Dr Anna Smith

Jingle 0:00

habits and health episode 44. Welcome to the habits and health podcast, where we believe creating healthy habits should be easy. Brought to you by an educator and coach for anyone who wants to create a healthier life. Here's your host, Tony Winyard.

Tony Winyard 0:20

Welcome to another edition of the podcast where we give you ideas and ways you can go about improving your health. My guest today is Dr. Anna Smith. She's an NHS GP for over 30 years. And she's also a medical acupuncturist. She's also a certified lifestyle physician, and a certified tiny habits health coach. And she combines all of that to give her clients quite a patient, quite a different set of different ways that she's able to help them. So we find out a lot more about that. In this episode, as we speak with Dr. Anna Smith. habits and health my guest today. Dr. Anna Smith, how are you?

Dr. Anna M L Smith 1:03

Very well. Thank you.

Tony Winyard 1:04

And you know, so a lot of the guests I interview are on the other side of the world, they're in America or Australia or wherever. But you're only a few miles down the road really for me. You're in Oxfordshire. I am absolutely yes. And is that is that where you originate from?

Dr. Anna M L Smith 1:20

No, I was born in Surrey and South Croydon in Surrey, which is where I grew up. And then basically I moved here we really moved here for jobs for my husband's job, Steven, he got a local job as a GP. And then I, you know, came obviously to so that's how we ended up here.

Tony Winyard 1:38

And speaking of being a GP, I mean, you've got quite an background in in medicine or in medical world revenue.

Dr. Anna M L Smith 1:46

Yes, yes. I haven't been a GP now for over 30 years. So yes, I have quite a bit of experience and heard an awful lot of things over the years.

Tony Winyard 1:56

And it's not just being a GP. I mean, when I looked at your website, the amount of study and amount of qualifications you have is quite extensive. Yeah. Would you like to tell us some some of the things that you've done? Well,

Dr. Anna M L Smith 2:13

I suppose if I was going to start by telling you whether I suppose I should tell you the story of how I got there maybe might be Yeah, interesting. Okay. So I would say, you know, as a child, my home life was slightly stressful. Sadly, there was sort of alcohol involved. And my sister sadly, developed an eating disorder in her teenage years. And we had anorexia nervosa, and sadly, she died when she was 22. And at that stage, I was in my sort of first year at university, I was 19. You know, it was a really difficult time. And that summer, I went on holiday with a friend and his family and I started feeling quite sad and tearful, and I didn't really know what was wrong with me. And in those days, no one really talked around mental health. It just wasn't it was the 1980s. It just wasn't something people really talked about, for a tonne of muddled through myself, continued medical school, got married, had a family became a GP. But it was over these years. And I think it was because of that experience I'd had that I started to kind of look at things and say what made me feel good, and what made me feel bad. And so in my own little day to day life experience, I'd be thinking, you know, what, if I go for a walk, or I go hillwalking, or I meet a friend for coffee, or I have a good novel on the go, that makes me feel really good. Whereas if I kind of eat junk food, don't sleep, so well don't do any exercise. I don't feel so good. So I think that was the sort of start of me thinking not just about being a GP, but also how our lifestyles affect our health. And so, a few years ago, I trained also as a medical acupuncturist with the British design and British Medical Association of Acupuncture. And then I had a little bit more time with patients. And because I had time with patients, I started to think about how their lifestyles affected their health. And someone once said to me one day, you know, you really should read this amazing book called The four pillar plan by Dr. Rangan Chatterjee. So I read it and it was like, wow, it was like a light bulb moment. For me. It was like, Oh, my goodness, there's another GP who's actually thinking about lifestyle and there's evidence to support it. And so it sent me on my journey really. And then I went on to get my diploma in lifestyle medicine, society of lifestyle medicine, and then I realised I had a reasonable amount of knowledge, but I didn't know how to enable people to change. So I went on a did various health coaching courses, including the tiny habits, health coaching course with BJ Fogg. And that's kind of my journey through my qualifications and into my lifestyle medicine and health coaching.

Tony Winyard 5:02

And that's it sounds like you were really young to have that amount of awareness about the things that you liked and didn't like and how they were affecting you. Because if I get if I understood you, right, you in your 20s, when that happened, I would say there's not many people in their 20s have that level of awareness.

