![]() Excuse me, are you lost? You've been shaken by life you say? Your roadmap doesn’t seem to work anymore? Congratulations. You are having a “midlife crisis.” They can be big or small, can happen at any age, once in a lifetime or many times (or, for the unfortunate, never at all). Perhaps your existential crisis was triggered by an event—a bereavement, illness, accident, divorce, redundancy, financial ruin or other trauma. Or perhaps it was just life that happened to you. You set out on your grown-up journey in reasonably good cheer, full of hopes and dreams. But sooner or later all that potential and possibility got mugged by reality. And one day you found yourself trapped in an unsatisfying job, marriage or town, struggling to pay the bills, stressed, sandwiched between looking after your kids and looking after your parents. You are miserable. You are at the bottom of the U-bend of happiness. “And you may ask yourself,” as the Talking Heads song goes, “how did I get here?” And you want to be someplace else. So you go, often leaving a trail of destruction in your wake. Dr Oliver Robinson and colleagues at the University of Greenwich recently presented their research into the midlife crisis, defined as feeling emotionally unstable, making major changes and overwhelmed for at least a year. They interviewed more than 900 adults and found that among people aged 40 to 59, 24 percent were "definitely" having some kind of crisis while 36 percent "maybe" were. One feature of crises that Dr Robinson identified was an increased curiosity, reflected in a greater interest in people, in one's own self, ideas in general, and the world around. Dr Robinson says: “While crisis episodes bring distress and feelings of uncertainty, they also bring openness to new ideas and stimuli that can bring insight and creative solutions, which can move our development forward. This enhanced curiosity may be the ‘silver lining’ of crisis. Armed with this knowledge people may find the crises of adult life easier to bear.” But a midlife crisis isn't an unfortunate affliction, an accumulation of dark clouds that come with the silver lining of enhanced curiosity while you wait for those clouds to pass. It is instead a journey beyond the clouds, from darkness to light. It is growth. It is something that is often unavoidable. With the help of therapy, you can transform all the breakdowns into breakthroughs and experience some kind of metanoia; a renaissance. A midlife crisis is painful. It is a clumsy grasp for a better life. In the darkness you might stub your toe and gash your shins; things can get spilled or knocked over. It can get really messy. People can get hurt. It can involve sports cars, motorbikes, tattoos and unlikely couplings, but does not have to be so dramatic or clichéd. The worst of times can turn into the best of times. Your physiological decline is outweighed by your psychological advance. The death of ambition is outweighed by the birth of acceptance. Instead of trying to live up to other people’s standards or expectations, you fully accept who you are. What Jungian James Hollis calls your “provisional personality” fades away, along with all the delusions of grandeur and internalised “rules” about how you, others and life “should” be. You start to play your own game—and play it with confidence and purpose and verve. Your relationships improve. You learn to love—and try to make it up to the people you hurt. You start to love life. ![]() There was a time when young children were allowed to be children. Primary school was about learning how to play, have fun and make friends. Happy children are more likely to learn and make the world a better place than unhappy ones. Childhood hasn’t been cancelled exactly, but it is under extreme attack, as I’ve written before (“Suffer little children”). Today's subjects: stress, self-harm, suicide. This week saw the launch of a campaign for universal access to school-based counselling services. Reports the story in Schools Week: “A motion being put to the Association of Teachers and Lecturers’ annual conference in Liverpool, which calls for better promotion of mental health awareness in schools and a campaign for all pupils in England to have access to a counsellor, is expected to pass with the backing of the union’s leadership.” There is certainly a need: • One in five children have symptoms of depression and almost a third of the 16-25-year-olds surveyed had thought about or attempted suicide. In Ireland, children as young as five are thinking of suicide. • A World Health Organisation survey in 2014 revealed a fifth of 15-year-olds in England said they had self-harmed over the previous year. • An ATL union survey of its own members revealed that 48 per cent of respondents had pupils who had self-harmed, and 20 per cent knew pupils who had attempted suicide “because of the pressure they are under”. General secretary Mary Bousted said it was “horrifying” that so many young people many are self-harming and contemplating suicide. Increase paperwork until standards improve! There is more testing, more homework, and it starts earlier. (Homework for 5-year-olds? Really?). Teachers are overworked and underappreciated (and underpaid), frantically trying to get results, write up reports, check all the boxes and generally enact the latest keep-up-with-China government initiative, all set against a backdrop of cuts in funding and services and in many cases financial hardship at home. The creative, nurturing, qualitative skill of teaching has been turned into a bureaucratic, morale-sapping, quantitative exercise in stress, low-grade trauma and Ofsted reports, one that kills joy in the classroom, erodes resilience and is creating a whole new generation of children who as adults will be susceptible to mental and physical ill-health. There are roughly 200 governments around the world—200 education policies (or lack thereof), 200 places to look for examples of good ideas and bad ones, 200 petri dishes. Why fawn over China—do we really want to look to an undemocratic communist government with a terrible human rights record for child-rearing tips? How about looking instead to the more relaxed approach of the Scandinavian countries, especially Finland, where education is free, safe and friendly, school starts at age 7, teachers are allowed to teach, and children are allowed to be children rather than treated as future economic units. Finland’s less-is-more education system has been described as the best in the world. Mental-health difficulties are the leading causes of disability worldwide—almost a third of people globally will experience mood, anxiety or substance-use problems in their lifetime. The best antidote is a happy childhood. As noted philosopher Whitney Houston put it: I believe the children are our future Teach them well and let them lead the way Show them all the beauty they possess inside Give them a sense of pride --John Barton ![]() Happiest days of your life? There was a time when young children were allowed to be children. Primary school was about learning how to play, have fun and make friends. Happy children are more likely to learn and make the world a better place than unhappy ones. Childhood hasn’t been cancelled exactly, but it is under extreme attack, as I’ve written before (“Suffer little children”). Today's subjects: stress, self-harm, suicide. This week saw the launch of a campaign for universal access to school-based counselling services. Reports the story in Schools