…aaand breathe

I try hard not to read the Daily Mail because I end up getting far too shouty, and I know there is little point in commenting on something written therein, but I get angry with articles published that are misleading, one sided and downright irresponsible – especially when concerning mental health issues. And, when TV psychologist Oliver James writes an article entitled “Therapy on the NHS? What a crazy waste of £600 million!” I can’t help myself, even when I bear in mind that 1) Oliver James has recently had a book published and is therefore likely to want a load of publicity, and 2) this is the Daily Mail.
Dr James is an outspoken person at the best of times. He has made unethical and potentially damaging comments in the past – most notably about Peter Mandelson. Now, he turns his attention to the general public, poo-poohing CBT – one of the most successful treatments for mental health issues such as anxiety disorders, depression, PTSD, and others. He doesn’t merely question the efficacy of this treatment, and provide links to evidence – instead he dismisses CBT as a “crazy waste” of money. He supplies anecdotal ‘evidence’ to support this. He spouts ‘facts’ about relapsing after CBT without backing them up. He comes out with impressive sounding phrases like “research has shown” without going further to say who researched what and where the reader can learn more.
The validity of his claims are questionable, however more worrying is that these claims have been published in a widely read national newspaper, and basically say “having CBT? Don’t bother – you’ll be just as bad as ever in a couple of years…” According to biographies all over the internet, Dr James has had clinical experience, so he should know that the mind is a fragile thing when it is being assaulted by a mental health problem – in other words, the very minds that CBT can probably help. He should know that many people with depression and anxiety disorders frequently have a negative image of the future. CBT is hard work mentally, and I can’t help wondering how many people would give up if they read an article like this, written by a psychologist who has featured on “This Morning” and written successful self help books.
If Dr James is so against CBT, why not research it properly? Why not suggest possible solutions to the perceived problem? Dr James advocates Cognitive Analytic Therapy instead of CBT, yet studies have shown that in Generalised Anxiety Disorder, CBT was more effective. Dr James suggests that “where patients have been examined two years later, at least half of panicky ones have relapsed or sought further help.” yet makes no reference to the fact that CBT is an ongoing process – and techniques should be practiced long after the patient has stopped seeing their therapist. I personally would like to see research into how many people expect to be ‘cured’ (indeed James uses that word in the article) and go back to their normal lives. How many people didn’t really realise that they would need to practice CBT techniques to keep their symptoms at bay or help stem a relapse. But rather than suggesting that patient follow-up should improve, James dismisses the entire therapy.
He talks about CBT as though it’s as structured as a course of antibiotics. In fact, CBT is tailored to the individual. The principles are essentially the same, but because the problems that CBT can help are so diverse, obviously individual patients receive individual care. The three cases he refers to in the article do sound as though they are very disillusioned with their experience of CBT, but this could be for a myriad of reasons, not because CBT “doesn’t work”.
I really can’t understand why he has written the article in this way. It’s certainly not been written with the best interests of sufferers in mind. Why be so negative? What does he stand to gain from approaching it in this way? At the start of the article, he talks about how CBT is inexpensive, therefore would appeal to the government. Maybe it’s an incredibly round about way of saying the government isn’t spending enough money on Mental Health Services. If this is the case, I’m sure there are a million other ways of doing it without saying ‘CBT is a load of crap’.
I’d like to think that Daily Mail readers would have more sense than to take this somewhat vitriolic rant at face value, but I don’t know. When you factor in things like third party recanting, and the strange way in which these illnesses mess about with your emotions, you have a rather worrying mix. The media’s enormous reach has the power to cause much harm – just look at the MMR vaccine controversy.
I’m not writing this because of my own feelings on CBT. Having been ‘in the game’ for a while, I know better than to advocate one particular treatment over another. CBT seems to be working for me, others may find that it’s not for them. I personally think it is up to the individual and their therapist to come together with a plan for therapy that is most suitable for them, their problem, their personality and their lifestyle. If your therapist suggests CBT, have a go and be open minded. If they say something or suggest something you don’t feel happy with, tell them. Good communication with your therapist is paramount. Remember, even though it doesn’t work for some people, it does work for a hell of a lot of others. Have a look here for some success stories where CBT was used to help people with Social Anxiety Disorder. Hopefully, it will redress the balance.
Finally, please for the love of all that is sacred, can the media get their facts right about how much disability benefit is? £750 a month? I bloody wish…

