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27/1/2020 Remembrance Is Easier Than Resistance. I’m writing this on Holocaust Memorial Day listening to the testaments of Survivors and their families. Again and again, they talk speak about the deliberate cruelty of their neighbours, colleagues, peers and friends, of children, administrators, managers, of Kapo – the day to day prisoner-managers of concentration camps. Again and again, presenters insist that they focus on the genuinely heroic people who risked their lives to help Jewish and other people that the Nazis systematically murdered.
The voices of Survivors and their descendants take precedence on Holocaust Memorial Day, to preserve and honour the memory of those killed, to hear the generational impact of the Holocaust. But this is published the day after because we also need to hear about the many more than 6 million people who allowed the holocaust to happen and positively participated in it. The mother in law of a friend of mine kept her Nazi uniform in her wardrobe until she died. She didn’t have horns, didn’t goose step down the road, by all accounts she was a normal housewife until she died a few years ago. Rochus Misch, Hitler’s bodyguard, died in 2013 unrepentant. Like many Germans of his generation he said that he knew nothing about the concentration camps, nothing about the abysmal brutality of his Party. But then, so did America and so did Britain, as early as 1941 The picture that illustrates this piece is of Nazis on holiday. Ordinary, hard working taxpayers, respectable, intelligent, fun, family people doing a respectable, legal job. The water in Germany wasn’t poisoned from 1939 to 1945 and it wasn’t in Rwanda, Cambodia, Armenia, the Americas, Greece, Assyria, Serbia, Ukraine, Indonesia, Guatemala, Bangladesh, Bosnia, Northern Iraq, Darfur, China or Myanmar. The British weren’t suffering from insanity in South Africa when we set up concentration camps at the turn of the 20th century, or at Amritsar, Bengal or Kenya. As a society, we always vote in favour of reduced State benefits and we all know about the hundreds of thousands of deaths and the endless grinding misery caused to the most vulnerable by austerity. The people most likely to vote in favour of this are least likely to be impacted by it. We know that it’s only when the more affluent are affected by things like the poll tax or cuts in tax credits and other State Benefits that they take these issues seriously, and only then does political change occur. Because we believe that the poor are responsible for their own misery. The working poor can look down on destitute and homeless. The disabled, who have suffered terribly under austerity, can scapegoat the mythical 'scrounger' someone who lies about being ill in order to live on £73 a week and be called in to endless meetings to prove how ill they are. Every single one of us is capable, not just of allowing but of actively participating in causing terrible harm to people we don’t know, and sometimes to people we do know. The reason our prisons routinely produce career criminals is because in the UK we want all prisoners to suffer. It doesn’t matter if they’ve not paid their TV license or are 12 years old, if they’re mentally ill or destitute, if someone’s in prison we resent them having sufficient food. The death penalty remains very popular, and if you gamble put £5 on it being discussed in Parliament within the next 5 years. Very few of the people who want other people to suffer – not to be rehabilitated and returned to be useful to society, but to really suffer, often to be sexually tortured – would identify as sadists. Any number of people who want a return of the death penalty are highly educated, excellent company, good, friendly people who just want to kill other people. 5 days before Holocaust Memorial Day people we very recently chose to represent us voted to prevent refugee children being united with their parents. These politicians have huge public support, the same public who yesterday bowed their heads and shed a tear for people dehumanised by a State that had huge public support. Humans are pretty simple: if you’re in our gang you must be good or you wouldn’t be in our gang. Anyone not in our gang might be tolerable, but some will be our enemy, and many of our enemies are so unlike us that they can should be harmed and sometimes killed. Some years ago the friendly husband of a lovely woman told me all about his latest design, a belt with pockets for cigarettes and a lighter. “We’re aiming at 13- to 15-year-old girls.” He’d made entirely legal fortunes from this kind of business, getting his designs made in China or India, avoiding rather than evading paying taxes, resenting the minimum wage, and was welcomed as a good chap within his social circles. He was friendly, generous, and always found a silver lining to every cloud. 13-year-old girls – not girls like his daughters, or the daughters of his friends - were things to make money from, as were the Chinese or Indian workers creating his cheap goods. Don’t mistake pleasant people for decent people. Annoying people who won’t shut up about how awful things are are the ones who get things changed for the better. None of us is entirely innocent. Our success as a species is due to our innate, predatory aggression. If that statement horrifies you or makes you proud you may as well be horrified by or proud of walking upright on two legs. There’s no shame or pride in being what we are: mammals with sharp teeth and forward facing eyes who are also capable of great acts of generosity, sacrifice, even heroism, for people we care about. The work, certainly of therapy but perhaps of being alive, is about becoming as fully rounded as we can be, about being able to look at parts of ourselves we find difficult, shameful, even frightening, and accepting that they belong to us as much as the lovely, friendly, hard working, respectable, helpful, generous, caring parts. Because that which we find unbearable in ourselves we dump on to others. And history endlessly illustrates where that leads. 28/1/2019 Certainty Is Not Synonymous With Truth. Illustration by Dominic McKenzie This morning a woman* on the tills suddenly dived into a monologue: “There’s no good news, I just wish Brexit would be over, we’ll wake up one morning and it’ll be done and we won’t notice any difference. We’ve got to stop all these foreigners from coming in and using our health service and being on benefits, we just can’t afford them any more.”