Dr. Anna M L Smith 5:21

No. And I think that probably goes back to my experience, as you know, I'm sure there's some holidays after my sister died, I had quite severe depression. And because, and no one really talked about it or told me what was wrong with my me. So I kind of muddle through. And I think it was from that I started to notice, gosh, that makes me feel better, that makes me feel worse. So I suppose in some ways, you're right, I was reasonably young, but then I carried it on through my life, partly because then other things, you know, became more prominent, you know, GPS, quite a stressful, intense job. So I was aware of stress in my life, and always trying to manage my stress. So there's various things throughout my life, which made me think about that.

Tony Winyard 6:04

And you mentioned about when you read Dr. Chatterjee, his book, and how that surprised you, I guess, in some ways, you know, the approach that he takes and some of the things he talks about in that book. And it seems to be I mean, I'm, I'm not a GP, but from what I understand of many GPS in the UK, there isn't that level of Kanaka mindedness is not the right word, but being open to sort of many different areas around health, like, especially with nutrition and stress and and some of the other areas that he talks about in that book.

Dr. Anna M L Smith 6:42

I think that's really true. And what I think you have to understand is when you go to medical school, peep, although on all the guidelines that we call them, the NICE guidelines, the national guidelines for chronic disease, one of the first treatments is advice about lifestyle. And yet, when we're at medical school, we're not taught how food affects us how exercise affects us how sleep does how stress does weed, we're just not taught any of that. And so I think, really, we're taught to treat disease, which I think we're very good at. What I like about lifestyle medicine, and how life does affect our health is it works alongside traditional medicine.

Tony Winyard 7:30

And actually, what you just said there about at medical school when you're, you're learning Yeah, he was, I mean, was it seven years of studying and there's so many things that you're taking in. And the other thing that I understand about for many people I've spoken to who have done that, is in those seven years, your work so hard and expected, many people are doing crazy hours of studying, and such to a point where it's almost ignoring the advice that we should be given patients about getting good sleep, not getting too stressed in those studies. Many, many of the students aren't getting good sleep, they are very stressed. And that's the way they're starting their medical career. Is it as if that's normal?

Dr. Anna M L Smith 8:15

I think that's very true. I mean, there's a lot of fun that goes on in medical school, too. But I think what's interesting, so you go into your medical career and some of the hospital jobs. They are very long hours. Yeah.

Tony Winyard 8:30

Yeah, yeah.

Dr. Anna M L Smith 8:32

And as a GP, you take on a huge amount of responsibility for people as any doctor does. So I think there's quite a lot of stress in the career and you're right, we've never been taught it.

Tony Winyard 8:46

So what was it that made you look to acupuncture?

Dr. Anna M L Smith 8:53

I was in the stage where obviously, I'd been a DP for quite a number of years. And I was interested in using my medical knowledge in another way to try and develop my career so that I could have maybe a slightly less pressured area of my working life. And so a friend of mine had trained with acupuncture in acupuncture. And I rather I was rather interested in it as an alternative, again, to perhaps pain relief, and all the issues around that. So is it slightly alternative way of dealing with some medical conditions?

Tony Winyard 9:33

It would seem that there's a real in, in Britain and maybe in many other Western countries as a real misunderstanding of acupuncture is so some people think of it as kind of woowoo and, and there's some people think there's no validity, scientific validity behind him.

Dr. Anna M L Smith 9:49

I mean, I think that's a shame. I trained as a medical acupuncturist and what that basically is is looking at evidence based treatment evidence base acupuncture treatment involving fine needles. Now, it's all adapted from Chinese acupuncture. But we look at sort of modern understanding of how the body works. We use a medical diagnosis as we would in traditional medicine, and then we decide whether acupuncture will work for that condition, is there enough evidence to treat acupuncture in that condition? I think it'll be interesting. There's quite a problem nowadays, with treating pain in traditional ways, and there is a crisis now with a lot of people using stronger painkillers. And I think the good thing about acupuncture is it often provides good pain relief, it reduces prescription medication, you've got no side effects, as you would have in medication, and other things such as it might reduce referrals to secondary care, you have a much longer time, I have a much longer time with patients so much sort of hands on approach. And I can look a little bit more around the holistic side of the problem that the patients come to me with so I can look a little round the lifestyle side as well.

