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psychogram #73

12/3/2017

 
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Crackers at Christmas

6/12/2016

 
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One of the tropes of a certain brand of conservative media outlet is that Christmas is under threat. The usual suspects are rounded up: The EU, Muslims, immigrants.

Dame Louise Casey, the government’s “integration tsar,” cited Christmas in a report in September, saying: “I have become convinced that it is only the upholding of our core British laws, cultures, values and traditions that will offer us the route map through the different and complex challenge of creating a cohesive society.”

Laws of the land are one thing; British culture and traditions quite another. For the latter, apparently the “integration tsar” doesn’t believe in integration. Shouldn’t she be called the “assimilation tsar”—or perhaps even the “re-education tsar”?

As Santa Claus might say: Ho ho ho.
• A lot of Christmas traditions, like so much of British culture, came from elsewhere. To name a few: Christmas trees were likely a German idea originally; panto came from the Italian tradition of commedia dell’arte; mulled wine from the Ancient Greeks. The jolly, rotund image of Santa famously began in a 1931 Coca-Cola ad.
• “British values” are often described as religious, Christian values. But for the majority of Britons, Christmas doesn’t have much or anything to do with Christ any more. People of no religion now outnumber Christians in England and Wales, and this year the number of people attending Church of England services each week for the first time dropped below 1 million, accounting for less than 2 percent of the population. Non-Christian Britons are no less British.
• Having some sort of celebration in the dead of winter has long been appealing to many people whether religious or not. It was something people did long before the idea was co-opted by Christianity—and long before any politician uttered the phrase “British values.”
• One longstanding Christmas “tradition” is that for many, it’s a terrible time of year. If you are not living the soft-focus, pastel-hued fantasy life depicted in department store Christmas ads, you feel guilty, a failure, literally and metaphorically missing out on the party. Instead of this being a time of light, warmth, food, gifts, singing, laughing and good company, for many it is instead one of darkness, cold, hunger, loss, silence, tears and loneliness. Clients complain of the stress and expense of Christmas, and the pressure to be happy. The Samaritans volunteers are especially busy at this time of year.

Do it your way
​​Human unhappiness is often caused less by how things are than by a belief in how they “should” be. It turns out that a lot of those boxes we are so busy checking in order to lead what we presuppose will be a full life, with all the trimmings, actually belong to someone else. There is great joy in abandoning them, identifying your own and giving yourself permission to pursue them.
As Ralph Waldo Emerson put it: “To be yourself in a world that is constantly trying to make you something else is the greatest achievement.”

Those who presume to define “British culture” and impose it on people who are free to decide what that means to them can be just as oppressive as their opponents, the hardline advocates of “political correctness gone mad.” The two extremisms travel in opposing directions but meet on the far side of the circle, a rotten compost of fear, intolerance and fascism.

What has become known as “Christmas” doesn’t belong to Christians, the government, the Daily Mail, Facebook or John Lewis. It belongs to culture, the ultimate democracy. It belongs to you. So spend this time however you want to.
Observe it, or not. Make it religious if you want to, or don’t. Call it Christmas, or Yule, or Hanukkah, Kwanzaa, or Saturnalia or something else entirely.

One great British tradition is to flout convention in the name of eccentricity. You want to celebrate by surfing through Canterbury dressed as Santa, or an Elf? Go for it.

Make Christmas yours.
Make your life your own.

May they be whatever you want them to be.
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One great British tradition is to flout convention in the name of eccentricity. You want to celebrate by surfing through Canterbury dressed as Santa, or an Elf? Go for it. © Diana Turner

​Read my 6 Christmas survival suggestions
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The 5 stages of Brexit

14/9/2016

 
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No.5: REUNIFICATION
 
The new client, United Kingdom, shuffles into the room and slumps down uncomfortably in the chair. There is no eye contact. We sit in silence. Finally there is a cough and a muffled voice, a sort of low growl: “Don’t really need to be here. Just been feeling a bit down lately.” Another silence. A tear rolls down from Scotland and lands somewhere near Darlington.

Yes, if countries were people, the UK might be looking for a therapist right about now.

It has been having a hard time of late. It was a summer of discontent. Before the Brexit referendum, this was a largely peaceful, united land that prided itself on never losing its great sense of humour, come what may—the land of Monty Python, Alan Partridge, the Office, Mr Bean. A nation that believed in fair play. A creative, resilient, quirky place that didn’t just tolerate difference and eccentricity but embraced it. The land of Churchill (half American), fish and chips (brought here by Spanish jews), beer (probably middle Eastern), sliced bread (American), England’s St. George (from Cappadocia, never visited our islands), Morris dancing (originally “Moorish”), the Queen (at least a little but German). The country whose two favourite dishes are chicken tikka masala and Chinese stir fry. The country that fought fascism and won.
We used to be mostly in the middle, proud of our patchwork cultural history, a big-tent bell curve of British decency, tea and sympathy.
Post-referendum, the bell curve has been turned on its head. The centre has been vacated, and you’re either jeering from the terraces on the star-spangled blue side, shouting “You idiots—what have you done to our future?” or you’re on the other side, amid a sea of red-and-white-painted faces, chanting “Get over it, we won.” With added swear words from both sides, obviously.
 
The UK is at war with itself. When a person feels like that, in crisis, the old ways of doing things no longer work, and nothing seems to make sense any more. Time to take stock—with the help of a therapist, ideally—turn the spotlight on you and your life and, fortified by knowledge and love, make some changes.