Part of a therapists training is to learn to hold a neutral face and non-confrontational eye contact and I was glad I had been using these skills just minutes before because I was amazed and then curious: what was going on for this woman? How far would she go? For how long? She had quite a way to go. She was livid that her vote – the only vote she’d ever cast – 'was being ignored.' I learned about her family and how confident they were that we’d be just fine after Brexit because of our existing trade deals and because of the high status Britain has in the world. I stopped the interaction at that point - smiling and behaving like a customer - for a couple of reasons. The person working beside this woman was black. For all I know he too may have voted to leave Europe, he might be in complete agreement about ‘foreigners,’ he might have been stone deaf, but for me the use of the word ‘foreigners’ was so powerful that I was no longer comfortable with how it might be impacting him. Secondly, the woman was beginning to move in an increasingly agitated way. There’s a way of being as a therapist that gives space which often fills with powerful feelings, feelings that we know to be only part of reality, and in the confidentiality of a boundaried space those feelings and words can be aired, held without judgement and examined. A shop queue is not that space. The encounter troubled me deeply. What should I do? I could accept this woman’s monologue for what it was - unbearable distress - knowing that it was possible that the woman would be shocked at herself and not repeat it or, more likely, that someone would make a complaint about her. Where do my responsibilities to this woman, to the social contract and to my own conscience lie? Do I let her take enough rope to hang herself? Isn’t that how this works, that we push boundaries until someone pushes back? I don’t know what the right thing to do might have been but this is what I did. I spoke quietly and without heat to another member of staff at the customer service desk. He took me seriously and although he apologised he knew I wasn’t looking for that. I didn’t identify the woman and emphasised how distressed she seemed, that I wasn’t making a complaint and that I didn’t want anyone punished. He said, “It sounds like she’s on the edge. If she’s feeling like that lots more people probably are,” and I relaxed. That took 5 minutes of my time and I was able to hand over my own anxiety to someone who was in a position to deal with the situation more meaningfully than I. However we voted or didn’t vote in the referendum, whatever the rights and wrongs of it all, we are living through volatility unseen for generations and it’s exhausting. We are treating each other in hateful ways and there is very little that anyone can do about it because we seldom get the opportunity. And sometimes there’s an opportunity where we might not recognise it. We don’t have to take refugees into our own home but we can understand that brown and black mothers love their children as much as we love ours, and imagine what it would take for us to put our baby into an overcrowded boat knowing that in the next few minutes they may drown. We don’t have to give all our possessions to homeless people but we can understand that homelessness, addiction and mental illness cost the public purse vastly more than social housing, and remember that social housing was originally for everyone, whatever their income, because that’s what a vast majority (the military more than any other section of society) voted for. We can ignore racism, or confront it face to face, or make an entirely justified complaint. Or we can attempt to address the situation without aiming to make anyone’s life a misery. We can feel contempt for the 1 in 12 people who are holocaust deniers, and despair or understand that this was a poll of just 2000 people, and that it speaks to a need for much greater social mixing, every day, forever. We can clutch our pearls at the video that’s doing the rounds again of a 4 year old and his granny yelling “Millwall, fuck ‘em all, fucking black cunt,” for the camera and demand someone saves us from them. Or we can understand that this attitude is very far from unusual, that it’s held by people who are charming, polite, solid churchgoing members of rural communities who would not dream of uttering such profanities, and that this family are very likely to be the epitome of the much admired Hard Working Tax Payer. Complexity is gruelling. There are seldom straightforward answers to anything. If concepts like “keep an open heart” help then use them but what you may actually be doing is approaching a problem logically and strategically, for the best possible, most sustainable outcome. It’s not as satisfying as knowing that the person causing you grief is a dangerous animal or an elitist libtard pervert but at the very least it keeps your options open. At best, it makes you a wiser, more rounded person. Even if you get it wrong. *I’ve aimed to fictionalise events sufficiently so that the people involved would not recognise themselves. 9/7/2018 No One Is Coming To Help The estate management service is contracted to cut the grass every 2 weeks between April and October and now, having erased the last remains of desiccated vegetation two weeks ago, they're slicing into dust.
