Positive Health Online

This article was inspired by a fortune cookie of all things, in which it said, “reading without reflecting is like eating without digesting”. Now I have always been a huge advocate of reflective practice for professional practice as a complementary therapist, but it got me thinking about how important reflection is in our everyday life too and how this can help us become better versions of ourselves as well as better practitioners.

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What is Effective Reflection?

In our practices, this is used to evaluate the efficacy of our treatment and the approach taken for each client. We need to assess how and why client outcomes have been met. We also use it to evidence CPD as it is not enough to just read some information, such as you find in this magazine, but as the statement says as the top of this article, we have to evidence CPD by digesting what we have read and then writing up a small piece in our CPD log to show how that learning has influenced our practice – putting that learning and experience into professional use. We also use reflection to assess the direction our professional life is taking and therefore, to plan what CPD to undertake in terms of courses we select that are the most appropriate for the types of clients we are seeing. It is important to do all these things so as not to forget the aspirations we once had when we started out as therapists. In essence it is a way of celebrating our work through reflection and learning at work. For qualified therapists, much like many people in any workplace, it is easy to fall in to the “working on auto-pilot” syndrome and just going through the motions. Effective practice requires us to be constantly aware of our actions, striving to improve on the service we offer. In some ways this is more important for therapists as we tend to work in isolation. Ultimately, reflection is an essential part of our professional lives.

The Basic Elements of a Reflective Process Are:

• Keeping an open mind about what, why, and how we do things;
• Awareness of what, why, and how we do things;
• Questioning what, why, and how we do things;
• Asking what, why, and how other people do things;
• Generating choices, options and possibilities;
• Comparing and contrasting results;
• Seeking to understand underlying mechanisms & rationales;
• Viewing our activities and results from various perspectives;
• Asking "What if...?";
• Seeking feedback and other people ideas & viewpoints;
• Using prescriptive (advice) models only when carefully adapted to the individual situation;
• Analysing, synthesizing and testing;
• Searching for, identifying, and resolving problems & result limitations;
• (Roth (1989).

These basic elements are of course great for professional practice, but reflection happens all the time in life, so how do we use it in our day to day and how is this beneficial? How do we actively engage in meaningful reflection that has value? For me, the last 3 months of 2022 were full of huge personal changes. It started with a return to Cyprus after 34 years, our honeymoon destination in 1988, only this time for my daughter’s wedding. This was a wonderful family celebration, but we had had to leave my Mum behind as she was not well enough to travel, so there was also some sadness. We are very close also with my husband’s parents who were able to attend, but my Mum-in-law has Parkinson’s Disease (PD), so needed lots of support. On the holiday, my Dad-in-law was obviously unwell and struggling to eat. We managed to get a GP appointment for the day he arrived home to the UK, only to be told to go immediately to A&E. After some fretful time pushing for tests in what is clearly a swamped and understaffed NHS, we received a diagnosis of terminal cancer. The primary was in the oesophagus, but it had already spread widely to his bowel and there was no treatment available. We spent time with family supporting everyone through the shock and then it was a horrible time trying to get the right care at home because paperwork was too slow coming from one department to another. We only received palliative care home support 2 days before his death, 4 weeks almost to the day of diagnosis. Then of course you are dealing with grief, loss, paperwork, and funeral arrangements. All during this time, I did not have the time I needed for work and so people were getting frustrated. I felt as if I was letting everyone down. In the week that followed, my computer died, and it took a week to repair it, again making it impossible to work. Then along came Christmas and we all contracted COVID-19. You get to the point when such a run of “bad luck” grinds you into the ground.

So how can reflection help when life happens like this as we have all experienced bad times and wondered why this must happen? Unlike with professional reflection, you do not need to write anything down, but you can if it helps. For us, just giving ourselves the space to think and then share thoughts worked best. I am quite good at just taking myself off to sit and gaze at the sea or at home, I reflect a lot when walking the dogs. You will have your own special ways of being able to be still and have the space to sort through your thoughts and it is essential to give yourself the time regularly to do this. It is not a negative thing at all. You are not brooding but instead questioning, in a positive way, how you feel about something.

To start with, my husband and I were reflecting on how Cyprus had changed in 34 years, and we agreed that it had lost the Greek charm we had loved so much. It made us evaluate what we want from a holiday in the future. That is a very positive outcome as holidays are few and far between and costly. We had also had to question how we ensure my Mum is cared for when we need to go away. She lives with us since suffering a stroke in 2021 and we found a wonderful place for respite care. We needed to evaluate how that went and any changes for the future, considering her perspective and how we can improve her experience in the future. All of this invoked an honest conversation about how everyone felt and the need to have a break from each other even though we care deeply for everyone. Whilst on holiday, we had open and honest conversations with my in-laws about their holiday needs moving forward after evaluating issues with the PD and how it impacts her in getting around.

When we received the devastating cancer diagnosis for my Dad-in-law, as a family we spent a lot of time talking about how to do things, but less pragmatically were lots of questioning as to why this had to happen and what it all means. It makes you re-evaluate your life and its priorities when faced with death. We try to make sense of it all and most importantly, shared together as a family how we felt. I found myself reading up everything there was to know about his condition and what was happening as this is how I know I can cope best and be useful in explaining it to the rest of the family. As we grieved together, I reflected on what grief teaches us and this also helped. Grief teaches us that loss in inevitable and that we should never take our lives and our loved ones for granted. It teaches us about our belief system and what we believe happens after death. It also teaches us how important it is to live every day to the fullest and try to create good memories that can be a comfort to look back on after someone passes away. I came to the realization through reflection that grief is an expression of love. My husband is struggling at the moment to try and return to “normality” and we have reflected on the fact that life does not return to normal following the death of a loved one but we have to create a new redefined life without his Dad in it. We know from losing other family members that the pain never leaves us but in time, we can learn to cherish those happy memories.

On reflection, having my computer processer go caput and then getting a nasty COVID hit was not all bad either. I would have tried to launch myself back into work and to catch up on what I felt I had neglected. In reality, and in the grand scheme of the universe, a couple of months of not being able to work at 100 miles an hour is not a terrible thing, especially given the circumstances and when you explain what you have been going through, most people are very empathetic and understanding. Reflection turns to communication and sharing, all very valuable to help others understand what you are feeling and what you need at that moment.

So, to summarize, using reflection helps us to question our lives in a positive way, evaluating what is working, what isn’t, how to deal with issues, problem-solving, and creating choices and new possibilities. It is therefore all about personal growth and learning to understand yourself and other people and to know that you cannot always control every given situation. Reflection is good for your mental health and can make you a more whole and confident person, which in turn is attractive to all those around you. If we don’t stop to reflect, we fall into the trap of just pushing through life, never changing, or adapting. We stay in jobs or relationships that do not serve us and leave us feeling stressed out and unhappy. So, unlike waiting for the forced stop that I have experienced in the last couple of months, from now on I am going to hop off the treadmill more regularly and spend time reflecting to identify how I am feeling and see, if anything, what changes need to be made. Life is too short to get to the end and have regrets so use your magic mirror and make the most of this precious gift. Self-awareness is essential to happiness and success in life and reflection allows you to stand back and view the bigger picture rather than getting bogged down in the minutiae. It allows you to respond to situations with a level head rather than react under stress and do something you may regret. It is important to challenge yourself and your perceptions. Just because you have an opinion, doesn’t make it right! Most of all, it gives you confidence and in life and in your practice so go on and think about how to use your magic mirror!