Inauguration Day USA.
The time has come for the 45th president, Donald Trump, to take the oath of office. The property developer and reality TV host is one of the richest people in the world and, at 70, the oldest president to be elected.

​But what do we really know about the man beyond the biographical facts and his rather cartoonish public image?
Underneath all the bluster, self-promotion and insatiable hunger for power, wealth and women, is there a sensitive, damaged soul? A conscience? An inner life? Or just the sound of a chill wind whistling through empty, dark chambers of the Trump machine, bereft of emotion, spirit, light or love?
Who is Donald Trump?
What is his psychology?
 
Narcissistic personality
Three prominent American psychiatrists wrote to president Obama in late November stating that Trump suffered from Narcissistic Personality Disorder and was thus unfit for office.
“Professional standards do not permit us to venture a diagnosis for a public figure whom we have not evaluated personally,” stated the letter, which was made public. “Nevertheless, his widely reported symptoms of mental instability — including grandiosity, impulsivity, hypersensitivity to slights or criticism, and an apparent inability to distinguish between fantasy and reality — lead us to question his fitness for the immense responsibilities of the office.”

The diagnosis of NPD—also the conclusion of five therapists in a story in Vanity Fair—is summarised by the industry standard reference book, The Diagnostic and Statistical Manual of Mental Disorders (DSM), as: “A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
3. Believe that he or she is “special” and unique and can only be understood by, or should associate with other special or high-status people (or institutions)
4. Requires excessive admiration
5. Has a sense of entitlement
6. Is interpersonally exploitative
7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
8. Is often envious of others or believes that others are envious of him or her.
9. Shows arrogant, haughty behaviors or attitudes.”
 
Worse than Hitler
Others have meanwhile diagnosed Trump as a psychopath. One Oxford professor used a psychometric scale to conclude that Trump is more of a psychopath than Hitler.
Psychopaths, which I have written about previously, are usually not chainsaw-wielding serial killers but are instead the kind of driven, high-functioning, succeed-at-any-cost characters who can be found in all walks of life. In his 1993 book Without Conscience: The Disturbing World of the Psychopaths Among Us, Robert Hare estimated there were at least 2 million psychopaths in North America, and by that measure there are likely 400,000 in the UK.
Hare identified 20 characteristics of psychopaths that are used in his diagnostic test, the Psychopathy Checklist-Revised (PCL-R), such as: Glibness/superficial charm; Grandiose sense of self-worth; Pathological lying; Cunning/manipulative; Lack of remorse or guilt; Shallow emotions; Callousness/lack of empathy; Failure to accept responsibility for own actions; Need for stimulation/proneness to boredom; Impulsivity; Early behaviour problems; Promiscuous sexual behaviour. (Take this quiz if you want to find out your level of psychopathy.)
Psychopathy isn’t a recognised disorder in the DSM—it only gets a brief mention in the description of Antisocial Personality Disorder.” ASP is defined as “a pervasive pattern of disregard for and violation of the rights of others” and includes ego-centrism; self-esteem derived from personal gain, power, or pleasure; goal-setting based on personal gratification; lack of empathy, incapacty for intimacy; manipulativeness; deceit; callousness; hostility;  disinhibition. Criminal activity is also among its diagnostic indicators (eg. “Failure to conform to social norms with respect to lawful behaviors”).
 
I have met Trump on more than one occasion and in 2014 interviewed him for an hour and a half in his Fifth Avenue Trump Tower office for the American magazine Golf Digest (you can read it here). So as a qualified psychotherapist, what’s my professional opinion: NPD? Or ASP?
Neither.
Why?

Firstly, there’s the American Psychiatric Association’s “Goldwater Rule” which stipulates that its members should not make a diagnosis of someone who they have not examined face-to-face; nor should they publicly discuss the mental health of anyone without their consent.
The rule takes its name from the 1964 election, when Fact magazine reported psychiatrists’ opinions—not “facts”—about the mental health of the Republican nominee Barry Goldwater, describing him as “warped,” “narcissistic,” “impulsive,” a “paranoid schizophrenic,” with much condemnatory armchair speculation as to his psychobiography, motivation and overall mental health. Goldwater lost the presidency but won a lawsuit against Fact for libel.

Many practitioners have broken the Goldwater Rule—desperate times apparently call for desperate measures. And there is no explicit equivalent of the rule to be found among the ethical guidelines of British psychotherapy professional bodies like the UKCP and BACP. But mental health professionals’ urge to diagnose public figures from afar is to be resisted. Anyone is free to have an opinion about a public official and express it, within the bounds of libel law--calling someone for instance a lying, power and money-hungry sexist racist bigot. But using your professional position to label any human being—yes, Trump is human—with a specific clinical diagnosis without their input and consent is an an act of violence to that person and to the absolutely vital notion of confidentiality which underlies the profession.

For me, however, a bigger concern with branding Trump as an NPD or an ASP is with the validity of such diagnostic labels.
There is an obsession in western psychiatry with attempting to apply a medical model to mental health, as if all psychological distress can be divided up into a textbook of discrete, objectively-measurable, uniform conditions, as if terms like “depressed” or “schizophrenic” or “narcissist” were something more than broad adjectives that mask vast individual differences, experiences and meanings.
This return to a reductive conception of mental illness has been driven by political and economic forces. There is much commerce in pathologising aspects of the human experience that are deemed problematic, itemising them according to their supposedly reliable patterns of symptoms, ascribing biological causes to those symptoms, then prescribing drugs which promise to reduce or eradicate them.
The DSM is a kind of license to medicate. By 2005 for instance, facilitated by enormous amounts of sponsored “research” and marketing, one in 10 Americans had a prescription for an antidepressant. “Shyness” is now considered an unacceptable sickness. The diagnosis of “bipolar” has risen by 4,000 percent since the mid-1990s.
This is not to say that mental illness is a myth, a mere social construction, a form of political control, as the “antipsychiatrists” like Laing and Szasz claimed.
Nor is it to say that there is no place for medications and biological considerations of the psychological, or that the DSM has no value—it does provide a framework and a language; a shorthand that facilitates communication among colleagues, and clues about treatment direction.

