v ideos talking about mental health As it turned out , I w as not the onl y one w ho w anted to talk about this stu Before I kne w it , I w as making almost dail y v ideos for millions of follo w ers across social media But the platforms w here I could reach the most people seemed to be those w ith short - form v ideos This means I ha v e a large collection of v ideos w ith no longer than 60 seconds to get m y point across While I ha v e been able to catch people ’ s a ention , share some insights and get them talking about mental health , I still w ant to go one step further When y ou make a 60 - second v ideo there is so much that y ou ha v e to lea v e out So much detail that gets missed So , here it is The detail The ins and outs of ho w I might e x plain some of these concepts in a therap y session and some simple guidance on ho w to use them , step b y step The tools in this book are mostl y taught in therap y , but the y are not therap y skills The y are life skills Tools that can help e v er y single one of us to na v igate through di cult times and to fl ourish In this book , I w ill break do w n the things I ha v e learned as a ps y chologist and gather together all of the most v aluable kno w ledge , w isdom and practical techniques I ha v e come across that ha v e changed m y life and those of the people I ha v e w orked w ith This is the place to get clarit y on emotional e x perience and a clear idea of w hat to do about it When w e understand a li le about ho w our minds w ork and w e ha v e some guideposts on ho w to deal w ith our emotions in a health y w a y , w e not onl y build resilience , but w e can thri v e and , o v er time , fi nd a sense of gro w th Before lea v ing their fi rst therap y session , man y people w ant some sort of tool the y can take home and start using to ease their distress For this reason , this book is not about del v ing into y our childhood and w orking out ho w or w h y y ou came to struggle There are other great books for that But , in therap y , before w e can e x pect an y one to w ork on healing an y past traumas , w e must ensure the y ha v e the tools in place to build resilience and the abilit y to tolerate distressing emotions safel y There is such po w er in understanding the man y w a y s y ou can in fl uence ho w y ou feel and nurture good mental health This book is all about doing just that This book is not therap y , in the same w a y that a book about ho w to ma x imi z e y our ph y sical health is not medicine It is a toolbo x fi lled to the brim w ith di erent tools for di erent jobs You cannot master ho w to use them all at the same time , so y ou don ’ t need to tr y Pick the section that fi ts w ith the challenges y ou face right no w , and spend time appl y ing those ideas E v er y skill takes time to become e ecti v e , so gi v e it a chance and plent y of repetition before y ou discard an y of the tools You cannot build a house w ith just one tool Each task requires something slightl y di erent And ho w e v er skilled y ou get at using those tools , some challenges are just much harder than others To me , w orking on ma x imi z ing our mental health is no di erent to w orking on our ph y sical health If y ou put health on a number scale w ith z ero as neutral – not un w ell but not thri v ing – a number belo w z ero w ould indicate a health problem and an y number abo v e z ero w ould indicate good health In the last fe w decades it has become acceptable and e v en fashionable to w ork on ma x imi z ing y our ph y sical health through nutrition and e x ercise Onl y more recentl y has it become acceptable to openl y and v isibl y w ork on y our mental health This means y ou don ’ t need to w ait until y ou ’ re struggling before y ou pick up this book , because it is OK to build upon y our mental health and resilience , e v en if y ou are not un w ell or struggling right no w When y ou feed y our bod y w ith good nutrition and build up stamina and strength w ith regular e x ercise , y ou kno w that y our bod y is more able to fi ght infection and heal w hen faced w ith injur y It ’ s just the same w ith mental health The more w ork w e do on building self - a w areness and resilience w hen all is w ell , the be er able w e are to face life ’ s challenges w hen the y come our w a y If y ou pick a skill from this book and fi nd it useful , in hard times don ’ t stop practising that skill w hen e v er y thing starts to impro v e E v en w hen y ou are feeling good and don ’ t think y ou need it , these skills are nutrition for y our mind It ’ s like pa y ing a mortgage rather than rent You are in v esting in y our future health The things included in this book ha v e a research e v idence base But I do not rest on that alone I also kno w the y can help because I ha v e seen them help , time and time again , for real people There is hope With some guidance and self - a w areness , struggle can build strength When y ou start to share things on social media or y ou w rite a self - help book , lots of people get the impression that y ou ha v e it all sorted I ha v e seen a lot of authors in the self - help industr y perpetuate this idea The y feel the y ha v e to look as if the things life thro w s at them lea v