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!
 

I loathe this kind of Inspirational Quote. The cliché of a Wise Exotic Person, in this case that acme of wisdom, a Native American; the shrewd observation of nature; the comparison between something ordinary and ubiquitous against something noble and clever; and the requirement to change your attitude, you weak, stupid fool.

Clearly, this person has never seen a raptor in the rain. This kind of ‘inspiration’ is too often built on fantasy, ignorance and the desire not to encourage but to load blame on to vulnerable people. It has the added benefit that it makes us feel better about ourselves.

Viktor Frankl and his selectively quoted book, "Man's Search For Meaning" is often used to punish people: "When we are no longer able to change a situation - we are challenged to change ourselves." "Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom."


Can we be clear? Frankl was writing about his experience in a Nazi concentration camp. Although he hypothesised about what signs individuals gave of despair as a prelude to their death these are not research results, they are the desperate observations of a dying man. Using Frankl’s words in this way suggests that if only those spineless failures in concentration camps who gave up had just changed their attitude a lot more of them would have survived. Frankl turned the memory of his wife into a kind of religious mania, an act he credited with keeping him alive, but I’m not aware of any inspirational quotes suggesting we all do the same. 

There’s a great deal to be said about altering our attitude towards events. It’s absolutely true that if we can gather ourselves after a failure, loss or catastrophe and keep moving forward then we are more likely to achieve more and perhaps be happier. This can be very important for people who’ve experienced bereavement, at some point they need to drag themselves away from misery and shock if they’re not to remain out of the world. But some people will remain in that state. Do they have terrible attitude? Are they stupidly refusing to be helped?

Or has no one offered them the kind of help that they can accept?

There’s always a reason for a ‘bad attitude.’ Sometimes it’s a personality habit and it’s no use saying that this can be dealt with by snapping out of it: in every situation people do what they believe is best. When we say they should just try harder or be nicer their perception of the world as a place full of cruel people who have no empathy is compounded.

Happily, an increasing number of people are beginning to speak out about their failures and anxieties, their inability to buzz through the world like a chainsaw, the mental illness that floors them and the shock and humiliation of collapse. Less dramatically, we’re recognising the existence of introverts who make up around half of the population and who are quickly exhausted by having to do things that extroverts are energised by. Like go to meetings. Or talk to people.

By the time that most people come to therapy they’ve moved past the possibility of changing their attitude into miserable paralysis. Thank goodness. That’s the place where change happens, not in denial of reality.

Let’s look at another Viktor Frankl quote – one that’s longer, more complex, requiring more reflection than those chosen by other people who want us to get a grip:

“Love is the only way to grasp another human being in the innermost core of his personality. No one can become fully aware of the very essence of another human being unless he loves him. By his love he is enabled to see the essential traits and features in the beloved person; and even more, he sees that which is potential in him, which is not yet actualized but yet ought to be actualized. Furthermore, by his love, the loving person enables the beloved person to actualize these potentialities. By making him aware of what he can be and of what he could become, he makes these potentialities come true.” 
― Viktor E. Frankl, Man's Search for Meaning

When we tell people to change their attitude we shut them down. When we acknowledge the reality of their situation - that they are unique, that they are not us - when we give each other compassionate space, then genuine, individual growth becomes possible. Not growth to satisfy anyone else’s idea of success but growth that leads to their own concept of accomplishment.

Happy St George's Day, a day to appreciate the many, many benefits we have as people living in a first-world economy. 

The World Service broadcast a particularly interesting piece last night, on how France Must Change. High unemployment, a State-bound economy in the doldrums, strikes, laughable working hours, and now – get this! – legislation that prevents employees from responding to work emails after 6pm! What an outlandish and economically naive country.

Strange then, that France is ahead of our own Hard Working, endlessly striving, entrepreneurial economy, second only to Germany in Europe and fifth in the world. In a survey out today comes the news that “Britain has the lowest quality of life of 9 major European countries." 

France has the highest quality of life.

The weather has something to do with it as does our naturally cynical nature – we expect to be treated badly and so it comes as no surprise when we’re treated badly – but here’s a chilling analysis:

“We may still be enjoying the fourth highest household income in Europe, but the high cost of living means we are living to work.”

Person Centred counselling has a useful principle called the Locus of Evaluation. It proposes that when we’re allowed to remain in touch with how we genuinely feel we can make good choices; good for ourselves and good for the people around us. This is called The Internal Locus of Evaluation. The External Locus of Evaluation develops when we’re told how we must feel and criticised for feeling differently from the people around us. We have to ignore our genuine feelings to continue to be valued. People who function from an External Locus of Evaluation continue to look to people in authority to decide how they must feel and often feel absolutely dreadful, even if they determinedly continue to believe they are content with the way things are. You can read up on the theory here.

