Posts Tagged ‘Mental health’

I generally write a short reflection for our (Cliftonville Moravian Church) newsletter. Here is the May instalment:

Quite a few years ago now, when I travelled extensively with work, I would often pick up items of interest from the countries, town or cities I visited.  One of my favourite items is a Malaysian painted face mask I bought whilst visiting the Johor Bahru region, a few miles across the causeway from Singapore.

These masks, I later found out, were historically tribal attire that was used in a range of ceremonies, in addition to decorating homes.  I was struck by the intricacies of the hand-painted design and the beautiful mixture of vibrant colours that really brought an inanimate object to life.

And so this ‘souvenir’ sits proudly on a display shelf in my sitting room; the colours catch my eye each and every time in walk in to the room.  It is a welcoming face that reminds me of an earlier period in my life, filled with travel and the joy of learning about new and diverse cultures, some of which are significantly different to our own.

The mask is an item known to many cultures throughout antiquity.  In our own contemporary society, we frequently ‘put on a mask’, although in a metaphorical sense. We hide our true emotions behind that mask, which can be multifaceted and every changing, but however it manifests itself, it always has a spiritual dimension at its core.

How many times, I wonder, do we hide our true emotions behind a smile or an upbeat demeanour?  How often, do we say ‘I’m fine’, when the truth is somewhat different, or even radically different – when we are struggling to cope with a painful life event or series of perceived failures? Or what about those instances when we wrestle with a spiritual malaise that there seems to be no answer to?

In truth, we can never really tell at first glance whether or not the facade is real or forced; it can take some time to unearth emotional turmoil and pain bubbling underneath the surface.  And that is why we need to take to heart that aphorism attributed, sometimes to Plato, but by others to John Watson: ‘Be kind; everyone you meet is fighting a hard battle’. How hard that battle actually is we can only guess at, in each individual we meet, from an emotional and physical distance.

As a therapist I see people from all walks of life; many exhibit an outward demeanour of confidence and contentment with life, but behind the mask, constructed to please others, or even to convince themselves, there is much suffering and pain, struggling to find an outlet.  As a Minister I know that those who care for others are sometimes the hardest hit and feel under the most pressure to retreat beneath the facade they have either carefully constructed and cultivated, or has been projected on to them.

But society is changing, and I would contend, very much for the better.  No doubt you are aware that recently, in their quest to encourage us all to tackle the stigma and prejudice that still sadly accompanies mental illness, the new generation of the royal family have been very proactive in encouraging us all to step from behind the facade and to talk openly of our emotions.  That can only be a good thing, for individuals, but also for wider society. The typical ‘stiff upper lip’ approach of our culture has been advantageous in displaying fortitude and Stoicism, but leaves us ill-prepared to deal with the emotional health and wellbeing of ourselves and others.

As a community of faith, we should be especially alert to these messages of openness and honesty.  After all, Jesus himself was a master of seeing beyond the facade and engaging with the real person behind it.  When we consider those many awe-inspiring and life-changing encounters he had in his earthly ministry – reaching out and touching the spiritual core of those on the margins.  We read of a Jesus who could see the pain of the Samaritan woman, the struggles sick man at the Pool of Bethesda, and the spiritual distress of the woman who was haemorrhaging and ostracised from her community.

Also as a community of faith, we are reminded in an equally important manner of the Jesus who saw beyond the legalistic and pious mask of the Pharisees, and found within a dearth of spiritual connectedness with the God of grace and love for all.

So what do we do?  Where do we go from here?  Well, it is no small step to admit our vulnerability, to each other as a loving, Christian community; it is no small step to open up and admit when we need help or support, emotional or otherwise.  It can be hard too, to see those around us in the light of their own struggles.  Remember those words of the famous Lutheran Minister, Dietrich Bonhoeffer, who wrote in his book ‘The Cost of Discipleship’:  “Suffering, then, is the badge of true discipleship. The disciple is not above his master. Following Christ means passio passiva, suffering because we have to suffer.”  And I would add, not being ashamed to own that suffering and to let others enter into our emotional and spiritual lives to share in all that we go through; we can only do that by ridding ourselves of the ‘all is well’ mask.

