By Dr John Baker

In support of Mental Health Awareness Week we highlight five common mental health conditions. The theme of this year’s week is Body Image #bebodypositive so we’re starting with Body Dysmorphic Disorder.

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Body Dysmorphic Disorder

Many of us can find our mood affected by changes in our weight and appearance and most people would readily identify physical aspects of ourselves we’d gladly change. But for some people their dissatisfaction with their appearance and specific perceived flaws can become more obsessive and distressing. People with Body Dysmorphic Disorder (BDD) can experience obsessive anxiety and demonstrate obsessive behaviours related to aspects of their physical appearance.

Physical characteristics that might be unnoticeable or appear very minor to other people can be fixated upon and amplified by someone with BDD. Symptoms can vary in severity but at the extreme people may feel unable to carry on day to day activities and interactions, or may feel compelled to engage in obsessive controlling behaviours to soothe their body-related anxieties or improve the perceived flaw.

If you recognise the symptoms of BDD in yourself or someone else more information is available on the Mind website here.


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Obsessive Compulsive Disorder

Obsessive Compulsive disorder (OCD) is a serious anxiety related condition affecting approximately 1.2% of the population.  OCD-UK describes it as involving ‘frequent intrusive and unwelcome obsessional thoughts, often followed by repetitive compulsions, impulses or urges.’ It can be experienced by children, young people and adults and often involves checking, contamination, hoarding or ruminations.

OCD is very treatable with psychological interventions using techniques such as Cognitive Behavioural Therapy and mindfulness, all of which I can provide.

Here is an extract from OCD-uk website highlighting the usefulness of ‘externalising’ as a technique to ‘fight back’ against OCD.

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Anxiety affects everyone at some point; for example exams and job interviews, but sometimes this feeling can become out of control and start affecting everyday life.

Anxiety is the main symptom in a lot of conditions such as panic disorder, phobias, and Post Traumatic Stress Disorder.  One common condition is Generalised Anxiety Disorder (GAD).  GAD is estimated to affect up to 5% of the UK population and is a long term condition that makes people feel anxious about a wide range of situations and issues, rather than one specific thing.  This can cause both physical and psychological symptoms such as feeling restless or worried, having trouble concentrating or sleeping, and heart palpitations.

For more information look at the Mind website here.

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Depression is a common mental health difficulty affecting young people and adults, men and women.  The severity of symptoms can change over time and may range from low mood to feelings of self harm and suicidal thoughts.  It is always best to see your GP when you first start to notice these feelings.

There is often a trigger for depression but it can also appear to come out of the blue.  There are many things that can help and qualified healthcare professionals are the best people to advise on what treatment is most suitable for each individual.

This recent article from The Independent offers some insight into a psychological treatment that has been found as useful as anti-depressant medication.

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During a psychotic episode the way in which people perceive or interpret things are affected, commonly experiencing hallucinations (seeing or hearing things that aren’t real) or delusions (thinking things that aren’t real).  Often the cause of psychosis is a specific mental health condition such as schizophrenia, bipolar disorder, or even severe depression.

If you’d like more information the following leaflet may be useful.

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Most children learn how to walk somewhere around the ages of 9 to 18 months. It’s usually a case of trial and error and children typically progress through strategies for getting around starting with rolling, progressing to crawling, cruising, toddling and finally walking (sometimes with some bum-shuffling in between). Most parents would probably agree that children’s walking skills are mainly self-learnt and, if you stop to think about it, most of us wouldn’t know where to start in teaching someone how to walk – either for the first time or after an injury.

Nonetheless most of us manage to find a way of walking that does the job.

But as children head to preschool then primary school it can sometimes become apparent that a child isn’t quite making the same strides as their peers. As older children start to take part in sport they might want to improve their speed, agility and physical confidence. Other than lots of practice there’s not much that you can do, right? Well, not quite.

Dynamic Movement Skills 

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Dynamic Movement Skills (DMS) is a neuromuscular re-education movement methodology (which basically means it’s away of getting your brain and your body to coordinate better to produce more optimal movement patterns). DMS was developed by Mike Antoniades, Performance and Rehabilitation Director at The Running School and The Movement School. DMS helps develop, refine & improve gross motor skills, coordination, agility & quickness. 