But to pretend that there is such a uniform, distinct condition like NPD or ASP that descends on the unwitting, passive recipient as might measles or tuberculosis, is ridiculous. Our psychology affects how we live our lives, and how we live our lives affects our psychology, leading to an infinite branching of the tree of function and dysfunction. The complexity of humans and the diversity of their distresses defy neat pigeonholing.

So what can we say about Trump?
The most accurate “diagnosis” of the new president is that he has a very extreme case of being Donald Trump. Society has richly rewarded him for that. He represents a kind of extrapolation of the laws of the jungle, a quintessence of capitalism, where there is no place for doubt or indecision or self-reflection; no let up. Like a hungry shark, Trump is always swimming, alone, and everything else in the ocean is viewed solely in terms of opportunity and threat. In his get-rich, self-help, self-homage book Think Big, he writes: “The world is a vicious and brutal place. We think we’re civilised. In truth, it’s a cruel world and people are ruthless. They act nice to your face, but underneath they’re out to kill you.” 

A psychologist in the magazine The Atlantic last year concluded: “It is always Donald Trump playing Donald Trump, fighting to win, but never knowing why.”

New Yorker writer Mark Singer memorably described Trump’s life as “an existence unmolested by the rumbling of a soul.”

In my interview with him, I concluded by asking Trump if there was ever a pause in the relentless self-promotion and salesmanship:
Q: Does it ever stop? Do you ever switch off?
A: Um, probably, but... not too often.
Trump looks puzzled, as if this notion had never occurred to him. He laughs.
Q: Yeah.
A: I don't know.
Q: What would happen if you did?
A: I don't know. It might be a disaster. I think it could be a disaster.

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.

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.

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!
​
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.
​

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.

No. 4: POLARISATION
 
The nation is feverish. It is infected with a new plague—the first recorded case of Brexitosis.
 
Before the affliction, Britain was a largely peaceable nation. If they thought about the European Union at all, most Brits could probably agree that it was a bit meddlesome. And who were these people anyway? Yes—bossy, interfering, undemocratic and in need of reform. A union with you Europeans, fine, but we’d rather not have an “ever-closer union” thank you very much. We’ll shake hands with you, our neighbours, but no hugging or kissing if you please. What’s that you say? You’d like us to give up our 12-centuries-old currency for the brightly-coloured banknotes of the Euro? Gosh is that the time? We really must be going. Awfully nice to see you!
 
But then, suddenly, the supposed British tolerance and reserve were reversed. In an attempt to quell an uprising in the backbenches of the Conservative Party, David Cameron’s call-my-bluff referendum happened. A complex issue was reduced to an in-or-out, yes-or-no, old-Etonian-Dave-or-Old-Etonian-Boris choice and served up to nation of people starved of a voice. And how we all shouted! The veneer of politeness was stripped away, and long dormant furies and humiliations and aggressions were unleashed. Living rooms, public places and internet forums burned with acidic invective.

Britain started to be at war with itself. Its very name—the “United” Kingdom—came to sound ironic. We were no longer one people but two. We retreated from each other, to opposite corners of the ring. Leavers vs Remainers is a fight that took on a tribal quality, akin to Cavaliers vs Roundheads, Mods vs Rockers, United vs City.
 
The Remainers portrayed the Leavers as all kinds of things, but mostly as a bunch of stupid and/or old racists.
The Leavers characterised the Remainers as all kinds of things, too, but mostly as a naive, deluded, out-of-touch or uncaring urban elite that looked down on the working class.

Simultaneously, the Remainers suddenly cast aside any prior reservations about the EU and anointed Jean-Claude Juncker as some kind of beatified visionary. For the Leavers, the EU was no longer a mere bumbling bureaucracy but a sinister, power-crazed, fascistic regime.
 
The media stuck to their predictable, flame-fanning “we-good-they-bad” scripts.
Stories about the rise in racist attacks across the country after the vote, or the Brexit voters who regretted their choice, or the parallels between Brexit voters and Donald Trump supporters across the Atlantic seemed to further the redneck stereotype.
On the other side, one typical pro-Leave column described Remainers as “rich, metropolitan types” who “fear for their second homes in Tuscany and the south of France” and “fear they might no longer get dirt-cheap nannies and au pairs from Eastern Europe.”

​On a recent Sunday, two consecutive stories appeared on a Facebook news feed on my phone:
• “Britain just got its first concrete sign that Brexit will destroy the economy” (Independent)
• “IMF 'clowns' forced to admit Britain’s economy is GROWING despite predicting Brexit doom” (Sunday Express)
In the tabloid world, what Nietzsche wrote in 1887 is true: “It is precisely facts that do not exist, only interpretations.”
 
Research and polls generally suggested that these factors tended to correlate more with a Leave vote: being older, less educated, unemployed or retired, white, English or Welsh.
And these factors tended to correlate more with a Remain vote: being young, educated, employed, not white, Scottish or Irish.
 
But these are very loose, broad brushstrokes and anyway, as we know, correlation is not the same as causality. (There are innumerable absurd examples of this; there is for instance a very strong correlation between margarine use and divorce in Maine, or US highway fatalities and the volume of lemons imported from Mexico.)
But the need to stereotype “the other”—the enemy—is strong. When I wrote on the World of Therapy Facebook page that people who voted Leave aren't any one type; nor are people who voted Remain, one person responded: “We ARE two different groups of people. WE, are Patriots and believe in democracy. Whereas remainers are a bunch of bitter and twisted, racist traitors who don't believe in democracy. We don't need a discussion because we've had it and we won. So suck it up buttercup WE ARE OUT.”
 
