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Our father

2/2/2023

 
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My Dad died recently.

He’d been bedbound for the better part of a year, and he was unhappy about that, and he was suffering a great deal at times. At the age of 98, he’d had enough.


We had a few brief conversations about death. He was driven by fact and reason and was not a religious man — “when you die, that’s the end of it,” he would say. But even without the prospect of being greeted by heavenly cherubs or reunited with my dear old Mum or any kind of afterlife, he so wanted to go. He would wake from a doze and shake his head in disbelief that he was still alive. In a recent Christmas card — his home-made cards, marvels of eccentric design, were legendary — he wrote simply: “Still here. I know not why.”

My Dad’s early life was a combination of great privilege coupled with extraordinary privation. He was born into a world of colonial excess. From 1903 to 1938, his father — described by a colleague as “small, active, rubicund with a choleric eye” — managed a 1,700-acre tea plantation in Assam. The household included a domestic staff of 18 people, and life revolved around golf, tennis, polo, bridge and hunting parties. Pandit Nehru came by for tea. My dad remembers climbing trees to pick lychees and sweet red bananas, sailing on the mighty Brahmaputra, and once, being driven home after dark by his parents, seeing a huge tiger up close, eyes burning bright in the headlights.

But at 6, this princeling life came to an end when he was sent to boarding school in England, as was his sister, Ann, who was just 5. For the rest of their childhood, they didn’t see their parents very much. The hardships of English boarding schools between the wars and too many school holidays and Christmases spent in the company of strangers were never mentioned, though Dad did record in his self-published memoir: “I remember Fellowes who was a bully; I broke a window throwing a shoe at him.” Later, at Wellington College, Dad writes: “I once, in a spirit of rebellion, smoked a cigarette in full view of everyone and was duly beaten with a cane by one of the prefects, called Fraser, who seemed apologetic about the whole affair.” 

A bath at Wellington was to take no more than 3 minutes, including filling and emptying. Occasionally a “double bath” would be permitted: 6 luxurious minutes!

In preparation for World War Two, the pupils were put to work digging trenches and air raid shelters. One October night in 1940, the headmaster was too slow to heed the air raid siren: he was killed by a bomb. Well into old age, the sound of a siren would still send a lurching spasm through Dad’s stomach.

Jungian analyst Joy Schavieren describes “boarding school syndrome” (2011) — the trauma of being sent away comes with the imperative to show no feelings, so these infants learn to cut off their reactions or bury them deep — a kind of emotional circumcision. They can grow into adults who remain wounded by their early broken attachments, divorced from themselves, capable only of superficial relationships. To an extent this is how all boys are raised.

“We create numb, inarticulate loners," I write in “The Humanity Test" (2022). “We idolise flinty, monosyllabic killers played by John Wayne, Charles Bronson, Clint Eastwood, Sylvester Stallone.

“Men are taught to be tough; to win, not love. We don’t know how we feel. We certainly don’t know how others feel. We are raised to be expendable cogs in a loveless machine."

​Pathological humility
One day in the Prospect of Whitby pub in London’s east end, Dad’s and Mum’s eyes met for the first time across a crowded room; their hearts soon followed. In her he found someone who shared his experience of a childhood starved by parental absence. In 1940, my Mum, aged 10, was evacuated from rural Suffolk to America — Suffolk was the kind of place kids from London were evacuated to — and for the remaining five years of World War Two saw her mother not at all and her father only for one weekend in 1942, when his troop ship docked in New York.

​These early experiences forged in both my parents a curious mixture of confidence and resilience — a kind of superiority even — yet coupled with an almost pathological humility.

They loved babies and dogs and they loved each other; outside of the family, however, any other actual adult humans on the whole were likely to be problematic, and best avoided. Dad believed in thrift, logic, hard work, self-reliance, independence. He was unfailingly polite and considerate. On holiday, whatever the time of day, we children learned to shuffle silently down hotel corridors — still do — because, Dad said, “people might be sleeping.” Once in his late 80s, he tripped over backwards in his yard and gashed the back of his head on a concrete ornament. Later, we asked him how long it took for an ambulance to arrive. “Oh I didn’t bother with that,” he said. “I’m sure there’s someone who would have needed it more.”

There was a time when sons would work alongside their fathers, in the fields, on the farm or in the family business, within a wider community with village elders, mentors, apprenticeship and ritual to help usher young men into adulthood. But the industrial revolution and the wheels of capitalism have spirited our fathers away from us; the village is long gone. The father is absent, or an exhausted ghost-like presence who will not speak and then disappears once more, like Hamlet’s murdered father. 

I don't ever recall discussing a personal problem with my Dad, or getting advice. I never saw him cry. It's obvious he loved his children, but saying it out loud was unthinkable. A hug? No thank you. For much of my life, I never really understood what Dad did for a living. A lot of what I now know about him today comes from a presentation and slide show about his life that he gave to his fellow care home residents, five years ago, when he was 92.

Intergenerational trauma
There may not be many words in the space between fathers and sons, but it is far from empty. Much is communicated; family culture is handed down. Words are the least of it.

There’s a lot of research and theory on the effects of intergenerational trauma and what unparented parents bring to their own children (eg. Julia Samuel, 2022). The day before Dad died, I watched excellent presentations online from Dr Oonagh Walsh and Dr Michael O’Loughlin on the long shadow cast by the Irish potato famine and its effect still today on loss, grief and healing in the Irish diaspora. We inherit a lot of the pain of our ancestors. My Dad had a mother who lost two brothers and a fiancé to World War One, and a third brother to the Russian Civil War in 1921. She carried them with her into old age — she died in 1963, 8 days after I was born. 