Who is it for?

DMS can be used for those anyone who is not developing as well as they would like or for those who are doing well but want to maximise their abilities. 

It’s suitable for children and adults; whether looking to move more confidently, to improve pain and injury problems, or to enhance athletic performance.

The system has been provided by The Running School as part of training at top professional football clubs including Manchester United and Chelsea and has been used with many professional sportspeople and athletes (including Olympic Gold Medalists). 

Children From age 6 upwards: 

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It can help children whose movements are not developing as quickly as others; for example they may have been diagnosed with dyspraxia or autism; or their parents, teachers or coaches may have noticed that they just don’t seem to move as well as their peers or that they shy away from physical activity and sports. 

It can equally help children who are doing well but would like to do better in certain areas. For example we often contacted by parents of children and teens at football academies and professional clubs: as they’ve progressed from school, to clubs, and into academies they have identified that perhaps they are not as quick off the mark as others at that level. Dynamic Movement Skills gives them the edge they are looking for. 

The system is becoming increasingly popular in schools, both to develop foundation movement skills and in some cases as a method of helping children who find it difficult to settle in class. 

At Core we’ve worked with cricket and football academies, with individual children attending academies, runners of all abilities, and many professional sports professionals. 

But don’t we develop these skills naturally? 

Every child develops their movements at different speeds and in different ways and unfortunately those who develop more slowly can sometimes shy away from physical activity which can make matters worse. DMS coaching can help children to increase their physical confidence, enabling them to join in with physical activity and enjoy the many lifelong benefits that brings. 

Children ideally need 3 hours of movement per day (whether playing, walking, running, sport, dance, martial arts or any other activity) however many fall short of this. It is not unusual for kids in their first session of DMS to want to sit between exercises or lean on a wall or piece of furniture (until I advise them not to!). 

Even children who prefer to be more active may have had to sit for much of the day; their muscles and nervous system being static at school, and then they are suddenly asked to fire up in the evenings and weekends. 

For adults too, modern lifestyles can also make it easy to avoid physical activity – like cars, electronic entertainment, a curriculum that favours academic over physical subject. And following injury, when we are in pain, or periods of illness our movements can also be affected – we can lose previous abilities or change the way we move, perhaps to avoid pain or using certain muscles, which can have knock on effects. DMS can be used as part of recovery from injuries and to help both return to activity and prevention of re-injury. 

How does it work? 

Specific gross motor movements of footwork and jumping in multiple directions (depending on your level) are practiced and coached using advanced coaching techniques. These are ‘foundation’ movements that are repeatedly used in all movement of multi-directional physical activity and sports, firstly to develop improved movement patterns including: placement of feet and foot contact, coordination, sequencing, rhythm, lightness of feet, and reduced time spent on the ground. 

The repetition of these movements help develop the patterns through stronger and faster neuromuscular firing patterns and improved activation sequences.  The repeated practice helps the muscles to fire simultaneously rather than individually, creating smoother and faster movements. 

The DMS mat is the best place to perform the movements as it gives focus to placement and direction and adds to motivation. The system can however be performed indoors or outside using track lines, markers or similar.  

What can it help (in short)? 

What does a DMS programme involve? 

An initial assessment of the foundation movements is performed.

We typically recommend a programme of 6 or 12 weekly sessions, with each session lasting an hour; home exercise tasks are also given. 

Those who have acquired a good level at the end of their first course can then progress onto the running technique programme. 

 I love the progress that I see from kids undergoing a Dynamic Movement Skills programme as they develop movement, coordination, body control and speed. They find the sessions fun and feel great about the improvements that they achieve. Equally, the programme can make a huge difference to athletes and sportspeople of all abilities as they try to improve their performance and avoid injury.

David Brown BSc (hons), Movement Coach (and Occupational Therapist). Certified Running Technique Specialist ® accredited by The Running School.

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Stress is a modern epidemic. 

