This Week in Mentalists – Creeping Hashtags Edition

Morning all. Zarathustra from The Not So Big Society here.

Nothing particularly triggery (I think!) today. On with the weekly round-up.

We’re used to the argument over whether or not mental illness is an “illness” per se (pick your sides, gather together a handy selection of throwing implements…) but can imprisonment also be considered a disease? Frontier Psychiatrist ponders the idea.

During London’s 1854 outbreak of cholera, John Snow’s insight famously led to the removal of the handle of the Broad Street water pump. Soho’s residents could no longer drink its contaminated water. What is the pump filling America’s prisons, and is it possible for the handle to be removed? Drucker shows how in one state­­—New York—the rate of incarceration clearly surged from the 1970s. This coincides with the introduction of the state’s so called Rockefeller drug laws: punitive legislation introduced in response to a rise in heroin use in the 1960s. These laws made it possible for those caught in possession of even small amounts of illegal drugs to receive the same sentences as imposed for violent crime. Similar legislation would be enacted throughout the country.

Most of New York City’s prison population comes from just six neighbourhoods. This echoes the distribution of deaths on the Titanic, which reveal the rigid social structure of the Edwardian era. On the Titanic, those in the highest social class were more than twice as likely to survive as those in the lowest social class. In New York some areas are plunged into near anarchy by the so called war on drugs being waged on their streets, while others are almost untouched.

Incarceration also causes disability, just like disease, and is passed on to future generations, just like disease. The children of families where a member is incarcerated have a lower life expectancy and are six to seven times more likely to go to prison themselves.

Is cognitive therapy helpful in preventing at-risk people from becoming psychotic in the first place? Neuroskeptic isn’t convinced.

Check it out (image from here, coauthored by Graham Dunn, senior author of the present work.)

If you accept that, then it seems that literally the worst possible thing you could say to someone in the ‘at risk mental state’ is “Watch out! You’re at risk of going psychotic!” According to CT, exactly that line of thinking is the root of the whole problem.

The authors of this paper indeed write that “Key ingredients of the approach [include] a focus on normalising psychotic-like experience”. But who deemed them abnormal in the first place? The patient, all by themselves… or some well-meaning professional? It’s not clear.

We are told that the patients were “seeking help for symptoms”, but why? Of their own accord, or after someone else raised concerns? 45 people were referred to the study but excluded because they said that they didn’t want help. So there was at least some degree of professional ‘railroading’, driven by the idea that people with such symptoms ought to seek help

Iyou accept the CT account of psychosis, then I’d say you ought to think very seriously about whether this whole thing isn’t equivalent to giving everyone an X-ray to detect cancers. The X-rays might end up causing more tumours than they find.

Chaos and Control recently experienced an anxiety episode while on holiday in France. This resulted in a successful bout of self-help.

I decided to write a note to myself in my journal that 12 April 2012 was the date that I decided enough was enough. It then occurred to me that I had my Kindle with me. I didn’t need to remind myself of my decision to Sort This Out. Instead, I downloaded a copy of Overcoming Anxiety by Helen Kennerley. I skimmed the first part which reinforced what I already knew. My thoughts and fears were feeding off my physical state and these two things were in a perpetual cycle. Part two was quite helpful. It reinforced that I was already doing the right thing – deep breathing and so forth. What the book really helped me to do was put myself in the shoes of Mr P Jr and Mrs P. I was focusing on the Me Me Me aspect of things. What I hadn’t done was ask myself how I would react if Mrs P was visiting Happyville and was unwell. I doubt I would think anything of it. I would be sympathetic, after all, it’s horrible being unwell at the best of times, let alone when you’re away from home. In addition, a change of routine a day of travelling plus different water and food would cause many people to feel a bit queasy.

The anxiety spilled over a bit into the following day. I counted that on at least 6 different occasions I had to stop myself “what ifing?!” I reminded myself that no one knew I was having an internal meltdown. I just stood and breathed deeply and mindfully focused on my breath.

The rest of my holiday was fantastic. I ate loads of cheese and drank some excellent wine. My favourite evening was when we sat talking by an open fire. When we had put the world to rights we sat and read. While I was away, I managed to plough my way through Nurse, Nurse: A Student Nurse’s Story and An Unsuitable Job For a Woman. I’m about 70% through Quiet: The power of introverts in a world that can’t stop talking.