Tony Winyard 11:16

Does it does it surprise any of your patients that you know what the the benefits they get from it?

Dr. Anna M L Smith 11:25

I think the people who do come and see me are quite open to having acupuncture. So have them had it before. Or sometimes they're looking for an alternative. I think they feel quite confident because I'm a GP as well. And I have an interest in lifestyle medicine. So I think there's a sort of confidence around coming to see me. But I think they're delighted when it works. That's what I do think,

Tony Winyard 11:51

are there any specific treatments it's really beneficial for?

Dr. Anna M L Smith 11:55

Yeah, it's beneficial quite a lot of things. I mean, pain is the sort of typical thing we think about using acupuncture for so musculoskeletal pain, neck pain, back pain, shoulder pain, etc. And then it can be very good for some of those very difficult things to treat like tennis elbow golfer's elbow. And then some other sort of disorders such as irritable bowel syndrome, overactive bladder, migraine headaches, menopause, or hot flashes, so quite a variety of conditions. As well as some people and get sort of tight bands of muscle, you know, a lot of people get it around their necks and shoulder unit from computer work and studying and whatever. And acupuncture is very good at releasing those what we call myofascial trigger points in muscles and taking that pain and tension away.

Tony Winyard 12:49

And is it something that can be just treated once or does it have to be done over a series of weeks months, or

Dr. Anna M L Smith 12:56

I would say the average number of treatments for a condition is about six, it may be slightly less than that, it may be slightly more than that. And you often don't get an immediate benefit. So sometimes you have to have sort of three, four treatments before you start noticing the benefit with acupuncture. And then you have that benefit. And then once you get to that stage, you can decide whether the treatment is you know how long the treatment is.

Tony Winyard 13:24

And do many people fear the needles.

Dr. Anna M L Smith 13:29

I have a couple of patients who are a little bit nervous about the needles. I think that the that they are very, very fine needles. So I think people are very surprised when I put in the first needle, they often haven't even felt it go in. Yeah, I do try and make the whole experience quite relaxing, so that people aren't nervous and anxious about it. But I've not had any major I've had no one feigned or anything like that, to me partly you lie someone down when you do acupuncture, so it doesn't tend to happen.

Tony Winyard 14:00

What would be maybe someone's listening, and they've got a condition that they would never have considered acupuncture for. And so maybe I'm what I'm getting at is Is there something that some people would be quite surprised that acupuncture would actually help them with that they probably wouldn't even consider acupuncture in their minds.

Dr. Anna M L Smith 14:23

I think more along the lines of irritable bowel syndrome. Maybe headaches there is in the national guidelines for headaches. So I think more the overactive bladder, irritable bowel syndrome, maybe men are hot paws or hot flushes are probably the things you don't naturally associate acupuncture with.

Tony Winyard 14:43

Okay? And when you it's so easy when you're seeing a patient or your normal patients. Is it Are you only doing acupuncture now? Are you still doing your normal sort of GP practice practice as well?

Dr. Anna M L Smith 14:57

I keep them separate so I didn't work on A couple of days a week is an NHS GP. And then I have my private acupuncture clinic and health coaching clinics like these separately.

Tony Winyard 15:08

Okay. And you talked about how Dr. chatted us book was, so you enjoyed it so much. So I'm good and your whole lifestyle approach. So you do you have a, maybe a different approach in your GP practice than many other GPS would say?

Dr. Anna M L Smith 15:27

I hope so. I mean, I think that it's really important when someone comes to see you with a chronic disease, and that could be diabetes, high blood pressure, heart disease, it can be mental illness, that rather than just treat the disease with medication, which may be very appropriate, we also ensure the patient has some knowledge that lifestyle affects these conditions. And I'll often say to a patient, has anyone ever spoken to about how your lifestyle might affect your blood pressure, your lifestyle might affect your depression? And if they say, Yes, I'll then explore a little bit, what do you know about it? If they say no, I might ask them, you know, how would you feel if we just we had a little chat about how your lifestyle might affect your health in the long term. So it depends where the patient is and how I might approach it. And it's whether the patient is happy for me to talk about those things and introduce that onset. What I'm usually nicely surprised about is that people generally are very receptive to talking about lifestyle and how their lifestyle affects their disease.