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Picnic Ponderings

Apologies for not posting sooner, but truth be told, I’ve felt utterly wrecked all week. I’ve been going to bed at 8pm because I’ve been nodding off on the sofa, then not sleeping properly because both my neck and lower back have been painful. So, my brain has also been fried and concentrating on anything for very long has been hard.
Meanwhile, I’ve been trying to write something that makes what I achieved on Friday sound like I was climbing a mountain. In the end, I’ve decided that the right adjectives aren’t out there, so just imagine, okay?
By half past eight on Friday morning, I was aware of every car going past, even though B wasn’t due to pick me up until 9.30. I packed and repacked my huge wicker basket with knitted food, stuff to knit while I was there, my mp3 player, a little tin with my tablets in, a bottle of water – the list goes on. When I thought I was ready, I stood at the window, my thoughts swirling. “Do I take that yarn? Maybe I should take a book – what about…” and so it went on. Eventually I said out loud to myself – “stop it. There’s only so much room in the car…”
The car journey was uneventful anxiety wise, we chatted about all sorts of things which helped, and affirmed the knowledge that B is very understanding. In fact, B should stand for brilliant. She reassured me by telling me what and who would be there, and told me that there were quiet corners in the place where we would be (an old converted church). I’d be lying if I said it didn’t feel strange being out without Mr D, but even stranger, I didn’t feel too terrible about it. Of course, I felt like something was missing, but once I got there and saw all the familiar faces from the knitting group, I was fine.
I took a few photographs, and sat down with the knitters. At first, I fumbled with bits and pieces, noticing that my hands were a bit shaky, but eventually settled down with the most Amazing Sock Yarn Ever. Casting on and doing some of the rib helped me concentrate. I know that’s avoidance rather than dealing with it – but to be honest, I didn’t care. I just wanted to enjoy my day.
A woman from the local newspaper turned up, and once she’d interviewed the organisers, she frustratedly lamented that her photographer had gone missing. My inward sigh of relief was shortlived – she pulled out a compact camera from her bag and announced “I’ll just take a few photos”. That, I thought, was a perfect opportunity to nip to the loo…
Four hours went over so incredibly quickly. When a voice piped up, “right, d’you think we should start packing up?” my response was “what, already???” Just as we were about to take things out to various cars, a flustered young man walked in and announced he was the photographer for the local paper. Torn between staying and lusting after his camera (a Canon EOS 1D if you want to drool with me) I chickened out and opted for the comfort of the lavatory again. When I later told Mr D, he joked that now I’ve been in the Guardian, the local rag isn’t good enough!
I know it sounds so utterly ordinary, but it was a big step for me. Plus, the ordinary-ness means that it was a success. No panic or madness, unless you count accidentally stealing Carrie Anne’s lemonade..

Anticipation

I thought I’d mentioned this, but looking back on my old posts, it seems I haven’t.
As I mentioned a bit ago, this week is national knitting week, and my knitting group have been busy knitting items for a Teddy Bear’s Picnic, culminating today in an exhibition and sale. On a Friday. Whose idea was that? When I found out, my response was “great, Mr D will never get time off work” but as the weeks progressed, so did my CBT.
About three weeks ago, I spoke to my friend B. She is my yarn guru – she has a market stall selling some gorgeous stuff, she runs weaving classes and the knitting groups, and I knew she would be going to the exhibition. I’d talked to her before about my CBT, and got the feeling she really understood. People like that are in the minority – usually it’s between “pull yourself together” and “back away from the crazy person”, but B was fine with it.
So, I asked her. “can I come with you?”
I explained that so far, I only go anywhere with Mr D. This could be part of my therapy – just outside my comfort zone. I said that I might back out, and she shouldn’t worry. People, B was lovely about it. She said that it was okay, and that even if I felt like it was too much, she’d bring me home. That understanding has meant that I’m sitting here waiting for her, and although I feel anxious, I’m also excited, expectant, eager.
I shall let you all know how I get on…

Progress

The health food shop was small, familiar. Ideal. Heart in mouth, she glanced round. The street was still fairly quiet – it was only 9am.
“Can you wait there?” she asked, the words tumbling somewhat. “I’m going in by myself.”
He nodded, going with the flow.
She took a deep breath, mentally reminded herself that her phone was in her pocket, and he would be waiting just there. Not too far away. Determined, she strode into the shop, aware that if she waited too long outside she’d put herself off and not do it. There were a few people around, but it wasn’t busy. She knew what she wanted, and where it was. She had deliberately chosen something that was at the back of the shop – it would be far too easy if she could do this whole thing while barely taking a few steps inside. Remember, “just outside your comfort zone”. Mentally taking the journey through a familiar shop, it had seemed so easy when she’d planned it. Now she was here.
She got to the back of the shop effortlessly, picked up the bottle of eco fabric conditioner, and started walking quickly to the front where the till was. Suddenly, she stopped. “I’m doing this far too fast” she thought. Aware of what J had said about staying in the situation until the anxiety had passed, she started to look at soap, essential oils, herbal teas – anything, something. She tried not to look at people, not wanting to be drawn into conversation. Not wanting to suddenly notice they were there. “right” she thought, “I need to pay for this”.
At the front of the shop, she could see through the window to the street where he was waiting. The sight was familiar, comforting. This was nearly over. With renewed zeal, she approached the counter, smiled, handed over her money – and in a few seconds she was leaving the shop.
At the door, there was a moment of increased anxiety as she realised she was Outside again, but within moments she was standing by his side – safe again.
“OK?” he asked.
She nodded, feeling slightly sick, rather anxious, tired yet somehow happy.

