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 am entranced by this video

The song is about the singers relationship with her father, but it elegantly describes some of the processes that some people – by no means a particularly damaged or miniscule proportion – go through in order to discover more about their problems.

Michael * came to therapy with acute symptoms of stress. His workplace was stultifying, his boss out of his depth and another member of the team was a bully. The workload was too heavy for everyone and Michael had become the earthing rod for the offices collective unhappiness. We worked together to identify the shock and shame of being stressed, addressed the office dynamics and considered why Michael might have become a scapegoat. Michael felt much better prepared to deal with the complexities of his toxic work environment and decided to remain in therapy to explore the other matters that had begun to unfold during our time together.

Most of us have lost the innate power of our imaginations by our mid teens. Our heads are stuffed with factoids that will help us become hard working taxpayers and tremendous machine parts. You don’t have to write poetry or wear a rainbow jumper to be something other than a component: part of being a whole human being is about knowing what you feel and why you feel it, and therapy is a good way of kick-starting that process.

Michael found it straightforward to remember his past but realised that he couldn’t recall how he felt about events. His memory had become almost entirely cognitive. I wondered what his younger self looked like and we began thinking about Michael as a child of around 9 – how did he dress, what did he eat, did he have a nickname, what he liked and disliked, and so on. In a short period of time this younger Michael regained his own voice and began speaking with older Michael reminding him how he felt in some detail.

Like most people who come to therapy there was nothing poisonous or horrific in Michael's past. Part of growing up is, as well has having good times, experiencing disappointments, shocks, fears, loss, unhappiness, the usual stuff of an ordinary childhood and dealing with them. For all of us there are events that stand out usually because the adults around us behaved in ways that were unhelpful.

In therapy this work is never about blame. Circumstances make people behave in certain ways, no one is perfect, and it’s useful just to consider how things happened so that we, as adults, can make better sense of them.

Remembering the difficult feelings – betrayal, abandonment, shock, bereavement, resentment, terror – can be much more difficult and so we tend to say, “Well, that happened, it’s over. Let’s move on.” In fact, those feelings remain, unacknowledged and hidden away. 

But they’re alive. And if we ignore them they begin to run us. 




I'll be writing more on this subject in my next post.

Part of my training as a nurse was to spend time on a mental health ward so in 1983 I was sent to what was genuinely a bin. One of the women there had arrived as a child when the building had been a Work House. There was an elderly man with Alzheimer's, a 16-year-old young woman with alcohol problems, several young people with learning difficulties and about 20 other people with diagnoses that I knew nothing about.

Young doctors practiced electro-convulsive ‘therapy’ on the elderly woman. Every couple of days the elderly man was dragged naked and shouting through the ward and made to stand in a bowl by his bed where water was poured endlessly over him as he became increasingly distraught. The 16 year old young woman was sedated every time she challenged the staff on the basis of what she was actually feeling, which was often. In retrospect she was being punished because the staff felt threatened by her obviously splendid intellect. One of the young women with a learning difficulty was offered voluntary work at London Zoo but the staff laughed at her, saying that the idea was as stupid as she was and they prevented her going. All the women were sexually assaulted by some staff and some patients.

Aged 18 and stuffed with the high moral ideals of my nursing school I imagined that this was an urgent problem. It was only because I was a gobby teenager who didn’t know better that anything got done: none of the managers and just one of the (very senior) teaching staff took me seriously. The school of nursing protected me and two members of staff were sacrificed. Nothing changed. I kept banging on about it until one of my teachers said, “What do you want? Blood?” I was flabbergasted that the alternative to dealing with grotesque abuse was perceived to be killing someone and at that point began to learn to shut up.

News that staff knew about Jimmy Savile’s abuse of patients shouldn’t come as a surprise. We know that people - often very senior, generously paid people - find it easier to punish less senior people than to take whistle-blowers seriously. We know that whistle-blowers are treated with absolute contempt and ill treatment, not just by managers but also sometimes by relatives of abusers.

DBS checks are a waste of time and a horrific waste of money. What actually protects vulnerable people is a culture, not of suspicion but of openness and transparency where every person from the most senior manager to the youngest student are expected to speak out about what they see. That culture is supported by a policy that has to be followed if someone alleges abuse: it's a statement on the poverty of where we are now, that a policy has to drive people towards transparency. 

I wasn’t the only student nurse on that ward but when I spoke to my peers about what we were seeing I was told that we were only there for 6 weeks, that it wasn’t that bad, that the staff knew what they were doing, that they didn’t want to risk a good review, that they were frightened. Just a kind of non-specific, generalised fear. As if the sky might fall on their head.