Tony Winyard 16:50

We hear in the media all the time that GPs are so under so much pressure, they were only able to have 1015 minutes of each patient. Is that something? That's that is true in your practice? Or is it different for you?

Dr. Anna M L Smith 17:03

I think it's true everywhere. I think we are under huge time constraints. Yes, we are. And so, in a way, I'm quite lucky with my health clinic, because I do have longer time. But I equally think it's really important for my NHS patients that they have at least some understanding, and because my time is more, you know, restricted with, with my NHS patients, I might often say to them, you know, would you ever read a book if I if I suggest a book? Is that the kind of thing you do so that they can go off and perhaps do some of the reading themselves and gain knowledge that way?

Tony Winyard 17:40

So it sounds like it's quite tricky for you to to be able to do the job that you know you can do for these patients, because there's such such limited time.

Dr. Anna M L Smith 17:50

Yes, we are very limited in time. There is no question about

Tony Winyard 17:54

that. Yeah. Is that frustrating?

Dr. Anna M L Smith 17:57

Yes, it has its limitations, and it can be very frustrating. Yes, it can. Yes.

Jingle 18:03

We hope you're enjoying this episode of the habits and health podcast, where we believe that creating healthy habits should be easy. If you know a friend or a loved one who might be interested in learning simple habits to improve their health, then please share this podcast with them. We also invite you to subscribe to leave us a review on your favourite podcast app. Now, back to the show.

Tony Winyard 18:27

So you mentioned about that you did the habit, the training in tiny habits. So how? How do you implement that in what you do?

Dr. Anna M L Smith 18:36

Tiny habits is a course run by BJ Fogg, a behaviourist in America. And his really key message is people will change behaviour, if they feel good. And one of the slight problems we have is we often consider that motivation is what gets us up and going to change behaviour. And the problem is motivation is a wave. It's quite an unreliable thing. So if I give you maybe I'll just talk through an example perhaps me. So for instance, I had this 30 year old lady came to see me and she wanted to lose weight. So we kind of looked at all aspects of her life. Her diet, which actually was very good exercise regime, I couldn't really fault she was doing sort of aerobic exercise three or four times a week, she was doing boot camps at weekends. Her sleep wasn't great. She was waking up a few times at night. And what I noticed was her stress around work and some of her home life was very high. So she had very high stress levels. Now aspiration was to lose weight. And so what we ended up doing is we looked at that aspiration and we then what looked at all the different behaviours That might help her manage her stress. Now, I know that people might be a bit confused why you're managing her stress when she's coming to weight loss. But there is quite a lot of evidence to say with stress increasing your cortisol levels, which causes something called insulin resistance, it affects your hunger and your satiety hormones. And therefore, weight gain. And also poor sleep does a very similar sort of thing. Where you get if you had poor sleep, you tend to have, you want more high calorie sugary foods, you get poor impulse control, it feeds into insulin resistance, and you put on weight. So I thought stress was quite a key factor to look at, for this lady. So we looked at all the behaviours that might make her reduce her stress levels, we looked at kind of breathing exercises, we looked at maybe could she stretch at intervals in the day? Could she perhaps change one of her aerobic classes to a yoga class? Was there any time in the day when she had could have a quiet cup of tea, anything that would reduce his stress, and we literally just went through lots and lots and lots of different behaviours. And then with each one of those ideas, we looked at, how impactful would that behaviour be? And how easy would it be to do and what we did with we chose behaviours that had high impact for her aspiration, that would lower her stress, and would be very easy to do. And then what we did is we made it tiny, because if you don't make it small, and you don't make it easy to do, you won't do it. She chose a couple of things. So she chose a breathing, I think it was she did choose to replace one of her aerobic classes with the yoga class in the week. And she did choose a quiet cup of tea when she came home in the evening. And what we did was we said she needed a, you need a prompt to remind you, then you do the behaviour. And then the idea is you feed back and feel good about yourself or celebrate Yeah. So the prompt for her with the breathing was that she did quite a lot of driving and her job was getting in the car, kept on getting in the car, starting the engine, she would then remember, that's when I'm going to do some calm breathing. That was one idea. And the other was the quiet cup of tea when she got home. So that involved sort of coming in the front door, she'd let the dogs out in the garden. And then she'd go and make the cup of tea, sit in the sitting room in a particular space, and have a quiet cup of tea and just sit with her feelings about the day. And it was that what we went through was reducing her stress. So that then that improved her metabolism her insulin resistance, as we call it, and that she started to lose weight because it had had been the stress that had probably stopped her losing weight in the first place.