Although feeling anxious was really uncomfortable, I am glad that it happened. I have learnt that I can overcome this thing that has plauged me since I was a teenager. On a day-to-day basis, my anxiety has greatly reduced. In part, I credit the work that I did with Dr Partridge for this. In addition, I think the Sertraline that Dr Shrinky and Dr GeePee prescribed help too. The holiday was fantastic and my “arghghghghghs!” didn’t spoil it. Although I was only out in France for three full days, I felt like I was out there for much longer. I am relaxed, rested and ready to head back to work.

This Compassionate Life wonders if she might be not so neurotypical after all.

Anyway, while they were here I had a talk with my mother basically about being mental (one of many such talks we have had over the last twelve years!)  One of the things I told her during our talk was that I don’t naturally pick up on social cues. I don’t think those words had ever come out of my mouth before, but the minute I said them I knew I was speaking a truth.

To be honest, I find people befuddling- they often act in ways opposite to what I would expect, and a lot of the time I don’t know what behaviour to expect in a given situation, even if I know them very well. (I remain convinced that one of the major reasons that my husband and I managed to develop and maintain a close relationship despite all my social and relationship problems is that he is incredibly open and easy to read, much more than is the norm.) However, if you were to observe me in a social situation in which I was not racked with anxiety (say, at work), you would find me seamlessly interacting with people as if I had no problem picking up both their verbal and non-verbal cues. Here’s a secret: I only manage to function effectively around other people because I am constantly watching others- I am hyper-observant of other peoples’ behaviour in social situations in order to pick up on things that most would perceive effortlessly.

Through My Eyes: Adventures in Borderline Land has an insightful post on the emotional experience of borderline personality disorder.

People with Borderline Personality Disorder have an overly sensitive system, that is to say we tend to become distressed much easier than most people, become more distressed and have a harder time returning to our normal emotional baseline.  This emotional vulnerability can leave you in constant emotional pain, whether it be a dull ache, or agonizing pain (Ive experienced both and everywhere in between depending on the time in my life and the circumstances that went with it), that is constant.  It becomes almost intolerable, so any added pain, even very small things (which never feel like small things) can push you over the edge.

There are a few analogies and quotes that Ive read that I think describe what its like to live with BPD perfectly.

The Road to Recovery – Thoughts During the Journey describes coming out of a depressive episode.

The suicidal thoughts and feelings have lessened considerably since the last post, for now I only get them when I first wake up and its fleeting as by the time I’ve made myself a cup of tea they pass by.
So for now it appears the worst of this episode is over although the depression still has a firm grip and makes facing a new day unpleasant, I got so used to it though I barely notice it, that is until I need to make an effort then its anything from somewhat difficult to an ordeal depending on what I end up doing.
Why is the worst over? Not a lot has changed, in fact my circumstances have not changed and so it would seem odd I should feel a little better. There is two things I can point to, two small things at that but combined they replenish some of the emotional strength that gets sucked out during the episode.
Ron’s Rants takes issue with Ian Duncan-Smith.

Among much else to infuriate any normal person, he says this:-

“The Government’s Work Programme is designed to do just that, harnessing the knowledge of the best private and voluntary sector organisations and giving them freedom to tailor the support they offer to individuals’ needs.

We must also see work as a positive step on the journey to recovery, doing all we can to support those who can work into appropriate and productive employment.”

That is about as wrong as it could possibly be. I think the technical term is “pack of lies”. It might also be “bovine ordure”.

Work is NOT a positive step on the way to anything but disaster for many of those who are seriously mentally ill – or physically ill, as I know too well (every job I’ve had I lost through excessive sick leave).

Work, while desirable, is not always an achievable aim for those with mental illness, the stresses involved – often difficult enough for anyone who is mentally sound to deal with – would doubtless tip them into a crisis. Not everybody, you dumb bastard, rises to a challenge by digging deep into their reserves – many mentally ill people simply have no reserves.

For the Wildcard, let’s celebrate the YouTube video that helped kick off the #creepingsharia hashtag which so gloriously ridiculed the English Defence League’s Tommy Robinson.

About Zarathustra

Trained as a nurse, currently working in Child and Adolescent Mental Health Services (CAMHS). Co-editing the Not So Big Society blog. May possibly be an incorporeal being called Phil Dore. All views expressed are in a personal capacity and not necessarily the views of my employer.

4 Responses to “This Week in Mentalists – Creeping Hashtags Edition”

  1. great round up Z :)

  2. Thanks for the round up Z :)

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