​With a bit of luck, the breakdown turns into a breakthrough.

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The root of the problem
It can be a small thing that triggers such a crisis. Someone inexplicably bursts into tears getting dressed for work, or their boss finds an empty vodka miniature in their desk, or they shout at a little old lady fumbling in the checkout queue, and their world unravels. It of course can be a big thing, too: illness, redundancy, divorce, trauma, bereavement.
The UK’s problem—manifested by the referendum—began as a squabble within the Conservative Party. Since World War Two, there has been a growing chorus of Tory backbenchers—big and small “c” conservatives—who decry the rise of the European Union. They have tended to see Britain in heroic, benighted terms, as a proud, fiercely-independent land, in living memory the supposedly-magnanimous, beating heart of the biggest empire the world has even seen, shining the light of civilisation into the dark corners of the world and teaching them how to play cricket. The idea of being told what to do by the French, or the Germans, was beyond the pale. Who won the war anyhow? These nostalgic, elegiac chords were played at full volume by the likes of Enoch Powell, Margaret Thatcher and ... Nigel Farage.

When traditional Tory voters began to flee to UKIP, the eurosceptic harrumphs turned into howls.

PM and former PR man David Cameron was facing a mutiny. He hoped to quash it by calling the rebels’ bluff. He called for backup; he took it to the nation, gambling his job, career and the nation’s future.
 
The referendum took on a life of its own. It grew. It turned into a referendum on everything.
• Was it about the EU? Yes, although three recent consecutive eurosceptic Conservative Party leaders, William Hague, Iain Duncan Smith and Michael Howard, failed to gain any traction among voters on the issue. And in the immediate aftermath of the vote, an awful lot of people in the UK Googled “What is the EU?”
• Was it about democracy? Yes, although shouldn’t Brexiteers also therefore be tirelessly campaigning to end the monarchy, abolish the House of Lords, the cronyism of the honours system, the influence of the City on domestic policy, and of Washington DC on foreign policy?
• Was it about immigration? Yes, although overall immigrants are net positive contributors to the British economy, and since the days of the Normans, the Saxons, the Danes and the Hugenots, Britain, British culture and British people have been forged from outside influences.
 
Perhaps what the referendum mostly was about was dissatisfaction with the status quo. As with the unfortunate American embrace of Donald Trump, Brexit was a protest vote against hard times and the struggle of life—exacerbated by a government policy of austerity that crippled poorer parts of the nation—with the finger of blame pointing every whichway: at politicians, the EU, immigrants, refugees, Muslims, “experts,” the Establishment, the media, old people, young people, rich people, poor people.

Let’s hope the sunlit uplands of prosperity that the Brexiteers voted for come to pass. Regrettably, however, it seems more likely that there will instead be much more dissatisfaction to come.

Cameron didn’t expect to lose. There was no plan. More than two months later, there seemingly still isn’t. No one seems to know how or when Brexit will happen or what it will look like. But hey, great news: our passports are going to be blue!
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The person in charge of implementing Brexit—the unelected pro-Remain Theresa May—has to get on with it now, directing enormous time and resources to extricating the UK from the EU and disentangling decades of legislation, and trying to set up new trade deals around the world with countries for whom the post-Brexit UK is, according to some, something of a laughing stock, and who are in the strong bargaining positioning of knowing, and knowing that we know, they we need them more than they need us. The PM also has to deal with all the domestic fallout: the possible disintegration of the UK, businesses threatening to make their own Brexit and head to the Continent, a tanking pound, the rise of racism.

We might spend years at the side of the road, wiping all the mud off our weary old boots while other countries sprint by in new hi-tech gear that was probably made in China.
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In the hot seat
The new client, United Kingdom, looks tired, broken, but still proud. It hasn’t been sleeping. It’s been drinking too much. Some mornings it can barely get out of bed. In despairing moments it can scarcely see the point of carrying on.
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Some therapists might spend a few sessions interrogating the hapless client, offering a battery of questionnaires and tasks in hope of arriving at a diagnosis. They would discuss the UK with their supervisor and proffer labels like “depression,” but perhaps also “Narcissistic Personality Disorder” (feel small, act big), or “Antisocial Personality Disorder” (doesn’t play well with others), or schizophrenia (signs of psychosis include delusion and paranoia). Maybe some early indications of dementia.

Such labels can be helpful. They normalize the client’s reality, and provide access to resources, support and other sufferers. But they can also unhelpfully delimit and incorrectly define a client, masking over the subtleties of their unique experience, or else be so broad as to be almost meaningless. One person’s “anxiety” or “bipolar disorder” or “schizophrenia” might be quite different to another’s.

Clients might be living in extremely difficult circumstances, or have relationship problems, or terrible backgrounds. Often they are living at the mercy of a highly problematic interior system of government. Freud’s 1923 “structural model” is useful—he likened the internal conflict between id, ego and super-ego to a legendary 5th century battle between Attila and the Romans and the Visigoths.

For many clients, an internal dictator has taken over. They are stressed, overworked, overcommitted and run ragged by a kind of sergeant major—a relentless, joyless bully who loudly barks criticism of everything about them, in every way; a superego which Freud said “rages against the ego with merciless violence.” Other clients are similarly out of balance in the other direction, at the mercy of their id: their desires, pleasures and passions seemingly cannot be contained.

Freud’s model is simplistic. A useful construct is to think of humans as being made up of a committee multiple “selves”; there are lots of versions of you, each with a seat on the board (including some, from your “shadow,” that you may deny, disown, or project onto others).