On Sunday the Mail felt it would be profitable to send an undercover reporter to a food bank and, despite noting that the reporter was asked lots of questions about his circumstances, recount that he walked away with £40 worth of groceries, unquestioned. In the past that would simply have added to the sneering disgust of the nation but this time it resulted in £35,000 in donations to the Trussell Trust.

Times and nations are not going to change much. Against all the evidence, as a country we’re going to continue believing that the French are lazy and on the verge of economic collapse whilst we lead the world in toughness and fiscal wisdom. But, as the Daily Mail incident demonstrates, individuals are now more than ever capable of effecting change. I’d propose that the conditions that bring individuals to the point of collapse are those that we are experiencing now. We’re being told one thing – that food banks are stupidly supporting evil people to lie around laughing at the Hard Working Tax Payer – when we know something very different – that food banks are a symptom of an unequal society, that the more unequal the society the more miserable society becomes and that we have the lowest productivity in the whole of the G7. Social media is a tool that individuals use to subvert propaganda, but attending to the messages that we constantly berate ourselves with is another, more difficult matter.

It can be profoundly sad and even disturbing to understand that many of the beliefs we hold dear are nothing but empty words, to realise that the way we've lived to this point has been largely meaningless and for someone else's benefit. It takes time to understand how it happens at all, but if you find yourself wondering about this kind of thing then you're ready to explore it. There's a lot to cherish in the English (and British) way of being, we'd be foolish to reject all of it, and there's a lot that needs to be examined too.





*Written by Cecil Rhodes, who left England at the age of 9.

The Sales are on and every year the news shows us scampering masses plunging into Selfridges to buy a handbag.

There’s nothing wrong with getting something you’ve always wanted but couldn’t usually afford, especially if it’s something you need. But our reasons for buying are often less rational.

Private therapy can be expensive, but it’s more of an investment than buying things that make you feel elated and then make you feel guilty. Corporate employers recognise the value of counselling to their profits by offering free, confidential therapy to their employees via Employee Assistance Programmes.

Normally, I charge £80 to £120 per session (find out more about why I have a sliding scale here) but in the spirit of the times, I’m having a sale of my own. Rather than you paying £480 to £720 I’m charging £360 for 6 pre-paid sessions. This offer is open until the end of January. To offer professional care I limit how many hours I work per week, and if those hours are filled when you call to take advantage of this offer I can put you on my waiting list.

If you’re not sure how counselling can help have a look at the British Association for Counselling and Psychotherapy website.

Feel free to phone to ask any questions and have a great 2014.

The majority of my clients come to me with very similar stories: “I have too much work, my boss is either very nice but doesn’t support me or is unpleasant and doesn’t support me. I’m working way over my contracted hours and achieving very little of actual value, but as long as all the boxes are ticked that’s all that matters. I like my work but the kind of stuff I’m expected to do now has really worn me down. I don’t see my family. Secretly, my children have become a burden, they get in the way of my work.”

In some cases coaching helps the client to break down what looks like an enormous pile of never ending demands into smaller, more manageable tasks and attention to relationships, and whilst this can be very valuable it is not the whole answer.

Whether we like it or not the UK is now in the grip of a fantasy approach to life where a lack of hard work is the only thing keeping you from success and the unemployed are all workshy scroungers. I read an article in Forbes yesterday that partly drove me to write this blog entry: “Mentally Strong People: The 13 Things They Avoid.” What really chilled me were the comments, 65 pages of “Thank you so much, this really made my day, this is so amazing and I can see where I need to do more work on myself.”

So many clients are being told that they have ‘the wrong attitude’. Almost always what this means is “You’re not doing what you’re told to do fast enough and you ask too many questions.”

Our concept of success makes us all feel like failures. It may be that a person has to be single-minded to increase their income but the actual facts show us, again and again, that being male, remaining in full time employment and the income of the family you're born into are better determinants of not living in poverty than either hard work or ‘attitude’.

While some of the points in the first article are valid and good advice, for a moment let's turn the rhetoric on its head. Emotionally Damaged People: 5 ways to understand them.

1. Emotionally Damaged People don’t seek insight. They have learned that their feelings – and the feelings of others – are unimportant and they're disinterested in concepts of fairness or integrity. They have been trained to ignore their feelings and to treat harsh life lessons as something to be grateful for, as a matter of personal survival in an incredibly brutal environment. When a situation turns out badly they cannot bear to examine why, or who may have been affected.