Every sphere of employment is full of bullies. Often, those bullies are out of their depth and anxious because they’ve been promoted on the basis of ticking some boxes in a selection process rather than because they are actually suited to their role. How many of us would admit that, turn down the big wage and move somewhere where we might be happier? But that’s their business. What is our business – your business too – is to ensure that we safeguard people who are weaker than we are. It’s not just in healthcare; it’s in offices where you have the power to make someone’s life worse.

Don’t.

The energy that you will have to use to protect yourself from knowing that you have made someone live without heating, without a home, without dignity will exhaust you. The people around you need to tell you that you’re doing the right thing because they’re doing it too. If this kind of behaviour makes you feel uncomfortable, take note. Leave if you can’t change the culture. If it makes you feel powerful, if you’re just following orders, you really do need support to stop. 

Depression has been under the spotlight this week after Robin Williams’ suicide. It’s great that despair – lets call it what it is rather than a medicalised euphemism - and mental ill-health are finally coming out of the dingy little spare room closet for an airing and wonderful that people who are suffering depression are having their voices heard. Talking about how mental ill-health can feel shameful, that there is little parity of esteem (a nice, tight, catchphrase) between the care offered to people with physical illness and people with mental illness is temporarily refreshing. Politicians and policy makers are saying worthy things about how dreadful this and that are and how they’ll make things better.

They're being economical with the truth.

People with chronic illnesses, physical and emotional, are being driven to suicide by the same ministers now saying how awful depression is, something that was recognised by the DWP back in 2012. It's only going to get worse.

It’s not just people at the end of their financial tether that are killing themselves. Successful men, you are killing yourselves at a catastrophic rate.

“We have a series of assumptions about suicide that are explicit and implicit, and they make a toxic mix,” Powell says. “One is that suicide is undertaken by failures: people who have no friends, who spend all their time in their room, who have something wrong with them. Are you going to talk about people close to you who might have taken their own lives if that is what others are thinking? If you say your son has taken his own life, then that means saying he’s a failure too. But when you look at the people who do this it’s quite the reverse - it’s often true that they are admired, well-loved and talented - though they might push themselves extremely hard.”

Take a look at this article:

"The most deadly criticism one could make of modern civilization is that apart from its man-made crises and catastrophes, is not humanly interesting. . . . In the end, such a civilization can produce only a mass man: incapable of spontaneous, self-directed activities: at best patient, docile, disciplined to monotonous work to an almost pathetic degree." Lewis Mumford, 1951

Unhappy women generally medicate and endure, unhappy men kill themselves.

I’m no fan of the Good Old Days when we all lived in each others pockets and did our socialising at the communal launderette or men-only club, but when as a nation we took the decision to vote for personal prosperity people began getting more sad. Now we're reaping that whirlwind. People who bought their council houses find their adult children have nowhere to live. When we all demanded cheap washing machines it was inevitable that manufacturing was going to go abroad. When we decided to treat each other as economic units it can’t come as too much of a surprise when we are also treated not as individual people but as things that make other things function. Like a widget. 

Counselling falls into this trap too. Far too many counsellors join in the scroungers and strivers nonsense. Too many believe that success is a client returning to work, even in the face of a foundational belief that our job is to support the client in discovering their own meaning for their own life.

For a great many people depression is a sign that your life has lost any meaning. A lot of people believe that having a high status job title, two posh cars, a big house and garden owned by the bank, and some nice clothes will mean their life is complete, but if they ever attain all that life remains just as hollow and meaningless as ever.

Look to the US which is 5 or so years ahead of us. If you want that life then do nothing, it’s on its way. You may be interested to learn that the American Dream has been totally debunked: if it were true then immigrant women would be sipping champagne in a swimming pool on a Learjet.

If you’re depressed take yourself seriously. As well as going to the GP and doing all the stuff you already know helps depression, think about what you want to do with your life. It may be that you want to spend more or less time with your children. You might want to spend more time awake, relaxed and communicating with your partner or you might want to get far away from them. You might regret having got on your bike like you were told to at 18, to move far away from your family, who are getting old. You may have to sell your house and move somewhere smaller (If you move out of London this won't be a problem.) you may have to take a significant wage cut. But you really are more than your job title and bank balance.

