India: world leader in suicide
About 800,000 people commit suicide worldwide every year, of which 135,000 (17%) were in India in 2010, though Indian suicide rates are likely grossly underreported—one study put the figure at 187,000; another report claims 258,075 people committed suicide in India in 2012, more than any other country in the world (though to be fair, only China has a greater population). Poisoning (33%), hanging (31%) and self-immolation (9%) were the primary methods used to commit suicide in 2010. Unlike in the West, the majority of suicides in India are committed by young adults—the under-30s—with two-thirds being male. “Family problems” and “illness” are the leading causes but as with any developing country, the high suicide rate in India can be partly understood as being the result of socioeconomic deprivation. More than 11% of all suicides in India are committed by farmers, many of whom are struggling financially.
     Mental distress can of course pay a visit upon the affluent, the seeemingly-privileged, too. In their 2009 book The Spirit Level: Why Equality is Better for Everyone, authors Richard Wilkinson and Kate Pickett demonstrate that the more unequal a society, the greater the health and social problems—poorer health (and mental health), more obesity, larger prison populations, more teenage pregnancies, lower levels of literacy, and so on. “Inequality seems to make countries socially dysfunctional across a wide range of outcomes," they conclude. And these societal ills in unequal states are not concentrated just among the poor but are significant across the board. The Scandinavian countries and Japan tend to do well; the U.S. (and the more unequal U.S. states), the U.K. and Portugal fare poorly. India's extremes of inequality are notorious—only a dozen years ago economist and philosopher Amartya Sen wrote that two-thirds of Indian women and a third of Indian men could not read or write—and are most vividly apparent in its cities, like Mumbai, where beggars, businessmen, paupers and princes are thrown together in close quarters, where gleaming glass-and-steel offices and hotels rise up above the shanty towns at their feet--more than half of this wealthy city's 14 million people are slum-dwellers. No wonder many find living in such circumstances too hard to bear. And mental health service provision in India is woeful according to a a recent Human Rights Watch report, "Treated worse than animals."
     Yet curiously, suicide was the only social marker Wilkinson and Pickett found which was worse in more equal countries. They partly attribute this to the idea that in more collectively-minded societies, you might be more inclined to blame yourself when things go wrong rather than The System or other people or the world in general—the book notes that suicide is often inversely proportional to homicide.
     Regardless, suicidal ideation can be indiscriminate, as shown by wealthy, talented stars like Philip Seymour Hoffman and Robin Williams, who both took their own lives this year, In August, The Guardian's Dean Burnett wrote a blog post about the suicide of Williams, specifically addressing those who describe such an act as “selfish" (or “cowardly” or “taking the easy away out"). That it is none of these things should be obvious, but the post hit a nerve, and has been shared more than 432,000 times. “A brilliant but tortured individual has taken his own life, and this is a tragedy," wrote Burnett. “But levelling ignorant accusations of selfishness certainly won’t prevent this from happening again. People should never be made to feel worse for suffering from something beyond their control."
     Suicidal thoughts can plague a broke farmer in Kerala, a bereft celebrity in Hollywood, or anyone in between. They can come to a relative, a friend, a colleague, a neighbour. They can come to you and to me. Anyone with suicidal feelings needs support, reassurance, care and contact—not condemnation and incarceration. With the legal change in India and the generally compassionate response to Williams' death, maybe, by small turns, the world becomes just a little kinder.

• If you are feeling suicidal, or if you know someone who is, please:
—talk to someone: a family member, friend, colleague and your GP:
—call the Samaritans: tel: 08457-90-90-90: www.samaritans.org;
—go to the section on suicidal feelings at Mind's website to understand more about what might be going on with you, causes and ways of coping;
—click on my Help page and find access to other immediate support.

Nick Clegg holds first Mental Health Taskforce meeting
Members of the Deputy Prime Minister's Mental Health Taskforce met for the first time to look at 3 priority mental health areas. Welfare and employment, the criminal justice system and services for children and young people were the focus of the first meeting of the taskforce with ministers from across the coalition. Chaired by the Deputy Prime Minister, the meeting was attended by senior ministers including Jeremy Hunt, Iain Duncan Smith and Danny Alexander, to examine urgently how to improve mental health services. (Gov.uk)
• Time to Talk Day: breaking the silence. On Thursday 5 February 2015, Time to Change will hold the second edition of Time to Talk Day, an event that hopes to reduce the stigma around mental health problems and encourage people to talk openly about it. (The Guardian)