74% of UK adults have felt so stressed at some point over the last year they felt overwhelmed or unable to cope.

While you may be able to eliminate the external causes of stress in your life, there’s a lot you can do to reduce the adverse effects of stress on your physical and mental health. Understanding the fundamentals of your nervous system biology and how it responds to stress is a great starting point to creating the space to reclaim your power over your stress responses.

Your Autonomic Nervous System

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Your Autonomic Nervous System is the part of your nervous system that controls and coordinates your body’s ‘automatic’ processes (like breathing, digestion, blood flow). There are two parts of the system: the sympathetic and parasympathetic nervous systems. When they are working well together they ensure that the body remains in balance in response to ever-changing circumstances.

The sympathetic nervous system is action-focused: it stimulates the heart, lungs and major muscle groups and triggers the ‘fight or flight’ response in response to threats.

The parasympathetic nervous system essentially calms and restores the body to a resting state and–when activated properly–helps us to renew when we are at rest.

When you experience stress (physical or emotional) your nervous system has to work harder to maintain equilibrium. It is the sympathetic branch that tends to dominate during times of stress and it is important to note that this is not harmful in the short term, and may even be beneficial.

However, if stress levels remain high for too long then physical and mental changes can begin to show. Because the nervous system controls and supports so many of our bodily structures and functions, stress-related symptoms can show themselves almost anywhere.


Physical Stress Symptoms

  • Difficulty falling asleep or staying asleep
  • Muscular aches and pains
  • Poor digestion
  • Headaches
  • Breathlessness / chest pain
  • Elevated blood pressure
  • Skin breakouts
  • Fatigue
  • Frequent infections / poor immunity

Emotional Stress Symptoms

  • Anxiety
  • Difficulty concentrating
  • Restlessness
  • Irritability
  • Irrational worries and panic attacks
  • Depression
  • Feelings of isolation and hopelessness
  • Addictive behaviours e.g. over-eating, over-drinking
  • Over-emotionality
Stress isn’t necessarily a problem in itself (nor entirely avoidable); it’s how we respond to stress and how well or poorly we recover that can cause problems.
In a healthy stress response, we have a consistent wave-like line that goes from baseline (rest and digest) to peak arousal (fight or flight) and recovers fairly quickly .
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Problems occur when we function outside of that nice up and down line, i.e. if we stay around peak arousal for too long. If this happens the body will initiate a freeze response as it is unable to sustain that high arousal charge. However there is still a sympathetic charge under the freeze so it’s a bit like hitting the accelerator and the brake at the same time.

Chronic stress response

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If our stressors go beyond a certain intensity or duration, the sympathetic response becomes more intense. When we are unable to “complete” the stress response and come down from peak arousal, the ‘rest and digest’ portion of our parasympathetic system is unable to kick in.
Without the ability to “digest” properly, you can see how chronic cases of gut problems can start and become exacerbated over time. Furthermore, if we are unable to “rest” properly, our sleeping is disturbed, and this can lead to further health issues down the line.
Many people may actually be walking around in a ‘functional freeze’ whereby you are able to get through your day only by being constantly busy. Often, this state will ‘mute’ our capacity to feel joy and happiness because we our body’s resources are fundamentally being marshalled for a fight or flight response which is then papered over by a freeze response.
How can you restore a healthy stress response? 
Through appropriate intervention you can return your nervous system to a more healthy and functional state; without such action the hyper-reactive state could last indefinitely, but not without wider health implications.

In order to restore a healthy stress response to ourselves, we have to become aware of when we get triggered into an automatic response (that creates a negative feedback loop), and start to unwind this response.

In the process of doing this, we can further work on increasing our nervous system capacity, as well as building exit pathways to allow a smoother flow of stressors in and out through our system.

 There are many ways we can do this kind of work on ourselves–here are a few:

1) Meditation and mindfulness

At the top of the list, but quite often these are perceived as difficult techniques for people to access easily as beginners.

There are lots of groups, classes, and apps that can help you to develop these skills or you might like to have a few one to one sessions with a practitioner who specialises in these techniques.