Therapy is not simply a process during which a client fires the sergeant major, discovers the inner hippy sitting barefoot on the floor in the lotus position and lives happily ever after. It is in therapy that ALL the parts of ourselves can be safely aired, explored, understood and accepted. No one team member is bigger than the team. The sergeant major and the hippy and all the other players have got to learn to get along and pull together.
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We are able to “feel like one self while being many” as Philip Bromberg writes: “Health is the ability to stand in the spaces between realities without losing any of them.”



​The 5 stages of Brexit

STAGE 1: ALIENATION
STAGE 2: DISCRIMINATION
STAGE 3: MISINFORMATION
STAGE 4: POLARISATION
STAGE 5: REUNIFICATION

Pyrrhic victory

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Meet Pyrrhus, King of Epirus, who inspired the phrase "Pyrrhic Victory"
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Definition: A victory that is offset by staggering losses. King Pyrrhus defeated the Romans at Asculum in BC 279, but lost his best officers and many of his troops. Pyrrhus then said: “Another such victory and we are lost.” 


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​Right vs Left

For countries, the internal battle is not quite id vs. super-ego, but rather left versus right. Which voice should prevail—which is correct?
Attempts to deconstruct voter preference are always problematic. One large study, for instance claims that lower intelligence is more likely to be correlated with prejudice and right-wing voting. Another theory is that voting is determined by your overall worldview. As a species, we are capable of unbelievable kindness, generosity, altruism, creativity, diligence, resilience and love. We also can be very good at being selfish, telling lies, cheating, manipulating and stealing. Because of our individual biology, childhood, life experiences, relationships and education—and probably many other factors—each of us tend to resonate more with one or the other, the good or the bad, trust or mistrust. As a piece of research from the Royal Society puts it: “Greater orientation to aversive stimuli tends to be associated with right-of-centre and greater orientation to appetitive (pleasing) stimuli with left-of-centre political inclinations.”
In very broad terms, this idea claims that the Righties generally want society to be about law and order, border controls, defence spending, monoculturalism, punishment rather than rehabilitation, limited benefits, competition that rewards the “winners.” They look to all that’s good in the past. The Lefties want society to be about caring and sharing, cooperation, equality, diversity, multiculturalism, rehabilitation rather than punishment, a welfare state, redistribution that benefits the underdogs. They look to all that’s good in the future.
The Righties accuse the Lefties if being hopelessly naive, out of touch, idealistic, “soft.” The Lefties accuse the Righties of being greedy, uncompassionate, small-minded, dogmatic, “hard.”
But of course these characterisations are hugely simplistic, as are the caricatures of the Remainers and the Leavers. The former included the young, ethnic minorities, urban lefties and the Scots, but also big business that benefits from cheap labour and free-market fundamentalists. The latter included the working class in disenfranchised former industrial towns, but also wealthy retired traditional county conservatives and a lunatic fringe of far-rightists and racists.
The referendum result does not mean that the Leave position is vindicated and the Remain voice should ever more be silenced. Both voices are vital, ensuring a system of checks and balances. We need both walls and bridges; defence and offence. And both voices are in fact each a vast choir. To be whole, all the voices need to be heard.
 
The way forward
The evolution of national systems of government starts with warring tribes and feudal empires, moves to totalitarian, authoritarian or dictatorial regimes, then onto the 20th century representative democracy of the UK today. But people do not feel represented. Politicians are the least-trusted people in the nation. Brexit at least partially have been a vote of no confidence in the current system. Instead of entrusting politicians to do the right thing, might we herald the birth of a new, fairer social democracy that better involves the populace, and better serves them, too? If there were a referendum about having more referendums, wouldn’t the likely response be a resounding “yes”?
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Consider these points (from an earlier post: Does your government make you happy?):
• The Scandinavian system or “Nordic model” of government features high taxes, a large, well-run welfare state, a high standard of free education and healthcare, and low levels of inequality. The machine works for betterment of the people, not the other way round. (In John Rawls “A Theory of Justice,” he demonstrates through his “original position” experiment that if people don’t know how they will end up in an imaginary society, they will generally opt for a fair, redistributive political and economic system that treats all fairly, maximising the prospects of the least well-off.) The Nordic model is a system that appears to make people happy: Denmark and its close cousin Iceland, plus Norway, Finland, Sweden, and the Netherlands, are all in the top-8 happiest nations in the world. Why isn’t such a superior form of governance the rule rather than the exception? (“Yes,” people say, “but these are countries with small populations and low immigration”—as though water, sunlight and soil were only good for some trees but not others.)
 
• According to the World Happiness Report: “66% of respondents in the Netherlands and 61% in Sweden answered that most people can be trusted, compared with just 35% in the US and 28% in Russia. Moreover, comparing the extent of trust in the 1981-84 sampling period with the recent period, trust rose in Sweden (from 57 to 61%), while it declined in the United States (from 45 to 35%).”
 
• Scandinavian cities tend to do well in the famous “lost wallet” experiments in which full wallets are left lying around to see how many get returned or handed in.
 
• The happiest nation, Switzerland, meanwhile, is the closest state in the world to a direct democracy. There are referendums on town, city, district and national level. They don’t just scrawl an X on a ballot paper once every 5 years. The Swiss really have a say in how their country is run. They are invested in their government, and vice versa.
 
The times they are a’changing. Donald Trump’s fearmongering, xenophobia, and foghorn declarations about the virtues of greed are like the terminal groans and expirations of a witless dinosaur, ignorant of his impending extinction.
 