Crikey

Um, hello to all the lovely people coming here from The Guardian.
I feel like I should say something meaningful, but I can’t think what. I shall post something proper soon – all my time at the moment seems to be spent knitting food…

Food for Thought

On October 10th, it’s World Mental Health Day.
I only found out about this last week, although the World Federation for Mental Health says they’ve been doing it since 1992. I can’t help feeling bemused that “Breast Cancer Awareness” gets a whole month of promotion, and a hell of a lot of it too – while mental health issues which (at a guess) affect a hell of a lot more people only gets one day, and not very much promotion unless you’re looking for it.
When I heard about it, I did a bit of a search to see what I could write up here to promote it. The Mental Health Foundation have a campaign called “Make a Meal of it” – the idea being that we get together with friends and family for a meal. I was incredibly cynical about this – people with social phobias are going to love that idea, and the Foundation’s own research in 2001 found that one in three people felt that friendships had become strained or they had lost contact altogether. Rebuilding those bridges takes time and a hell of a lot of effort – something many people with mental health issues would feel to be overwhelming.
Eventually I came to the conclusion that it wasn’t these people that the MHF are targetting. Maybe they’re going after the people who sometimes go to their GP for a sicknote for “stress”, or claim they have depression because they’re feeling a bit down after a breakup or redundancy. I guess for many people, these simple ideas could work, but I’m not sure how this campaign is going to highlight awareness of mental health issues in a scopic way.
I want to take part – but don’t like this social eating idea. Then I remembered – I’m taking part in a knitted “teddy bear’s picnic” for National Knitting Week. I’m doing the food…

oh nurse…

I didn’t always want to be a nurse. When I left school in the mid 1980’s with no qualifications, I had no idea what I wanted to do for a living, but my interests were firmly in the arts – drawing and writing. “No-one in Real Life does that, though” I thought. I remember going to the careers office aged 16, and telling them I wanted to be a window dresser in a department store.
It took me til I was 20, working in various shops and going nowhere near the window displays, before a chance opportunity saw me change direction completely. I started working in the Occupational Therapy department of the hospital, in Stroke Rehab. This was on a government scheme, and at a time when retail jobs were few and far between, I thought I had nothing to lose.
I loved it, and was fascinated by the myriad of ways in which a stroke can affect someone. I discovered a thirst for learning, far removed from my school days when I quickly got bored, and was told I’d never amount to anything. At the end of the year, there was no budget for an OT Helper, so I decided to go to college and try doing some O levels while I figured out what to do next. I didn’t think I had the brains to go to university to do OT, and the Head OT in the department had mentioned that there weren’t many jobs about anyway. I loved working in the hospital, I loved helping people, so I made a decision. I was going to train to be a nurse.
A year later, I had five O level passes, a student handbook and application form for nurse training. The process was not a quick one, so bearing this in mind, I started another government training scheme. (I tried going down the route of being an auxilliary nurse on the nurse bank, but there were no vacancies at the time). This time, I ended up on the Day Surgery Unit. The Sister and Charge Nurse were both fantastic – knew I wanted to do my training, and tried their level best to make sure I had both a good grounding in basic nursing skills, and a wide variety of experiences. It is something I shall always be grateful for.
I eventually started nurse training in early 1994, under the new Project 2000 scheme. I learned because I wasn’t afraid to ask, and because I already had that groundwork, I really think the ward staff appreciated my previous experience, and not having to teach me the basics.
In June 1995, disaster struck. Two weeks before an important exam (CFP, if you’re interested), my beloved Grandma died. I was devastated. She had more or less raised me as a child, and we were incredibly close. I sunk into a deep depression and contemplated suicide. I started having panic attacks (although I didn’t know what they were) and I stopped caring about myself or what happened to me. It happened during a placement on children’s ward, and I guess in that respect I was lucky – at least I wasn’t looking after old ladies…
Back in college a week or so later, my heart sank when I looked at the timetable – Wednesday morning, “last offices and bereavement”. This certainly was a case of bad timing, and I asked the tutor if I could sit out. She said no. The college was well aware of the situation. I’d sat in with my personal tutor a few times, in floods of tears, trying to explain how important Grandma had been. Now the college ignored that. I sobbed silently through the lecture, and eventually walked out, unable to listen to any more.
The following week, I was to sit the exam. I blundered through it, was referred, resat it the week after with similar results. I appealed to the university, and after hearing my heart wrenching plea, they said I could take it again. Three days later.
I was in no fit state to sit exams, and inevitably, I failed again. My nursing career was over. I found out several months later that I could have taken six months out and joined the intake behind ours, but this was never suggested to me. In all, the support from the so-called “caring profession” was frankly shit.
In the coming months and years, I found myself frequently regretting what had happened. As time went on, I became interested in new things and considered new careers. I still wondered one day whether I would go back. Later, when people asked, I said no – I wouldn’t go back partly because of my health problems, and partly because my interests have moved.
I still maintain an interest in the medical profession, being a fan of Tom Reynolds, Dr Crippen and Mental Nurse, but when I read this post by Dr Crippen about an email from a student nurse, I felt glad that (even though traumatsing) I’d got out early.
Now, if I’m asked if I’d go back into nursing, I’ll refer them to that post, and say “not on your nelly”.