Whose side are you on?
Human life falls neatly into binaries: male or female, night or day, yin or yang, good or evil, yes or no, here or there, this or that, crunchy peanut butter or smooth.
Philosophers through the ages have extolled progress through the resolution of two conflicting ideas. Dialectic exchange, or Hegel’s thesis-antithesis-synthesis model, goes something like this:
Person 1: “I think X.”
Person 2: “Oh yeah? Well, I think the exact opposite. I think Y.”
Person 1: “Y? You’ve got to be kidding me!”
Person 2: “Are you calling me a Nazi?”
After a debate—or the building of walls, invading countries, ethnic cleansing, war—A and B find a way to integrate and resolve their positions: They agree on Z!
Person 1: “Yes of course—Z. It seems so obvious now.”
Person 2: “Remember when we used to fight about X and Y?”
Person 1: “It seems so silly now!”
Person 3: “Excuse me, I couldn’t help but overhear you talking about Z. Have you ever considered A instead?”
Persons 1 and 2: “Oh f*** off!”
 
How do we make choices? Why do some people gravitate to X while others fall for Y?
Humans like to regard themselves as rational and logical, able to make conscious optimal choices. In practice, however, we are often more like wild animals. Heidegger said we discover our intentions through our actions rather than the other way round, and neuroscientific studies have reinforced that. Our first response to situations often is an immediate, unconscious, emotional one, occurring in a part of the brain called the amygdala—two little almond-shaped lumps that play a key role in the animal/mammalian brain. The human, thinking part, the cerebral cortex, then quickly has to come up with a rationalisation, like a PR manager left to explain why his rock star client trashed the hotel room. Neuroboffin Antonio Damasio says: “We are always hopelessly late for consciousness.”
There have been some lovely experiments to illustrate how we retrofit our thoughts to accommodate or justify our inexplicable actions. In Festinger and Carlsmith’s 1959 research project, people were made to do a really boring task, then for a very small fee invited to lie about how interesting it was to new recruits—they happily did so. Surely they weren’t the kind of people that could be bought so easily; to resolve their “cognitive dissonance” they decided the task had actually been quite interesting after all.
To be at the mercy of the immediate, instinctive gut reaction—the emotional traffic light—is often to make irrational, definitive, ill-considered responses. Sometimes they can work in our favour. But sometimes not. By the time the cerebral cortex arrives on the scene, the damage might have already been done: you’ve tipped the salad bowl over the nasty lady’s head or run a red light or signed up for the pointless extended warranty scheme. Ideally the grey matter sketches in some shades of grey before it’s too late, allowing for more tempered, nuanced responses.
That primal, visceral first impression allows us to make snap judgments and decisions, navigate a complex world, and stave off the unbearable uncertainty of our existence. It can powerfully bind us—to a religion, a political party, a celebrity, a brand. It is not generally diminished by reason or logic. It can be a kind of love. It can also be a kind of hate for “the other.” Hate at first sight.
Christopher Hitchens, who saw all religions as incapable of standing up to any kind of rational scrutiny, wrote in “Letters to a Young Contrarian”: “It will very often be found that people are highly attached to illusions or prejudices, and are not just the sullen victims of dogma or orthodoxy. If you have ever argued with a religious devotee, for example, you will have noticed that his self-esteem and pride are involved in the dispute and that you are asking him to give up something more than a point in argument. The same is true of visceral patriots, and admirers of monarchy and aristocracy. Allegiance is a powerful force in human affairs; it will not do to treat someone as a mental serf if he is convinced that his thralldom is honorable and voluntary.”

Western foreign policy since World War Two has a pretty dismal track record, dropping bombs on dozens of countries, invading distant lands overtly and covertly, doing deals with dictators one minute then demonising them the next--embracing Saddam Hussein, say, or calling Nelson Mandela a terrorist—buying or selling arms or anything else to or from practically anyone or doing or saying practically anything if it serves the dollar, with very little regard to decency or morality or honesty.
It’s not clear if this quote attributed to wartime US president Franklin Delano Roosevelt about the Nicaraguan dictator Anastasia Samoza was ever actually uttered, but it sums up American foreign policy: “He may be a son of a bitch, but he’s our son of a bitch.” And Britain blindly follows America in its misadventures, as the Chilcot report showed, with a few notable exceptions like Vietnam (thank you Harold Wilson).
People who write books or publish newspapers or lead political or religious movements that promote xenophobia and division, often invoking as inevitable a “clash of civilizations”—eg. in Somalia, Rwanda and the former Yugoslavia—are guilty of inciting violence and hatred and are responsible for much suffering. Can’t we give these eighth century, eight-year-old you’re-an-infidel/barbarian-no-I’m-not-you-are arguments the contempt they deserve? Are the Scots and the English suddenly to remember, I don’t know, the Battle of Flodden? And take up arms again?
This war of words has been going on between Muslims and Europeans ever since they first came into contact, in 732, each side denouncing the other as a means of justifying exclusion, discrimination and attack. Edward Said calls this “Orientalism,” a system of thought by which dominant powers establish versions of “knowledge” and “truth” about both themselves and those over whom they wish to exert power, creating a “drastically polarized geography dividing the world into two unequal parts.” The West and “the Orient” are constructed in the West as polar opposites, the former as rational, developed, humane and superior, the latter, a monolithic, homogenous “other”—barbaric, inferior, backward, aberrant, unchanging. The “other” is to be feared, contained, controlled or destroyed.