Whether you are a Leaver or Remainer, Brexit showed that the British are hungry for democracy. We want to be heard. Brexit was a crack in the walls of the house that was built on the old order of patronage, privilege and politics as usual—a crack that lets in the light.

Primitive societies kill people, then evolve to enslaving them, then to giving them the vote. The next stage is to listen to them.

After a few months of hearing all the differing viewpoints and “standing in the spaces” between them, the client, our dear old friend UK, started to feel much better. The therapy came to a natural end. “It’s all about considering all the different views, and being fair,” said Scotland, speaking for the whole person, who now was sitting tall and proud and relaxed. “The more we listen to all the voices, the better we feel.”

The cure for a sick democracy, it turns out, is more democracy.

psychogram #54

1/8/2016

 

via GIPHY

The 5 stages of Brexit

3/7/2016

 
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No. 1: ALIENATION 

All was not well in the Kingdom.
Times were hard. People were angry, a lot of them with good reason. After the global financial crisis and six years of government spending cuts, the age of austerity had sent a chill wind through the hills, valleys and high streets up and down the land. It was bleak, especially in the poorest, most neglected rural areas and forgotten, boarded-up English towns, far from Westminster. Unemployment was low, but zero-hour contract arrangements were increasing, and this green and pleasant land now had 1,000 food banks where previously they were rare. Depending on which study you believe, roughly a sixth, a quarter or a third of Britons were living in poverty. Meanwhile, in an already increasingly unequal nation, the richest 1% were getting ever-richer, ever-faster.
Whose fault was it? It must be someone’s fault?
 
The blame game
Human interaction can be a complicated dance around a “Drama Triangle”—the three points of the triangle are labelled persecutor, victim and rescuer. Where are you on the triangle today? And why? Are you a rescuer? Do you ever become so strident in your complaints on behalf of the victims that you become persecutory? Or do you need to be needed, so you do all that you can for the victim, who is as a result disempowered—a classic codependent relationship? Or are you a victim? Do your demands for help become so unreasonable that you become the persecutor and turn the rescuer into a victim? The roles can change in a second.
Whether within families, between work groups, cultural groups or even between countries, these roles are remarkably fluid and heavily dependent on the eye of the beholder. This was the case in the run-up to the Brexit referendum a week ago as the actors took up their positions on the stage:

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• Is the millionaire politician or tabloid newspaper editor a rescuer who gives the disenfranchised a voice; or a persecutory opportunist who peddles fear and loathing of foreigners?
• Are the eurocrats a sinister cabal of power-hungry persecutors hellbent on annexing the UK, or—for all the EU’s many faults—rescuers who dilligently try to collaborate with their neighbours for the common good?
• What about big business—corporations, the banks, the entrepreneurs? Are they part of the problem, dodging taxes, exploiting workers, buying off politicians, rigging the system in their favour? Or are they rescuers, people who invest, create jobs, generate tax revenue?
• Are the victims Britain’s poor, the disenfranchised, struggling to get by in neglected parts of the country where budget cuts go deepest? Or do some see even them instead as persecutors, a kind of dysfunctional underclass of criminals, perhaps, “benefit scroungers,” or racist thugs?
• And what of migrants? Are they also the downtrodden victims, fleeing economic hardship or violence in their homelands, risking it all to come to the UK to search for a better life for their families? Or are they persecutors—“coming over here, claiming benefits"—and jumping the queue—“stealing our jobs, housing and women," “stealing generally," all while imposing their alien ways on “British culture"?
Something is rotten in the state of old Britannia. Whose fault is it? No one puts their hand up. Instead we point: left, right, up and down. It's obviously those people. No not them, they're good. Yes, those ones—they're really bad. It's all their fault! 
​How can we all have such differing opinions?

Me and my shadow
We like to think we’re fine upstanding citizens, we know how the world works and above all, we are right! There is no uncertainty, and we just don't understand other points of view—those people must be hopelessly naive, or ill-informed, or stupid, or spineless, or selfish. We find evidence that supports our view, listening only to the obviously common sense voices in politics, the media and among friends. Any evidence to the contrary is demonized, derided, ridiculed, ignored or denied. It's easier to see life in black and white.
But is there a voice of doubt? It might be a tiny voice. You can't bear to hear it.
The voice says, no, you're deluding yourself. It's not that simple. There are shades of grey. The voice says: maybe you are wrong. Maybe you are the bad guy.
The stance of your fiercest opponent, your most hated foe, lies within you. Why? Because you are a complete human being. Lurking in what Jung called our shadow are all the unpleasant or unwanted parts of ourselves. We might deny them, repress them, avoid them (or, in therapy, get to know them). But often it’s easier simply to disown them: to package them up and hand them over to someone else saying, “here, this isn’t mine, it must be yours.”
This is the Freudian defence mechanism of projection.
The virulent homophobe for instance might fear his own gay desires. The shaven-headed youth hurling racist abuse at a man on a tram might feel afraid and vulnerable. The man who flirts with a female friend accuses his wife of having an affair.
The city banker with the clever accountant pays little tax; her bugbear is “benefit cheats."

The public school-educated chauffeur-driven politician berates “the establishment.”
The racist newspaper proclaims without irony that eastern Europeans are “deeply racist.”
 
