Thursday, 30 December 2010

Seasons of Goodwill

It seems every culture has a season of goodwill. Shouldn't we be asking why every season isn't overflowing with goodwill? Is it that we also need seasons to not care about others too?

It got me thinking about what prompts goodwill, selflessness and support of any kind. Here's a few ideas of what might be our motivation.

  1. Obligation
  2. Winning friendships
  3. For gratitude
  4. To impress others
  5. To earn entry/rewards in the next world
  6. Out of love and compassion for others
  7. Out of wanting to increase our self-esteem
  8. Because others deserve more support than us
  9. To salve our own conscience
  10. To 'out do' another
  11. For popularity

I can honestly say all the above reasons have been my motivation at some time or another except for the last two. Now that I'm in my 40s though I find I have become more cautious and more selective, not least because I've learnt to identify those in genuine need a bit better and I've made the conscious decision to reserve my efforts for them, but only when I myself am up to it. I'm no use to anyone if I am burnt out.

I've also learnt that being a 'people pleaser' is a form of self-neglect, as to please others to ingratiate ourselves with them or for popularity involves negating our own needs, sympathies, beliefs, opinions, thoughts and feelings. It becomes an acting role with the heart, soul and truth of the person who is the performer steadily getting diminished and crushed. It is not uncommon for selflessness to manifest itself in those who have little or no self-esteem or self-worth.

The root of such behaviour can be down to all manner of distressing events and experiences including neglect, smothering, manipulation, conditioning, rape among many forms of emotional and physical abuse. Feeling you are less deserving; that your thoughts, feelings and needs are less important than another is quite simply, wrong. We are all of equal value to anyone and everyone else. We are never more deserving of attention than anyone else, merely equally deserving. Who is it who can say they have had the worst of life? There are always more horrors that we have not encountered but that someone else has, but they won't have experienced our suffering. In a nutshell, pain is pain. It's not a competition.

The truth is harsh. Life isn't fair. When it comes to life's ordeals and traumas the question perhaps ought to be "why not me?" instead of "why me?" Unpleasant things do happen, but the trick is not to let them have the effect of devaluing our sense of worth and belief in ourselves or to think it gives us a license to railroad other others as if they don't matter.

This week I came across a person who expressed their pain in a very curious way. They had been extremely generous and supportive of another, but they had also become bitter and angry about it too and suddenly and savagely turned on the person they had been so supportive of.

If it is likely that we will end up resenting giving emotional, practical or emotional support I would argue it is best not to offer the support in the first place. I would suggest that it is best not to promise things that we may come to regret doing, or things that may cause us harm or damage in any way. To give false hope to another, in my view, is one of the cruellest forms of emotional torture (even when unintentional) hence why I have tried to avoid promising anything at all. To ensure this I have adapted how I offer support by using phrases such as 'if I can' and 'I'll try but I don't promise' thus making it clear to that person where they stand.

Reliance and dependency upon others at times of need is all too tempting but I feel it's best avoided if possible for fear of disappointment. Instead, I've tried to only ask and only accept help for the essentials I need at any given time, be it emotional, practical or financial support.

My closest relationships are with those I am allowed to be supportive of in return. I don't feel an obligation to those people, but a gratitude and a desire to be there for them as they have been for me out of love. Sometimes I've been supportive first, sometimes not.

What sets them apart from the rest of my acquaintances is the respect they've shown me at all times. Of most value has been the suggestions and advice on how to cope or resolve a difficulty.

I wish I could remember where I heard this quote from but the fact is the words stood out so much I have forgotten the source. "Remember that when you give to others, you are also taking something away." That 'something' I think is pride and when we are desperate for help we often forget how easy it is to view it as a luxury that we simply can no longer afford. A homeless person begging for money for food has to give it up just to ask for support.

I wonder now if dependency beyond childhood is not a form of enslavement. I prefer, and advocate, empowerment by giving people the means by which they can shape their own future. In my opinion advice is of equal value to financial or practical support for this reason. Indeed I think it always ought to go hand in hand.

The Need for a Break
None of us are superhuman or gods. People who are renowned for their 'selflessness' are no exceptions; who's to say they didn't go through an internal personal hell before they became strong enough and balanced enough to do their good works. They acquire an absolute inner peace before they devote their lives to others.

For the rest of us we simply cannot give, give, give and if we do so without first addressing our own needs we are likely to be causing ourselves harm. When that happens are we really the best people to be supportive of others? If we haven't learnt how to address and overcome our own hurts and harms, are we really the best people to advice and support others?

Seasons of goodwill are there to celebrate the fact that there is goodwill. I think it is wrong to expect it of anyone 24/7. We all need time to recharge our batteries, to learn from our own troubles before giving to others and to take a step back from the plight of others to see the situation more clearly too. It doesn't mean though that goodwill is not there all the time. Would it could always be very apparent to one and all but the answer to that lies in everyone doing their bit toward that goal, when they can. That way we can all share the weight and worry instead of it becoming an all consuming activity of a few. Teamwork and taking turns I think is the route toward everyone getting help when they need it.

Happy New Year everyone!

Sunday, 12 December 2010

Boundary Battles

It's easy isn't it setting personal boundaries for how others react and treat you? No?

No. It is one of the hardest things to learn to do, hard enough when it's a work setting; all the more difficult when you know you need to set boundaries with people you know, love and care for.

Let’s pause to think what life would be like without them. Life would be an absolute nightmare if we had no laws and so it is with personal boundaries. Too often those of us with mental health histories allow ourselves to be rail-roaded over due to our appalling low levels of confidence and self-esteem. We often find ourselves arriving there because we can all too easily end up rejecting who we are for becoming ill. Such is the extent of the prejudice and stigma that even we are affected by it. Some even negate themselves completely.

The proof of this comes in the shocking statistics of the suicide rate actually going up when people come to realize they are ill. It is why patients, when sectioned for the first time, are often put on a 'suicide watch'. Exactly at that moment when we wake up to the fact that we are not well, we can end up wanting to give up on life itself because of the nature of the illness and all that it implies in mainstream society. The battle to restore and reclaim trust, respect and confidence from others begins and for some it sadly becomes too much of a battle for them to want to fight.

I remember experiencing that feeling myself when I was sectioned - it was the worst day of my life to wake up realizing both how ill I was and all that I'd done. I cringed with embarrassment to think of how I'd behaved and treated others who had tried to help and that feeling was so intense that I never wanted anyone who knew me to see me again. I felt it would be better for them if I ceased to exist because of the burden I felt I had become.

The answer is to always remember that we have had better days, and are capable of them and therefore can get back to them. We also have to remember that not everyone is uncaring or inconsiderate - many people want to, and actively try to, be supportive. We should not deny them the choice to do so if they truly have out well-being at heart. We need that depth of love and compassion as much as anyone else.

It's a battle that involves standing up to the prejudice, assumptions and stigma from others who act according to their ignorance frankly and in my view are riddled with issues of their own. Even our nearest and dearest friends and relatives can be prone to this. It is only through continuing to communicate that we can overcome these difficulties.

We have a right to express ourselves; our thoughts, feelings needs and wants. What no one has a right to do is dictate or impose those things on others. If we want others to respect our limits, so we must respect other people's.