2) Reiki
As well as being a very relaxing therapy which benefits our parasympathetic nervous system, reiki has been shown to positively influence our locus of control which, in turn, can reduce the perceived danger of external threats.
3) Aromatherapy
Our sense of smell is closely connected with the parasympathetic nervous system. When scent molecules connect with the cilia (tiny hairs in our nose) the olfactory cells produce a nerve impulse which reaches the Limbic System.
The Limbic system is one of the most primitive parts of the brain concerned with survival instincts and emotions. Scientists believe that the activity of the nerve signals passing through this region cause mood change by altering brain chemistry.
Proper utilisation of essential oils can positively impact our bodies and our nervous systems, thereby helping our bodies and minds return to a state of balance.

4) Somatic Body Practices and Visualisation

Somatic bodywork can help enhance our internal perceptions of our bodies and then helps us integrate these perceptions with our sense of ourselves in our external world. Utilised in conjunction with visualisations, this can become a powerful way to ground into our bodies and help start the unwinding process in the case of a messy and/or incomplete stress response.

Combined with reiki and aromatherapy, this can be a self-nourishing and pleasant way to help us juggle the stressors in our lives and maintain balance.

If you are interested in finding out more, please don’t hesitate to contact the clinic, or stay tuned for future posts diving into these areas in further detail.


Joli Knott, Reiki master

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Making positive lifestyle improvements and keeping track of the symptoms of chronic conditions to help you manage them better can be much easier with the help of an app.

Here we round up seven of the best.

Migraine Buddy 

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Migraine Buddy is an advanced migraine diary and tracking app, designed with the help of neurologists and data scientists. It’s had more than 1 million downloads and is rated as the best Migraine App by both patients and doctors.

The app allows you to record the frequency and duration of your migraines and pain location and intensity. You can also record symptoms and medications. The app can help you to identify migraine triggers.

Migraine attacks are recorded on the dashboard including start and end time and details of the attack (like pain level, location when your migraine began, and potential triggers). The app also records any signs that presented before the attack, migraine symptoms, medication taken, relief methods that you used, how your migraine affected your daily tasks, and a head map to select the area of your pain.

After entry, the dashboard shows you how long you have been attack-free. The record of your attack is stamped on the calendar and can be accessed through the records section. The reports dashboard gives insights about your migraines and factors that could be linked.


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Headspace is a meditation and sleep app that can help you focus, breathe, stay calm, perform at your best, and get a better night’s rest. It helps you develop skills of relaxation, meditation and mindfulness which have been proven to have a whole range of mental and physical health benefits.ust sit back, relax,

There are exercises on everything from managing anxiety and stress relief to breathing, happiness, calm, and focus. If you’ve never meditated before there’s a free Basics course that will teach you the essentials of meditation and mindfulness.

In the Sleep by Headspace experience, you’ll find sleep meditations, sleep sounds, and specially-designed sleepcasts to guide you to a place of rest. Sleep by Headspace was built around the needs of restless sleepers so the screen is darker and the buttons are easy to find. It’s perfect whether you have trouble falling asleep, or you wake up in the middle of the night.


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If you often wake up feeling groggy and unrefreshed then Sleepcycle could be a great app for you to try.

It’s like an intelligent alarm clock that tracks your sleep patterns and wakes you up when you’re in light sleep. When you wake up during light sleep you’re more likely to way to wake up feeling rested and energized.

As you sleep, you go through different sleep phases, ranging from light to deep sleep and back again. The sleep phase you are in when your alarm goes off is critical for how rested you will feel when you wake up.

While you sleep, your movements vary depending on what sleep phase you are in. Sleep Cycle’s sound technology tracks your sleep patterns using sound or vibration analysis (you don’t have to install it on a wearable for it to work). The app then finds the optimal time when you are in light sleep to wake you up in the morning, during a predefined 30 minute time window that ends at your set alarm time. Waking up in light sleep feels like waking up naturally without an alarm, leaving you feeling rested and energized.

Kaia - 7 of the best health apps for mental and physical health

Kaia is the first medical exercise therapy app that aims to relieve back pain at home. It can Kaia plays an active role in the effective and natural treatment of your back pain, guiding you through every step.