Western Islamophobes like to cite barbaric bits of the Quran as “evidence” of some kind of inherent barbarism despite their own religion’s sacred texts being filled with equally primitive imperatives that are just as comically irrelevant to today. In Britain, Christians often assert “Christian values”—these presumably no longer include a biblical call to cut off people’s hands or stone people to death or otherwise punish people who work on a Sunday, or have sex with someone they’re not married to, or have parents who aren’t married, or who are women who have had sex, or who talk in church, or defend their husbands, or who actually are just women, or people who are gay or disabled or who masturbate or eat bacon.
Those who regard ”Muslims”—1.6 billion people, almost a quarter of humanity—as a fixed, homogenous, united group of people who speak with one voice or think with one mind, need to get out more.
​As the saying goes, blaming all Muslims for appalling acts of terrorism by Islamic extremists is like blaming all musicians for Kanye West.
It’s frightening how easily people can buy into loud, simplistic, aggressive, finger-pointing explanations as to why life is hard, especially when the finger points down, to the powerless, rather than up, to the powerful.
The best response to trumped up men—it is usually men—who try to peddle fear and xenophobia, whether they are a US president-to-be, a zealot with a cellphone and a megaphone, or the racist next door, is to hold up your hand and say, no, I disagree, I believe you are mistaken.
Carl Jung said that when we identify with one end of a continuum, we project the other end: I am good, right, well; you are bad, wrong, ill. But the bad bits are in us too. They are our shadow. The shadow keeps us grounded.
 
What happens next?
There are four possible outcomes in a conflict characterized by polarised postions, according to Wood and Petriglieri in “Transcending Polarization: Beyond Binary Thinking”:
1) a complete split or dissociation of the opposing positions, that is, the end of a connection or relationship;
2) a complete overcoming of the opposition, essentially, annihilation of one position by the other;
3) the possibility that no significant change takes place and the positions remain in a more or less stable relationship of continued strife;
4) synthesis, which is identical to neither of the two original conflicting positions but emerges from the tension and includes elements from both.
 
How will the Leavers and Remainers ever be friends again? Is there a cure for Brexitosis? Will the patient recover?
 
NEXT TIME: No. 5: Reunification

No. 3. MISINFORMATION
 
The EU referendum campaigns were marked by a catalogue of fibs, porkies and whoppers.

On the Leave side (“Take Back Control”), campaigners promised that the £350 million a week that the UK supposedly paid the EU would go instead to the NHS (it was even emblazoned on the side of their tour bus); that the divorce from the EU would be swift and painless; that we could still set up better trade deals with EU nations while slashing immigration from them; that there was a plan; that there were sunlit meadows ahead.

While the Leavers were accentuating the positive, the Remain team (“Better Together”) were full of gloom and doom; their campaign was dubbed “Project Fear." They predicted a dire economic downturn; panic wiping trillions off global financial markets; the pound plummetting to record lows; a surge in popularity of the far right and a dramatic increase in hate crime. Ridiculous scaremongering...
Except that after the Leavers unexpectedly won the referendum, all that actually did happen (respectively here, here, here, here and here).
The Brexiteers became a swiftly-diminishing peleton moving in reverse, with much backpedalling: here, here, here, here and here, to cite a few examples. There was little celebration. No one was in charge. No one wanted to be (“you take control—you touched it last”). Nausea and unease swept the land, along with a new bitter-tasting phenomenon, especially keenly felt in Wales: “bregret.”

But it’s early days. Let’s see how Theresa May, the new unelected PM who doesn’t believe in Brexit and voted against it, gets on with implementing it.

​Pathological liars
Appearing to support something you disagree with, of course, is what politicians habitually do for a living, and why they are so unpopular. They rarely speak their mind—they’re trying to speak yours. You can tell when they’re lying, the joke goes—their lips are moving. Nixon didn’t know about the Watergate Hotel break-in. Clinton did not have sex with “that woman.” Blair thought there were WMDs. All governments lie, as rebel American journalist I. F. Stone observed.
An archetype of the species, or perhaps a parody, is would-be US president Donald Trump. He doesn’t exactly lie; he simply regards it as irrelevant whether or not something is actually true and speaks instead like a defiant 10-year-old: I am the best, I didn’t do that, it’s not my fault, they did it, I didn’t take it, it was broken when I took it, I’m not a liar you are, you’re ugly, a dog, a fat pig....” And so on.
Pathological lying is not regarded as a clinical condition in its own right. But it is a common feature of many people who suffer with some kind of psychological illness. The Diagnostic and Statistical Manual of Mental Disorders (DSM) includes a number of “personality disorders” which might describe the kind of inner world that could give rise to lying: the “borderline” might lie to avoid abandonment; the “histrionic” to be the centre of attention; the “narcissistic” to preserve a grandiose self-image. Perhaps the best-fitting DSM label for liars is “antisocial personality disorder”—the closest thing to what the layman might call a “psychopath”—which includes among its diagnostic criteria: “Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.”

Lies about immigration
One of the things politicians lie about in Britain, a lot, is immigration, a key issue of the referendum. They know it’s good for the economy—if the goal was just to maximise GDP, a purist neoliberal would feed the market with free movement of goods and services, capital—and workers. Such a person would advocate completely open borders.
But politicians know too that pandering to people’s fears and appearing “tough on immigration” is a sure vote-winner (as discussed in Part 2, Britain is a nation built on discrimination). So they play a peculiar game: with one hand, they hold up a stop sign—especially when the cameras are on. With the other, new arrivals are discreetly beckoned with a nod and a wink.
Governments similarly rarely counter the arguments against immigration, either. For example:
• Immigrants are a drain on the economy. Actually they tend to be young, fit and keen to work—they respond to demand, relieve skill shortages, and create new jobs. They are known to be net positive contributors to the British economy (one study showed a contribution of £4.4 billion between 1995-2011). Without them the demographic crunch caused by declining fertility rates and increasing longevity would be even more acute. Benefit cheats? If immigration stops, you’ll be cheated out of your most important benefit: your pension.
• Britain is “full up.” Really? Have you ever taken a train from London to Edinburgh and looked out of the window? Only about 1 percent on our land has been built on. Britain ranks 51st in population density, slightly ahead of Germany and Italy, well behind the likes of Belgium, the Netherlands, Japan, South Korea, Taiwan.
• Immigrants are taking over. The public’s average guess at what proportion of the UK is foreign-born is 31 percent. The real number? 13 percent. And while about three-quarters thought immigration was a problem in Britain, only about a quarter thought it was a problem in their own local area.
• British culture is under attack. It always has been, shaped by outside forces for centuries. But it is large enough and robust enough to take what it likes and discard the rest. Culture is democracy. If chicken tikka masala is indeed Britain’s national dish, it’s because people like it. Of the immigrants to the UK in 2001, the leading country of origin was Australia, yet there was no debate over Britain being “swamped” or “flooded” by Australian culture.