Recently I read an article about how to find God by not living for ourselves, but instead living for others. I will never advocate absolute selfishness, but nor do I advocate absolute selflessness. I question the mindset of people who do so. To give your life entirely to others by definition means negating your own needs. It can lead to people taking advantage of you emotionally and financially and is dangerous because it suggests that others are of more worth, more value and are more important than you. Rubbish. We are all equals in these things.

How to set boundaries
Like deciding upon what to build and how high a fence or wall it should be to protect our property, or deciding on whether or not we should have net curtains, blinds and shutters for privacy on our windows, so we need to decide what boundaries we want in our lives for our emotional well-being.

Among the range of people who visit me at home, there are some who are allowed in some rooms but not others; some are allowed free run of my home as they are particularly close to me. There are some people who I know personally who know I write this blog, and others who don't. I have set the boundaries and I manage them. I have control, and if that trust is seriously abused then people just get blown out of my life.

It's the same with behaviour and how we wish to be addressed. It may be handy but it would be very long-winded and extremely odd to issue a written set of terms and conditions for everyone we meet, but fortunately it is largely unnecessary. Relationships tend to evolve and only when something we don't like occurs do we need to inform people of it. People who are close to me initially weren't because it takes time for that level of trust to develop. My door is always open to more people in effect passing my personal tests to become close friends but if they don't pass they are still friends on a less intimate level. I think it's good to have a range of relationships as that way I increase my chance of all my needs being met.

We cannot reasonably hold something against another person if we don't tell them what our beliefs, thoughts and feelings are, so if there is a misunderstanding or dispute ask yourself if you've given that person a fair chance to understand you. You may decide you don't want them to which is fine, but it could be unfair then to judge them harshly.

Friends are now those who support me but also people who allow me to be supportive of them as I know I need to feel needed to ensure that I retain a sense of worth. They are people who I can have an argument with, or disagree with without it feeling like it's the end of the world. They are people I can turn around and say 'I'm really sorry but I need my own space right now.' without fear of them disappearing forever, and they can and do the same with me.

Time Out
I recently had to do just that because of the problems a couple of my friends were having were triggering bad memories for me. I was also becoming obsessed with their difficulties and ignoring important issues of my own that I needed to address. We cannot be of any real help to anyone while we are wading through problems ourselves. What we can do though is root for them in the hope that they will be doing the same for us.

It is ludicrous to expect or assume that anyone will always be on the same wavelength as us. Just as all manner of things can be affecting us at any given moment, so it is for others and sometimes that can lead to tensions getting out of perspective. I've learnt through counselling that we can only ever be truly aware of ourselves.

So, sometimes it is better to take a break and note down issues and wait until a loved one is in a better place themselves to be able to hear things, and to wait until we are in a better place too to speak them.

Compromise and Negotiation
I believe a real compromise should involve both parties giving up on something that they want. This does not mean that the compromise has to be written in stone. At a later date both parties will often find that what we want today changes. I think of things being on hold rather than given up on for this reason. Everything is subject to review and re-negotiation over time.

I have a feeling that assertiveness is a topic I will be returning to at some point but these are the basic principles that have helped me enormously. Most of all setting boundaries means asserting our needs. There are some instances whereby I will never compromise and at such times I need to put my foot down and plainly state 'No'. For example I dislike being asked to lie for others as I believe that honesty really is the best policy. So I try to encourage people to think how to phrase things better so that they don't lie. Being economical with the truth may be necessary out of consideration and fairness for all the people involved in a situation.

Assertiveness is not about letting rip and being angry. It is about stating your boundaries succinctly and with the utmost clarity. It is about being firm but fair. It should never be seen as an opportunity to be critical of others, to launch into a personal attack of their personality or character. If we do that, it will most likely lead to our receiving the same in return or potentially causing harm and damage to others and I would rather not have that on my conscience. It's tantamount to bullying. It is not about imposing your needs as being more important than anyone else’s, that too is a form of bullying.

Some of the most effective phrases I've used are "I'm sorry I don't agree with that.", "No, I find that upsetting." and "I think that's insensitive." What I don't do is add the word "because". Over the years I've discovered that by avoiding using that word I'm less likely to be put in a position of justifying myself as if I'm in the wrong for holding a different opinion. Different doesn't mean better or worse, it just means not the same. Only when asked do I explain why I hold my view, as being asked is a sign of respect and interest being shown to me. It offers dialogue at that point.

A brilliant manager once told me that they kept socialising with their staff to a minimum for two reasons. The first was that it helped them to maintain their authoritative role; the second was so that the staff had the opportunity to moan about them. What she was saying was that she recognised that in her role she was obliged at times to tell people to do things they often didn't like to hear and that as a consequence staff needed to get their upset out of their systems by going off and moaning. Due to the way she handled things and her careful phrasing she is highly respected even when she had to announce redundancies.

In my personal relationships I now do the same. I will rant and call people who annoy me all the names under the sun away from them. I share those feelings only with those who are not involved in the situation that I trust to keep it to themselves. I find that once I have got my feelings out of my system I am able to think more clearly, see the other person's side of things and deal with whoever has upset me more respectfully. I also benefit from getting an objective view of the situation that way and often get advice and suggestions on how to communicate better.

If all else fails we always have the option of walking away. Relationships are complicated because we can never know everything about everyone and the more people who are involved the more complicated it gets. I hope that this has a least triggered some ideas on how to protect yourself in all of them. The rewards come when you find people do see that even the mentally ill can be intelligent and of value, for the truth is, we are.

Saturday, 27 November 2010

Perceptions about the Insane

Whatever happened to those adorable and totally acceptable eccentrics that in all cultures were so venerated? I was reminded by a friend of mine who has recently been diagnosed with OCPD (Obsessive Compulsive Personality Disorder) of how those of us who are diagnosed can often not see we have a problem at all and that it's other people's lack of acceptance of our eccentricities that are at fault. It reminded me of my own training at MIND that there is a new theory developing that absolutely no one is free of some disturbance of some kind or another.

Finally this week I was reminded of an excellent Horizon programme 'How Mad Are You?' on the BBC in 2008, which itself was based on an American experiment by David L. Rosenhan. The experiment was to see how accurate and how definable mental illness is by getting volunteers with no known mental illness, and no symptoms to pretend to be ill to see how good psychiatry and in particular diagnosis really is.

'On being sane in insane places' is listed on the web and you can find many links but I recommend or wikipedia for the most considered if not the most objective accounts. Both the BBC programme and this experiment illustrates just how difficult it is for mental illness to be accurately diagnosed and how diagnosis relies upon a combination of factors.

I would personally argue that people who want to pretend to be ill in order to gain entry to a psychiatric unit unless done as a controlled and supervised experiment do have something wrong with them. It's a disturbing place to want to go to because it is full of distressed people as that's what it's there for.

Out of all this though come many lifelines for the mentally ill, not least that people are monitoring and constantly assessing mental health care services. It triggered a thought too that if we can learn to pretend to be well and are able to sustain that persona, are we not then well? I would say not necessarily but it might be a step toward improving on our health to at least start imagining that person and that can then become a target to aim for. The first step is always the desire to function better by not letting the illness control who you are or what you want to achieve.