The app offers individually personalized guidance: whether you are a beginner or consider yourself an athlete – the exercises adapt to your fitness and pain levels via intelligent algorithms.

The daily training sessions take just 15-30 minutes and don’t require any special equipment.

Studies of Kaia users show an average pain reduction of over 40% and there’s evidence that the use of the app can help prevent new back pain episodes from becoming chronic. As well as offering practical steps and exercises Kaia is educational (increasing your knowledge about back pain) and motivational.

My pain diary

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My pain diary is an award winning app which makes it easy to track your pain and symptoms both for your own use and to report to your doctors or clinicians. If you have a chronic condition, or even multiple conditions, it can be a real challenge to keep track of your symptoms or to remember how you’ve been since your last appointment. The my pain diary app makes it easy for you to keep track which can give both you and your healthcare professionals valuable insights into patterns and potential management strategies for your pain or other symptoms.

The app is completely customizable to suit your specific tracking needs; you can track as often as you and record as much data as you need.

My fitness pal

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MyFitnessPal is a great companion app if you want to make positive lifestyle changes or follow a specific fitness-related plan. It can help with goals including weight loss, toning up, and improving your overall fitness. The app can integrate with your other health apps and scan food barcodes to gather nutrition information.

The app is highly rated by users but its focus on nutritional values and calories as well as exercise targets might make it better suited to someone who is already somewhat engaged in a fitness plan and finds targets like these to be motivating rather than oppressive.


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As the name suggests Happify aims to increase your happiness! by helping you overcome stress and anxiety and building your resilience so that when life is challenging it doesn’t affect your wellbeing so much.

Happify was jointly developed by scientists and game designers and uses games and exercises to help you change your habits towards happiness. It also lets you track your progress over time which as well as being motivating can help you to identify patterns and areas to focus on.

by Angela Vossen

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I work in a multi-disciplinary healthcare clinic with 26 colleagues and I also coach healthcare professionals and small business owners.

Everyone in my team is dedicated to helping others to achieve the best possible health and wellness outcomes. We are all pretty knowledgeable about lots of aspects of health and wellness and we support our patients to make positive lifestyle changes to improve their wellbeing. 

As a mum and step-mum I also manage the health of our family. I’m full of good advice when a friend tells me about their mum’s headaches, their dad’s back pain, or their own anxiety.

But when it comes to consistently looking after my own health? Hmm, ‘could do better’.

This week I’ve been thinking about how I can start to improve that.

Knowing what’s healthy can be hard enough;  doing what’s healthy is even harder. Many of us who work in health and wellness, or who have some responsibility for others’ health and wellbeing – perhaps as employers, teachers or parents – have a fairly good level of knowledge about health topics.

But a visit to your local NHS hospital will quickly show you that just because you work in healthcare and ‘should’ (and probably do) ‘know better’ does not mean that you’re following your own advice. For example, it’s estimated that 1 in 4 nurses are obese, 4 in 10 NHS employees are affected by work-related stress, and there’s evidence of increasing numbers of GPs turning to alcohol or drugs to cope with rising stress levels in their profession. 

This presents a real credibility challenge for healthcare professionals who are trying to encourage patients to eat better, move more, stop smoking, drink less, or talk about their mental health challenges when they aren’t managing to do these things themselves.

In our team at Core Clinics we are very aware that actions speak louder than words and we can’t expect our patients to follow our advice if it’s clear that we aren’t.

We offer a generous level of free treatments to our team members and strongly encourage health-promoting behaviours through training and simple actions like providing bowls of apples in reception and team areas. But despite of all this we all acknowledge that we’re not as good as we could be at looking after our own health and wellbeing.

We have busy work days and when the slot we’d booked for our treatment with a colleague is requested by a patient we give it up. We are rubbish at following up the home-care advice we’ve been given by our colleague because, well, because they’re our colleague.

