A-Z of Health and Wellbeing

Happy New Year!


We often start a New Year with resolutions, things which we would like to change for the better. so, I thought I’d start this year of blogging with a vlog about my perspective on the A-Z of what affects your Health and Wellbeing the most.


It’s longer than most of the videos on my new YouTube Channel (Dr Andy Knox), at nearly 15 minutes long, but it is pretty tricky to talk through 26 different aspects of health and wellbeing in under 3 minutes!


So…..he is a list of the things I talk about……and if you don’t want to watch the whole thing, then you can find the bits in the video that are of interest to you, in helping you think about some changes you might want to make or help you might want to access this year.


A is for Alcohol

A is for Adverse Childhood Experiences

B is for Blood Pressure (140/90 – the magic numbers)

C is for Cigarettes

D is for Don’t want to live anymore

E is for Exercise

F is for Fluids

F is for Food

G is for Glucose (Sugar)

H is for Housing

H is for Heating

I is for Irregular Pulse

J is for Joy

K is for Kindness to NHS Staff

L is for Loneliness

M is for Money (Debt)

N is for Narcotics (Drugs)

O is for Obesity/Overweight

P is for Pollution

Q is for Quarrelling

R is for Road Taffic Accidents

S is for Stress

T is for Temper (Anger)

U is for Underweight

V is for Violence (Domestic Violence)

W is for Worry

X is for Xenophobia

Y is for Your Ego

Z is for Zzzzzzzzzzz (Sleep Deprivation)



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Our Nation’s Biggest Public Health Problem

The subject of this blog is sensitive and difficult. It may stir up some difficult issues or memories for you, as you read. If this happens, then please take time to seek the help you need. I believe this blog and ones to follow might be some of the most important I have written to date.


UnknownI am currently reading a phenomenal book, sent to me in the post, by a dear friend of mine, who is a trained counsellor and knowing the work I do, felt that I should read it also. The book is called “The Body Keeps the Score” by the eminent Psychiatrist, Bessel Van Der Kolk. In my humble opinion, it should be compulsory reading for every person training in any of the clinical specialities, including public health and for those working in education. The book focusses on the detailed research and work done by Van Der Kolk and others at Harvard over the last 30 years in the whole area of Complex Post Traumatic Stress Disorder (CPTSD), or “Disorders of Extreme Stress, Not Otherwise Specified” (DESNOS). It is not a part of our vocabulary, unfortunately, because even now, after a huge evidence base and many studies, there still remains no such psychiatric diagnosis. However, it is a hidden epidemic affecting huge numbers of our population and is the root of many of our major public health issues. So what causes this problem and just how wide spread is it? The evidence shows so strongly that the cause of CPTSD or DESNOS is Adverse Childhood Experiences, which we more starkly call Child Abuse.


Child abuse falls into four main categories: Physical abuse, Sexual Abuse, Verbal Abuse and Emotional abuse – usually in the form of neglect. 10% of children suffer regular verbal abuse. 25% suffer regular physical abuse. 28% of women and 16% of men have suffered sexual abuse. 16% regularly watch domestic violence. 87% of all those who suffer one type of abuse, are also abused in other ways. Each of these forms of abuseUnknown lead to major health problems later in life and studies are showing that it is not just mental health issues (many of which lead to inappropriate diagnoses like Borderline Personality Disorder or Bipolar Disorder and ineffective treatments) but also major physical health problems. Those who have been abused are twice as likely than others to develop cancer and four times as likely to have emphysema. The more difficult a person’s experiences, the higher the chance of developing heart, liver or lung disease at an early earlier age with much higher chances of taking more health risks with smoking, becoming overweight or having multiple sexual partners. There is good evidence to suggest a link with autoimmune diseases, such a lupus, and other complex conditions like chronic pain, chronic fatigue and fibromyalgia. The body cannot be separated from the mind and literally keeps the score of the internalised turmoil. So, even if the abuse happens before memories are formed, or our minds manage to forget or block out what has happened, the body simply cannot forget and sometime and in someway, the damage will show itself. Studies show that the overall cost of this appalling reality far exceed those of cancer or heart disease. In fact, eradicating child abuse would cut depression rates by over 50%, alcoholism by 66% and suicide, IV drug use and domestic violence by 75%. Antidepressants and antipsychotics are now some of our largest prescribing costs. We know this, but are doing very little about it. Perhaps it feels too big. Perhaps we don’t want to face the demons involved. Instead, we are numbing the problem, trying desperately to get people to be just functional enough to keep on serving the needs of our economic system, but we are not facing up to or dealing with this horrific problem, nor its true cost.


