Thursday, 8 March 2012


Dishonour and depression - BBC radio 4

Yasmin Khan made a sad and redemptive programme about mental distress among South Asian women. Rates of self harm among South Asian women are 31% compared to 18% in the general population. Sad statistics on rail suicide near Southall were also very telling – 1/3 were by women of South Asian origin. 

The women are often victims of domestic violence.  This abuse, coupled with uncertainty about their immigrant status, leads to distress and depression. Southall Black sisters provides a welcoming and supportive place for them to go. The worry about their status as immigrants is also added to by the fear of deportation back to their countries,  where divorcees can be at risk of honour killing (murder).


Newsnight special on new advances in treating mental illness
Much flagged up and much heralded. There was lots of jazzy content about scanning techniques improving how patients are ‘treated’ and using brain imaging and getting into the realms of ‘deep biology’. More from the molecular lot at Cardiff too, gamely bashing away to find gene susceptibility. Epigenetics is a fascinating and worthy field to explore, and diverts from the search for the elusive gene for mental distress (which I’m pretty sure will not be found).   But all pretty medical  and compared psychiatry to cardiology, reduced the whole concept of distress to imaging and bloodtests. I feel sad that the person themselves has disappeared in all this – what is basically neuroscience. And there’s not much room here for talk of recovery. Where is the holistic, the person’s narrative, the effect of experience on mood and behaviour? And finished with a great puff for….Ketamine, a much abused very dangerous street drug. K is seen now by US psychs (where else?) as the answer to severe clinical depression. Hmm. Jury firmly out on this one.

Inspired by Exhibition

Victoria and Albert Museum “Inspired By” Exhibition July 2011

‘Inspired By…’ is the Victoria and Albert’s Museum annual art, craft and design competition for students on part-time courses and is supported by NIACE, the National Institute of Continuing Education. It encourages entrants from diverse backgrounds and/ or different and mixed abilities to create a work of art inspired by an object in one of the museum’s collections. A friend took part in entering the exhibition, therefore invited me to attend although it was free of charge. 

I was honored to see the beautiful arts and unusual pieces! Not knowing where to start, sometimes I do get lost in certain places -  I guess being overwhelmed by people’s talents whilst observing such magnificent work! Martha Acorn Orbach -  a student at Camberwell College of Arts -  won the ‘Word and Image Prize’ as part of the part time Art foundation course. 

I really enjoyed the animation film as part of the drawings as well. Daphne Golding who made a ‘Chinese Zip’ Vase during her pottery and sculpture class at City College Peterborough was the winner of the ‘Access’ category and Diana Brothers won the ’Sculpture’ prize entitled ‘Being a Mother – It’s No Picnic’ during her Working with Glass class at the Creative Glass Guild. Siham

ESCAPING to the Highlands

Getting away from the run of the mill routine can really help with stress. Personally speaking, changing patterns, even for a brief period can help reduce stress. Though getting away is not always an easy thing. Sometimes it seems even getting to the local park can seem like such a struggle, let alone the coasts of England... let alone the plane flights abroad! Perhaps my days of long haul travelling our done, now with kids on boards. But getting away to Scotland proved to be a great respite, though it didn’t come cheap, when you add in the coast of a family train journey, the hire of a car to negotiate the open lanscapes of north west scotland, and of course, the hiring of a cottage on top. No wonder a trip to Scotland can seem like a trip to deepest congo, the logistics involved seem equally demanding.

Having never been to Scotland before, I looked forward to the experience, of course I’d always known of the mountainous ranges, had read of the Cairnghorms, and had always seen the typical highland paintings with the sublime, romantic dear, antlers aloft, staring out towards misty peaks.

A tiny flat, two children, the cramped conditions, it eats away at you, your vision can become narrow, blinkered, you lose the expansive perspective which allows the spirit to thrive, Perhaps we’re just not designed to live like pent-up rabbits, and yet so often we hear of the stressful lives of rural people, the isolation, the unemployent, perhaps there is nowhere that is particular fruitful for the spirit – other than change itself. Perhaps the spirit tires of the familiar, while it fails to stimulate, and yet a time away, AND ON RETURN, it can do just that.

Leaving our flat was a blessing, and yet returning to our flat was equally a blessing. in time, wherever you set up stock, perhaps it will always accrue the mediocrities of every day life. A change is like a honeymoon period away from stress. But when the honeymoon period is up, its time for change! Though this might suggest we’re to live our lives in a state of constant flux. And yet why not? When did we get to be so permanent? When did we lose that nomadic wandering aspect of our nature? And yet we are creatures of comfort, of familiarity. And so getting back to a cramped apartment can still seem like a breath of fresh air.

