Painful periods and loneliness often go hand in hand

A recent study finds that physical functioning links menstrual pain and loneliness, offering an opportunity anticipate the impact of periods on social lives.

23 October 2025

By Emily Reynolds

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Menstrual pain affects many of those who have periods. And, while we're all familiar with the image of someone lying in bed clutching a hot water bottle to try ease their menstrual pain, how painful periods shape social wellbeing in the long term has received comparatively little attention. This is particularly the case when it comes to loneliness, which we already know is strongly associated with other pain conditions.

Writing in the British Journal of Health Psychology, a team led by Julia McCurry of Deakin University looks at this issue, exploring the links between menstrual pain, physical functioning, and loneliness. Their findings suggest that it is not the presence of pain alone, but rather the way in which pain impairs daily functioning, that contributes to loneliness. They believe that physical functionality may therefore serve as an important early warning sign, helping clinicians identify those at greater risk of becoming socially isolated, and intervene before loneliness becomes more entrenched.

The study formed part of a larger longitudinal project looking at menstrual health among Australian women aged 18 to 50 years old. Baseline data was collected from 289 women in May 2019, with follow-up surveys in 2020 and 2021.

Measures included self-reports of menstrual pain severity, responses to loneliness items such as "I lack companionship" and "I feel left out," and assessments of physical functioning. The latter captured perceptions of health and ability to carry out daily activities, including ratings of statements such as "to what extent does pain prevent you from doing what you need to do?" and "how well are you able to get around?"

Participants' fluctuating pain levels across the course of the study gave the team a window to observe the ways in which pain and physical functioning influenced each other. Higher menstrual pain at one stage predicted lower general physical functioning later, and lower physical functioning also predicted higher pain: the relationship was reciprocal.

Yet pain alone did not predict loneliness. Instead, overall physical functioning was the key mediating factor: women who were better able to manage day-to-day activities at the end of the study also reported lower levels of loneliness. This suggests that it's not the experience of pain itself that drives feelings of loneliness, but the way it disrupts daily activities and mobility. In short, physical impairment appears to be the main pathway through which menstrual pain contributes to loneliness, making low levels of physical functioning a valuable early warning sign for future social difficulties.

This distinction has important clinical implications. Efforts to preserve or improve physical functioning during menstruation could help reduce loneliness, even in cases where pain can't be fully eliminated. Addressing the impact of pain on daily life, rather than focusing solely on symptom intensity, may represent a more fruitful avenue for interventions designed to protect wellbeing.

The authors note several limitations. Recruitment through peer support groups may have meant that those who participated don't necessarily have the same experiences or insights as those who are more isolated, for example. Additionally, loneliness was measured only at the final time point, preventing analyses of its interaction with pain and functioning over time. Future research could also explore exactly what kind of social connections or strategies those with more severe pain need to mitigate feelings of loneliness.

Overall, the findings highlight the ability to maintain daily activities as a central link between menstrual pain and loneliness, underscoring the need for clinicians to attend not only to pain severity, but also to its impacts on everyday life and social functioning. Supporting individuals to stay active — through strategies from medical treatment to practical guidance for managing daily activities — may help reduce the social burden of menstrual pain and address its significant impact on quality of life.

Read the paper in full:
McCurry, J., Skvarc, D., Evans, S., Mikocka‐Walus, A., Druitt, M. L., Payne, L., & Marshall, E. M. (2025). In pain and lonely? A longitudinal study examining the associations between menstrual pain, physical functioning and loneliness. British Journal of Health Psychology, 30(3). https://doi.org/10.1111/bjhp.12805

ΠΗΓΗ:

https://www.bps.org.uk/research-digest/painful-periods-and-loneliness-often-go-hand-hand(accessed 27.10.25)

Overconfidence can thrive even with detailed, continuous feedback

A new study looks at overconfidence in chess players, and suggests that efforts to reduce it in everyday life via feedback can still fall flat.

06 October 2025

By Emma Young


Overconfidence has been dubbed "the most significant of the cognitive biases", with research suggesting that it contributes to poor decisions in fields as diverse as medicine, financial investing, political leadership, and management, note the authors of a recent paper in Psychological Science.

Various ideas about what causes this bias have been proposed. One theory is that if we don't receive good objective feedback, it's hard to make accurate judgements about ourselves. If your partner tells you that you're really smart — or a wonderful cook, for example, whether that's true or not, you might well believe them. Patrick R. Heck and colleagues therefore set out to investigate whether a lack of quality feedback really could be to blame.

The researchers picked a group of people who get very regular, accurate and precise feedback on their performance in one particular domain: tournament chess. If these people are overconfident about their chess-playing abilities, the cause can't be a lack of quality feedback, the team reasoned.

With help from the US Chess Federation, a chess magazine, and a chess-training app, Heck and colleagues recruited a total of 3,388 tournament players aged 5 to 88, from 22 different countries. These players had an average of almost 19 years of tournament experience, and included people with a range of abilities, up to a grandmaster who at the time was ranked as the 20th best player in the world.

All of these players had official ratings, known as Elo ratings, which are known to accurately predict the outcomes of games. These ratings are displayed next to each player's name at tournaments, updated after every tournament and regularly discussed between players, meaning that most tournament players are well aware of the rating system and how it works, the team writes.

The participants completed a questionnaire, which, among other things, asked them to indicate their current, official tournament chess rating, and then to supply the rating that they believed would accurately reflect their true current chess ability. The participants also made predictions about the outcome of a set of hypothetical 10-game matches between themselves and other players of varying hypothetical ratings.

When the team checked official records, and analysed the participants' responses, they found that on average, these players knew their own ratings, but felt that their true ability was substantially higher. They also believed that in the hypothetical matches, they would do better than would be expected based on their current rating. To put this difference in perspective, the researchers explain that the average degree of overconfidence among these players would have shifted expectations for a match that actual ratings data would predict to be a tie "to a resounding victory".

Not all the players were equally over-confident, however. About 29% believed their current rating was accurate, and 14% believed it was too high. When the researchers dug further into the data, they found that highest-rated players tended to be the most realistic. This finding is consistent with the well-documented Dunning-Kruger effect.

Perhaps these apparently overconfident players may have actually been capable of playing better than their initial official ratings suggested; to check this, the team looked at their ratings six and twelve months after they completed the survey — and found no evidence this was the case. At both time points, only around 8% of the players who had felt that their initial actual rating was too low had reached or exceeded the rating that they felt would have accurately represented their true ability.

The results of this work do show that (in this sphere at least) accurate, plentiful feedback did not eliminate overconfidence, suggesting that players' self-perceptions are biased towards optimism, the team writes. This observation might support an alternative theory for the cause of the optimism bias beyond the realms of chess — that it a fundamental, deep-seated human bias. If so, efforts to tackle overconfidence in critical areas such as medical decision-making or financial investing by improving feedback would seem unlikely to be effective. Further investigations involving different populations would be needed to confirm this idea, however.