In the same way that paraplegics, blind and deaf people learn how to function in mainstream society so we need to learn how to manage our own conditions to function at the best we are capable of. I personally loathe the word 'disability' as it immediately conjures up the notion of limitations. I have not met a person yet who does not have limitations.

So just as other 'disabilities' have learnt to combat this pre-conception by proving they have ability, so too do people with mental illness. The list of famous people 'coming out' is increasing all the time, high achievers. And yet still the perception remains that insanity = dangerous people on a killing spree as that is the only regular story to hit the headlines when it comes to mental illness. The fact that murders are committed by sane people far more regularly still hasn't hit home (See Stats Facts on the right hand side of this screen).

Unlike other disabilities we actually require very little in the way of adjustments to be made in the way of equal rights and opportunities, support and inclusivity. Most things could be improved by consideration, respect and compassion. On October 1st 2010 the law changed in the UK so that it is now illegal for employers to ask about your health history from either yourself or former employers or for them to consciously or indirectly discriminate against anyone with mental health problems. They are also not allowed to discriminate against you for who you are related to or associated with, which I think is a very bold step. How enforceable any of this is remains to be seen but I think that overall its intent is a step in the right direction despite its pitfalls.

The belittling of intelligence of the mentally ill is sadly still shocking, alarming and rife. Just as deaf people get treated as if they are stupid, so too do the mentally ill get treated as if they are unable to think straight at all. It is simply not true. It is usually one area of thought processes that gets problematic not the whole lot and these can have very real and easy to understand reasons, e.g. a victim of crime may fear certain situations and types of people or other events that trigger phobias.

Both the Rosenhan experiment and the Horizon programme illustrate psychiatry's pitfalls. It is not perfect, far from it. It is after all, a comparatively speaking new science; a new medical discipline. In common with all medical care it has and does make mistakes while it learns. In the 19th century limbs were cut off to save lives as a treatment against a deep gash because medics didn't understand about infections then, now limbs are totally reconstructed where at all possible. The progress mental health care has made since the 1950s when lobotomies were common is substantial. That progress hasn't stopped and it is only through our help that progress can be more rapid yet.

I advocate going for help as early as possible so we can avoid being sectioned when things get much more complicated. When sectioned it is far harder to complain and be taken seriously and impossible to just walk out. If you go to the medics early, you are still free to discuss with others how good or bad the treatment is and if you've got a good team they should willingly accept and facilitate a change of psychiatrist, therapist/counsellor or medication.

Don't imagine I don't know how phenomenally brave we have to be to take that enormous leap of faith to enter into accepting help from anywhere let alone complete strangers which is what mental health professionals will be to you the first time. I remember the day I woke up when sectioned to do so. I was petrified, not least because I was under the delusion that they were only using me as a guinea pig in some elaborate experiment - a fear triggered by and based on mental health history. However I had become so desperate that I had nothing to lose by turning to them and everything to gain. I gained... I got better.

Correct your medical team on anything and everything they get wrong about what you think and feel. They may deal in psychiatry, but they are not psychic. If you don't tell them, how would they know what on earth's wrong? If you don't tell them, all they're left with is assumptions based on another patient they've come across, but that patient isn't you. You are unique and even if you do fall into a 'category' and get a label for your illness it is still a very individual experience. No two people will be exactly the same in their responses to drugs, therapies or anything else.

Admit when your medical team have it right so they know when they are on the right track. If you don't know, tell them. On many occasions with counselling, I had to say, "I don't know, let me sleep on it." And that's exactly what they did and they further helped me if I got stuck.

Tell them what you need. You may be anxious or depressed about many things; have many things going wrong. Again only you can tell them what they are. This includes the effects of medication, such as "yes I'm less anxious now, but I've lost all interest in even things I enjoyed." That should prompt a discussion on what you want to be like and what your recollection of being well is.

After I was released from being sectioned I went back and banged on the door because all the practical problems were exactly the same as before. Nothing had changed, the situation was as bad as ever. I was admitted as a voluntary patient and I point blank refused to leave until I was allocated a community team to help me sort all the practical problems, from a Social worker to help with finances (benefits and creditors), to having a Community Psychiatric Nurse to help me with all the events and drug management on a daily basis while undergoing counselling for the long term issues at the root of my depression.

In the UK I know we are so much luckier than in other countries around the world. Some countries have next to no National Health Service, let alone anything to help the mentally ill. In others you can only access health care if you pay insurance or have enough money to pay to see psychiatrists. Such cultures are a goldmine for rogues and fraudsters. Never be guided by their claims, quotes or satisfaction ratings or comments. The world wide web is there though to help steer you in a safe direction for the help you need so seek advice on how to choose your medical team from recognized and long established organisations and institutions (e.g. MIND and the Institute of Psychiatry here in the UK). Also look for suggestions from organisations like MIND for the best publications to suit your needs.

I do not recommend on-line diagnostic services of any kind. Responsible organisations will always advise you to make an appointment with a professional for an assessment. I am dubious and suspicious of on-line counselling too. Nearly all of them expect you to pay at least a non-refundable deposit and many will end a session with a cliff hanger to make you go back for more - far from helping you, you are more likely to find that they will be doing their best to keep you ill until they have got your last penny out of you. However, I can see how on-line counselling could be used as a precursor to face-to-face appointments later on if you are too frightened to see someone to begin with but I have not yet come across anywhere that offers this under those terms yet.

Far better in an emergency is a call to the Samaritans, Social Services or the police in the UK who will be able to advise and help you. Sadly, some nations are such oppressive regimes that even the police cannot be relied upon. I despair that in the 21st Century such regimes still exist. Try the Red Cross or even appeal to the United Nations and human rights organisations if you can. There's also this one, that someone on Stephen Fry's forum site pointed out (many thanks). I would be interested to know of other sources of help there are globally to add to my website list so everyone can benefit.

I hope no one ever encounters a situation whereby you need to make a complaint, far easier in my opinion, if at all possible to change the medics you see. Sadly your case is all the harder to fight when you are ill than for people who battle over maltreatment and misconduct over physical conditions. The onus will be on you to provide evidence. You will need to do so in a very collected way in order to stand a chance of getting anywhere. You may be up to it once you get better, but you need the right team to get better in the first place.

There are some sources of help in the UK, including advocacy services, the CAB and your MP, but everything very much depends on evidence and the records you keep of the events as they happen.

In the UK you can contest being sectioned and you will be allocated a solicitor (lawyer) if you don't have one, but very few of them specialize in mental health and with the weight of medical opinion against you, your chances of success are slim at best. I tried and failed, but they were right to keep me in hospital back then, I needed to be there.

Yes, we in the UK are not doing that badly and it's thanks to the Anti-psychiatry movement that impersonal institutions have been closed and that we as patients are beginning to be respected as experts in our conditions albeit from a subjective point of view. We have a voice now, let's not lose it. I vehemently believe we must keep the dialogue going now others have fought so hard on our behalf to start it.

The Future of Mental Health Care
We can and will be (with or without our consent) instrumental in future progress. Better it comes out of collaboration as I would hate to see a return of some of the horrors of the past for us to be negated and reduced to silence once more.

Another Horizon programme covered hermaphrodite babies (children with no clear gender). Within the first few weeks of their lives their gender is decided upon and a gender is allocated through surgery. Some of the children grew up quite happy with no problems, while others developed problems because they felt they were the wrong gender. During studies of these people scans were taken of their brains, and the conclusion was that there is strong evidence now to suggest that a part of our brains determines our overall sexual orientation.