Tabloid tales
On referendum day, the Daily Mail ran a lead article (“Day of Truth”) that lamented “a campaign characterised by mendacity.” What does it have to say about its own mendacity? The endless sensational stories over the years about supposedly idiotic EU regulations that were either very exaggerated or completely false? Did it report the analysis in The Economist that revealed the Daily Mail to be the clear leader in publishing stories about the EU that weren’t true? Such as Euro banknotes being responsible for impotence; or the EU demanding that cows wear nappies; or that the Latin name be used for “cod” instead of fish and chips; or that corgis be banned; or the one about EU immigrants being convicted of 700 crimes a week? (This of course is just a very small sample. And it’s not just the Mail. All the tabloids tell tall tales of asylum seekers stealing royal swans or donkeys from London parks and barbecuing them or councils banning hot cross buns from being served at Easter in favour of naan bread.)
In the 1930s, the Daily Mail was owned by Harold Sidney Harmsworth, 1st Viscount Rothermere, reportedly a keen prewar admirer and supporter of Adolf Hitler and his annexation of Czechoslovakia; he wrote in the newspaper in praise of fascism, Oswald Mosley and the British Union of Fascists, too. How much of the discriminatory editorial content, politics and tone of today’s Mail is a reflection of the beliefs of the current owner, great-grandson of Harold, Jonathan Harold Esmond Vere Harmsworth, 4th Viscount Rothermere? We don’t know, but wealthy press barons have a history of explaining away the problem of gross inequality with a simple message: blame the poorest, most desperate, most foreign.

Rivers of racism
​Is one of the Mail’s former reporters, Brendan Montague, correct when he says in a 2012 article in The New Yorker that there is institutional racism at the Mail? There is certainly in its pages endlessly repetitive, disparaging, stereotyped negative characterisations of immigrant groups, asylum seekers and refugees—using words like “criminals”; “scroungers”; “dirty”; “barbaric”; “violent”: “cruel”; “deviant.” Isn’t demonizing faceless foreigners with an ever-flowing stream of cruel rhetoric by definition racist? Papers like the Mail and the Daily Express have been doing this for a century—articles about Jewish refugees fleeing Nazi Germany used the same denigrating words as articles about refugees today.
There is much hyperbole, metaphor and repetition to convey a sense of threat. Stories that conform to the negative stereotype—“British holidaymaker burgled in Bulgaria!”—get published. Those that don’t get spiked. People ask: where are the moderate Muslims denouncing acts of Islamic terrorism? They are online, in cafes, mosques, in demonstrations—yet mysteriously absent from the Daily Mail. The moderate voices are muzzled—on both sides of the playground, only the loudest, most cartoonish, most offensive voices are heard.
Governments have been known to manipulate media coverage for their own propaganda purposes. A century ago  American journalist Walter Lippmann wrote that society consists of two groups, a small, powerful, educated elite, and the rest, which he called the “bewildered herd.” And to keep democracy ticking over, in Lippmann’s view, the bewildered herd must be kept complacent, pliant and distracted by things like sports, soap operas, the fantasy of salvation through material goods. Occasionally, the bewildered herd needs to be sold on an unpopular action, invasion or war—with a highly sophisticated propaganda apparatus to demonize a supposed enemy and their supposed evil intentions. Writes Noam Chomsky: “Propaganda is to a democracy what the bludgeon is to a totalitarian state.”
The influence surely occurs in the opposite direction, too. Newspapers can frame a debate, or make or break a policy or a politician. Hence all the cosy chats with that guardian of British culture, Rupert Murdoch, the octogenarian Australian-turned-American overseer of an alleged phone-hacking, police-bribing empire that publishes The Sun and The Times. Murdoch might have more influence on the tabloids’ beloved “British way of life”—whatever that means—than EU figurehead/straw man Jean-Claude Juncker, yet this outside influence goes uncontested.
The tabloids have found that stories of fear and loathing are good for business. Why? As a species we have survived by being hypervigilant to danger and the British tabloid press overflows with a daily diet of things we should supposedly worry about: ebola, sars, swine flu, zika, the flesh-eating virus, killer food bugs, MMR, HPV, benefit cheats, hoodies, paedophiles, new age travellers, terrorists and a litany of other “moral panics,” the leading one being, of course: foreigners. Without a hint or irony or shame, the same pro-Leave newspapers that slammed “Project Fear” now join in the fearmongering about a post-Brexit world. If a tabloid newspaper were a person, he or she would be terribly, terribly worried about the world today, and probably never venture out into it very much.
The media and the government seem to be locked in a desperate dance, a series of pitiful vicious circles—a race to the bottom that assumes and panders to the idea that the public is inherently racist. The results are self-fulfilling.
The news today: Be afraid. Be very afraid.
No thank you. I’d prefer to live.