Bridge of hope—or wall of fear?
What we project onto who determines how we vote. If you fear the worst and ascribe bad intentions to others—immigrants and eurocrats, for instance—you might be tempted to vote Leave; if you hope for the best and ascribe them with good intentions, maybe you go for Remain. Of course it is much more complicated than that. But our projections have been fueled by this black and white, yes-no, in-out referendum, and all the associated marketing, campaigning and propaganda on both sides.
The choice has split my country in two. It feels at odds with itself. Since the referendum, old friends and family members have been falling out, hate crime and racial abuse are skyrocketing, and there is a slight air of menace on the streets of London. In therapy, clients talk of their existential anxieties. It feels like the end of the world as we know it.
No one is in charge. There is no plan. Everyone wants to know what will happen next.
There are wildly exaggerated fears of a dystopian future, of our land degenerating into the isolated pariah state of Anglia as portrayed in Julian Barnes' satirical 1998 novel England, England—a country that had “cut its own throat and was lying in the gutter”; where free movement to Europe gets withdrawn, and gunships patrol the Channel intercepting English boat people attempting to flee to France.

There is faith in humanity, though.

At our best, the Drama Triangle gets replaced by a healthier version. Instead of persecuting others you find your true power and use it wisely, for good. Instead of avoiding your troubles by co-opting those of others, you accept responsibility for your life and rescue yourself. Instead of feeling like a victim, you own and express your vulnerability.
​
In Greek mythology, when Pandora’s Box is opened, all the evil spirits are released. One thing is left behind: Hope.
 
NEXT TIME: No. 2. Discrimination

psychogram #41

3/5/2016

 
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Weekly news round-up #41

15/4/2016

 
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​A world of worry
This week saw a new study on global mental health. To no one’s surprise, it turns out that if you are poor, you are less likely to have access to help.

The research, published in Lancet Psychiatry, argues for greater funding, claiming that the economic benefits of treatment greatly outweigh the costs: For every dollar spent on improving treatment for depression and anxiety, the return on the investment could be fourfold or higher in terms of increased productivity and health.
"This analysis sets out, for the first time, a global investment case for a scaled-up response to the massive public health and economic burden of depression and anxiety disorders," write the authors, led by Dan Chisholm of the World Health Organization's Department of Mental Health and Substance Abuse.
 
Almost a third of humans experience common psychological ill-health at some point during their lifetime. The vast majority live in poor countries, but clinical care resources are predominantly found in wealthy countries. Low- and middle-income countries spend less than $2 per year per person on the treatment and prevention of mental ill-health compared with an average of more than $50 in high-income countries.
According to Nature: “A teenager in Afghanistan seeking mental-health care does so in a country that has 1 psychiatrist for every 10 million people, not 1 per 5,000, as in, for instance, Belgium. But no country has sufficient numbers of trained mental-health-service providers. Nearly one-third of the US population lacks adequate access to mental-health-care providers. There are similar shortages in parts of countries as diverse as Australia, Canada, Finland, France, Japan, New Zealand and Slovakia. Even in wealthy countries, 40–60% of people with severe mental disorders do not receive the care they need.”
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Mental health has received very little attention in terms of large-scale global health initiatives compared to say malaria, or HIV. That is slowly changing. There is now some political consensus around mental healthcare, both at home—it was a hot topic in the General Election last year—in America, and transnationally. It’s terrific that as of last September, mental health is now included among the United Nation’s Sustainable Development Goals.
There are some impressive programmes that aim to create a more level playing field. The UK-funded Programme for Improving Mental Health Care (PRIME), for example, is a consortium of organisations brought together to scale up mental-health services in Ethiopia, India, Nepal, South Africa and Uganda, taking an informed, integrative approach in these countries with help from community advisory boards that include district health administrators, service users, traditional healers and police.

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All well and good. But there are questions. Take 5:
1. Is this all window dressing, a token public relations exercise that diverts attention away from the real business of globalisation—making money and preserving power by and for those that already have it?
2. Do the big pharmaceutical companies have a hand on the lever, attempting to create and colonise large new markets for their patented medications?
3. Is the need for some kind of responsible global governance being served by unelected bodies like the World Bank, IMF and WTO which cater to the “prosperous few” at the expense of the “restless many,” in the words of Noam Chomsky, or like the UN’s WHO which, in this latest report at least, likes to regard people as mere economic units?
4. Could global mental health programmes become a form of cultural imperialism and control, as some have argued, trampling over local norms and practices and instead imposing monolithic “one-size-fits-all” western solutions?
5. If you don’t have access to drinking water say, or your children are starving, doesn’t counselling come fairly low down on the hierarchy of needs? The Indian government offers counselling to help farmers, for example--5,650 Indian farmers committed suicide in 2014, an average of 15 a day. But perhaps what they most need is better financial security. And some rain.

