A bubble has burst and the banking system is reeling. Since the early ‘80’s we’ve all been in awe of the City, convinced that we’re too dumb to know what this mythical place was up to.

People in banking know that ‘The City is a massive cesspit,’ as Vince Cable said yesterday, or that it is, as the Governor of the Bank of England described it, ‘excessive, shoddy, deceitful and manipulative.’ The Governor of the Bank of England, Chairman of the Monetary Policy Committee and the Financial Policy Committee might have had authority but he had no power to address the everyday corruption that everyone knew about.

This Cycle of Corruption, of money, power and policy all feeding each other, is not new and the turning of this current cycle is very far from over. Bankers are not alone in choosing personal gain over gains for all, we are all of us more or less happy to allow people we don’t know to struggle. We know that if only the poor had made different choices they too could be wealthy, if only the homeless weren’t so lazy and self indulgent they could be kings of the world.

And of course we know this is nonsense. The tension between what we know in our hearts and what we say we know can make people judgemental, bitter, aggressive and even slightly mad. The comments section of any online news outlet demonstrates this perfectly. 

Recalibrating our values can be difficult especially when it can effect what we earn, how we support or are supported by people we value, and most especially our status. But ultimately it's about how we want to be related to and remembered. Success is so much more than the size of your bank balance.

I’m becoming increasingly amazed and recently annoyed at the tone of a lot of counsellors’ advertising. Just today I’ve read that “Thinking is something we all do every day,” “It’s our choice every moment to be Joyful, sad, fearful or angry,” “Smiling is a great antidote to the current economic climate,” and “Do these three things for absolute freedom.”

Presumably these counsellors, and the many like them who churn out this appalling nonsense, must believe clients are idiots. That or they’re utterly untouched by the kinds of experiences that the rest of us are increasingly immersed in. Smiling will not help you if you are under 25 and your housing benefit is apparently under threat. How much choice do you have in your emotions when your husband has just died, or you’ve been made redundant or your child has been diagnosed with something worrying? Just what is absolute freedom? Indeed, we all do think every day but I do wonder about the quality of some of those thoughts.

When we’re vulnerable we all want to be contained and seek advice but it seems an increasing number of counsellors are setting themselves up as Guru figures that can cure people. This is absolutely the antithesis of what you should expect from counselling.

A good counsellor will offer you a space in which you can feel safe and will interact with you so that you discover your own answers which may occasionally be found via tentatively offered suggestions. But this is very different from offering a cure, especially if you’re not at all ill. Imagine the DWP has accidentally closed your claim: you’re entitled to panic, rage, despair, fear and contempt as you struggle to reinstate your claim whilst having not a penny for food or the electric. A counsellor who wants you to look on the bright side is clearly very frightened of their own rage and panic.

I invite you to approach any counsellor who presents themselves as wiser than you with great caution. Please bear in mind that no one has discovered a foolproof cure for the fear of spiders so more complex psychological distress can only be approached cautiously and with questions rather than answers. It’s natural that you’ll want to be vulnerable with your counsellor and even collapse for 50 minutes a week, but you can also expect to be treated as an equal: it’s the absolute foundation of all the modern psychological models, and you should expect your counsellor to say that explicitly. This holds true whether you’re 4 or 94, you’re entitled to very respectful listening and relating. You’re paying for it.

Imagine if hundreds of thousands of people were wandering our streets dragging a badly broken, untreated leg behind them for years on end or bearing a ghastly wound that was prescribed sticking plasters. We’d expect the person with the untreated leg to be permanently crippled and the person with the wound to get infections, be further damaged and perhaps to die. We’d also be shocked and outraged that such a huge number of people were being treated with contempt and cruelty by the NHS.

That’s the situation we’re in with mental illness.

• Mental illness now accounts for nearly half of all ill health suffered by people in Britain.
  


• A quarter of mentally ill people are receiving treatment. 
  


• One third of families have a member who is currently suffering from a mental illness. 
  