The estate managers make soothing noises and nothing changes. Everyone is fulfilling the terms of their contract. And you can bet that if they didn’t there would be residents who demanded that they do, because they’ve paid for the contract to be fulfilled. In the years that I’ve seen clients, both as a volunteer counsellor and in private practice, it’s been clear that people want to do their best which for a huge majority means fulfilling their contracts and avoiding trouble. They work full time on a part time contract, take on more and more work, don’t let their team, clients, boss or family down all the while becoming more and more frustrated, exhausted and despairing. Underneath these behaviours is often a fear that they will be seen to be not even deficient but just different and different is bad. All too often they have a boss who is putting pressure on them to do more. Never mind that their boss is also under pressure, the burden just gets passed down. There’s no good end to this. People get ill and go off work: if they’re employed they at least have the backup of sickness legislation, if they’re self-employed they lose income hand over fist with very serious implications. Teams have to take up the burden of an absent colleague, customers have to wait and vulnerable people’s services become less functional until they become harmful. Blame rears its head. People who have followed policies and made all the right noises cannot be to blame; look, here are all the boxes, ticked. People who have become ill may well be to blame, particularly if that illness isn’t physical or if a physical illness is invisible. Slipped discs, irritable bowel syndrome, stress, migraines, well, anyone can make them up, right? Looking meaningfully at the causes of stress, of illness, doesn’t pass through anyone’s mind while finding and getting rid of a scapegoat makes everyone feel better for a month. ‘We’re not getting the support we need,’ is a truism. I can’t think of one group of working people who is. Because what almost every working person needs is less work. I mean it. Healthy people of working age in the west are most likely to find satisfaction by working an 8 hour day, sleeping for 8 hours and doing what they want for 8 hours. That’s well established and we are simply not prepared to take responsibility for it, waiting like a damsel in distress for someone to come and rescue us. Worse, growing numbers of people embrace the performance of martyrdom finding perverse pleasure in and measuring their worth by their public suffering. There’s a reward in being seen to be faithfully ploughing on, not letting anyone down, being good. Being very, very good. That’s fine, go giddy with masochism, but be aware that you’re doing it and take responsibility for it. People who don’t get gratification from overwork are directly and adversely impacted by people who do. An organisational culture of virtue/performance overwork can begin with just one person, becomes normal then expected from everyone. A good manager isn’t one that goads their teams to further work but who has the confidence and wisdom to say, “Mary, John, I can see that you really want to do your job well. But that means taking the time to go home and relax. You’re putting other people under unnecessary pressure. We’re working for the long term here, sickness and burnout are avoidable costs to our business.” Yes, absolutely easier said than done. But it doesn’t mean that it can’t be done. It just means that you treat people respectfully rather than like a herd of abused donkeys. You don’t overload your business. You don’t take on work you can’t fulfil without brutalising yourself or your workforce. You accept that there are endless numbers of people who need help and that your power to help them lies more in your vote than in your ability to work an 18 hour day. While we wait for the entire culture of the UK to alter you may have to take your life into your own control by making long term plans involving seeking a new job, retraining, moving, all kinds of profound and stressful changes. You may have to lose money. You may very well lose status. Genuine self respect will lead to people treating you with genuine respect and that is worth more than a title and a 50-hour working week. You’ll have your price, everyone does, and balancing your financial needs against your long-term wellbeing is a delicate matter. The sooner you begin the sooner you’ll find a better, more satisfying way of living. But you have to begin.   Stress is the theme for this years Mental Health Week and there are announcements across media including a Mental Health Minute across commercial radio and the BBC performed by royals, Lady Gaga and Judy Dench.