Mental health professionals weigh in on possible American police reforms
While thousands march and demonstrate to protest police brutality and killings of unarmed black men in American cities, therapists and researchers are looking to improve relationships between “the force” and those they serve. Writes Maiken Scott: “Stress, violence, and traumatic experiences are often part of life in urban communities where tensions between citizens and police officers tend to flare. Some mental health experts want officers to be more aware of the effects of trauma—and how it affects behavior.” (Newsworks.org)

Homeless Veterans campaign: calls for better military mental health services
The UK should introduce a “quality mark” for services offering mental health support for veterans, one of the country’s leading experts on military health has said.
     Professor Sir Simon Wessely, who heads the country’s main military health research unit at King’s College London, said veterans could encounter a “bewildering” range of charities, NHS and social care organisations and that it was crucial they knew which could offer an effective service.
     Describing the veterans’ mental health “arena” as “a mess”, Professor Wessely said that good services would have to meet a range of criteria and show that they were “veteran-informed” – providing mental health assessments carried out by professionals who understood the issues that can affect former military personnel. (The Independent)

Irish counselling service sees dramatic rise in abuse victims
An Irish counselling service for abuse victims has reported a 22% increase in the number of people making contact. A total of 470 individuals have been supported by Connect so far this year. The service said that over half of the callers (54%) described an experience of sexual abuse committed in 2014. (Belfast Telegraph)
• Rise in calls to counselling service over abuse (RTE.ie)
• More sexual abuse victims are calling this counselling service (thejournal.ie)
• More abuse victims contacting counselling service (Irish Examiner)

Vulnerable mothers-to-be need more support
Women at risk of mental health problems or with existing conditions should receive more support at every stage of pregnancy and after childbirth, according to new guidelines issued by the National Institute for Health and Care Excellence (Nice). They spell out how doctors, nurses, health visitors and midwives should help pregnant women, new mothers and those who lose babies deal with mental health issues. (The Guardian)
• Royal College of Obstetricians and Gynaecologists statement on revised guidelines on antenatal and postnatal mental health

Doctors in Massachusetts required to offer end-of-life counseling
Doctors, hospitals, nursing homes and other health providers in Massachusetts are now required to offer end-of-life counseling to terminally ill patients. The requirement, part of a 2012 law, takes effect Friday with the posting of rules about how it will work. It’s believed to be the first such rule in the country. A similar proposal in 2009 for Medicare patients triggered claims that the government was trying to create death panels. (WBUR)

What is “Coyote Psychotherapy”?
Coyote Psychotherapy is Native American, indigenous inspired, body-oriented, narrative and social psychotherapy, and still a little more, because Coyote can never be completely contained . . . The concepts are powerful and important. All healing is spiritual. To thrive we need the help of the spirits. Community is everything. Healing is energetic. Faith and the power of belief matter enormously. Relationship is everything. These are the core concepts of our work. (OpEdNews)

Which Jung archetype best describes you?
Carl Jung, the famous Swiss psychologist and philosopher, believed that we all channel unconscious archetypes that deeply effect our behavior. We find these archetypes in myths, fairy tales, and even within ourselves! Are you the explorer or the hero? Maybe even the rebel? (Playbuzz)

A mental health manifesto: five things that need to change
In the UK today, up to a quarter of us will have some kind of mental health problem in any given year. Yet for children and adults alike, only a minority ever receive any help for it. As the issue rises up the political agenda and the general election draws nearer, we asked the Centre for Mental Health to create a manifesto to improve the nation’s mental health. (The Guardian)

A global depression-fighting strategy that could go viral
Depression is the most important thief of productive life for women around the world, and the second-most important for men. We sometimes imagine it is a first-world problem, but depression is just as widespread, if not more so, in poor countries, where there is a good deal more to be depressed about. And it is more debilitating, as a vast majority of sufferers have no safety net. Health care for all must include mental health care. It’s hard to believe but both Liberia and Sierra Leone have only a single psychiatrist. (The New York Times)

The ‘Skype therapy illusion' and the myth of functional equivalence
Psychotherapy at a distance holds out a shimmering promise; care for whoever needs it regardless of where they are. This is good news for people as different as depressed farmers in under-served rural areas, high-flying road warriors rarely in the same place week to week, NGO-workers on foreign assignment, and even ex-pats encountering linguistic or cultural obstacles to accessing care. For all of them, and others, tools like Skype promise access to at least some psychological care. But there is a potentially dangerous sleight of hand—the Skype therapy illusion—in how many who routinely offer such screen relations based treatment talk about the care they endeavor to provide. Consequently, the opportunism of some just may undermine the promise for many. (Forbes)