Read the paper in full:
Heck, P. R., Benjamin, D. J., Simons, D. J., & Chabris, C. F. (2025). Overconfidence Persists Despite Years of Accurate, Precise, Public, and Continuous Feedback: Two Studies of Tournament Chess Players. Psychological Science. https://doi.org/10.1177/09567976251360747

SOURCE:

https://www.bps.org.uk/research-digest/overconfidence-can-thrive-even-detailed-continuous-feedback(accessed 24.10.25)

Γονείς: Δεν είναι φυσιολογικό να μεγαλώνουμε τα παιδιά μας απομονωμένοι

Πώς οι γονείς μεγαλώνουμε πλέον τα παιδιά μας χωρίς βοήθεια;

ΓΡΑΦΕΙ: Ιωάννα Χουλιαρά - 16 ΟΚΤΩΒΡΙΟΥ, 2025





Ως σύγχρονοι γονείς με πάρα πολλές υποχρεώσεις- είτε εργαζόμαστε είτε όχι- συχνά ονειρευόμαστε ότι κάθε φορά που δεν προλαβαίνουμε να μαγειρέψουμε, κάθε φορά που θέλουμε να "πεταχτούμε" στο μίνι μάρκετ ή να πάμε τα παιδιά στις δραστηριότητες, παίρνουμε τηλέφωνο μια γειτόνισσα και της ζητάμε βοήθεια. Εκείνη εννοείται δέχεται με χαρά.

Κάποτε οι οικογένειες βασίζονταν στη βοήθεια της κοινότητάς τους- σε μια ομάδα ανθρώπων που τους βοηθούσε στο μεγάλωμα των παιδιών. Η γιαγιά, η μικρότερη αδελφή, η γειτόνισσα, η μαμά-φίλη ήταν εκεί για να σε βοηθήσει αλλά και να τη βοηθήσεις. Πλέον αυτό δεν "παίζει". Η μόνη βοήθεια στην οποία μπορείς να στηριχθείς είναι των παππούδων- αν μπορούν- ή της νταντάς που πρέπει να πληρώσεις. Κι αν δεν έχεις- που οι περισσότεροι δεν έχουν- θα πας τα παιδιά σου σε κέντρα απασχόλησης ή σε δραστηριότητες του δήμου σου.



Δεν είναι φυσιολογικό, όμως, να μεγαλώνουμε τα παιδιά μας τόσο απομονωμένοι ως γονείς. Όπως γράφει σε ένα πολύ ενδιαφέρον άρθρο της, η Louise Perry στους New York Times "Στη σύγχρονη εποχή μας αρέσει να φανταζόμαστε τον εαυτό μας ως αυτόνομες μονάδες· όμως, στον φυσικό κύκλο της ανθρώπινης ζωής, ένα μεγάλο μέρος το περνάμε εξαρτημένοι από άλλους: ως βρέφη, σε μεγάλη ηλικία, ή όταν είμαστε άρρωστοι, έγκυοι ή φροντίζουμε μικρά παιδιά. Σε εκείνες τις περιόδους εξάρτησης, συχνά νιώθουμε μια νοσταλγία για κάτι σαν μια κοινότητα-μια ομάδα ανθρώπων που είναι παρόντες στη ζωή μας και στους οποίους μπορούμε να βασιστούμε".





"Αν θέλεις ένα χωριό, πρέπει να είσαι διατεθειμένος να ζήσεις ως χωριανός"

Γιατί δεν λειτουργούμε πια έτσι; Γιατί πλέον η γειτόνισσα, η γιαγιά, η μικρή αδελφή έχει χόμπι, ενδιαφέροντα, δουλειές. Εκτιμά και αξιοποιεί διαφορετικά τον ελεύθερο χρόνο της. Και πλέον ξέρουμε ότι εάν θέλουμε να είμαστε μέλη μιας κοινότητας, τότε θα πρέπει να θυσιάζουμε κι εμείς τον ελάχιστο, ελεύθερο χρόνο μας.

"Στο αληθινό χωριό, δεν μπορείς τόσο εύκολα να αποχωρήσεις. Η ελευθερία σου περιορίζεται με τρόπο που οι περισσότεροι σύγχρονοι δυτικοί θα θεωρούσαν ασφυκτικό. Αλλά αυτό σημαίνει επίσης πως, όταν βρεθείς σε κατάσταση εξάρτησης, θα υπάρχουν σχεδόν πάντα άνθρωποι γύρω σου που θα νιώθουν καθήκον τους να σε φροντίσουν". Όπως γράφει η Perry: "Στις περιόδους της ζωής που δεν εξαρτόμαστε από άλλους, η ατομικότητα μοιάζει απελευθερωτική. Για κάθε μητέρα που θρηνεί την απουσία της ομάδας-κοινότητας, υπάρχει μια νεότερη αδελφή ή μια γιαγιά που τώρα έχει περισσότερο χρόνο για τον εαυτό της - για τη μόρφωσή της, την καριέρα της ή τα ενδιαφέροντά της. Δεν είμαι σίγουρη αν οι μητέρες που παραπονιούνται για την έλλειψη υποστήριξης συνειδητοποιούν πάντα ότι μια κουλτούρα αλληλεξάρτησης θα απαιτούσε και ανταπόδοση: Αν θέλεις ένα χωριό, πρέπει να είσαι διατεθειμένος να ζήσεις ως χωριανός", αν θέλεις βοήθεια πρέπει να είσαι παρόν όταν και οι άλλοι ζητήσουν βοήθεια.






Είχα διαβάσει σε μια επιστημονική δημοσίευση πως ο λόγος που οι άνθρωποι περνούν εμμηνόπαυση-σπάνιο στα υπόλοιπα είδη- είναι γιατί οι γιαγιάδες παίζουν πολύ πιο ενεργό ρόλο στη στήριξη των νέων γονιών. Οι γυναίκες, με λίγα λόγια, επιβιώνουν μετά την εμμηνόπυαση για αρκετά χρόνια προκειμένου να προσφέρουν τη σοφία τους και την παρουσία τους στις νέες μαμάδες και τα μωρά τους. "Τα μωρά μας είναι τόσο ανήμπορα και η σχέση μητέρας-παιδιού τόσο εύθραυστη, ώστε οι πρόγονοί μας βασίζονταν στη βοήθεια των άλλων μητέρων της κοινότητας για να επιβιώσουν τα παιδιά τους. Με άλλα λόγια, βασίζονταν στην κοινότητα", εξηγεί η Perry κι έχει δίκιο.

Αυτό το κενό που βιώνουμε σήμερα οι γονείς έχει επιπτώσεις στη ψυχική υγεία των γονιών αλλά και των παιδιών. Γιατί μεγαλώνουν κι εκείνα απομονωμένα, μεγαλώνουν με κουρασμένους και αγχωμένους γονείς. Με πολλές δραστηριότητες εκτός σπιτιού ή με τηλεόραση και video games εντός σπιτιού. Και χάνουν κι εκείνα την εμπιστοσύνη τους στους ανθρώπους, όπως την έχουμε χάσει και οι ενήλικες.

