Thursday 10 October 2013

So It's World Mental Health Day

It's world mental health day, and I'm sure there's all sorts of positive messages and articles out there on the internet but I'm going to focus on Derek Chamber's piece in thejournal  http://www.thejournal.ie/readme/the-power-of-the-internet-could-help-improve-mental-health-awareness-1121400-Oct2013/

According to Chambers we need to have a "positive conversation" about mental health.  As opposed to one that says that health is bad, and a thing to be avoided.  We need to be positive about our mental health, but also worry about it  and be constantly "minding ourselves".  Positive is tacked on here as a buzz-word, something being used to sell us a product; the concept of mental health.

Chambers writes that "Too often, mental health equates to mental illness in the public consciousness." He's right there. Headlines often proclaim that Celebrity X "struggles with mental health". The reason for the this confusion is due to semantic squeamishness on the part of editors. No one wants to write the words "mental illness".  So now we have "mental health problems" or "mental health issues" or even "mental health", as in "she suffers with her mental health". We all know what that means.

Attempts to bisect the coin that has health on one side and illness on the other are well-meant but illogical.  "Positive mental health" does not mean the blessed state of being free of psychiatric illness. Rather, it is a large sub-section of the wellness and well-being industry, a concept brought to us by self-help books, motivational speakers and life coaches.

"The trick, when it comes to changing attitudes, is to convince as many of the population as possible that mental health is personal to them." The trick, indeed. Read that sentence again, and ask yourself if you're starting to feel tricked, misled or misinformed.

"Through the internet, we have the potential to market mental health as a fundamental part of being human."  Chambers is right here; mental health is a product and we are being persuaded to but into the concept, to invest our time, effort and often money, into gauging, maintaining and repairing this new product. A product that, like the internet about which Chambers enthuses, is now so part of our daily lives that we take its existence for granted. It's hard to remember a time before "mental health" was not a given term in our lexicon.

The article ends on a positive note, telling us all to use an Australian-developed app to send each other "cyber-cuddles". World Mental Health Day is "about all of us". Or is it?  For all its positivity and celebration of the fun of mental health, the article is followed by an "If You've Been Affected List."

The list includes the Samaritans, Pieta House, Console and Aware. Now if positive mental health is the harbinger of a new happier way of life, then why are these help-lines for those affected by distress, suicide and mental illness?

Because the idea that mental health is a product, available to all who invest the right resources, and simultaneously as a vulnerable state that is as prone to decay as depleted uranium, has contributed to an increase in distress in the population. In particular it has convinced thousands of young people that they have a health problem, and need "help". It has convinced their parents of the same.

This is from today's Irish Times http://www.irishtimes.com/news/social-affairs/more-mental-disorders-among-young-irish-study-shows-1.1556225
A report from the Royal College of Surgeons in Ireland...indicates that one in three young people in Ireland is likely to have experienced some form of mental disorder by the age of 13.
This rate increased to more than one in two young people who had experienced some form of mental disorder by the time they reached the age of 24.
Based on international evidence, this means up to one third of Irish adolescents and over one half of young Irish adults are at increased risk of mental ill-health into their adult years

As commenters on thejournal.ie are so fond of saying, correlation is no proof of causation. But I wonder if there is any link between the numbers of young people who feel they are mentally different from others and how mental health is promoted. The report lists risk factors for mental health disorders but have these risk factors increased? Or has our detection rate increased, in which case this should be a good news story instead of an opportunity for the wringing of hands.

In cases of genuine mental distress, I think we are better at picking things up than before, but that progress has been slow or non-existent in the area of child protection. By the time a teenager presents with a mental health disorder, most of the damage of abuse or neglect has been done. These young people will not be saved by "cybercuddles" but a properly resourced and efficient social work system  would be a help.

And while family problems have historically been under-reported in Ireland, do we really believe that half of all Irish young people are from dysfunctional homes? One in two, that's half. A pandemic. Are all these young people really mentally ill, or have they just failed to meet the standards demanded by "positive mental health"? A standard that I've described as approaching perfection.

Helen Coughlan, clinical research fellow at the RCSI, is quoted in the Irish Times as calling for services to support young people in need before they reach a crisis. So far, so sensible but she goes on to assert that  "Mental health literacy should also be highlighted more within the education system".

Why? The majority of children are not at risk. Those that are, are at risk because of circumstances they cannot control, circumstances that it is our responsibility, as the adult members of society, to rectify as much as possible.

I'm going to leave you with an extended quote from Kathryn Ecclestone and Dennis Hayes' book "The Dangerous Rise of Therapeutic Education".

"Far from creating a more balanced and rounded personality, therapeutic education promotes the emotionally diminished human subject and promote a life focused on the self and self-fulfilment rather than with understanding and changing the world. The paradox of therapeutic education...is that an obsession with the self means that you will not change the world, and nor will you change yourself: it is active engagement with the world that leads to confidence, self-esteem, fulfilment, or to used the latest piece of therapy-speak "happiness and well-being" The wish and will to change the world characterises humanity; to turn humanity inwards is to diminish all our selves."

Sunday 6 October 2013

Theme of the Month: Time

Finally, on the sixth day of the month I get around to writing about this month's theme: time. This tardiness is not a result of poor time management; rather the opposite as, in fairness, writing the blog comes way down the list of things to do. And I've been sick. Too sick to type.

Andrew Marvell. I'd be coy too.

Three weeks ago this Monday my watch stopped at seventeen minutes past three. And it was Friday (the day before yesterday) before I replaced the battery. Yes, that was as poor as time management gets. Of course the delay in getting to the jeweller's was exacerbated by my lack of a working watch. I was late leaving the house every morning. Even though all our classrooms are equipped with functioning clocks, I found it hard to get into the habit of consulting them instead of my wrist, and class after class has been timed awry. I know there are those who get by without a watch, who rely on clocks and mobiles, but really -how do you people manage?

Losing and regaining the gift of accurate time-keeping has made me conscious of time itself.

"Make Time for the Things that are Important"
This phrase has been running through my brain for a few weeks now. It's one of the answers to my constant question "how do avoid similar f**k-ups in the future?" And sometimes life seems like one fuck-up after another. The answer to "how did I let this happen" is "you were busy doing stuff that doesn't matter"more often than not.
To say time is our most precious resource is a clichéd understatement. Time is not a resource, but one of the most important dimensions in which our lives are lived. Even though the path I've taken so far in life has taught me lots, and shown me some good places and great people, I feel that an appreciation of time would have helped me be happier.  For much of my adult life, time has been something to be endured. I suffered from chronic FOMO. Weekends were deserts to be crossed instead of two days crammed full of lovely time. I was hanging on in there, and hanging, and hanging...until letting go and falling became a fantasy.

Time is precious even when I'm alone. Time is precious even if I don't have children. Time is precious even when I'm tired. Because there is always something to be done. There are always things to do.

My first hospital admission. I remember it coming to me. Clear, clear as day. There was no need not to eat. There was no need to worry about money. Because the world was full of food, and the world was full of money (even if little of it was within my possession). But time. Time was scarce. I felt an incredible urge to live life. To do things. To make use of my time.
I was twenty-one, and in hospital on my first psychiatric admission. By the time I got out again, and free again, it was many years before time stopped being painful. Empty hours were the worst and I became adept at keeping busy by doing inconsequential things really slowly.

