• The Priory opens in City to tackle stress
“The Priory rehabilitation clinic, favoured by drug-addict celebrities, is to open a branch in the City of London, offering psychotherapy to financial workers.” A “well-being centre,” set to open in Fenchurch Street before Christmas, will employ 15 psychotherapists and counselors to cater to city types suffering from anxiety, depression, stress and addiction. The Priory started as a psychiatric hospital in south-west London in 1872.

• Mental health inequality among black people
Lambeth Council launches a new report targeting inequality and discrimination in mental health provision. Writes Edward Davie: “We hope to end a situation which means that while 26% of Lambeth’s population is black, nearly 70% of the borough’s residents in secure psychiatric settings are of African or Caribbean heritage. We also never want to see a repeat of the circumstances that led to the death in 2008 of black musician Sean Rigg who died in police custody after being restrained by officers during a schizophrenic episode.”

• Mind: 'unacceptably low' spending on public mental health
“Mental health charity Mind has found that local authorities in England spend an average of 1.36 per cent of their public health budget on mental health.” Paul Farmer, chief executive of Mind, said: “Just like physical health, we all have mental health. Mind’s findings show, however, that while local authorities are happy to spend on preventing physical health problems, their equivalent spending on mental health is unacceptably low.”

• Brain function altered by psychodynamic therapy for depression
“Psychodynamic therapy for depression can change brain function, and can possibly predict how a patient may react to that therapy, according to a study published October 16, 2014, in Psychotherapy and Psychosomatics.”

• Outlawing “conversion therapy"
Freud believed humans were innately bisexual. Many psychotherapists since, however, have regarded anything other than heterosexuality as aberrant, a pathology, a mental illness. Homosexuality was only removed from the Diagnostic and Statistical Manual of Mental Disorders as recently 1973 (and even made a brief reappearance—“ego-dystonic homosexuality”—in 1980). Beliefs in “conversion therapy” persist today. Now America’s National Center for Lesbian Rights has “announced the formation of the #BornPerfect Advisory Committee, a group of conversion therapy survivors, child welfare and mental health experts, and faith leaders with unique insights into the harms of conversion therapy.” Representatives are scheduled to attend the United Nations Committee Against Torture meeting in Geneva in November to educate the committee about the “cruel, inhuman or degrading” treatment practice of conversion therapy in the United States.

• Male suicides in England and Wales hit 15-year high
“Suicide statistics for England and Wales, show not just a record number of self-inflicted male deaths in 2013, but also an increasingly marked divergence between the ratio of male to female suicides; almost 80 per cent of all such deaths in England and Wales were male.” Charity CALM “wants the Department of Health finally to recognise the enormity of the problem facing men in particular, and develop a gendered and strategic approach to reducing all male suicide in the UK.”

• Sweden: therapy in the back of a taxi
A taxi company “is offering people who are stressed by work and feeling down because of the cold, grey Swedish winter a chance to speak to a psychologist as they travel.”

The time will come

when, with elation

you will greet yourself arriving

at your own door, in your own mirror

and each will smile at the other's welcome 


This is the first verse of the poem “Love After Love" by Derek Walcott, the Nobel Prize-winning poet from St. Lucia. The poem could be taken literally: it’s about love after love. Perhaps an all-consuming relationship has come to an end. The adventure is over. The pain is unbearable.
     Perhaps you're someone who tends to be very giving in a relationship; you have what some therapists call a “self-sacrifice schema.” Perhaps you often pair up with someone who tends to be very taking; someone perhaps more likely to be on the “entitlement/grandiosity schema” end of the spectrum. In such an arrangement, there’s an opposites-attract complementarity, a kind of equilibrium. But it’s doomed. You give all your love away, and in so doing, you lose yourself. Such a scenario led Yeats to the conclusion that you should “Never Give All the Heart”—as though it’s better to be just a little bit in love, half in a relationship, somewhat married. As if you have a choice anyway.
    So, it's over. Eventually, maybe even years later, you manage find your way back to that much neglected, overgrown metaphorical path to your own front door. You come home. And when you get there, you discover yourself. You’d been patiently waiting there all along. You reconnect, and “love again the stranger who was your self . . . who has loved you 

all your life, whom you ignored 
for another, who knows you by heart.” And you reclaim all that you gave to that other person who never loved you back, who never even saw you, for the narcissist knows only their own reflection. No need for blame—you cultivate some self-compassion, and you are ready to love and live again. Narcissus, meanwhile, has drowned.
     There are other ways to lose your self besides in love. You can lose yourself in work, in study, in the fanatical pursuit of pastimes—in being busy. In drugs, alcohol, gambling, shopping. In the cacophony of other people’s ideas about what you should be doing with your life. You lose yourself by being instead that person that you imagine other people want you to be—by trying to tick other people’s boxes. What relief, freedom, energy—what elation—when you realize that you can give up all that, your mask, your “false self.” You stop living from the outside in, and start living from the inside out.
     The last line of Walcott's poem is a command: “Feast on your life."