Huge amounts of time and money have been spent on trying to get us to take stress seriously, from luxe adverts to hard legislation. But we won’t. We won’t because if we could we would but some of us are in a situation where if we were to we’d start to fall behind on the mortgage, rent or other essential payments. We won’t because we don’t have the necessary backing from managers who in turn are unsupported. The internet is absolutely heaving with research around how management can make the workplace less stressful and techniques that individuals can use to manage personal stress, and as a nation we are dropping like flies. That's because workplace stress is seen as a badge of honour and these techniques are like using a water pistol to put out a fire. We won’t because being overworked has become a virtue. A significant number of us work over 45 hours a week and Londoners work, on average, three weeks more than people who live outside of London and we’re proud of it. On average men work longer hours than women and women do countless hours more housework, childcare and emotional labour. If you’re not constantly on the go, and your children are not in several after-school clubs as well as doing homework then WHAT ARE YOU DOING? I’m proposing two things:
Increasing numbers of us have moved from stress to burnout. The difference? One can make you ill. The other can devastate you. Working conditions in the 1840’s to 60’s were horrific with 12 hour days and 7 day weeks, 5 year olds working and people sharing beds on a shift system but people got on with it because they had to. Happily, we have much better choices. We just don’t take them. Like ‘mental health’ ‘Wellbeing’ is overused to the point of meaninglessness, reduced to chocolate, bubble bath and gin for women, exercise and material acquisition for men. You might get a five minute buzz from these things but they’re not going to save you. Your boss is not going to save you. The law is not going to save you from your boss unless you are very, very rich in which case you can afford to walk away from your job. Our political landscape is heading swiftly backwards in time and we are encouraged to vote to harm ourselves. Here are 3 meaningful opportunities to avoid burnout and limit stress: 1. Join a Union. Get over any derisive feelings you may have about flat caps and whippets, ask yourself who benefits from you having those derisive feelings, and join an organisation that will represent you if you are treated badly by your employer. Whether your employer recognises a Union or not is irrelevant. If you are an employer, ask for Union input. Get over any fearful feelings you may have about three day weeks and militant wreckers and discover how Unions can make your life better and your business more robust. Look to Germany where Unions and employers work together routinely, respectfully and productively. High staff turnover and unsafe working practices cost businesses avoidable losses. 2. Discern how status is making you anxious. It’s not unusual to not be able to tell who is very high status because their self esteem is such that they don’t care a great deal about what they look like or what car they drive. It’s genuine nonchalance not overcompensation for feeling unable to advance; their self-worth isn’t affected by their hairstyle or suit, by being seen to be having a wonderful life on social media or going out with the boys every single evening. If both of you have to work in order to cover childcare costs or to pay for two cars consider how much being employed is worth financially and in terms of status to you as individuals. Could you both work part time? Or is it important to your social standing to be seen to be employed? 3. Explore how you think about other people. There’s an element to many peoples’ personality where we are willing to suffer as long as we can cause people who are weaker than ourselves to suffer; it’s called 'Punching Down’ or ‘The Crab Bucket.’ We will embrace the identity of Hard Working Tax Payer because we hate scroungers on benefits. We would rather do without something that is in our grasp than help someone else get something. This grudging approach to life has its roots in fear and feeds on hate - and fear causes the release of adrenaline. Yes, immigrants exist. Yes Islamic terrorism is real. Yes, people on benefits cost £109.8 billion. And immigrants contribute more to the economy than they take, terrorism in the UK has never been lower (while rates of domestic violence are greater) and old age pensions account for nearly half of welfare spending, benefits for working people take up almost the other half and Jobseekers Allowance is up 1% of the total. If you know these facts and still feel angry or grudging about immigrants, Muslims or people on benefits you will suffer from a kind of confusion called cognitive dissonance which is a type of stress. You can choose to make large areas of your areas less stressful just by thinking carefully, logically and with an open mind which is precisely what counselling is. Learning to think in this way, to consider complexity, to deal with nuance, to recognise that you don't know what you don't know is much harder than it sounds which is why we need people to help us. And it’s absolutely worth it. NB My levels of stress went through the roof when the comparisons graph image totally refused to be embedded in the text. After half an hour I gave up. This doesn't mean I'm a quitter and have failed and should keep going until it goes right. It means the software is playing up and it's out of my control until someone else repairs it. It means that I believe you're an adult and can cope with imperfection. And it means that my life is worth more than obsessing with something that won't work. So is yours.  A young woman left a furious note on an ambulance that was blocking her drive: “Move your fucking van. I couldn’t give a shit if the whole street collapsed.” She was taken to court, fined, and her lawyer says that she accepts her behaviour was completely unacceptable. She feels shocked at her own behaviour, suddenly realising that what she has done has actually happened. Twitter has, of course, turned on her for being so crass using the same and often worse abuse against her. Other women with the same name have been subjected to online abuse. A number of people have mistaken the picture of the female paramedic who tweeted the abusive note for the woman who left it and have filled the web with abusive comments about her looks, her sex, anything and everything about her. Inevitably, the woman's employment status seems to be of particular value to people who are vomiting up bile about her vomiting up bile. Online disinhibition is very well understood: “the lack of restraint one feels when communicating online in comparison to communicating in-person. Possible influencing factors toward online disinhibition include anonymity, invisibility, asynchronous communication, empathy deficit, in addition to individual factors like personality and culture background.” I’ve spoken with a number of people who are alarmed to discover that they feel able to harm, sometimes to even to kill, particular politicians or criminals and I’ve spoken with larger numbers of people who defend their belief that prison should be a place of focused and formal torture. Not solitary confinement but clear eyed, state-applied cruciation, often sexual. The human propensity for abject cruelty is all too well understood. Various sanctions have been put in place to temper that impulse, from religion to the appeal to enlightened self interest and whilst some of that works some of the time it seems that once again, we are living through a period of casual and global malice. How many of the people who currently feel able to pull the trigger on a politician who genuinely has caused vulnerable people to die could actually do it? In fact, I believe a larger number than usual of us could. Media has always whipped up our natural animal instinct to see everyone that isn’t us as not-quite-human, almost certainly an enemy. The process of dehumanising a person in order to make harming and killing them as easy as killing a cockroach is all too well understood. We are living in a society where significant numbers of people will send death threats to doctors and nurses in Great Ormond Street Hospital. What is missing from all of this is face-to-face human relationship. Not people screaming abuse at each other, but being in a situation where you are heard, and listened to by someone who is not threatened or shocked or appalled by what you are saying. Being heard humanises us. When we feel unheard we feel able to say anything and most of us have an ethical core that is wounded when we say or think or feel things that are harmful to others. To drown out the knowledge of the harm it does to us we increase the volume of our abuse. Therapy has always had a societal impact: a person who knows that what they say is heard is much less likely to say vicious things because they can hear themselves. In a society where hardly anyone is heard almost everyone can say things that lead to malevolence. Who listens to you? Who do you really listen to? When did you last listen to yourself? 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Porto’s has been here for nearly 30 years and has hardly changed in all that time. In a sea of gentrification it is an island of stability and perhaps because of that a number of its regulars are people with pretty full-on mental health issues.