• It accounts for nearly half of absenteeism at work and mental illness accounts for nearly half of people on incapacity benefits.
  


• Two-fifths of patients suffering from anxiety or depression can recover if they are treated.
  


• Proper treatment would cost the NHS little or nothing because it would produce savings in other healthcare areas.
  


• The cost to the NHS of not treating mental illness is at least £10 billion. 
  


• There are 700,000 children in Britain with behavioural problems, anxiety or depression.
  

These are just some of the findings of the LSE research into UK mental health which actually makes good reading. It’s about time that people in power spoke robustly about ‘broken spirits’ and ‘troubled souls’, because this is precisely the issue. Organic mental illness caused by a head injury or chemical imbalance is quite rare, whereas the expectation that you can function like a machine for 80 years has a huge impact on mental wellbeing.  Anxiety and depression are perfectly reasonable responses to being expected to do just that, and increasingly high-pressure circumstances only add to the problem. Poverty is a causal link to many illnesses, including mental illness (no one’s getting richer) while the stress that far too many families are under causes children to go mad, and who can blame them?

An enormous amount of the time I spend with clients is spent in discovering what they actually value. People arrive saying they’re not doing as well as they want to at work, can’t sleep or drink too much and very quickly discover that they’re being bullied at work, hate everyone around them or feel destroyed by disappointment. Soon, from feeling defensive or personally disgusted with themselves, they move to feeling terribly sad and helpless in the face of apparently overwhelming circumstances.

Then they realise that they have more options than they knew. It is perfectly acceptable to go off sick. You are allowed to rest if you’re exhausted, just as you would be if you’d been in a car accident. You are allowed to go onto sickness benefits – it doesn’t make you a scrounging work-dodger: the existence of sickness benefits recognises and respects that if the State pays the interest on your mortgage or your rent for a period of time you are more likely to return to productivity.

Sometimes, people come to understand that there is more to life than productivity, and that there’s a difference between productivity and contribution. Churning out endless bits of paper is, for instance, far less useful and satisfying than giving meaningful support to an elderly neighbour or unhappy child or the local cats home.

A good number of clients relearn that, as Lord Layard has suggested, who we are requires just as much care and attention as how much tax we can pay. That’s now moving from a philosophical premise to a vital economic reality.

There’s been something to write at length about every day for at least the last fortnight, whether it’s the rise in demands to be ‘positive’ or the looming realization that, if something doesn’t change, we may be seeing Greek people starving and freezing to death come winter. Watching a fascist thug belt a woman three times on television reminded many of us that the circumstances we find ourselves in today are not dissimilar to the run up to WW2.

The death of Gitta Sereny, a journalist and historian who focused on the study of evil, was announced today. Rather than just reporting facts in a pulp biography she purposefully got to know the people she researched and found that she understood them. Her understanding led many of her subjects to contemplate their lives and, in one or two cases, admit their guilt. 

I’m writing this whilst listening to the Mental Health Debate in the House of Commons. The twitter hashtag #mentalhealthdebate is ticking along nicely. It’s an excellent debate with MP’s – notably men – discussing with care and respect how suicides have personally affected them, how mental ill-health has touched their families, and their own ‘mood swings’. 2 MP’s have revealed their own OCD and depression with some trepidation and bravery. Two have disclosed their post-natal depression.

One in four of us are affected by mental ill-health. It’s entirely laudable that the MP’s debating it are doing so at all, never mind with such sensitivity and warmth. 15 of them are present. Out of 650.

Amanda Williamson, a counsellor in Exeter, writes about her straw poll research on what kind of time boundaries people many want from their counsellors. 