Μήπως ήρθε η ώρα να φτιάχνουμε τις δικές μας κοινότητες; Στο εξωτερικό πλατφόρμες όπως το Live Near Friends, που προτείνει στους χρήστες να αγοράσουν "σπίτια πολλαπλών οικογενειών" - κατοικίες δηλαδή που μπορούν να στεγάσουν περισσότερες από μία οικογένειες, αλλά και κοινότητες όπως The Birds Nest- μια κοινότητα μόνο για γυναίκες στο Τέξας στη λογική των "mommune” των μαμάδεων που μεγαλώνουν μαζί τα παιδιά τους, ήδη δείχνουν αυτή την ανάγκη.
Μήπως πρέπει να αλλάξουμε τη στάση μας απέναντι στους άλλους;

Αυτές οι πρωτοβουλίες είναι βέβαια σπάνιες, απούσες στην Ελλάδα. Γιατί ενώ λύνουν πολλά από τα οικονομικά και πρακτικά προβλήματα των γονιών που νιώθουν εξαντλημένοι ή μόνοι, ελάχιστοι τολμούν να τα δοκιμάσουν. Γιατί όταν είσαι μέλος μιας τέτοιας κοινότητας, δεν μπορείς να αποχωρήσεις όποτε θέλεις. Πρέπει να βοηθήσεις κι εσύ. Πρέπει να είσαι αλληλέγγυος και παρόν. Κι αυτό κάποιοι δεν μπορούν να το κάνουν καν για τους παππούδες που μεγαλώνουν τα παιδιά τους.

Ίσως τελικά αυτή η κοινότητα που ονειρευόμαστε οι γονείς να μην είναι απλά μια ομάδα βοηθών, αλλά μια στάση απέναντι στους άλλους. Κάποτε η συνύπαρξη ήταν αναγκαιότητα, σήμερα είναι επιλογή και μάλιστα δύσκολη. Ζούμε σε σπίτια που μας προστατεύουν, αλλά μας απομονώνουν. Σε κοινωνίες που μας διδάσκουν να φροντίζουμε τον εαυτό μας, αλλά όχι να μοιραζόμαστε με τους άλλους. Ίσως λοιπόν η πραγματική πρόοδος δεν βρίσκεται στην απόλυτη ανεξαρτησία, αλλά στην ικανότητα να επιστρέφουμε, πού και πού, στην κοινότητα που χτίζουμε οι ίδιοι γύρω από όσους αγαπάμε.

ΠΗΓΗ:

https://www.themamagers.gr/family/502207/den-einai-fusiologiko-oi-goneis-na-megalonoume-ta-paidia-mas-apomonomenoi(accessed 21.10.25)

The menopause: is psychology doing enough?

We may be talking a lot about the menopause, but, asks Deputy Editor Jennifer Gledhill, can psychologists offer more support during this transitional time?

07 October 2025

We've all received the 'menopause memo'. Davina McCall is showing us how she applies her oestrogen gel on YouTube, Michelle Obama is podcasting about hot flushes and weight gain, and Gwyneth Paltrow is on TikTok, talking about how she feels 'sudden fury for no reason'.

Like many of us, I've been on mandatory workplace menopause awareness training, but it left me feeling no better. I was told to go easy on myself. I'm too busy feeling the shame of brain fog and the weight of anxiety – just a couple of the 30+ symptoms of menopause – to figure out how I do this.

My Instagram algorithm is pushing me to spend a month's salary on menopause supplements, which promise to help me sleep and find more energy and clarity. Yet it all feels more about money than science – the global market for menopause products is reportedly worth nearly 17 billion dollars.

So, what will help? Thankfully, we now know that the benefits outweigh the risks for many symptomatic women when taking hormone replacement therapy. That's a turnaround from the early 2000s when the Women's Health Initiative suggested a substantially increased risk of breast cancer. HRT can help to relieve symptoms including hot flushes, sleep problems and low mood. However, many women, including me, are advised not to take it due to medical family history and other risk factors. Can psychology offer us more options? And, more importantly, do they work?
'We need other options'

I speak with Aimee Spector, Professor of Clinical Psychology of Ageing and one of the psychologists at University College London's Menopause Mind Lab – dedicated to understanding more about the impact of menopause transition on cognition, mental health and wellbeing. When I tell her that the only thing I was offered when I reported heightened anxiety and low mood to my GP was antidepressants, she expresses disappointment.

'This shouldn't be the only option,' says Spector, who believes psychology can now play a huge role in making the transition a more positive one. 'I have firsthand experience of navigating this journey for myself. It's hard. There often seems to be a lot of focus on the biological changes our bodies go through, but there are lots of psychological and cognitive symptoms as well. For me, HRT was helpful at first, but then I got breast cancer, and the recommendation was to come off it. We need other options as well.'

Spector and her team have evaluated the effectiveness of psychosocial interventions, including Mindfulness-Based Interventions and Cognitive Behavioural Therapy, on non-physiological symptoms of menopause, including mood, cognition and quality of life, combining data from 3,500 women. 'CBT can help with the psychological thoughts about the physiological feelings,' she says. 'And the combination of CBT and HRT works well together. Take hot flushes that are disrupting sleep, for example. Someone may take HRT to help with the physiological symptoms, but they may well have also got into a negative thought pattern too, something I think we can all identify with – waking up in the night and not being able to drift back off because you are worrying that you are going to be awake all night. Or, we can worry about having a hot flush at work and being judged by our colleagues. CBT can be helpful when we are stuck in a negative pattern of thought, which may be hard to come out of, even when symptoms start to get better. It can help us to find strategies and techniques to help.'
One size doesn't fit all

But like with anything, there is no 'one-size fits all' and menopause support is no exception. 'For example, some neurodiverse people don't like CBT because something telling you to change the way that you think about things can be very challenging,' says Spector. 'One of the projects that we're doing now is looking at the results of Compassionate Mind Training (CMT) on women going through menopause transition; we're getting really promising results from it and hoping to expand it into a trial. CMT is a 'third wave CBT' that aims to reduce feelings of self-criticism and shame. It focuses on helping individuals to take better care of themselves and learn strategies to manage their symptoms.'

King's College London's Emeritus Professor of Clinical Health Psychology, Myra Hunter, who has worked in women's health for over 35 years, has been instrumental in creating a CBT programme that, in 2024, for the first time, was recommended by NICE as an intervention for the main menopausal symptoms – hot flushes and night sweats.

'This was good news,' she tells me. 'In the first menopause NICE Guideline in 2015, the only symptom CBT was recommended for was depression in menopause. We have now carried out six successful clinical trials and have enough evidence that CBT can help reduce the impact of hot flushes and night sweats, and help to reduce depressed mood and sleep problems. This offers a choice for women who prefer not to use HRT or for whom HRT is contraindicated. It can be used either in conjunction with HRT or on its own, and is available in self-help, group and online formats.'

Hunter explains that it is helpful to use a biopsychosocial approach to understand the range of factors that can affect a woman's experience of menopause. 'Although there are typical symptoms, we will all have our own experience, and an important need for people in perimenopause or menopause is to feel understood. As psychologists, how do we explore this? We can start by being informed and aware of what might happen during menopause, but not to judge or make assumptions. On average, about 25% of women have symptoms that impact quality of life. As well as biological factors, such as general health and menstrual changes, it makes sense to explore psychosocial factors, such as mood, beliefs about menopause and ageing, workplace environment, shame and stigma, and social support. There are bi-directional relationships between hot flushes and depressed mood, and this is important because mid-life is a time of higher reports of depressive symptoms for both men and women. There are many interactions between experience of symptoms and psychological stressors – children leaving home perhaps, older relatives needing more care – as well as expectations of how we should age and the social meanings and beliefs around women ageing.'