e no dents or scars The y suggest that their book contains the ans w ers – all the ans w ers y ou w ill e v er need in life Let me dem y stif y that one right no w I am a ps y chologist That means I ha v e read a lot of the research that has been produced on this subject and I ha v e been trained to use it to help guide other people in their quest to w ards positi v e change I am also a human The tools I ha v e acquired do not stop life thro w ing stu at y ou The y help y ou to na v igate , s w er v e , take a hit and get back up The y don ’ t stop y ou ge ing lost along the w a y The y help y ou to notice w hen y ou ha v e lost y our w a y and bra v el y turn on y our heel and head back to w ards a life that feels meaningful and purposeful to y ou This book is not the ke y to a problem - free life It is a great bunch of tools that helps me and man y others fi nd our w a y through The journey so far ... I am not a guru w ho has all the ans w ers to the uni v erse This book is part journal , part guide In some w a y s I ha v e al w a y s been on a personal quest to disco v er ho w it all pieces together So this book is me making use of all those hours spent reading , w riting and speaking w ith real humans in therap y to understand a bit more about being human and w hat helps us w hile w e are here This is onl y the journe y so far I continue to learn and be ama z ed b y people I meet Scientists keep asking be er questions and disco v ering be er ans w ers So here is m y collection of the most important things I ha v e learned so far that ha v e helped both me and the people I w ork w ith in therap y to fi nd our w a y through human struggle So this book is not necessaril y going to ensure that y ou li v e the rest of y our da y s w ith a smile on y our face It w ill let y ou kno w w hich tools y ou can use to make sure that w hen y ou do smile , it is because y ou genuinel y feel something It w ill describe the tools y ou need to keep re - e v aluating and fi nding y our direction , returning to healthier habits and self - a w areness Tools might look great in the bo x But the y onl y help w hen y ou get them out and start practising ho w to use them Each tool takes regular practice If y ou miss the nail w ith the hammer this time , come back later and tr y again As a fello w human being , I too continue to do this , and I ha v e onl y included techniques and skills that I ha v e tried and found useful both for m y self and for the indi v iduals I ha v e w orked w ith This book is a resource for me as much as it is for y ou I w ill keep returning to it time and time again w hene v er I feel I need to M y w ish is that y ou w ill do the same and that it can be a toolbo x for life CHAPTER 1 Understanding low mood E v er y one has lo w da y s E v er y one But w e all di er in ho w frequent the lo w da y s are and ho w se v ere the lo w mood Something that I ha v e come to reali z e o v er the y ears of w orking as a ps y chologist is ho w much people struggle w ith lo w mood and ne v er tell a soul Their friends and famil y w ould ne v er kno w The y mask it , push it a w a y and focus on meeting e x pectations Sometimes people arri v e at therap y a er y ears of doing that The y feel like the y ’ re ge ing something w rong The y compare themsel v es to the people w ho appear to ha v e it all together all of the time The ones w ho are al w a y s smiling and apparentl y full of energ y The y bu y into the idea that some people are just like that and happiness is some sort of personalit y t y pe You either ha v e it or y ou don ’ t If w e see lo w mood as purel y a fault in the brain , w e don ’ t belie v e w e can change it , so instead w e get to w ork on hiding it We go about the da y , doing all the right things , smiling at all the right people , y et all the time feeling a bit empt y and dragged do w n b y that lo w mood , not enjo y ing things in the w a y w e are told w e should Take a moment to notice y our bod y temperature You might feel perfectl y comfortable , or y ou ma y be too hot or too cold While changes in ho w hot or cold y ou feel could be a sign of infection and illness , it could just as easil y be a signal of things around y ou Ma y be y ou forgot y our jacket , w hich is normall y enough to protect y ou from the cold Perhaps the sk y has clouded o v er and it has started to rain Ma y be y ou are hungr y or deh y drated When y ou run for the bus y ou notice y ou w arm up Our bod y temperature is a ected b y our en v ironment , both internal and e x ternal , and w e also ha v e the po w er to in fl uence it oursel v es Mood is much the same When w e e x perience lo w mood , it ma y ha v e been in fl uenced b y se v eral factors from our internal and e x ternal w orld , but w hen w e understand w hat those in fl uences are , w e can use that kno w ledge to shi it in the direction w e w ant it to go Sometimes the ans w er is to grab an e x tra la y er and run for the bus Sometimes it ’ s something else Something that the science has been con fi rming to us , and something people o en learn in therap y , is that w e ha v e more po w er to in fl uence our emotions than w e thought This means w e get to start w orking on our o w n w ellbeing and taking our emotional