Dr Emma Thurston qualified from Oxford University in 2015 with a distinction in Medicine (BM, BCh) and a MA in medical sciences. She’s recently completed a master’s degree in Public Health from the University of Edinburgh and is a practicing doctor based in New Forest (England).
Her career has taken an unusual path and Dr Emma is dedicated to helping people thrive through positive psychology and lifestyle medicine. She’s also researched and written about yoga as a method for stress management for doctors and medical students.
Dr Emma is the Regional Director for the British Society of Lifestyle Medicine (BSLM) for Hampshire & Dorset and is studying to become a health coach in order to help guide individuals on their journey towards thriving.
Medworld talked to Dr Emma to find out more about her approach to medicine and why she loves what she does. She’s kindly included references to interesting further reading and you can find out more about Dr Emma on her website or follow her in Instagram (@dremmathurston).
Tell us a bit about you, and why you wanted to become a doctor?
My passion is helping people to thrive, not just survive. I aim to achieve this by utilising concepts from positive psychology and entwining these with lifestyle medicine to share ways of how we can all support our emotional wellbeing and health.
Outside of work I love getting on my yoga mat and out in nature – on the beach and in the forest where I’m lucky enough to live.
You are passionate about health and wellbeing. How do you find the time to work as a doctor and look after your own health and wellbeing?
This can be a real challenge and I think inherently as a group we are not the best at looking after ourselves, often prioritising the wellbeing of our loved ones and patients. I think to ‘find the time’ you have to prioritise it. I’m lucky enough to have found things which look after my wellbeing that I love doing, so this helps me want to make time for them. Those still searching for activities which support their wellbeing that get them fired up and actively seeking opportunities to be able to enjoy them might need to literally book into their diary time for self-care – even if it’s just a walk, a cup of coffee and a new book, or a bubble bath – put it in your diary!
Why do you love yoga?
I actually tried to get into yoga a couple of times before I really connected with it. I think finding a teacher and style which resonates with you is so important. Once I had connected with a teacher and a style (my favourite is Vinyasa) it just grew from there. Like many I was initially drawn to yoga through the asanas, the physical postures, but have become increasingly fascinated by and value other aspects of it, particularly the pranayamas (breathwork) and dhyana (contemplation and meditation). Whatever mood I’m in I can find a practice which serves me in that moment. Particularly relating to wellbeing and resilience with work, I always feel a different person coming off the mat than when I stepped on it after a stressful day at work – I don’t always like the person who steps onto the mat but always like the person stepping off it! It’s also taught me a lot about enjoying the journey and not just the destination. Working towards a new posture, for example, I get so much joy from – I celebrate each incremental improvement, including the discipline and concentration this takes. There is also such a welcoming and supportive community within Yoga.
Do you think Yoga would be beneficial to a hard-working doctor? If so why?
Yoga has been shown to be beneficial for stress management. A common reason for people to take up yoga is to reduce their stress levels and feel more relaxed. It has repeatedly been shown to reduce the body’s primary stress hormone cortisol (Gothe, Keswani and McAuley, 2016; García-Sesnich et al., 2017). It can also reduce perceived stress(Michalsen et al., 2005) whilst improving quality of life and mental wellbeing (Smith et al., 2007).
I think it’s not an exaggeration to say that yoga has revolutionised my wellbeing. It has changed my outlook on exercise and provides me with a healthy stress reduction strategy when needed. By waking up and getting straight onto my mat every morning I start each day in a positive, calm mind-set. The benefit this brings to my outlook on the whole day has been noticeable.
It’s also very versatile with many styles (from power and hot yoga to yin and restorative) and ways of practicing – yoga studios, gyms and at home with YouTube or an app.
Looking at the research, I did an essay during my master’s in Public Health on how yoga could be used as a stress management strategy for doctors. Here I learned there is a gap in the evidence specifically looking into yoga and doctors, and this has been viewed as a potential subject to expand the research (Bond et al., 2013). What has been studied more extensively is yoga for stress management in medical students. Medical students are arguably the most akin population to doctors, as many of the former ultimately become the latter, yet each are exposed to different pressures and stressful stimuli. Yoga was shown to repeatedly reduced perceived stress (Bansal et al., 2013; Prasad, Varrey and Sisti, 2016), and biological markers thereof (Parshad, Richards and Asnani, 2011) in a statistically significant manner in medical students. One study demonstrated reduced biological markers of stress in a wide range of mental-health professionals including psychiatrists, nurses, social workers and psychologists (Lin et al., 2015).
So, from both an anecdotal perspective with myself and from the research, yes, I think yoga would be beneficial for a hard-working doctor.
It says in your bio that you help people improve their emotional wellbeing. Do you have any tips for how doctors could improve theirs?
There are so many ways, and I think it’s important to always consider a personalised approach contemplating what resonates with the individual doctor and what challenges they are experiencing. Some thoughts would be:
· Schedule in fun time, time to be with your friends and family, and exercise. If you get stressed and overwhelmed, you might skip out on these things that provide important balance in your life. If you enjoy and find exercise a stress reliever, put it in your diary and see it as an appointment with yourself so you don’t skip it. Even better, agree to go with your partner, friend or colleague. The social connection by doing so will be beneficial for your wellbeing and the social accountability will prevent you from dropping out last minute.