      Denmark’s initiative, a joint effort between social services and the police, doesn't demonize returning fighters or ask them to give up their beliefs and convictions. It simply offers various kinds of help, perhaps most pertinently free psychological treatment for trauma. 
      Steffen Nielsen, a crime prevention advisor involved in the Danish scheme told Al Jazeera: “A lot of guys who come home have experienced a loss of innocence and some sort of loss of moral belief. They thought they were going down there for a good cause. And what they found was thugs who are decapitating women and children and raping and killing people, and everything smells and you've got diarrhoea from drinking the water and it's not the great cosmic battle for al-Sham that you'd imagined."
     This mature approach will be hard to swallow for some people. It stands in stark contrast to the situation in Britain, where jihadists face likely arrest and the threat of prosecution on terrorism charges. It stands in stark contrast, too, to all the Islamophobic hysteria, the scaremongering, the "clash of civiliations" warmongering, the pathologisation of the world's 1.2 billion Muslims. What Edward Said wrote back in the Dark Ages of 1997—before the terrorist attacks of September 11, 2001 and the so-called “war on terror” that followed—is ever more true today: “Malicious generalizations about Islam have become the last acceptable form of denigration of foreign culture in the West.” 

What news of Denmark?
Denmark is not some Hans Christian Andersen idyll. But we could learn a thing or two about the meaning of the word “society” from this tiny, enlightened Scandinavian nation. As with jihadists, the focus with criminals in Denmark, too, is very much on rehabilitation as opposed to retribution. Crime rates and prison populations are small. Simon Jenkins writes this week: “Imprisonment is brutalism, reflecting society’s inability to police antisocial acts. The community needs to be protected from those who ‘cannot stop themselves’ from harming it. But that is a tiny minority of prisoners. Most are locked away in fortresses because we can think of nothing else to do with them. We have admitted defeat. It is as archaic a response to crime as bleeding and leeches once were to sickness.”
     Denmark also has excellent free schools, hospitals and healthcare for everyone, cheap and abundant public transport, and it gives more of its GDP to foreign aid than almost any other country. The government prioritises gender equality. Environmentally it’s miles ahead, entirely energy self-sufficient, with 43 percent of its needs coming from renewable sources such as wind and biomass. A few years ago, I went to Lystrup to see the world’s first “Active House”—one that generates more energy than it uses thanks to solar panels that create hot water, solar cells that generate electricity, and all kinds of other innovative ideas.
      It’s a civilized society with low levels of inequality and—surely not unrelatedly—is the happiest nation on earth according to several surveys. Not that Danish counsellors have nothing to do. Statistics show that that 38% of Danish women and 32% of Danish men will receive treatment for a mental disorder at some point during their lifetime. The winters are long and dark. Suicide is hardly uncommon. Mental dis-ease is indiscriminate.
     Clearly in need of some counselling was Hamlet, the bereaved, depressed and psychologically paralysed Prince of Denmark. "How weary, stale, flat and unprofitable seem to me all the uses of this world!" he says in his first soliloquy. "Fie on't! ah fie! 'tis an unweeded garden that grows to seed; things rank and gross in nature possess it merely. That it should come to this!"

I remember August 4, 2012. That was the day when Oscar Pistorius made his debut in the 2012 Olympics, in my home town, alongside so-called “normal” athletes. For many people like me with any kind of physical impairment or disability, he was a massively inspiring figure. Despite being born with no fibula bone in either of his legs and having had both amputated below the knee as a baby, here he was, running like the wind, a true Olympian. He showed the way: focus on what you can do, forget the rest. His charisma and his example of triumph over adversity attracted legions of followers, media, and sponsors. He was an icon.
     Then he shot and killed his girlfriend, the model Reeva Steenkamp.
     How did that happen? How did this very personification of the fine human virtues—courage, grace, perseverance—turn into a killer? Was it literally a moment of madness?
     Pistorius was found guilty of culpable homicide and sentenced today to five years in jail. The trial had been adjourned in May for six weeks so he could have a thorough psychiatric evaluation to determine whether or not he was criminally responsible for the shooting. There’s a long tradition of mental illness being used as a defence in court, dating back to 1843, when Scottish woodturner Daniel M’Naghten, in the grip of paranoid delusions, set out to shoot the prime minister Robert Peele (he killed his private secretary instead). M’Naghten was found not guilty on the grounds of insanity. Instead of prison he was sent to the asylum, and though the two were likely largely indistinguishable, his acquittal caused an outcry, leading to an enquiry and a clarification of the law from the House of Lords. What became known as the M’Naghten Rules stated: “To establish a defence on the ground of insanity it must be clearly proved, that, at the time of committing the act, the party accused was labouring under such a defect of reason from disease of the mind, as not to know the nature and quality of the act he was doing, or if he did know it, that he did not know that what he was doing was wrong.”
      Was Pistorius suffering from “defect of reason from disease of the mind” on Valentine's Day last year when he pulled the trigger? On one level, yes of course—you’d have to be mad to kill another human being. But we all have to be held accountable for our actions. Pistorius’ psychiatric evaluation reports rejected the insanity defence. The state prosecutor said: “Mr. Pistorius did not suffer from a mental illness or defect that would have rendered him criminally not responsible for the offence charged.”
      The reports did not, however, give Pistorius a completely clean bill of mental health. Professor Jonathan Scholtz, head of psychology at the South African psychiatric hospital where Pistorius was evaluated, described a “split” in his personality: there was the tall, confident international superstar, and then there was the "vulnerable and fearful disabled person" who felt “defenceless.” In a sense, the Oscar Pistorius story has been all about the former running away from the latter. He ran for his life.