You'd expect this theme, of making the most of time, to generate resolutions, productivity tips and trigger lists. I've tried these and concluded they're mostly other people's systems that work fantastically for them, but don't translate into my life and probably not into yours. I even borrowed a library book with the title "How to Make More Time" but realise I might as well have read "How to Turn Back Time" because none of us can add the twenty-fifth hour to the day. The one where I could've popped to the jeweller's or cleaned the car or had a nap before going out.

So this month there is no Resolutions Chart or small daily goals. There is only the mantra in the back of my head, always, to Make Time for What Really Matters. Not to fear its wing'd chariot, but to to live every minute, and appreciate every hour. 

Thursday 19 September 2013

Morto

It's been a stressful, tiring week and I sat down yesterday evening to post my thoughts on the reform on Junior Cert English. I'd left my hard copy of the Draft Specification in work and went to look it up online; I couldn't find it on the NCCA website but found something called the Draft Syllabus for English. That was quick, I thought, as consultation on the Draft Specifications only closed last Thursday. I went ahead and gave my assessment of this document without realising it dates from 1989 and is actually a draft of the current syllabus.  No wonder it looked nearly the same!

Seriously, am seriously red in the face morto. For one thing, I should have recognised the draft as being almost identical to the syllabus I'm teaching, though thank God when it came to composing the real thing they left out Writing a Letter of Condolence. Imagine if that came up in Functional Writing? Knowing the capricious minds that compose the Junior Cert paper, it's probably something I should be covering.

So back to the Draft Specification, which, as Evelyn O'Connor writes here http://leavingcertenglish.net/2013/09/j-c-consultation-conference/ is an impressive document. It's impressive mostly in its documentalism, being put together by people who really know how to write a document, but who might seem a bit removed from the English classroom.  The document runs high to psychobabble and is full of assumptions and low on facts. One generalisation that particularly infuriated me was "Education systems across the world are increasingly supporting teachers to get beyond marks and grades to more detailed feedback that focuses not just on how the student has done in the past but on the next steps for further learning."

I don't know any English teacher whose only comment on student work is a mark out of x. But the real point is the idea that we'll all jump at the mention of "education systems across the world".  We need examples, real references, real studies and footnotes or links to research that we can verify to our own satisfaction.

An example of psychobabble in the document is the link between English and Key Skills. (Everything to do with the new Junior Cycle involves keys.) Under the skill "staying well" we learn that in English students will learn to "be confident".  Big Pharma has indeed done its job in defining shyness as an illness. That is not to say that I hope my students won't be more confident writers, readers and hopefully speakers, but I don't fool myself that I can actually make them confident in themselves. And I don't see my shyer, less forthcoming students as less well or healthy than their outspoken peers.

The new course is incredibly broad and ambitious. Here is a selection of tasks students are expected to master
-Engage in extended and constructive discussion of their own and other students, work. ( Not just "discuss", mind you, but "engage in extended and constructive discussion").
-Demonstrate how grammar, text structure and word choice vary with context and purpose.
-Be creative with syntax
-Read for research
-Appreciate how the meaning of sentences can be made richer through the use of grammatical and/or syntactical manipulation
-Write their responses in a "personal voice" as their individual style is thoughtfully developed over the years.
-Search a range of texts, including digital texts, in order to locate information, to interpret, critically evaluate, compare, synthesise and create text.

It's difficult to see how all this is going to be achieved with a cohort who have difficulty knowing quite from quiet or there from their and who frequently write "a lot" as one word. And it's hard to see how students' writing will improve so much when we're being told to spend less time on literature and more time listening to soundtracks and multimodal texts.

The document promises "a wide range of study" but you cannot broaden, broaden and broaden and not expect to compromise on quality. Just as you cannot increase and increase teachers' workload and expect us to bound into class brimming with enthusiasm.

The downgrading of literature within the English classroom is particularly worrying.  I was quite pleased with the inclusion of oral presentation in the specification. It's an important skill and one that ties in with English. However, I learned on Monday that it would be unacceptable for a student to pick a literary topic as a subject for his or her presentation. Favourite authors or books are out. The point of oral literacy seems to be less about encouraging expression and oratory, and more about training mini-middle-managers in the art of  props and PowerPointlessness.

Like all initiatives, the new Junior Cycle English will be modified and made more realistic on the ground.  It's coming and we'll have to get used to it. But this strikes me as an exercise in formatting students as products; well-adjusted, self-centred and unchallenged by anything irrelevant to their own lives. Nowhere in the specifications does it mention how English can bridge gaps between ourselves and others, between us and other cultures, between our time and other times and how it can deepen our sense of what it is to be human.





Tuesday 30 July 2013

"Gratitude brings freedom from envy, because when you're grateful for what you have, you're not consumed with wanting something different or something more." Gretchen Rubin

Gretchen "Grateful" Rubin
I have decided to practise gratitude. I nearly wrote "started a gratitude practice "; I need to read some real books. You know, ones that don't come from the self-help section.

This is a serious defeat for my inner cynic. Not my inner skeptic, I'm still friends with her. I wrote before how I've always resisted the idea of counting my blessings. Was this because I was, as Brené  Brown would say, waiting for the other shoe to drop? She calls it the notion of being afraid to acknowledge your own happiness "foreboding joy" and writes
"Scarcity and fear drive foreboding joy. We're afraid that the feeling of joy won't last, or that there won't be enough, or that the transition to disappointment (or whatever is in store for us next) will be too difficult."

That's part of it, but in my own life, I've dismissed all thoughts of actively cultivating gratitude on the basis of one memory.

I had a GP at the time who's not my GP anymore. He was youngish and laidback and I kind of liked him. Other people liked him too and he had a busy private practice but I was one of his public patients. I was in the surgery one day getting my prescription and we were chatting.
"Why don't you go home, Ellen, and make a list. Write out all of the good things in your life."

I can understand now, the judgement behind his words, and the implications that I was an ungrateful, spoilt brat who couldn't grasp how lucky she was. "Ungrateful" is a word I've often had levelled at me. There I was with my parents still living and healthy, my educational opportunities, my prospects, my youth. What right did I have to be miserable?

I couldn't see that judgement then and, because I respected him, I went home and wrote my list. I'll dig it out next time I'm down in my parents' house but I'm fairly sure what was on it. My degree, my masters, the fact I was working on a PhD, my youth, my family, the friends I was sharing a house with, my active social life, the radio station I was volunteering at, the local paper for which I'd started to write reviews.
Within months my family was mad as hell with me, I'd lost my place in the house and was back living at home with no nights out at all, my friends weren't talking to me, I'd thrown in the PhD, the radio station wouldn't have me on the premises. I thought that all was lost. The only way I could get through it was to pretend it wasn't happening.

So when the books would talk about gratitude journals I think they're a dangerous idea. The one time I counted my blessings, most of blessings flew away like birds in the winter.  But is gratitude the same as counting your blessings? I'm beginning to think they aren't the same. Certainly we can be grateful for blessings, but counting them implies that somewhere there is a massive chart, where all our scores are recorded and adjusted. Being told to count your blessings means "Take a look at the chart there and see there are people with  far lower scores than yours. Get over yourself."