Tony Winyard 23:10

Did that surprise her?

Dr. Anna M L Smith 23:12

Yes. Yeah. Because as most people with wanting to lose weight, there's this message where sold about calories in calories out. And it's a lot more complicated than that it relies it's it's it's on, there are lots of different areas and issues around weight that we don't, you know, we don't no one is really told or informed about.

Tony Winyard 23:38

And you mentioned about the celebration aspects. As Brits, we're not always great celebrations. With did she find that easy? Or was that? How was that for her?

Dr. Anna M L Smith 23:48

I think it's the hardest thing to do. Because that's exactly you know, BJ Fogg says you have your prompt, so your mind, you have your behaviour, which is tiny, and then you do the celebration, which is a very American thing to do. And you're absolutely right. I think it's a hard sell for the British, British public. And I think you can do it in sort of ways that work for you. And, you know, it can just be a moment of just, you know, just feeling that pleased with yourself acknowledging in your own mind that you've done it, it can be a simple smile. It can be a kind of, you know, thumbs up, so it could be quite a small thing, but I think it is a harder thing to do. However, I do think it's really important. We make ourselves feel good. And if you feel good about something you will carry on doing the activity.

Tony Winyard 24:41

Anyone listening who's maybe not familiar with the tiny habits book and may be wondering, well, why is the celebration part so important? What would you say to them?

Dr. Anna M L Smith 24:51

We, because we only changed by feeling good. Basically, we don't generally change by people making us feel bad about things. And that's why it's so important to wire that good feeling and to also do the behaviour, celebrate in some way. So that the wire that behaviour back in.

Tony Winyard 25:17

And so has that person you were you were speaking about, she managed to maintain her weight now since since that. Yeah, so

Dr. Anna M L Smith 25:23

she's managed to stress much more, she's lost some weight. And she's much happier.

Tony Winyard 25:28

Right? So is this? I mean, when when did you do the course with BJ?

Dr. Anna M L Smith 25:34

I did the course BJ earlier this year. Okay. And

Tony Winyard 25:37

so how easy or difficult has it been to implement that into what you do?

Dr. Anna M L Smith 25:44

I think it's fairly easy. I think that because people often rely, people often think like, rely on motivation, like I said earlier. And also they think I have to make a big change. And I think the key is, don't rely on your motivation, rely on a prompt to remind you a tiny habit to very small, so you'll do it, and then feed back a feelgood factor back into your feelings and self esteem and your carry on doing it.

Tony Winyard 26:16

You talk to him? So before about in order the different training that you did, you've done you did some health coach training as well. Yes, and what was it that made you decide to do that?

Dr. Anna M L Smith 26:28

So it was really similar along the lines of BJ Fogg gave us about the fact that I felt I had knowledge in lifestyle aspects, you know, things like stress or sleep or how we should eat or move, but I didn't have the ability to enable people to change. So that's why I did health coaching with with tiny habits been one of those courses?

Tony Winyard 26:54

Is it I wonder if it was, if more GPs? Well, I want do many GPs have? Do extra training, like you have taken things like tiny habits and health coaching and so on? Or are they are there more GPs who are just so busy, they just don't have time to be doing those sorts of things.

Dr. Anna M L Smith 27:17

I think, general practice a very intense career, I think a lot of GPs are incredibly busy. What some GPs are starting to do is have what we call portfolio careers. So your part time GP and your part time do something else. It's hard to say how many of them would not be doing things like health coaching or lifestyle. But certainly, they're not as many GPS, who were just doing GP, they're often doing something else as well. Right. So

Tony Winyard 27:49

you think it work? Is it in the last 1020 years? Has it changed quite a bit, then?

