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Weekly news round-up

30/1/2015

 
PictureOur dogs: important members of the family. © Suzy Flood Photography
• R.I.P. Fido: Grief groups grow as American society views pets as family members
Writes Barbara Pash:
Cathy Bury holds dual titles at the animal hospital. She is reception supervisor and pet loss grief counselor. She was certified as the latter in 2012 by the Association for Pet Loss and Bereavement (APLB), a New Jersey-based nonprofit group that began offering the designation in 1998.
     “People grieve for dogs, cats, birds, lizards, snakes — they get attached to their pets. The biggest reason I got certified was because I don’t want them to feel alone. People say, ‘It’s just a dog, just a cat.’ But it was more than that to them,” Bury said.
     “To most people, especially if they don’t have children,” she added, “their pets are their family, even their children.”
     Bury’s clients are not alone. In a recent nationwide survey, 83 percent of pet owners consider their pets members of the family. The result is growth in the pet industry that is evident in many markets.
     There are dog walkers, cat groomers, house sitters, veterinarians who make home visits and doggy bakeries that turn out custom-made dog biscuits. Resorts for dogs feature individualized gym sessions and Reiki massage. Any number of hotels and resorts will accommodate pets.
     The trend extends to pet bereavement. “Pet cemeteries are more accessible. You have pet loss cards, pet hospices, pet grieving groups,” said Coleen Ellis, a Texas-based expert on the pet industry. (Baltimore Sun)

• Children and young people's mental health – policy, CAMHS services, funding and education
One in four people on average experience a mental health problem, with the majority of these beginning in childhood. A report by the Chief Medical Officer in 2014 found that 50 per cent of adult mental health problems start before age  and 75 per cent before the age of 18.
      The Government has committed to improving mental health provision and services for children and young people. The Government’s 2011 Mental Health strategy, No Health without Mental Health, pledged to provide early support for mental health problems, and the Deputy Prime Minister’s 2014 strategy, Closing the Gap: priorities for essential change in mental health, included actions to improve access to psychological therapies for children and young people and to publish guidance for schools on supporting pupils with mental health problems.
    This note outlines the commitments for children and young people’s mental health in Government policy. It sets out the current provision for children and young people’s mental health services (CAMHS), recent funding commitments, and describes concerns that have been raised around levels of access and provision.
     The note also identifies efforts to improve mental health provision in schools, including new guidance for teachers on mental health, access to schools-based counselling, and recommendations for mandatory mental health education on the national curriculum.
     The note also sets out recent discussions on funding and investment in CAMHS services. (Parliament UK)
• You can download the report here.

• Child adversity and psychological troubles may speed up aging
Maturing early may not be the only way children who face adversity age. Researchers have found that children who experienced childhood adversity or psychiatric disorders when young may age faster at a cellular level. Stress is also linked to health conditions like diabetes and heart disease.
     The study, published online in Biological Psychiatry, was conducted by researchers at Butler Hospital. They discovered that both telomeres and mitochondrial DNA (mtDNA) change, which can speed up physical aging, according to Science Daily.
     “Identifying the changes that occur at a cellular level due to these psychosocial factors allows us to understand the causes of these poor health conditions and possibly the overall aging process,” Audrey Tyrka, associate professor of psychiatry and human behavior at Brown University, told Time magazine. (The Herald-Times)

• The mental health of needs of gang-affiliated young people
A briefing on the burden of mental illness faced by young people involved with gangs, part of the 'Ending Gang and Youth Violence' programme.
      This briefing aims to understand and address the mental health needs of gang-affiliated young people, and outlines the:
--extent of mental illness in gang members;
--relationships between gang-affiliation and poor mental health;
--shared risk factors that contribute to both.
     It also emphasises the need for a life course approach to prevention that:
--addresses risk factors;
--promotes resilience in young people;
--provides appropriate support for vulnerable young people.
     The briefing summarises evidence of the types of interventions that can:
--protect children from antisocial behaviour and poor mental health;
--treat mental illness in vulnerable young people. (Gov.uk)
• You can download the briefing here.

• Scottish ministers under fire over huge drop in mental health research
Despite a growing consensus that psychological conditions should be given the same priority as physical illnesses, new figures have revealed that a declining fraction of Scottish Government research budgets are spent on increasing understanding of conditions such as depression and dementia or developing new drugs and therapies.
     The findings have led to demands that ministers back up their rhetoric over the importance of helping patients with mental illnesses with action. A recent survey revealed that more than a quarter of Scots have experienced a mental health problem.
     In the two years after the SNP won power in 2007, around £7m of Government cash was invested in mental health research. However, last year just £860,000 was spent on projects specific to mental health from a budget of £69m.
      In the current financial year, spending fell further with £526,000 so far allocated, the lowest annual total in eight years. (Herald Scotland)

• Los Creativamente Inadaptados: The alternatives to psychiatry movement in Chile/Argentina
Writes Sascha Altman Dubrul: 
At some point, after a few days, amidst the heat of the city, and all the stories I had heard from my new friends, and my time riding the subways and the buses, looking into stranger’s eyes, looking at the familiar slick advertisements and chain stores everywhere, the palm trees planted to mimic the city of Miami, it hit me like a hard slap in the face: this country, Chile, this “economic miracle,” this “neoliberal experiment,” is the perfect way to explain everything that’s wrong with the biomedical model of “mental illness.”
     Where I live, back in the United States, it’s so common to use the language of “mental illness” to talk about people’s individual problems. We take it as a given, as some kind of scientific truth that if we are depressed, it is because we have a chemical imbalance in our brain. We assume that someone who is “schizophrenic” is so because of some genetic flaw. There is something wrong with our neurotransmitters, our personal biology, something that can be cured with a pill. But this is culture, not science. Even if some us are born more sensitive and different, and even if some of us use pills to take care of ourselves in this crazy world, that doesn’t make us “sick.” The whole idea of “sickness” comes from the culture we live in. And it’s a culture that has a political origin.
     You can’t get a more stark example of how neoliberal politics and psychiatry work than in the country of Chile. (Mad in America)

The General Election: Anyone but “Camilibegg"