None of these stories, or my parents’ childhood separations, were discussed at home or for a long time even known to my siblings and I. It's hard to talk with a stiff upper lip. My Dad was mystified by the idea of therapy. I tried to explain it to him — and why I, his youngest child, followed a meandering career path that wound up with me choosing to become a therapist. “Hmmm," he said one time, “Most peculiar.”

Finding the father within
According to another Jungian, James Hollis, each man “carries a deep longing for his father and for his tribal fathers.” He concludes that healing only comes when men “activate within what they did not receive from without.” We each must be a father to ourselves. Jung said he learned more from his father in death than he ever did in life. Whoever our real father was — or wasn't — the world offers up to all kinds of other father figures, in all kinds of guises. 

I was lucky to have Dad for so long. And if it’s true that we inherit our ancestors’ pain, we must surely inherit their joy, too. Perhaps by way of compensation for all the suffering, or perhaps because the two things go hand in hand, Dad also had a great sense of fun, enjoyment and absurdity. He was really a bon viveur — he loved, food, wine, cars. He loved stuff — Dad was the first person I knew to own a pocket calculator, a videocamera, an email address. He loved to travel, roaming all over Europe by car with friends as a young man — including completing the 1954 Monte Carlo Rally in a Ford Zephyr — and all over the world by plane as a family and in his work as an engineer. On a flight to Tunisia in 1969, the pilot announced that humans had landed on the moon. We looked out of the window of the plane and there it was: A dazzling beautiful full pearl-white moon. A couple of years in the Navy on the Adriatic had given Dad a great, lifelong love of Italy (which I share). His enthusiasm, commitment and belief in his ability to speak Italian never once dimmed for a moment despite his glaring inability to speak Italian. Another thing we both loved but were bad at was golf, and I consider myself so fortunate to have spent so much of my youth with Dad, roaming the finest fairways at home and away, engaging in titanic Oedipal battles, then laughing at ourselves over drinks in the bar afterwards. We disagreed on practically everything — politics, colonialism, Brexit, climate change — but it never seemed to matter. We never really debated these things or allowed them to intrude on our relationship.

I last saw Dad a few days before he died, in his care home in Canterbury. He had a clean shirt on, there were hits from his youth playing on Alexa, and he seemed reasonably content. He wasn’t fully conscious and it wasn’t clear if he knew I was there. When “Walk like a man” came on, I asked him if he remembered it. He started singing — albeit a different song. 

I asked him if he could imagine sitting beside a pool with a glass of chianti on a warm day in the Italian lakes and — almost imperceptibly or perhaps not at all — he nodded and smiled. 

I thanked him for everything he has given us and told him how glad and lucky and grateful I feel that he is my father. 

I don’t know if he heard any of it. But it was nothing he didn't already know.

I wrote in our group family email: “It really feels like he is ready.”

People often call a death like this “a blessing.”

When we were little, Dad used to take us on epic road trips — to see family in Scotland, or sometimes to France and beyond. He'd always want to set off freakishly early; 4am was his preferred starting time. And so it was that at 4am one chilly Friday morning in January, Dad departed this life, alone and without fanfare or fuss, finally freed from his tired, worn-out body. I imagine he was thinking: “About bloody time!” If there were cherubs, the first thing they would have heard from Dad was a strongly-worded complaint.

A blessing.

Still, the news hit hard.

A punch in the face.

Even after all these years, it’s just so shocking how people that you love leave this earth.

Love you Dad.

X
 
References
Barton, J. (2022). The humanity test: Disability, therapy, society. PCCS
Hollis, J. (1994). Under Saturn’s shadow: The wounding and healing of men. Inner City Books
Samuel, J. (2022). Every family has a story: How we inherit love and loss. Penguin Life
Schaverien, J. (2011). Boarding school syndrome: Broken attachments a hidden trauma. British Journal of Psychotherapy, 27(2), 138-155.k here to edit.

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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psychogram #18

2/11/2015

 
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Weekly news round-up #35

17/7/2015

 
PictureGet out of town and head for the hills.
TRUE NATURE

This week I took a short work-related trip to Scotland. When I got out of the car, something was different. Immediately I felt the crisp, perfumed caress of something strange, something that city-dwellers have long had to live without: fresh air. I filled my lungs with this exotic elixir and instantly felt stronger, happier, fitter. I slept better in Scotland. I became more alive, more human.

If only you could bottle this extraordinary intoxicant, you could make a fortune. (Actually someone did that already, in China, whose cities bring pollution to a whole new level.)

Even though we may not understand all the reasons, it makes intuitive sense that metropolitan living can be detrimental not only to our physical health, but to our very psyches, too. The research findings are not a huge surprise: Urbanites have higher rates of anxiety and depression. We’re more frazzled, more sensitive to criticism. Schizophrenia, too, is much more common in cities. And since 2009, more than half the world’s population lives in cities, according to the United Nations. That’s almost 4 billion souls potentially denied the oxygen of a healthy environment, one free of pollution, car alarms, and armies of sharp-elbowed impatient people rushing to the next meeting—or away from themselves. The Hopi call it Koyaanisqatsi or “life out of balance" (and if you haven't seen the mind-blowing 1982 film of that name, please stop reading this or whatever else you are doing and order it now). 

So what to do if, like me, you’re one of the stressed majority, living in a state of such un-nature? How to combat the growing global scourge of “nature deficit disorder”? How to reconnect with our natural state, the one out there and the one within?

• Walk. A recent piece of research suggests that walking in nature results in less rumination and negative thinking and thus improved mental health. You don’t have to hike through Yosemite National Park to awaken your spirit, or even move to Scotland (although both sound appealing)—a stroll around your local city park works just fine. Check out city farms, nature reserves and wildlife centres, too; even a trip to your local natural history museum will soothe the soul.