Hunter tells me that's where CBT and working in groups can really help. 'I think it's important with menopause awareness to remind people we're not treating an illness but offering evidence-based information and useful tools to navigate the menopause journey. We offer CBT in groups and individually, and it's manualised for psychologists and other health professionals. The course is 8 hours in total and involves psychoeducation around how to reduce stress and how lifestyle, thoughts and behaviours can impact our wellbeing. We use diaphragmatic breathing to help calm stress reactions and hot flushes. We then move on to use cognitive therapy to challenge overly negative beliefs about ageing and menopause, and coping strategies for hot flushes, sleep and night sweats. We encourage self-compassion and use CBT to help reduce the stigma and shame that we can often feel around having them. In group settings, we look at how to talk about menopause, grow our confidence and not feel the need to apologise for it.'
Menopause not illness

However, when the NICE guidelines were initially published in a consultation document, there was an immediate backlash, with the media and some advocacy groups expressing outrage that psychological interventions were being recommended for their debilitating symptoms. A quick Google points to some early reactions: 'Rubbish. How is mindfulness going to help you when you wake again at 3am drenched in sweat?' and, 'Try being in a responsible job with long hours and making time for this. HRT got me through without fuss.'

Both Hunter and Spector remember the reactions well. 'Opinions can be very divided,' says Spector, 'but saying that CBT might help doesn't mean that HRT won't. It certainly helped me, but I was told to stop taking it! Many people would benefit from both, and some may want choices in terms of treatment options.'

'The wording of the final guidance, published in 2024, was changed to be clear that CBT is recommended as an option – not instead of HRT ', says Hunter. 'However, given that women's experience varies such a lot, it makes sense to wait to find out if you need to have HRT, rather than viewing it as something you should be doing. There have been people on social media talking about menopause as if it's a disease that you must take medication to treat. What we can do is not say that the menopause is automatically a disaster for everybody.'

After falling down a rabbit hole reading the responses to the NICE guidelines around CBT, I wonder if part of it is fuelled by the ongoing legacy of women not feeling heard by the health system. After all, a 2025 study funded by the Department of Health and analysed by The London School of Hygiene and Tropical Medicine has found that one in four women in England have suffered with serious reproductive health issues, with 'systemic, operational, structural and cultural issues' preventing them from accessing care.' Overall, 74 per cent of women reported experiencing some form of reproductive health problem relating to menstruation, menopause, pregnancy and diseases such as endometriosis and polycystic ovary syndrome.

If we haven't experienced personalised, compassionate care from our health care provider (and how much can we expect in a brief appointment?), and menopause-training has, for the first time, only just become mandatory for medical students, can we really expect our reproductive and menopausal health needs to be met when we ask for support? Do we need to stay on the defensive until we can be assured that professional caregivers have caught up?
Researching psychiatric disorders

'Progress is always too slow and too frustrating,' says Professor Arianna Di Florio, Professor of Psychological Medicine and Clinical Neuroscience at Cardiff University. Di Florio's recent 2024 study has highlighted just how much we need to question research methods that study the experience of perimenopausal people.

Her team looked at incidence rates of psychiatric disorders during the perimenopause (classed as four years around the final menstrual period – FMP) and found that, compared with the pre-menopausal period (6-10 years before FMP) incidence rates of psychiatric disorders significantly increased (0.59% to 0.88%), mainly due to small increases in new onset major depression and mania. However, these prevalence rates returned to premenopausal levels during postmenopause (0.50%).

The study was the first of its kind in the UK to include over 120,000 participants and use 'age at menopause' rather than simply 'age' as a variable. 'In my clinic, I found that some women, previously living lives without any experience of severe mental health issues, developed severe mental illness around the time of the menopause,' says Di Florio.

'Psychiatric disorders associated with the menstrual cycle, childbirth and menopause are very complex, very heterogeneous conditions. The crucial point to me is that, clinically, we cannot make any strong assumption based on averages. By using age at menopause rather than simply age, we found that participants without a previous history of mania were over twice as likely to develop mania for the first time in the perimenopause than in the late reproductive stage (6 – 10 years before FMP).'

'So, in practical terms,' says Di Florio, 'if a perimenopausal woman presents to the doctor for the first time with symptoms of bipolar disorder, the doctor should take her seriously and not, as sometimes happens, confuse a severe mental illness with another condition, such as major depression or, even worse, with an existential crisis or a stereotype such as the "empty nest syndrome" or, even, dismiss this as "only menopause". HRT is not enough to treat mania.'
'Why did nobody ever teach me about this?'

I'm fully aware I'm at the 'lucky' end of the scale in terms of my menopausal symptoms. I wasn't offered any psychological interventions when I asked for help, but I am a privileged, healthy, white woman, a psychotherapist who has access to experts and information at hand. For many women, it's not that simple, something Diane Danzebrink, founder of Menopause Support, a not-for-profit community interest company that campaigns for better menopause information, knows all too well.

As founder of the #MakeMenopauseMatter campaign – which calls for mandatory menopause education for doctors, a public health menopause information project, greater support in the workplace and for menopause to be added to the curriculum in secondary school education – Danzebrink knows that having a 'menopause policy' in the workplace isn't enough.

'The problem with awareness is that if you raise it, and more people recognise there might be options for their symptoms, then they are disappointed when the infrastructure isn't there to support them. It may take three or four weeks to see a GP. That appointment is probably going to be for about eight minutes. Unless they see someone who specialises in menopause, which is unlikely, they may come away no better off.'

Danzebrink says that despite working with lots of menopause specialists over the years, it feels like it's only now that there's more understanding about hormones. 'Often women have been experiencing premenstrual dysphoric disorder, which causes significant distress in some menstruating women, and they have been misdiagnosed as bipolar. There may be neurodiverse people who haven't had a diagnosis but perhaps have been masking throughout their lives, who then enter perimenopause, and all their coping strategies go out the window.'

Danzebrink's own experience of enduring years of painful periods, horrific pain and being fobbed off by doctors eventually resulted in a diagnosis of grade four endometriosis and adenomyosis following a total hysterectomy for suspected ovarian cancer in 2012, at the age of 44. Three months after surgery, her mental health plummeted. 'I came very close to taking my own life', she tells me.

'Not one doctor gave me information about the menopause, nobody mentioned HRT to me, not until I hit rock bottom. After I recovered, I thought, "Why did nobody ever teach me about this? Why didn't I hear about menopause when I learned about periods and pregnancy at school? And why is there no kind of national campaign to bring about public awareness?"'

Despite never campaigning before, with Menopause Support, Danzebrink has managed to bring menopause to the curriculum in schools, and mandatory menopause training for all medical students has just started. 'We are still campaigning for a government public health campaign, and we want to have menopause guidance and support in every workplace, regardless of the number of people you employ. We don't want it to be simply a tickbox exercise. We want to ensure that the entire workforce is educated about what menopause is, when it happens, why it happens, what people can do to support themselves, and what your role is in supporting your colleagues. I think the benefit would be enormous for the health and wellbeing of the whole population, but I think there would be a huge financial benefit too. However, not many women hold the purse strings when it comes to these decisions', says Danzebrink.