​Overall, the growing domestic, international and global attention paid to mental health is a good thing. But the implementation needs to be done the right way. Culturally-sensitive, local, diverse “bottom-up” mental health programmes are better than imposed, dogmatic, uniform, “top-down” western solutions. The book “Global Mental Health” recommends the liberal use of anthropologists and indigenous experts.
And underscoring all initiatives should be a recognition that mental ill-health is often the symptom, and economic disadvantage the cause. Not the other way round.
Whatever your language, it’s good to talk. Every country on earth could use more counsellors.
But it’s hard to pursue happiness, or perhaps Freud’s rather more modest goal of “common unhappiness,” without safety, food and water, and a roof over your head.
No amount of counselling will take away poverty and inequality.
—John Barton
 
 
U.K. NEWS
 
Mental health issues affect 8 out of 10 doctors
New Statesman
 
Doctors have a hard job. Every day they have to deal with difficult, demanding and demeaning people—and that’s just the politicians! No wonder 82 percent of English doctors have had episodes of mental illness:
 
When medical students enter university, their mental health is no different from that of the rest of the population. By the end of their first year, however, it is significantly worse. Stress accumulates throughout their training and, for many, things do not improve. A new study demonstrates what a problem this has become – especially for the doctors involved.
Debbie Cohen and colleagues at Cardiff University carried out a survey of almost 2,000 British doctors at various stages of their career. Of these, 60 per cent had experienced mental illness (the figure is 82 per cent in England) but most had not sought help.
Even the doctors don’t see it coming. In the survey, most medical professionals who have never experienced mental health problems say that they would disclose any problem that arose. But attitudes change when it actually happens. “You don’t do what you think you would do,” Cohen says.
The figures differ according to stage of career. Trainees and junior doctors are less likely to admit to having a problem – perhaps unsurprisingly, given the perception that it may damage their future. Disclosure rates also differ by career track. Among GPs, 84 per cent say that they would disclose; 39 per cent do so. Trainees disclose at the same rate as GPs but are more aware that they won’t: only 62 per cent say that they would disclose a mental illness. Locums and specialist staff are the least deluded and the least open: they acknowledge the lowest likelihood of disclosure (60 per cent) and they follow through, with 38 per cent making a disclosure of an issue.
 
• Mental health patients wait 'years' for treatment (BBC News)
• Trafficking victims in Britain suffer mental health problems (NewsDaily)
• Tragedy as nine young people died while patients in mental health units (Mirror.co.uk)

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U.S.A. NEWS
 
NY Jets wide receiver Brandon Marshall envisions AI bringing mental health to the masses
TechCrunch
 
New York Jets wide receiver Brandon Marshall paid a visit to Silicon Valley this week to explore opportunities and potential partnerships with tech companies around mental health issues. Part of the reason for his visit was because, in 2011, Marshall was diagnosed with borderline personality disorder. He spent three months in an outpatient program and now recognizes that what he went through wasn’t unique.
“They’re universal issues — things we go through just as young adults trying to find ourselves and navigate through the world and with all of the stresses and challenges,” Marshall told me. 
Since his diagnosis, Marshall has wanted to use his celebrity status to raise awareness about mental health issues, which are still, unfortunately, stigmatized in our society. That’s ultimately the impetus for Project 375, co-founded by Marshall and his wife, Michi Marshall. With Project 375, the goal is to raise awareness around mental health issues — something one in five adults in America experienced last year, according to the U.S. Department of Health & Human Services.
“I always say, football is my platform, not my purpose,” Marshall said. “There’s a unique opportunity where there’s 100 million avid football fans that I can speak to and talk to every single day because they follow football.”
 
 
WORLD NEWS
 
• Spiritual counseling at Turkish hospitals addresses patients' emotional needs (Daily Sabah)
• Challenges that African cultural beliefs poses to mental health (GhanaWeb)
 
 
VIEWPOINTS
 
Must a mental illness be revealed on a first date?
By “The Ethicist”—Kwame Anthony Appiah, The New York Times
 
When you grow close to another person, the unspoken covenant is that you’re not holding back a big, relationship-relevant secret. Unless you’ve said so, the assumption is that you’re not the princess of Ruritania, or living under witness protection, or struggling with a serious illness. Intimacy and candor have to be calibrated to some degree. One risk is that someone pulls away at once because he can’t deal with your history of mental illness, but another is that he pulls away later because you haven’t been honest.

Happiest days of your life?

9/4/2016

 
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There was a time when young children were allowed to be children.

​Primary school was about learning how to play, have fun and make friends. Happy children are more likely to learn and make the world a better place than unhappy ones.
Childhood hasn’t been cancelled exactly, but it is under extreme attack, as I’ve written before (“Suffer little children”). Today's subjects: stress, self-harm, suicide.

​This week saw the launch of a campaign for universal access to school-based counselling services.
Reports the story in Schools Week: “A motion being put to the Association of Teachers and Lecturers’ annual conference in Liverpool, which calls for better promotion of mental health awareness in schools and a campaign for all pupils in England to have access to a counsellor, is expected to pass with the backing of the union’s leadership.”

There is certainly a need:
• One in five children have symptoms of depression and almost a third of the 16-25-year-olds surveyed had thought about or attempted suicide. In Ireland, children as young as five are thinking of suicide.
• A World Health Organisation survey in 2014 revealed a fifth of 15-year-olds in England said they had self-harmed over the previous year.
• An ATL union survey of its own members revealed that 48 per cent of respondents had pupils who had self-harmed, and 20 per cent knew pupils who had attempted suicide “because of the pressure they are under”.
General secretary Mary Bousted said it was “horrifying” that so many young people many are self-harming and contemplating suicide.