Scotland was a great break, living by the coast, a little finger on the map, Portmahomack. A tiny harbour, small population, in fact a dwindling population as the aspitational youth head off to the fastest growing city in Britain, the heady heights of Inverness. But Portmahomack, local fishermen, no more than five tiny boats, seemed enough.

We approached a fishermen who’d just brought his crab pots in, asking to buy one, but no need, not at all, he simply gave us two huge live crabs. And what to do with them! Boil them alive? smash open the carapace?… and do what? Simple, ask the neighbouring chap, Scottie, a fishermen of old, who pops rounds, cooks and prepares both crabs – while we pathetically watch on with relief.

And from the tiny harbour, we clamber into our hired car, seven of us in total, heading off to the Cairngorms, famed peaks of many a climber. And yet the funicular train did all the work, took us to just below the summit, to the highest restaurant in the UK. Not quite Sherpa Tensing tales, huddled together over hot chocolate enjoying the views through glass panes.  I clambered over the forbidden exit to climb the last leg, perhaps and hour or so, to get to the very summit. In my own small way, going the extra mile, getting that extra bit of stimulation. And up there on the peak, like Kerouac on Desolation Mountain, I dreamed out over the horizon, alone, and breathing in the freshest air imaginable, enjoying the peace, the respite, the stimulation of change.

Nigel Prestatyn

Art therapy programme

A whole edition of the Culture Show on BBC2 was devoted to Combat Stress’ art therapy programme aired on November 11th.

With the lack of military hospitals, many veterans are turning to charities for help. One is using the unlikely weapon of art the help fight the psychological wounds of war, while another organisation is actively encouraging artwork in the army. Outside of the NHS, the charity Combat Stress is the biggest provider of support to armed forces veterans with conditions such as post-traumatic stress disorder (PTSD), depression and anxiety. Art therapy is one of the treatments it uses. Drawing, sculpting and painting are helping patients manage their symptoms with great success. “Traumatic memories take a different path from our normal memories and tend to be frozen in the body in the central nervous system,” explains Janice Lobban, who has been a trauma therapist at Combat Stress for the past 10 years. “When a trauma happens, the person will react to get through the experience, but it leaves the trauma unprocessed. A person might then get a sensory memory like a sound, or sight, or smell, that is reminiscent of the trauma and they re-experience it happening again.” Sessions begin with a quick creative session to get thoughts and images down on paper. Art therapy, therefore, aims to help people express themselves unconsciously and process the meaning afterwards.

Group sessions typically begin with the therapist giving a one or two word brief to inspire creativity before veterans are given a selection of materials for painting, modelling or writing. After 45 minutes of quick work, the group then get together to talk about and describe what they’ve just created.

Veteran Richard Kidgell ex RAF with his finished artwork inspired by an art therapy session.
Although many of the veterans who try the therapy may never have had any interest in art before, there are some servicemen who actively pursue the craft and use it to reflect their experiences.

The Army Arts Society, set up by war artist Linda Kitson after the Falklands War, promotes and supports arts and crafts within the British Army - working with serving military, those who have retired and even their dependants. One of its latest initiatives is to provide operational art packs to troops - the first 20 of which went out to Afghanistan in September. “Art is a way of keeping some people sane,” says committee member Francesca Bex, herself a painter and the wife of a bomb disposal expert. “The packs can give soldiers an alternative. A lot of them watch awful films when they have down time and art can give some a different option.”

Painting gave Nick Hendry something to aim for after becoming injured during his service. Nick Hendry won the Serving War Artist of the Year award for his watercolour, Deliberation. Nick says art has been invaluable in giving him something to aim for again: “I was struggling trying to justify everything, but as soon as I get hold of a paintbrush it takes my mind off some really bad thoughts and focuses my mind on one thing.”

He fully supports the operational art pack initiative. During his time in the army, he says there was no outlet for art - unlike the more traditional pastimes of rugby or football.

Richard Kidgell agrees it’s a good idea to give soldiers the opportunity to process what they are experiencing on a tour of duty. Potentially, it can allow the military to spot the symptoms of PTSD early.

“But even for the minority who will grasp the idea, the benefits for catching those people at an early stage and giving them a chance to vent will be brilliant.” Text from


I was eager to read this – what a subject! What a brief! How can anyone know what madness is, especially someone who is not an expert by experience? I have been mad and am no longer; who’s to say they could have looked into my psyche and read and understood what I was thinking or feeling or how I was interpreting the world?  For all the brain scans that are touted now as diagnostic tools, madness is elusive, particular , peculiar and totally individual – and anyone not mad will have to base their assumptions on anecdotal evidence…

To give Darien Leader a break, he is not a psychiatrist, which is a relief. To his disadvantage, he is a Lacanian psychoanalyst; thus the whole book is slathered with factor 50 Lacan which makes it very hard to scrape away to the bare flesh underneath.