Katherine Baldwin
I've decided to be conscious of my blessings without counting them or keeping score. I'm going to pick three things each day to be grateful for. Typing those words feels really uncomfortable which might be a good sign.  I'm following the guidelines from JustCharlee, that I got from Katherine Baldwin via Twitter https://twitter.com/From40WithLove . These are:


Three Little Steps
Commit to writing three things you’re grateful for, for 21 days.
1. Commit and share
Whether that means posting on facebook or buddying up with a friend, making it public means it’s likely to happen rather than go the way of many a gym membership.
2. Choose a fixed time
Make it a habit like brushing your teeth. First thing in the morning and last thing at night are great because they set you up for sweet dreams or create a positive start to your day. Three little things. You have time for that!
3. Keep track
To find out what difference it has made, keep a note of changes you notice.

http://justcharlee.ca/wellness/three-little-things-how-daily-gratitude-practice-changed-my-life/

This is, incidentally, almost identical to the gratitude journal kept by Gretchen Rubin in "The Happiness Project"  www.happiness-project.com . Rubin writes
"Gratitude brings freedom from envy, because when you're grateful for what you have, you're not consumed with wanting something different or something more."
 That makes sense to me, and is what I hope to achieve. Not to stop wanting something more (relationships, children) or something different (writing) but to not be consumed by that want.  Rubin only kept her journal for two weeks but found by then she was able to integrate gratitude into everyday life. Unlike the morning pages, which are an open-ended commitment, I'll just do the writing-down of the three things for three weeks and then see. I will let you know the outcome here.

 

So what were my three things for today?

1. Seeing my washing flapping in the wind on the clothes-line. I'm in love with my clothes-line. Seriously.
2.Spending almost two hours catching up, in person, with some-one I hadn't seen in ages.
3. Posting my entry to a local short-story competition.

The last is quite a step towards the mountain of being a writer again. A tiny, baby step but definitely in the right direction. And I have twenty-eight more days off in which to do little else but potter around, fix up my house and write. A happy day :-)





Friday 26 July 2013

Accepting Reality v The "I'm Doing Great" Consensus


This article by Jean Twenge appeared in The Atlantic on 19th June and has been much shared, discussed, leapt upon and derided. Twenge has written a book "The Impatient Woman's Guide to Getting Pregnant" in which she argues against age-related fertility scaremongering.  Scaremongering is not a good thing, but neither is the "But Ellen, you see people in their forties having babies ALL the time" speech I often get.  The article is called "How Long Can You Wait to Have a Baby".  Here is the link:

http://www.theatlantic.com/magazine/archive/2013/07/how-long-can-you-wait-to-have-a-baby/309374/


Let me deal first of all with the phrase "wait to have a baby." Yes, I've spent the last ten years waiting to have a baby. If I'd gone for it ten years ago, I'd have had a better chance of getting pregnany quickly and more chance of an optimally healthy baby. And more chance that that baby would have at least one, and preferably two, siblings.

So why have I been flying in the face of scientific fact? I base my lifestyle on the health section of the newspapers and every online magazine going. I eat loads of fruit and veg. I wear factor 50 winter and summer. I run. I used to do yoga. One of my Gretchen-Rubin-inspired-recommendations for this month is to use body lotion every day and I've gone for the paraben free kind. But in two big areas I appear to be ignoring the experts' advice. One is that I drink three or four (okay, most days four) cans of Diet Coke a day. The other is that I've yet to have a baby.

Is it because of my gambling gene? No. Is it because I've been waiting to be financially secure? No. It's because of probably the most common reason for delayed motherhood of all: I'm single. And I've now come to the roundabout conclusion that a factor in my lack of a mate is the sorrow I've felt from really early on that time was running out to have a baby. We're talking thirty here, not thirty-five.

I felt useless as my friends got married and began to pop out their bundles of joy. As the weddings started I felt lapped and every pregnancy announcement felt like another runner coming up behind me then passing me by, cruising despite having run 800 metres more than I had. It seemed so far. The gap was so wide and before I knew it second babies were arriving. The race was over and I was still running for nothing but the dignity of not being seen to give up. Except I wasn't running, but limping.

I had a big, bad villain to blame in all of this: my psychiatric history. That was why I was missing out. How could I start at twenty-nine, for God's sake? Every decent man seemed taken. Now I think of twenty-nine as practically neonate. There was, in effect, nothing stopping me. If I added up all my hospitalisations, they'd come to around four months. What was I doing the rest of the time?  I was sitting around the house at home, in love with unavailable men or having nervous breakdowns.

Even now I have a hard time with the idea that I'm responsible for my own happiness.  I used to go to an eating disorder support group years ago and the leader was very fond of saying things like "you're responsible for your experience" and "you create your reality". It made no sense to me. In fairness they took it to illogical levels, being heavily inspired by the books of Louse L. Hay.
I had no sense of agency. Things happened to me. My priority in life was to keep my parents happy.  I was the goodest, bestest daughter in the world. Family gatherings are now painfully ironic as I'm the one who hasn't brought them any of what I can see are their greatest happiness; their five, soon to be six, grandchildren.  I was the one who was good. I was the one who made no decision, none, without considering their reaction.

I was the best-behaved, but I was also the worst. I was the one who broke their hearts with my mad behaviour.  Even more worryingly, I got myself "in trouble with the law".  It was like a pendulum swinging. I'd go from being good to being bold and then, for the last eight years, it's been good as gold all the way.


Should I Aim to be Pregnant by Tea-time?

What use is panic? Thoughts of scarcity- too few men and those available of dubious quality, too few eggs and those available of dubious quality - lead to poor decision making.

This article in The Atlantic says the news is not as grim as I'd feared.  It says "with sex at least twice a week, 82 percent of 35-to-39-year-old women conceive within a year, compared with 86 percent of 27-to-34-year-olds. " The crux here is "with sex". Without sex, my chances are slimmer than none, unless I take the donor insemination route. (I've looked into this. The straws alone are over 1,300 euro. Yes, thirteen hundred euro for a teaspoon of the most common substance on earth after salt water. Maybe next year).

You might be thinking what the hell is your-one complaining about? Two posts ago I was describing my time locked and medicated in a psychiatric unit. I've admitted all forms of uselessness and madness. And here I am, a home-owning, gainfully employed individual who has no contact at all with the mental illness services. I'm doing great, considering. There's the rub: considering. I don't think I'm doing great. I feel, not that I've failed, but that I'm in the process of failing. I'm afraid that right now, today, is the crucial time and that I'm not doing enough. The whistle has blown and  I should be doing my utmost to score that golden goal.

Why can't I be happy? Why do I resist practices like gratitude journals and counting my blessings? Because somewhere in me, something kicks up and says "not fair". I'm as worthy as anyone of the Full Package; the job, the husband, the house, the children. (Now I know that this is an illusion. That many of those who look like they've ticked all the boxes live in misery.)

I can see now why I'm not married and why I've no children. It's the "who am I?" mentality. It was enough that I wasn't in hospital or on drugs. I was satisfied with far too little. I might have seethed with resentment while holding friends' newborns, but it was the resentment of "when will it be my turn", not realising that the dating-and-mating playground is unsupervised.  A friend of a friends broke off her engagement and the next time I saw, her, a few months later, she had a new man. I thought why am I not like her? Nothing's stopping her. I put the blame on who I was , rather than what I was doing.

What I was doing was refusing to accept the reality that  I was deeply dissatisfied with my life, and instead going along with the "she's doing great, considering" consensus.  Now I can face reality and it's hard, it's painful.  I fill my days up with outings, lunch-dates, correcting and calling down home but I turn off the lights every night and go to sleep alone. I'm doing internet dating and all my messages are from men ten years older than me. I don't know what the story is with my fertility. I could be fine; but I'm entering the phase where months count, rather than years.  I like this article, it gives me hope. Hope may be no more accurate than desperation but it's much more useful.