I'd like to think in the next 50 years science will have developed scanners to be able to detect a root physiological cause for all mental illnesses, and from that learn how to fix it. However, no such fix will ever eradicate mental illness, for while there are physiological factors involved (e.g. chemical imbalances) it will only ever be one factor in a very complex set of illnesses. Genetics play a part but whether I became ill due to genetics or due to environment is nigh on impossible to categorically determine for the two cannot be separated.

Thankfully people being sectioned for having an affair, or not behaving as other family members want them to are largely a thing of the past. Such were the dark times. It is no longer possible for people to be sectioned on the here say of family, employers, friends or the general public. No one can be sectioned without there being agreement from medical professional; usually a GP, a Social Worker and a psychiatrist.

Aside from genetic elements people become ill from sheer unforeseen events e.g. murder, torture, rape, abuse, robbery, poverty, fire, floods, the death of a child or indeed any relative by whatever means etc. And there's the truly massive global shocks such as volcanic disasters, hurricanes, droughts, tsunamis, 9/11, War, Nagasaki, Hiroshima, the holocaust.

No. Mental illness will never be eradicated, but from here on in I sincerely hope a greater awareness and compassion develops, out of which swifter and better recoveries evolve. I also believe that drugs and all therapies will continue to be refined and improved within my own lifetime. It requires all of us to give continual feedback on what works and what would be better for options to increase. Yes treatments are not where they could be, but at least we're on the road to increasingly better possibilities. The answer is in our hands to ensure that it happens and in how quickly it can happen. We overcome all difficulties and disputes quickest and best through dialogue.

Finally I hope we will see a return of our love and acceptance of people just being a bit different, quirky or eccentric but with an increase in the level of respect shown to them.

Monday, 22 November 2010

A Game of Questions

I have to thank a former boss for this challenging game for two people.

Two people take it in turns to ask questions. They are only to speak in questions and must continue the conversation in questions. If a player makes a statement they loose. If a player mutters to themselves trying to find a question they loose. If a player hesitates too long they loose.

An example of how this game can help
My boss was such an expert at this that she managed to keep batting back questions from half a dozen people at the same time. It sounds easy... but it's not. She gave me this exercise to help me stop forever saying "ok, I'll do it." as I was taking on too much.

By rehearsing asking questions it helped me to help empower other members of staff to think of solutions for themselves by asking them to think up new possibilities. It helped me think about alternative ways of doing things too.

Staff soon discovered that they could resolve many more things than they initially believed possible. Much better for them as it helped them grow and develop and for me as it enabled me to focus on my priorities better too.

So it might run like this...

Do you want to play questions?

Do you think it's a good time?

Is there a better time?

What questions would make for a good game?

Are there better questions to ask?

Which do you think would be better?

Do you think there should be a scoring system for them?

How would you like to structure it?

Who do you think will win?

When do think we'll know?

etc... etc... etc...

You might find it easier to start with a subject like, you're work or hobbies and interests.

What are your favourite hobbies?

Why do you want to know?

Don't you want to talk about it?

Why do you think that?

Did I say I thought that?


I love this game as it helps steer me away from making assumptions when I don't have any facts. It challenges us to utilise our logical head/hat.

Thursday, 18 November 2010

The answer is in your own hands

In the last month I've been on a journey; had to wrestle with my conscience, convictions and beliefs. I have been quite depressed about not having a magic wand for people who have likewise suffered from depression. Time and time again I found myself returning to one of my original blogs about only being responsible for our own feelings. We cannot command, control or govern how others respond or react. The answer truly is in our own hands.

The trouble with any form of depression is that one of two things tends to happen. We either withdraw which worries others who care for us, or we set about seeking a rescuer - usually in the wrong places. We can become demanding, aggressive and angry in our desire for attention, sympathy, understanding and compassion as a result of our heightened sense of desperation. It can be a harrowing ordeal for all concerned. Never forget though that there are always concerned people about who want us to overcome the dark chasms of the moods we experience.

Four actions to take when the black clouds gather
1. Find an appropriate outlet for the emotions - this might be stamping out a frustration on a long walk, bashing clay, writing down your feelings, sloshing paint, kicking a football. All things you can do privately to expel the worst of the intense feelings so you are better equipped to communicate lucidly and clearly with others about what is troubling you.

2. Seek a professional to talk to who will properly understand your symptoms and who has been trained to handle them. They are also bound by confidentiality so your darkest thoughts have an outlet. These are often thoughts you really don't want to share with those you care about. Not talking to a professional gives emotions room to fester and grow out of all realistic proportion. Talking to untrained people can often result in a response you may find unhelpful, patronizing, or even confusing and this will only heighten feelings of desperation and frustration.

3. Accept that our bodies are physiological entities which sometimes malfunction. All life forms are made up of atoms which combine in miraculous ways to form cells which in their turn produce the myriad of life forms we see all about us. Sometimes cells combine that cause damage and harm or cause illness - from flu to cancer and AIDs. It's no one's fault that this happens. It is never your fault that you become ill from whatever cause, but we all have a choice in what we do about it when it happens.

Ask yourself "do you want to be ill?" If the answer is no, then go to your doctor. Ask yourself "do you want to be depressed?" If the answer is no, then go to your doctor.

Fortunately we are now living in a time when there are increasingly better forms of medical help. Although some forms of mental illness require medication that subdues us to give us time to heal, most treatments involve and encourage you to continue to function. There are more and more options for prescription drugs to assist as well as a range of different therapies. If we have no qualms about taking an aspirin for a headache, why do we have them for depression and mental illness? And as the decades roll by prescription drugs are improving all the time and likewise so are the therapies.

Mental illnesses may not be as tangible to decipher, do not have a definable group of cells to neatly cut away and discard, but thankfully medical teams are making progress all the time in finding ways to alleviate the worst. Like the history of cancer treatments, some conditions are more easily combated than others; but all conditions are receiving attention in the hope of cures. We are, by seeking out medical teams very much at the forefront of helping that along and no longer as guinea pigs, but increasingly as sentient and respected people who are driving progress forward.

4. Challenge yourself. All too easily we can slip into a self-fulfilling prophesy by saying "I'm always depressed at this time of year." Imagine instead what it would be like not to be. What things can you do to diminish or eradicate that possibility? Think of things that make you happy, that motivate you, that you enjoy and plan and pack your life full of them.

It follows that if we are ultimately responsible for our own feelings, there can be no rescuers. We have to do it for ourselves. That's not to say there aren't plenty of people who will be more than happy to be supportive in whatever way they can including friends, family and work colleagues. What they cannot do is take on our thoughts and feelings and wave a magic wand to change them. In reality, would you really like it if they could? What if they came along and wiped away all the good stuff?

Certain types of mental illness manifest in the belief that that is something that really is happening to them. If you are not suffering from those symptoms, don't point yourself down that road. If you are a sufferer from those conditions (psychosis and schizoid disorders can have these symptoms) be brave and take the plunge to trust the medics and confide in them. It may be the hardest thing you've ever done, but what's the alternative? A full take over of who you really are?

Most of all buy into the idea of better things being possible regardless of how wretched your situation may be or feel; believe you deserve better, fight for it. Believe you are worth it. I believe you are - high time you did.