Dietrich Bonhoeffer

Bonhoeffer did of course put this more poetically than I ever could, when he observed: We must learn to regard people less in light of what they do or omit to do, and more in the light of what they suffer.” And we can only do that when we begin to chip away at that facade and reveal our true selves to those we live in community with, and to live honestly in the light of God’s love.

We all have burdens that we carry – some less significant and disabling that others – but they are burdens nonetheless that prompt us to turn to God.  We all know those immensely powerful words, uttered by Jesus and recorded in Matthew 11:28, “Come to me, all you who are weary and burdened, and I will give you rest”.

But as we turn to God, we need to be cognizant of the fact that he works through others in their vulnerability, and opens us up to new possibilities through our vulnerability.  Here, I want to finish this short reflection with the words of Teresa of Avila:

“Christ has no body now on earth but yours,
no hands but yours,
no feet but yours,
Yours are the eyes through which to look out
Christ’s compassion to the world
Yours are the feet with which he is to go about
doing good;
Yours are the hands with which he is to bless men now.”

So I look now at my magnificent souvenir mask, as an object of beauty and a reminder of new cultural vistas explored, but also as an aide memoire that the mask is not always meant to be worn – the contours of our true selves is infinitely more cherished and loved by God than any facade we may construct.

Every blessing, Scott

Friday past marked Holocaust Memorial Day in the UK, and the International Holocaust Memorial Day across the globe. Each year people come together, from across religious and cultural divides to remember the genocides that have scarred humanity deeply and irrevocably.

mental-health-foundation-holocaust

Many moving commemorative events have taken place; some have been very public events, whilst others have been very private.  I watched Auschwitz survivors gather at the former camp in Poland on the 72nd anniversary of its liberation, and I marvelled at the stoicism and dignity of those elderly survivors.  Having visited Auschwitz several years ago – an experience that I will never forget – I simply cannot understand why seemingly ordinary people can inflict such horrors upon their fellow human beings.  But then darkness and unfathomable cruelty are part of our collective human nature; for those that committed such atrocities, I am reminded of Proverbs 6:18 where it is written that there are those with ‘a heart that devises wicked plans, feet that run rapidly to evil’.

We now know the staggering statistics for the Holocaust, where six million Jewish men, women and children were murdered in ghettos, mass-shootings, in forced work camps and extermination camps. The scale of the suffering was, and still is, incomprehensible.

There were other groups of people that were persecuted and murdered by the Nazis.  Consider political opponents, priests, ministers, Jehovah’s Witnesses, Gypsy people, Slavic people and gay people amongst others.  But there is one group that is sometimes overlooked: the mentally ill.

The Mental Health Foundation website published a powerful article to remind us that those with psychiatric conditions were deemed, in that most egregious of phrases, to be ‘life unworthy of life.’  The prevailing eugenic ideology in Nazi circles was driven by defective science and woeful ignorance.  The consequence of this was that an estimated quarter of a million people living with varying degrees of mental illness were murdered. That few people spoke up against this outrageous programme is chilling.

As we reflect on the voiceless and the persecuted, the question of speaking up and speaking out against injustice comes to mind.  As the Holocaust Survivor and Author Elie Wisel once wrote: ‘There may be times when we are powerless to prevent injustice, but there must never be a time when we fail to protest’. This maxim is applicable today as it was before and during the Holocaust. Our world does not want for examples of injustice and persecution; it is therefore our duty as Christians to raise our voices, to challenge and cajole, and to remain informed and vigilant as to what is going on, on our doorsteps and in the world around us.

Every blessing,

Scott

Prof. Jim Lucey, Medical Director at St. Patrick’s Mental Health Services and Clinical Professor of Psychiatry at Trinity College Dublin, has more than twenty five years’ experience in his field of specialisation.

Lucey has used this experience to pen a thoughtful and compassionate look at the varied experience of some of the patients he has encountered. Coalescing around the themes of experience, worth, freedom, memory, truth, balance, hope and possibilities, he explores individual stories, and pieces together complex narratives with a view to understanding and facilitating recovery.