Joseph is a regular. Today he gave the women behind the counter a 5p tip (no one tips in Porto’s) and talked succinctly about the purposeful destruction of self-esteem. “You know that man who gave me £20? Straight after that the other man gave me 5p. If he’d given me the 5p before the £20 or way after I’d know he was doing it out of goodness and I’d be grateful, but he was doing it out of wickedness. Do you understand me?” “I see it with girls too, they see a beautiful woman and they say “You look so tired, are you OK?” and they know what they’re doing, they just can’t stand anyone having something they think they haven’t got.” Joseph, like so many people who can’t fit comfortably into the world, sees things all too clearly and cannot endure it. He’s homeless and so sees people as we do not like to see ourselves, in ways that social scientists have described very well. We see someone getting something, we believe they do not deserve it and we become aggressive. A man saw a mentally ill homeless person get £20 and was so infuriated that he felt the need to punish someone. He didn’t confront the giver. He didn’t confront Joseph directly. Instead, he instinctively did something immensely sophisticated. He destroyed Joseph’s feelings of warmth, pleasure and thankfulness by giving him more money. Joseph knew precisely what had happened. He explained it to me more accurately than many of my colleagues can manage. Articulate, whip smart, incredibly empathic, and teetering at the edge of his endurance all day long. The man who gave him the 5p is a respectable family man, a Hard Working Tax Payer; being another Porto’s regular I know him well. Suave, expensively dressed, edgy if he thinks he’s been insulted, and he often feels insulted. He once required service at Porto’s before a woman who was there before him and when she quietly corrected him he was dumbstruck. 5 minutes later he showily approached the woman to tell her to be more polite next time. When she reared up into his face, copying his behaviour of bashing a coin on the marble counter to get the staff’s attention he was sufficiently cowed to back off but his face showed simmering hatred. In truth, I doubt he had even been aware of the woman; he wasn’t being intentionally rude it’s just that she wasn’t important enough to him to be visible. But when she became visible, popping into existence to censure him, his – what? shock? fear? certainly an adrenaline response - led him into a situation where he has made an enemy and been shown not to be as urbane as he’d like to be. The woman later told me that she’d purposefully brought her husband to Porto’s the next day because she felt that this man functioned at a level where he would feel compelled to make her submissive unless he could see that she had a male owner who might object to his property being damaged. How tiresome all of this is, what a soap opera. The research across cultures and across species repeatedly demonstrates that our relational interactions seem little more than hormonally-driven survival behaviours, somewhat developed in childhood. Doing more than that is fantastically difficult, tiring work, something that other animals don’t seem to have much interest in. How much instinct or desire to care for individuals who are not in a family or social group do meercats, owls or chimps have? And yet that desire to do better is what has made modern civilisation possible. We watch the results of survival-driven behaviours all day long, all our lifetimes and throughout history, but the genuinely sophisticated leaps forward have been when slavery was abolished or workers are given better pay and conditions, when healthcare free at the point of need was established and universal education legislated for. There’s no doubt that national wealth would be better served by making children work, by slavery, by very low wages and long working hours and by disabled and elderly people dying as soon as they need support. We instinctively incline towards that. Over the entirety of the Second World War 67,100 UK civilians were killed. In the last 8 years the BMJ estimates that 120,000 deaths can be attributed to austerity. One of the reasons I go to Porto’s so often is for a break from bleakness, human contact mediated by financial and social tropes that keep us comfortably together, comfortably apart, knowing our own and everyone else’s place in a familiar dance. It’s very like the therapeutic relationship. I find Porto’s more comfortable than the much more polite, much more mannered and much more expensive cafes in the area. I like Porto's honesty of interaction. 14/12/2017 Beyond Resilience I published this six months ago on Linkedin, and think it's worth revisiting.