Week: “A motion being put to the Association of Teachers and Lecturers’ annual conference in Liverpool, which calls for better promotion of mental health awareness in schools and a campaign for all pupils in England to have access to a counsellor, is expected to pass with the backing of the union’s leadership.” There is certainly a need: • One in five children have symptoms of depression and almost a third of the 16-25-year-olds surveyed had thought about or attempted suicide. In Ireland, children as young as five are thinking of suicide. • A World Health Organisation survey in 2014 revealed a fifth of 15-year-olds in England said they had self-harmed over the previous year. • An ATL union survey of its own members revealed that 48 per cent of respondents had pupils who had self-harmed, and 20 per cent knew pupils who had attempted suicide “because of the pressure they are under”. General secretary Mary Bousted said it was “horrifying” that so many young people many are self-harming and contemplating suicide. Increase paperwork until standards improve! There is more testing, more homework, and it starts earlier. (Homework for 5-year-olds? Really?). Teachers are overworked and underappreciated (and underpaid), frantically trying to get results, write up reports, check all the boxes and generally enact the latest keep-up-with-China government initiative, all set against a backdrop of cuts in funding and services and in many cases financial hardship at home. The creative, nurturing, qualitative skill of teaching has been turned into a bureaucratic, morale-sapping, quantitative exercise in stress, low-grade trauma and Ofsted reports, one that kills joy in the classroom, erodes resilience and is creating a whole new generation of children who as adults will be susceptible to mental and physical ill-health. There are roughly 200 governments around the world—200 education policies (or lack thereof), 200 places to look for examples of good ideas and bad ones, 200 petri dishes. Why fawn over China—do we really want to look to an undemocratic communist government with a terrible human rights record for child-rearing tips? How about looking instead to the more relaxed approach of the Scandinavian countries, especially Finland, where education is free, safe and friendly, school starts at age 7, teachers are allowed to teach, and children are allowed to be children rather than treated as future economic units. Finland’s less-is-more education system has been described as the best in the world.
U.K. NEWS Britain's top psychiatrist challenges Government The Independent Following on from his rather rosy picture of mental health services in the U.K. last week, this week Simon Wessely, Britain’s top psychiatrist, has challenged the Government to ring-fence spending for mental health: Professor Sir Simon Wessely, president of the Royal College of Psychiatrists (RCPsych), said that claims from a former health minister that the new standards – the core recommendation of a recent landmark report – have no funding to back them up, were “crushingly disappointing”. As revealed in The Independent, Norman Lamb, the Liberal Democrat’s health spokesperson who served as care minister in the Coalition government, has been told by senior NHS England officials that there is no guaranteed funding to implement a set of new waiting times standards for treatment of a wide range of mental health conditions by 2020. Holyrood 2016: Parties set out mental health plans BBC News Politicians have been setting out their plans to boost mental health services ahead of the Holyrood election. SNP leader Nicola Sturgeon pledged to "transform" mental health care in Scotland if her party is re-elected. The Liberal Democrats said they would introduce a mental health "rapid reaction force". Meanwhile, the Tories claimed Labour was in a "state of civil war", and Labour accused the SNP of "hypocrisy" over council budget cuts. 'Mental health' issues lead to soaring levels of sick days in the civil service Express.co.uk Soaring levels of stress, anxiety and depression have been reported in the over-stretched civil service, which has led to a rise in the number of sick days taken by staff. The leap in absences has sparked concern about the general mental health of the Whitehall workforce. Absences classified as “mental health” now account for 28 per cent of all sick days taken at the Department of Health compared to 15 per cent in 2011, claims figures revealed in the House of Commons. Other departments also reported a rise in days off “due to mental disorders”, like the Communities and Local Government Department, which saw the figure rise from 18.3 per cent in 2011 to 32.8 per cent now. ![]() U.S.A. NEWS Beyoncé: 'Women have to take time to focus on our mental health' USA TODAY A throwaway line becomes a news story when it is uttered by Beyoncé. Here’s the line: "We have to care about our bodies and what we put in them. Women have to take the time to focus on our mental health—take time for self, for the spiritual, without feeling guilty or selfish." Unusual marriage counseling retreats PR Newswire (press release) Is your marriage all at sea? In turbulent waters? Do you feel as if you are drowning? Maybe this boat in North Carolina could help. But what an unfortunate name! Even Boaty McBoatface would be better! Love Odyssey Charters has announced that it is ready to start booking new marriage counseling retreats. They have re-launched their pilothouse sailboat "Dragon Lady" after its annual maintenance. The company offers an intensive marriage intervention service for couples seeking to revive their troubled relationships. More than a gimmick, the service is based on sound neuroscience according to Dr. Bryce Kaye, psychologist and author of the book "The Marriage First Aid Kit." He explains: "We keep them moving and out of their stuck roles. We sail them from port to port where they stay in quaint B&B's, explore the historic towns and enjoy the down-east restaurants. They are surrounded by beautiful natural scenery on the rivers and sounds of North Carolina. The marriage counseling retreats take place in a cozy teak-lined pilot house of a Finnish-made sailboat. All of this puts them into an exploratory state in which their minds are more receptive to new ideas." VIEWPOINT Clare Allan: Why words matter when it comes to mental health The Guardian It happens all the time. If not every day then at the very least several times a week. Someone describes someone else as a “nutter” or a situation as “mental”, and, listening, I am faced with a choice: to speak or not to speak. It happens in the media too. And not just in tabloid headlines about “schizos”, “psychos” and so forth. In arts discussions on BBC Radio 4, I regularly hear the word “psychotic” used as a shorthand for lacking in conscience, or “schizophrenic”, when what is meant is in two minds. ![]() Has the dawn of the internet age been good for our mental health? Or really bad? There is great optimism: the digital revolution heralds a utopian, democratic, postmodern world where we are all connected, resourced, empowered, heard, transparent, authentic and free to be who we are. There was even a theory that the internet might flatten a chronically unlevel playing field, though perhaps only for those that have a smart phone and good wifi. There is great pessimism: we’re entering a dystopian, virtual world where a person is reduced to an online profile to be swiped left or right, texts replace