27/1/2015

 
Picture"Camilibegg"—a morph of David Cameron, Ed Miliband and Nick Clegg—represents the bland, centrist "false self" of British politics.
The General Election is 100 days away.
     How will you vote on May 7?
     Which fortysomething white heterosexual male from the south of England do you support: David Cameron, Ed Miliband or Nick Clegg? Which party leader will you be rooting for in the TV debates?
     Does it matter? Are their ideologies so radically different anymore? The left and right have both moved to the centre, because there, in the marrow of the bell curve, is where the voters are to be found. “New Labour”—nothing to do with the old Labour Party—has marched towards the “compassionate Conservatives” coming the other way. When they met in the middle ground they discovered, to their surprise, that Clegg was there, too, like a genial host, making the introductions, pouring the wine and keeping the conversation going.
     All three parties dance to the tune of free market economics, differing only in the degree to which they’re willing to support those who get crushed by capitalism’s wheel of fortune as opposed to elevated by it—the amount of inequality they can tolerate; the size of the deficit. That and the colour of their tie.
     Human and chimpanzee DNA is 99 percent the same. How infinitesimally small then the difference between Miliband, Cameron and Clegg?
     They have morphed into one, “Camilibegg,” a horrific, animatronic parody of clean-shaven, regular-guy wholesomeness that wants to please all the people all the time. These three “leaders” are like the inoffensive department store music that you soon stop even noticing, the magnolia-painted walls of the house you are trying to sell, the stale white toast left behind at the breakfast buffet.
      They claim to care about the young, the elderly, the poor, the unwell. The NHS, the BBC, world peace. (“Sincerity is everything,” said Groucho Marx, “if you can fake that, you've got it made.”) They go through the motions of striking a tough-sounding posture on immigration, even though they know just how essential it is to the economy. Each week they strut and fret upon the House of Commons stage, acting out the point-scoring pantomime of Prime Minister’s Question Time, but beneath the bluster and the mock indignation, conformity wins the day. As Henry Kissinger said, politics can get vicious when the stakes are so low. You want the Judean People’s Front, or the People’s Front of Judea?
     This is a mere semblance of democracy. The “choice” between Dave, Ed and Nick—three empty suits—isn't really much of a choice at all. No wonder voter turnout is so low (more than a third stayed home in 2010). No wonder some colourful characters and richer, more ideological voices are striking a chord—love them or hate them, there's something more honest and alive about the likes of Russell Brand, Al Murray, the Green Party. Even ghastly UKIP--at least we know what they stand for.
     What used to be the Liberal Democrat problem—piggy in the middle, standing for nothing—is now a Labour and Conservative problem, too. The centre cannot hold.
     In the 1951 General Election, Labour and the Conservatives cornered 97.5 percent of the vote.
     Last time, in 2010, Conservative, Labour and Liberal Democrats scooped 88 percent of the vote.
     So this year, whatever your political leanings, how about continuing this trend toward plurality? Let’s not vote for the status quo. Let’s vote for authenticity, for diversity. Let's vote for anyone but “Camilibegg”!

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Daring to be seen
What has any of this got to do with therapy? One common complaint is from people who have fallen into the same trap as Cameron, Miliband and Clegg, albeit for entirely different reasons. They, too, feel they must present to the world a highly edited, sanitized version of themselves. Not to win votes, but to survive. Perhaps as children they learned that they had to be helpful, or funny, or nice, or successful, or not show any emotion, or not ever be any trouble, or any number of other parental commands that can be communicated in myriad ways. They adapted to their early environment. They learned they had to be a certain way to get love, or attention, or not get a clip round the ear, or worse (in some cases, much worse). Today, as adults, these clients are still trying very hard to be who others want them to be. They continue to deny their feelings, their needs, their selves, or keep large swathes of their uniqueness hidden from view. They are chameleons, adapting to any situation. They are unfailingly pleasant, polite, always on time. But since they only ever reveal what English psychoanalyst Donald Winnicott called a “false self,” they are hard to get to know. They are unhappy, ever-anxious, constricted, isolated, disconnected from their fellow humans. They grin and bear it.
     You can think about this schematically with something called the Johari Window, a grid devised by (and named after) two American psychologists, Joseph Luft and Harrington Ingham, in 1955. There are four quadrants in the grid:
• The “Arena” is your public face, the part of you that you know and others know, too (“known-knowns”). This is where politicians, salespeople and other false selves live. False selves, by the way, can do great things. They aren't really false. They are part of you. But only a part.
• The “Secret” is your private self that you keep hidden from view (“known-unknowns”). Your vulnerability is here, your needs. But there’s plenty else you keep locked away in this damp basement: Your shameful moments, your primitive desires and base instincts—your “shadow” self.
• The “Blind Spot” is what others see in you that you are unable or unwilling to see in yourself (“unknown-knowns”). There’s a simple way to make this known to you, too: ask people.
• The “Unknown” is a mystery to all (“unknown-unknowns”). Herein lies the unconscious, the spiritual, the cosmic, the future.
     The smaller and more tightly prescribed the “Arena,” and the more rigid and impermeable the boundary around it, the harder and lonelier life can be. When we can lower our defences and learn to share a little bit of our inner world, our vulnerability, our difficulties, with trusted, safe others, and they respond in kind, then our “Arenas” grow (and our “Secrets” and “Blind Spots” shrink). We become closer, more intimate, more whole. We can breathe a little. What we choose to share—we have cognitive, emotional, behavioural and physical Johari Windows—and when, and how and with whom, are all tricky questions. We need connection but we also need protection.
     Sometimes, though, we just have to take a risk to move forward (something politicians could take note of, the headlines be damned). Therapy is a good place to draw back the curtains and start looking through your Johari Window. You might see a different, brighter view, a more integrated you, a richer way of living.

Blue Monday: How was yours?

24/1/2015

 
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How was your week? Did you survive “Blue Monday”? The third Monday of January has supposedly been “scientifically” proved to be the most depressing day of the year. The warm glow of Christmas (another myth) is now a distant memory, the credit card bills have arrived, your New Year’s resolutions have already all fallen by the wayside. You’ve lost your mojo. There’s nothing on TV. It’s raining.
     The Blue Monday equation has been thoroughly debunked. Not everyone suffers from “Seasonal Affective Disorder.” Not everyone despises grey days, wind and rain, despite the TV weather forecasters’ habitual insistence on deciding for us what constitutes “good” weather and what we are to accept is irrevocably “bad.” Not everyone wants to live on the Costa del Sol, or San Diego, where you feel like people could do with a little rain in their lives.
     There is some evidence that springtime/early summer is actually a much sadder time of year. This is when suicide rates tend to peak. If you’re feeling empty or desperate or dead inside, it can be painful indeed to see the world come alive again, with fields and foliage (and people) emerging from hibernation and suddenly blossoming into ripe fullness. The noonday sun can be too bright, too exposing.
     In “Tulips,” Sylvia Plath wrote of the calm, wintry peace of her hospital bed being ruined by the arrival of a bunch of flowers from a well-meaning visitor. The tulips are “too excitable”; they suck the life from the room (and her):

The tulips are too red in the first place, they hurt me.
Even through the gift paper I could hear them breathe
Lightly, through their white swaddlings, like an awful baby.
Their redness talks to my wound, it corresponds.
They are subtle: they seem to float, though they weigh me down,
Upsetting me with their sudden tongues and their color,
A dozen red lead sinkers round my neck.


Tips, jokes and kittens
It seems there’s no escape from the stereotype of winter blues. We’re saddled with the tradition of Blue Monday. Newspapers and other media outlets up and down the land took the opportunity to offer their readers facile tips, stale jokes or pictures of kittens. A selection:
• Blue Monday 2015: 18 simple ways to banish the blues
(Metro)
• Blue Monday: Readers share their best jokes and one-liners
(ChronicleLive)
• Top 10 ways to banish Blue Monday blues
(Daily Mail)
• Blue Monday: 13 easy ways to feel happy
(Telegraph.co.uk)
• Blue Monday: Manchester's best (and worst) jokes
(Manchester Evening News)
• Blue Monday 2015: 18 ways to lift your spirits this January
(Birmingham Mail)
• Blue Monday: 10 reasons why today is actually pretty great
(The Independent)
• Blue Monday 2015: Ways to cheer yourself up
(Essex Chronicle)
• Beat Blue Monday by starting a totally new fitness regime
(Yahoo Lifestyle UK)
• Blue Monday: 7 photos to make you cheer up and crack a smile!
(Get Surrey)
• Blue Monday movies: 5 uplifting flicks for the most depressing day
(Irish Independent)
• 19 funny cat and dog videos guaranteed to brighten Blue Monday
(Huffington Post UK)

