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.