The shadow
Carl Jung described a similar split that all of us carry within. We are all governed by an “ego ideal"—the “rules” of how we are to be in the world, shaped by social mores and customs and the demands of family, community, society (Freud called his version the “super-ego”). And then there’s “the shadow" (Freud: “id”). We tend not to talk about the shadow. It is all of our bad stuff; all our uncivilized, embarrassing, shameful bits that we'd rather disown. If the various constituents of our personality were to have a party, the shadow would gatecrash it, like the drunk uncle who shows up uninvited at Christmas, and pick a fight with the host, grope his wife, steal someone’s purse, make racist remarks, and throw up all over the buffet table. Says Jung: “The shadow personifies everything that the subject refuses to acknowledge about himself and yet is always thrusting itself upon him directly or indirectly.”
     The more demanding and restrictive the ego ideal, the larger and louder the shadow becomes. People who have a personal or public image of “goodness” often struggle mightily with their “badness.” Wealthy dowagers are caught shoplifting. Politicians who are supposed to be model citizens are exposed for their sordid private lives. The church is rife with sickening stories of child abuse. Cardigan-wearing Frank Bough, the avuncular, friendly face of the BBC in the 1980s, liked to visit Soho sex clubs to wear lingerie and snort cocaine with prostitutes.
      In sport, time and again, our role models let us down. Pistorius. Lance Armstrong. Tiger Woods. Enough disgraced footballers, cricketers, NFL, NBA and NHL players to fill a jailhouse. For a while they are like demi-gods—generous philanthropists, spokespersons for worthy causes, nuclei of perfect families. Their ego ideals become big business—central to the “brand,” and they must at all times stay on message. Maybe people like Pistorius even start to believe it all—the idealisation happens from within as well as without. But it’s just a construction, a product of marketing, literally too good to be true. Beneath the public-image veneer—the wholesome photo shoots, the sanitized utterances to the media, the vanity charitable foundations—the shadow, for so long shunned, ignored, repressed, denied, is plotting a grand insurrection. When firearms are involved, the consequences are likely to be deadly.
      So let’s stop pretending. Let’s stop worshipping false idols. And let’s accept the shadows—other people’s as well as our own. Jung believed that owning and integrating our shadow side—without surrendering to it—allows us some measure of conscious control. By knowing about our base, primitive instincts, we're in a better position to live with them.
      I've worked with clients who have tried so hard, for so long, to live solely within the narrow, suffocating world of their imagined ego ideal, which demands that they only ever be “good” or “nice” or “useful" or “funny" or whatever it was that their childhood environment necessitated. Trying always to be to other people's liking is what some of us learned to do when we were little. It's understandable. We can forgive. But as adults, it's an exhausting way to live, and it doesn't work. Everybody loses. The result is anxiety, isolation, and misery. Better to accept our humanity, warts and all.
     And the shadow is not all bad. Cultivating an awareness of it can inject a little passion, play and authenticity into the proceedings; a little freedom. No need to be afraid of the dark. Our shadow makes us whole. It can, with great relief, bring us back to ourselves, and back to life.

The Guardian published a moving extract of Laurel Braitman's book Animal Madness, featuring a homesick gorilla, a heartbroken otter, a bereaved schnauzer, a tiger with a nervous tic, and Braitman's deeply disturbed rescue dog called Oliver.
     She writes:

