Who’s that man?

By admin on March 10, 2012

I wasn’t watching the screen but I heard a name announced that was almost familiar and I started paying attention. Some was being interviewed for an expert opinion on something.
It was the psychologist who Mottsu has consulted in the weeks before he died.

I haven’t met the psychologist. In the aftermath of Mottsu’s death the psychologist rang me to offer condolences and express his regret. I know he was interviewed by the police, a matter of course, as part of the Coroners inquest. I know he talked about Cognitive Behaviour Therapy with Mottsu. I know Mottsu found his advice helpful, although ultimately not helpful enough.

I was glad Mottsu sought support as his well being deteriorated and I wondered about a cognitive approach for someone so ensnared in their emotions. I still worry that the therapeutic goal was to make him different, in some way less than who he was. I remember Mottsu feeling he had to be more spontaneous, to me seemed a goal that mocked and taunted his depressed state. I know he struggled with spontaneity and how he should achieve that ironic and impossible goal.

Anyway I saw his psychologist on TV and struggled to know what to feel – how do I feel about that person from the past? I waited a couple of days for my reaction but there is almost none – not resentment or acrimony but I do notice a little cynicism welling up. I am content that the past is becoming the past, and somewhere I can’t influence.

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Simon says…

By admin on December 14, 2011

Simon Hogan, in his typically Australian laconic style, describes himself as a 23 year old footy player. Footy is Australian Rules football, a game with an estimated 9 million followers. Simon plays for the Geelong Football club, the team Mottsu followed and the current competition premiers.

Simon Hogan is an elite athlete and professional sportsman, and he has had major depression over the past three years. His depression led to considering suicide, and to seeking support. Listening to him, I am considering taking more of an interest in footy.

He speaks frankly about his experience, here’s his story in print and below on video.

Fittingly he is now an ambassador for headspace, Australia’s National Youth Mental Health Foundation. Impressive.

If you, or someone you know, needs emotional support call Lifeline on 13 11 14 in Australia. Crisis counselling is available around the world.

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Halloween

By admin on October 31, 2011

ECT is rarely mentioned without One Flew Over the Cuckoo’s Nest being referred to. For many of us that movie perhaps the only contact we’ve ever had with the mental health system. McMurphy’s story is a memorable one of an archetypal struggle of an individual against the establishment – it taps into a shared fear of being unable to exercise self-determination. Not having control.

The image of shock therapy was reportedly changed by the movie, ‘tarnished’ this report says. There is no denying that ECT, or shock therapy, is frightening. Having an electric current flood your brain is frightening, even those of us who haven’t seen the movie might imagine the treatment barbaric.

The song is the title track from Shock Treatment, the sequel to the The Rock Horror Picture Show. My brother gave it to me as a single years ago, in a time when I didn’t realise ECT was offered as a therapy for depression. The clip highlights a problem with the portrayal of ECT in that it is invariably depicted as an involuntary treatment. Note the caged person in the clip and recall the callous institution shown in One Flew Over The Cuckoo’s Nest.

Thanks to the movies, we know ECT as something one is subjected to and it is shown as more brutal than I believe it might be. Still I can’t say I would undergo this treatment, I am most likely to opt for talk therapy over physical treatments – if the choice is mine to make. I very firmly believe ECT should not be administered on anybody being held as an involuntary patient.

Tonight is Halloween that’s why I am reflecting on scary things.

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Normal is as normal does (with thanks to Forrest)

By admin on June 26, 2011

An article about the life and work of Marsha Linehan, a therapist and researcher at the University of Washington. Her work is centred on ‘radical acceptance’, her own method for working with suicidal people . As a therapist she is an ally to her clients rather than an adversary. Radical acceptance of oneself and one’s own feelings, accepting who and how you are rather than how you’re supposed to be.

Radical? It sounds simple, and not really – acceptance is a radical thought. I find I am sensitive to a lot of feedback about what I need to change. Trying to accept who and how I am is not so simple in the face of the opinions and (not so) helpful suggestions of family, friends and beyond…

Perhaps self acceptance is a bit like a building block, if I can find part of me that is good enough (I mean not bad, stupid, wrong, abnormal etc.) then others might discover that good in me too.

Is that it? On a societal level, I think I am saying that others are less likely to marginalise what I embrace… Stigma and marginalisation are symbiotic, one feeds the other – or I imagine a frenzied sort of feeding off of each other. Whatever it takes for stigma and marginalisation survive it is to the detriment of individuals, individuality and acceptance.

Is accepting myself an act of defiance? Possibly not what Dr Linehan is advocating through her work, but these are my own Sunday morning musings. me with lots to say and lots to learn, and defiance appeals to me.