conversation, virtual friends replace real ones, “likes” replace activism, emoticons replace emotions (except for anxiety—lots more anxiety). Human intelligence outsourced to machines, vast amounts of time wasted, attention spans worse than a goldfish, retrograde evolution. We plug into a world wide web and watch helplessly as our humanity drains away. To stay alive, and truly connected, we sometimes have to unplug. One story this week highlights the internet as a problem for our inner worlds; another explores its claims to be a solution: Problem? Parent Zone’s report, The Perfect Generation: Is the Internet Undermining Young People's Mental Health?, contains the results of a survey of teachers and teenagers. Among the findings: • 44% of teachers think the internet is bad for young people’s mental health, compared to 28% of young people. • 91% of teachers believe the frequency of mental health issues among pupils is increasing. • Of these issues, schools report stress and anxiety (95%), depression (70%) and self-harm (66%) as the most common issues amongst pupils. • 84% of schools say they do not have adequate resources to deal with pupils’ mental health issues. Vicki Shotbolt, CEO of Parent Zone, says: “The internet has destroyed any notions we might have had about keeping some things away from children until they were ‘old enough to cope’. “All of the indicators suggest that the prevalence of mental health problems and the severity of those problems are increasing. Some people are linking the internet to the increase.” The report concludes that new problems require new solutions, that schools need much better resources for responding to mental health issues, and that tech companies “should recognise both their duty of care and their unique opportunity to create online spaces that are positive and inspiring.” ![]() Solution? Meanwhile, in “I tried to fix my mental health on the internet,” anxiety sufferer Joe Madden made himself a human guinea pig to see if computers could replace counsellors, subjecting himself to three varieties of e-help: text-based, social media and video-conference. Writes Madden (for the BBC): “Could e-counselling be the answer to the mental health issues escalating amongst under-30s? With cuts to mental health services really starting to bite, digitised therapy could be just the ticket for young adults who already filter nearly every aspect of their lives – friends, work, sex, entertainment – through a screen.” He concludes: “E-counselling still feels like it's finding its feet: there are useful tools out there for the mild-to-medium prang-brained, but, as yet, no killer app that feels destined to reinvent mental health care for the hashtag age. What form might that ingenious wonder app take? No idea. If I knew that, I'd be off making it, instead of here, recklessly toying with my mental well-being for your half-distracted amusement.” In “The psychodynamics of social networking,” therapist Aaron Balick quotes Kranzberg’s First Law of Technology: it is neither good nor bad; nor is it neutral. Concludes Balick, “The need to relate has not changed. The need to recognise and be recognised has not changed. The need to seek and be sought has not been altered. The architecture, however, of the ways we do all these fundamental things that ake us human has indeed changed, and that may be changing us.” We are increasingly addicted to our “electronic cocaine” and sometimes we must unplug, disconnect, such that we might return again to the real connections, the ones that are a primary human need—connections with self, with others, with nature. Traditional therapy, as old as the hills, remains untouched by technology, and untouchable. Two people sit in a quiet, spare room. One is there to serve the other. If all goes well the encounter facilitates acceptance, change and growth. For the better. It is not a cure, for there is no cure for life. But it helps. Therapy is a place where you can become who you want to be—who you are meant to be. Where you can learn to live—if not the life you imagined, then the life that has been waiting for you all along. --John Barton ![]() Rewired: The need to unplug Has the dawn of the internet age been good for our mental health? Or really bad? There is great optimism: the digital revolution heralds a utopian, democratic, postmodern world where we are all connected, resourced, empowered, heard, transparent, authentic and free to be who we are. There was even a theory that the internet might flatten a chronically unlevel playing field, though perhaps only for those that have a smart phone and good wifi. There is great pessimism: we’re entering a dystopian, virtual world where a person is reduced to an online profile to be swiped left or right, texts replace conversation, virtual friends replace real ones, “likes” replace activism, emoticons replace emotions (except for anxiety—lots more anxiety). Human intelligence outsourced to machines, vast amounts of time wasted, attention spans worse than a goldfish, retrograde evolution. We plug into a world wide web and watch helplessly as our humanity drains away. To stay alive, and truly connected, we sometimes have to unplug. One story this week highlights the internet as a problem for our inner worlds; another explores its claims to be a solution:
Vicki Shotbolt, CEO of Parent Zone, says: “The internet has destroyed any notions we might have had about keeping some things away from children until they were ‘old enough to cope’. “All of the indicators suggest that the prevalence of mental health problems and the severity of those problems are increasing. Some people are linking the internet to the increase.” The report concludes that new problems require new solutions, that schools need much better resources for responding to mental health issues, and that tech companies “should recognise both their duty of care and their unique opportunity to create online spaces that are positive and inspiring.” ![]() Solution? Meanwhile, in “I tried to fix my mental health on the internet,” anxiety sufferer Joe Madden made himself a human guinea pig to see if computers could replace counsellors, subjecting himself to three varieties of e-help: text-based, social media and video-conference. Writes Madden (for the BBC): “Could e-counselling be the answer to the mental health issues escalating amongst under-30s? With cuts to mental health services really starting to bite, digitised therapy could be just the ticket for young adults who already filter nearly every aspect of their lives – friends, work, sex, entertainment – through a screen.” He concludes: “E-counselling still feels like it's finding its feet: there are useful tools out there for the mild-to-medium prang-brained, but, as yet, no killer app that feels destined to reinvent mental health care for the hashtag age. What form might that ingenious wonder app take? No idea. If I knew that, I'd be off making it, instead of here, recklessly toying with my mental well-being for your half-distracted amusement.” ![]() In “The psychodynamics of social networking,” therapist Aaron Balick quotes Kranzberg’s First Law of Technology: it is neither good nor bad; nor is it neutral. Concludes Balick, “The need to relate has not changed. The need to recognise and be recognised has not changed. The need to seek and be sought has not been altered. The architecture, however, of the ways we do all these fundamental things that ake us human has indeed changed, and that may be changing us.” We are