     People who talk about the emotional lives of animals sometimes get accused of anthropomorphism but it's patently obvious that animals feel, and if you don't believe it, spend Guy Fawkes night or New Year's Eve with a nervous dog when fireworks are going off all around.
     An undergraduate professor, John Crook—a wise and enlightened Buddhist—used to talk to us about the evolutionary survival benefits of emotions. He wrote the book on the evolution of consciousness. It doesn't start and end with humans. In the book The Feeling of What Happens, Antonio Damasio describes a continuum: animals first developed instinctive, emotional reactions (reptilian brain), then they evolved to experience inner feelings around those emotions (mammalian brain), followed by an ability to have knowledge of those feelings, to think about them (human brain). 
     Along with emotions and feelings emerges the possibility of animals developing mental health problems. There are dogs who are anxious, narcissistic, schizoid. Paranoid dogs, OCD dogs, psychotic dogs. Dogs that were abused as puppies and suffered lifelong post-traumatic stress. I know a dog called Daisy, a lovely rescue from Battersea Dogs' Home, who sometimes gets the blues. Peter Singer argues that we all have a responsibility to examine the amount of suffering that we are directly or indirectly responsible for, or complicit in—that's the yardstick. It's hard to live ethically, but we do what we can. Humans are at their best when they're being humane. We need to treat animals with great care, especially our fellow mammals. Partly to save them, and partly to save ourselves. 
     Bridging the animal-human divide works both ways. We are animals, too, and we forget that at our peril. So often our human brain takes over and tries to rationalize away emotions or deny them, or repress them, to overrule our reptilian and mammalian brains, with unfortunate results. InWaking the Tiger, Peter Levine writes that by cutting ourselves off from our "primitive, instinctual self, humans alienate their bodies from their souls." As a result, we exist "in a limbo in which we are neither animal nor fully human." Ignoring our animal responses is akin to taping over the warning lights on the dashboard of your car. Eventually you blow a gasket, run out of fuel, or your engine melts down. The car stops. Time to call a breakdown service and get help.

     Paying someone to hit you with a stick might gratify masochistic tendencies but any therapeutic benefits seem extremely dubious. At my school there was a geography teacher who liked to punish students by whacking them with his hockey stick, which he called "my willy" (I swear I'm not making this up). He was also fond of hurling his wooden blackboard duster at pupils, and occasionally had been known to grab a miscreant, drag him to the front of the classroom, and plunge his head into a bucket of cold water which he kept on his desk. Who knows how many children he traumatized over the decades with such barbarism. Some people say they had a good experience of boarding school. Many however did not and still suffer today from the devastating consequences of broken attachments and a stunted, shut-off emotional life (I was spared the former—I was a day pupil). Joy Schaverien calls this boarding school syndrome, and many of the afflicted end up in positions of power. And in therapy, too. Repression and denial work up to a point, and then they stop working. The middle-age man suddenly bursts into tears on his way to work one day, or out of the blue he hits his wife, or he finally notices that his drinking has got completely out of control. A crack appears in the facade. For the lucky ones, the crack lets in a little light. With some coaxing, such men emerge, blinking, out of their psychic foxholes, to discover that the war is over.
     While this supposed Siberian spanking therapy is extreme, there are many other, subtler, more insidious ways that therapists can abuse their clients. A skilled therapist might challenge you, provoke you, stir things up, which can be all well and good. There might be times when you leave a session feeling really terrible, as fragmented as a shattered mirror. You might even at times hate your therapist. These things are often all part of a healthy, helpful therapeutic process. Psychotherapy is not just about patting a client on the head and offering nice affirmations. The "do not disturb" sign hangs on the outside of the door, not the inside.
     But if you feel that your therapist doesn't have your best interests at heart, isn't on your side, is exerting an unhealthy power over you, undermines you, always makes you feel bad, or in some way seems to take out their own issues on you, then you have a choice. You could stick around and explore what's going on, share your experience of the therapist and vice versa and analyse the dynamics of your relationship and so on, all the while blaming yourself. Or do yourself a favour and walk. Don't let anyone beat you with a stick, whether actual or metaphorical.

Life was meant for living
Nietzsche is perhaps most famous for his declaration that “God is dead." He shunned the dogmatic rules of the church. Life for him wasn't about humbly conforming—dutifully submitting to higher powers, being meek and mild in the hope of some dull reward, whether in this life or the next. Life was for living, to the full, here and now! Turn up the volume! He believed that we all have a responsibility to be who we are and to live by our own rules, the consequences be damned. He became increasingly strident. He seemed to become motivated less by a desire to invent his own way to live and more by a need to deride everyone else's and be different. Nietzsche didn't just want to kick over all the tables in the saloon, it seemed. He wanted to burn it down, too.
     But whether we believe or don't believe, or something in between, an important message remains. So many of us have internalized so many injunctions—from our parents, our community, our society, our religion, our culture. We are enslaved by so many “shoulds" that are impossible to live up to (and often mutually exclusive). We forget our desires, our dreams, our freedoms. It takes a certain radical, fierce Nietzschean courage to live your life your way—to “come out" as you, without apology, in all your glory.

     Thus spoke Friedrich Wilhelm Nietzsche. I would say Happy Birthday, but he'd probably regard such a platitude with utter contempt.