I loathe exhortations to "stay positive" but I suppose that's what I'm trying to do. I think "hopeful" might be better than positive. It doesn't carry the same connotations of expectation and certainty.  So that is my step for today: to live in hope.

Wednesday 24 July 2013

Ten Things to Love About the Samaritans


Today is the 24th day of the 7th month and that is why it has been chosen by Samaritans as their main annual day of raising awareness of their service.  I always thought of the organisation as "the Samaritans" but notice that now they seem to style themselves as Samaritans without the definite article. I'm not ashamed to say that I have called Samaritans in the past and think they're a worthwhile cause to support. I'm not going to say I recommend calling them right now this minute wherever you are. Just bear them in the back of your mind.

I've come up with ten reasons why I think the Samaritans are a beacon of sense and humanity in a world crowded with helplines and awareness groups.

1. 24/7
Like it says on the tin, the Samaritans really are there 24 hours a day, 7 days a week, 365 days a year. While the centres are open for anything up to ten o'clock at night, there is still always some-one in the building to answer phones in the middle of the night.

2. Confidentiality
Whatever you say to Samaritans stays within the organisation. Volunteers are forbidden from divulging information about callers. They're not going to call your mother, or your spouse, or your GP. They're not the thought police and won't shop you for disclosing suicidal thoughts or even plans

3. Non-directional support
This ties in with number two.  The Samaritans believe adults are responsible for themselves and do not tell callers what to do. This holds true for the big decisions in life, such as whether or not to leave a spouse or partner, as well as the small things, such as should I go home for the weekend? The impulse to offer advice is very strong among humans, and some people attract it like a magnet. I spent years of my life being told what I should do, by my parents, my siblings, my doctors, my friends, fellow patients, people on the bus and even  the guards. There's nothing wrong with wanting to help people but the thinking necessary to formulate advice can inhibit empathy.  The advice-avoidance also recognises that the volunteer and the caller are equals. Neither is an expert on the other's life.

4. Variety of Contact Options.
The phone is the best known option for contacting the Samaritans but they also run an email and text service. While I can see the point of emails, I'd be a bit ambivalent about the value of the texting service. I'm sure they thought it out before they introduced it but wonder how much emotional connection you can cram into 160 characters.  There are twenty centres around the country that are open for most of the day. Imagine; a person can walk in off the street and sit down with a real, life person who'll sit with him or her, listen, connect and impose no kind of conditions and charge no fee.

5.Diversity
I don't have figures available but from what I know the Samaritans recruit both men and women, gay and straight, across as wide a social spectrum as possible. Not only is the organisation itself diverse but it recognises and respects diversity in its users.

6. Responsible Marketing
I once emailed the Advertising Standards Authority about an Aware campaign that stated how many had died in Ireland by suicide the previous year and exhorted listeners to send them money and "stop this pain". It reminded me of the American magazine that in the 1980's had an issue with a puppy on the cover and the headline "Buy This Magazine or We'll Shoot the Puppy".  In recent years I've heard radio ads for  other helplines that include dramatisations of families hearing the news that their son has taken his own life. There is also the indirect marketing whereby some organisations write articles for newspapers or sites like www.thejournal.ie hyping up the "epidemic" of mental health problems among young people or among men. In contrast to these, the Samaritans explain the nature of their service and never claim that their service "saves lives" although they hope, indirectly, that it does.

7. Listening
The Samaritans' core value is listening. In a complex, fast-based world it is easy to underestimate the importance of something so simple. Listening sounds like a passive activity, but can be extremely powerful.

8. Independence
The Samaritans won't diagnose you with any kind of health problem. They're unaffiliated to the mental illness industry. This is perhaps the most common misconception about them; that they're a mental health charity who offer support to those with mental health issues or who work to promote mental health. They do no such thing. When I called the Samaritans I was never asked had I taken my medication or told that I was catastrophising or that that my brain wasn't working. They just listened.

9. You Don't Have to be Suicidal
There's a sign up down the post office with a number for the HSE that you're supposed to ring if you're suicidal. Presumably so they can talk you out of it. I've always kind of looked at it funny, thinking, from my own experience that if you're suicidal you're unlikely to call some-one whose paid job it is to stop you. The poster also implies; don't call us unless you're suicidal. We don't want to hear about your pain, or your grief, or your disappointment or how you feel life's been unfair. We just care about bringing down the numbers because they're making us look bad. The Samaritans' "here for everyone" approach takes the heat out of the situation. There's no drama. You just call.

10. Normality
In the end, I did struggle to come up with ten reasons. I'm going to pick normality for my last one.  There are 2,188 current volunteers in Ireland, who are normal people from all walks of life, not purported experts.  They got 412, 167 calls and visits last year. We live in a world where emotions and painful feelings are increasingly pathologised. We also have more and more of what Robert Putnam calls "bonding" or special interest groups, but fewer "bridging" groups where that bring people together based on location. This can lead to splintering, and the fear of being different can become the belief that one is abnormal. In all their work, the Samaritans stress the normality and universality of human emotions, although our stories and prolems can indeed be unique to us.

Contact Samaritans on 1850 60 90 90  or email jo@samaritans.org

Thursday 18 July 2013

Memories of the Asylum

http://aftertheasylum.com/

I was watching these online videos from The Irish Times "After the Asylum" and they brought me back.  Not to the asylum. I mean the people in the videos weren't in real asylums either; they closed years ago. They were in psychiatric hospitals or on the psychiatric wards of general hospitals. I was watching them thinking this is the reality. Mental illness isn't a pop singer having a fit of the jitters before going on stage or some teacher complaining because she's too many copies to correct. This is the thicker end of the mental health wedge.

What do I remember?

I must've never heard of David Rosenhan's "On Being Sane in Insane Places" study or else I wouldn't have tried it. I had just been chased through the ground-floor corridors of a large teaching hospital. I had been sent to the A&E there and I was trying to escape. Like that was ever going to work. I was cornered and was in a room with some staff, including a youngish doctor. She had long blonde hair, was wearing a blue blouse or shirt, and had big blue eyes. I remember thinking I could trust her.  If you've never had a room full of people look at you in the certain knowledge that you're extremely mentally ill and possibly dangerous, you won't know how I felt.
She asked me was I hearing voices. This was a standard question and I usually answered truthfully. But my trust in this doctor, and my desperation, made me take a truly crazy leap. I knew that mad people heard voices and that they often had religious delusions and these could be mixed together. So I came up with my religious delusion/ hearing voices mash-up.
"Yes I do."
"What do they say?"
"They say I'm Mary Bernadette." I was thinking of Bernadette of Lourdes but getting a bit confused. Mary was also a name I associated with madness, I'm not sure why. I went on about visions and things for a while. Why did I do this? She was a young doctor, close in age to myself. I remember thinking that she'd go "Ah, go on out of that". That she'd turn around and tell everyone that I wasn't really mad, that I was faking it. You see, I was mad in a way, just not in the way they thought I was.
I can still see the round, pale pink pill on the table. It was Haldol. There was no way I was taking that. No way I was. For about five minutes.
"If you take the pill we'll let you go."
Well, that was a no-brainer wasn't it? I took it and by the time they had me in the car for the transfer to the unit appropriate to my geographic area, ( that turned out to be their version of "letting me go")  I was groggy and the whole world had taken on fuzzy, blurred edges. My mouth was dry. I could offer no worthwhile resistence. So I just offered what I could.