increasingly addicted to our “electronic cocaine” and sometimes we must unplug, disconnect, such that we might return again to the real connections, the ones that are a primary human need—connections with self, with others, with nature. Traditional therapy, as old as the hills, remains untouched by technology, and untouchable. Two people sit in a quiet, spare room. One is there to serve the other. If all goes well the encounter facilitates acceptance, change and growth. For the better. It is not a cure, for there is no cure for life. But it helps. Therapy is a place where you can become who you want to be—who you are meant to be. Where you can learn to live—if not the life you imagined, then the life that has been waiting for you all along. --John Barton U.K. NEWS “I wanted a new kind of mental health support group: we meet in the pub" The Guardian Jessica Spires tells the story of the creation of Let’s Go Mental, “an informal, peer-led support group for young people with experience of mental health issues.” They meet once a month in a London pub: One day I met with a friend for coffee, and inevitably some of the unfounded anxieties I was having about my relationship came up. Instead of the usual response, “I’m sure that won’t happen, don’t worry about it”, I was met with an answer so refreshing it was like a verbal slap around the face: “I totally get what you mean; I think that all the time too.” Those few words brought more relief than all of the conversations I’d previously had about my anxiety put together. I wanted that feeling again. I turned to Google (naturally) to look for a support group, but found very little that appealed, and mostly they weren’t local. So I decided to start one myself. The paradox of mental illness is that even though I felt alone, there were so many people around me going through the same thing, but I had to reach out and find them. I think Let’s Go Mental (LGM) was born at that very moment. ....I wanted LGM to be different than the depictions of support groups I’d seen on episodes of BBC crime dramas. No sitting around in a circle of chairs in a starkly lit room with a few bourbons and some weak tea. I wanted to recreate the ease of that conversation I’d had over coffee with a friend. Where is the best place to make British people feel at ease? The pub, of course. That’s how it happened, the premise of the group is really that simple. We go to the pub, we hang out and have a drink, and we talk about mental health. “We must have change” BBC News Conferences of the great and the good in areas like science, health and politics take place at Oxbridge colleges most weeks of the year. But this one was like few others. Conceived and organised by the father of an 18-year-old who had taken his own life barely a year earlier, this one-day gathering offered a broad and challenging view of the state of mental health care of young people in England. It revealed a widely shared view that notwithstanding the recent publication of NHS England's Mental Health Taskforce report, there is a lack of drive and joined-up thinking in government and the health service. Steve Mallen has already shared his grief and anger at the loss of his son. A talented straight A-grade student, Edward was set to go to Cambridge University. But in a matter of weeks he succumbed to depression and took his own life. ![]() • She waited 18 months for counselling: heartbreaking Facebook posts before falling to her death (Mirror.co.uk) University of Edinburgh hits record number of students seeking counselling services The Student A study into mental health at 24 of the UK’s top universities has found that the number of students seeking counselling has increased from 34,000 to 43,000 in just three years. In all the universities surveyed, the University of Edinburgh saw the largest increase in students pursuing counselling services with figures rising by 75 per cent in the three year period, with a 15 per cent increase in the last year alone. In an interview with The Student in February, Edinburgh University Students Association (EUSA) Vice President Societies and Activities Andy Peel said the counselling service received one hundred referrals a week. Anxiety was the most common reason for attending counselling services, with more than 6000 students reporting to suffer from the condition. Exercise may help young people with psychosis Live Science For young adults who have experienced severe mental health disorders, exercise may help reduce the severity of their symptoms, a new, small study suggests. In the study, researchers looked at 38 adults, ages 18 to 35, who had experienced an episode of psychosis — a serious mental disorder in which a person loses touch with reality and may experience delusions and hallucinations. All of the people were receiving antipsychotic medications and mental health care through early-intervention mental health services in England. ... The researchers found that the people who participated in the exercise program experienced a 27 percent decrease in the overall severity and frequency of their symptoms over the 10 weeks, on average. In comparison, the severity and frequency of symptoms among the people in the control group decreased by nearly 8 percent, on average, over the same period of time, they found. ![]() Girl Guides can now earn a badge for talking about mental health Cosmopolitan UK When you were young, Girlguiding was either something you did or something you wanted to do, because everyone who went was taught useful skills that saw them earn badges. Those skills were always things like camping, science and cookery, but the latest badge Girl Guides are striving for is rather different - and very useful. A new badge programme, called Think Resilient, gives Girl Guides an opportunity to talk about mental wellbeing, and it's been introduced with the aim of breaking down the stigma surrounding mental health. ...It's great news that Girlguiding sees the importance in talking about mental health, and is acting upon research they conducted in 2015. At the time, they found that 82% of girls and young women aged 11 to 21 feel that adults don't often recognise the pressure that young people are under, and that 62% in the same age group know a girl or young woman who has experienced a mental health problem. ![]() Prince Harry confronts the stigma ATTN In an interview with “Good Morning America” Prince Harry of Wales addressed the negative stereotypes attached to those who have mental health issues, particularly the stigma that often plagues war veterans who suffer from ”the invisible injury.” Says Harry: “The simplest thing, just talking about it, makes all the difference.” WORLD NEWS