And one more, which because of the paradoxical nature of living, might actually help to elevate your mood . . .
• 10 songs to make Blue Monday even worse
(Londonist)

Weekly news round-up

23/1/2015

 
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Goals in the political game of mental health
Two big announcements this week: the Deputy Prime Minister calls for zero suicides, and the leader of the opposition pledges to put an end to “child mental health neglect.” Politicians of different stripes speaking with one voice! Cross-party consensus! Is mental health finally becoming a political priority? Or are these more empty promises, more pie-in-the-sky targets, more examples of cynical electioneering rhetoric? Time will tell.
• Nick Clegg calls for zero suicides across the NHS
On Monday 19 January the Deputy Prime Minister Nick Clegg hosted a Mental Health Conference, bringing together leading clinicians, policy makers and campaign groups to discuss the future of mental health services in England.
     At the conference, co-hosted by the Minister of State for Care and Support Norman Lamb, the Deputy Prime Minister called on all NHS trusts to commit to a new ambition for ‘zero suicides’ in order to dramatically reduce suicides in our health service. This ambition has already been adopted in some areas with Mersey Care in Liverpool, South West England and East of England all making the commitment. (Gov.uk)
• Miliband pledge to end child mental health 'neglect'
Labour says it will “end the scandal of neglect” of child mental health issues if it wins May's general election. Leader Ed Miliband will use a visit to a mental health group to say greater emphasis is needed on prevention, early intervention and better support. It forms part of his plans to improve mental health provision in England. Mr Miliband will say the proposals would save NHS money and improve care. Ministers have said they are working to improve mental health care. (BBC News)

Other news
• The promise and limits of 'mental health first aid'
In just the last few years, experts have begun arguing that we need a program like this for mental health emergencies, too. Last year, a program called Mental Health First Aid received federal funding for the first time. In Australia, where the program originated, 1 percent of the adult population is said to have attended a course; there and in the United States and Europe, experts are beginning to test how well it works. In the United States, more than 300,000 people have been trained, including more than 2,000 in Massachusetts. The idea is to be able to respond to mental health emergencies calmly and proactively, and to be able to promptly steer those in need toward the right resources. (Boston Globe)

• Online mindfulness training
Online mindfulness training can improve mental health. An online platform is a viable medium to implement and disseminate evidence-based interventions and is a highly scalable approach to reach the general public. (Journal of Medical Internet Research)

• Ditch the Prozac, take up crafting?
As the popularity of crafting grows, researchers studying brain-craft links are increasingly finding mental health benefits. Let’s be honest — there aren’t a lot of studies that focus on the mental impact of one craft vs. another. But increasingly, research shows that picking up needles, of any kind, isn’t just about feeling more satisfied or happier, though those are oft-mentioned benefits. We’re talking help with depression, ADHD, anxiety and a host of other mental health issues. (Yahoo)

• Every two seconds somebody in th UK Googles ‘depression’
Using the latest results for Google’s Keyword Tools (a resource for advertisers to monitor search volumes for terms such as ‘depression’), we have found that people in the UK are making 27 searches a minute for depression, 22 a minute for stress and 21 a minute for anxiety.
      These findings offer a real insight into the mental health of the nation, and reflect Office for National Statistics’ figures which show that more than 15 million working days per year are lost to sickness absence for stress, depression and anxiety. (The Priory Group)

On change: Turn and face the strange

23/1/2015

 
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After the formalities, the details, the terms and conditions of therapy, the first thing a therapist might say to a new client is: “So, what brings you here?”
     There are three different kinds of client, according to Steve De Sheza:
• Visitors are highly ambivalent about the whole exercise—very often they are there grudgingly, at the behest of a partner, boss, educational establishment, medical professional or court of law.
• Complainers love to catalogue all their problems, how much they suffer and are mistreated by others, but they refuse to see any role that they might play in either the cause or the cure. They are greatly attached to their troubles and have no intention of actually doing anything to relinquish them (they will defend them, wrote Freud, like a lioness defends her young).
• Customers—the best clients—are present, open, engaged and highly motivated. They want things to change. They’ve had it with the status quo, with feeling bad all the time, with aspects of their life that have become worn out or problematic. They’re tired of being stuck. They have faith that better days lie ahead.
     “Customers” have a sense of some kind of direction or goal for their therapy. A partial list:
--to feel less anxious, depressed, afraid, panicked, unsafe or stuck;
--to improve relationships;
--to express and manage emotions in a better way;
--to change specific unhelpful repetitive behaviours, habits or patterns;
--to come to terms with some kind of loss;
--to process difficult events or trauma of the past;
--to explore and “find” oneself;
--to be supported in coping with a great, transformative challenge such as leaving home, bereavement, redundancy, divorce, illness and disease;
--to make sense of the story so far;
--to live life more fully;
--to find some meaning, purpose or spirituality;
--to prepare for death.
     Can therapy meet these goals? Sometimes, to some extent, for some people. But change is not always so easily steered. Unhindered, it happens naturally: we’re born, we grow, we blossom into a gorgeous ripening. We can't help but grow—it's what we do. We are fluid, like a river, as Heraclitus argued two and a half thousand years ago. Nothing will ever again be quite the same as it is right now. But sometimes our growth can be stunted, stuck or skewed. We don’t get the optimum psychological light, water, nutrients and nurturing that we need. Life’s troubles, stormy weather and other obstacles get placed in our way. We get shackled; as Rousseau wrote we are “everywhere in chains.”
     What prospects for growth, for change, in these circumstances? Carl Jung wrote: “We cannot change anything unless we accept it. Condemnation does not liberate; it oppresses.” This paradoxical theory of change, echoed by Carl Rogers, Arnold Beisser and others, says: We can only become more like the person we want to be by first fully cherishing the person we are. I believe this acceptance arises from two factors: self-knowledge, and, for want of a better word, love.
     We are troubled by our symptoms, defences, age-old problematic patterns, unconscious desires or other less pleasing, disowned or denied parts of ourselves. But when we have a thorough grasp of these things and where they came from, coupled with an acceptance of them by both Self and Other, they cease to bind us so tightly and in some cases simply melt away. We come to realize that we do not need our crutches any longer, that the world will embrace us without them, that it is safe to lay them down. By contrast, when we don’t understand them, don’t have compassion for them, cannot accept them, we are subjecting ourselves to oppressive condemnation. We try to command our stifling troubles away but discover that they only cling to us ever tighter. We have limited success with our diets, our New Year’s resolutions. Our CBT assignments may offer respite from our symptoms, but the relief seems superficial and short-lived. We quickly develop negative thoughts about our doomed attempts to “think positive.”
      For lasting change to occur, both ingredients are necessary: an integration of knowledge and love, head and heart, the intrapsychic and the interpersonal, “Logos” and “Eros,” yin and yang.
• Knowledge can emerge through reflection and self-help, but is more effectively gleaned in therapy, via collaborative exploration, enquiry, interpretation and analysis. Our unconscious processes, evident in the “transference”—our habitual emotional responses that get activated in the consulting room—are made conscious. The experience of therapy can deepen emotional and physical knowledge, as well as the purely cognitive kind. We come to understand and make meaning out of how we have learned to be in the world—we did what we had to do to survive our childhoods or later challenges. We shine some light on the shadows. We gain insight, and some control. We become more integrated. The river flows freely again.
• Love is clearly a highly-charged word. It's a hopelessly simplistic shorthand for a kind of human energy that comes in many flavors. In this context I mean it as a quality of the therapeutic bond between client and therapist, nurtured by Rogers’ “core conditions” of empathy, congruence and “unconditional positive regard,” and greenhoused in a non-judgmental, safe, boundaried space. According to Jackie Gerrard: “Unless and until there can be felt moments of love for the patient by the therapist, the patient is not able to develop fully.” But love is not just some positive affirmation that the therapist directs towards the client; what is beneficial is to be able to love as well as feel love; to experience a certain sort of intimacy, to explore vulnerability in the presence of another, a sense of what Karen Maroda goes so far as to call “mutual seduction” and “emotional surrender.” This kind of love is what keeps you both in the room when things get bumpy. It allows the client to trust that it’s OK to reveal the more unpalatable, unspeakable parts of their experience. Love allows you to admit to hate, for instance, and work with it, which can be highly therapeutic. In a letter to Jung, Freud wrote: “Psychoanalysis is in essence a cure through love." The love gets internalised; self-rebuke and condemnation are replaced by self-compassion and acceptance.
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The dodo bird
Outcome research shows that there is little difference in effectiveness of one kind of therapy over another—the so-called “dodo bird verdict.” However, research also shows huge variation between individual therapists within the same orientation. So what makes the best therapists so special? Different authors and researchers have emphasized the importance of different common factors. Miller et al argue, for example, that “supershrinks”—the best of the best therapists—demonstrate “deliberate practice”: they think, act and reflect with the client’s goals and tasks always in mind. For O’Brien and Houston, therapists “need to have the ability to engage the client in a co-operative participation with regard to the goals and tasks of therapy, to provide an opportunity for the client to express emotion and to create a healing therapeutic bond.” Perhaps it is simply the capacity for client and therapist to form a relationship which transports them to a place of knowledge and some kind of love that is most helpful in facilitating change. All a therapist has to offer is their subjectivity—the flawed, imperfect sum total of their personality, training, years of therapy, life experience and history.
       There are, of course, some things that can’t be changed. I don’t believe the idea that you can have anything if you just want it enough and work hard enough to achieve it—this is often a piece of self-aggrandisement offered by privileged people who have been the lucky recipients of a fortunate environment. I don’t believe in “conversion therapy”—I want to live in a world where people are free from oppression, the subtle kind and the not-so-subtle kind, for their natural, human, unimpeachable sexual orientation. I don’t believe people have much opportunity to bring about change in the levels of inequality, social immobility, and government and corporate power that weigh on them—the so-called “complainers,” it turns out, have much to complain about. Life is more of a Greek tragedy, less of a Richard Curtis movie. Circumstances conspire against us; we don't get anywhere near to reaching our potential. I agree with David Smail that psychotherapy’s tendency to suggest all a client’s problems exist within the client—to “blame the victim”—is disrespectful, unethical and oppressive. Smail takes the argument to an extreme, as if we have no personal agency at all. “There is no such thing as an autonomous individual,” he writes. But even from that vantage point, he sees a modest role for therapy—to provide clarity, encouragement and solidarity.
       Ultimately, change is not an event but an ongoing process. Therapy is perhaps less about achieving a specific, tightly-defined goal, and more part of an ongoing attempt to foster greater self-knowledge, and an enhanced capacity for love. Armed with these, the client (not to mention the therapist) is in a good position to heed the call of the “serenity prayer”: We walk out of the consulting room and back into real life with heightened reserves of courage to tackle what can be tackled, of serenity to accept what can’t be tackled, and of wisdom to know the difference between the two.