10/9/2017 Longing For An End Perhaps because it’s the biggest killer of men under 50 talking about suicide has become less taboo but there’s still a lot of stigma and fear when it comes to actually talking about suicidal feelings. People fear that talking about these feelings will result in panic and chaos, that a counsellor will call the police or prevent them from leaving the room until an ambulance arrives with a mental health team and a straight jacket. Some suicidal people want something like that to happen, for someone to relieve them of all responsibility, to take control and let them rest but anxiety about how that may happen prevents them from taking a first step.
My contract has four clauses that limit confidentiality and one of them is if the client is seriously suicidal, but what does ‘seriously’ actually mean? If a client tells me that within the last few hours they’ve taken an overdose then I’ll call an ambulance whether the client says they want me to or not – the fact that they’ve told me at all suggests that some part of them wants my intervention. So far that’s never happened to me. What has happened is that a client has told me enough to make me concerned that they may actively try to kill themselves within the next few days. I’ve asked their permission to contact their GP to get them involved. I’ve done this twice, both times with the client and me in the same room and with the speakerphone on. It’s important for the client to know precisely what is happening. Both times the client saw the GP within 4 hours. They weren’t sectioned or coerced into anything and continued to come to therapy. Huge numbers of people feel more or less suicidal every day. When things seem too overwhelming, when you’re too tired and worn down, when there are too many demands and nowhere near enough resources suicide can seem to be a rational choice. The vast majority of people who feel this way don’t want to die, they dearly want to live, but to live differently from the life that they are trapped in. Poverty, pain, violence, shame, discrimination, fear, exhaustion and a long list of other circumstances can make life anguished and hopeless, compounded by the wretched fashion of positivity that boils down to ‘You are always failing.’ Suicidal feelings can be comforting, they offer a semblance of control when everything else seems frighteningly out of control. If the pain or other struggles become too much then suicide simplifies everything. It’s why prisoners are kept on suicide watch: to stop them having any control whatsoever over their own life. To remove that final aspect of control from a person who sees suicide as their last resort is a form of torture. Feelings of despair and suicidality are more than worthy of being heard, they are the heart of the matter. Sometimes they are a howl from the past when events took over and swept you away. Sometimes the present is unbearable. You know that no one ever gets over the death of a child or another dearly loved person and the idea of living with this pain seems impossible at the same time as beginning to come to terms with it can seem like a betrayal. Moving into the liminal space between life and death can be caused by cumulative smaller events: being subjected to ‘regeneration’ or being made redundant; the end of another relationship or many long years of a violent one; workplace insults and misery can wear a person down to nothing. Living with suicidal feelings can become habitual, the neurological pathways between anxiety, a sad thought, a difficult event and the solution of death become well worn and more swiftly travelled without us even realising it. Whatever the case examining these feelings and thoughts is the work of therapy. Bringing a light into these places can make them less mysterious, less alarming. Looking at them squarely can diminish their power and witnessing them honours what may have been longing to be seen for many years. No counsellor can stop a person who is determined to kill themselves. For some people life is genuinely too complex and painful to endure and no amount of care, trust, relationship, medication, voluntary or involuntary hospitalisation or anything else will ultimately prevent it. Yes, suicide often bequeathes more pain and misery, no one denies that, and there are often ways out of present agony other than death. If you can choose to die at any time, take the time to share your truth with someone who can bear it. Maytree - 020 7263 7070 MIND Samaritans 116 123 International Resources 31/8/2017 You May Not Need Therapy At All A fair number of clients describe very similar problems. They’re constantly tired, or very edgy and unable to rest; teary, stressed and not coping. What used to be small problems have become insurmountable. They’re irritable, panicky and can sometimes behave in ways that seem beyond their control leaving them feeling ashamed, stupid, defensive and angry. As well as taking these symptoms seriously in a psychological sense I’ll also ask them to visit their GP to request some blood tests. Full Blood Count (FBC) This measures your general health, including how much iron you have in your blood. Anaemia – a lack of iron – can make you feel exhausted, short of breath and cause palpitations. Shortness of breath and palpitations are also symptoms of panic attacks. Low levels of magnesium and calcium can cause panic attacks. An FBC will show if you have any underlying infections which will make you feel tired and less able to get through the day. Thyroid Function Test The symptoms of an over- or under-active thyroid are very close to the symptoms of anxiety or depression. An overactive thyroid can also result in mood swings, insomnia, persistent tiredness and weakness, and the classic symptoms of a panic attack, palpitations, nervousness and irritability. A Blood Glucose Test GP’s generally offer 2 types of blood glucose (sugar) test for people who are not showing overt signs of diabetes: the fasting glucose which shows what is happening to your glucose levels after 8 hours of not eating, and the HbA1C which shows what your average glucose levels have been over the past three months. Type 2 diabetes is increasingly common and can lurk for years before it’s diagnosed. Some of the symptoms of it are tiredness, depression, and the classic symptoms of a panic attack: anxiety, sweating, palpitations, trembling. If your blood sugar suddenly drops, as it can do in diabetes, you can also feel irritable and bad tempered. These tests are performed at the same time with just one needle and take about 20ml of blood in total. Once you and your doctor get the results you will both have a much better idea of what may be causing you to feel psychologically unwell. Even if you have a clinical diagnosis of depression, anxiety or panic disorder, get these tests done. Physical causes of symptoms are notoriously ignored in people with a mental health diagnosis. And as with any medical issue if your GP is unhelpful get a new GP. There’s an intimate link between the body and the mind and just by attending to what the body needs, whether that’s more or less thyroxin, iron or just water, we can improve and sometimes even cure what seem to be emotional problems. If you have an underlying physical problem that you don’t know about therapy can help you be more motivated to attend to your health so that you eat better food, exercise and drink water more regularly, but this will not address a problem thyroid gland, low iron or diabetes. You never know, you may be able to avoid therapy altogether! 16/8/2017 A Level Results Stress Tomorrow is the big day and I’ve yet to meet anyone waiting for their results who isn’t anxious. For young people this is an especially critical time because so much depends on it. Whether or not you get into the university that you want to. Whether or not you leave home. How you’ll compare to your peers.