• Gardening has been shown to relieve stress and is enormously therapeutic for all kinds of people (for example pop star Kim Wilde). There’s something so elemental about the ancient satisfaction of getting your hands into the earth and making things grow. We are nurtured by nurturing. If you don’t have a garden, go and help a neighbour who does, apply for an allotment, support community gardens, volunteer with a gardening charity or join a Green Gym.

• Fill your living space with greenery, and photographs or artwork depicting the great outdoors. Research shows that having a pot plant and even looking at scenes of nature can significantly improve your mental health. The upcoming Edinburgh Fringe play “Garden” is about an office worker who revives a pot plant and in so doing revives herself. Don't just get plants, commune with them, too. Buddha once gave a famous wordless sermon to his disciples: he simply held up a white flower. By saying nothing, the disciples were free to experience the flower fully and appreciate its tathātā, which might loosely be translated as “suchness."
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Slow down, you move too fast. Top to bottom: Tokyo commuters; London's epicenter, Oxford Circus; Lower Manhattan, New York.
PictureAlways in a hurry, off-balance.
• Relieve stress. Whatever works for you. Mindfulness. Music. Exercise. Take up golf—a way of being among greenery and it might make you live five years longer (or, depending on how you play and who you play with, it might just make you feel five years older). If the stress of city life gets really bad, or even if it doesn’t, get some help.

• Join or get involved with local wildlife organisations like the London Wildlife Trust, or global ones like Friends of the Earth, the World Wildlife Fund, or Greenpeace.

PicturePlaces like the Rose Garden in London's Regent's Park offer psychic soothing.
• Take regular daytrips beyond the city limits (and beyond your comfort zone). Hopefully this will be more successful and uplifting than the legendary, foul-mouthed scene from “Trainspotting” when “Tommy” drags his sceptical city pals to the beautiful, desolate Rannoch Moor (“This is not natural man,” says one.) 

• Use your vacations, too, to get back to basics. Head for the hills: camp in the Lake District for instance, and “walk in blessedness” there as Wordsworth did all those years ago.

As the wandering, wondering wordsmith said: “Nature never did betray the heart that loved her.”
—John Barton


U.K. NEWS

Large UK trial to ask if mindfulness boosts teenage mental health
From Reuters:

Nearly 6,000 British school children are to take part in a major trial designed to assess whether mindfulness training for teenagers can improve their mental health.

Mindfulness is based on the idea of being more aware of the present by intentionally focusing on emotions, thoughts and sensations and viewing them with acceptance. Advocates say this understanding helps people to respond in ways that are more purposeful, rather than reacting on "automatic pilot".

The three-part study will include the first large randomized control trial of mindfulness training compared with teaching as usual in 76 schools.

Further parts of the study include experimental research to establish whether and how mindfulness improves mental resilience of teenagers, and an assessment of the most effective way to train teachers to deliver mindfulness classes to pupils.

Brain scientists know that teenage years are a crucially vulnerable time for mental health, particular in brain regions responsible for decision-making, emotion regulation and social understanding. More than three-quarters of all mental disorders begin before the age of 24, and half by the age of 15.


U.S.A. NEWS

Even mild mental health problems in children can cause trouble later
From NPR:

It's not easy for a child who has had mental health issues to make a successful transition into adulthood. But even children who have symptoms that are mild enough that they wouldn't be diagnosed are more likely to struggle with life as adults, a study finds.

Children and teenagers with a psychiatric disorder had six times higher odds of having at health, legal, financial and social problems as adults, according to a study published Wednesday in JAMA Psychiatry. Those with milder symptoms were three times more likely to have problems as adults.

We already know from previous studies that most adults with mental health issues had a previous psychiatric disorder during childhood – it doesn't have to be the same exact condition. But this study shows mental health problems that occurred during childhood can make it more likely that someone will struggle as an adult, making it more likely that they won't graduate from high school or commit a felony, for instance.


Judge orders counseling for Obama critic Dinesh D'Souza
From India West:

A New York judge has ordered Dinesh D'Souza, an Indian American conservative scribe and Obama critic filmmaker, to do community service for four more years for breaking campaign-finance laws and undergo further counseling.

Judge Richard Berman clarified July 13 that under the sentence he handed down after D'Souza pleaded guilty last year, he has to do eight hours each week for the entire five years he is on probation and not just the eight months he was confined to a halfway house.

The Manhattan federal court judge also read aloud a report from a court-appointed psychologist who called D'Souza "arrogant" and "intolerant of others' feelings," according to the New York Post.

"In my mind it was never contemplated that the eight hours only applied to the period of home confinement," Berman was quoted as telling defense attorney Ben Brafman.

He later read out a report from a psychologist who saw D'Souza, the maker of the anti- Obama film "2016: Obama's America,” and then ordered him to continue attending weekly sessions, the Post said.

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WORLD NEWS

Global health workforce, finances remain low for mental health
From the World Health Organization:

Worldwide, nearly 1 in 10 people have a mental health disorder, but only 1% of the global health workforce is working in mental health. This means, for example, that nearly half of the world’s population lives in a country where there is less than one psychiatrist per 100,000 people.

Huge inequalities in access to mental health services exist depending on where people live. On average globally, there is less than one mental health worker per 10,000 people, according to the World Health Organization’s Mental Health Atlas 2014, released today. In low and middle-income countries rates fall below 1 per 100,000 people, whereas in high-income countries the rate is 1 per 2,000 people.

Spending on mental health is still very low
The report states global spending on mental health is still very low. Low and middle-income countries spend less than US$ 2 per capita per year on mental health, whereas high-income countries spend more than US$ 50. The majority of spending is going to mental hospitals, which serve a small proportion of those who need care. High-income countries still have a far higher number of mental hospital beds and admission rates than low-income countries at nearly 42 beds and 142 admissions per 100,000 population.