The very great Gail Hornstein set out to understand the meaning of madness in Agnes’ Jacket, which is a must-read as a balance to this. She is a psychologist, thus has a much enhanced and less culty vantage point. Through wonderfully vivid tales, first –person interviews and a detective style, she gets there in the closest way possible without being mad herself.  I must admit to a suspicion of psychoanalysis,  though admire the movement for pushing the talking cure. Much of Freud’s fringier theories have been debunked and are seen as almost laughable, and his denouncement of his finding that abuse leads to mental distress still horrifies.  The five-times-a-week grip that analysis often holds over its clients is surely outdated, unproven and wrong as a successful technique. Feminists have deconstructed psychoanalysis and found it deeply wanting.

However, Leader has a refreshing take on mental ‘illness’  and does not believe that distress is an illness to be chemically treated.  He sees creativity in some aspects of psychosis, and reads into mental ‘illness’ an attempt to ‘respond to and elaborate..difficulties’. He also acknowledges the huge potential for recovery,  set against the depressing prevalence of the ‘science’ led clinicians’ doom and gloom scenarios as told to many patients today.

What he deals with mainly is what he calls the ‘discreet psychoses’ – subtle, reserved madness – those who are paranoid without developing breakdown or crisis,  He cites Bleuler’s theory that the most common form of schizophrenia was latent ‘subtle, reserved madness’ also called ‘everyday psychosis’.

He is refreshingly candid about the damage done by 20th century ‘treatments’ – from insulin coma to shock to knockout pharmaceuticals.He interrogates DSM and finds it severely wanting. He aims to understand delusions as a way of understanding one’s experiences. When Leader introduces basic psychoanalytic ideas – including mirrors, symbols,  reformed Oedipus complexes , paternal metaphors, the Other, localization of libido, phallic lenses etc I started to lose the will to continue the book, I’m afraid. I felt like a nonbeliever being bashed on the head by a fervent proselytiser. I ploughed on though and there was enough to engage with. 

He examines the meaningless and confusion of trying to diagnose ‘schizophrenia’. He seems more at ease describing paranoia and the paranoid delusion. He delves into language and psychosis, and the logic of it (the Other is always walking beside..). He visits diagnosis again, and foregrounds startling moments in the lives of those who developed unshakeable beliefs or delusional ideas,  such thinking random people were their real parents.

He is brave enough to tackle causes of psychosis – a field littered with IEDs. He acknowledges the vogue for genes and biological explanations that predominates now,  and successfully busts it theoretically. He dwells on the parents shaping a child’s early life and perhaps seeding later psychosis. Its all rather muddied with Lancanography, but there’s some sound stuff. Not enough about the effects of the overwhelming stress of early abuse, loss and trauma though. 
His filtered look at madness deals essentially with the ‘quiet psychoses’, the world he mainly comes across.  He does not deal much at all with the ‘louder’ psychoses – ‘schizophrenia’, bipolar disorder/manic depression or severe depression.  He revisits the Wolf Man story and rubs on the magic lamp of  Lacan way too often in mid book.

His chapter on Shipman is revealing and frightening, and highlights the equation of madness and normality. Shipman, later revealed to have murdered over 200 people, was sought out as a GP by many people. Leader is careful and considered and delves sagely into Shipman’s past to try and gain answers. 

‘The diagnosis here is not ‘ pure evil’ but paranoia; he occupied the place of an exception, and was committed to imposing his own knowledge on the world around him, which he deemed contained a fault’.

His final chapter Working with Psychosis could be used to inform and educate a lot of the medical-modellers in psychiatry – listen, take note, believe, hear properly, and trust. Celebrate psychosis’ creative side  - encourage and facilitate communication. ‘Create a safe space in which to live’.

Emergence Plus Exhibition

Emergence Plus has organised alongside Whitechapel Gallery some attractive exhibition that I went along to. I was really looking forward to it as I haven’t managed to attend a number of their events for sometime... Daniel Lehan, an artist at the Gallery patiently talked us through the whole of the exhibition; looking at one of the spectacular painting by Wilhem Sasnal (a young boy sitting on the edge of a lake) inspired by Georges Seurat’s work Bathers at Asnieres (1884) Daniel clearly demonstrated plenty of knowledge in the subject of Arts and most of all made the whole show quite appealing. 