2. Emotionally Damaged People don’t care about people who are less powerful than them. They couldn’t care less about criticism or advice from people they perceive to be beneath them. If the criticism comes from people they believe to be more important than them they are trained to be grateful, even if that criticism is persecutory. They can only function in a hierarchy. And they strive to be as high up as possible in that hierarchy, whatever the cost to their family or to themselves.

3. Emotionally Damaged People ignore the costs that instability have on them and on others. Emotionally Damaged people are not interested in how bereavement, low pay, illness, children, elderly parents or anything else affects anyone. They perceive themselves and especially other people as things.

4. Emotionally Damaged People are not interested in the causes of problems or how to alter anything for the better, other than the manner in which their betters perceive them.

5. Emotionally Damaged people are desperately lonely. They've been told from childhood that they are entirely alone in the world. They know that they will not be supported by anyone and they’re not interested in supporting anyone else. If their culture includes being seen to be supporting others via charity or mentoring they will become involved in these activities in order to be seen to be compliant. They have learned that human nature punishes failure and non-compliance, even if that’s the failure to be born in a prosperous family, and the emotionally damaged person is resigned to this situation. They have learned that it is better to stand on other people than to be trodden on.




Genuinely successful people know that relationships are what matter, not status or income. Having enough money to remain healthy, pay the bills, eat and sleep well, spend time outdoors for pleasure and relaxation and with people who contribute positively to their wellbeing is important – having more is nice but not necessary.

Here’s another piece of research: 1 in 5 British workers have taken time off due to stress.

“According to the study difficult deadlines, management pressure and a lack of support are the main reasons for workplace stress and 6% and 3% of stressed workers resort to unhealthy practices to cope, smoking and drinking alcohol respectively.”

Look at your attitude. See who you're trying to please, and why, and what you genuinely want from life.

I went to lunch with a friend this afternoon and talked about how much more sane she felt having left her work. Marian used to work for a large organisation moving terribly important bits of paper around, something that added very little to the sum of joy or convenience to the world. When she joined the organisation she had to opt out of the Working Time Directive which would limit her working week to an average of 48 hours. Predictably, she began experiencing racing thoughts, became anxious, started having panic attacks, felt paranoid (although her employers really were out to get her.) got insomnia, began drinking too much alcohol in order to regulate her mood and sleep, lost friends, got exhausted and crashed. Her ex-employer provides a GP something Marian believed to be altruistic until she realised that this GP was contracted to let HR know about staff ailments. And so Marian was unable to see an actual GP rather than a sinister informant for some weeks, and then, not surprisingly, was signed off work for 3 weeks. 

To cut a depressingly common story short, her life was made hell and so she left.

There's something punitive and smug about employers who, in the 21st century, believe their staff should work more than 48 hours a week. Is their company so disfunctional, so incompetent, that people have to work this many hours? And yet an increasing number of people are buying into this nonsense. There's been a very sharp increase in the numbers of people I'm seeing who are suffering not so much workplace stress as workplace abuse, being asked to sign away their lives and privacy to organisations that bleat loudly about how awful The State is and then behave like a Statist dictatorship.

The rhetoric around Hard Working Tax Payers has become pathetic. If hard work is the route to success then the recent immigrant with three low status jobs or the pensioner who can't afford to give up work should be living the high life. The LSE agrees.

I'm seeing people on the verge of serious mental illness because their employer treats them like a disposable machine part. This has a lot to do with status - somehow it's become high status to work like a donkey as long as money is thrown at you. Let me say this clearly: having lots of money doesn't make you better than anyone else. Time and again, it's been proven to make people behave very badly. 

I tried to find an image to illustrate this blog and searched images for "Hard Working Tax Payer." Endless snarky pictures about how the poor are milking tax payers came up. There are a growing number of people who are very content to punch down, to hate and fear people who are vulnerable, and they're useful to people and organisations who like to keep employees hard at work. But it's poison to the soul. 

If you want to be happy then behave like a human being. Spend time with your friends and family. Get some sunlight in the fresh air - if you can't spend an hour a day outdoors then your life is way out of balance. When you leave work, leave work. Get some exercise, not a three minute blast in the gym but a pleasant run or walk. Do something that you enjoy and give yourself enough time to enjoy it. And for goodness sake, do something meaningfully useful for someone who can't pay you.

It may be that you lose status if you stop commuting (in conditions that are illegal to transport cattle) to your ace job and take up something less exciting closer to home. You may have to move house if you take a lower-stress job but that's much better than making an emergency sale when you're thrown away because you can't handle the pressure. Yes, you won't be working in the same glossy environment, but you will be able to take a leisurely lunch with a friend, soak up a bit of autumn sunlight and think about how much more human you've become.