Reading about Marsha Linehan’s life and work one sentence stands out as if written in neon lights. The New York Times journalist, and author of the article, comments that: “No one knows how many people with severe mental illness live what appear to be normal, successful lives…” That sentence, at first glance, may appear innocuous enough but it hits me right between the eyes. I start to think about the stigma surrounding metal health and a pungent whiff of discrimination is apparent. Is it just me who smells it…

Let me rephrase it to test it out:
- No one knows how many people who can’t swim live what appear to be normal, successful lives…
- No one knows how many people with thinning hair live what appear to be normal, successful lives…
- No one knows how many people with cats live what appear to be normal, successful lives…
- No one knows how many people with no imagination live what appear to be normal, successful lives…

What irks me about the statement? I think it is the assumption of what is normal. Worse is the appearance of normal – that I might look normal but really I am not. The deception implicit in maintaining a normal façade and looking successful, hurts me. There is also a discrimination built into the sentence that people with mental illness can not lead normal successful lives. Irk! I’m really irked…and I know it is an innocuous sort of statement that normal people wouldn’t question as not being a perfectly normal thing to say.

The sentence makes me think of Forrest Gump, the park bench philosopher, saying “Stupid is as stupid does”. I think Forrest was saying that having a low IQ doesn’t mean you are stupid. Now I want Forrest to say “Normal is as normal does…” Isn’t the tenet of radical acceptance to defy labels of ‘normal’? My normal may be different to your normal but that doesn’t make me, or you, not normal.

It can be a struggle to keep up appearances and look normal by being who I am expected to be. At the same time I want to bridge the gulf of perception around what is normal and what isn’t, and one way to that is to be less predictable and expected – pushing normal at the edges.

Sunday morning and at my house it’s normal is as normal does. Some days there is no normal.

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It might be time to talk but not with a psychiatrist…

By admin on March 13, 2011

An article in the New York Times caught my attention. It states that:
“Recent studies suggest that talk therapy may be as good as or better than drugs in the treatment of depression, but fewer than half of depressed patients now get such therapy compared with the vast majority 20 years ago.’

The story describes how brief consultations are required by insurers who reimburse patients and set the rates schedules. In a 15 minute consultation a psychiatrist can do little more than provide a prescription. I understand it is only psychiatrists can prescribe psychiatric medication, and other types of therapists can not, and previously psychiatrists could also provide talk therapy, with more patient time (and more patient insurers), there was more opportunity to tailor the treatment.

I find that alarming and worthy of talking about, because medication is not for everyone. Mottsu,for example did not feel psychiatric medication would be helpful and he sought psychological support. The treatment is not condemned by the outcome, Mottsu’s situation and process were complex.

The treatment of depression requires healing in the guise of both medical science and healing arts, there’s no panacea. Anybody’s situation and process are complex, what works for one may not work for another. I like talk therapy.

Returning to the article, linked above, “Dr. Levin expressed some astonishment that his patients admire him as much as they do. ‘The sad thing is that I’m very important to them, but I barely know them,’ he said. ‘I feel shame about that, but that’s probably because I was trained in a different era’.”

That’s a good reminder: my therapist is, in all likelihood, more important to me than I am to them.

There are many helping professions offering healing interventions, psychiatrists, psychologists, psychotherapists, counsellors, and then doctors too. Standards are established and maintained by professional authorising bodies. Qualifications and requirements differ in different states and countries, so I won’t attempt to describe them and risk getting it wrong. Each offers different forms of treatment and there are some overlaps, and there are different schools of thought and approaches within a profession.

A doctor would be a good person to advise on what each can do. Recommendations are helpful and listen to your inclinations and leanings, follow your them. Trust your cynicism and seek treatments that fit best. Talk about it.

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Facing down fear

By admin on February 21, 2011

I learned a little while back that Electroconvulsive Therapy – ECT is still used in the treatment of deep depression. I was shocked, but that sounds wrong so let’s say I was aghast. ECT was something I only knew of from movies, and the my memory of the movie images was fairly frightening.

I mention it because I have been thinking about fear. I have a friend who is going to face down her fear of heights. She is challenging herself scaling great heights freezing up, coming through and then setting another challenge. She terrifies herself while learning she can be safe even at uncomfortable heights. It is working she is proud and victorious. I hope her efforts prove the antidote to fear. I admire her tenacity but it’s not for me. I have my own mantra “No pain – no pain”.