The hours up to 8am tomorrow can feel unbearable but there are a few simple things you can do to manage your stress. Most importantly, move around. It doesn’t matter if the movement is housework, going to the gym, taking the dog for a walk whatever it takes to get the air moving in your lungs and to build up a bit of a sweat. Stress releases adrenaline and the purpose of adrenaline is to make your muscles more efficient for escaping or fighting. If adrenaline just hangs around in your body you will become irritable and restless. If it comes to it, just jump up and down on the spot until you get breathless. If any of that breathlessness is because you’re laughing at yourself jumping up and down on the spot, so much the better. From now on any time you feel anxious, use the adrenaline that is produced by your anxiety. The next most useful thing you can do is have a drink of water. Just water. Not juice or coke or alcohol. There’s a link between even very slight levels of dehydration and anxiety, so rule that out. And have a glass of water every hour or so. Now, spend 30 seconds breathing properly. Stand up. Plant your feet firmly on the floor. Imagine a thread pulling you gently upright from the crown of your head. Breathe in through your nose and imagine that you’re filling your lungs from your belly button upwards. Your tummy should move, then your chest, but not your shoulders. Let the air move into your body and then gently let it flow out again. Again, your tummy should move then your chest, and your shoulders shouldn’t move. The in and the out breath should take about 12 to 15 seconds. That breath is how you should be aiming to breathe all the time. From your belly button up as your breathe in. From the belly button up as you breathe out. Simply breathing like that will ensure that you’re not breathing shallowly and too quickly, in a way that can actually bring on a panic attack. If you’re breathing effectively your voice should become a little deeper. If you hear your voice getting high pitched you know that you’re not breathing effectively. Slow down. Plant your feet flat on the floor. Breathe. This kind of breathing will slow your thoughts down and help you get things in perspective. The only admin you can do between now and then is to get the email address and phone numbers of the universities you want to go to, and those of your insurance choices The UKAS Track website will freeze from 6pm today. For what it’s worth, I’d leave it alone now. You’ve already changed everything you need to. It doesn’t update at midnight and won’t be open until 8am tomorrow. UCAS’ social media team will be around from 6am and the contact centre opens at 7.30am for enquiries. There’s no point in spending any more time with the website until then. So get some things in place from now until you pick up your results. Try not to make alcohol one of them. Timetable in a couple of exercise sessions – yes, a couple! - and if you can do them with a friend so much the better. Go swimming, go for a run or a long walk. Do some sit ups, press-ups or planks. Do the washing up, cook dinner, clean the windows, walk the dog, try to make the expenditure of energy meaningful. If you can’t find anyone to do exercise with just do it by yourself. Exercise will help you sleep better tonight, so put your heart into it. Plan a good evening meal, something that has a decent amount of protein in it. Tryptophan is an amino acid, one of the building blocks of protein, that aids sleep and combats anxiety. You’ll find good levels of tryptophan in nuts, tofu, meat – especially turkey – eggs, cheese, beans, lentils and oats. Plan your breakfast around this list too. Set an alarm, right now, to remind you to breathe properly for 1 minute every waking hour. That’s a total of about 12 minutes. About 50 good breaths. Find a good distraction and immerse yourself in it. If it’s an outdoor distraction that’s great. If it’s outdoors with friends, even better. If it’s gaming, well so be it, just don’t turn into a slob. Drink water. Get away from the screen to eat a good meal. Run up and down some stairs once in a while. And stop around 10pm at the latest. Be kind to yourself. There may be some very critical voices in your head telling you that your life will come to an end if you don’t get the results you need, that you didn’t work hard enough, that you’re a disappointment to your family and to yourself. Perhaps you didn’t work hard enough. There’s nothing you can do about that now. You can determine to work harder from now on. That’s all anyone can do. When I did my A levels a friends mother wouldn’t talk to him for 3 days because he didn’t get the results she wanted him to get. We all thought she was cruel and wrong. 