health into our o w n hands It reminds us that our mood is not fix ed and it does not de fi ne w ho w e are ; it is a sensation w e e x perience This doesn ’ t mean w e can eradicate lo w mood or depression Life still presents us w ith hardship , pain and loss and that w ill al w a y s be re fl ected in our mental and ph y sical health Instead , it means w e can build up a toolbo x w ith things that help The more w e practise using those tools , the more skilled w e get at using them So w hen life thro w s us problems that hammer our mood into the ground w e ha v e something to turn to The concepts and skills co v ered are for us all Research sho w s them to be helpful for those w ith depression , but the y are not a controlled drug that y ou need a prescription for The y are life skills Tools that w e can all use as w e go through life facing fl uctuations in mood , big and small For an y one w ho e x periences se v ere and enduring mental illness it is al w a y s optimal to learn ne w skills w ith the support of a professional How feelings get created Sleep is bliss Then m y alarm o ends m y ears It ’ s too loud and I hate that tune It sends a shock w a v e through m y bod y that I am not read y for I press snoo z e and lie back do w n M y head is aching and I feel irritated I press snoo z e again If w e don ’ t get up soon the kids w ill be late for school I need to get read y for m y meeting I close m y e y es and see the to - do list l y ing on m y desk in the o ce Dread Irritation E x haustion I don ’ t w ant to do toda y Is this lo w mood ? Did it come from m y brain ? Ho w did I w ake up like this ? Let ’ s trace back Last night I sta y ed up late w orking B y the time I got into bed I w as too tired to go back do w nstairs to grab a glass of w ater Then m y bab y w oke up t w ice in the night I ha v en ’ t slept enough and I ’ m deh y drated The loud alarm w oke me from a deep sleep , sending stress hormones shooting through m y bod y as I w oke up M y heart started pounding and that felt something like stress Each of these signals sends information to m y brain We are not OK So m y brain goes on a hunt for reasons w h y It searches , it fi nds So m y ph y sical discomfort , brought about b y lack of sleep and deh y dration , helped to create lo w mood Not all lo w mood is unidenti fi ed deh y dration , but w hen dealing w ith mood it is essential to remember that it ’ s not all in y our head It ’ s also in y our bod y state , y our relationships , y our past and present , y our li v ing conditions and lifest y le It ’ s in e v er y thing y ou do and don ’ t do , in y our diet and y our thoughts , y our mo v ements and memories Ho w y ou feel is not simpl y a product of y our brain Your brain is constantl y w orking to make sense of w hat is going on But it onl y has a certain number of clues to w ork from It takes information from y our bod y ( e g heart rate , breathing , blood pressure , hormones ). It takes information from each of y our senses – w hat y ou can see , hear , touch , taste and smell It takes information from y our actions and thoughts It pieces all these clues together w ith memories of w hen y ou ha v e felt similar in the past and makes a suggestion , a best guess about w hat is happening and w hat y ou do about it That guess can sometimes be felt as an emotion or a mood The meaning w e make of that emotion and ho w w e respond to it , in turn , sends information back to the bod y and the mind about w hat to do ne x t ( Feldman Barre , 2017 ). So w hen it comes to changing y our mood , the ingredients that go in w ill determine w hat comes out The two-way road Lots of self - help books tell us to get our mindset right The y tell us , ‘ What y ou think w ill change ho w y ou feel .’ But the y o en miss something crucial It doesn ’ t end there The relationship w orks both w a y s The w a y y ou feel also in fl uences the t y pes of thoughts that can pop into y our head , making y ou more v ulnerable to e x periencing thoughts that are negati v e and self - critical E v en w hen w e kno w our thought pa erns aren ’ t helping , it is so incredibl y hard to think di erentl y w hen w e feel do w n , and e v en harder to follo w the rule of ‘ onl y positi v e thoughts ’ that is o en suggested on social media The mere presence of those negati v e thoughts does not mean that the y came fi rst and caused the lo w mood So thinking di erentl y ma y not be the onl y ans w er Ho w w e think is not the w hole picture E v er y thing w e do and don ’ t do in fl uences our mood too When y ou feel do w n , all y ou w ant to do is hide a w a y You don ’ t feel like doing an y of the things y ou normall y enjo y , and so y ou don ’ t But disengaging from those things for too long makes y ou feel e v en w orse The loop also occurs w ith our ph y sical state Let ’ s sa y y ou ha v e been too bus y to e x ercise for a fe w w eeks You feel tired and lo w in mood , so e x ercising is the last thing y ou w ant to do The longer y ou a v oid the e x ercise , the more y ou feel lethargic and lo w on energ y When y ou are lo w on energ y , the chance of e x ercising goes do w n , along w ith y our mood Lo w mood gi v es y ou the urge to do the things that make mood w orse