Weekly news round-up

17/1/2015

 
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Art therapy may help kids with behavior problems
Begun in 2002, The Art Room program is aimed at children between the ages of 5 and 16 who have been identified by their teachers as needing emotional and behavioral support.
     Currently there are nine Art Room programs in UK schools. More than 10,000 children have been through the Art Room program since it started.
     In a study published in the journal The Arts in Psychotherapy, researchers found that children emerged from the 10-week Art Room program with less depression, fewer behavioral problems and improved self esteem. (Reuters)

Headteachers believe pupils are ‘let down’ on mental health
Demand for mental health services among the young is increasing. Economic pressures, parental separation and the impact of social media are all cited by headteachers as factors behind the rise in behavioural and emotional problems among pupils.
     But when schools in England do refer pupils to mental health services because their needs are considered too complex to be managed “inhouse”, more than half, 54%, report that the referral system is ineffective. (The Guardian)

Bisexual women are ‘more likely to suffer mental health problems than lesbians’
The largest British survey of its kind found bisexual women are more likely to feel depressed, self-harm, and develop eating issues. Bisexual women were 64 per cent more likely to report an eating problem and 37 per cent more likely to have deliberately self-harmed than lesbians, according to the research published in the Journal of Public Health. (Daily Mail)

Why is America’s mental health the worst in the world?
The rate of mental illness is growing in lockstep with our failed economy. There is a definite correlation between the growing rate of mental illness and our obvious failures as a country. Over 20% of Americans have a diagnosable mental illness. Anywhere from 35-40% are receiving no treatment. This means that when the economy collapses, millions of displaced people with a significant mental illness will greatly exacerbate the coming civil unrest. There is now evidence that Americans are far more mentally ill than our foreign counterparts. (The Common Sense Show)

Tears of Ishtar: women's mental health in Iraq
Iraq was the seat of culture, knowledge, and art in the ancient Arab world. In the past few decades, Iraq has dealt with a large share of violence in the region due to three major wars: first the Iraq–Iran War from 1980 to 1988, then the Gulf War in January, 1991, and most recently, the US-led invasion in March, 2003. These conflicts have had a serious effect on women in Iraq, yet mental health services are generally inadequate. (The Lancet)

Study challenges notions of Australian men’s openness to counseling
Australian men have a reputation for being macho and practical, but when it comes to using phone helplines most men just want to talk about their feelings, according to researchers at the University of Adelaide.
     “It’s widely believed that men don't like to seek help, and that this behaviour typically stops them from visiting the doctor or using face-to-face counselling services,” says Dr Rebecca Feo, a Visiting Research Fellow in Psychology at the University of Adelaide.
     “Until now, past research in this area has suggested that when men do seek help, they need practical advice and solutions only, because that's the kind of people they are. However, our research has told quite a different story.” (Medical Xpress)

Voodoo priests, doctors on frontline of Haiti's mental healthcare
Mental illness is still a taboo in the Caribbean nation, which had no functioning mental health system in place before earthquake. In Haiti, it is common for people with mental illnesses to be locked up in hospital psychiatric wards or, believing they are possessed, to seek help from voodoo priests.
     Yet plagued by guilt, fear, trauma and grief, mental illness remains a reality for many Haitians still struggling to cope with the loss of their relatives, homes and even, limbs, in the aftermath of the Jan. 12, 2010 quake. (Reuters)

Download New Year, New You
Download the free ebook New Year, New You: Tips and Strategies for Self-Improvement. Brought to you by Routledge, it's made up of hand-selected excerpts from some of our leading experts and resources.
     New Year, New You is designed to help you stick to your plans and achieve your goals. With concrete tips and practical advice to make positive changes in 2015, New Year, New You offers you the tools you need to stick to some of the most common New Year's resolutions, addressing areas in which we could all benefit from a little help. (routledgementalhealth.com)

The 6 relationship types: What colour is yours?