Dr. Anna M L Smith 27:54

It's changed hugely. I would say in the last sort of 20 years, it has changed hugely. Yes, people much people are more likely to have a portfolio type career where they do different jobs,

Tony Winyard 28:06

right? We are them more GPs now with a maybe open to say nutrition and so on. And the reason I asked that is because I had an experience once why I saw my GP and this was probably about 15 years ago. And I my iron count was quite low at the time. And I was kind of doing some experiments in with not eating meat and dairy at the time. And I was very aware that the reason my iron count was low was because of the eating, I was getting underway. I was eating at that time. And I remember her saying somehow this has nothing to do with what you're eating. I said, what it's got everything to do with what I'm eating. And so I was really, I was just so surprised that her reaction, but it's got nothing to do with nutrition was basically what she told me.

Dr. Anna M L Smith 28:54

I think I think it goes back to you know, when we're medic school, we're not taught about lifestyle about what foods we should eat, or how we should sleep or how we should move. And so I think a lot of GPS aren't really very aware of those aspects. And yet, as I said in the Chronic Disease guidelines, the number one treatment is lifestyle advice. Yeah. I also think it's it is also hard for the public because also there's lots of information out there but it's very confusing and overwhelming as well.

Tony Winyard 29:36

And since you've done the the training in the behaviour, science and health coaching and so on, are you do you feel you're able to get get much better results for your patients?

Dr. Anna M L Smith 29:47

I hope so. I do hope so. I think I hope I open up to them the opportunity that they have a chance to change their life. Change their health. And that can be mental and physical health.

Tony Winyard 30:05

And for people listening who maybe aren't really sure, what is a health coach? What, what would you say? How would you describe that?

Dr. Anna M L Smith 30:14

A health coach is someone who helped, who helped someone, manage their health coaches them to better health. Because like we said before, people don't know how to change, or they are too busy with their lives, their time constraint that overloaded with information, they're confused. And so the idea of a health coach is they may come, they may come to me saying, Oh, look, I've got high blood pressure. I'd like to sleep better, but they don't know how to do it. Right. And so the idea is, I would help them work through that with them,

Tony Winyard 30:56

as opposed to a GP would maybe just diagnose something instead?

Dr. Anna M L Smith 31:01

Yes, I mean, as GPS, what we're excellent at doing, I think, is making a diagnosis and treating people. I think we're very, very good at that. What's nice about lifestyle medicine is it works alongside traditional medicine, right?

Tony Winyard 31:19

On the subject of behaviour, change, and habits and so on, what, what habits have you found most helpful in your own life implementing?

Dr. Anna M L Smith 31:30

Probably the most helpful habit, I think, is I injured my knee a few years ago, and I don't know whether you you know, I was I went to see a physio and was given exercises to do and, you know, life takes over. And I was thinking, When am I ever going to do these exercises, I don't have time. But I was also interested in the time with mindfulness, and maybe a little bit of meditation and things. So I started to think, right, I have got to fit these exercises in somewhere. So what I my best habit is really I get up in the morning, showered, get dressed, come downstairs, let the dogs out. That's my, my prompt, goes straight into the sitting room. And I basically do 10 minutes of exercises. Partly, it started for my knee. But it's ended up being sort of mindful movement and a little bit of resistance exercise that we should all do. And I just do 10 minutes every morning, and it sets me up for the day mentally. It makes me feel like I don't react to things in the day. I tend to respond to things. I think my stress levels are lower. And I feel generally better in myself. I wish I started doing it years ago.

Tony Winyard 32:47

But when did you start doing this?

Dr. Anna M L Smith 32:49

Only about three or four years ago?

Tony Winyard 32:52

Um, can you is it noticeable? The difference?

Dr. Anna M L Smith 32:55

To me? Yes. And what about trust levels are less? I noticed, like I said, I tend to respond rather to react to things.

Tony Winyard 33:05

And but is it noticeable to people around you as well?

Dr. Anna M L Smith 33:09

I hope so.

Tony Winyard 33:13

Because I mean, you mentioned about how stressful it is working as a GP. So doing something like that is it sounds like so important?