She's right. UK grant-making charity, The Rosa Foundation, announced in 2023 that from a total of £4.1 billion worth of grants awarded to charities, the women and girls sector received just 1.8 per cent.
Making a difference

In addition to educating the workplace and the next generation of GPs, should there be plans to educate more psychologists? Professor Spector informs me that plans are afoot as we speak: 'We are about to launch a half-day online course called 'Introduction to Menopause for Psychological Therapists' from the Menopause Mind Lab. This is because most psychological therapists in the UK haven't had any menopause teaching. The course not only provides a background and biopsychosocial perspective but also encourages people to formulate using case vignettes and discuss if, when and how to bring menopause into a discussion with the client. I have just run a session for our second year Clinical Psychology Doctorate trainees at UCL,' says Spector, 'and most were amazed that this was the first time menopause had been introduced to our curriculum. Thankfully, this will now be an annual session at UCL, but I believe that all psychology training courses should be covering it.'

Perhaps the best way psychologists can make a difference to the menopause experience is by creating interventions that can reach the largest number of people. Professor Hunter is working on that right now.

'With the British Menopause Society, Drs Melanie Smith and Janet Balabanovic are training health professionals to use the manualised group CBT program and the therapy is being implemented in NHS trusts and cancer charities. With colleagues – Prof Amanda Griffiths and Dr Claire Hardy – we have developed an online package for organisations to use called Menokit that's got something for everybody – for employers, for menopause champions and with CBT for those who need it. We aim to make it available to organisations as soon as possible. It is important to consider the work environment as well as the individual. And important not to forget that menopause is a process and most symptoms are time-limited. When we have done qualitative studies with women who have come through it, they talk about feeling stronger, with a renewed sense of themselves and their identity. Maybe that's through shaking off some of those negative gender stereotypes and taking the opportunity to reflect on who we are, and what we need to look after ourselves.'

SOURCE:

https://www.bps.org.uk/psychologist/menopause-psychology-doing-enough(accessed 15.10.25)

Γιατί κανείς δε μιλάει για την ψυχολογία του ζευγαριού σε διαδικασία εξωσωματικής; Πώς να διαχειριστούμε το άγχος

Ένα από τα πλέον ευαίσθητα θέματα που μπορεί να απασχολεί αρκετά ζευγάρια αφορά την εξωσωματική διαδικασία. Οι ερωτήσεις που πρέπει να απαντήσουν μεταξύ τους τα ζευγάρια και οι συμβουλές της ψυχολόγου.

ΓΡΑΦΕΙ: The Mamagers Team - 04 ΣΕΠΤΕΜΒΡΙΟΥ, 2025



Η σύγχρονη καθημερινότητα ενδεχομένως οδηγεί αρκετά ζευγάρια στο να καταφύγουν στην εξωσωματική για διάφορους λόγους, μια διαδικασία η οποία εμπεριέχει έντονη ψυχολογική φθορά. Αυτή η ψυχολογική φθορά σχετίζεται με τις έντονες προσδοκίες του ζευγαριού για την απόκτηση παιδιού (αυτές οι προσδοκίες ενισχύονται κάποιες φορές ακόμη περισσότερο και από τις προσδοκίες του οικογενειακού ή φιλικού περίγυρου).
Τα 2 ερωτήματα που πρέπει να απαντήσουν τα ζευγάρια πριν από την απόφαση


Έτσι λοιπόν είναι αναγκαίο να έχουμε στο νου μας ότι η εξωσωματική είναι μια ιδιαίτερη και συνάμα πολύ ευαίσθητη διαδικασία όπου χρειάζεται να εστιάσουμε στο τι σημαίνει για το κάθε ζευγάρι η απόκτηση παιδιού και για ποιο λόγο είναι σημαντική η απόκτηση παιδιού. Αυτά τα δύο ερωτήματα είναι απαραίτητο να απαντηθούν πριν ξεκινήσει κανείς τη διαδικασία.

Σε σχέση με τα παραπάνω ερωτήματα είναι κάποιες φορές ενσταλαγμένη η πεποίθηση ότι οικογένεια σημαίνει απόκτηση παιδιού. Αντιστοιχεί όμως αυτή η πεποίθηση στην πραγματικότητα; Η απάντηση είναι αρνητική καθώς κάθε ζευγάρι χρειάζεται να έχει στο νου του ότι είναι ήδη οικογένεια και ότι η απόκτηση παιδιού σημαίνει την επέκταση της οικογένειας.




Παρόλα αυτά αρκετές φορές παρατηρούμε ότι η παραπάνω πεποίθηση μπορεί να υπερισχύει στο νου αρκετών ζευγαριών λόγω κάποιων κοινωνικών πιέσεων π.χ. επίμονες ερωτήσεις ή πεποιθήσεις "πότε θα κάνετε παιδί;”, "ακόμη να κάνετε παιδί;”, "χωρίς παιδιά δεν έχει νόημα η ζωή”, "τα παιδιά είναι ευτυχία” οι οποίες επιβαρύνουν ψυχολογικά το ζευγάρι.

Βάσει των παραπάνω κατανοεί κανείς ότι η ερμηνεία του όρου οικογένεια είναι πολύ σημαντική σε σχέση με το πώς τα ζευγάρια αντιλαμβάνονται τη διαδικασία της εξωσωματικής την οποία ξεκινούν. Σε αυτό το σημείο χρειάζεται να προστεθεί η σημαντική αναπλαισίωση της πεποίθησης ότι η εξωσωματική γίνεται όχι "σε μένα” αλλά "για μένα” ως μια ευκαιρία, δυνατότητα να αποκτήσει κανείς παιδί.

Έτσι λοιπόν τα ζευγάρια που ξεκινούν αυτό το ιδιαίτερο ταξίδι της απόκτησης παιδιού είναι αναγκαίο να λειτουργούν ως ομάδα. Το ομαδικό πνεύμα σε συνάρτηση με τον κοινό στόχο, το κοινό όραμα, την αλληλοϋποστήριξη, την αλληλοκατανόηση, τον αλληλοσεβασμό είναι σημαντικά στοιχεία τα οποία θα βοηθήσουν στη διαχείριση των κάθε είδους δυσκολιών που μπορεί να εμφανιστούν κατά τη διάρκεια αυτής της διαδρομής. Ταυτόχρονα η διάθεση ουσιαστικής επικοινωνίας στο ζευγάρι μέσα από το μοίρασμα των ευκολιών καθώς και των δυσκολιών είναι ο ακρογωνιαίος λίθος για μια γόνιμη ζωή.
Ένα ταξίδι με έντονα συναισθήματα και διακυμάνσεις

Επιπλέον χρειάζεται να δώσουμε έμφαση στα ποικίλα συναισθήματα που εμπεριέχει αυτό το ταξίδι για την απόκτηση παιδιού π.χ. αγωνίας (αν η προσπάθεια θα είναι επιτυχής), ανησυχίας (αν κάνουμε ό,τι χρειάζεται με τον πιο κατάλληλο τρόπο), άγχους (αν η κάθε απόφαση που λαμβάνουμε είναι η πιο κατάλληλη), απογοήτευσης (τι δεν πήγε καλά), θυμού και θλίψης (κανείς δε μπορεί να καταλάβει όσα βιώνουμε), χαράς (δίνουμε την ευκαιρία σε εμάς να προσπαθήσουμε να αποκτήσουμε παιδί), ηρεμίας (κάνουμε το καλύτερο που μπορούμε), ικανοποίησης (βρισκόμαστε ολοένα και πιο κοντά στην απόκτηση παιδιού) καθώς είναι ένα ταξίδι στο άγνωστο με τελικό προορισμό το θαύμα της απόκτησης παιδιού.