Sweden: We Need to Talk About Europe's Refugees Care2.com Given their tough circumstances and traumatic pasts, it’s no surprise that refugees are more likely to experience depression, anxiety and PTSD than the general population. But what about more serious mental health issues—is psychosis, too, more common among the exiled? According to a Care2 story, yes: Researchers based at the Karolinska Institute in Sweden and the University College London in the UK have attempted to gain insight into this serious health issue. In an article published in the British Medical Journal this month, researchers describe how they used anonymous data from a cohort of 1.3 million people born after 1984 — excluding those below age 14. ...the researchers found that refugees in Sweden were around 66 percent more likely to develop nonaffective psychotic disorders than migrants — people not claiming refugee status — from the same geographic location. This finding contributes to a body of research that already demonstrated a greater risk of psychosis among migrants. But this is the first study to look at the particular situation of people claiming refugee status. ...“The dramatically increased risk among refugees shows that life events are a significant risk factor for schizophrenia,” lead author Anna-Clara Hollander explained. U.S.A.: Undivided attention—Mental Health Reform Act Care2.com Lawmakers in the Senate Committee on Health, Education, Labor and Pensions have just released the draft text of a bill that, they hope, could bring about a much needed update and reform of mental health care in the United States. It also shows that bipartisanship is not dead, and that when lawmakers work together the potential for serious legislative change is still possible. The bill is being worked on by Senator Lamar Alexander (R-TN), leader of the Senate Health Committee, with Democrat Senator Patty Murray (WA) and Senators Chris Murphy (D-CT) and Bill Cassidy (R-LA). The legislation is known as the Mental Health Reform Act of 2016, and it aims to achieve what could end up being the biggest overhaul in mental health care in decades by dramatically cutting the federal bureaucracy around mental health programs. It would increase state funds for certain mental health services and increase treatment options and availability for at risk groups such as children, people with no fixed address, and people who are already at risk of suicide. Lebanon: “Karim” delivers psychological support to Syrian refugees The Guardian More than 1 million Syrians have fled to Lebanon since the start of the conflict and as many as one-fifth of them may be suffering from mental health disorders, according to the World Health Organisation. But Lebanon’s mental health services are mostly private and the needs of refugees – who may have lost loved ones, their home, livelihood and community – are mostly going unmet. Hoping to support the efforts of overworked psychologists in the region, the Silicon Valley startup X2AI has created an artificially intelligent chatbot called Karim that can have personalised text message conversations in Arabic to help people with their emotional problems. As the user interacts with Karim, the system uses natural language processing to analyse the person’s emotional state and returns appropriate comments, questions and recommendations. Eugene Bann, the co-founder and CTO of X2AI, says: “There are barely any mental-health services in refugee camps. People have depression, anxiety, a sense of hopelessness and fear of the unknown.” Indonesia: The living hell of people with mental health conditions Human Rights Watch More than 57,000 people in Indonesia with mental health conditions have been chained and locked up in overcrowded rooms or filthy sheds at least once in their lives. About 18,000 are still believed to be shackled, despite a 1977 government ban on pasung, as the practice is called. Access to support and mental health care is desperately needed. Yet with only 48 mental hospitals for the country’s 17,000 islands, families continue to either admit relatives with psychosocial disabilities without their consent to institutions where they are subjected to a wide range of abuses or to chain or lock them up at home. Human Right Watch’s Kriti Sharma visited 18 mental hospitals, social care centers and private institutions run by faith healers or traditional healers and interviewed about 150 people across Indonesia’s heavily populated islands of Java and Sumatra. Her new report, “Like Living in Hell” for the first time gives those who have been locked up for years a voice. • Govt prepares mobile counseling for teens (Jakarta Post) Myanmar: Lacking support, mental health patients suffer in silence Mizzima News When Chit San was finally released through an amnesty in 1996 his struggle, however, was not over. Like many thousands of former political prisoners in Myanmar, he suffers from symptoms of depression, anxiety and post-traumatic stress disorder (PTSD), which he developed as a result of the psychological and physical trauma he experienced at the hands of the former regime. Another legacy of the military government, the country’s wrecked healthcare system, means that many of those suffering from psychological problems, whether from torture or other causes, cannot receive much-needed psychological treatment from government healthcare facilities. Cultural stigma and a lack of public understanding in Myanmar about common disorders, such as depression and anxiety, further worsens their plight. Many people choose to suffer in silence rather than face being labelled 'ayoo', or crazy. ...With government care almost non-existent, non-profit organisations and overseas supporters have stepped in. Programs like the Mental Health Assistance Program (MHAP), of the Thailand-based Assistance Association for Political Prisoner's (AAPP), provide such support. Funded by Johns Hopkins University in the United States, MHAP uses a psychotherapy treatment method called Common Elements Treatment Approach, which is suited for low-resource settings like Myanmar. ![]() Forecast: Unexpected outbreaks of sunny spells in remote Scottish islands. Fair becoming good in Cornwall. Unending downpours in Liverpool and London. The Office of National Statistics last week released its figures on the state of the nation’s emotional weather: happiness, anxiety, life satisfaction and how worthwhile life seems. It’s the culmination of three years of data collection. The highlights • Liverpool and Wolverhampton are supposedly the unhappiest places in Britain (average happiness scores of 6.96 and 6.99 out of 10) Wolverhampton also has the second-lowest “life satisfaction” score. The lowest life satisfaction—where life is also ranked the least “worthwhile”—is in Harlow, just off the M11 in Essex, famous for being the site of Britain’s first modern residential tower block and first pedestrian precinct. • Derry and Strabane in Northern Ireland have the highest levels of anxiety in the U.K. with a score of 3.73 out of 10, closely followed by and Belfast, Liverpool and a string of London boroughs Northern Ireland is however the happiest part of the U.K, followed by Scotland, Wales and England. Is it possible to be anxious and happy? It is. Chesterton wrote of the Irish: “All their wars are merry / And all their songs are sad.” And the converse is true also: you can be free of stress yet really miserable—unhappy Wolverhampton has the lowest levels of anxiety in all of Britain (1.95 out of 10). This perhaps suggests that trying to eliminate stress from your life in order to be happier may not work—you may just get depressed instead. People who achieve their dream of early retirement often make this confounding discovery: six months down the road they are bored and fed up. A certain amount of stress sharpens the focus, motivates people, boosts the heart and immune system—it enlivens. Too much of the wrong kind for too long, however—you get fried rather than fired up. This is the principle of hormesis—a little bit of hardship is good. In one experiment, mice that were given a small dose of poison outlived those who were given none. We are drawn to our cities not in spite of their stressful demands but because of them. • Top of the happiness table—and the “life satisfaction” and “worthwhile” rankings, too—is Eilean Siar: the Outer Hebrides The sample sizes for various remote Scottish islands were too small to be statistically significant, yet places like the Hebrides, Shetland and Orkney consistently crowd the opposite ends of these kinds of rankings from the likes of Liverpool, Wolverhampton and London. The Eilean Siar tourism website says: “This is a lively and challenging place. It’s a place where community matters...The sheer diversity of the landscape is remarkable. Endless machairs and dunes. Mountains and stunning beaches. Vast expanses of moor and lochs. Vertical sea cliffs and stacks... Little wonder that visitors to our islands are enchanted by what they find here.” Where incidentally should you be living? The BBC has devised a quick personality test which tells you where in Britain you would be happiest, and where you would be least happy. It’s nonsense of course but fun. You can take the test here. I was advised to move to somewhere called Craven, and to avoid at all costs relocating to somewhere called Spelthorne, where I could expect a life satisfaction score of only 32 percent, whatever that means. • Women are slightly happier than men (7.41 versus 7.35) Women are also almost twice as likely to seek psychological help than men, who are conditioned instead to do a Clint Eastwood impersonation if ever they feel anxious or sad. Men are more than three times as likely than women in the U.K. to be alcohol-dependent, or commit suicide. Plus, women in the U.K. live on average four years longer than men. The debate about gender equality quite rightly focuses on gross injustices in terms of violence and sexual violence, pay, political and corporate power, and cultural representation, but those four lost years—four summers, birthdays, anniversaries; a thousand nights to sleep perchance to dream—rarely warrant a mention. • Married people are happier than singletons (7.67 versus 7.11); the divorced or separated are the least happy (6.89) Does marriage make you happy—or are happy people more likely to get married? A review of the literature from the National Bureau of Economic Research claims that there really is a cause-and-effect relationship between marriage and happiness. Marry, live happily ever after, right? The authors of the report suggest that this is especially true if you marry someone who, you know, you actually like: “We explore friendship as a mechanism which could help explain a causal relationship between marriage and life satisfaction, and find that well-being effects of marriage are about twice as large for those whose spouse is also their best friend.” On the other hand, marriage is the source of much misery for many. Untold sleepless nights lie behind the fact that 42 percent of marriages end in divorce in the U.K. There is some old evidence that marriage is good for men and bad for women. There is other evidence that nowadays the happiness boost from marriage is identical for both genders—feminism has redefined married life. For all its ups and downs, imperfections and frustrations, marriage for most is better than the modern-day scourge of loneliness. Humans need other humans as much as they need food and water. ![]() • Life satisfaction and happiness on average are lowest in the 45-59-year-old age bracket; Those aged 65-79 tended to report the highest levels of well-being This is in accord with the “U-bend of happiness” pattern across the lifespan, which I have written about before: one day you find yourself trapped in an unsatisfying job, marriage or town, struggling to pay the bills, stressed, sandwiched between looking after your kids and looking after your parents. You are miserable. You are at the bottom of the U-bend. “And you may ask yourself,” as the Talking Heads song goes, “how did I get here?” One study of happiness data in 72 countries reported that the global average bottom of the U-bend is 46 years old (though this of course masks enormous variety and individual differences). But then, after a midlife crisis or two, things get better. Midlife is an opportunity to return to the changing room, review what went wrong in the first half of the match, chat with coaches, colleagues and counsellors, attend to any bruises, fortify yourself and then, renewed, refreshed and utterly changed, charge back out into the pitch for the second half. You might play a quite different game until the final whistle. • The employed are quite a bit happier than the unemployed (7.42 versus 6.89) This is hardly surprising—so much unhappiness is dictated by socioeconomic misfortune. Western governments tend to blame the poor and the unwell for their fate so as to divert attention away from their own policies that maintain poverty and inequality. Corporate happiness is top of the agenda. If you’re a divorced, unemployed, middle-aged man in Liverpool, with your dreams tossed and blown, it would be insulting in the extreme to suggest happiness can be achieved with a few sessions of CBT. It’s not his thoughts that need changing so much as his economic environment. The happiest countries, of course, are egalitarian, truly democratic and with high levels of social capital. • The happiest religion is Hindu, followed by Christian, Sikh, Buddhist, Jewish and Muslim (the happiest ethnicity is Indian; the least happy is “Gypsy / Traveller / Irish Traveller”). People with no religion are the least happy. A conviction that you’ve been pencilled in for a good karmic afterlife or a place in heaven probably does make a lot of people quite happy. Atheists might regard such believers as deluded, cocooned in blissful ignorance. In the film “The Truman Show,” Jim Carrey would have stayed blissfully happy if he’d never discovered he was living in an entirely artificial town—an unwitting pawn in a reality TV show. Buddha became very unhappy when he left the palace to discover a world beyond the confines of his walls of privilege—a world that included poverty, illness and suffering—but thank goodness he did or the valuable philosophy, art and culture of Buddhism wouldn’t have happened. The First Noble Truth of Buddhism is not that life is about happiness. It is that life is suffering. Questions for you What to make of all this? Is it meaningless—just an example of “lies, damn lies, statistics”—and, worse still, happiness statistics? Or is this an opportunity to take stock and maybe make some changes? How happy are you—how “worthwhile” is your life? Do you have good stress to contend with, or bad? If your new year’s resolutions didn’t work out, should you come up with new ones today, the first day of the Chinese New Year? Should you marry your best friend, join the Hare Krishna, move to Stornaway and find a job? Or stay exactly where you are but change your attitude—turn your own personal Wolverhampton into some kind of heaven on earth? Should you talk things through with a therapist? Maybe you will, maybe you won’t. Maybe you’ll live the life you imagined, or maybe your dreams will forever elude you. Maybe it doesn’t matter. Your glass is neither half empty or half full. The existentialists believe life is not about the pursuit of happiness. It is the pursuit of itself—to live to the full. Nietzsche famously argued that “god is dead”—there is no heaven, no afterlife, so you might as well throw caution to the wind and live intensely, making brave choices, feeling deeply, fully present, right here, right now. Get to grips with the ups and downs, advise Echo & The Bunnymen, "because there's nothing in between." Or as Anaïs Nin wrote: "I must be a mermaid ... I have no fear of depths and a great fear of shallow living." ![]() Long considered a sexist dinosaur with a cocaine habit and some bizarre ideas—does anyone believe that little boys literally fear castration, want to kill their fathers and have sex with their mothers?—Sigmund Freud is enjoying something of a renaissance. As Oliver Burkeman recently outlined, the therapy Freud invented, psychoanalysis, is at last gaining some much-needed empirical support, while at the same time the default treatment on offer in the U.K., quick fix, symptom-focussed cognitive-behavioural therapy (CBT), is increasingly looking like some sort of snake oil. CBT appeals to our common sense. But common sense isn't as common as we'd like to believe. Freud’s revelation was that we are not necessarily always logical, rational beings making optimal choices as we navigate through life’s vagaries, that we are in fact to a large extent strangers to ourselves.