Training of primary care staff in mental health is critical to building capacity for recognizing and treating persons with severe and common mental disorders. Since 2011, the number of nurses working in mental health has increased by 35%, but shortages still exist in all disciplines, particularly in low and middle-income countries.

The Atlas finds countries are making progress on creating policies, plans, and laws for mental health, which provide the bedrock for good governance and service development. Two-thirds of countries have a policy or plan and half have a stand-alone mental health law. However, most of the policies and laws are not fully in line with international human rights instruments, implementation is often weak, and persons with mental disorders and family members are frequently only marginally involved in their development.


Mental health professionals demand cancelation of Israel conference
From The Electronic Intifada:

More than 200 leading mental health professionals from around the world have signed an open letter calling for the cancellation of a European psychotherapy conference scheduled to be held in Jerusalem in August.

In the letter, published in the UK newspaper The Independent, the psychologists and psychoanalysts, many from the UK, France and the United States, urge their colleagues to respect the Palestinian call for boycott and stay away from the conference should it go ahead as planned.

Meanwhile, leading actors, authors, academics and architects in the UK have put their names to an open letter to David Cameron, urging the UK prime minister to push for immediate EU sanctions on Israel until it abides by international law and ends its occupation and siege of Palestinian territories.

The two letters, with their diversity of signatures, highlight how the boycott, divestment and sanctions movement (BDS) is growing in range and scale.


Iran changes law to make divorce harder; makes counselling compulsory
From Daily News & Analysis:

Iran has changed a law to make divorce by mutual consent invalid unless couples have first undergone state-run counselling, the country's latest move to tackle a rise in broken marriages.

The measures, reported by media at the weekend, are contained in a new family law that a top official said would be implemented by Iran's judiciary.

"A decree of divorce by mutual consent, without counselling, is forbidden," Parnian Ghavam, head of the judiciary's social work and counselling office, was quoted as saying by Tasnim news agency.

All Iranians filing for divorce would be obliged to go to a counsellor, she said. "From now on, without this it will not be possible to register divorces of mutual consent." Iran's average divorce rate peaked at 21 per cent last year, with big cities showing far higher rates.


Time to tackle Australia's mental health crisis, Tony Abbott told
From The Guardian:

Mental health, welfare and medical groups have intensified their call for a fully funded mental health agreement, warning the system remains in crisis.

Mental Health Australia has penned an open letter to the prime minister, Tony Abbott, and the premiers and chief ministers calling for action ahead of next week’s “leader’s retreat” in Sydney.

The chief executive of Mental Health Australia, Frank Quinlan, said the federal health minister, Sussan Ley, had indicated the country needed a national, coordinated and binding agreement on mental health.

“We have waited too long for such and agreement,” Quinlan said. “The system is in crisis right now, and we need action, not after the next budget, not after the next election, but starting now with a commitment from our leaders.”

Abbott will meet the premiers next week for a Council of Australian Governments meeting which will discuss the division of service delivery responsibilities between Canberra and the states.


VIEWPOINTS

I came out of a teenage mental health unit worse than when I went in
From Fern Brady in The Guardian:

For us, a typical day would be spent bickering with support staff in the morning over petty, ever-changing rules, followed by group therapy, doing strange artwork-cum-trust exercises with the occupational therapist and watching telly. Despite the known curative properties of watching repeats of Jeremy Kyle, I selfishly replaced them with “school time”, where my justifiable panic over how I’d ever study for my highers in a mental unit were mistakenly interpreted as part of my illness.

There was no sharing of information between services (the small matter of me trying to top myself was never passed from A&E to the referring psychiatrist), there was never any explanation of a structured care plan, or if there was, no one told me. I received one hilarious session of what I think was meant to be cognitive behavioural therapy, where the unit manager dramatically pushed a tissue box askew (“How does THAT make you feel, Fern? Hmm?”) as I tried not to laugh.

We were spoken about with disdain and in oddly clinical terms – “the young people” and “service users” – instead of treated as real people with valid feelings. There was always the vague sense that I’d done something wrong, that we’d all done something wrong, even though we hadn’t.


Psychiatry's identity crisis
From Richard A. Friedman in the New York Times:

It seems that leaders in my field are turning their backs on psychotherapy and psychotherapy research. In 2015, 10 percent of the overall National Institute of Mental Health research funding has been allocated to clinical trials research, of which slightly more than half — a mere 5.4 percent of the whole research allotment — goes to psychotherapy clinical trials research.

As a psychiatrist and psychopharmacologist who loves neuroscience, I find this trend very disturbing. First, psychotherapy has been shown in scores of well-controlled clinical trials to be as effective as psychotropic medication for very common psychiatric illnesses like major depression and anxiety disorders; second, a majority of Americans clearly prefer psychotherapy to taking medication. For example, in a meta-analysis of 34 studies, Dr. R. Kathryn McHugh at McLean Hospital found that patients were three times more likely to want psychotherapy than psychotropic drugs.

Finally, many of our patients have histories of trauma, sexual abuse, the stress of poverty or deprivation. There is obviously no quick biological fix for these complex problems.

Still, there has been a steady decline in the number of Americans receiving psychotherapy along with a concomitant increase in the use of psychotropic medication in those who are treated in the outpatient setting. These trends are most likely driven by many factors, including cost and the limited availability that most Americans have to mental health practitioners. It is clearly cheaper and faster to give a pill than deliver psychotherapy.


Timing is everything when it comes to marriage counseling
From Terry Gaspard in the Huffington Post:

Truth be told, the effectiveness of marriage counseling is directly related to the motivation level of both partners and timing. For some couples, marriage counseling is really divorce counseling because they've already thrown in the towel. For instance, one or both partners may have already decided to end the marriage and he/she uses the counseling as a way to announce this to their partner. Sometimes, the problems in a marriage can be too ingrained and longstanding for the counseling to be effective. For others, they don't honestly share their concerns with the therapist.