Όπως γίνεται αντιληπτό ένα ζευγάρι μπορεί να βιώσει διάφορες συναισθηματικές διακυμάνσεις λόγω των εναλλαγών στα παραπάνω συναισθήματα. Για αυτό χρειάζεται να τεθούν όρια (π.χ. πόσες φορές αντέχει το ζευγάρι να κάνει την εξωσωματική διαδικασία χωρίς να καταρρεύσει ψυχικά), δικλείδες ασφαλείας στις επιλογές που θα γίνουν (αν νιώθει το ζευγάρι ασφάλεια στη συνεργασία με τους επαγγελματίες υγείας), στα βήματα που θα ακολουθηθούν (αν λαμβάνονται υπόψη τα δεδομένα και οι συνθήκες που επικρατούν στη ζωή του ζευγαριού) ώστε να υπάρχει αυτοπροστασία του για να μη διακυβευθεί η ψυχική ηρεμία του.

Και αν κάποια στιγμή λυγίσετε σε αυτή τη διαδρομή να έχετε στο νου σας ότι είναι εντάξει και ότι είστε οι ήρωες στη δική σας ζωή! Η όποια πιθανή αδυναμία σας γίνεται η δύναμή σας! Να εμπιστεύεστε τη διαίσθησή σας και να κρατάτε στο νου σας πώς ό,τι συμβαίνει γίνεται για κάποιο λόγο, για να οδηγηθείτε σε εκείνο το μονοπάτι που είναι το πιο κατάλληλο για εσάς! Έτσι μονάχα έρχονται και τα θαύματα στη ζωή σας!

Ευχαριστούμε την Φωστηρία Αμανατίδου, Ψυχολόγο, Ειδικό στη Γνωστική-Συμπεριφορική Θεραπεία-NLP Master Coach, www.amanatidou.com

ΠΗΓΗ:

https://www.themamagers.gr/egimosuni/501590/pos-diaxeirizomai-to-agxos-stin-exosomatiki(accessed 8.10.25)

Dominant and submissive relationships

by Meg-John Barker



Welcome to my website! You’ve found my most popular post, and in a second you can read more about Dominant/submissive relationships. If you want to find out more, check out my books and zines which cover this topic in more depth. If you like this, please do consider supporting my Patreon.

Why do people sometimes prefer Dom/sub relationships?

D/s is one aspect of the wider category of BDSM (Bondage and Discipline, Dominance and Submission, and Sadomasochism), sometimes also known as kink. Some people are into all of the things listed under BDSM, and some only some of them. D/s is generally distinguished from SM because it is more about power than about physical sensation (although some use these terms more interchangeably).

In D/s activities one person generally dominates the other, or has power over them, therefore people tend to prefer D/s if they find a power dynamic to be exciting in some way. Of course it is pretty common for sex and power to be mixed together in our culture. For example, a lot of romance fiction involves people being rescued from peril or being swept away by somebody more powerful, and a lot of people fantasise about having the power of being utterly desirable to their partner.

What is involved in a Dom/sub relationship?

If somebody identifies as being into D/s, or having a D/s relationship, then they probably include power play in their sex life, and perhaps in other aspects of their relationship. People can identify as dominant, submissive, or switch (which means that they are sometimes dominant and sometimes submissive). It might be that people stick to the same roles each time they play together, or that they take different roles on different occasions.

For most people, being D/s will be something that they only do some of the time (for example, just in pre-arranged scenes – often, but not always, involving sex). Such scenes could involve any kind of exchange of power. For example, the submissive person might serve the dominant one food, or give them a massage; the dominant person might order the submissive one around or restrain them or punish them in some way; people might act out particular power-based role-plays such as teacher and student, cop and robber, or pirate and captive.

Some people who are into D/s might have longer periods, such as a holiday, where they maintain their power dynamic. And a few have lifestyle or 24/7 arrangements, where one person always takes the dominant, and the other the submissive, role. However, even in such cases much of their everyday life will probably not seem that different to anybody else’s.
How does it differ to the traditional ‘vanilla’ relationship?

This depends very much on how important it is in the lives of those involved. Some D/s relationships would look very much like a vanilla relationship but just with a bit more power-play involved when people have sex. Others would have something of the D/s dynamic in other parts of the relationship. However, it should be remembered that most vanilla relationships have specific roles (e.g. one person takes more responsibility for the finances, one person is more outgoing socially, one person does more of the looking after, one person takes the lead in sex). In D/s relationships those things tend to be more explicit, but perhaps not hugely different.

So perhaps the main difference is in the amount of communication. Most people involved in BDSM stress the importance of everything being ‘consensual‘ so there will probably be much negotiation at the start about the things people do and do not enjoy, and the ways in which the relationship will be D/s. Checklists and contracts can be useful ways of clarifying this. So, for example, there may be limits about the kinds of activities and sensations people like, whether they enjoy role-play or not, and which aspects of the relationship will have a D/s element.

Why do so many people have misconceptions of this type of relationship?

The media portrayal of BDSM has tended to be very negative, often associating it with violence, danger, abuse, madness and criminality. Research has shown that actually people who are into BDSM are no different from others in terms of emotional well-being or upbringing, and that they are no more likely to get serious injuries from their sex lives, or to be criminal, than anybody else.

Often the media also focuses on the most extreme examples, such as very heavy and/or 24/7 D/s arrangements, rather than the more common relationships where there are elements of D/s. For these reasons people may well have misconceptions about D/s relationships. This is why it is useful to get a range of experiences out there in the media – so people can have more awareness of the diversity of things involved and the continuum (e.g. from light bondage and love bites to more scripted scenes and specifically designed toys).
How do couples go about beginning a relationship like this?

A good idea for all people in relationships, whether or not they are interested in D/s, is to communicate about what they like sexually early on, and more broadly about what roles they like to take in the relationship. Often people just assume what they other person will enjoy or how they would like the relationship to be.

For example, one good activity from sex therapy and from the BDSM community is to create a list as a couple of all of the sexual practices that either of you is aware of, and then to go down it writing ‘yes’, ‘no’, or ‘maybe’ about whether it is something that interests you, and sharing your thoughts. It can also be good to share sexual fantasies or favourite images/stories and to talk about whether (and, if so, how) they might be incorporated into your sex life (the Nancy Friday and Emily Dubberley collections of sexual fantasies can be helpful with this). It is very important that people only do things that they really want to try (rather than feeling coerced into certain activities) and that it is accepted that there will likely to be areas which aren’t compatible as well as those that are.

BDSM communities and websites are a great place to look for more information from those who have been involved in these kinds of practices and relationships. Also local fetish fairs and kink events often include demonstrations and workshops. There is more in my books Enjoy Sex and Rewriting the Rules about communicating about sex and relationships.
Some people have a BDSM relationship outside of an existing ‘vanilla’ relationship. What effect can this have on a marriage or couple relationship?

Again this varies. Although it isn’t always out in the open, many couples have arrangements where they are open to some extent (e.g. monogamish couples, the ‘new monogamy’, open relationships, swinging, polyamory, and ‘don’t ask don’t tell’ agreements).

Having different sexual desires is one reason why some couples open up their relationship to one or both of them being sexual with another person. If this is communicated about clearly, kindly and thoughtfully, it can work perfectly well. The important thing again is kindness and communication.

