Opening a window on the world

Every week for many years I have collected medication for my daughter and delivered it to wherever she was staying at the time, usually a room in a lodging house. The reason for a weekly rather than a monthly collection has been the prevention of suicide by overdose. Since I am still making these collections this, at least, has worked.

Over the years I have been a visitor at pharmacies in various parts of the city and have rubbed shoulders with junkies at all of them because that is where they go for methadone, which they swallow out of the public gaze in a discreet back room or booth. That way, the pharmacist knows it is being taken and cannot be sold on to third parties.

Being an early bird by nature I have met many junkies. Due to the urgency of their need many of them are early birds too. The methadone they take is used as an alternative to heroin but is also an opiate in its own right.

If you were in the right place at the right time you would see me mingling with the gentlemen in question at a quarter to nine and, who knows, might mistake me for one of them. Why not? I am there for drugs too.

Today as I was walking up the steep footpath from my daughter’s current flat, two of them met me on the way down. I heard them coming from some way off, as anyone with ears would have done. As they passed, one of them made me an offer.

‘Want some cheap steaks, mate?’

My guess is they had stolen the steaks with a view to selling them on to impoverished souls like me – an easy mistake to make since I am only well turned out on state occasions, which in my case never seem to arise.

What they would do with the money I can safely leave you to guess, but judging from the route they were taking they had liberated the steaks in question from Farmfoods or Lidl. How they did it I don’t know.

When I got up this morning I had no intention of dealing with life on the streets, but we are all at the mercy of events. Certain images stick in the mind whether we like it or not.

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Life imitating art

1
I recently published a novel called Time to Talk and today I find an article under the heading ‘Talking literally saved my life’. The story is about Jonny Benjamin, a mental health campaigner who has had ‘schizoaffective disorder’ – defined in the article as a combination of schizophrenia and depression.

A panel within the article is headed ‘It’s Time to Talk’. In it we learn that Time to Change is an anti-stigma programme run by leading mental health charities Mind and Rethink. Time to Change ‘is holding the first national Time To Talk Day’ with the aim of starting ‘a million conversations about mental health’. Good luck with that.

2
Last week I discovered that my narrator, Max, has found his way into a dissertation. In the likely event you think I’m making this up, the subject was resilience considered from a transactional analysis point of view and the method of questioning used with respondents was interpretative phenomenological analysis. (Don’t ask me, I just live here!)

3
According to several sources, one being the BBC News website, scientists from Sydney University have come to the view that shivering for 10-15 minutes a day could be equivalent to doing an hour of exercise. ‘They found that the process triggered hormonal changes producing brown fat – which burns energy to keep warm.’

In my forthcoming book, A Serious Business, one of the characters is already using this technique. ‘Ah yes,’ I hear you say, ‘but your book’s not out yet. Maybe art is copying life here?’ At this point I have to reveal that I finished the first draft in November  2006. Right, so what on earth have I been doing since then?

Revising. It’s a long story, but it’s shorter now.

Alice looked bemused. ‘And who came up with this one?’
‘Jefferson P Dangerfield, an America vet. You’ll find his recent best-seller in June’s drawer beside the biscuits: The Keep Cool Weight Loss Program, Homeostasis and Health.’

4
And finally, as they used to say introducing a ‘human interest’ story to round off the news, and finally I have to report that my character, Max Frei, has had a geranium named after him. It doesn’t get better than that.  Where’s your Nobel prize for literature now?

Geranium_'Max_Frei'_03

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Therapy and the lightbulb

1
How many psychotherapists does it take to change a lightbulb?
Only one, but the lightbulb has to want to change.

2
How many group therapists does it take to change a lightbulb?
None. Group therapy doesn’t change anything.

3
How many psychiatrists does it take to change a light bulb?
One, provided the lightbulb is fully compliant with all components of treatment. Otherwise, it’s the lightbulb’s fault that it doesn’t get changed.

4
How many clinical psychologists does it take to change a lightbulb?
Well, they’ll be able to change it quickly and efficiently, once they’ve figured out the correct DSM-V diagnosis. Until then, how do we know it needs changing?
(The DSM is the diagnostic ‘bible’ of the American Psychiatric Association)

5
How many depressed psych patients does it take to change a lightbulb?
Who cares?
____________________________________________________________________________

These are my favourites from a longer list of psychiatric lightbulb jokes posted by Dysthymia Bree. This is a link to her blog.

dysthhttp://tinyurl.com/pnpx4zl

The lure of hypnosis

Shortly after I published Time to Talk, which features a fictional therapist and several equally fictional examples of therapy, the offers arrived in my in-box. How could this be, I wondered, were the marketing people on to me already? Did the NSA have a hand in this, or GCHQ?

The first encouraged me to undertake an on-line course in CBT (Cognitive Behavioural Therapy) at a greatly reduced cost.

The second encouraged me to undertake an on-line course in hypnotherapy, also at a greatly reduced cost. I really wondered about the second. I was tempted. According to a therapist whose course I recently attended, I might have some talent in that direction, evidenced by an ability to put myself to sleep while waiting for dental treatment. (She called it ‘dissociation’ but I prefer to think I was hypnotising myself out of pain’s way.)

I then began to wonder how hypnosis could be taught and learned online. Would the student have a subject on screen whom he could then hypnotise with his honeyed tones, references to balmy breezes, ocean waves, cup cakes and so on? My mind was invaded by a series of cartoon images – I really wanted to give it a try.  ‘Hi, Mildred.’  ‘Hi, Rod.’  ‘About your credit card details . . . .’