In the last few weeks I’ve supported several of my colleagues and family members with health-related challenges. I make all the right noises and take practical steps to help and enable them to take the mental health day at home, get the treatment, or speak to the doctor. I schedule my children’s appointments and give them daily encouragement to improve their eating, sleeping and activity habits. I keep a watchful eye on my husband’s health. In spite of all of this I’m often left perturbed when people don’t take the steps they know would be beneficial to their health (even though I’m well aware of lots of the reasons why).

But, I’ve asked myself this week, how good am I really at looking after myself? After a few discussions and self-reflection I asked myself the question ‘if I were coaching myself, how would I do it? What approach would I take to help myself to get better at self-care?’ I’m still very much working through that process but I’ve started to form a few thoughts that might be helpful.

Factor myself as an equal member of the team or family schedule

I schedule and coordinate health and wellness related activities for people in my work team and for my family. But I’ve noticed that I don’t factor myself into that planning.

I tend to plan and schedule everything and everyone else and then, if there’s any time left at the end of all that, I might sneak a moment for myself. But there’s not enough moments for me to really look after myself: I might either have time to go for a nice walk with the dog, or to have a massage, or to make myself a nice healthy lunch, but not all 3.

So by including myself in the planning I do for those around me perhaps I’ll have more opportunities to build healthier habits rather than making them an afterthought or the first thing to be sacrificed when someone else has a conflicting need or want.

Get support by sharing my health priorities with others

I am a natural facilitator. At work, at home, and socially, I don’t have a strong sense of what I want or need independently of what I’m trying to help the group (or family) to achieve.

While I genuinely derive a lot of happiness from helping others to thrive, I sometimes ‘lose’ my sense of self in that and don’t know what I want or need, let alone ask others for support with that.

There’s a lot of evidence that sharing goals (in writing, with others, publicly) can help us to achieve them. So, as I continue to consider what my health priorities are I’m going to also try to get better at sharing those with others who can support me.

Don’t beat myself up when I fall short of my own expectations

As much as it’s great to make positive changes towards a healthier lifestyle, when we fall  fall short of our own aspirations – the ‘broken’ diet, the unsuccessful attempt to moderate our drinking, the injury that sets our training back – we can often fall back to a worse place than we started and pile a load of self-undermining negative chatter on top of ourselves for good measure.

Over the years I have definitely got better at not beating myself up with my ‘should stick’. You probably have a ‘should stick’ too. It’s made up of your expectations (and probably others’ expectations of you that you’ve internalised) about what you should do, who you should be and what you should be able to do. When I was a young adult my ‘should stick’ was more of a timber trunk on a monster crane and some of the biggest health challenges I’ve had have been a direct result of that stick.

But over the years I’ve worked hard at breaking the trunk down into a branch, into a stick. Now whenever my inner voice starts saying ‘should’ I am far less triggered by it and far more interested in what ‘is’ than what ‘should’ be. And if other people try to hit me with their should sticks well, they can stick it! By focusing on where I’m actually at rather than where I tell myself I should be I can take realistic steps towards where I want to be.

Identify and practice my own self-care priorities

There are some self-care principles that are pretty universally beneficial. Like eating a balanced diet but not being obsessive about it. Being at least moderately active. Trying to be more aware of your stress levels and taking steps to manage them.

But the detail of self-care varies from person to person and across your life-stages. It’s not all about beasting it in the gym, kale smoothies and mindset coaching programmes.

Sometimes my self-care is accepting that I can’t and shouldn’t try to run at 100 miles an hour all the time and asking my husband to take the children out for a few hours. Sometimes it’s binge-watching a box set and embracing that downtime as beneficial rest and recuperation (and not as a failure or failing). Sometimes it’s a walk, a run, a bike ride: but because that’s what I want and need; not because that’s what I’ve guilted myself in to doing.

It’s very hard to stick to any activity that isn’t really aligned with your values, priorities, or lifestyle. So if you try to take an approach to eating or exercise or lifestyle because you’ve been told to, because a friend swears by it, or because it’s the latest instagram trend, it’s unlikely to stick. It’s far better that you start with one thing that you’d really like to make positive steps towards and just focus on that.

As ever with these things, it’s easier said than done. But you’ve got to start somewhere.