Monday, 8 November 2010

Multi-Faceted You

How many personalities are you?

But I'm just me aren't I? Well yes and no.

Here's some questions to help you to find out how well you know yourself. It's something I've conjured up as a result of counselling and studying and comes in a series of mini exercises which bit by bit get you to understand your own way of thinking and seeing things.

There's no right or wrong unless you happen to stumble on something you want to change about yourself.

Important: No change is ever possible unless you yourself want to change, and then it's entirely up to you what (if anything at all) you change.

If you repeat the exercises every five years you will reveal how you have developed, grown and evolved. These things do take time, repeating the exercise more often than annually doesn't usually result if any significant difference as it's very rare for personality traits to alter that quickly. I say rare because I don't rule it out being possible. Also some changes may be to get you through a difficult time and therefore temporary.

Personally, at times I'd like to be more methodical at certain things, but on balance it's not that important to me to devote time to changing that aspect of my life. Other things I have changed though, such as refusing to be ashamed of my mental health history anymore. It's been a feature of my life, but is only one of many aspects that have shaped who I am. I've taken ownership of it, but it does in no way represent the whole of me anymore than having toothache can.

Before starting I need to add it works best if you are honest about yourself. After all it's for you, and you alone. You are not obliged in anyway to ever share your answers with anyone at all.

Exercise 1
Describe your personality.

Exercise 2
Describe how others perceive you.

Exercise 3
Name and count the various moods you can find yourself in.

For this exercise it might help to think about how you are in different situations e.g. in a shop, seeing a bank manager, at the doctors, with colleagues at work, at home with friends or family, at a party etc.

Exercise 4
Start with a list of 20 everyday situations, then describe how you are in those situations according to the following;

  • when you are on your own
  • when you are with a companion you like
  • when you are with a companion you dislike

Exercise 5
Repeat Exercise 4 but now add in how you are when you are:

  • talking to someone you like
  • talking to someone you dislike
  • trying to impress or seeking approval
  • trying to be dismissive and get away

There are so many variants to this exercise e.g. how are you when in the company of someone you like but have just had an argument with when trying to impress say a bank manager or boss? Gets complicated doesn't it? Keep going though, you're nearly half way through!

Exercise 6
Look at your description of yourself (Exercise 1). How accurate and honest have you been? Did you include all your positives and all your negatives or only some? What does that tell you about how you see yourself? Now fill in the gaps!

Exercise 7
Look at how you think others see you (Exercise 2). Who have you chosen to think of for this exercise? Why is that? How well do you think they know you? What have you shared with them for them to know you well? What would happen if you picked someone who knew little about you or who you don't get on with. Write your thoughts down.

Exercise 8
Describe how you want to be perceived by others. Who in particular do you want to see you in this way and why?

Exercise 9
When does it not matter how you are perceived? Why is this?

Exercise 10
From all the exercises count up and list how many of the situations were you 'performing' or 'acting' a part. e.g. trying to impress someone you dislike, or the bank manager.

Exercise 11
From all the exercises count and list how many different moods and behaviours you have got in your repertoire.

Exercise 12
What, if anything would you like to change about your personality? And what examples of your own behaviour can you draw upon to develop in this way. Write down your findings.

If you can put on a performance for an interview, be pleasant to relatives and colleagues you don't really like, then what is it that's stopping you becoming the person you want to be known for? What is stopping you from having the confidence to reach for your goals?

We all act, perform and pretend we are ok when we're not etc, every day of our lives as different situations require certain codes of conduct. Consequently we are never entirely one thing or another as we change according to what's happening at any given moment and who we are with. It might make for an interesting interview to tell them in graphic detail about throwing up after a party, but I doubt it will get you the job!

We develop different masks to protect ourselves from getting hurt and to win attention and favour, but the over use of them becomes the barrier to our own development and can prevent others from finding out who we really are. If we don't know our inner selves, no one else stands a chance.

Final Exercise
List all your best qualities and greatest ambitions. Add to the list, all the nice things that have been said about you, compliments and praise given. You should be able to find something somewhere that indicates you're not a bad person and that's the crucial bit to focus and build upon, from now onwards.

It doesn't mean ignore our bad habits, moods and behaviours, but by looking at the list of good habits and qualities we are better equipped to combat them with positive action instead of torturing ourselves over how rotten a person we might feel we are.

No one is all good; but equally, no one is all bad either. Everyone is multi-faceted. The trick is to polish and hone the best bits. It's a continual process as we journey through life. And along the way we all need to remember to admit to mistakes, forgive ourselves for making them and be open and active in learning from them. That's how we grow, that's how we develop, that is how we evolve.

I've found it to be one of the key ways I've found to enriching and improving my quality of life.

Thursday, 4 November 2010

Myths about Counselling

One of the main sources of help for me has been learning about counselling and embarking upon training. I learnt in two ways, firstly by being a client and secondly by starting training.

I first encountered counselling as a patient following on from my psychotic breakdown. I knew I needed to talk and talk and talk about everything that was troubling me - the feelings of isolation, the feeling I was being punished for being bereaved, the practicalities of finance of getting work and most of all my family history and its problems that had led to my breakdown.

I was sent for Cognitive Behavioural Therapy (CBT), which is one form of many talking therapies that are available. It didn't work. It didn't help and I felt more frustrated than ever as a consequence. Fortunately, I was not told that I had options in counselling; that I could ask for a different counsellor or a different form of counselling.

One of the reasons it didn't work for me then was because my emotions ruled by head. I was unreceptive to everything that was being said, unreceptive to the approach. I was not in the right place for that form of help at that time. So timing as well as the form of therapy is crucial for counselling to be of help. You have to really know what you need and want that form of support.

Looking back I now know I needed help in getting my head to take charge, I needed to understand the dynamics of my family and how my formative years had effected how I developed relationships outside of my family (work and friends). Back then I did not know how to voice why that particular counsellor was not for me.

It took a while, but eventually I was referred to another counsellor and this time it did help. It was certainly what they call a 'person-centred' form of counselling and may even have been CBT again. The difference was I felt more comfortable with the counsellor; the medication had calmed me down and most of all I was allocated a Community Psychiatric Nurse (CPN) and Social Worker who helped me with all the practicalities of life (paying bills, eating and sleeping and looking for work).

That enabled me to concentrate on all the emotional stuff in counselling. In turn that enabled me to work through, examine and devise better coping strategies. I've always been a person not to share troubles when they happen which meant they built up until (like a dam bursting) I couldn't hold it in any longer.

It's a habit that I still slip into, but less often than before and, when I do share things with others it's less of a shock to others and less intense (though it's still not always perceived that way). Such things are relative though and compared to how I was, it is a lot better.

Most of all it gave me the confidence to share what troubles me. It helped me to see I wasn't a failure for feeling helpless or depressed. Some people still might walk away when I am ever strugglinh, but by understanding better why they might it has become less of a disappointment and hurts less.

It has enabled me to appreciate that I am not the centre of their universe only the centre of mine, and that therefore they too could need to work through stuff of their own. It has enabled me to form stronger and more worthwhile relationships with people who do stay to listen. It has enabled me to be more open-minded about what people are trying to do to help. It has enabled me to articulate why some forms of help are not what I need at that time, which lets others know where they stand.