"At the agency where I work clients are expected to commit to weekly sessions of 10 weeks, or weekly sessions of an undetermined duration. The “open-ended” contract is to be reviewed periodically but the expectation is that the client will come along at the same time, on the same day on a weekly basis, except for pre-agreed holidays. Allowance is made for emergencies and illness but generally speaking, cancelled sessions are expected to be paid for. One of the justifications for this is that the agency can only charge such low costs for counselling based on regular client attendance. Also, that the clients needs to show commitment to their therapy

In my private practice, I have tended to leave the duration and regularity of therapy entirely up to the client. This may have something to do with the fact that my therapist, whom I saw throughout my training and beyond, does not bring up the issue of frequency or ever ask if I want to book the next session. I have always liked this lack of pressure and the fact that the decision is left entirely to me. It suits my personality and I had assumed that everybody would share this appreciation."

What do you prefer? Why? 

Take a look at Amanda's blog and see what other people think.

I’ve always had trouble with the phrase ‘Self Esteem.’ We all think we know what it means but try to define it in a sentence.

‘An evaluation or appraisal of ones self worth.’ ‘Valuing yourself,’ ‘How I feel about who I am.’ But how is that measured? By whom? On what scale?

The huge majority of work on the subject addresses low self esteem but we know that people, particularly young people, who have an inflated, entitled attitude to the world often have high self esteem:

“Likewise, people with high self-esteem think they make better impressions, have stronger friendships and have better romantic lives than other people, but the data don't support their self-flattering views. If anything, people who love themselves too much sometimes annoy other people by their defensive or know-it-all attitudes. Self-esteem doesn't predict who will make a good leader, and some work (including that of psychologist Robert Hogan writing in the Harvard Business Review) has found humility rather than self-esteem to be a key trait of successful leaders.”

I see people who are suffering from a lack of confidence; from years of being told they’re rubbish or from being told they are wonderful but not believing it (usually because the people telling them didn’t believe it either.) I’ve met people with brittle smiles who have been repeating affirmations about how great they are, often fed to them by other people with brittle smiles neither of whom actually believe any of it. And then there’s the pseudo-science of The Secret which blames you for being such an idiot and totally crap at manifesting high self-esteem.

(The quantum mechanics that The Secret and its offshoots has plundered is beautiful, profound and barely understood by the peer-reviewed scientists who’ve dedicated their lives to it, let alone anyone else. As with diluted understandings of Karma it’s ridiculous to suggest ‘You want and deserve your horrible life, the Sultan of Brunei wants and deserves his privileged life.’ The real message, as with so much of the self help industry is ‘This is all your fault,’ which seems calculated to keep you in need of further guidance, teaching, courses and books from people making money from it.)

Over the years, I've taught workshops on self esteem referring to the research and using tried and tested techniques but felt it was somehow missing the mark of authenticity. Eventually, I stopped teaching this workshop when I felt it put me in the same category as the brittle smilers. And there’s still something to say about how we feel about ourselves in the world.

Self-Compassion looks as if it may have some good answers:

“Dr. Kristin Neff, a researcher at the University of Texas at Austin is the pioneer of self-compassion as a tool to promote psychological healing, well-being, and better relationships. She contrasts self-compassion with self-esteem in that it does not require us to elevate ourselves above other people and compete with them. While high self-esteem is generally based on evidence of superior achievement, self-compassion is a more constant personal quality, in which we value ourselves and treat ourselves kindly just because we are human.”

That’s a message I can relax with – that simply by virtue of our existence we are worthy of the same care, respect and healthy relationships as anyone else. Not because we work harder or achieved more or anything else, but just because we exist. That’s the message from counselling research too, that if the counsellor prizes the client, doesn’t judge them and is genuine in relationship with them then the chances are that therapy will work. This is an attitude not a set of techniques, and it’s a damn sight harder than chanting affirmations. I think it’s worth the effort.

A report out today suggests that, despite years of repeating the mantra “Exercise Helps Depression” it doesn’t. Unless it does: the outcome of the research is that therapy or antidepressants or exercise have the same effect on depression.