The Brexit referendum, ostensibly about the UK’s relationship with the European Union, about sovereignty, democracy, the economy, also unleashed a fierce national debate about something else: the hot button-issue of immigration. For some, the word "Leave" was an instruction not just to the UK but to foreigners within it, too; a message to new arrivals, a giant metaphorical sign to be hung at ports and airports around this sceptered isle. Theirs was a protest vote; their internal rallying cry was: There are too many of “them” coming over “here” and “we” don’t like it (ironic fact: the U.K. has more citizens living abroad than any other EU country). The objections were primarily economic or cultural. If you live in a neglected, underfunded town with scarce resources, and your job has gone to someone from another country, or you can't get a doctor's appointment or a school place, and your home town feels crowded and different, your choice is obvious—it's a matter of survival.

Most people who voted Leave did not do so out of racism. But no opinion poll is needed to hazard a guess at the voting preference of those who are unabashed racists. Regardless, the Leave vote sparked a resurgence of racism across the land. There was a 5-fold increase in hate crime within a week. Synagogues, mosques, schools and community centres were vandalised. People were attacked and verbally abused in the street. Racists stood outside multicultural schools flicking victory signs and telling people who didn’t look like them to “go home.” Sinister notes—and worse—were pushed through letterboxes. Suddenly closet racists were out and proud, emboldened in their everyday conversations, not even bothering with the standard prefix of “I’m not a racist but....”

Not that racism was dormant prior to June 23. According to the Home Office, 52,528 hate crimes were reported in 2014-2015, over 80 percent of them racially motivated, and that was an 18 percent rise in a year. In general black Britons are chronically under-represented in the professions, and over-represented in the prisons. In the field of mental health, young black men are far more likely to be referred to secure psychiatric settings via the courts than their white counterparts; black people of African and Caribbean heritage are six times more likely to be sectioned than white people. In therapy consulting rooms, clients tell shocking stories of violence, oppression and abuse.

5. Racism: part of human psychology?
There isn’t a great deal of writing or research on the psychology of racism, perhaps because it is such an emotive issue. But there is an argument that prejudice is a part of being human. Our survival has depended on a certain level of anxiety, vigilance and distrust towards the unknown, and an affiliation with the safety of the known. Malcolm Gladwell says we navigate through life with the help of “thin-slicing,” in which we use our senses, our experience and our beliefs to process a given situation very quickly, largely unconsciously, and take action.
Sometimes thin-slicing can be completely wrong, with disastrous consequences, such as when white policemen gun down an innocent nonwhite civilian like Jean Charles De Menezes. Last year in America, young black men were nine times more likely to be killed by police, with a total of 1,134 such deaths.
A number of studies have shown just how easy it is to create “in-groups” and “out-groups” based on the most meaningless of differences, and the hostility towards the out-group can escalate with depressing ease. Examples are the Lord of the Flies-like Robbers Cave experiment with two arbitrary groups of 12-year-old boys, Jane Elliott’s classic schoolroom blue eye brown eye exercise, or Saturday afternoon tribal violence between people who support different football teams.
Using the power of projection, the out-group is demonised: “we” are good; “they” are bad—deviant, dangerous, dirty, lazy (and any number of other aspersions). The more unknown “they” are, the easier it is to imagine them as devils. Racism—and concerns over national identity—are strongest in the least diverse parts of Britain.
This crude scapegoating of people from foreign fields, or “othering,” is vigorously and cynically exploited by poisonous politicians (Farage, Donald Trump, far rightists like Marine Le Pen), newspapers (the Daily Mail has been peddling xenophobia for a century), apartheid regimes (South Africa), dictators inciting genocide (Somalia, Rwanda, the former Yugoslavia), or western governments seeking to justify illegal overseas interventions (Iraq, Afghanistan).
The message used to be that the Russians were the primitive barbarians who want to take over the world. Now it is Muslims (the idea that 1.6 billion people—more than a fifth of humanity—speak with one voice or think with one mind is patently foolish).
Writes Mark Salter: “The ‘barbarian’ represents a rhetorical well from which politicians have drawn throughout the twentieth century and from which they still draw.”
 
“Race” is a construction: There is no basis for making sweeping assumptions about groups of people—positive or negative—based on skin colour. Farhad Dalal defines racism as: “The manufacture and use of the notion of race.”
​
But racist stereotypes are nevertheless hard to escape from; they are embedded in our culture. We unwittingly enact them, reinforce them, and hand them down. They are part of our social unconscious. They can be made conscious, and the othering, denigrating stereotypes and those who promote them can be treated with the contempt they deserve. But the history remains. No amount of whitewash will change that.
 
NEXT TIME: No. 3. Misinformation

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:

Mental Health Awareness Week: Relationships
16/5/16
It’s Mental Health Awareness Week, the focus on this year’s campaign being relationships.
The Mental Health Foundation writes: “We believe we urgently need a greater focus on the quality of our relationships. We need to understand just how fundamental relationships are to our health and wellbeing. We cannot flourish as individuals and communities without them. In fact, they are as vital as better-established lifestyle factors, such as eating well, exercising more and stopping smoking.”
The Foundation is lobbying governments, public bodies and employers, and they have a challenge for you too: prioritise your relationships by making a relationship resolution. Some examples: “I resolve to tell people I love that I love them” or “I will say sorry to a, b and c” or “I resolve to be a better partner, friend, sibling, child, parent, relative, lover, colleague, teacher, student to x, y or z” or “I resolve to stop playing games” or “I will develop a better relationship with my self” or “I resolve spend less time relating to my phone, iPad or laptop, and more time relating to actual human beings.”
 
• The 6 relationship types: What colour is yours?
 