As his approach towards people was open and friendly; many felt at ease in sharing their views and asking questions.  Whilst following the tour, I noticed some newcomers and tried to interact with as many as I could. A graphic painting by the the same artist illustrated a camp concentration image; using mainly black colours of a high up bunk bed and a high crossed fence with a white background, it personally associated the painting with lots of darkness and sadness.  Unfortunately, I was unable to take any photos... 

Despite several stunning and beautiful paintings all around the Gallery, there was a particular one that really amazed my curiosity; it portrayed David Bowie standing between many thoughts... a pair of lungs?  A pair of ears or an apple for some! My straight symbolic perception of it was a heart divided with different  kinds of love ... The exhibition was accompanied by Sasnal’s acclaimed shorts and feature films screened as part of the events programme. Also, the show was followed by the Government Art Collection display of various artists work.  

Finally, Daniel invited us all for some tea and tempting chocolates biscuits whilst still showing interest in what the group individually thought and or any comments they would have liked to share. There was this genuine awareness of such a warm atmosphere throughout the whole event! It makes you and truly made me realise how important deep within that happiness doesn’t just come - we make it happen! And one of the keys is being open to others and acknowledges their presence. Siham

TUKES: Guardian public services award

Congratulations to TUKES winners of the Guardian public services award for service delivery: complex needs. This sounds a solid and brilliant scheme which is a social enterprise named after William Tuke , 18 c Quaker founder of the Retreat hospital in York, who believed in encouraging mental health patients to play an active role. 

It’s based at Harrison House, Grimsby, an acute mental health facility, and Tukes staff do all the cleaning catering and laundry and manage a cafĂ© open to the public. They do the grounds work , building maintenance and reception work.  The work is carried out by a mix of paid staff( many with mental health issues,)and unpaid members form Harrison House. The structure allows people to be involved at any stage of their illness, including acute.

They are doing increasing amounts of community work too – managing a charity shop, running three cafes, and doing individual gardening and painting jobs.

General manager John Ogden:

‘Everyone looks after each other. Because most people have had their own problems they understand others problems we see people who are shy, timid and lacking in confidence, and suddenly they are managing one of the cafes or cleaning team or taking charge of the buffet. 

We’ve found a simple recipe of giving people a role and making them feel good about themselves, and that can do so much good for them’.

Utopia alert: Mindblowingly simple and hugely effective. Some of the older asylums offered this sort of rehab to their patients, with very good effect. And somehow it got washed away by the 20th c desperate rush to drug and write off too many people. This model should be adopted everywhere!

Maltreated children show same pattern of brain activity as combat soldiers

Children exposed to family violence show the same pattern of activity in their brains as soldiers exposed to combat, new research has shown. 

In the first functional MRI brain scan study to investigate the impact of physical abuse and domestic violence on children, scientists at UCL in collaboration with the Anna Freud Centre, found that exposure to family violence was associated with increased brain activity in two specific brain areas (the anterior insula and the amygdala) when children viewed pictures of angry faces.

The authors suggest that both maltreated children and soldiers may have adapted to be ‘hyper-aware’of danger in their environment.
However, the anterior insula and amygdala are also areas of the brain implicated in anxiety disorders. Neural adaptation in these regions may help explain why children exposed to family violence are at greater risk of developing anxiety problems later in life.

Dr Eamon McCrory, lead author from the UCL Division of Psychology and Language Sciences and the Anna Freud Centre, said: “All the children studied were healthy and none were suffering from a mental health problem. What we have shown is that exposure to family violence is associated with altered brain functioning in the absence of psychiatric symptoms and that these alterations may represent an underlying neural risk factor. We suggest these changes may be adaptive for the child in the short term but may increase longer term risk”.

In the study, which is published in the journal Current Biology, 43 children had their brains scanned using an fMRI scanner. 20 children who had been exposed to documented violence at home were compared with 23 matched peers who had not experienced family violence. The average age of the maltreated children was 12 years old and they had all been referred to local social services in London.
When the children were in the scanner they were presented with pictures of male and female faces showing sad, calm or angry expressions. The children had only to decide if the face was male or female – processing the emotion on the face was incidental. As described, the children who had been exposed to violence at home showed increased brain activity in the anterior insula and amygdala in response to the angry faces.

Professor Peter Fonagy, Chief Executive of the Anna Freud Centre and professor of psychology at UCL, said: “Dr McCrory’s groundbreaking research has undoubtedly taken us an important step closer to understanding the devastation which exposing children to violence can leave in its wake. His exciting findings confirm the traumatic effects these eeriences have on brain development. 

Professor Fonagy added: “The report should energize clinicians and social workers to double their efforts to safeguard children from violence. 

The research was funded by the Economic and 
Social Research Council.