![]() Therapy today Freud’s influence was far-reaching and profound. But he was a flawed character. You get the feeling he started to believe in his own myth. Patients often had to fit into his theories rather than the other way round. Any dissent might be met by indignant harrumphing or an ended friendship. He was capable of exploiting his position as a white male authority figure for personal ends. His work was sometimes more to do with furthering the legend of Sigmund Freud than with healing. Some of his ideas and speculative musings have great metaphorical and symbolic value, yet he invited ridicule by insisting on speaking in absolutes and the rigid certainties of hard science. He was somewhat obsessional, detached, and ironically perhaps not so much of a people person, once writing, “I have found little that is ‘good’ about human beings on the whole. In my experience, most of them are trash.” The best they could hope for was “common unhappiness.” In photographs, his facial expressions run the gamut from utter foreboding to grim disdain. Freud claimed psychoanalysis worked. He would identify unconscious motivations and unhelpful patterns, explain them to the grateful patient and, thus fortified, the patient would make better choices going forward. Except that very often they didn’t. Today’s therapists who work at any depth will, like Freud, want to uncover your blueprint, your patterns, your unconscious processes. They might explore your childhood, interpret significant memories, analyse your dreams, which for Freud were the “royal road” to the unconscious. But they know that, while self-knowledge is helpful, it only takes a client so far. Lasting change and healing comes from the heart as well as the head, through acceptance, support and love. Research shows it is the therapeutic relationship itself which heals. Good therapists are not inflated with their own importance, nor blinded by their own certainties. They treat clients ethically, not just because there are codes of ethics to abide by, but because ethical therapy is inherently good therapy. Above all, they are fully engaged with the client, noticing what is happening between them, and always working in partnership with them, in their best interests, rather than lording over them as they lie on the couch, prostrate and exposed (whether as a client or a therapist, I prefer to sit chair to chair and eye to eye). A good therapist cares. It’s not enough to know and be known. To thrive in this life it helps, too, to love and be loved. In 1817, in a letter to his brother, the poet John Keats wrote about how people of achievement had a quality he called “negative capability.” They were capable, he said, “of being in uncertainties, mysteries, doubts without any irritable reaching after fact and reason.” Negative capability is an acknowledgement of complexity, a mature respect of life’s shades of grey, an understanding that despite what the strident headline, indignant tweet or demanding placard says, the situation is probably not quite so simple.
![]() “We can never know in the beginning, in giving ourselves to a person, to a work, to a marriage or to a cause, exactly what kind of love we are involved with. When we demand a certain specific kind of reciprocation before the revelation has flowered completely we find ourselves disappointed and bereaved and in that grief may miss the particular form of love that is actually possible but that did not meet our initial and too specific expectations. Feeling bereft we take our identity as one who is disappointed in love, our almost proud disappointment preventing us from seeing the lack of reciprocation from the person or the situation as simply a difficult invitation into a deeper and as yet unrecognizable form of affection.” ![]() A digression: Do you feel lucky today? Richard Wiseman, a magician turned popular psychologist, conducted some research on luck. He advertised for people who considered themselves very lucky, or very unlucky and received many replies. The lucky people seemingly had led charmed, successful, happy lives. They were always in the right place at the right time, and good things inevitably just happened to fall in their lap. The unlucky people? The opposite. An extraordinary catalogue of calamities, disastrous romances, failed businesses, missed connections, lost harvests. Wiseman conducted a series of tests on these people. One was to count the number of photos in a newspaper. The unlucky people took a few minutes to complete the task. The lucky people took just seconds. Why? Because on page 2, half the page was devoted to a notice that said, in large letters: “Stop counting: There are 43 photographs in this newspaper.” The “unlucky” people, blinded by the certainty of the task, never saw it. According to Wiseman, people make their own luck. The house of uncertainty holds no fear for lucky people. Which side are you on? Our brains have two hemispheres: the intuitive, holistic, creative, transcendent “right brain,” and the more logical, rigid, pedantic, detail-focused “left brain.” Iain McGilchrist calls the former the “Master” and the latter the “Emissary.” The problem, he says, is that the Emissary is supposed to be in service to the Master, but somehow he has taken over the controls. As a result, he has profoundly changed us—and our world. All power, says McGilchrist, now rests with the Emissary “who, however gifted, is effectively an ambitious regional bureaucrat with his own interests at heart. Meanwhile the Master...is led away in chains.” (A simplistic binary split of the brain into left and right perhaps shows a lack of negative capability—it ignores all the shades of grey matter. But we'll stick with it.) Instead of working together, our bird-brained inner accountant turned on our wise and thoughtful inner poet and, in a desperate ontological battle, the latter was slain. The poet, needless to say, embraced negative capability; she lived it. The accountant however, clipboard, ruler and calculator in hand, can tolerate only certainty. He has created a fragmented, western world of technology, mechanisation and bureaucracy, a world of alienation, where love is hard to find, and beauty gets bulldozed, a world of spreadsheets instead of sonnets, a world where everything is measured, itemized, indexed, where the little picture matters and the big picture doesn’t. Einstein had a sign hanging in his office which read: “Not everything that counts can be counted, and not everything