Why did I do that? Why would anyone lie to a psychiatrist and say they heard voices, and invent what those voices were saying? Why would anyone take a powerful major tranquillizer, knowing the unpleasant effects, and also that it was being prescribed totally inappropriately? Why would anyone do that if he or she wasn't insane? Isn't the status of psychiatric patient proof enough of serious mental health problems? I mean, they don't go locking people up for nothing, do they?

Why? is a question I ask myself now. Why did I ever go back there? Why did I keep going back over and over, and even now, sometimes fantasise about lying on a bed in a dimlylit room with no responsibility beyond breathing? It was a case of touching the devil and not being able to let go.

I thought they would help me. I thought they would fix me. I thought they would read my diaries and understand. That's how I got involved in the first place. I wanted to go on one of those ten or twelve week inpatient eating disorder programmes. I thought I'd come out all fixed. And part of me thought it would be great having a big, long break from being me. Me being what I now recognise as a false self, who spent every waking minute, and lots of dreaming ones, trying to figure out what people around her wanted and how they her wanted her to be.

In the end I never completed one of those programmes. I remember how it ended. It was around two years after the lying-about-hearing-voices episode and I had finally been referred, at my own request, to probably the most well-known inpatient eating disorders programme in the country. I'd recently spent four weeks in the same hospital, not doing any programme, mostly just hanging around being cured of my delusions. I was back for my pre-admission interview for the programme. I said I was vegetarian and asked  could I be excused from eating a fry every morning. He said no, the fry was compulsory and in his experience no-one ever recovered from an eating disorder while remaining vegetarian. I suspect that he saw vegetarianism itself as a psychiatric symptom. I looked across the desk at this man, who was pre-eminent in his field, the country's leading expert on women and girls like me and I made the decision not to do his programme, though I didn't tell him there and then.  I went home and thought about it, and decided it'd be me and my DBT workbook against the world. Did I make the right decision? I'll never know, but I don't regret it.

I've other memories too. There are too many to hold in my head all at the one time so they flit in and out, some staying longer than others. Most often they provoke anger at how I was treated but some of them evoke guilt and shame as I remember times when I was actually quite aware. At times I used a whole wing of the health service to for my own ends, to prove how upset I was or to demonstrate that I was being responsible and tackling "my issues".  Was I mentally ill? I don't know; I think I might have been but not in the way they thought I was. One of the nurses told me that I was just like a diabetic and needed my medication the way a diabetic needs insulin. For years I felt outraged at that analogy and it is true that no insulin-dependent diabetic would survive without insulin for the nine years it's been since I took a psycho-active pill. But maybe it isn't too inapt an analogy; after all there are non-insulin dependent diabetics who can control their condition through diet and exercise and lifestyle. And there's a grey area where people can decide to take the pills or take the responsibility.

The whole time I spend as a patient no-one ever suggested to me that there was anything, anything I could do to improve my situation. My role was to accept my status as mentally ill, to gain insight into my condition, and most importantly, to comply.  I look back now and think what were the words that would have made the most difference to me? Not "We're going to try something new. It's called Zyprexa. Has transformed the lives of millions of young people like you..." but "There's nothing wrong with you. You're fine.  You don't feel great and everything is hard but you're fine. You're normal."

Monday 15 July 2013

Review of "Daring Greatly" by Brené Brown

I'm hoping to make book reviews a regular feature of the blog, and I'm happy to start with a book from an author you all (okay, both of you) know I enjoy very, very much. Despite awaiting an ordered copy,  I bought one on sight in that awful high-street chainstore that I keep saying I'll stop patronising but haven't yet.

What bliss it was to read through its pages for the first of no doubt many times! Short-lived bliss though; this is no weighty tome but a quick read that is at times, dare I say it,  "light and breezy".  It's considerably more mass-market than her last book, the excellent "The Gifts of Imperfection." Much of the same content is here about shame, vulnerability, resilience and so on, but in a snappier, less formulaic and more accessible format.  It's a book for everyone, not just those who'd self-define as needing to "let go of what other people think and be who [they] really are".

Brown takes the title from a 1910 speech by Theodore Roosevelt.
It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly
.

Dowtcha, Teddy.
Stirring words and an equally stirring book. I had page after page of "aha!" moments. You know, like when Oprah compares her random thought with her guest's half-decade of academic research. One moment came in the chapter on the Vulnerability Armoury, which describes the shields we use in vain to protect us from shame. One such shield is Viking or Victim binary opposition, or in layman's terms "assholes and suckers".

Vikings and Victims
I love that I now have a term for people who see themselves as winners in life, thanks to their inherent abilities but even more so their hard work and take-no-prisoners attitude. An attitude that understands that life is a competition and you have to get up early to beat the losers. Even though beating losers is easy (because losers have only themselves to blame) Vikings can still feel good about it.

Brown says that Vikings are deluded, which is refreshing as half the self-help books out there could carry the tag-line "how to be more Viking-like".  Brown defines you as  a Viking if you're "some-one who sees the threat of being victimised as a constant, so you stay in control, you dominate, you exert power over things, and you never show vulnerability." . Her whole thesis is that being able to live with vulnerability can only make us stronger, meaning that those who deny it in themselves punish it in others are stitching themselves into a straitjacket of inflexibility and stress. The links she makes between the Viking/Victim opposition and suicide among veterans make interesting reading in light of this week's Panorama investigation. http://www.bbc.co.uk/news/uk-23259865

The opposite of Vikings are Victims. You're a Victim is you're "a sucker or a loser who's always being taken advantage of and can't hold your own".  Self-help books in general are often scathing on the issue of "victimhood" and hector their reader to "stop being such a victim" or "refuse to be a victim". Brown takes a different approach, arguing that the Viking/Victim, winner/loser opposition is itself an illusion. There is therefore no need to make a huge effort to climb out of victimhood. This makes huge sense to me. I seem to often find myself being taken advantage of, or on the losing end of  confrontation. In fact, I rarely even have confrontations because I head them off with my agreeableness.  I sometimes feel that the only thing I have going for me is my reputation as a "lovely girl" and I don't want to risk losing it in battles I don't see myself winning anyway. This is fine, because in Ireland you can keep on being referred to as "a lovely girl" well into your fifties.

Part of this trap is that I too believed in the Viking/Victim division. This could be because the Vikings in my life, and probably Vikings in general, have no problem voicing their beliefs.  Brown writes that Victims may stay that way because they don't want to be Vikings. This may be true but it could also be that we see the Vikings getting the spoils, boasting about it, and conclude it's not worth trying because "Only Vikings win". I used to want to be a Viking (without knowing the term) but in the same way that I took up gymnastics because I wanted to do back-flips on the beam. It was just never going to happen, and turning up for two years for a sport at which I was always going to be useless only turned me off organised exercise for twenty years. Attempts to "be more assertive", "go in there to her office and just tell her to give you what you want" or "show that bold sixth year who's boss" would leave me more convinced than ever of my own chronic ineffectiveness.