Further, it's important to choose a therapist who has experience working with couples and who is a good fit for both you and your partner. If both partners don't feel comfortable with the therapist, this can negatively impact progress; or one person may prematurely drop out.

Timing is an essential element in whether marriage counseling works. Unfortunately, most couples wait much too long to reach out for help repairing their marriage. According to relationship and marriage expert Dr. John Gottman, couples wait an average of six years of being unhappy before getting help. Think about this statistic for a few minutes. Couples have six years to build up resentment before they begin the important work of learning to resolve differences in effective ways.

Does your government make you happy?

17/5/2015

 
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So, in case you missed it, the Conservative Party won the General Election.

• Will this make us happy?
• Will an emboldened second-term government, now freed from the handbrake of its Liberal Democrat coalition partners, move further to the right?
• Will austerity be accelerated, further reducing public services and benefits?
• Will tax breaks and loopholes continue for those that need them the least?
• Is the solution to inequality more inequality?
• Will the NHS increasingly be contracted out to a private sector more concerned with profits than patients?
• Will the backbench nationalists lead a charge that pulls us out of the European Union?
• Will an invigorated Scotland, united under the SNP, reconsider its codependent relationship with Westminster and head for the exit, for independence?
• Will the United Kingdom become ever-more disunited?

Delighted Danes, frolicsome Finns
You would think that with so many governments around the world struggling with similar issues—200-plus grand petri dishes—that there would be more consensus over the best way to run a country.

What system seems to work best? Where are people happiest?

In looking for answers, the Gallup organisation surveyed people across 158 countries about their happiness. In the latest edition of the resulting annual World Happiness Report (http://worldhappiness.report), the 10 happiest countries in the world were deemed to be:

1.       Switzerland
2.      Iceland
3.      Denmark
4.      Norway
5.      Canada 
6.      Finland 
7.      Netherlands 
8.      Sweden 
9.      New Zealand 
10.    Australia 

If you were born into any of these prosperous, well-run, generally egalitarian nations, you should be thankful—it could have been so much worse. It could have been bottom-of-the-pile Syria, Burundi or Togo for you. The U.S. is 15th on the list; the U.K. 21st.

So what do the top-10 have in common? What makes the Swiss and the Swedes smile? Why so many cheerful Canadians, delighted Danes, frolicsome Finns?
The 6 keys to happiness
The report identifies six key factors which contribute to the happiness ranking: “The six factors are GDP per capita, healthy years of life expectancy, social support (as measured by having someone to count on in times of trouble), trust (as measured by a perceived absence of corruption in government and business), perceived freedom to make life decisions, and generosity (as measured by recent donations, adjusted for differences in income).”

A crucial ingredient that cuts across these criteria, the X-factor, is the concept of “social capital,” which is defined as: “the networks of relationships among people who live and work in a particular society, enabling that society to function effectively.”

Social capital describes the extent of trust, social support, and pro-sociality that exists. These things are the mark of an evolved human society—the antithesis of the kind of Ayn Rand law-of-the-jungle dystopia that is so prevalent in many parts of the world.

Writes sustainable development advocate Jeffrey D. Sachs in the World Happiness Report: “When social capital is high, individuals are more prepared to incur such individual costs for the greater good; and when most people in society behave in that manner, society as a whole benefits in higher economic productivity, stronger social insurance, greater societal resilience to natural hazards, and greater mutual care.”

Almost no-one can keep a straight face when the Prime Minister, the Chancellor and the Mayor of London—old Etonians David Cameron, George Osborne and Boris Johnson—inevitably utter the party line: “We’re all in this together.” We live in a deeply divided world—a world where 85 people have the same wealth of the poorest half of the global population, 3.5 billion people. But in egalitarian, truly democratic nations with high levels of social capital, the words are slightly easier to swallow.

The happiest nations are awash with social capital:

• 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.

Blame the victims
The World Happiness Report thus reveals that our mental state is highly dependent on the kind of society we live in, and our place within it. This should be obvious. We already knew that: there is a longstanding, strong correlation between low social “class” and mental health problems.

Yet in the West, there’s a tendency to blame the victims of unhappiness or other mental distresses for their own suffering. The rationale is that these unfortunate people need to pull themselves together, think more positively, be tougher, develop better strategies, stop whining or whatever. Or have 6 sessions of CBT—that should be enough to right their faulty thinking and behaviour, to make them see the error of their ways.

The late British clinical psychologist David Smail called this wishful thinking or “magical voluntarism.” The reality, he argued, is that our problems are caused by external circumstances, the harshness of living, an oppressive, unjust society. Aside from the likes of Erich Fromm, Harry Stack Sullivan, Karen Horney and the social environment psychologists, society’s role in mental dis-ease has generally been overlooked by a profession that for Smail is too often part of the problem rather than the solution.

Psychology, he says, has become part of the machinery of capitalism, co-opted to locate distress in the individual and so take the spotlight away from social iniquity, hierarchical structures and machiavellian manoeuvres in the corridors of power. Writes Smail: “I can think of no mainstream approach to psychological therapy which doesn’t harbour at its core a humourless authoritarianism, a moralistic urge to control, that has the ultimate effect of causing infinitely more pain than it could ever conceivably hope to cure.”

As in Bhutan, with its concept of “Gross National Happiness,” the U.K. government’s utterances and election promises around mental health are perhaps less about a genuine concern for the public’s wellbeing and more about public relations. The Improving Access to Psychological Therapies programme is welcome, but partly helps to window dress the real agenda: cutting back on public services and serving the needs of the powerful rather than the powerless. Likewise, it's easier for politicians in India to call for counselling for suicidal farmers than to give them a fair deal. Meanwhile, in the U.S., a powerful elite peddles the myth of the “American Dream”—anybody can become anything they desire, and if they don’t they’ve only got themselves to blame—as though a profoundly unequal playing field were an irrelevance.