• Perfect love
 
• On sex and sexuality

The mental health benefits of living by the seaside
Express.co.uk
 
Living by the seaside boosts mental health, makes people happier and more relaxed, according to new research.
In fact, the health advantages linked to a coastal home are so pronounced, scientists behind the study say more flats and affordable property should be built along Britain's shores so increased numbers of people can benefit.
American analysis of New Zealand data found residents whose properties had an ocean view were happier than their land-locked neighbours.
It is the first report to find a link between health and the visibility of water, which the scientists call 'blue space'.
The research shows how the sound of waves alters wave patterns in the brain lulling a person into a deeply relaxed state. Relaxing in this way can help rejuvenate the mind and body.
Also, floating in the nearby sea diverts blood from the lower limbs and pumps it towards the abdominal region - the part of the body near the heart - because we are no longer standing upright.
This fresh blood brings more oxygen to the brain making people more alert and active.
Professor Amber Pearson, of Michigan State University in the USA, said: "Increased views of blue space is significantly associated with lower levels of psychological distress. However, we did not find that with green space."
 
 
Child mental health crisis 'worse than suspected'
The Guardian
 
The crisis in children’s mental health is far worse than most people suspect and we are in danger of “medicalising childhood” by focussing on symptoms rather than causes, the government’s mental health champion for schools has warned.
Natasha Devon, who has been working in schools for almost a decade delivering mental health and wellbeing classes, said an average of three children in a class were diagnosed with a mental illness, but many more slipped under the radar.
Devon, who founded the Self-Esteem Team, was appointed by the government to look into young people’s mental health and find out what a good school support system looks like. However, she said the government was asking the wrong question.
“The question we should be asking ourselves is what are the emotional and mental health needs of all children and are they being met in our schools?” she said.
 
• Children in care too often denied mental health treatment, MPs warn (The Independent)
 
 
Teachers use early-warning system to spot mental health issues
Telegraph.co.uk
 
Top private schools – including Harrow and Wellington – are testing pupils’ mental health as teen stress levels reach all-time high because of social media bullying.
There are currently 15 schools using an early warning system that helps teachers identify potential self-harm and drug abuse and 30 were already involved in a recent study.
Teachers say they are opting for the tool as a preventive measure in an era where adolescents are facing old-age challenges in a “more pressurised academic environment”, which means some “are finding it harder to cope”.
The schools, which also include some from the state sector as well, are using the tool called Affective Social (AS) Tracking to present teens with a series of scenarios where they display patterns of thinking that may affect their behaviour.
 
 
UK online pedophiles 'could face counselling not arrest'
Newsweek
 
One of Britain’s leading law enforcement officials has suggested that some people viewing child abuse images online should be directed to counselling instead of being arrested.
Lynne Owens, head of the U.K.’s National Crime Agency, told The Times that the “massive” scale of online paedophilia meant that there was a case for trying to get low-level offenders to change their behavior by engaging with charities.
“[If] it looks like they’re not individually engaged in abusing children, they are just viewing the images, but we want them to stop, you can see it could be possible, with a whole load of ethical checks and balances, to try and make contact with them overtly and get them to engage with charities to improve their offending behaviour,” she said.
Owens said that as law enforcement was bombarded with huge numbers of referrals from Internet companies, the priority had to be protecting children. “I want to crack down and pursue those people who are abusing children now,” she said.
 
 
WORLD NEWS
 
China's unorthodox marriage counsellor or “mistress discourager”
South China Morning Post
 
Yu Feng, 45, dubbed the ‘mistress discourager’, tells how he helps clients – mainly desperate wives – by persuading husbands with mistresses to stay with their wives and families
 
“I am married, with two children. I believe marriage should be happy and an essential part of life – that everyone should be married.
Some people complain that marriage is a burden, but I don’t agree: if you take enough care you won’t face such difficulties.”
 
 
ISIS offers marriage counseling to stop jihadi brides from fleeing
New York Post
 
ISIS is being forced to offer marriage counseling to stop their brides from fleeing the terrorist group during tough times.
The terrorists opened their first “relationship counseling center” for troubled jihadi lovebirds in Raqqa, Syria, according to the UK Sun.
A photo, released by the Islamic State’s media branch, shows one tearful wife seeking help from a shrink next to a box of tissues.
Male ISIS fighters — connected to any number of brutal beheadings, bombings or other atrocities — have attended the sessions, too, according to the site.
Thousands of Western women, many of them British, have joined ISIS after being radicalized online in the past two years.
But times are tough in Raqqa, where airstrikes have caused food, water and power shortages, making tense marriages even more strained.
“At least before [ISIS] we had electricity, we could bake and cook. Our basic needs were met. Now we are back to ancient times,” one of the women told dissident site Open Your Eyes.
“There’s no electricity, no drinking water. There are no services,” another moaned.
ISIS has lured female recruits by promising them a new life in Syria.
 
 
 
 

Cannabis: scientists call for action amid mental health concerns
The Guardian

There has been a move lately towards some kind of greater acceptance of psychedelic drugs. Travelling in the opposite direction, however, is cannabis. As this story shows, increasingly it is acknowledged that it carries potential dangers—including psychosis—especially for frequent users. Lots of people, especially young people starting out on their journey, venturing into a bewildering, unfair, uncertain adult world, think cannabis is the answer, or an answer. But maybe it might be more helpful to engage with the question. Yes, the world is messed up. This does not mean you need to be, too. Talk to someone. There is help.  

The risks of heavy cannabis for mental health are serious enough to warrant global public health campaigns, according to international drugs experts who said young people were particularly vulnerable.
The warning from scientists in the UK, US, Europe and Australia reflects a growing consensus that frequent use of the drug can increase the risk of psychosis in vulnerable people, and comes as the UN prepares to convene a special session on the global drugs problem for the first time since 1998. The meeting in New York next week aims to unify countries in their efforts to tackle issues around illicit drug use.
While the vast majority of people who smoke cannabis will not develop psychotic disorders, those who do can have their lives ruined. Psychosis is defined by hallucinations, delusions and irrational behaviour, and while most patients recover from the episodes, some go on to develop schizophrenia. The risk is higher among patients who continue with heavy cannabis use.