So on Brown's advice, I have stopped trying to be a Viking and that alone has meant that I gradually feel less of a Victim.  She recommends defining success in the different areas of my life, and surprisingly few of them involve "beating" anyone. There's writing, where I wrote success as "producing and sharing work I can be proud of" and teaching where it was "ensuring students achieve their potential in exams and develop as writers and MFL speakers/supporting and connecting with colleagues". The one exception is was in relationships. This feels increasingly like a game of musical chairs where I'm the only one left standing when the music stops.


Disruptive Engagement

I looked forward to this chapter as it deals with education, my day job. Was Brené going to suggest I show my vulnerable emotional underbelly to the students in a effort to get them to learn? Far from it.  The book is very strong on the idea of the teacher as leader, not just as  the "lead learner" or "facilatator"  we're so fashionably described as in current pedagogical thinking but actual leader as a distinct role. This is important, as I believe, as Frank Furedi www.frankfuredi.com writes in "Wasted: Why Education isn't Educating" that "the exercise of adult authority is indispensable for the running  of an effective education system". Also in common with Furedi, Brown recognises that for learning to take place, the learner must at times experience the discomfort of venturing outside their previous experiences and reference points. She says that she tells her own students "If you're comfortable, I'm not teaching and you're not learning." Fair enough, but I would like to have read more recognition that the school-teacher/pupil relationship is quite different to that between a lecturer and an adult student who has freely elected a course of study.
Brown writes of course about the corrosive effects of shame on students and says that "85% of the men and women we interviewed for the shame research could recall as school incident from their childhood that was so shaming. it changed how they thought of themselves as learners".  That doesn't mean that shame is that rampant in today's schools though. Practices such as asking the dyslexic child to read aloud as a punishment are generally a thing of the past. I honestly don't think any teacher believes any more that you can shame a child into better academic performance. I have seen however, students get told so often that they're bold, that it becomes part of their identity. The refusal to even try to change their behaviour is, in fact, part of the anti-vulnerability armoury described in the book.
I wonder if part of the shame-inducing effects Brown describes as resulting from children being "shown or told they weren't good writers, artists [or] musicians" the result of this coming as a shock to the children. She does use the phrase "weren't good" not "were terrible" or even "were good". Maybe we tell children they're "fantastic" and "brilliant" at creative things too long past the toddler stage. Creativity then becomes about pleasing and performance and when the show inevitably drops, as it does for most of us, then our motivation goes with it. Maybe the solution isn't to safeguard the "I'm fantastic" illusion until adulthood but to foster more of a "this feels fantastic" experience of the arts from a very young age.


Diagnosis as Detrimental to Healing and Change
Couldn't have put it better myself


Finally, I'm going to share my favourite quote from the book.
Diagnosing and labelling people whose struggles are more environmental or learned than genetic or organic is often far more detrimental to healing and change than it is helpful.
I'm thinking of having a poster made and hanging it, in a guerrilla sting, at the entrance of my local psychiatric unit.  Brown is writing here about narcissism but the same could be said of BPD, PTSD, anorexia, bulimia, most cases of depression, learned helplessness, anxiety disorders. I could go if I had a copy of the DSM-5 to hand. This for me is the great strength of
Brené Brown's work, and of this book in particular. Again and again she stresses the universality of shame. even those of her interviewees that she admires as living "Wholehearted" lives are not immune to painful feelings, just resilient. She does not shame the shamed or hold up examples of those living "Halfhearted" lives as object lessons but stresses how we're all vulnerable and we might as well own it. 

There is no division in these pages between the mentally ill, those with "mental health issues, or the lucky rest of the population. It is a call not to arms, but to drop arms, and face the world with courage. At times the anecdotes can seem nauseatingly wholesome, and there's far too much cutting- and-pasting from her previous books but on the whole this is one to buy and keep. To read and reread.
 
"Daring Greatly. "How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent and Lead" Penguin  E11.50  ISBN :. 978-0-670-92354-0






Tuesday 9 July 2013

Getting on with Things

That's me on 24.My next throw's a four
I opened the door to my lovely, cheery postman this morning to take delivery of my work for the day, and also a perfunctory letter from the government saying, well I'm wary of writing what they actually said, we'll just say it wasn't good news. I'll have the guts of a job again in September but no improvement in my security.

I sat at my desk/kitchen table with the words of the official hanging on my heart.. I felt weary and disheartened, like I'd landed on a snake and had to slide down its back to a square I'd passed two years ago.
I looked at my stack of envelopes and wondered how I'd ever bring myself to open the first one. Resentment to be working at all during "the holidays" combined with the boredom I could almost smell wafting out of them. Then my mother rang and was all sympathy, so much I felt annoyed. I found myself thinking, while on the 'phone "Come on, it's not that bad".  In a way she must have said the right thing, although she said almost nothing, because I came off the 'phone thinking "Alright, let's do this."

"This" meant opening the packets and starting work but also a more general commitment to Getting On with Things. First I rang the union. They'd call me back later. I corrected away for the morning, and then I photocopied the letter at the library, went to the beautician ( not crucial to my contract but maintenance is still important)  and stocked up on groceries. Groceries consists mostly of Diet Coke; making sure I always have a supply is just about the only New Year's Resolution that has made it to July.
I also have the work to do of typing up the short story I finished yesterday. Realising I'd actually finished the thing that I'd started months ago was quite a ladder to land on. A step, indeed, towards the mountain. I can't wait to see it printed and lined up in front of me in neat, double-spaced lines. it'll be like old times.

Getting On With Things can be sensible, and reminds me of this Brian Johnson video I saw on www.mindbodygreen.com . There's a lot to be said for recognising a setback as minor and just getting on with gritmin of life, as Ruth Field calls it. There is a danger this can be confused with "soldiering on" under conditions where the limitations are internal rather than circumstantial. I mean going to work when sick  -  or just sick and tired of work -  and not acknowledging the paradox that a single person who lives alone and doesn't work long hours can need a day off to do nothing. Does anyone else do this? Carry on and on instead of pulling back? Not that I'm a workaholic. My relationship with work is more cordial alliance than passionate affair. Soldiering on is more about me seeing myself as a brave Stakhanovite getting so much done when feeling so bad, when those around me just think "she seems a bit distracted."

I didn't feel exhausted this morning, just dejected and discouraged.it turned out I was quite capable of getting quite a bit done.. Loads more to do tomorrow.



Saturday 6 July 2013

Brené Brown at the RSA: Down with Atleastism!



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This is Brené Brown www.ordinarycourage.com  giving a talk at the Royal Society for the encouragement of Arts, Manufactures and Commerce in London. The talk took place last Thursday, the 4th of July, on the day the small paperback of her latest book "Daring Greatly" was published this side of the world. I'm still awaiting my copy as I don't own a Kindle and I'm trying to avoid using Amazon. It'll be next week before I can get my hands on it. I haven't been this excited about a new book since "Bring Up the Bodies". I hope "Daring Greatly" won't be the disappointment that one was. Not that "Bring Up the Bodies" isn't a  great book; it's just not "Wolf Hall Continues".

Brown clearly explains things that we all know, but most of us are afraid to admit. Her books and internet talks are about shame, vulnerability and empathy, with hardly a mention of mental health in sight. They stress the normality of emotion, even extreme emotion, without seeking to pathologise it.

Her "Wolf Hall" (that is, the best of her books that I have read so far) is " The Gifts of Imperfection" which I started reading on the bus home and ended up missing my stop. What she says about shame struck a deep chord with me, as it does with most of her readers. There were lots of "aha!" moments where I recognised that what let to my involvement with the services and most of the poor(ok, crap) decisions I made were driven by feelings - no, that's not strong enough - convictions of not being good enough. I also believe that long after I'd grown out of the original shame triggers of not being pretty enough, organised enough, quiet enough, popular enough, academic enough or talented enough,  I found I had managed to pick up the heavier, and socially sanctioned, shame burden of not being mentally healthy enough.