You don’t need to come to counselling to discover this – though it can be helpful to get some support as you explore your fears, desires and options. But you do need to recognise that something is wrong, understand that you don’t have to do what’s expected of you – even if it’s just you who’s putting you under pressure – and then dare to think of what you genuinely want to do with the rest of your life.

Campaign Against Living Miserably is a charity specifically for men under pressure.

4 senior bankers have killed themselves in the last week. 

As a Bloomberg article says,



Though the reasons are not clear in either case, the coincident deaths will feed the discussion of excessive stress levels in the financial industry, not just for the young interns working 100-hour weeks but also for accomplished executives. Stress-related resignations, heart attacks and suicides may be par for the course in a high-octane, risky businesses, but the public does not really want finance to be one of these: Its money is at stake.

That sounds callous but it’s what all employers, including yours, are ultimately concerned about. If you are self-employed then you are likely to be even less caring about your own wellbeing than the average money-focused, gimlet-eyed employer.

Enough now. These men were amongst the most high-status, intelligent and wealthy people in society and they killed themselves. If they can find themselves locked into a despairing panic state then any of us can.

I don’t think it’s possible to say these 6 things too often:

• You want something to change as long as everything stays the same? Can you see why that’s not going to work?
• Your employer is not going to change. It’s going to have to be you.
• It’s very likely that to make your life better you’ll have to work fewer hours.
• If working to your contract and no more isn't possible then you may have to reduce your income.
• Even in a recession – and there is no recession in London – this is possible.
• You need to decide what’s more important to you: your status, your income or your health.
  

There are a great many techniques that will help you manage your time and your attitude towards work but working a consistent 50 hour week is just not sustainable. Don’t swallow the rhetoric about Hard Working Taxpayers. With unemployment down, why is productivity also down? Economists are baffled but for a small fee I'll tell them why this is: Everyone is outrageously hacked off, largely for excellent reasons. Don’t wait until you want to jump out of a window before you address it.

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.

Seasonal Affective Disorder is now in full swing and there’s a month to go before the winter solstice marks the planets’ tilt towards the sun and the return of light to the northern hemisphere. Many of my clients, colleagues and friends are experiencing SAD symptoms and are grateful for support that takes them seriously and offers practical, achievable solutions. I can’t guarantee that you will be totally cured if you follow this advice but you will feel much better.

As always, your GP is your friend and if s/he’s not, change your GP.





WHAT IS SEASONAL AFFECTIVE DISORDER?
A form of depression that coincides with autumn and winter when levels of sunlight are low. Very occasionally, a person can experience SAD associated with high levels of sunlight. It’s less conventional depression, more of a kind of despair that you’re finding it impossible to do what you’re expected or needed to do.

WHAT ARE THE SYMPTOMS OF SAD?

• Sadness, hopelessness, despair
• Anxiety, panic attacks
  
• Apathy
• Lack of energy
• Sleep problems – usually needing much more sleep than in spring or summer
• Problems with concentration
• Forgetfulness
• Irritability 
• Loss of libido.
• Overeating
• Self-isolating
  

Many mammals, including humans, significantly slow down over winter. Needing to conserve energy, eat carbohydrates to keep warm, snoozing and sleeping more during winter is entirely natural but not compatible with modern life.


WHAT HELPS SAD?
Natural Light – get out into daylight for an hour every day. If you find that you can’t spend one hour a day in daylight your life is out of balance. This is not New Age nonsense, this is a fact. It is not reasonable to be unable to spend one hour a day – just seven hours a week – in daylight.

Exercise
Walking or running outside is especially helpful, but getting to the gym is great too.

Eat well
Big breakfast, lighter lunch, smaller evening meal. Fruit and veg. The usual advice. Splurging over Christmas holidays is not a sin.

A lightbox.
The later in the year you buy one the more it will cost, but still you can get a good one for £50 in December. Look for one that is Medically Certified and no less than 10,000 lux (Lux is the SI unit for illumination).

A light alarm clock
Most people with SAD find that they wake as the sun rises. In December this can be around 8am and on a grim day barely at all. A light alarm clock simulates dawn, slowly and steadily increasing illumination until it’s very bright at the time you’ve set it to wake you. This helps regulate your sleeping and waking patterns.

Visit your GP
Ask her if she will order the following blood tests:

hbA1c – a much more accurate test of blood sugar than the fasting test. Your fasting blood sugar can be fine and you can have Type 2 diabetes, which will make you feel tired.

Thyroid – low levels of thyroxin can make you sluggish, feel cold and put on weight. High levels can increase your anxiety and tendency to panic.