Dr. Anna M L Smith 33:21

Yes, I think these things are important. And for GPS, but I think so many people, one of the main things I see in general practice is stress related illness, you see a lot of depression, anxiety, we see a lot of people who have high blood pressure and getting overweight because of stress. So I would say stress and managing stress is one of the key things for a lot of people managing their work and their home.

Tony Winyard 33:51

And is so such, you mentioned that stress is probably one of the most prevalent things you're seeing with people and what about sleep?

Dr. Anna M L Smith 34:01

I think that stress often feeds into poor sleep. And I think a lot of people are quite troubled with sleep. Yes, I would say it's quite prominent. Again, it comes in. If you have mental illness, often your sleep isn't very good. And if you have physical illness, often your sleep isn't very good. And certainly if you have stress, it often disrupts your sleep pattern.

Tony Winyard 34:26

And how has the whole situation we've had in the last two years with this sort of lockdowns and pandemic and so on. How would you say there's more stress since since this has happened with with your patients you're saying?

Dr. Anna M L Smith 34:40

I think there has been an explosion of mental health issues. Whether that's through the loneliness, and the lockdown. People now working from home on their own, not having that necessarily face to face social support. I think there's a certain Mount of social anxiety from having been in lockdown, and now we're out of lockdown. And, you know, generally we made the connection with people it's good for our physical health is good for our mental health. We know if we're socially isolated our stress hormone cortisol goes up and our stress levels go up. So I think it has had a huge effect.

Tony Winyard 35:26

You talked before about Dr. Chatterjee, his book has given you a taste of maybe writing your own book. Oh,

Dr. Anna M L Smith 35:37

if I could write a book that was as good as that I would. I don't know if I will ever quite write a book. Yes, we will see we will see.

Tony Winyard 35:47

Are there is there a book that is that has really moved you that you can remember in your life?

Dr. Anna M L Smith 35:55

A book that's really moved me would be the salt path. Okay. That probably is a book that's really moved me. And why? It's a really incredible story, true story, credible story about homelessness.

Tony Winyard 36:16

And how long ago was it? You read that?

Dr. Anna M L Smith 36:18

I read that about two or three years ago.

Tony Winyard 36:23

Okay. If people want to find out more about you, and where we'll be the best places to look,

Dr. Anna M L Smith 36:30

I'm probably on my website. www.gp acupuncture oxford.co.uk You can find me on Facebook GP acupuncture and lifestyle and on Instagram. I'm not that active on social media. But I do occasionally post things there.

Tony Winyard 36:50

And I you I'm guessing are your own? Do you only see people face to face? Or do you do online appointments as well?

Dr. Anna M L Smith 36:56

Obviously, for the acupuncture, I do face to face but I do do online zoom appointments for health coaching. Yes.

Tony Winyard 37:03

Right. Okay. And just before we finish, is there, is there a quotation that you like?

Dr. Anna M L Smith 37:10

Yes. I don't know who wrote this or when it was something I read. But I like one that goes a healthy lifestyle not only changes your body, it changes your mind, your attitude and your mood.

Tony Winyard 37:27

And what what is it about that that appeals to you?

Dr. Anna M L Smith 37:31

Because it's about the fact that our lifestyles affect our mental and physical health.

Tony Winyard 37:40

Anna, thank you for your time. It's been a real pleasure. I haven't it's the first time we've spoken about acupuncture on this on the podcast and I've been wanting to for quite a while so so thank you.

Dr. Anna M L Smith 37:50

Thank you very much for having me.

Tony Winyard 37:53

Next week, episode 45 is with Renée Jones. She spent 40 years on a diet yo yo before other overcoming emotional stress, and has been eating to reach and maintain her goals since 2012. She has a master's degree in counselling, clinical residency and training in contemporary models of care. And her book. What's really eating you overcome the triggers of company two is an Amazon bestseller. So that's next week with Renée Jones. If you did get some real value from this week's episode with Dr. Anna Smith. Please do share the episode with anyone who you think could get some real value from it.

Jingle 38:34

thanks for tuning in to the habits and health podcast where we believe creating healthy habits should be easy. If you enjoyed this episode, please subscribe and leave us a review on your favourite podcast app. Sign up for email updates and learn about coaching and workshop opportunities at Tonywinyard.com See you next time on the habits and health podcast.

Transcribed by https://otter.ai