Another friend was offered ECT as treatment. Scary and no pain – no pain didn’t hold true this time. The treatment and its side effects were explained to her, the fear didn’t disippate but she was determined to be better, whatever it took. Her bravery was different to my heights-fearing friend, both are amazing women.

The friend considering ECT as a path to wellness listened to her doctors, she asked questions, talked to her family and expressed fears. She went into her treatment with eyes open and scared. ECT might not be what I would do in the same situation, I can’t say. My dear friend however is proud and victorious just like the first friend.

Fear can be stared down, you don’t have to. In any situation seek qualified advice find out what you need to know and make your own choices. Fear can be respected, and it can be overcome, both are valid choices.

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A Friend Indeed

By admin on January 8, 2011

What can you do for a friend with severe depression? It is an important question, I am sometimes asked what should be done, what might help? Depression is a serious condition that people can die from, it needs treatment. I would just say that if a problem is shared with you don’t wait, start listening and understanding. There is a lot you can do as a friend:

• Be a friend to your friend.

• Hold your friend’s hand in any way that is comfortable. If a substantive physical clasp isn’t your style (or perhaps their style) hold on metaphorically.

• Talk to them and listen to them. Stay in touch, be around. Answer the phone if your friend calls, and ring them just to check-in and say hello. Here is a great practical list of things to say and not to say to a friend with depression.

• Seek support, encourage them to see a doctor. Support your friend to get to appointments, sit in the waiting room and drive them home, be supportive of their treatment. Help them feel safe.

• Look after yourself, make sure you have a soft place to land and seek support for your own well-being.

Here is another practical list of things, there’s some overlap with the list above (as you would hope), it is useful information. Being a friend to someone with depression can be demanding, and you can make a difference.

Crisis counselling is available around the world. In Australia Life Line 13 11 14.

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You’ve got a friend

By admin on December 26, 2010

I care about you and what happens to you, I am your friend.

I don’t say that very often, sort of expecting people to know that’s how I think. I do trying to practice caring by listening. A model I like is credulous listening, taken from the work of George Kelly, an American psychologist, therapist and educator. He developed Personal Construct Psychology.

The term credulous listening is self explanatory and I want to define it for clarity, it’s about understanding versus explaining. Credulous listening, can be described as:
• Encouraging, without demand
• Supportive, without judgement
• Empathic and emotionally warm, without criticism

George Kelly may have called that credulous listening, I call it being a friend. I can expand further on the qualities of a friend, trusting, kind, generous, present and accepting.

‘It all depends on what you want. You can trust to stick with you through thick and thin-to the bitter end! And you can trust us to keep that secret of yours – closer than you keep it yourself. But you cannot trust us to let you face trouble alone, and go off without a word! We are your friends Frodo…’ Tolkien, J. R. R. Lord of the Rings: Fellowship of the Rings

That’s sort of friend I strive to be.

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Glory glory psychotherapy

By admin on September 25, 2010

You might not agree that everyone should be in therapy as Thomas Moore says. I vehemently agree, I think everyone should be in therapy. In therapy may just be the new normal.

I’ve written before about how much I ♥ therapy it is valuable to me. There is nothing wrong with me, strictly speaking (maybe don’t ask my family they may express another view), and I draw incredible support from my therapist. Incredible unconditional support.

Thomas Moore says he is “…yet to meet a completely healthy, adjusted neurosis-free person”, and maybe he is yet to meet you. For me everyday dysfunctional, neurotic, and emotional is more interesting and more normal.

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I ♥ therapy

By admin on May 18, 2010

I use the term therapy and you could call it counselling, or seeing psychologist, whatever term is familiar, you will know what I mean. I want to recommend therapy for lots of reasons.

Firstly it’s a relationship that offers sanctuary. When I sit with my therapist anything can be aired and explored. I say sit as some may have images of reclining on couches, however I’ve never laid down on a couch, I sit.

Then there is the unconditional acceptance of whatever I feel whatever I think and whatever I say. That’s unconditional support and acceptance of me. It’s potent. That’s therapy.

I feel empowered to stand on my own and I feel brave beyond what my innate super-powers would normally allow. I doubt I would be writing here if my therapist hadn’t encouraged me to start a little writing project.

She uses a Process Work orientation. The best. When she holds the mirror I like what I see. It’s a very special relationship that’s all about me and how I am in the world.

I know myself better, I am not as afraid of the world that Mottsu couldn’t live in… not as afraid as I used to be. I’m making my own way, maybe not boldly (and maybe bold is coming) but certainly with more awareness of a whole raft of things.
Yep I really ♥ therapy.

I would be here without therapy, that much it true, and I would be duller less me sort of me. Less true to myself.

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