Increase paperwork until standards improve!
There is more testing, more homework, and it starts earlier. (Homework for 5-year-olds? Really?). Teachers are overworked and underappreciated (and underpaid), frantically trying to get results, write up reports, check all the boxes and generally enact the latest keep-up-with-China government initiative, all set against a backdrop of cuts in funding and services and in many cases financial hardship at home. The creative, nurturing, qualitative skill of teaching has been turned into a bureaucratic, morale-sapping, quantitative exercise in stress, low-grade trauma and Ofsted reports, one that kills joy in the classroom, erodes resilience and is creating a whole new generation of children who as adults will be susceptible to mental and physical ill-health.
There are roughly 200 governments around the world—200 education policies (or lack thereof), 200 places to look for examples of good ideas and bad ones, 200 petri dishes.
Why fawn over China—do we really want to look to an undemocratic communist government with a terrible human rights record for child-rearing tips? How about looking instead to the more relaxed approach of the Scandinavian countries, especially Finland, where education is free, safe and friendly, school starts at age 7, teachers are allowed to teach, and children are allowed to be children rather than treated as future economic units. Finland’s less-is-more education system has been described as the best in the world.

Mental-health difficulties are the leading causes of disability worldwide—almost a third of people globally will experience mood, anxiety or substance-use problems in their lifetime. The best antidote is a happy childhood.

​As noted philosopher Whitney Houston put it:
I believe the children are our future
Teach them well and let them lead the way
Show them all the beauty they possess inside
Give them a sense of pride 
 
--John Barton

Weather report: notes on being happy

8/2/2016

 
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​Forecast: Unexpected outbreaks of sunny spells in remote Scottish islands. Fair becoming good in Cornwall. Unending downpours in Liverpool and London.
 
The Office of National Statistics last week released its figures on the state of the nation’s emotional weather: happiness, anxiety, life satisfaction and how worthwhile life seems. It’s the culmination of three years of data collection.
 
The highlights
• Liverpool and Wolverhampton are supposedly the unhappiest places in Britain (average happiness scores of 6.96 and 6.99 out of 10)
Wolverhampton also has the second-lowest “life satisfaction” score. The lowest life satisfaction—where life is also ranked the least “worthwhile”—is in Harlow, just off the M11 in Essex, famous for being the site of Britain’s first modern residential tower block and first pedestrian precinct.
 
• Derry and Strabane in Northern Ireland have the highest levels of anxiety in the U.K. with a score of 3.73 out of 10, closely followed by and Belfast, Liverpool and a string of London boroughs
Northern Ireland is however the happiest part of the U.K, followed by Scotland, Wales and England. Is it possible to be anxious and happy? It is. Chesterton wrote of the Irish: “All their wars are merry / And all their songs are sad.”
And the converse is true also: you can be free of stress yet really miserable—unhappy Wolverhampton has the lowest levels of anxiety in all of Britain (1.95 out of 10). This perhaps suggests that trying to eliminate stress from your life in order to be happier may not work—you may just get depressed instead. People who achieve their dream of early retirement often make this confounding discovery: six months down the road they are bored and fed up. A certain amount of stress sharpens the focus, motivates people, boosts the heart and immune system—it enlivens. Too much of the wrong kind for too long, however—you get fried rather than fired up. This is the principle of hormesis—a little bit of hardship is good. In one experiment, mice that were given a small dose of poison outlived those who were given none. We are drawn to our cities not in spite of their stressful demands but because of them.
 
• Top of the happiness table—and the “life satisfaction” and “worthwhile” rankings, too—is Eilean Siar: the Outer Hebrides
The sample sizes for various remote Scottish islands were too small to be statistically significant, yet places like the Hebrides, Shetland and Orkney consistently crowd the opposite ends of these kinds of rankings from the likes of Liverpool, Wolverhampton and London.
The Eilean Siar tourism website says: “This is a lively and challenging place. It’s a place where community matters...The sheer diversity of the landscape is remarkable. Endless machairs and dunes. Mountains and stunning beaches. Vast expanses of moor and lochs. Vertical sea cliffs and stacks... Little wonder that visitors to our islands are enchanted by what they find here.”
Where incidentally should you be living? The BBC has devised a quick personality test which tells you where in Britain you would be happiest, and where you would be least happy. It’s nonsense of course but fun. You can take the test here. I was advised to move to somewhere called Craven, and to avoid at all costs relocating to somewhere called Spelthorne, where I could expect a life satisfaction score of only 32 percent, whatever that means.

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​• Women are slightly happier than men (7.41 versus 7.35)
Women are also almost twice as likely to seek psychological help than men, who are conditioned instead to do a Clint Eastwood impersonation if ever they feel anxious or sad. Men are more than three times as likely than women in the U.K. to be alcohol-dependent, or commit suicide. Plus, women in the U.K. live on average four years longer than men. The debate about gender equality quite rightly focuses on gross injustices in terms of violence and sexual violence, pay, political and corporate power, and cultural representation, but those four lost years—four summers, birthdays, anniversaries; a thousand nights to sleep perchance to dream—rarely warrant a mention.
 