My favourite parts of the talk are when Brown talks about the different faces of empathy.  I've been as guilty as anyone of thinking "at least..." when some-one talks about a problem. "at least you have a husband/child/full-time job..." Have resolved to avoid spoken, and even unspoken, atleastism. She also says it's fine to say you don't know what to say, and that that's better than saying nothing.

"Rarely can a response make something better, what makes something better is connection."
                                                                                                                                    Brené Brown
 
That's a kind of liberating idea, isn't it? Sometimes I feel I'm in a play and no-one's remembered to hand me the script. But I know there IS a script and those around me aren't improvising but saying their well-rehearsed lines.  That's how I feel and there's no getting around it. So there is a choice: do I make something up, do I admit I don't know what to say or do I ignore, or feign ignorance of, the other person's situation? I have to say I've been guilty of taking the last option.

Empathy is a prerequisite for being a writer, because how else are you ever going to write anything that's not the story of your own life?  Feeling starts in imagination, and imagination starts in feeling.  You can't feel some-one else's feelings; you can only imagine that they have the same emotional infrastructure as you and wonder how it interacts with their situation. Given that everyone is different, but everyone is the same. If the similarities breed connection, it's the differences that breed curiosity.

Thursday 4 July 2013

"When Motherhood Never Happens"

I'm reposting this from www.jezebel.com

"Not having kids, having kids, letting life make the decision for you, regret, desire, the fucking Aniston headlines, it's a lot. They say the unexamined life is not worth living. I'd argue that on the other hand, the over-analyzed life is a suffocating wet blanket. Sometimes you have to just be.
And maybe instead of picturing myself as the straggler at the party, it's important to see beyond all the baby mama drama, recognize that on this side of the fence, there's plenty of love, good times, late nights, late mornings, travel, shopping, joy, indulgence, pleasure, accomplishment. It might not be celebrated, revered, fetishized on TV and in magazines the way the motherhood narrative is, but it's there. It exists"

http://jezebel.com/5908514/when-motherhood-never-happens


Dodai Stewart's on to something there with the over-analysed life.
Does anyone else feel like she's facing the same four options as me?
-resign myself
-keep hoping
-settle
-go it alone.
I'm considering opening an online poll.

 

Wednesday 3 July 2013

My Glass is Full, My Life is Not Yet Done

Chidiock Tichborne 1158-1586
"My glass is full and now  my glass is run
And now I live and now my life is done."
Chidiock Tichborne.

When poor Chidiock Tichborne wrote those lines in 1586 his life was indeed, effectively "done". The following day he was hanged, drawn and quartered for his part in the Babington Plot to assassinate Elizabeth I of England. Hopefully my own life is a good bit away from done, but I was thinking it might be helpful to think of parts of it as "done". As in done and dusted, finished and completed, even if they were done clumsily and selfishly and in ignorance of all that matters.

"My Youth is Spent and Yet I Am Not Old"
If I were to die today, I'd be young. Thirty-eight is young to die but I'm not young, not really. In work I'm no longer one of "the young ones". My youth is gone, it's done.

It's done and I should let it go. but I don't want to. I have a desire to go back do it right this time. To do this right and that right. But in trying to hang on to my youth, I'm reliving my darkest days.

There was no good reason for them to be dark, they just were. I sometimes think of how people are able to recover from serious physical illness and go on and "lead full lives" while my time as a psychiatric patient follows me like a stench. Part of that comes from acceptance, from accepting that they were ill, of everyone else accepting it, and of accepting recovery and all that comes with it. That is why so many people who know me, who see me as fully recovered, would be surprised to see me writing this and be surprised how much it still weighs on my mind.

I can't use words like "illness" and "recovery" to describe my twenties. I spent much of that time in hospital or hanging around the house between appointments, so it must follow then that I was sick. Now and then I used to get very thin, now and then I'd cut myself, and now and then I'd  take too many of my pills at one time. I even made a couple of dashes for the exit door of life.

She must have had a mental illness, I can almost hear you conclude. But was my illness an illness? The proof against, I think, is that when I walked away from it all, from the doctors and the hospital and the drugs, life began to improve. Further proof is that the thing that helped me most initially was following the programme set out in Marsha Linehan's "Skills Training Manual". (This my be taken as proof in the opposite direction, as the full title of the book is "Skills Training Manual for Treating Borderline Personality Disorder". BPD was one of my many diagnoses).  This programme doesn't include drugs, it discourages hospitalisation and it doesn't involve cognitive retraining.  There is no mention of negative thoughts.  Instead it is practical things that can be done every day to improve life.

The Radical becomes Mainstream
I found Dr. Linehan's book myself in the library. I read it in my own time. I did find a DBT therapist in Ireland but she worked too far away from where I was living.  So I worked through the book on my own, and also bought the books of Thich Nat Han and Jon Kabat-Zinn. I had to order Kabat-Zinn's "Full Catastrophe Living"
but I saw one the other day in the newsagents next to my local supermarket. What was once an esoteric medical therapy, is now completely mainstream. The shelves of Easons are laden with books on mindfulness. Half the country is meditating.

I keep mentioning the "The Happiness Project", a book that is almost as mainstream as Rachel Allen's "Food for Living".  Part of the project is filling out daily resolution charts which are remarkable similar to the homework cards of DBT.  These homework cards document efforts made to live in the moment, refrain from judging ( but don't judge your judging!), do something nice for yourself every day and remembering to exercise.

My conclusion is that if what was wrong with me could be cured by such simple things, it can't have been an illness. I remember the day my consultant in the private hospital came in to see me. I'd been there five days.
"There's nothing wrong with you. You don't have any psychiatric illness that we can diagnose. You're not depressed. You're just emotionally immature."
How, if that was the case, had I managed to spend more than five years in and out of my local hospital? And done a spell in this consultant's own hospital, under a different doctor? How indeed? Should I believe this one doctor, or the scores I'd seen up until then?  I made my choice and I think I made the right one.

My Life is Done, or At Least Part of It Is.
So if acceptance is necessary in order to get on with the business of being alive, where does that leave me?  I don't have to accept that I was ill. But that leaves me with something different to accept; that those years were taken from me. Not deliberately, but through incompetence.
Whatever the truth of it, my youth is gone. It's done. No-one is going to set up a tribunal on my behalf. And I'm alive. I've escaped now and I'm on the outside.  I bought a notebook the other day, to jot ideas for writing down. I was at lunch weeks and weeks back with a woman who, when a pen and paper were suddenly needed, whipped hers out with the words "I always have a notebook. I'm a writer."
I bought the notebook because it's a step towards the mountain. I'll have to start using it now.

Monday 1 July 2013

Theme of the Month: Belonging





There's a coffee shop on the Northside that I used to frequent when I lived up there. I could walk down from my house, browse in the bookshop next door and sit drinking my peppermint tea in its summer-cool and winter-cosy interior.  I never really belonged there as I gave up coffee years ago and even then my tastes ran no farther than Maxwell House Mild Blend. Still it felt nice there and I'd often meet some-one I knew.