Red blood cell count – anaemia can make you feel cold, weary and unwell.

Vitamin D – there’s some evidence to suggest that lack of vitamin D is linked to depression.

All these blood tests can be taken via one needle!

Talk with her about taking antidepressants. Selective serotonin reuptake inhibitors (SSRIs) help increase the hormone serotonin, low levels of which are associated with SAD. Many people with SAD start taking prescribed antidepressants from around October until March every year.

Psychotherapy
If you’re using psychotherapy to discover the deep-seated roots of your seasonal misery you may well discover something that helps you make sense of this part of your life. But in my opinion it’s like looking for a psychological cause for kidney failure. Therapy can offer support while you’re experiencing SAD or exploring the best treatments for it.

Cognitive Behavioural Therapy (CBT) that focuses on helping you get SAD into perspective and planning activities that will help you move through it more easily is helpful. CBT that aims to make you a person who doesn’t experience SAD is not.




Further information

MIND Seasonal Affective Disorder

NHS Seasonal Affective Disorder  

The Automated Morningness-Eveningness Questionnaire – an interesting self test to determine your circadian rhythms and when you might find it most useful to use a light box.   

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.

Some months ago a friend and I were talking about his experience of Flooding as a treatment. He very kindly agreed to share that experience here. 

I had a really awful time at school, for a while I would wash taps before washing my hands, just to make sure I had clean hands, then return to my pit of a bedroom with no hint of hypocrisy at all. Then I got a thing about my Achilles tendons, probably from a lesson describing what Achilles did to his tendons, (still makes me shudder to this day!), and would walk in an exaggerated manner that I felt made them less prone to injury. I had no evidence that this was the case, but nor did anything bad happen. 

Then one time we had inoculations, I didn't like it but it was no big deal. Soon after however, I went on a family holiday to Morocco that required two courses of six jabs, three in each arm, the arm would swell up and become a target for any pillock who was looking to cause someone pain, and hey presto, my needle phobia reared it's head, leading to a morbid terror of any sharp surgical instrument. Even knowing this, being reasonably certain of why I felt the way I did, and rationalising that hypodermic syringes were used to inject preventative medicaments, I could not shake the feeling of utter terror to the point where, when visiting people in hospital, I would try to sit with my back to the wall, or as far from anyone walking behind me just in case they tripped or decided I needed a jab from something.

My fear kept me away from the dentist for over ten years even when I had a gaping cavity, made me think twice about visiting anywhere there might be medical tools and forced me to look away when syringes appeared on TV: if I wasn't quick enough, I'd feel jittery for hours. When I did go to get my tooth filled I mentioned my phobia, so the well-meaning dentist caught me by surprise with the syringe, I don't think his nurse was too pleased with me crushing her hand though! I stayed conscious, but if my Mum hadn't been to hand I'd have had to sit in the waiting room for the next six hours, I was white as a sheet, jittery and weak as a kitten.

I think it was the dentists episode that sold me on the idea of getting referred to a psychologist. I've a sneaking suspicion that my GP didn't take me entirely seriously and  I'm fairly certain my psychologist was newly qualified. In any case, a large proportion of my treatment was talking therapy and the use of a clean hypodermic to touch on my skin which was actually reasonably helpful now I think about it. The Flooding part of it wasn't: watching videos of surgical procedures, the lung biopsy just freaked me out! It didn't help much.

Being the sort of person who's an obstinate bugger at heart, I pushed myself to have a vasectomy, my wife would've gone for sterilisation and said as much, even going as far as to try talking me out of it, but I was sick and tired of being scared, I was facing redundancy and going though stress at work so it wasn't like I was feeling balanced or strong. I'd just tried every other way and thought that voluntary flooding in the form of the vasectomy under local anaesthetic  would be kill or cure.

As it turned out I could cheerfully watch injections on the TV for over a year after without a flinch, it's resurfaced but only as a discomforting anxiety, rather than an overpowering horror and I'm not left feeling shaky afterwards. I still hate having the undersides of my fore arm touched, that comes from the idea of blood being taken, but I don't think I'd be a screaming mess if I woke up in hospital with tubes in my arm which could not have been said of me 20 years back!!!

Thinking about it, I did try a little flooding soon after seeing my psychologist, I got my ear pierced, which was ok, and a tattoo (the first of six, they're addictive!), but the needles and procedures, not to mention environments, were entirely different as were the outcomes, so the experiences were of little practical use, other than to demonstrate that fear can be overcome, you just have to be a stubborn bugger!!