10/1/2015

 
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What colour is your relationship? When we walk down the metaphoric aisle towards coupledom, we’re both dragging behind us a sackful of experiences, memories, ideas, habits, fantasies and other oddments collected over the years. An important part of all that baggage is our attachment style, our habitual way of relating to other people—a tendency we might crudely characterize as either hot, warm or cold. It's how we learned as children to be in the world. We adapted to our environment.
     Our early attachment experiences as babies and infants inform all our relationships in later life. They are the backdrop to every romantic entanglement and disentanglement, to every Machiavellian workplace manoeuvre, to how we operate as parents. They can be felt in the raw anguish of John Lennon’s voice as he sings “Mother.” It is through early attachment that we become who we are. Attachment, too, provides an X-ray vision into our relationship patterns, which as a result can be broadly broken down into 6 different types. But first, a little background.

Attachment: How we relate—then and now
The idea that children seek strong, nurturing early relationships with caregivers for optimal social and emotional development, was formulated by John Bowlby in the 1950s, following a World War in which so many attachments were violated. His ideas were strenuously resisted by the psychoanalysts and drive theorists of the day, but gradually his position became accepted as more child studies revealed the impacts of early maltreatment. Paraphrasing Schopenhauer, attachment theory, like all truth, first was ridiculed, then violently opposed, then accepted as self-evident.
     Largely thanks to Bowlby, many of the old parenting norms, such as limiting newborns’ exposure to their parents in maternity wards, rationing the attention parents paid to babies, and even subjecting them to prolonged periods of isolation outdoors, fell out of vogue in the 1950s and ’60s. These anachronistic attitudes live on in spirit still, however, with notions of “controlled crying” and bestselling parenting guides that reject “baby-led” approaches in favour of the imposition of strict and sometimes cruel one-size-fits-all routines peddled by the likes of Gina Ford.
      In the 1960s and ’70s, one of Bowlby’s former researchers, Mary Ainsworth, devised and developed a study in which infants were subjected to brief, controlled separations from their mothers. It became known as The Strange Situation. Ainsworth discovered that the children’s behaviour fell into specific patterns of responding, which were dictated by the habitual patterns of communications between mother and child. This gave rise to a classification system of attachment styles or “schemas”:
• “Secure”: The infant misses the mother on separation, shows signs of distress, is comforted on return, then quickly resumes play. Ainsworth said that securely attached children are beneficiaries of “maternal sensitivity”—the mother’s ability to notice the infant’s signals, interpret them correctly, and respond appropriately and quickly—a skill known as attunement. Two-thirds of infants are estimated as being “secure.” Or, at least, secure enough.
• “Insecure-avoidant”: The child shows few overt signs of missing the parent on separation, offers little protest, then ignores and avoids her on return and continues to play throughout—an apparent unemotional indifference. However, physiological studies show there is a significant nervous/stress response. The child has typically experienced consistent maternal unresponsiveness, insensitivity or rejection—postnatal depression can have such consequences—and in response deliberately detaches.
• “Insecure-ambivalent/preoccupied”: The infant is greatly distressed on separation and highly focussed on the parent, and cannot be soothed on return, alternating between clinging and displays of anger, and generally failing to return to play. This is associated with inconsistent responsiveness or availability from the mother, sometimes including moments of intrusiveness—when mothering becomes smothering. This parental Jekyll & Hyde inconsistency, an example of “intermittent reinforcement,” leads to a maximised focus on the attachment system—the baby becomes an expert in interpreting and predicting the mother’s mood. Donald Winnicott memorably described this as “studying the weather.” (A fourth category, “insecure-disorganized/disoriented,” added in 1990, is reserved for those rare, tragic children whose odd, erratic and inappropriate behaviour shows no consistency. They have generally been victims of frightening or disorienting patterns of communication from the parent; fear and love get mixed up. Such children are at the greatest risk of developing psychiatric problems.)
     Many studies have shown the persistence of attachment styles across generations. Secure children generally have secure mothers; insecure-avoidant children have “dismissing,” unresponsive mothers; insecure-ambivalent children have “preoccupied,” inconsistently responsive mothers. (Insecure-disorganized/disoriented children have “unresolved,” terrifying mothers.)
    These categories are of course gross simplifications. I like to think of attachment as a spectrum; a bell curve. The dial on the attachment meter is marked “cold” at one end and “hot” on the other. Dismissive/avoidant people are deactivated; underinvolved with emotions and with other people, cherishing their own autonomy, self-reliance, stiff upper lip. Preoccupied people, by contrast, are hyperactivated; overinvolved with emotions and other people, organising their behaviour around their emotions, often letting their heart rule their head. Secure people—“warm” on the dial—fall somewhere in the middle. We all constantly jump around on this scale—the “temperature” is in constant flux—though for each of us there is a default setting dictated by childhood attachments.
     What’s your default setting? And what’s the setting of your partner, or partners past, or imagined partners in the future? Here are my 6 archetypal relationships derived from the matrix of possible hot-warm-cold combos—again, I acknowledge that this is just a simple model, a coarse categorisation that masks all kinds of varied partnerships. Each and every relationship, of course, is unique. Read the descriptions, decide what colour your relationship is, then tell us by taking the poll.
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The 6 relationship types
1. The Yellow Couple: When “avoidant” meets “avoidant” (cold+cold)
Terry & June
This can be a stable but oh-so-quiet, arid kind of connection. These are the couples who keep a polite distance from their own feelings, from each other, and from everyone else. They marvel that over all the years, they’ve never had an argument. They sit in silence in restaurants with nothing to say. Conversation—and sex—petered out years ago; they’ve lost any physical and emotional intimacy, if they ever had it. They appear to be biding time, waiting for the end, existing rather than living. “Anything for a quiet life” is their coda. They sip their tea from matching mugs that say: “Keep Calm and Carry On.” This can be a stale, fetid pool where marriages might collect if left unattended. I can’t really remember much about the unrelentingly beige 1980s sitcom “Terry and June” save that it seems to represent perfectly a certain kind of suffocating, suburban existence. For American readers, it’s hard to find an equivalent to this uniquely British celebration of the mundane. Maybe Terry and June are roughly what "Friends" Chandler and Monica might become after moving to Connecticut.

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2. The Red Couple: When “preoccupied” meets “preoccupied” (hot+hot)
Burton & Taylor
Fireworks every day! This relationship—which often starts as an illicit affair—is a volatile, tumultuous, dramatic roller-coaster full of passion, obsession and jealousy, with violent storms and ecstatic sunsets; a potent cocktail of love and hate, break-ups and make-ups, and lots of sex. Alas, whether it’s Romeo & Juliet, Bonnie & Clyde or Sid & Nancy, the relationship is doomed to self-destruct. The fireworks burn everyone in sight, or simply burn out, and the show is over. Motto: “Can’t live with you, can’t live without you.” Richard Burton and Liz Taylor were both married when they began their affair. They had a white-knuckle ride of 10 years of marriage, then divorced. “You can't keep clapping a couple of sticks [of dynamite] together without expecting them to blow up,” said Burton. The divorce didn’t hold: they remarried a year later, then redivorced a few months after that. Between them they had 13 marriages.