• Married people are happier than singletons (7.67 versus 7.11); the divorced or separated are the least happy (6.89)
Does marriage make you happy—or are happy people more likely to get married? A review of the literature from the National Bureau of Economic Research claims that there really is a cause-and-effect relationship between marriage and happiness. Marry, live happily ever after, right?
The authors of the report suggest that this is especially true if you marry someone who, you know, you actually like: “We explore friendship as a mechanism which could help explain a causal relationship between marriage and life satisfaction, and find that well-being effects of marriage are about twice as large for those whose spouse is also their best friend.”
On the other hand, marriage is the source of much misery for many. Untold sleepless nights lie behind the fact that 42 percent of marriages end in divorce in the U.K. There is some old evidence that marriage is good for men and bad for women. There is other evidence that nowadays the happiness boost from marriage is identical for both genders—feminism has redefined married life.
For all its ups and downs, imperfections and frustrations, marriage for most is better than the modern-day scourge of loneliness. Humans need other humans as much as they need food and water.
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​• Life satisfaction and happiness on average are lowest in the 45-59-year-old age bracket; Those aged 65-79 tended to report the highest levels of well-being
This is in accord with the “U-bend of happiness” pattern across the lifespan, which I have written about before: one day you find yourself trapped in an unsatisfying job, marriage or town, struggling to pay the bills, stressed, sandwiched between looking after your kids and looking after your parents. You are miserable. You are at the bottom of the U-bend. “And you may ask yourself,” as the Talking Heads song goes, “how did I get here?” One study of happiness data in 72 countries reported that the global average bottom of the U-bend is 46 years old (though this of course masks enormous variety and individual differences). But then, after a midlife crisis or two, things get better.
Midlife is an opportunity to return to the changing room, review what went wrong in the first half of the match, chat with coaches, colleagues and counsellors, attend to any bruises, fortify yourself and then, renewed, refreshed and utterly changed, charge back out into the pitch for the second half. You might play a quite different game until the final whistle.
 
• The employed are quite a bit happier than the unemployed (7.42 versus 6.89)
This is hardly surprising—so much unhappiness is dictated by socioeconomic misfortune. Western governments tend to blame the poor and the unwell for their fate so as to divert attention away from their own policies that maintain poverty and inequality. Corporate happiness is top of the agenda. If you’re a divorced, unemployed, middle-aged man in Liverpool, with your dreams tossed and blown, it would be insulting in the extreme to suggest happiness can be achieved with a few sessions of CBT. It’s not his thoughts that need changing so much as his economic environment. The happiest countries, of course, are egalitarian, truly democratic and with high levels of social capital.
 
• The happiest religion is Hindu, followed by Christian, Sikh, Buddhist, Jewish and Muslim (the happiest ethnicity is Indian; the least happy is “Gypsy / Traveller / Irish Traveller”). People with no religion are the least happy.
A conviction that you’ve been pencilled in for a good karmic afterlife or a place in heaven probably does make a lot of people quite happy. Atheists might regard such believers as deluded, cocooned in blissful ignorance. In the film “The Truman Show,” Jim Carrey would have stayed blissfully happy if he’d never discovered he was living in an entirely artificial town—an unwitting pawn in a reality TV show. Buddha became very unhappy when he left the palace to discover a world beyond the confines of his walls of privilege—a world that included poverty, illness and suffering—but thank goodness he did or the valuable philosophy, art and culture of Buddhism wouldn’t have happened. The First Noble Truth of Buddhism is not that life is about happiness. It is that life is suffering.
 
Questions for you
What to make of all this?
Is it meaningless—just an example of “lies, damn lies, statistics”—and, worse still, happiness statistics? Or is this an opportunity to take stock and maybe make some changes? How happy are you—how “worthwhile” is your life? Do you have good stress to contend with, or bad? If your new year’s resolutions didn’t work out, should you come up with new ones today, the first day of the Chinese New Year?
Should you marry your best friend, join the Hare Krishna, move to Stornaway and find a job? Or stay exactly where you are but change your attitude—turn your own personal Wolverhampton into some kind of heaven on earth?
Should you talk things through with a therapist?
Maybe you will, maybe you won’t. Maybe you’ll live the life you imagined, or maybe your dreams will forever elude you. Maybe it doesn’t matter. Your glass is neither half empty or half full.
The existentialists believe life is not about the pursuit of happiness. It is the pursuit of itself—to live to the full. Nietzsche famously argued that “god is dead”—there is no heaven, no afterlife, so you might as well throw caution to the wind and live intensely, making brave choices, feeling deeply, fully present, right here, right now.
Get to grips with the ups and downs, advise 
Echo & The Bunnymen, "because there's nothing in between." Or as Anaïs Nin wrote: "I must be a mermaid ... I have no fear of depths and a great fear of shallow living."

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Loneliness among young women

8/11/2015

 
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I've written about loneliness before. Britain is the loneliness capital of Europe. Five million Brits have no friends. Nearly 30 percent of households in the U.K. now consist of one person. This has been called the “Age of Loneliness.” We’ve become an alien-nation, isolated from each other—and our own selves. The cup of human kindness is empty.
​

The December issue of Marie Claire has an article about loneliness—including some quotes and thoughts from me—in which writer Anna Moore makes the case that it is young women who are feeling the awful ache of isolation the most. “We associate this condition with the housebound elderly," she writes, “yet, in fact, the younger you are, the more likely you are to feel lonely—53 percent of the 18-34 age group compared to 32 percent of those over 55, according to the Mental Health Foundation. And, though women may seem so much better at friendships and intimacy, we're actually more likely to feel lonely than men are."

Are you lonesome tonight? You can read my 3-point plan for overcoming loneliness on the Harley Therapy site here: How to Overcome Loneliness.

The 3 steps in brief are: 

1. Get to know your loneliness; 
2. Get to know you;
3. Get to know other people.

You don't have to go through the process alone. To find a therapist click here or to enquire about an appointment with me, leave a message at 0207-724-3075 or email me at: help@johnbartontherapy.com.

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The most terrible poverty is loneliness, and the feeling of being unloved”
— Mother Teresa

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If you're lonely when you're alone, you're in bad company” 
―Jean-Paul Sartre

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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.

JOHN BARTON IS A COUNSELLOR, BLOGGER AND WRITER WITH A PRIVATE PRACTICE IN MARYLEBONE, CENTRAL LONDON
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