In My Room

At the outset, Prof. Lucey sets out the conceptual framework around which he practices medicine.  He writes: ‘psychological medicine has no role in directing anyone along any specific philosophical route or towards any specific response to the personal challenge of existence’. Whilst I very much agree that it is never the place of the physician to dispense spiritual advice, it has to be acknowledged that each form of psychological intervention, from CBT to logotherapy, and from psychoanalytic psychotherapy to individual psychology, is underpinned by a specific psychological worldview.  Consider Viktor Frankl’s logotherapy where the ‘will to meaning’ is at the fore; contrast this with Freud’s psychoanalysis where the ‘will to pleasure’ underpins the therapeutic theory.

Notwithstanding minor differences in semantics, Prof. Lucey understands exactly what it means to be a patient.  He very perceptively writes: ‘to be a patient describes an experience that deserves respect.  We will all be patients at some stage and this is part of what it is to be alive’.

Depression, anxiety, self-harm, OCD, suicide and other issues are explored through the lens of his patients.  The pain is obvious in each individual, but crucially so too is the will to wellness and the capacity to recover. And if you’re not sure about some of the medical terms, the author has included an excellent jargon-free summary in the notes section at the end of the book.

Prof. Lucey does a superb job of dispelling the myths that all-too-frequently surround mental illness.  Shockingly, Lucey writes this of his own institution’s findings:

‘In 2013 St. Patrick’s Mental Health Services published some disturbing findings from its own nationwide survey of attitudes to mental health disorder in Ireland.  Over one-fifth of people surveyed believed that those suffering from mental health problems are below average intelligence and 31 per cent of respondents revealed that they would not accept someone with a mental health disorder as a close friend. It was discovered that 62 per cent would discriminate against hiring someone with a history of mental illness on the grounds that they would be unreliable, and 42 per cent believed that undergoing treatment for a mental health disorder is a sign of personal failure’.

That this degree of ignorance and prejudice still exists in a modern society is deeply worrying.  And that is why Prof. Lucey’s book makes such a valuable contribution; it is very well written and one senses that author’s deep concern and sensitivity for those in his care. In describing ‘ordinary’ people dealing with mental ill health, Prof. Lucey does an enormous amount to normalise our perception of mental illness and to see his patients just as they are – just like any other person, but with the added burden of living with a complicated condition.

Recovery is very much possible, as attested to by Prof. Lucey’s clinical experience.  With the right blend of medication, therapy and psycho-social intervention, recovery is achievable, although it does of course look different for each patient.  Lucey demonstrates that Psychiatry is very much an art as well as a science and understanding individuals, their circumstances, drivers and aspirations are as important as prescribing medication.

And before I forget, there is another aspect of the book that I really like – Prof. Lucey uses poetry at the end of the chapter.  By referring to Emily Dickinson, Robert Herrick, Philip Larkin, Seamus Heaney and other such literary luminaries, Lucey adds to the poignancy of his case studies and encourages reflection. It really does round off the book beautifully.

I thoroughly recommend this book to anyone who lives with mental illness, those who treat them and to the wider population looking to understand a phenomenon that is still shrouded in too much mystery, misunderstanding and prejudice.

The mental health provision in North Korea is truly shocking.  In my bipolar blog – ‘an uneasy awakening’ I explore some of the issues that confront those struggling with mental illness in this isolated country.

Bipolar In North Korea: A Frightening Prospect?.

Vikram Patel MSc MRCPsych PhD FMedSci is Professor of International Mental Health & Wellcome Trust Senior Research Fellow at the London School of Hygiene and Tropical Medicine.

In his recent TED talk, Patel presents the shocking statistic that nearly 450 million people are affected by mental illness worldwide.  In wealthy nations, just half receive appropriate care, but in developing countries, close to 90 percent go untreated because psychiatrists and associated mental health professionals are in such short supply.

The situation in the developing world calls for a novel and radical approach.  In his talk, Patel outlines a highly promising approach — training members of communities to give mental health interventions, empowering ordinary people to care for others. Studies have shown that such interventions have positive outcomes and are highly effective mode of care delivery.  Patel calls this the ‘democratization of medical knowledge’, a concept he also advocates for the developed world, albeit in a modified form.

You can watch Prof. Patel’s short presentation below:

Bipolar disorder can cause suicidal ideation that leads to suicide attempts.  The statistics show that one out of three people with bipolar disorder have either attempted suicide at some point, or have been successful in taking their own lives. With an annual average suicide rate of 0.4%, bipolar sufferers are 10 to 20 times more likely to attempt suicide than the general population.