This report comes out on the 40th anniversary of an extraordinary psychiatric experiment. Healthy researchers went to several psychiatric hospitals, reported they were hearing voices, were admitted and diagnosed with schizophrenia. The medical staff spent an average of 6 minutes a day with each ‘patient’ and treated them as if they were indeed schizophrenic, while many genuinely unwell patients realized there was something very different about these people, that they were not, in fact, ill. When some researchers took notes this was diagnosed as ‘writing behaviour’ and part of their illness, and it took a surprising amount of persuasion from outside sources to get some of the researchers out of hospital. On being released, every single researcher was diagnosed as being in remission, that is, still ill but not floridly so.

The resulting paper was a bombshell to the psychiatric establishment. One hospital challenged the researchers to repeat the experiment and later reported identifying 41 researchers posing as having schizophrenic symptoms. In fact, none had been sent.

Context is everything. The context in which the depression research is being received is one of cost cutting – now the hard working tax payer can stop paying for pointless gym sessions for depressed people, even if this is not what the research demonstrates. What the research also demonstrates is that when people are given quality human contact over a sustained period, whether that attention was counselling or research-led monitoring of people on antidepressants, or 13 sessions of exercise advice over 8 months, they felt better. 

We live in a context that demands simple answers but in care of the mind there are very few of those. Psychiatry, psychology, psychotherapy and counselling have more in common with philosophy than, say, diabetic or bone care. Pancreases and bones tend to do the same things whoever they’re in but the mind and heart are less fixed. That said, we do know that if we expect to hear something we tend to hear it and so it’s no bad thing to question what we believe we know, what the basis’ for our beliefs might be and, essentially, how what we believe we know informs how we live ourselves and how we treat others.

Right on cue for the beginning of the Jubilee celebrations, it’s raining. So much energy has been expended in creating this huge national event that we could have a volcanic eruption and it would still go ahead. The school over the road from me have been jumping up and down and shouting joyfully all week in their celebration of Monarchy. Are they being taught history, identity, team spirit, or being indoctrinated? Perhaps a bit of both? Where does one end and the other begin?

Whether you’re a Royalist or a Republican you’ll recognize the value of a shared public celebration, as well as the value of dissent. Despite what the media might tell us it’s entirely possible to hold a nuanced, moderate view that appreciates parts of both beliefs. It’s important that we learn this skill so that we don’t contradict ourselves – while it’s not unusual for huge numbers of people to hold incongruous beliefs when it’s done unthinkingly it can have sobering consequences: how many low paid workers will be whooping it up under the bunting for 4 days but griping about lost revenue when unions close a few streets for half a days march against low wages?

People in power encourage our tendency for simplistic thinking. Here’s a particularly loathsome phrase: “Hard Working Tax Payers.” Not just working, but working HARD. This week, HR Magasines poll suggested that (at least) 1 in 10 workers were ‘dormant’. If you’re content in work you almost can’t help but be productive but if you’re a taxpayer, the focus isn’t on productivity it’s on working HARD. In the days of heavy industry this might have had some meaning, these days it’s more likely to mean that you’ve not been properly trained, your boss is stressed and taking it out on you and the commuting is killing you. But you can feel secure that simply by being employed you are a Very Hard Working Tax Payer, inherently superior to those dole scroungers (who may, because of the Byzantine nature of the benefits system, low wages and a lack of full time jobs, have an income as good as yours. NB this is not unemployed people's fault.)

It’s was wonderful to wander down the Golborne and Portobello Road today, flags flying, tea flowing, cupcakes galore, the Sally Army tooting away and, as you can see from the photo, the WI baking and volunteering for England. It's good to share in genuine appreciation of 60 years hard work of a now elderly woman who volunteered to pay tax in 1992, when she feels like it. She didn’t, for instance pay £20 million inheritance tax when her mother died. We've got bunting up, will be going over to the street party later and will shed a tear as we sing Gawd Save The Queen, and I’ll remember to ask myself “Cui Bono?” "Who Benefits" from our slipping back to something that looks and sounds very like a fictionalized version of the 1950’s?

Enjoy your long weekend.