M s. Myrick, 50, the chief executive of a nonprofit organization, who has a diagnosis of schizoaffective disorder, a close cousin of schizophrenia, and obsessive-compulsive disorder. “I needed to hide out, to be away for a while. I wanted to pamper myself — room service, great food, fluffy pillows, all that — and I was lucky to have a therapist who understood what was going on and went with it.”

Researchers have conducted more than 100,000 studies on schizophrenia since its symptoms were first characterized. They have tested patients’ blood. They have analyzed their genes. They have measured perceptual skills, I.Q. and memory, and have tried perhaps thousands of drug treatments. Now, a group of people with the diagnosis is showing researchers a previously hidden dimension of the story: how the disorder can be managed while people build full, successful lives. The continuing study — a joint project of the University of California, Los Angeles; the University of Southern California; and the Department of Veterans Affairs — follows a group of 20 people with the diagnosis, including two doctors, a lawyer and a chief executive, Ms. Myrick.
The study has already forced its authors to discard some of their assumptions about living with schizophrenia. “It’s just embarrassing,” said Dr. Stephen R. Marder, director of the psychosis section at U.C.L.A.’s Semel Institute for Neuroscience and Human Behavior, a psychiatrist with the V.A. Greater Los Angeles Healthcare System and one of the authors of the study. 

“For years, we as psychiatrists have been telling people with a diagnosis what to expect; we’ve been telling them who they are, how to change their lives — and it was bad information” for many people.

No more so, perhaps, than for Ms. Myrick, who after years of devastating mental trials learned that she needed a high-profile position, not a low-key one, to face down her spells of paranoia and despair. Her treatment regimen, like most others’ in the study, is a combination of medication as needed and personal supports, including an intuitive pet dog, the occasional weekend stay at a luxury hotel — and, not least, a strong alliance with a local psychiatrist.

From The New York Times October 2011

Mind Journeys Exhibition with Exposure

Bruce Castle museum had a fantastic art exhibition representing young people and their own personal experiences with mental health. All of the art work has been created by those young people. Also, there were a series of short films recalling times of difficulties to cope with life and how it has affected them for various reasons. It has enables many to build their confidence through those projects as they somehow manage their mental health condition better. 

In one of the video’s Takeo imagines himself as a Japanese warrior. The music theme of the film is quiet soothing and peaceful, although he seems struggling a battle… 

Vicky’s endured psychological problems due to bullying. She felt isolated and suicidal; it has affected her confidence although she has achieved good GCSE grades. Vicky’s short video was moving and impressive!

All of the short films were great to watch and inspiring. However, one of my favourite portrayed with three different young people experiencing traumatic events following the use of drugs and drinking alcohol was quiet moving and intense. It pictured perfectly well how often it could affect anyone mental state to struggle with problems in life i.e. relationships and their difficulties, some issues that become addiction, one’s admission to hospital.

 In fact it makes you think and wonder why it can be so painful and devastating for anyone to go through anything like it. Quite often, many young people will find secondary school challenging as they discover they are entering the beginning phase of adulthood in a way; as they start to experience various and complex challenges to deal with which can have an impact on their well being at a later stage.

Siham Beleh 

What next for mental health Admissions

According to the Haringey independent NHS. bosses met on Thursday 1.12.2011 and planned to withdraw funding for the Alexandra Road centre.  This leaves the council who manage the day to day running of the centre no choice but to close it down. As most people are aware plans are in the pipeline to close the remaining wards at St, Ann’s and the idea being to open “new recovery units” in the borough which according to Haringey NHS. will better the needs of patients as the units will be more local? They add that recovery units in Barnet and Enfield will be available for Haringey residents. This means if it is decided you need a bed in a recovery unit and not in Chase Farm hospital you are not guaranteed a place in the “new Haringey recovery units”

Those patients who need acute care will in the future have to go to Chase Farm Hospital Enfield. This undermines the argument put forward by Haringey mental health trust that its actions are in the best interests of patients. Surely patients who are in a more severe i.e., acute condition need more they anyone the support of family and friends. Moving to chase farm will not facilitate this taking into consideration the cost, and the time it will take to get there, a journey of at least seven miles from the centre of Haringey and not serviced by an underground station.

The closure of Alexandra road and the proposed closure of St Ann’s leave people in the mental health system no idea what the future holds. This along with other developments such as the cutbacks in funding for day centres like the Clarendon gives the impression the council and the mental health services in Haringey have launched an aggressive policy against one of the most vulnerable groups in the community who are in no position to fight back. Major cutbacks in the area of mental health are a soft option and an example of the onward march of a more inhumane society.  Michael