Suicide is devastating for all involved, and that’s why this short Channel 4 documentary – ‘One Under’ – is so poignant.   In examining the impact of suicide on the London underground, tube drivers give poignant and moving first-hand accounts of their experiences of what is colloquially known as a ‘one under’.

Suicide is too important an issue to be swept under the carpet and not spoken about.  This film is important in that it shows the impact suicide can have, not just on families, but also on those whose lives are changed forever in the blink of an eye.

Talking Suicide – Another Perspective.

As I’ve made reference to in the last number of postings, as part of my treatment, I’ve engaged in some ‘art therapy’ where I attempt to express my emotions without words.  For some reason, the end result tends to be what could loosely be termed as ‘abstract art’; I’m not quite sure why that’s the case with me!  Anyway, here are my latest drawings – a ‘trinity’ of faces, each with different thoughts running through their minds; I’ve collectively called it ‘The Three Faces of Bipolar Disorder’ and uploaded it to my bipolar blog (An Uneasy Awakening).  I hope it makes sense!

via The Three Faces of Bipolar Disorder.

This graphic (courtesy of NAMI) speaks for itself:

Flight from Darkness‘ is an excellent documentary on bipolar disorder.  Charting the Canadian mathematician Percy Paul’s battles with the debilitating symptoms of bipolar disorder, the film-maker presents an intelligent, well-balanced and informative overview of the course of one man’s illness.

The protagonist in the film is a very bright, articulate, well-educated and compassionate character.  He talks candidly about his struggles with alcohol abuse, suicide attempts and relationship difficulties.  The film accompanies Percy through periods of mania, depression and relative wellness and in doing so brings to the fore the difficulties faced by bipolar patients in attempting to lead a normal and productive life.  Percy’s main downfall appears to be his inability to consistently take his medication; the devastating results of his failure to do so are glaringly obvious to the outsider looking into his often chaotic and disordered life.

What shines through though, is Percy’s love for his children (who live with his ex-wife) and the existence of a network of family that care very much for his well-being, but that are often at a loss to help.  Such a feeling of helplessness will no doubt resonate profoundly with many carers who live with a loved one who is afflicted by this complicated and often misunderstood disease.

Percy is an incredibly talented individual – a trait that seems to be rather common in bipolar disorder sufferers and a topic that has been exhaustively researched by the psychologist Prof. Kay Redfield Jamison, and persuasively presented in her magnificent book, ‘Touched with Fire: Manic-Depressive Illness and the Artistic Temperament‘. A bipolar sufferer herself, Redfield Jamison is featured in a ‘Flight from Darkness‘ discussing an illness that she knows intimately.

This film is a ‘must see’ for anyone who suffers from bipolar disorder, their carers, family, friends and employers.  You can watch the full-length documentary here, courtesy of youtube:

McAleese makes plea over suicide – Republic of Ireland, Local & National – Belfasttelegraph.co.uk.

Once again, Mary McAleese reminds us that as outgoing President of the RoI, she’ll be a hard act to follow.  In this piece in the Belfast Telegraph, McAleese laments the toll that suicide has on families and society at large.  She goes on to comment that:

“Mental ill-health and suicide have been with us in good times and in bad but these difficult economic times undoubtedly increase the strain on individuals and families as unemployment and indebtedness take their toll”.

“They make it all the more imperative that we do all that we can to reduce the suicide rate, reduce the unnecessary waste of human life, reduce the awful legacy of grief for the bereaved and reduce the awful, overwhelming misery of a life that feels compelled to contemplate suicide.”

Sadly, mental health issues are not taken seriously in all quarters of society; I sense that this is particularly the case here in Northern Ireland.

One of the most devastating responses a suicidal person can receive when they take the enormous step of reaching out to friends or employers for help is to be ignored.  We all have a responsibility to be more aware of the emotional well-being of those around us.

Depressive illnesses are real and their individual and societal impact is exacerbated by ignorance and misunderstanding. My own painful personal experiences have borne this out.  That is why we need more people like Mary McAleese to publicly discuss, ‘de-mystify’ and de-stigmatize suicide and mental ill-health.  It really can, and does, make a difference; in fact, it can be literally life-saving.