Elefriends: the social network for the mental health community
A “pull your socks up type response” was one of the reasons behind the launch of Elefriends, a social network launched and managed by the charity Mind, says their Digital Community Manager Eve Critchley. Since February 2013, 20,000 people have joined Elefriends, mostly within England and Wales. The users are 75% female, with the most interest from 18-25 year olds, although many users are much older. “It has definitely grown quicker than we expected,” says Critchley. “This is a space where you can be yourself. People feel under social pressure to be positive on Facebook. Elefriends shows that there are a lot of people out there who simply need to talk.” (The Guardian)

Historical abuse victims ‘face counselling delay’
Victims of historical sexual abuse are facing long delays in the wait for counselling, a support group has claimed. BBC Wales has learned that the number of people contacting three of the four Welsh police forces with such complaints rose more than 50% between 2011 and 2013. Charities say high profile cases have prompted so many people to come forward with claims of abuse that services to help them are being badly stretched. (BBC News)

 A road to mental health through the kitchen
Many cooks know what a sanctuary the kitchen can be. Now, some health-care clinics and counselors are using cooking or baking as therapy tools for people suffering from depression, anxiety and other mental-health problems.
     The courses are often partly aimed at teaching healthy cooking and eating skills to people living tough, chaotic lives. Counselors say the classes also soothe stress, build self-esteem and curb negative thinking by focusing the mind on following a recipe. Often the courses are part of a larger treatment plan that can also including talk therapy or medication. (Wall Street Journal)
• Meanwhile, a “Shrine Cafe” opens in Tokyo, offering fortune-telling and counseling services with your tea. All of the staff members are professional and fully qualified Shinto priests, counselors, or fortune tellers. (RocketNews24)
 

 

It’s Christmas! Excited? Happy? Full of festive spirit, glad tidings and ding-donging merrily on high? Have you decked the halls with boughs of holly? Or does the whole sorry business make you shudder and want to crawl under the duvet until 2015?
     “Christmas”—by which I mean that holiday period butt-end of the year that also encompasses Hanukkah, Kwanzaa, other denominational time off work, atheist trips to the pub, New Year's Day etc—can be a great celebration; a send off for the year gone by and a welcome to the new. But all too often it’s instead a time of abject misery, a welter of disappointment, a year’s worth of sorrowful Sundays rolled into one. Calls to the Samaritans peak at this time of year (they received over 240,000 during the holiday period in 2013)
     The pressure is on to have a good time. Money is tight. It’s dark and gloomy. If you already feel lonely, as so many people do, at Christmas time the loneliness gets turbocharged. The people we normally rely on—friends, colleagues, therapists—are away. Sometimes it all makes us feel sad. Sometimes it makes us feel murderous: Forget goodwill to all—a kind of infantile jealousy and rage kick in against anyone who is seemingly actually having the exalted “Happy Christmas,” the one that we’re supposed to be having, the one we deserve. Psychoanalysts attribute “Christmas neurosis” to sibling rivalries reawakened by the baby Jesus, or to some sort of Oedipal conflict with Santa Claus (yes, they really think like that).
     We eat too much, we drink too much, and we feel bad. A vague sense of religious guilt seems to descend like a fine mist. Maybe we are not so optimistic about the coming year. We think about a Christmas from a while back, or from many years ago, when we were younger, healthier, and we remember people who are now gone, and it all aches. The losses accumulate; on significant days on the calendar, they seem to get multiplied and amplified. The magical wishes we had from childhood never came true, and this time of year is a keen reminder of those past disappointments, and a harbinger, too, of inevitable frustrations to come. We turn into Scrooge—cynical, alienated, depressed, numb—as a defence against all the pain.
      We get the Christmas blues. Santa Claus isn’t coming to town after all. There are no chestnuts roasting on an open fire. The tiny tots’ eyes are all aglow but only with fury or disappointment because they didn’t like their present—you got the wrong one, or it’s broken already, or it’s lacking batteries or some other vital part is missing. It’s not a white Christmas—it’s grey. Those loud noises you hear aren’t party poppers, or champagne corks, or funny punch lines, but the eruption of family tensions that have simmered all year. (Or worse, they don’t erupt but just carry on simmering in silence.) Your Christmas is a million miles away from the one that’s depicted in all those ads on TV.
      If it could be accepted for whatever it turns out to be this year, Christmas might be OK. A lot of the problems come with the feeling that yours doesn’t quite measure up—and, by extension, you don’t measure up, either. You try and inevitably fail to live up to an idealized, fantasy version of what Christmas “should” be. It “should” be the most wonderful time of the year, bathed in celestial light, warmth and goodness. And while we’re at it, you “should” have done more with your life. Your relationship “should” be different, better, more loving, more alive. You “should” have written a novel by now, made more money, been a better parent, son, daughter, student, employee, neighbour, friend. You should have made a difference. You should have fed the world. Oh yes. How small our grandiosity makes us become. We wallow in our deep and dreamless fog of self-recrimination while above us, unnoticed, the silent stars go by.