Good intent if not appropriately directed can actually be more harmful than some malicious intent. As a direct consequence of this I now have some close friends and stronger relationships with my family and work colleagues. I feel I am more respected and valued.

One of my closest friends is still not comfortable with my intense emotional side, but time and again has offered fabulous forms of practical support - helping me come out of those battening down the hatches moods and behaviours by getting me out to play badminton and socialising with others. Another helps with sharing feelings and allows me to help them too which is important in increasing my self-esteem.

Following my mother's death I knew I needed more counselling. In an early session I was remembered what the atmosphere at home was like as a child. All I could do was picture the house with a big black cloud continually hanging over it. I hyperventilated. There was no memory attached, no event, no incident I could recall. The counsellor said that I would remember only when it felt safe to do so.

That time came. The memory was all to do with being witness to my mother's distress in her illness; the helplessness, frustration and anger I felt in not being able to find a solution to make her happy. At that time I was referred for Cognitive Analytical Counselling (CAT) which is a form of psychotherapy. Frankly it transformed me.

Different situations require different forms of support and help to find the solution that's right for you at any given time. Only by informing your GP of what you feel you need can you get what you need. That changes each time because as we grow we develop and each experience shapes our development and alters our perception, sometimes gradually, sometimes dramatically. We learn by many methods and from many things.

Good Counselling

  • In counselling you are in charge, not the counsellor.
  • You can request a different counsellor, but you must be honest about why it hasn't worked with the one you've got so people can help identify one that might.
  • You can request a different type of counselling.
  • Counsellors should never dictate, advise or tell you what to do.
  • Counsellors should be acting as a catalyst to help you find out what you can do to take better control of your emotions and your life.
  • Counsellors are bound by strict confidentiality. They should only break that confidentiality if they believe you are a threat to yourself or others. They are not allowed to share with your GP, authorities or family members otherwise.

These are all things that should be outlined in the initial assessment session. The initial assessment is for both parties to see if they will get on.

Training to be a counsellor
After I lost my Mum that I started training to be counsellor. All the above was pointed out in the very first session of my introductory course. Throughout the course we each had to keep a journal of our thoughts and feelings. We were encouraged to share this with the group but didn't have to share all or indeed any of it. Sometimes this would result in very personal and emotional revelations; sometimes it would be struggles with aspects of the course. I remember struggling with trying to define 'empathy' for ages.

Empathy is favoured above sympathy. Pity can be flashed from safe distances, but it's an inert, inactive emotion in itself. Empathy enables the counsellor to see things objectively and helps them not to be tempted to judge which is a natural human trait. Empathy enables them to see the whole situation better which in turn helps the client to do so too.

I found the course to be of immense value to me as it helped me to understand how we get into the pickles we find ourselves in by the way we perceive things. Learning to step outside ourselves and look in on what we do helps us to see where and how these situations arise, which then leads to us beginning to understand what we can do to avoid such things happening.

WARNING: It takes many years to become a fully qualified counsellor, it is not something you can just teach yourself and you should only go to qualified counsellors.

I recommend everyone doing an introduction to counselling course at some point in their lives but believe it's important to sign up for a course and not try to self-learn by reading alone. However I will recommend my favourite book in my first course, 'Introduction to Counselling' by Pete Saunders. As I am only at Level 3 I still believe it's irresponsible for me to counsel anyone yet. As an individual though I am free to suggest and recommend but that is all.

Sunday, 31 October 2010

Maslow's Menu and Diet

Just about every teacher, Mental Health practitioner and many business managers (though frankly not enough) are aware of Abraham Maslow's Hierarchy of Needs. Maslow was a psychologist who decided that the way to understand psychology was to study where it was working right, not where it's wrong.

He therefore concentrated on studying people like Albert Einstein, Eleanor Roosevelt and Frederick Douglass who were perceived to be in pretty good shape to be able to become as successful and respected as they were in their respected fields. (In modern psychology there is now debate as to whether or not anyone is 'normal' or mentally healthy - I shouldn't laugh, but I do!).

Regardless of how it was arrived at Maslow's Hierarchy of Needs has become highly influential in determining how well a person is doing and certainly helps by providing a structure and plan to work toward for any and everyone at any and every point of their life. The simplified version consists of five levels of need.

Maslow_Needs_Hierarchy.jpg (604×363)
  • Level 1: Basic (Physiological) needs (food, shelter, drink, sleep - the essential requirements to facilitate life)
  • Level 2: Safety needs (Security of: body, structure (e.g. law and order), employment, finance, family, morality - things that make us feel safe)
  • Level 3: Social Needs (family, community, friends and partnerships)
  • Level 4: Esteem Needs (confidence, feeling valued and respected, being allowed to need and be needed etc)
  • Level 5: Self Actualisation (creativity, accomplishment, achievements, problem solving etc)
The theory is simple: the more levels you can manage to cover the better your quality of life will be. The idea is to ensure all levels are covered in order to be happy and to achieve and reach our own full potential.

When we are depressed though, we can be reduced to only managing Level 1 at best. So, in order to protect ourselves from slipping that low, the more we can get Level 1 to be an automatic routine the easier it will be to build and recover from depression; the more we can keep hold of the things that make us feel safe, the more we can stay connected to others, the better our chances. The more we can ensure we don't lose sight of our dreams, ambitions and goals (so long as they remain realistic) the more we will be improving things for ourselves. Small steps get you there, trying to run before you can walk is far less likely to.

That's why Mental Health Services have worked so hard in providing so many forms of support through sport, creative and social activities as well as linking up with training courses for work and for independent living and social services to help with finances and housing concerns among many others.

Key to Level 1 is diet and exercise. That doesn't mean a special diet full of weird and wonderful restrictions and limitations, it merely means a sensible balanced diet and regular eating pattern. It also doesn't mean having to take up a sport (but it would help), it means keeping physically active by going for a walk regularly or sit-ups or even turning house-work into an exercise routine.

A Balanced Diet = Carbohydrates (which includes fresh fruit and veg, natural sugars, cereals, bread, fibre etc), Fats (self explanatory really) and Proteins (meat, fish, nuts). Too many of any category will create all manner of nasty health problems as will too little of any.

Research has shown that certain chemicals that whizz around our brains are beneficial to our moods, concentration and motivation. If you think of it as checking a car for oil and water you can help your health by including (in moderation) certain foods to firstly get it into tip top condition and maintain it.

Three really helpful chemicals are:
Dopamine: can help regulate and improve attention and motivation.
Good food sources: chicken, oats and a little dark chocolate (several bars of chocolate a day is never the best of ideas no matter how yummy they may be).

GABA: can help regulate anxiety and muscle tone
Good food sources: Almonds, broccoli and walnuts.

Serotonin: can help regulate mood and limit impulsive behaviour
Good food sources: Turkey and bananas.

Never radically change your diet or exercise habits without first discussing doing so thoroughly with a fully trained medical practitioner. Any medication you are on may effect what you will respond to. Any medical condition may effect what you should eat and what you should avoid. Be safe.

Two other important factors help you to stay healthy - sleep and relaxation. Until my training last week I had always thought that diet and sleep were top priorities, but recent research has revealed that exercise is more important than sleep. This is because if you exercise you naturally become tired more easily and therefore sleep better.