People are unhappy? Well, continue flogging until morale improves. Or let them eat cake.

Perhaps Smail goes too far. “There is no such thing as an autonomous individual,” he writes. But we of course do have personal power. A lot. More than we realize sometimes. Regardless of our circumstances, we always have choices, as Viktor Frankl so eloquently described. The caged bird can still sing. There is a role for talking therapies.

As Sartre wrote: “Freedom is what you do with what's been done to you.”

Weekly news round-up

17/4/2015

 
PictureStephen Fry demonstrates the classic "headclutch" though without the stereotypical anguished expression.
U.K. news

The death of the “headclutcher” picture of mental ill-health
From BBC News:

A campaign backed by Stephen Fry has been launched to try to change the type of images used by the media for stories about mental health. But what is wrong with the ones currently used?

A solitary figure, with their head in their hands, more often than not cast in dark, sombre lighting. These stock images, often termed the "headclutcher", have become a familiar sight in media portrayals of mental illness.

Charities and campaigners have, for many years, lamented the use of such imagery, arguing that people with mental illnesses do not always "look" depressed.

Charlotte Walker, who has bipolar disorder, says these pictures can be harmful, and that images of people in distress have become synonymous with mental illness.

"It's the only image we see of mental distress," she says, "unless it's about obsessive compulsive disorder, in which case you always get someone washing their hands, or self-harm, where you get the obvious. It's too reductionist."

• How a visual cliche about mental health can slip through (The Guardian)


Wristbands for the mentally ill?!
From The Guardian:

If you’re wondering how much work is still left to do in dissipating stigma around mental illness, look no further than recent comments made by Chamali Fernando, the Tory parliamentary candidate for Cambridge.

When asked at hustings how authorities, such as the police, could better help those with mental health requirements, Fernando apparently suggested that vulnerable people could wear colour-coded wristbands denoting their condition, immediately alerting public figures to any special needs they might have.

When this statement hit Twitter, it was immediately seized upon and ridiculed by opponents, and with good reason: the last thing sufferers of any form of ill-health want is to make everyone they meet aware of their condition. It’s hard enough when Katie Hopkins is calling your debilitating mental illness “a passport to self obsession” without hanging a sign around your neck declaring: “I AM MEDICALLY SAD, PLEASE BEAR THIS IN MIND WHEN DEALING WITH ME.” Fernando’s main competition for the seat, incumbent Lib Dem MP Julian Huppert, wasted no time in making political capital from the comments, pointing out – correctly – that singling mentally ill people out with wristbands would only exacerbate the continual stigma that surrounds mental health issues.


Hundreds of mental health experts issue rallying call against austerity
From The Guardian:

Austerity cuts are having a “profoundly disturbing” impact on people’s psychological wellbeing and the emotional state of the nation, hundreds of counsellors, psychotherapists and mental health experts have said in a letter to the Guardian.

They said an “intimidatory disciplinary regime” facing benefits claimants would be made worse by further “unacceptable” proposals outlined in the budget.

These amounted to state “get to work” therapy and were both damaging and professionally unethical, they said.

Increasing inequality and poverty, families being moved out of their homes and new systems determining benefit levels were part of “a wider reality of a society thrown completely off balance by the emotional toxicity of neoliberal thinking”, according to more than 400 signatories to the letter. The consequences were “most visible in the therapist’s consulting room”.

The letter’s writers said it “sounds the starting bell for a broadly based campaign of organisations and professionals against the damage that neoliberalism is doing to the nation’s mental health”.


New review recognises the importance of counselling in those affected by infertility
From the Royal College of Obstetricians and Gynaecologists:

The psychological impact and private agony of infertility must be carefully considered by healthcare professionals, suggests a new review, published today (Friday 10 April) in The Obstetrician & Gynaecologist (TOG). The review identifies infertility as a complex state and life crisis and sets out the dangers of neglecting the emotional impact of involuntary childlessness and viewing it solely in biological or medical terms.1

The article provides an introduction to infertility counselling in the UK, within the context of fertility treatment. This includes an explanation of the differences between the three main types of counselling, implications, support, and therapeutic counselling, and the role of various bodies, including the Counselling Service, Human Fertilisation and Embryology Authority and British Infertility Counselling Association.
 

TfL spends millions on counselling for 'stressed' staff
From the Evening Standard:

London transport chiefs are spending millions of pounds to pay for counselling for stressed employees, it has been revealed.

Transport for London spent £3.1m on staff counselling from 2010 to 2014 in what union bosses said was a reflection of the "massive pressure" faced by employees.

Almost 5,000 staff members were given counselling for causes including stress, anxiety, train suicides and harassment, a Freedom of Information request by London Loves Business showed.

RMT general secretary Mick Cash told the website: "These figures are a reflection of the massive pressure that staff find themselves under against a background of cuts to numbers, services and safety.

“They serve as the clearest evidence that staff are bearing the brunt of Boris Johnson’s cash-led attacks across the London Underground network and reinforce the unions determination to fight his plans.”

And Finn Brennan, from the Aslef rail union, added: "The £3m spent on counselling is money that is extremely well spent.

"TfL employees do a very important yet difficult and stressful job. One of the big worries is the closure of ticket offices which will lead to reduction in staff. This will definitely leave staff more vulnerable."

Responding to the Freedom of Information request, TfL said the health and wellbeing of its staff is "paramount".