In regards to the hit book 50 Shades of Grey, many husbands have bought this for their wives and girlfriends. What does this say to them, and how would you help a couple who want to get more involved in this sort of lifestyle but don’t know how, or they are too shy to approach it?

The kinds of conversations and activities mentioned above are a great idea. One of the good things about 50 Shades of Grey is that it has opened up this kind of conversation for many people. However, it is important not to assume that the only form of BDSM is the one described in the book. In a heterosexual couple it may well be that the woman is more dominant, for example, or that both people switch roles, and the things that they enjoy may well be different to the ones which Ana and Christian engage in in the book.

If you want to read more about different practices and how to do them, then there are lots of good books available about BDSM. Dossie Easton and Janet Hardy’s books The New Topping Book and The New Bottoming Book are great places to start, as is Tristan Taormino’s The Ultimate Guide to Kink.

For couples who are really struggling to communicate about sex, or who have very different desires and are finding it hard to reconcile this, it might well be useful to see a sex and relationship therapist for a few sessions. The Pink Therapy website includes many kink-friendly therapists.

SOURCE:

https://www.rewriting-the-rules.com/sex/dominant-and-submissive-relationships/(accessed 6.10.25)

Considering digital change alongside planetary health

Sarah Lake and Dr Penny Trayner argue they are two sides of the same coin.

01 October 2025


The next generation of applied psychologists have a dual inheritance: a planet in crisis, with its profound psychological impacts, and a healthcare system in the midst of digital change. Against this background, the British Psychological Society (BPS) recently approved new standards for the accreditation of doctoral programmes in clinical psychology, with some notable updates reflecting contemporary clinical practice in these two areas.

The publication of 'Clinical psychology and planetary health: Changing course in the storm' (BPS, 2004b) is both a call to action and a resource for psychologists. It positions planetary health as fundamental to psychological wellbeing, offering evidence and direction for clinicians while urging the profession to take an active role in both mitigating and adapting to climate change.

As an aspiring Clinical Psychologist (Sarah) and a Clinical Psychologist and Paediatric Clinical Neuropsychologist, and Academic Director on the Liverpool Doctorate (Penny), these new competencies are highly relevant to us. We are involved in digital change through Kompass Health, a rehabilitation data platform that tracks patient assessments, goals, activities, and outcomes to support personalised recovery and service evaluation. To us, planetary health is intrinsically connected to digital change. Technologies have a material footprint, including energy use and data centre demands. This lens makes a response to the climate emergency feel immediate and practical: it is not only a matter of advocacy; it is about how we design, procure, and use the systems that underpin everyday healthcare.

Here, we summarise the BPS's position on planetary health, explore digital change and investigate the climate effects of different aspects of it.
Planetary health

We live in an era of unprecedented human-driven environmental change. Global temperatures have already risen ~1.1°C above pre-industrial levels, fuelling more frequent extreme weather events and posing threats to both physical and mental health. Whether that is the direct psychological impact of climate disasters such as hurricanes or wildfires, or the indirect effects of the changing climate on socioeconomic and political status and climate anxiety, the mental health impacts are both ranging and growing with the issue itself.

Growing awareness of climate change, though valuable for public knowledge and campaigning, is also driving climate anxiety, fear and hopelessness about the future shaped by the climate crisis (Boluda-Verdú et al., 2022). Younger generations are disproportionately affected, as those who will most directly face its consequences. Surveys report sadness, anxiety, and powerlessness, with 45 per cent stating these feelings negatively impact daily life (Hickman et al., 2021). Distress is compounded by a perception that governments are not doing enough. The BPS (2024a) recognises this anxiety as a rational response to an existential threat, but warns that without support it can become debilitating (Clayton & Karazsia, 2020). Without activism and change, which foster agency and social support (Schwartz et al., 2023; Stanley et al., 2021), young people are left with their rational worries, to see little being done about it.

The BPS publication also emphasises that the climate emergency's mental health effects are starkly unequal. Those in the poorest communities, who contribute least to emissions, experience the greatest burdens (Lobell et al., 2008; Pourmotabed et al., 2020). In lower-income countries, repeated trauma from climate-exacerbated disasters combines with limited recovery resources. In wealthier nations, disadvantaged groups, including low-income families, indigenous peoples, and individuals with disabilities, face higher risks due to barriers in adapting to heatwaves, evacuating from storms, or accessing mental health care (World Health Organization, 2023). Thus, climate change intertwines with social injustice: those least responsible bear the heaviest toll.

Underscoring the whole publication is the reality that human well-being is inseparable from the health of our planet. This is the principle of planetary health – the idea that human health depends on natural systems doing well. Clean air, safe drinking water, stable climates, and biodiverse ecosystems form the foundation for healthy communities. Their degradation directly harms mental health, whether through increased disaster trauma, food and water insecurity leading to chronic stress, or the loss of green spaces that normally support psychological well-being. Thus, the climate emergency calls psychology to broaden our scope to consider the larger ecosystems that support our collective health.

Consequently, the Standards for the Accreditation of Doctoral Programmes in Clinical Psychology (BPS, 2024a) frame sustainability and planetary health as integral to training. It is considered as both a moral and professional responsibility, tightly linked to sustainability, social justice, and health equity – and thus extremely important to future clinical psychologists.
Digital change

With the use of technology in healthcare steadily increasing across services worldwide (Rittenhouse et al., 2017), such innovations are set to play a pivotal role in advancing planetary health, simultaneously reducing the sector's ecological impact and promoting high-quality, effective care. This expansion reflects the broader reality that healthcare is constantly transformed by technological innovation, a trend set to continue at pace in coming years (Thimbleby, 2013). The regulatory landscape recognises this, with the Health and Care Professions Council's updated Standards of Proficiency (September 2023) requiring practitioner psychologists to 'use information, communication and digital technologies appropriate to their practice' (Standard 7.7) and to adopt digital record-keeping tools where required (Standard 9.3).

In clinical practice more broadly, emerging technologies are advancing far faster than is often appreciated, requiring clinicians and policymakers to think 'exponentially' and 'expansively' about how to integrate them into both pre-clinical and clinical interventions (Hategan et al., 2019). This growth has also been driven by significant financial investment in health technology (Chandra & Skinner, 2012), and was further accelerated by the Covid-19 pandemic, which exposed the need for rapid digital transformation (Clipper, 2020; Hammers et al., 2020). However, the pandedmic also revealed enduring gaps in digital skills and confidence, often due to limited time and structured support amidst competing clinical demands.

In rehabilitation, technological developments have expanded the scope and effectiveness of the discipline (Anderson et al., 2019; Schreyögg et al., 2006), while adoption of such tools has been linked to policy initiatives aimed at tackling healthcare inequalities (Chishtie et al., 2022; Joynt et al., 2017). Policy mandates, such as the forthcoming NICE 2025 rehabilitation guidelines, reinforce this shift by embedding digital care pathways into best practice, aligning with the UK government's aim to achieve full digital maturity within the NHS by 2025 (UK Parliament, 2023). At the same time, digital tools are increasingly recognised for their role in empowering patients (Fitzpatrick, 2023).