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3. The Blue Couple: When “avoidant” meets “preoccupied” (cold+hot)
Charles & Diana
Opposites attract . . . until they annoy. The former, the avoidant one, loves the excitement, drama and passion of the latter. The latter loves the security, peace and calm of the former. But gradually, after the honeymoon period, these kinds if couplings can dissolve into a never-ending argument between never-enough and always-too-much, the nagger and the nagged, Felix and Oscar in “The Odd Couple”; "Abigail's Party." The avoidant half is mystified that he is constantly berated for leaving his shoes in the wrong place, or buying the wrong kind of pasta, or any number of seemingly-trivial offences that the preoccupied partner sees as more entries on the huge and ever-growing rap sheet of you-don’t-really-love-me slights. So he curls up in a ball, like a hedgehog, which enrages the neglected partner even further, exacerbating the problem. Maybe she eventually abandons the boring hedgehog and his unwelcoming spikes and goes looking for love instead. After 13 years together, Prince Charles said his marriage to Lady Di had “irretrievably broken down.” What’s remarkable is it lasted that long. The monarchy hoped it might turn yellow, or perhaps beige, but Diana wanted brighter colours.

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4. The Purple Couple: When “avoidant” meets “secure” (cold+warm)
Bogie & Bacall
A well-adjusted person, often female, might be drawn to a “strong, silent type,” often male. The latter gets to bask in the charm, vivaciousness and social network of the former without actually having to contribute or do much. Eventually the more secure partner tires of the avoidant’s moribund lack of generosity, his paucity of spirit, his refusal to engage—to live. She now sees his once so seemingly strong silence for what it really is: fear. She leaves him behind—he can’t be budged from the sofa, or his laptop—goes out on her own, and has a good time among her many close friends. Maybe she meets someone new. Unless they can meet halfway. “Successful marriage is the infinite capacity for taking pains,” said Humphrey Bogart of his fourth-time-lucky union with feisty Lauren Bacall, 25 years his junior. “I guess I didn’t take quite enough pains over the other three.”

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5. The Green Couple: When “preoccupied” meets “secure” (hot+warm)
Bill & Hillary
The secure partner can be a real anchor for the preoccupied person, if she’s willing to put up with his excesses and be supportive. Preoccupied people ride on emotions—their own and other people’s. As a result they often have an ability to connect, swiftly and deeply. They have a lot of libidinal energy that can manifest in conversation, charm, creativity—and cheating. They love their partner dearly . . . but they love everyone else, too—especially other highly-charged, preoccupied people. Lots of successful people have a high-rev, preoccupied attachment style—and a secure, rock-steady partner. There are lots of David Furnishes who put up with the tantrums and hissy-fits of the Elton Johns of this world. There are lots of Marge Simpsons who forgive their Homers time and again. Despite the enormity of the public humiliation and shame, the Clintons are still together—Hillary did not desert Bill. Society is however far less forgiving of women who stray and too much follow their heart. From Anna Karenina to Madame Bovary, from the bunny boiler in “Fatal Attraction” to the disgraceful contemporary phenomenon known as “slut shaming,” the femme fatale gets punished.

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6. The Black and White Couple: When “secure” meets “secure” (warm+warm)
John & Yoko
You are alike but not too alike. There is safety and security but also uncertainty and excitement. Your partner is someone you know really well, yet also a complete mystery. There is yin and yang. On the vast, complex board game of relationships, this might seem like the winning square, the destination; a place to call “home.” The optimistic goal of hopeful but troubled couples who haven’t quite yet given up on their ancient vows, who doggedly drag themselves week after week to see a relationship counsellor, who keep trying, against the odds, despite it all, for better for worse, for richer for poorer, in sickness and in health.
      In truth, we never quite get there. Thinking that we “should”—that there’s a fundamental flaw in any relationship that hasn’t arrived in this exalted place, this mythical land of wine, roses and happily ever afters—is a major cause of marital dissatisfaction, discord and divorce. In fact, any of the 6 relationship types can work just fine. No one can say one is better than another. Every square on the board game contains a potential treasure chest of love and happiness. 
     Not getting there, actually, is kind of the point. Love is a process, one that is not meant to run smooth. For as long as a relationship lasts, it is a commitment, a choice, a belief (“I don't believe in Beatles,” John Lennon sang in “God” in 1970. “I just believe in me. Yoko and me. And that's reality.”) It is work, the kind of work that is really helped along by insight into, understanding of, and making allowances for your self, your partner, and the relational dynamics between you. It is helped, too, by communication, not just in words but feelings; by generosity; by play; by laughter.
      Love is not a destination. It is not some kind of heaven. Because heaven, as the song goes, is a place where nothing ever happens. If you ever find yourself there, there’s one thing you’ll know for sure: the game is over.

What colour is YOUR relationship? 
TAKE THE POLL

Weekly news round-up

9/1/2015

 
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Did you survive “Divorce Day”?
Monday was supposedly “Divorce Day.” Subjected to the stress test of Christmas, relationships that were already shaky came apart at the seams. At the first opportunity—the first Monday after the holidays—one or both parties call the lawyers to start the long goodbye.
     A selection of some of the stories:
• It's divorce day – let's bust some marriage myths
If you’re married, there is a one in five chance you’re considering a split (according to a survey by legal firm Irwin Mitchell); it sounds improbably large, but there it is. If it’s not you, it’s probably him; check his phone, that’s how all the best divorces start. (The Guardian)
• Today's the most popular day for women to file for divorce, so . . . why can’t husbands see when wives stop loving them?
In my 30 years as a marital therapist, I’ve found men aren’t only reluctant to call it a day, but rarely even recognise there’s a problem. That’s not to say that any woman takes the decision to ask for a divorce lightly. Even after years of unhappiness, it’s always the last resort.
So, when they do finally pluck up the courage to say 'I don’t love you', they don’t expect it to come as a surprise . . . But it almost always does. (Dailymail.co.uk)
• 'Divorce Day' blues? Counselling can help
Many couples will have made a conscious decision in the New Year to seek the help and support of counsellor, having realised over the festive period that something is not right in their relationship. Others will have decided that they want to end their relationship and will begin the difficult process of separation and possibly divorce. (Scotsman)
• Couples you meet in counseling: The wife who wants more and her annoyingly satisfied husband
Although I thought I was done after 
Mr. Perfect and His Crazy Wife, The Ice Queen and the Martyr, and Mr. and Mrs. Just not Feeling it, I have realized that I have neglected the most common couple that I see in counseling: The Wife Who Wants More and Her Annoyingly Satisfied Husband. (PsychCentral)

Nominate your heroes here
Deputy Prime Minister launches search for “Mental Health Heroes”
One in four people will experience a mental health problem this year but for many the stigma and discrimination that surrounds mental health will make it harder for them to speak out and seek the support they need. That’s why the Deputy Prime Minister is calling for nominations for local Mental Health Heroes to celebrate those from every region - from healthcare professionals to next door neighbours - who have gone above and beyond to help, support or inspire people with mental health conditions.
     Deputy Prime Minister Nick Clegg said: “It could be the woman sitting next to you on the bus, the dad picking his child up at the school gates or a colleague from work - everyone knows someone living with a mental health problem.
     “I want to celebrate those who have gone that extra mile, whose passion and commitment have helped someone get through their darkest days and helped challenge the taboo around mental health which has existed for far too long.
     “It is my ambition to bring mental health out of the shadows and create a fairer society where people can speak up about how they feel and get the support and treatment they need to live the life that they choose.”
     To nominate someone complete and return the nomination form. (Gov.uk)