U.S.A. news

Obama calls for end to 'gay conversion therapies'
Following a massive petition and commentary in support of a ban, including this one from world of therapy, President Barack Obama has denounced the so-called “pray the gay away” practice of conversion therapy. From the BBC News:

US President Barack Obama has condemned psychiatric therapies designed to "repair" gay, lesbian, bisexual and transgender youth.

Mr Obama's statement was in response to an online petition calling for a ban on conversion therapies. It gained over 120,000 signatures in three months.

The petition was inspired by Leelah Alcorn, a 17-year-old transgender youth who killed herself in December.

Some conservative groups and religious doctors support conversion therapy.

"We share your concern about its potentially devastating effects on the lives of transgender as well as gay, lesbian, bisexual, and queer youth," White House adviser Valerie Jarrett wrote in response to the petition.

"As part of our dedication to protecting America's youth, this administration supports efforts to ban the use of conversion therapy for minors."


Baseball teams nurture players' mental health
From The New York Times:

For Cubs General Manager Jed Hoyer, Josh Lifrak is just like the hitting coach John Mallee or the pitching coach Chris Bosio.

Lifrak is the director of the team’s mental-skills program, while Mallee and Bosio are two vital members of Manager Joe Maddon’s coaching staff. Hoyer looks at each of them in a similar way, and he knows what that means in terms of a shift in thinking when it comes to mental health and major league baseball.

“I think that it used to be the kind of thing that people would talk to people. They didn’t, like, advertise it,” Hoyer said. “Some guys were ashamed of it, and some people didn’t want to have any part of it. I think now it’s almost impossible to find someone who doesn’t understand that your mental-skills coach is no different than a hitting coach or a pitching coach. He’s a guy that can really help your players get better.

“That’s a shift from, like, partial acceptance to, like, total acceptance in a very short amount of time.”

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Lena Dunham’s mental health “workout selfie”
From Huffington Post:

Lena Dunham shared a powerful "workout selfie" on Instagram yesterday. "To those struggling with anxiety, OCD, depression: I know it's mad annoying when people tell you to exercise, and it took me about 16 medicated years to listen," she wrote. "I'm glad I did. It ain't about the ass, it's about the brain." There's a lot to take from this selfie, beyond her "slim figure" and the fact that she is wearing a sports bra. Yet again, Dunham is working to combat the stigma surrounding mental health.


World news

Germany: Psychotherapy proven to normalize brain activity
From Medical Daily:

For years, psychiatrists and psychologists have lacked physiological proof of the "disordered" mentalities they diagnosed. Brain imaging technologies changed all that by offering hard evidence of the differences between the brains of patients and of people without mental illness. Now, a recent study from German scientists confirms theories of mental dysfunction underlying depression, while the research also shows how depressed brain activity can be normalized following psychotherapy — minus any form of drug therapy.

For some time now, neuroscientists using brain imaging technologies have been able to examine the changes that occur in the brains of patients as a result of mental illness. Depression, in particular, marks the brain in a particular way.

“The human brain responds to depression,” Dr. Svenja Taubner, lead author and professor in the department of psychology at the University of Kassel, explained in a press release. “Patients typically show hyperactivity particularly in the amygdala, the striatum, and other limbic regions.”

Along with this characteristic hyperactivity, depression also produces generalized network dysfunction, as neuroscientists conceptualize it, in the cortico-limbic loops. Since depression affects the functioning of the brain, it only stands to reason that successful treatment would impact the brain as well. In other words, patterns of hyperactivity should normalize as a patient’s mood stabilizes.

However, this is where brain imaging studies fall short — some studies show increased hyperactivity in limbic and subcortical regions following psychotherapy treatment, while others show decreased hyperactivity. Taken together, the studies did not prove psychotherapy could normalize the brain of a patient. For the current study, then, the researchers wanted to confirm the positive effects of psychotherapy.


Australia: Refugee experiences of mental health services
From the Australian Institute of Family Studies:

It can be challenging for anyone to attend a mental health service.

But for a young person who has fled a war-torn homeland, is currently learning the language, culture and systems of a very different country, and who is anxious about what their family and friends will think of him or her for attending a mental health service – it can be a very difficult experience indeed.

The stigma around mental health problems is often greater within refugee communities, with a common perception being that only those who are seriously disturbed or “crazy” use mental health services.

These are some of the barriers that young people from refugee backgrounds face in accessing and using mental health services. For the small number of this population who do access these services, no previous research has explored their experiences.

In order to address this need, we conducted in-depth interviews with 16 young people (aged 18-25) who were refugees. We asked them a range of questions about being clients of Australian mental health services.


Botswana: Pre-marital counselling critical
From AllAfrica.com:

Lack of pre-marital counselling leads to families and marriage disintegration in Botswana.

This was said by the chairperson of the newly found The Family Institute Trust, Mr Tebogo Duna, when briefing the media in Francistown on April 10.

He said given the rising divorce rates, one of the best things they could do to help save marriages was pre-marital counselling. Mr Duna said couples who attended pre-marital counselling had the opportunity to discuss issues that most couples argued about and most of these often led to divorce or separation.


Weekly news round-up

17/1/2015

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

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

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

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

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

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

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

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

Weekly news round-up

2/1/2015

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

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

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

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

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

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

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


Suicide decriminalised in India

21/12/2014

 
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In many countries, attempting to commit suicide was long seen as a criminal offense, born most likely of religious ideas—Christianity and Islam for instance both regard suicide as sinful. So you are desperate enough to want to take your own life, you try to kill yourself and the attempt fails, and now, just when you thought things couldn’t get any worse, you find yourself behind bars? Not to mention facing eternal damnation from a higher power? Great. Thanks a lot.
     Fortunately, common sense and compassion have generally prevailed and in most developed countries suicide has been decriminalised, though there are still some holdouts that apparently want to further punish those who suffer the most (here's looking at you, Singapore). India is the latest country to have come to its senses. Prime Minister Narendra Modi hit on the brilliant idea that some care and support for those who are suicidal might be more helpful than incarceration.
     “Why does a person commit suicide?” Modi said at a recent election rally. “The person who attempts suicide does not need punishment but counselling and empathy.”
     Says an IBNLive report: “Attempt to suicide that was punishable by a one-year jail term is no longer a crime with the government deciding to remove Section 309 of the Indian Penal Code (IPC) to decriminalise the offence.” 