The Standards for the Accreditation of Doctoral Programmes in Clinical Psychology (BPS, 2024a) therefore recognise the need for psychologists to adapt and lead digital change, being able to understand and utilise digital platforms and methods within their work. Digital competency is embedded not just as a practical skillset but as a fundamental shift in clinical governance, communication, education, and research.
Technology and its effect on planetary health

The Health and Care Act 2022 made the NHS in England the world's first health system to legislate for a net zero strategy. This sets two milestones: achieving net zero by 2040 for directly controlled emissions (with an 80 per cent reduction by 2028–2032), and by 2045 for supply chain emissions (with an 80 per cent reduction by 2036–2039). Operationally, this embeds net zero into procurement, infrastructure, care delivery, and travel. Suppliers are now required to consider carbon footprints in the tendering process, cascading an environmental responsibility across the entire supply chain.

This shows how planetary health and digital change also represent two sides of the same coin. Operationally, they have to be considered in tandem. And the workforce are open to this: conversations with clinical psychologists and rehabilitation professionals highlight a strong openness to innovation, underscoring the broader shift toward digital solutions (Hategan et al., 2019; Trayner et al., 2023).

Here are some areas that need to be considered as part of that shift.

Electronic patient records

Electronic patient records (EPRs) are replacing paper systems in contemporary practice, offering environmental benefits such as reduced paper use, less physical storage, and more efficient information sharing (Clarke et al., 2018; Kwon et al., 2024; Turley et al., 2011). Cloud back-ups also strengthen disaster resilience, ensuring data is preserved during events such as floods or fires.

Unfortunately, EPRs are not impact-free. Their footprint lies in energy use: powering servers, data centres, and networks requires significant electricity, while the manufacture of hardware involves resource-intensive mining and processing, contributing to pollution and depletion. In some cases, EPRs may even produce higher greenhouse gas emissions per patient than paper records, largely due to server demands (Eyesustain, 2025; Kwon et al., 2024). However, if powered by renewable energy, digital records retain their eco-efficiency.

Telerehabilitation

The Covid-19 pandemic rapidly accelerated telehealth across medicine and psychology, with video consultations, app-based condition management, and online appointment systems becoming routine. This shift came with a compelling climate benefit, the lack of transportation required. Studies show that the small emissions from data use are negligible compared to the savings from reduced journeys (Hantel et al., 2024; Nordtug et al., 2022; Rahimi-Ardabili et al., 2022; Vidal-Alaball et al., 2021). At scale, widespread telehealth adoption could reduce national healthcare travel emissions by nearly one-third, preventing tens of millions of kilograms of CO₂ annually (Nordtug et al., 2022; Vidal-Alaball et al., 2021). With this climate benefit, comes accessibility benefits too.

Digital care does, however, carry an energy cost: running video calls, transmitting data, and powering servers all consume electricity. While per-appointment use is minimal, system-wide adoption increases demand on data centres, and if coal-powered, some travel savings are offset. Encouragingly, many centres are transitioning to renewable energy, and streaming efficiency continues to improve. This positions telehealth as a strong example of digital change that advances planetary health.

Artificial intelligence

AI is increasingly integrated into clinical psychology, from clinical decision-making and conversational tools to administrative tasks like minute taking and record management. However, unlike telehealth, the environmental cost of AI is substantial, particularly in the training of models (Strubell et al., 2019; Truhn et al., 2024). While deployment has relatively low emissions, training is energy-intensive (Truhn et al., 2024), and as AI applications expand and become more complex, training demands and their climate burden will grow (Morand et al., 2024). At the same time, AI could mitigate healthcare's environmental impact by streamlining processes, reducing waste, and enabling low-carbon alternatives such as virtual care (Ueda et al., 2024). This duality highlights AI as both a potential climate solution and a significant environmental risk.

Moving forward, the focus must be on sustainable AI: reducing the energy required for training, using renewable power, and demanding transparency from vendors about carbon footprints and offsetting practices. For psychology and rehabilitation, aligning AI adoption with planetary health is essential.
Practice points

Considering the effects, both positive and negative, that digital change can have on our planet, the discipline must act. Consequently, psychologists must embrace digital innovation in ways that actively protect and promote planetary health, ensuring technology is a tool for sustainability, not a new source of harm.

Some practical ideas of how to do this include:Adopt sustainable digital systems: Choose electronic patient record (EPR) platforms hosted on renewable-powered servers, implement device recycling schemes, and extend hardware lifespans through repair and refurbishment rather than replacement. Evaluate platforms not only for clinical utility and usability, but also for energy efficiency and supplier alignment to NHS carbon targets.
Align with policy: Prepare for NICE's digital maturity targets (2025) by embedding environmental criteria into procurement, service design, and commissioning. Psychologists should advocate for sustainability to be built into the digital standards their services adopt.
Embed equity and climate justice: Ensure digital health solutions do not widen inequalities (such as by perpetuating digital exclusion) and design interventions that specifically support vulnerable populations affected by climate-related crises.
Teach sustainable digital literacy: Incorporate training for psychologists to critically assess the environmental costs and benefits of digital tools, helping the workforce see sustainability as integral to clinical effectiveness. Build in protected time for digital upskilling and reflective discussion within teams.
Make positive everyday digital choices: Reduce the hidden carbon footprint of digital work by sharing files via cloud links instead of email attachments, regularly deleting old emails and clearing spam, avoiding unnecessary printing, and using digital notepads and secure recording systems. Where clinically appropriate, use low carbon defaults such as remote supervision and paper-light workflows. Even small changes, such as streamlining email habits, can have measurable impact. Using a carbon calculator can make these savings visible, motivating behaviour change across services.
Far-reaching transitions

The challenges of climate change demand that clinical psychology 'change course', rethinking our practices, priorities, and use of technology in light of the planetary emergency. Both digital change and planetary health are key changes affecting our discipline, and should not be considered as isolated factors, especially as they both directly contribute to the discipline that future professionals will inherit.

Technology will undoubtedly be a part of the path forward in tackling the climate emergency. Its potential to shrink healthcare's carbon footprint, whilst present, must be tackled thoughtfully to avoid unintended environmental consequences. Thus, a mindset of sustainable innovation is required, embracing digital change whilst considering the full lifecycle environmental impact and ways to mitigate any climate downsides of developments. This is why the two considerations are two sides of the same coin, as they must be acted on concurrently. Psychologists are well positioned to advocate for this, bringing a human-centric lens to ensure that technology best serves human well-being without undermining environmental health.

Finally, a tone of advocacy and reflection is fitting. There is no denying that both the climate crisis, and the rate of digital change can feel overwhelming, and it is easy for healthcare providers to feel that their individual actions are a mere drop in the ocean. Yet, as the BPS (2024a) paper emphasises, collective action and leadership from professionals are indispensable for the 'far-reaching transitions' required, and digital change is no different.Sarah Lake is a Research Assistant working with Kompass Health. Sarahlake@kompass.health
Dr Penny Trayner is a Clinical Psychologist and Paediatric Clinical Neuropsychologist, and the Founder of Kompass Health, a rehabilitation data platform that tracks patient assessments, goals, activities, and outcomes to support personalised recovery and service evaluation. Penny is also joint Academic Director of the DClinPsy at the University of Liverpool.

Inspired by:

British Psychological Society. (2024b). Clinical psychology and planetary health: Changing course in the storm. Leicester, UK: British Psychological Society.

See also the 'Climate and the environment' collection.
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SOURCE:

https://www.bps.org.uk/psychologist/considering-digital-change-alongside-planetary-health(accessed 6.10.25)