• Relatedly, a story in Parent Herald highlights the findings by Action on Smoking and Health (ASH) on the links between mental health, longevity and smoking: people with mental health problems have significantly lower life expectancies than the general population and much of this can be attributed to smoking.


UK NEWS

Mental health goals may not be met, audit office warns
The Guardian

A government pledge to bring mental health services up to the standards of those for physical ailments will struggle to be met, the government’s official spending watchdog has concluded. 
The National Audit Office has examined the Department of Health’s strategy for bringing a “parity of esteem” to ensure that patients do not have to wait longer for mental health therapies. New waiting time targets for those seeking help with mental illnesses were supposed to be introduced at the start of this month.
Although it is five years since the government first drew up the ambition, a report by auditors has found that the DH does not yet have a grip on how much the policy will cost. 
The report found the department and NHS England have made available £120m of additional funding over the two years 2014-15 and 2015-16.
However, most of the cost of implementing the new access and waiting time standards will be met from clinical commissioning groups’ existing budgets – at a time when the NHS is under increasing financial pressure.
The findings have emerged as more people are seeking mental health treatment from the NHS.


USA NEWS

Lawsuit: Sperm donor lied about mental health
WDSU New Orleans

He was handsome and healthy, with several degrees and a genius-level IQ. On paper, Donor 9623 embodied the best genetics had to offer. At least 36 children were born using his donated sperm. According to a lawsuit filed by three families, it took almost 14 years before the donor's true identity was revealed: A schizophrenic college dropout with a felony conviction. 
Families that used his sperm are suing the Georgia-based sperm bank Xytex Cryo International, saying it should have done a better job of vetting its sperm donors.


WORLD NEWS

Grandmother benches, smartphone apps and other mental health boosts from around the world
World Economic Forum

More than 10% of the total disease burden in low and middle income countries (LAMIC) is due to mental health disorders, yet they receive less than 1% of many of these countries’ health budgets. A striking example of this is in Zimbabwe, where only 12 psychiatrists serve a national population of 15.3 million.
Considering this huge under-investment, a key question is how to provide support for people suffering from mental ill health when resources are scarce.
These five collaborative, low-cost care packages - delivered by lay people who are trained and supervised by professionals - all have the potential to close the treatment gap, and improve the mental health of hundreds of thousands of people.


Education, trauma counseling key to helping Syrian refugees in Lebanon
Catholic News Service

The more than 1.06 million Syrians who remain in neighboring Lebanon face continuing struggles with war trauma, dwindling funds, and a very uncertain and often dangerous future. 
"They have internalized the violence and loss in the conflict in Syria. Perhaps they saw loved ones killed, their houses destroyed in front of their eyes, or even being uprooted from their country has caused trauma," Monette Kraitem, a Lebanese psychologist working the Catholic charitable agency Caritas, told Catholic News Service.
She and fellow Caritas psychologist Christelle Ltief have so far helped 1,500 Syrian refugee children and women sheltering in this part of the Bekaa Valley to process the pain at the Caritas Lebanon Migrant Center in the nearby town of Taalabaya.
"We try to help the children deal with their trauma by expressing their feelings" through "play, art and music therapy, relaxation and respiration techniques, and individual and group therapy, where children can say how they feel without being judged," Ltief told CNS.


Why Pakistan needs to embrace Arts Therapy
The Nation

In the past decade, the field of Art Therapy has gained strong ground in the West and is being taught at the university level, offering graduate and post-graduate programs. In Pakistan, however, the awareness is gradually increasing among masses and the future looks promising. Asim Amjad, Samina Jamshed, Ufaq Ehsan and Shazia Mohamad are some of the iconic Pakistani Art Therapists who often arrange Art Therapy workshops and seminars for kids throughout the country.

VIEWPOINTS

Why do people have affairs?
The School of Life

Do you tend towards clingy neediness? Or cold aloofness? Relationships tiptoe along the knife edge of each person's need for closeness at times, and distance at others. When it gets out of kilter, the spectre of an affair looms (Dumas said marriage is a heavy burden that requires two people to carry it, and sometimes three). This new 3-minute film from The School of Life explains: "A lot of the reason why people have affairs isn’t to do with random excess horniness. It’s do to with issues of closeness and distance."


We need to talk about mental health
Financial Times

The most striking result that emerges from surveys of mental health at work is the awkwardness. For all the progress made in taking the stigma out of mental health problems, a large number of people just do not want to talk about it.
31%
would not feel able to talk to their manager if they had a mental health problem
A survey last year for Time to Change, a programme run by the charities Mind and Rethink Mental Illness, found that 28 per cent of people in England would feel uncomfortable asking someone close to them about their mental health problems. Why? Because it would make the other person feel uncomfortable, they would not know what to say or because they would not feel able to help.
The same embarrassment surrounds surrounds mental health at work, one focus of the “wellbeing” category of the Responsible Business Awards. In another survey conducted for Mind by YouGov in 2014, 31 per cent said they would not feel able to talk to their manager if diagnosed with a mental health problem. Some 33 per cent said that if they told their boss that they were stressed at work, they felt their ability to do the job would be questioned.


11 things to do daily
Bustle

A good roundup of pretty obvious things we could be doing to feel better. It's common sense...yet not all that common,

When it comes to taking care of ourselves, we often focus more on our physical body. However, maintaining your mind is just as important, and there are things we should be doing everyday to improve our mental health. Just like our body needs to get into a routine, so does our brain, and taking the steps to ensure our optimal mental health can have us feeling just as healthy as eating a good kale salad.

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 Electionlast 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.

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.