Other news
• Children's mental health services ’cut by £50m’
NHS spending on children's mental health services in England has fallen by more than 6% in real terms since 2010, according to official figures.
      The cut, equivalent to nearly £50m, was revealed by NHS England in a parliamentary answer. Labour, which had asked for the figures, accused the government of breaking its promise to make mental health a priority. (BBC News)

• Online counselling: easier for students to seek help
The case for using online counselling services as an additional fixture is strong. Considering the fact that Generation Y are digital natives, offering an online counselling service that enables students to get help as and when they want it is an appealing option. (The Independent)

• One woman's fight for mental healthcare in China
According to a 2009 study published in British medical journal The Lancet, around 173 million Chinese suffer from a mental disorder. However there are only 20,000 psychiatrists, equaling 1.5 for each 100,000 people, or a tenth of the ratio in the United States. Last year saw the introduction of China's first mental health legislation, which took a reported 27 years. (CNN)

• Good diet, good mind? What you need to know
Obviously, a good balanced diet is important for everyone, but for people who might be prone to mental health problems, it’s often advised that, in addition to exercise, we try to manage our diets especially carefully so as to ensure optimum health.
     In terms of scientific evidence, it’s only relatively recently that scientists have started looking into how diet might affect mental health. However, what they’ve seen so far is that the link is, to quote one researcher, “unusually consistent.” (Care2.com)

Weekly news round-up

2/1/2015

 
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Children with mental health issues 'should learn the violin'
Learning to play an instrument may be more effective for treating childhood psychological problems than pills, a study has found.
     Children who play musical instruments are more focused, emotionally controlled and less anxious.
     Brain scans found playing music altered the motor areas of the brain, because the activity requires control and coordination of movement.
     But even more important were changes in the behaviour-regulating areas of the brain. (Telegraph.co.uk)

7 mental health resolutions for 2015
When it comes to New Year’s resolutions, our self-improvement efforts often focus on getting a better body. And we ignore that other, equally important part of our wellbeing: our mental health. This year, prioritize your mind as well as your body, and make a resolution for better mental health. (Time)

Couples therapy: The envy of lost youth
Couples with teenage children are at risk of breaking up because they suffer from “lost youth envy,” experts say.
     Many people become unhappy when they see their children dating and partying because they can no longer do so themselves, according to a study. And this causes some parents to become dissatisfied with their own relationships.
     Susanna Abse, chief executive of the Tavistock Centre for Couple Relationships, which conducted the research, said the risks are even greater over Christmas. (Independent Online)

Demi Lovato campaigns for mental health awareness
Demi Lovato is not just a talented singer. Recently, she campaigned for a cause inspired by her own dark experiences.
     According to E! News, Lovato, in partnership with The Mental Health Listening & Engagement Tour, aims to spread awareness about bipolar depression.
     The former “X Factor” judge announced she had bipolar disorder. She claimed she had “some dark times” during the depressive phase of her condition. However, she shared there is still hope for those who are experiencing the illness. (Movie News Guide)

Meeting Africa’s mental health needs
According to a 2003 WHO report, close to 90 per cent of those in developing countries who need treatment for mental health problems receive no assistance. Across Africa, there is only one psychiatrist for every million people. As a result, doctors throughout the continent are realising that if they want to widen access to mental health, they can't wait until there are more psychiatrists. (SciDev.Net)

How Argentina's 'Loony Radio' is changing attitudes about mental health
Silvina and Eduardo know too well the difference between “inside” and “outside.”
     As former inpatients of Argentina's largest psychiatric hospital, they have experienced the stigma attached to those who are confined inside it, and the difficulty of building a new life outside.
     But once a week, they go back inside the hospital for a few hours to present a radio show, and the difference becomes blurrier. (CityLab)

Ten essential psych studies of 2014: Making narcissists empathise, memory boosting spice and more…
A fun roundup from PsyBlog. My favourite was research by the charity Action for Happiness into the habits that make you happier. Writes PsyBlog author and founder Jeremy Dean: “A survey asked people which happy habits they actually practised and how they felt. This found one of the largest associations between happiness and self-acceptance, despite the fact that people performed this habit the least."
     Here are 10 habits for happiness, arranged to spell out GREAT DREAM. The scores are the average ratings of the 5,000 survey participants on a scale of 1-10, as to how often they performed each habit:
• Giving: do things for others — 7.41
• Relating: connect with people — 7.36
• Exercising: take care of your body — 5.88
• Appreciating: notice the world around — 6.57
• Trying out: keep learning new things — 6.26
• Direction: have goals to look forward to — 6.08
• Resilience: find ways to bounce back — 6.33
• Emotion: take a positive approach — 6.74
• Acceptance: be comfortable with who you are — 5.56
• Meaning: be part of something bigger — 6.38


On motivation—or why resolutions don't stick

1/1/2015

 
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January 1. We emerge from 2014, unsteady and slightly hung over, blinking at the harsh light of a new year. A clean slate. A line in the sand. A fresh start. This time round, surely, things will be different. We resolve to be fitter, happier, more productive in 2015. We will give up bad things: unhelpful food, people, duties, habits. We will instead do the things we always wanted to do. We will finally live the unique, courageous, beautiful life that we deserve.
     Why doesn’t it ever quite happen—why are those new year resolutions forgotten by February? Are we not rational, logical, conscious beings, able to make choices—masters of our own destiny? Are we not brave? We might make some mistakes along the way, but aren’t we in general trying to do the right thing, staying true to ourselves and our values, heading toward some kind of elevated, enlightened summit? We are inherently sensible and good . . . aren’t we?
     Perhaps not entirely. We’re not always sure what we really want—our true desires are often ambiguous, ambivalent, illogical or hidden from view. Our conscious, stated wishes can be completely at odds with our unconscious ones—Lacan said that faced with the possibility of a wish actually coming true, we often run the other way (Freud called this “the wish for an unsatisfied wish”). Sometimes, to our surprise, our behaviour doesn’t quite tally with our cherished principles and beliefs. The German philosopher Heidegger said we discover our intentions through our actions rather than the other way round, and neuroscientific studies have since confirmed that. You watch in disbelief as your hand goes up to volunteer for something you hadn’t even considered. You hear yourself agreeing with someone who flies in the face of opinions you held dear. You fall for someone who supposedly isn’t suitable, isn’t your “type.” Poets, priests and politicians—not to mention psychotherapists—preach wholesome, “family values,” with sincerity, while compartmentalising away their own chaotic, operatic private lives.
     Our motives, instincts and behaviours are not always pure. Humans are all perfectly capable, in a certain light, of being craven, weak, cruel—or criminal. We have an immense propensity for good . . . and for bad. Consider these famous psychology experiments:

• In Festinger and Carlsmith’s 1959 research project, participants were made to carry out a really boring task, then they were asked to describe the task to a new recruit in glowing, positive terms. The ones that were paid a modest amount for lieing in this way later reported that they had changed their mind: they decided the task had actually been quite interesting. We go to extraordinary lengths to manage our “cognitive dissonance” and preserve the fiction that we are rational, logical, consistent and “good.” “I don’t smoke,” a friend once told me as she lit up yet another cigarette.