Switching your brain off in relaxation is important and a good idea in preparation for sleeping. Watching TV, doing a jigsaw, scribbling a doodle, yoga or meditation are all good ways to help relax so long as whatever you choose isn't so interesting that it turns into a stimulus. Exercise is also a brilliant way for your body to produce seretonin and a few other good feel chemicals besides.

Few people ever fully reach Level 5 (Self-actualization) regardless of whether they have suffered mental health problems or not. This is because Self Actualization really means reaching our full potential and for that to happen often requires two important factors; opportunity and response e.g. the right job and the right employer, or finding a partner and them saying yes!

Level 3 is about average, but Level 4 I believe is more likely for people who have experienced difficulties including illness because they examine their lives in order to identify what's gone wrong and from there work on how to improve things. It becomes a conscious effort which those who have not faced difficulties rarely enter into.

Where I'm at...
My personal needs are to slow up a bit on blogging for I've been guilty of being a bit of a hypocrite by neglecting some essential mundane routine things. The good thing is I've noticed and know what to do. It is a common habit to slip into when we are worried, anxious or depressed to only focus on what makes us happy. The downside is that when the reality hits it hits harder due to that neglect. We always have to face life's less pleasant aspects.

It's rather like fearing going to the dentist though. In anticipation our fear of the thing we want to avoid becomes a monstrous mountain to overcome. However, when we face it we find it's not half as terrible as we imagined - the less time we spend in worrying and avoidance, the less of an ordeal it becomes. Mountains are merely a series of molehills bunched together. The trick is to kick them away one at a time.

Friday, 29 October 2010

Wisdom and Beliefs

This week I received a chain mail urging me to pass it on or I would miss out on getting some money. I chose to pass it on partly in support of the friend who sent it, but partly because one never knows, or as I put it, I wanted to hedge my bets. I normally don't do that with chain mail as I vehemently disagree with them precisely because they prey on people's vulnerabilities. So why did I this time? It was a bit of fun. I don't really think it will alter my life at all. However, it started me thinking about what people do believe in and why.

One of the things that irritate me about some highly talented and respected scientists including David Attenborough and Richard Dawkins is their dismissals and criticism of religion. It angers me because, for many people all they've got left to keep them going is a faith as that's how hard and lonely life can be for them. I still admire the work of these people but cannot condone their stance to eradicate what for many is their only lifeline.

Moving in cycles
Charles Darwin's book 'The Origin of the Species' introduced the concept of Evolution. It did not negate the existence of God and cannot. One of the quirks of science is that one theory is rubbished in favour of a better one. However, its habit is to return to the original theory from a different angle, which then marries with the new theory, which in turn develops into a new theory.

Newton's theory on Gravity did not fit with Einstein's Theory of Relativity until they did this and Einstein's theory was itself brought into question when people started exploring quantum physics. So who knows, maybe the God of Creation will be the entity responsible for the Big Bang, String Theory, Membrane Universes etc.

Religions evolve too and it is wrong to think that they don't. "If all were of the same religious opinion, there would be no religion. No sooner does a religion start than it breaks into pieces. The process is for the religion to go on dividing until each man has his own religion, until each man has thought out his own thoughts and carved out for himself his own religion." Swami Vivekananda. Within each religion there is variation.

On the radio this week was a programme about Salman Rushdie's 'Satanic Verses' and how it led to books being burnt, rioting, death threats and people being killed. Extremes are, by their nature, dangerous because they are obsessive and inflexible. I know of no religion that hasn't got its extremist version where leaders dictate and shun those who don't follow their edicts.

Yet scriptures from all religions are written by mere mortals... and what do we know about mortals? They have been known to corrupt and distort things for their own benefit and to sell the ideas they are passionate about, among other things. Humans are imperfect, so therefore any interpretation of God is likely to be inadequate in some way.

What is uncanny though is the fact that all human communities from the dawn of time have come up with the concept of God (or Gods), and they all have evolved to produce a code of ethics which in turn has formed the foundation stones for the myriad of nations and societies that we have today. The interpretation varies on both, but there is a core of moral values that are shared by all societies.

In counselling it was pointed out to me that people believe what they want to suit their own purpose. In other words, we buy into religions and spiritual ideologies that speak to us, that help explain things, comfort us or help us to walk a moral path that ties in with what we already want to feel. Science itself can be seen as a form of religion as it too has its own belief structure based on accepted knowledge just as religion does. Yet as I've already highlighted even science is not infallible and is constantly adapting to new theories.

We also buy into beliefs (including gossip) about others to suit our own needs and wants. We end up laughing at someone because we want to feel a common bond with others. It doesn't mean it's based on fact, and rarely is when it comes to gossip. We criticise others for the same faults we have ourselves if we would but look.

Devout atheists are devout on the grounds that Evolution doesn't explain the God of Ethics and Morals. For myself, I'll continue to hedge my bets. Thank you Tom Stoppard for highlighting this point in your play 'Jumpers' all those years ago. This is an extract where a philosopher is trying to prepare a talk about the subject of God.

"Is God? And then again, I sometimes wonder if the question ought not be, 'Are God?' Because it is to account for two quite unconnected mysteries that the human mind looks beyond humanity and it is two of him that philosophy obligingly provides. There is, first, the God of Creation to account for existence, and second, the God of Goodness to account for moral values." Tom Stoppard.

Final thoughts
Personally I can't see why God cannot be an energy force, for how could He/She/It/They be 'omnipresent' and 'almighty' otherwise? If that were so, God would suddenly tie in with science. That personal interpretation then opens my mind to all sorts of other possibilities so that Reiki, Acupuncture, Feng Shui, Homeopathy and Astrology might have something right about them, even if I cannot understand what. Most of those belief structures can be traced back further than modern science or current mainstream religions. Scientists find it difficult to define/prove what green is as it's all down to perception.

Religion and belief is always a good thing if it brings comfort and encourages kindness, compassion and consideration and is invariably harmful whenever and wherever it tries to bully, dictate and be unforgiving. Rather like democracy, if it is imposed it becomes tyranny.

As Dave Allen always used to say at the end of his comedy sketch shows "May your God go with you."

Monday, 25 October 2010

Coins and chairs - what to decide

Does this sound familiar I wonder... Tossing and turning at night as to what's the best thing to do? Here's a couple of techniques I came across that have really helped.

For minor choices e.g. whether to go out or stay in etc then flip a coin. Heads can be go out. Tails, staying in. If you secretly want it to fall one way or the other you will be wishing it falls that way. If it really doesn't matter either way, follow how it falls. And if you're not completely happy with the result it comes up with flip it a few times until you are.

For major decisions e.g. moving home try using two chairs. A counsellor taught me this one when I was dithering about whether or not to move. On the one hand I loved where I lived. It was in the country, open fields with sheep bleating and distant church bells and a lovely long (but narrow) garden, nice neighbours, a nice terraced house with open fireplace and lots of wonderful memories.

On the other hand it had become associated with death as that's where I grieved over losing my father and two dear friends and two dear neighbours. It was isolated and a cold house as it had no gas central heating. It was out of the way for most of my friends to pop in and visit. It was like retirement cottages since the only young family had moved out.