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

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


“If I had no sense of humour, I would long ago have committed suicide”
—Mahatma Gandhi


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Broadmoor: a glimpse inside the asylum

7/11/2014

 
PictureBroadmoor: horror and fascination.
After five years of negotiation, for the first-time ever TV cameras were allowed into Broadmoor, the world’s most notorious high-security psychiatric hospital. The result is a two-part ITV documentary; part 1 aired last night. (You can watch the 30-second trailer here.)
     Broadmoor was opened in 1863 as the “State Criminal Lunatic Asylum,” where originally 300 men and 100 women would enjoy croquet on the lawn, dance parties and other social activities in and around the grand building with sweeping, highly therapeutic views over Berkshire and Surrey.
     Today the hospital treats about 210 men—it became single-gender in 2007—most of whom have severe mental illnesses and have committed serious, violent crimes. About 35 per cent come from prisons, 35 per cent from the court system, and the rest from other psychiatric units and high-security hospitals. The average stay at Broadmoor is six years; some have been there for more than 30 years. Patients past and present include Charles Bronson, often referred to as the “most violent prisoner in Britain,” Yorkshire Ripper Peter Sutcliffe, Stockwell Strangler Kenneth Erskine, and 1950s London gangland Kray twin Ronnie Kray, who suffered from paranoid schizophrenia.
    On average there are four assaults a week on staff. “You have to learn to work with that,” says clinical nurse manager Ken Wakatama in the documentary. Some patients require a “six-person unlock.” At one point, a patient refuses to come back inside when his time in the exercise yard is up—it takes nine staff to get him back into his room. Another time, the camera crew is asked to leave when the team feels “Lenny” has become too manic—they chase him down like a wild animal and forcibly sedate him.
     For the most part, however, the documentary avoids too much sensationalist voyeurism. Sutcliffe declined to participate, which is probably just as well. The patients, with their faces blurred and details of their crimes undisclosed, are invited to tell their stories. We meet “Daniel,” an intelligent 24-year-old and clearly a talented artist who 10 years ago was convicted of a violent crime against his own family. His family, he says, have stuck by him. He is grateful for that, and for Broadmoor.
     And we meet “Declan,” who recalls being put into care, at age nine. “I remember the day,” he says. “My mum took me to the office, I was sat there on the chair and the next minute she just left. She went, ‘You’re not coming with me.’ ” He was abused in the care home from the start, ran away, lived on the streets, and ended up committing a crime that involved torture. Other patients had stories of sexual abuse in care homes from a very young age, too. Robert Kennedy once said: “Every society gets the kind of criminal it deserves.”
     Dr Amlan Basu, clinical director at Broadmoor, sums it up: “Patients that come here, they will have perpetrated often horrendous crimes but they are also victims and it’s very easy to see somebody as either the perpetrator or the victim. It’s much more difficult to understand that somebody might be both.”
     It is hard not to feel for the staff, working with dignity in a really tough environment, but hard also not to be moved by the stories of some of the patients. This is a hospital, not a prison. The staff have not given up on the patients, and perhaps as a consequence, a lot of the patients seemingly haven’t given up on themselves. We see them taking part in talking therapy, playing with a Labrador from the pets-as-therapy scheme, participating in a poetry event. If the measure of a society is how it treats its most unlovable members—as no doubt Plato, Samuel Johnson, Gandhi or Nelson Mandela once said—then on the evidence of this documentary, Broadmoor appears to score rather well.

Are you mad?
The Victorian asylums of old, like Broadmoor, inspire both horror and fascination. Whatever the original intentions of the asylums, by the height of the British colonial period—when there were 120 in England Wales alone—they had largely become cruel and barren warehouses for the dispossessed of society, somewhere to dump all the outcasts and misfits and keep them out of sight. The conditions—and some of the “treatments"—were often quite barbaric. We are still haunted by these tales. And by the dread of finding ourselves in an asylum, restrained, powerless, afraid. The famous Rosenhan experiment from 1973 showed just how easy it is to get committed, and how hard to be released. “The asylum" looms large in our imagination. It perhaps serves as a warning, a deterrent to letting everything fall apart. We imagine a slippery slope, a great unravelling: one minute we're upset, silently weeping in the supermarket perhaps, the next, we fear, we find ourselves in a straightjacket, a padded cell, semi-comatose from sedatives, dimly aware that we're being prepped for a lobotomy. We project all of our fears onto the asylum. We desperately fear our own madness.
     And yet, one definition of sanity is a recognition, an embrace even, of the madness within. Winnicott wrote: “We are poor indeed if we are only sane.” If we edit out all our rough edges, our creativity, our spontaneity, our urges, our energies, our roiling emotions, our all-consuming passions, strange habits, wacky ideas and silly schemes—are we then sane? Or are we rather presenting to the world what Adam Phillips calls a “superficial sanity"—obedient, no trouble, soulless, uninspired? Writes Phillips in Going Sane: “Madness, at its best, is a journey towards true sanity, towards authenticity of our real nature; through madness we are in contact with the best things about ourselves."
     Our superficial sanity is deadening. Our madness, if we can safely let it breathe a little, is on the side of life.

Part II of Broadmoor: Wednesday 12 November at 9pm on ITV



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

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