• Our capacity for conforming to others was tested by Asch in 1951. In the experiment, a participant was brought into a room with eight fellow participants who were really stooges. The group was then shown three lines of differing lengths, and a reference line. All they had to do was state which line—A, B or C—was the same length as the reference line. The stooges all gave the same answer, which was clearly wrong. Half of the participants succumbed to peer pressure and gave the same wrong answer as the stooges on more than half of the trials. Only a quarter ignored the stooges and gave the right answer every time.

• A newspaper report of the 1964 murder of Kitty Genovese in New York claimed that 38 people had heard and seen the attack, which lasted an hour, but did nothing. Darley and Latane (1968) observed this “bystander apathy” in an experiment in which participants were unlikely to help someone apparently having a seizure if other people were present—the larger the group, the less likely the participant was to act.

• In Zimbardo’s notorious, controversial 1971 Stanford Prison experiment, a mock jail was created: Some of the participants were randomly assigned to role play being prisoners, the others were to be guards. Freed from their own identities, the young participants took to their new roles; the “prison” quickly became all-too real. The “guards,” mostly idealistic, peace-loving young men, found themselves enjoying humiliating, abusing and even physically assaulting the prisoners. The experiment was stopped after 6 days.

• Most chilling of all is the 1963 Milgram experiment in obedience. Each participant was told by the researcher that they would be posing questions to an unseen person behind a screen, and delivering a small electric shock each time a question was answered incorrectly. The researcher asked the participant to increase the voltage each time an incorrect answer was given. How far did the participants go? Nearly two-thirds went all the way—to the maximum voltage, past the point where the actor behind the screen had stopped screaming.

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Why do we do what we do?
So our supposed rational, logical mind doesn’t quite seem to be in charge to the extent we imagined. It might think it’s steering the ship, but there appear to be other hands on the wheel, too, and some of them, at times, feel beyond our control. We don’t have absolute free will. But nor is everything pre-destined. Buddhists believe instead in a middle way: things happen as a result of multiple causes, conditions and connections. As Frankl and others have said, we have choice, but within constraints. We are neither free nor not free.
     What drives those choices? Where do we want the ship to go? There are no simple answers to this question. Theorists tend to follow one of four broad beliefs:
• We are biological creatures. We are motivated by survival. Freud said we had natural instincts for sex and aggression; for love and death. Many years later, Dawkins wrote that we’re at the mercy of our “selfish genes.” The behaviourists believed that, like rats in a maze, we simply respond optimally to external stimuli.
• We are individual psychological creatures. Maslow said we each have an innate tendency towards psychological growth, which happens via what has been called a “hierarchy of needs.” Once the basic physiological demands have been met (food, water, sleep, safety), we can find love, esteem and, finally, “self-actualisation,” which might be searching for knowledge, understanding, meaning or spirituality in life; a kind of transcendence. This was taken up by Rogers with his idea of “individuation”; by May, Fromm and other humanists. Some critics say this focus on self and individual autonomy gave rise to a selfish, navel-gazing “me-generation” of people only concerned with their own personal growth.
• We are relational creatures. Bowlby was the first to say that we’re motivated by our powerful need to form social bonds: the way we formed attachments with early caregivers—or didn’t—influences all our subsequent human actions and interactions. Unlike some mammals, we are born half formed. We quickly learn to adapt to our environment. For better or worse, whatever we learned as children about how best to be in the world tends to manifest in lifelong repetitive patterns. The unconscious wish to gain parental approval persists long after the parents have gone.
• We are societal creatures. We each exist within complex cultures that in subtle and not-so-subtle ways dictate the rules of the game. We are presented with a double bind: we are told to be true to our self, to find our own way, yet we are also under the influence of society’s laws, customs, rituals and beliefs. For Smail, this usually involves some kind of oppression from distal forces, especially political, economic and corporate power.
      The truth is, all of the above are at play. We are motivated by self and others, nature and nurture, the conscious and the unconscious, left brain and right brain. Drozek writes that motivation “emerges from body, mind, and environment including conscious and unconscious affects, intentions, proclivities, values, and ideals that are physiologically, emotionally, relationally, and culturally mediated. But it is exactly because motivation involves all these sources of experience, uniquely configured and textured in every life and every psyche, that we cannot easily make generalizations that would apply to all of humanity.”
      It’s hard enough to make generalizations that apply just to us, never mind all of humanity.  The late British psychologist Mair broached the idea that we are each a “community of selves”; previously I’ve written that we are like a rubbish football team, filled with players who all wear the same kit and are subject to the same rules, but who all have different motivations and don’t always get along. So we can be at war with ourselves. We can get stuck. Human motivation is such a complex cocktail. No wonder cognitive behavioural therapy so often fails. And no wonder our new year’s resolutions are doomed. 

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New year’s resolutions gone bad
Here are three scenarios:
• You resolve to lose weight. But your animal, survival-oriented self wants you to keep eating. Your teenage rebellious self says to hell with losing weight (not to mention social conformity). And your hurt, emotionally-starved self finds comfort and nourishment in food. (Who is it that wants to lose weight, anyway—is that your rational, logical self speaking? Or your social self that thinks you’ll be more lovable if you’re thinner? Or your societal, comforming self that is bombarded by cultural images and messages that offer only one very tightly-prescribed—and very skinny—conception of beauty?)
• You resolve to relax more, not work so hard, and have more fun. But a primitive part of you is always anxiously on guard, hypervigilant to danger. Perhaps your child self learned from your parents that you will only be loved if you achieve great success. Your social, relational self says you “should” work hard, because that’s what your colleagues seem to be doing. And your societal self, too, tells you to get a sensible job, settle down, keep calm and carry on—that’s what everyone expects of you.
• You decide you’re tired of being alone. You go through the motions of online dating. But the rejected self that was once unloved by a parent, or deeply hurt by a lover, secretly sabotages every approach to prevent the possibility of any further pain. The requirements for a future partner become absurdly numerous so as to ensure that they will never be met.
     In all these scenarios, we end up with a kind of internal mutiny on our hands. So perhaps new year’s resolutions are best avoided. They only set us up for inevitable failure and disappointment. Perhaps, instead of wishing for change, we might resolve in the coming year to try to be grateful for all that we have. To be more accepting of all our various imperfect selves. And those of the people around us, too. You can understand, accept and have compassion for things being exactly as they are. Or your can be filled with frustration, resentment and disappointment. What we sometimes fail to grasp is the paradox that the former mindset is much more likely than the latter to result in positive changes.
     When we consider the shortcomings of our lives, it's better to be empathic than emphatic.
     Love is a much better motivator than hate.
     Happy new year.



The optimist says: the glass is half full

The pessimist says: the glass is half empty

The therapist says: how does the glass make you feel?

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    John Barton is a counsellor, psychotherapist, blogger and writer with a private practice in Marylebone, Central London. To contact, click here.

DR JOHN BARTON IS A PSYCHOTHERAPIST, BLOGGER AND WRITER WITH A PRIVATE PRACTICE IN MARYLEBONE, CENTRAL LONDON
© 2023 JOHN BARTON