What can be done in the face of such evil? How can we develop aimages culture of compassion and restorative justice in which we can find a new way through for humanity? It isn’t getting any better. It is just as widespread and far reaching in its consequences as it was a generation ago. Is it possible for us to face up to the startling reality we face? Van der Kolk offers much hope, but it is not within the gift of the health service and social services to tackle this alone. If we are to take this issue seriously, we must embrace what Bessel refers to (at the end of chapter 2) as four fundamental truths:


  1. Our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring wellbeing.
  2. Language gives us the power to change ourselves and others by communicating our experiences, helping us to define what we know and to find a common sense of meaning.
  3. We have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through simple activities such as breathing, moving and touching – (learning to be present in our own bodies is a vital way of separating out the memories of the past which can overwhelm us at times).
  4. We can change social conditions to create environments in which children and adults can feel safe and where they can thrive.

images-1People can be healed of trauma. We need this at both an individual and corporate level. We have become so focussed on saving money, on quick fixes to ensure the NHS and Social Care System can survive, but we are ignoring the root cause of many of our ill health issues. If we are willing to face up to the truth of child abuse in our society and its long lasting and far reaching impact on overall health and wellbeing, then we might just be able to find a way through to healing and restoration of what has become an extremely broken society. In the blogs that follow, I will look at some of the ways we might find a way through this crisis of epidemic proportions. One thing we must face straight away is that we are spending our resources in the wrong places and are focussing our attention in the wrong areas. We must protect our children and help people learn how to be good parents. We must strengthen our school teachers and sense of community. We must invest in the first five years of life far more than we are doing so currently, especially those key first 12 months of bonding and attachment. Together, if we want to, with love, care, bravery and determination, we can change the future. There is hope. There is healing. Our systems are not yet designed to cope with this, but we must speak the unspeakable, break the silence and face up to the truth. The truth will set us free and enable us to develop the kind of wellbeing that every human being should be able to live within.




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Solutions Focused Thinking for the NHS

Tweet One of the main headlines in the news this morning is that without extra funding, the NHS is in dire straits and patients are beginning to suffer as a result of less financial provision than is needed.   http://www.bbc.co.uk/news/health-38019771   One of the things I have trained in, during my career is Solutions Focused [Continue Reading …]


Learning to Celebrate Success

Tweet The NHS really is amazing. Today, I have been at the NHS confederation (confed2016), a conference which helps to set the pulse and rhythm of the health system over the following 12 months. I heard Dame Kelly Holmes speak movingly about her own experiences, help she received from across the NHS and how grateful [Continue Reading …]


Reconnecting Clinicians to Healing

Tweet In the USA, doctors have the highest rate of suicide of any profession. In the UK, a similar picture unfolds. Why is it, that 69% of all physicians suffer with depression at least one time in their career? It could be because of the high workload, high stress, high demand, an increased sense of professional [Continue Reading …]


Love – It’s a Two Way Street

Tweet There is a lie that has been told, to clinicians in particular, that it is wrong to get too close to patients. One is told to keep a healthy separation, perhaps to make the tragedy we often deal with somewhat more bearable. We have shaped medical ethics around the four core principles of beneficence (do good), [Continue Reading …]