So following the instructions I set two chairs out. I then wrote down all the pros and cons of staying and then did the same for a new place to live. I paused to have a cup of tea before finally sitting in the first chair - staying put. Once you sit in a chair you imagine that's the decision you've made. No going back, no swapping. As I sat there with all my memories and thoughts both good and bad I began to cry. I thought about all the things I would miss if a left and how much I loved the place, but I was also thinking about all the problems I had there too. I left the chair and had a long break.

Eventually I returned and this time sat in the other chair - the one for moving house. And I did the same exercise, imagining all the positives and negatives of finding a new place, new neighbours (would they be sociable and supportive like the ones I had or not - they might be better or they might be worse). I also thought about the upheaval and the stress that can cause and of Poppy my cat and whether she'd be ok with a new place.

My counsellor had warned me that I might have to repeat this exercise several times before finally coming to a decision. The trick is to really believe that the decision has been made once you sit in each chair. When I sat in the staying chair, there was no going back; when I sat in the moving chair I had moved.

I chose to move as more than anything I needed new life around me. My tears (and there were many) were of letting go. Yes I miss that house even to this day as it was very special to me but I still feel I made the right decision for what I most needed. I moved to a small town which has lots of interesting shops and restaurants and I am surrounded by young couples and families. Some of them became good friends and others not so much but civil enough. Moving enabled me to clear debts so I could treat myself a little and start living again.

In this example I got the choices down to two, if possible try to do the same as it can make it easier. (I didn't add more chairs for all the possibilities of where I could be moving to which kept it simple). However, sometimes that's exactly what you need to do. e.g. getting a row of chairs out for all the houses I was interested in and trying each of them out.

It was one of the most difficult decisions I've ever made, but this exercise helped me to explore all my thoughts and feelings so that I became sure it was the right one. I hope you find this exercise helps you as much as it did me for those emotionally difficult situations.

Friday, 22 October 2010

Believing I was Bipolar

Back in 1998 I quite rightly was sectioned after being isolated for two years following the death of my father. Friends at that time didn't visit, send cards, phone or email unless I quite frankly hounded them and eventually I gave up on doing even that.

I say, rightly sectioned because (as mentioned in an earlier posting) I was imagining my house was under surveillance with tiny microphones and cameras. Helicopters flying overhead, and people driving past with earpieces to their mobile phones were all spying on me or so I came to believe. Such was the effect of lack of company, lack of a job, lack of food and sleep. I went down three dress sizes.

I'm about to make this one exception to my rule of not divulging anyone else's personal history, but for a good reason. I used my sitting in two chairs exercise to decide whether or not to do so (which will follow shortly). The reason is that my history of mental illness was profoundly effected by that of my mothers. The ripple effect of living with someone with any form or long-term illness (mental or physical) is profound. Her condition has had an impact on every member of my family in one way or another.

In order to prevent others being affected or becoming as severely ill as she was I have chosen to share my own experiences and something of hers. She would feel betrayed if she was still living I know. It's been a family secret and a taboo to mention it outside the family, but I believe it's that very taboo that makes matters worse. We can't resolve or come to terms with difficulties if we don't face up to them.

Like many who have lost a loved one, I still talk to her and in my mind, and in my mind, she is completely well now and understands and is backing me up on this. My siblings and father would agree that I was the closest member of the family to her and her primary concern throughout her life was to put a stop to all the suffering and cruelty.

She had been a nurse in Northern Ireland in her early life, patching up bomb victims from both sides. It's not the whole reason why I believe she became ill by any means, but as it's enough of a reason for anyone to become ill. I will leave it at that.

As the medical team were aware of her illness they made an assumption, that I was ill in a similar way. Over the weeks and months of my treatment I was diagnosed as bipolar, schizoid affected disorder, and more recently 'mixed', meaning I had learnt my behaviour patterns from my Mum's illness. But she wasn't the only person I learned from, I learned from all members of my family and from everyone outside of it too.

I saw people throwing tantrums and getting their way at work by being angry. I saw how people staying quiet were often overlooked and railroaded over. I saw how being supportive of others won respect and love too. I saw how playing the victim and seeking sympathy could win support. I tried everything I saw in attempts to find meaningful relationships in my life. Though at the time I was unconscious of my mimicry.

There was only one problem with all this - none of them were quite me, or at least the whole me. It's taken me many years of exploration, work and practice to find out who I am and take full ownership of my own responses.

I now no longer want sympathy at all. Years ago I really thought I did and that I deserved it. Now what I want is acknowledgement for my experiences which is very different. I've wanted respect for having largely overcome them too, but have found that if I don't seek it the more I receive it.

My history highlights the age old debate between nature and nurture, between what is genetic and what is learnt from the situations and circumstances we find ourselves in. In my counselling I've learned that the percentage of what is nature (genetic), and what is nurture (learnt), varies for each individual and that both can change with a lot of practice and by having a bit of luck in who you mix with.

My genetics are a mix of both my parents, only one of which was mentally ill so it was in many ways very wrong of the medical team to assume I was a repeat of my mother. Aside from anything else none of us what to feel identical in every way to anyone else. We all want to be regarded as individuals in our own right and appreciated accordingly.

However, I am not angry with my medical team because despite the labels (which never to justice to the reality of living with any form or illness or disability 24/7), I find I can do nothing but thank them for guiding me back to health; for being the catalysts in helping me find the true me; for giving me the courage to find my voice and use it.

Nor do I regret all the work I had to do to manage what they thought to be a bipolar condition, for that process of setting limits of my thoughts and moods has given me better control, improved the quality of my life immeasurably and made me a happier person. Even the medication I was put on gave me insights that helped.

Most of all I found the talking therapies to have been the greatest source of help, but am conscious that they might not have been as effective had I not also been on medication. Talking therapies only really work when we are receptive to them and enter into them with full commitment and honesty and that means sharing what we don't ever like to admit about ourselves and what is painful.

Recently I came across an article about Ruby Wax in which she feels Stephen Fry is irresponsible for not taking any medication for his bipolar condition. Ruby is also bipolar and she opted for medication. I will never dictate to anyone what they should do about their health (mental or otherwise) because I believe you have a right to decide for yourself what is best for you. All I would do is suggest and recommend. I am not responsible for your life, you are.

So here's my recommendation - speak out for what you need and keep people updated. And my personal opinion (you are at liberty to vehemently disagree) is that I am open to the idea that talking therapies alone being all a person may need to prevent becoming so ill they need to be sectioned.

However, I see no difference to a person needing medication when sectioned to a person needing medication in an Accident and Emergency department to save their lives when brought in from a car accident. The point is, while we are out of hospital we should use our ability to seek forms of help that work for us and that is different for everyone.

I take aspirins for headaches and antidepressants if I'm depressed. What's the difference? Diabetics have to take insulin to ensure that they are healthy, others takes mood stabilisers to secure their health. It's not their fault their bodies don't naturally produce enough of what is needed. Thankfully there are drugs these days that can help if required. As I never want to be as ill again I doubt very much I will ever come off medication entirely. You have the power to choose, do so wisely.

One last point - as a consequence of the work done following being sectioned I have never been sectioned since - not even when my closest family member (my Mum) died. It didn't prevent another deep depressive episode which ‘seemed’ as bad at the time but looking back now I can see that being sectioned had taught me how to survive and cope far better.