30+ years on, knowing all about the causes of punishing behaviours I still think she was cruel and wrong. If your family or anyone else punishes you for not getting the grades you need they too are cruel and wrong. There’s no point in punishing you. Punishment – including passive aggressive sighing “It’s OK. I know you did your best,” ie "I know you're not very clever," – is not going to alter your grades. Some families look to their children to lift them out of poverty. In countries where that is a matter of survival pressures are different but in the UK getting good grades is not a matter of life and death. Your parents may well have made sacrifices to get you through education. That’s what parents are meant to do. What people who take A levels are supposed to do is to work hard enough to get the best grades they can without driving themselves mad. Anorexia, bulimia, depression and anxiety have exploded in young people. That’s a price that’s just not worth paying for A grades. For anything at all. OK. Stand up! Breathe in and out properly twice RIGHT NOW! Then go and get a drink of water. Good luck! |
CategoriesAll Abandonment Abuse Ancestors Anger Anxiety Ash Wednesday Attitude Banking Bereavement Birthday Bravery Breivik Bystander Effect Camila Batmanghelidjh Carnival Cbt Challenger Charlotte Bevan Childbirth Childhood Children Christmas Coaching Compassion Contemplation Control Counselling Culture Dalai Lama Death Death Cafe Democracy Denial Depression Domestic Violence Dying Eap Earth Day Empathy Employment Eric Klinenberg Ethics Exams Existential Failure Family Annihilation Founders Syndrome Francis Report Gay Cure Genocide George Lyward Goldman Sachs Good Death Greg Smith Grief Grieving Grooming Groupthink Happiness Hate Hungary Illness Interconnectedness Jason Mihalko Jubilee Kids Company Kitty Genovese Life Light Living Loneliness Love Mandatory Reporting Meaning Men Mental Health Mid Staffs Mindfulness Money Mothers New Year Nigella Lawson Optimism Organisational Collapse Oxford Abuse Panama Papers Panic Panic Attacks Parenthood Petruska Clarkson Pleasure Politics Positivity Post Natal Depression Power Priorities Priority Productivity Psychotherapy Ptsd Red Tent Reflection Rena Resilience Riots Rites Of Passage Ritual Robin Williams Sad Sales Savile Scared Seasonal Affective Disorder Self Care Self Preservation Self-preservation Shock Sin Singletons Sport Spring Status St David St Georges Day Stress Suarez Suicide Support Talking Terry Pratchett Time Transition Trauma True Self Truth Understanding Unemployment Valentines Day Viktor Frankl Violence Whistleblowing Who Am I Winter Blues Women Work Archives
January 2019
CategoriesAll Abandonment Abuse Ancestors Anger Anxiety Ash Wednesday Attitude Banking Bereavement Birthday Bravery Breivik Bystander Effect Camila Batmanghelidjh Carnival Cbt Challenger Charlotte Bevan Childbirth Childhood Children Christmas Coaching Compassion Contemplation Control Counselling Culture Dalai Lama Death Death Cafe Democracy Denial Depression Domestic Violence Dying Eap Earth Day Empathy Employment Eric Klinenberg Ethics Exams Existential Failure Family Annihilation Founders Syndrome Francis Report Gay Cure Genocide George Lyward Goldman Sachs Good Death Greg Smith Grief Grieving Grooming Groupthink Happiness Hate Hungary Illness Interconnectedness Jason Mihalko Jubilee Kids Company Kitty Genovese Life Light Living Loneliness Love Mandatory Reporting Meaning Men Mental Health Mid Staffs Mindfulness Money Mothers New Year Nigella Lawson Optimism Organisational Collapse Oxford Abuse Panama Papers Panic Panic Attacks Parenthood Petruska Clarkson Pleasure Politics Positivity Post Natal Depression Power Priorities Priority Productivity Psychotherapy Ptsd Red Tent Reflection Rena Resilience Riots Rites Of Passage Ritual Robin Williams Sad Sales Savile Scared Seasonal Affective Disorder Self Care Self Preservation Self-preservation Shock Sin Singletons Sport Spring Status St David St Georges Day Stress Suarez Suicide Support Talking Terry Pratchett Time Transition Trauma True Self Truth Understanding Unemployment Valentines Day Viktor Frankl Violence Whistleblowing Who Am I Winter Blues Women Work |
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