that can be counted counts.” Doubt in the consulting room The Emissary’s hand can be seen in every detail of our lives—in tax returns, Ofsted reports, market research. In doomed attempts to deconstruct jokes or works of art. And, as I wrote earlier this week, in the field of mental health. The Emissary wants to shoehorn your troubles into a neat, clearly-labelled pigeonhole. He wants to eradicate your symptoms with a drug and, if you insist, a bit of talking in the form of some short-term cognitive-behavioural therapy (CBT). A little adjustment to your levels, a bit of soldering under the bonnet, and you should be good to go—back to your spreadsheets. If it were that simple, we would not be human. On the first page of the introduction in her book The Impossibility of Knowing, psychotherapist Jackie Gerrard writes: “I am sure that I, like many of my colleagues, started my training eager to learn and to know, and I have subsequently spent the years post qualification learning that I do not ‘know,’ cannot ‘know,’ and, indeed, should not ‘know’ . . . by saying I do not ‘know,’ I am continually endeavouring to hold a state of mind that can tolerate remaining open, bearing uncertainty, and avoiding, wherever possible, omnipotence and omniscience.” Not “knowing” is not the same as indecision or ignorance. In Tales of Un-knowing, existential therapist Ernesto Spinelli says therapists should aspire to be un-knowing—as opposed to “unknowing”—they should “attempt to remain as open as possible to whatever presents itself in our relational experience.” The Emissary therapist reaches for theories, models, personality tests and questionnaires about your mental state so that he can enter your score on a spreadsheet. He reaches for the manual to find a clinical diagnosis such as “generalized anxiety disorder” or “oppositional defiance disorder” and some techniques to make it go away. American existential therapist Irving Yalom marvels that anyone can take diagnoses seriously, adding: “Even the most liberal system of psychiatric nomenclature does violence to the being of another. If we relate to people believing that we can categorize them, we will neither identify nor nurture the parts, the vital parts, of the other that transcends category.” The Master therapist, by contrast, see you—all the vital parts, all of you. All her senses are alive to you and your experience of distress. This level of presence and empathy was memorably expressed by British psychoanalyst Wilfred Bion, who wrote that every therapeutic session should be approached “without memory and without desire.” Even the therapist’s wish for their client to be, say, less depressed is, according to Bion, an imposition that will cloud that therapist’s mind. He believed that in every session there had to be a genuine open-mindedness and freedom. All too often therapist and client conspire to flee from uncertainty. The therapist who claims to be “sorted” might be cut off from their own vulnerability and woundedness, and perhaps not be the best guide to accompany a client as they traverse a landscape of despair. Integrative psychotherapist Diana Voller writes: “The tension of the experience of being in uncertainty brings the person of the therapist well and truly back into the therapy.” The therapist, too, needs “the scariness and excitement of being willing to be in the unknown, allowing oneself to be temporarily overwhelmed, feel stupid for a while...gaining new perspectives and growing.” (I am grateful to Voller for a presentation she made on negative capability years ago in London—thank you.) Increasing your negative capability So perhaps we would be better people if we could cultivate a little more negative capability in our lives. There'd be more good things like luck, love, empathy. Negative capability transforms a profane world into one of poetry. For Keats, ways to cultivate more negative capability were: “books, fruit, French wine, fine weather and a little music out of doors played by someone I do not know.” Voller suggests that films, TV, art, literature and the theatre are all “rich everyday resources for choosing to be temporarily unsettled and ready to be ultimately changed by other ways of seeing things.” Here are 9 tips for a greater capacity for uncertainty: 1. Have therapy There’s no better way to experience the discomfort of uncertainty, to encounter those frontiers of yourself that you have for long retreated from, than to be a client. The consulting room is a safe place to explore your distress, your history, your way of being in the world, all your secrets and shadows. Processing such dark matter affords some control over it rather than the reverse. 2. Keep a journal Another great way of exploring, of cultivating a better relationship with our self—or rather, disparate selves. Start the conversation. 3. Improvise Now and again, put away the instruction manual, or the sheet music, or the cookbook, and just do it. 4. Meet new people Hurl yourself into unfamiliar social situations. Interact with a wide range of people. Richard Wiseman wrote of how some of his “lucky” participants often sought out ways to force them to meet different people. One noticed that whenever he went to a party, he tended to talk to the same type of people. To disrupt this routine, he now thinks of a colour before a social event and then speaks to people wearing that colour of clothing. 5. Get lost Take a different route to work, take your watch off, travel without a map, go somewhere new on holiday, camp in the wilderness, explore a very different country, travel alone. Develop a sense of what psychoanalyst Nina Coltart called xenophilia. Lose yourself in nature. Gaze at trees, clouds, thunderstorms. Waste time. 6. Spend time with children Learn from their streams of consciousness and ability to play, and to be spontaneous and joyful and un-selfconscious. They haven’t yet learned, as we have, to filter, to not see. Negative capability is the antidote to old age. Viewpoints, like arteries or neural pathways, can become clogged, fewer, narrower, less fluid. 7. Have new experiences Sign up for that retreat, workshop, meetup.com event. Do things that you’ve always wanted to do but haven’t because they scare you a little. Try different genres of art and music and film and food. 8. Be with your body Dance. Play. Sing. Act. Exercise. Move. Do yoga. Touch and be touched. Our psychology affects our body—the reverse can also be true: putting your body into unfamiliar, freeing positions can also free your mind. 9. Stop making lists! Ultimately, negative capability is a stance, a state of mind, an awareness. A willingness to give up the life you planned in order to have the life that is waiting for you, as American mythologist Joseph Campbell so succinctly put it. It’s not easy. There are times when we need to be on autopilot, or seek refuge from the world under a giant metaphorical duvet. But we are only fully alive in those fleeting moments when we are brave enough to throw away all the old rules and maps and guidebooks and lists and embrace living in a state of uncertainty, eyes wide open to the world, engaging our fluid self with a fluid environment in original, creative and spontaneous ways. I’m pretty sure there some truth in that. But of course, I can’t be certain. |
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AuthorJohn Barton is a counsellor, psychotherapist, blogger and writer with a private practice in Marylebone, Central London. To contact, click here. |