· When you’re having a bad time at work, it’s important to remember what the job brings to your life and actively acknowledge this through a practice of gratitude. Does your job enable you to pay the mortgage? Pay for you to go on holiday with your partner? Financial security isn’t something to be taken for granted. Did you have a chat with a colleague today? Did someone say thank-you and mean it? Whatever it is, big or small, remember to feel grateful for the things you can so easily take for granted.
· Identifying your limits is a really important lesson for yourself, and learning to say no when asked to reach beyond these. Everyone will be different. It will depend upon many things, your resilience, how much you enjoy the time you spend at work, your home life etc. It can be challenging to stick to these limits whilst being a junior doctor. I know where I work it’s not uncommon to be asked to fill antisocial hours at the 11th hour. Saying no to this can be a real challenge and you can be made to feel guilty for doing so. Remember, you have to look after you to be able to look after others.
· As the old saying goes, ‘a problem shared is a problem halved’, and it couldn’t be more true. Find someone who you are comfortable opening up to and talk about your stresses with them. You can do this officially through supervisors at work or with family and friends, offloading is not a sign of weakness.
Tell us a bit about the health and wellbeing of your particular industry. How do you think it could be improved, and what do you do to look after yourself and your own mental health?
I do think that sadly the wellbeing of doctors is often overlooked in the industry. It is starting to get more recognition, the day we all wear miss-matching socks for example! Yet at a deeper level? I’m not so sure it’s given the attention it deserves – and I think this needs to change when you look at the prevalence of mental distress in doctors. To improve things, I think ultimately we need a culture shift where the industry makes the wellbeing of doctors as big as a priority as that of patients. These are actually highly interlinked (Rimmer, 2016).
Do you have any advice for other doctors wanting to make changes to prioritize their own health and wellbeing?
If I had to pick three take home messages I would say:
· Pick an appropriate level – if you’re really struggling you might need help from a doctor or therapist.
· Find something you love – just because I love yoga, if you don’t and you force yourself to do it that’s not going to bring you any peace – this said, I do honestly believe there is a teacher and style of yoga that will resonate with most people and it might be that you need to try a new teacher or style.
· Learn to say no and prioritise your own health – I think as a profession we often neglect looking after ourselves. It isn’t selfish to practice self-care, in fact it makes you more able to care for your own family, friends and patients.
Bansal, R. et al. (2013) ‘Impact of short term yoga intervention on mental well being of medical students posted in community medicine: A pilot study’, Indian Journal of Community Medicine, 38(2), p. 105. doi: 10.4103/0970-0218.112445.
Bond, A. R. et al. (2013) ‘Embodied health: the effects of a mind–body course for medical students’, Medical Education Online, 18(1), p. 20699. doi: 10.3402/meo.v18i0.20699.
García-Sesnich, J. et al. (2017) ‘Longitudinal and immediate effect of Kundalini Yoga on salivary levels of cortisol and activity of alpha-amylase and its effect on perceived stress’, International Journal of Yoga, 10(2), p. 73. doi: 10.4103/ijoy.IJOY_45_16.
Gothe, N. P., Keswani, R. K. and McAuley, E. (2016) ‘Yoga practice improves executive function by attenuating stress levels’, Biological Psychology, 121(Pt A), pp. 109–116. doi: 10.1016/j.biopsycho.2016.10.010.
Lin, S.-L. et al. (2015) ‘Effects of Yoga on Stress, Stress Adaption, and Heart Rate Variability Among Mental Health Professionals-A Randomized Controlled Trial’, Worldviews on Evidence-Based Nursing. John Wiley & Sons, Ltd (10.1111), 12(4), pp. 236–245. doi: 10.1111/wvn.12097.
Michalsen, A. et al. (2005) ‘Rapid stress reduction and anxiolysis among distressed women as a consequence of a three-month intensive yoga program.’, Medical science monitor : international medical journal of experimental and clinical research, 11(12), pp. CR555-561. Available at: http://www.ncbi.nlm.nih.gov/pubmed/16319785 (Accessed: 23 February 2019).
Parshad, O., Richards, A. and Asnani, M. (2011) ‘Impact of yoga on haemodynamic function in healthy medical students.’, The West Indian medical journal, 60(2), pp. 148–52. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21942118 (Accessed: 25 January 2019).
Prasad, L., Varrey, A. and Sisti, G. (2016) ‘Medical Students’ Stress Levels and Sense of Well Being after Six Weeks of Yoga and Meditation’, Evidence-Based Complementary and Alternative Medicine, 2016, pp. 1–7. doi: 10.1155/2016/9251849.
Rimmer, A. (2016) ‘Junior doctors’ low morale is putting patients at risk, Royal College of Physicians warns.’, BMJ (Clinical research ed.). British Medical Journal Publishing Group, 355, p. i6493. doi: 10.1136/bmj.i6493.
Smith, C. et al. (2007) ‘A randomised comparative trial of yoga and relaxation to reduce stress and anxiety’, Complementary Therapies in Medicine, 15(2), pp. 77–83. doi: 10.1016/j.ctim.2006.05.001.