I went back there today, as part of my reintegration into society project. This month's theme is Love and Belonging and I wanted to go somewhere where there were people. The Cheers theme tune is running through my head.

I sat down, pulled out Gretchen Rubin's "Happier at Home" and proceeded to read. The place was as quiet as you'd expect for a hot Monday afternoon. And then a girl with blue hair came in. The temperature dropped a few degrees as she chatted with the staff. Being on terms with the wait staff and bar staff of the city is as much a measure of cool as clothes or job or even taste in music. They'd a chat and then another girl came in, they talked and then both the girls left before I did. It was getting busy, although most of the queue were ordering take-away iced lattes: the new 99 and a can of Tanora.

I thought then about groups and belonging and how easy it is, when young, to belong without being in a group. How just the casual being around town, maybe working in a job that brought you into contact with the public, like in a pub or a bookshop, sharing a house with people who knew people, the college friends, the friends of friends, their boyfriends, their girlfriends, once created a web of acquaintance. A web that can seem strong when it means knowing some-one on the door, when it's being at the gig of the summer or never having to think of something to do on a Saturday night. Or a Friday night. And if it's Wednesday it must be Freakscene. Back to some-one's gaff, walking home at dawn to bed. There's the nudge, shh of taking illicit substances, thereby joining one of the few clubs on Earth that's got more members than facebook.

For some that young web of connection grows deeper and stronger. They fall in love, they form real relationships and real friendships.  Some threads break but there are new webs then, of career, of sport, of the world's biggest club of all; parenthood.

There is no web for singletons in their late thirties who go out every weekend and hang out in each other's houses. Or if there is I'm not sure I want to join. Instead I've focused on joining Groups. I joined a running group and found something that can seem almost like a religion. I volunteer. I've thought about joining a book club. Groups are what is left when the habit of socialising falls away. Those who had sense were joining groups even before the network of connection fell apart. Like in college, they joined Dramat or played trad in a pub once a week. They say you're never alone if you have music.

So where do I feel I belonged? In school (in the school I went to for a year), to a small degree in the college bar but in college on the whole I didn't belong, I went to a different University then and I felt I belonged when I joined the arts magazine. I worked in a Dublin theatre and felt I belonged there. And I joined Campus Radio and really, really feel I belonged there. The only trouble was I simultaneously belonged in a certain pub down town, and in a couple of night-clubs, and in houses where parties happened three nights a week. I was just wallpaper there though, and it was in the station that I had a role and was useful. Usefulness is central, I believe, to belonging.

So that's this month's theme; to get out there, to join in, to belong.

Sunday 30 June 2013

Mental Health without Mental Illness?

The Sunday Times www.thesundaytimes.co.uk  boasts two agony aunts: Mrs. Mills and Sally Brampton . Aunt Sally deals with the serious stuff and has a side-bar that recommends books, products and websites she thinks might help readers. In today's issue there's a recommendation for a book: Jonathan Haidt's "The Happiness Hypothesis". This might be a fine book and I may even read it but the wording of  the recommendation itself bothers me. Brampton writes that the book is "part of the positive psychology movement (which emphasises mental health rather than mental illness)".

Which Emphasises Mental Health Rather Than Mental Illness.
This got me thinking; is it possible to emphasise mental health without mental illness? Those who advocate more thinking about mental health, more talking about mental health, more funding of mental health and that we all need to look after our mental health would dispute that they are raising the incidence of mental illness. They claim that the more we look after our mental health, the less likely we are to succumb to mental illness.  I would argue that the opposite is true.

This is because you cannot promote one side of the coin without the other. The definition of mental health espoused by the positive psychologists is broad and its breadth necessitates a corresponding broadening of mental illness. Take this definition of mental health from the, ahem, well-known yoof website www.spunout.ie
“Mental health is about more than being free of mental illness such as depression, bipolar disorder, schizophrenia etc. It is also about having a positive sense of wellbeing. Positive mental health allows us to enjoy life’s pleasures, believe in our own abilities, cope with the normal stresses of life, work/study productively and enjoy socialising.”
Is this telling a young person that if he or she doubts their own abilities, finds life hard to cope with, find study difficult or look forward to the school disco only to find it the inner circle of Hell, that they have a mental health problem? The problem with this definition of mental health is that it can be summed up in one word: perfection.
Because if you're a young person who enjoys socialising, studies productively, believes in your own abilities, appreciates life's pleasures and has developed adult coping skills while still a teenager, then you're just about perfect.
This is the mental health that we are promoting to young people, that the ads on television urge us to mind, that SPHE and tries to inculcate and that Minister Quinn wants to put at the heart of the new Junior Cert.  Schools are adorned with positive thinking slogans. Motivational speakers are brought in to address Transition Year students, often on the theme of Positive Mental Health.  My local Mental Health Organistion no longer satisfy themselves wth providing support to psychiatric patients and their families. They now run an annual Mental Health Fair, attended by teens from the entire province. Past speakers include Patrick Holford. You can read more about his work here www.badscience.net

Promoting Inadequacy
I believe that promoting mental health as not just the absence of mental illness but as a state of psychological perfection is leading to the rise of mental illness. Not actual, real mental illness but rather Mental Illness Lite, or mental health problems as described by another website, this time aimed at a younger audience than SpunOut. This website is www.jigsaw.ie

 A mental health problem occurs when someone's thoughts or feelings are troubling them, to the extent of affecting their day to day activities or relationships. They may not necessarily have a mental illness, but could need help to get them through a difficult time. A mental health problem that isn't sorted out could lead to someone developing a mental illness.

A mental illness is a more serious or long-lasting problem, which can be diagnosed by a doctor or mental health professional. It may require medical treatment as well as support. There are many different types, just as there are different forms of physical ill health. Examples include schizophrenia and clinical depression.”

Needing help to get through a crisis does not mean having a mental health problem. It means being human. These campaigns are dangerous not only for the effect they have on unhappy young people who are encouraged to self-diagnose and seek medical help for non-medical problems, but also for the effect they have of lowering compassion and empathy in the population at large. Categorising some-one else's difficulty as a health problem might lead to an increase in sympathy but it also leads to a categorising of the person affected as the Other.  We would be far better off cultivating the idea of Common Humanity, as defined by Dr Kristin Neff
 " Common humanity recognises that suffering and feelings of personal inadequacy are part of the shared human experience - something we all go through rather than something that happens to "me" alone." www.self-compassion.org
Mental health advocates try to get around this by arguing that all of are vulnerable to mental health problems, that we all need to take care of our mental health but this not true. Most of us do not carry genes for disorders like bipolar, the majority of people will never experience psychosis or debilitating depression.

I have written here mostly about young people, not just because I work with them, but because my own experiences with the mental illness services began when I was sixteen. I was a vulnerable teenager, full of unrecognised anger at those around me, full of  what David Grey calls "the yearning inside to swim with the tide and taste it" but I wasn't as atypical as I feared. And I can see now, looking back, that what would have helped me was compassion and acceptance and reassurance. Instead began a ten year slide that started slowly, with counselling, and developed over time to anti-anxiety drugs, to anti-depressants and anti-psychotics, to self-harm, to failed bids to end my life, to locked wards and social exclusion.

I think now of myself as I sat in the GP's surgery for the first time. I didn't enjoy socialising. I struggled to reach my potential in school. I found it hard to cope with  living at home after all  my siblings had left. I doubted my own abilities. But my mental health? My mental health was fine.
 

 

WTS Day XXXVI

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