I remember a Chuck Jones cartoon where Wile E Coyote tries to hynotise the Road Runner, but the Road Runner – prescient as always – has equipped himself with a mirror and bounces his hypnotic rays back into Coyote’s eyes. Coyote, holding out his arms in front of him, duly obliges by walking off the edge of a cliff.

Seriously though, do we think an online hypnotherapy course could work?

‘Today’s deal from the Hypnotherapy Centre of Excellence will give you the tools you need to become a hypnotherapist. With training from highly skilled professionals, two certificates upon completion, scripts to help with your sessions and marketing tips. •£39 (regular price £599) for an online hypnotherapy practitioner course •Includes full course materials, a course manual, hypnotherapy scripts, e-books, free monthly practice groups and ongoing help and support •Upon completion you’ll receive 2 certificates from the Hypnotherapy Centre of Excellence and IANLPC •You can also receive a third certificate from the Institute of Leadership & Management (ILM) for an additional cost •To view the course details please click here’

[A reblog of my previous , this time with a title]

A musical way to reduce stress

At a course I was on recently, I learned that when we breathe in our heart-rate increases and when we breathe out it decreases. So a useful technique for reducing stress is to exhale slowly following a sharp intake of breath.

It is possible to do this as an exercise, but I find it requires considerable discipline. So an obvious approach would be to play a wind instrument. Since I used to play the trombone, I considered that. But I no longer have one and, besides, people tend to notice when you’re playing. The trombone isn’t the quietest of instruments. On the other hand, it does require a fair bit of air to fill it, hence my present lung capacity.

So in theory, the best way to go about stress relief using a wind instrument would be to select one which requires a lot of air. And the obvious candidate would be – yes, you’ve got it! – the Sousaphone.

Sousaphone

Photo by TAZphotos via Flickr Creative Commons

Unfortunately I don’t have one of those either, and in any case the neighbours would notice that even more than the bone. Yet if only I had one what couldn’t I achieve? I could set up a tribute band playing old Temperance Seven numbers and call myself the Reverend Rod for purely promotional, as opposed to devotional purposes.

Leaving such fantasies aside, I think of the flute. It takes more air than you might think to play the flute since you need two flows of air – one into the instrument and the other across the mouthpiece. I used to have a flute but don’t any longer, so an alternative had to be found. I sashayed into various music shops till I located what I was looking for – a tin whistle, also known as a penny whistle. (Life being what it is, there isn’t an ounce of tin in it: it’s made of brass and costs a bit more than a penny.)

The whistle is small, but you can hold a note on it for a long time, hold several successive notes for a long time. It beats just breathing out. But – and there is always a ‘but’ – the whistle comes with a problem. A flute has keys, so closing holes as you play is fool-proof: let go of the key and the cap with its pad closes each hole and no air escapes. Perfection itself. But the whistle has no keys, so unless you cover each hole COMPLETELY with the appropriate finger it will – and does – emit horrible screeching noises. And covering each hole completely is harder than you might think, especially with the lower notes.

So now we have these ghastly noises and they have an effect – they increase your stress level. Well, that worked, didn’t it! But we learn to look on the bright side. You can’t win them all, but with practice you can surely win some.

If these are the symptoms, what is the condition?

These are not all of the symptoms, just some of them, but enough to be going on with.  And I am not making any of this up.

1) Stopping frequently in her tracks when walking along

2) Refusing to wear her glasses with the stated aim of reducing ‘sensory overload’

3) Frequently relieving herself in anything to hand despite having a toilet on the same floor (anything to hand including what you might be drinking from next)

4) Frequently thinking of suicide over a twenty year period

5) Mild self-harm

6) Often stated fear of not being able to communicate, so often with a pen and paper at the ready

7) Difficulty breathing which she attributes to panic attacks

I am asking in the hope of enlightenment, since an assessment is coming up which may result in compulsory treatment.

Right, but treatment for what?

Depression – a chemical imbalance in the brain

This well-known theory first gained currency in an article which appeared in The American Journal of Psychiatry in 1965. Was the chemical concerned serotonin? No, it was norepinephrine. The author himself, Joseph Schildkraut, described the theory as ‘at best a reductionist simplification’. He was right, and this is still the case today.

But accepting the theory for argument’s sake, let’s make a comparison. Let us suppose that Madeleine is having trouble with her thyroid gland. She is producing too little thyroxine  and so has a chemical imbalance. The extent of the imbalance is measured by blood test and she is prescribed synthetically produced thyroxine to correct it. The amount of thyroxine required is worked out by reference to Madeleine’s test results.

And now a second case. Albert is a worried man. He goes to his doctor and, after a short chat, the doctor concludes that he is suffering from depression. She then prescribes an SSRI (selective serotonin re-uptake inhibitor) which will correct the chemical imbalance in Albert’s brain.

But wait a minute, where is the test in this case? Madeleine was tested, why wasn’t Albert? How can the doctor know there is a chemical imbalance to correct without testing the chemical levels in Albert’s brain?

So, in prescribing an SSRI, the doctor is assuming:
–  That the chemical imbalance theory has solid evidence to support it
–   That Albert is one of those affected by a chemical imbalance and his ‘depression’ does not have some other cause
–   That the SSRI she prescribes, and in the quantity she is prescribing it, will correct this supposed imbalance

When it comes to the prescribing of anti-depressants, bold assumptions like these are now being made on an industrial scale.

[To be fair to the doctor, she errs on the side of caution when it comes to quantity, starting with a small dose of Albert’s SSRI and gradually increasing it: something she would not do with thyroxine, where she would know – as a consequence of testing – how much was required.]