6 survival suggestions this Christmas
• Modify your goals, expectations and hopes. Maybe you don’t need all the trimmings this year. Literally and symbolically, if there are too many decorations on the Christmas tree, you can’t even see the Christmas tree or, worse, it buckles and collapses under the weight of expectation. Less can be so much more.
     Years ago, the English child psychologist Donald Winnicott propounded the notion of the “good enough” mother. The guilt of not doing more, not being a perfect mother, not being a goddess offering an ever-flowing fountain of selfless love—it all just gets in the way. As the saying goes, great is the enemy of good. Sometimes, accepting mediocrity is what gives you the space to transcend it. You can’t be extraordinary without first embracing your ordinariness. And so it is with Christmas—and other things in your life. So here’s to a good enough Christmas. And a good enough everything else, too.

• Have the Christmas you want. What would be good for you? There might well be family obligations, duties, expectations that have to be met, but are there also spaces over the holiday period where you can do what you want? Where and when and how are you going to play? Are you going to start or continue your own quirky, individual Christmas traditions that have nothing to do with how it’s all supposed to be? Are you going to do your thing? When Scrooge awakens, transformed, from his dreams on Christmas morning, he is liberated, free, alive, and sets about living his life like an unleashed puppy. Writes Dickens: “He cared not if people laughed at him—his own heart laughed.”

• Look after yourself. It’s a stressful enough time as year as it is—our coping strategies are more important than ever. Yet there’s a tendency over the holidays to stop doing all the normal things that you do to keep healthy and happy. It’s a time of year when we give ourselves permission to relax the normal rules. In Freudian terms, we give our “superego” the rest of the year off, and our normally repressed “id” leaps onto the stage, ready to party. We stay up late eating ice cream, we have red wine for breakfast, we wear really terrible sweaters. We do silly, impulsive, embarrassing things. That’s all fine, well and good—Christmas is indeed playtime. But then sometimes, it suddenly isn’t good, and we feel listless, irritable, bored, apathetic, empty, guilty or anxious. We’ve gone too far; there is psychic indigestion. We need some balance. There’s no need to completely lose control; no need to give the “ego” the rest of the year off, too. Think about the things that make you feel good—a little exercise, perhaps, a good night’s sleep, some healthy food, creativity, some music, meditation, moderation. Don’t abandon them—or you—just because it’s Christmas.

• If things get really bad, seek help. Organisations like the Samaritans and Sane are there for you throughout the holidays. Go to my help page to find details of organizations that offer support.

• Do some giving that doesn’t involve a credit card. Give some of your time, energy and presence to a friend in need, a neighbour, a charity, a crisis centre. Make your Christmas presents instead of buying them, and make them personal. Giving is a massive reward—a gift to you, too. (Trade secret: That’s why people become therapists.)

• Plan your own ascension, renaissance, transformation. Away from Christmas—the loud and drunken parties, the relentless extortions and exhortions to buy things, the epicurean excesses, all the tinselly, frivolous nonsense—there is something else, something eternal, timeless, a kind of immutable wisdom. For some, of course, this has religious significance. For others, it’s all about the Winter Solstice. At this time of year, long before Christmas was invented, people would celebrate Saturnalia, a pagan festival of light—December 25 was said to be the birthday of Invictus, the Sun God. The shortest day is past and a new sun is rising. The days will be getting longer and things will soon start to grow afresh. The world turns. Here, in the quiet and stillness of the dead of winter, when everything is stripped back and bare, we can reflect, plan, and prepare. Sometimes we make a list of new year’s resolutions as a substitute for actually doing them, making changes, taking charge of our life. Maybe this time it will be different. It's a new dawn, it's a new day, it's a new life.