Looking on the bright side (Mar/Apr 10)

Friday, 01 April 2011 08:05
Dorothy Rowe on the bad science of positive thinking Barbara Ehrenreich is a renowned American writer who is relentless in her pursuit of those who prefer fantasy to the truth. Her latest book, Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America[1], followed her encounter with the fantasies that prevail in the treatment of breast cancer. Ehrenreich developed breast cancer in 2000. She had been taking hormone replacement therapy for eight years, ‘prescribed by doctors who avowed that it would prevent heart disease, dementia, and bone loss. In 2002 HRT was shown to increase the risk of breast cancer, and, as the number of women taking it then dropped, so did the incidence of breast cancer. Ehrenreich had not only discovered the bad science of HRT but she had also encountered the bad science of positive thinking. Ehrenreich holds a PhD in cell biology and thus looks at research, whether in biology, medicine or psychology, with a scientist’s stern eye. Since the 1970s it had been known that severe stress ‘could debilitate certain aspects of the immune system’. It’s now clear that severe anxiety or deep depression can lead to cancer or heart disease. However, the reverse of…

Changing our minds (Jan/Feb 10)

Friday, 01 April 2011 08:05
Don't get depressed in Alaska My son Edward spent September in Alaska, exploring the glaciers and reading the local papers. He texted me to say that in the Anchorage Daily he’d read about Sarah Palin’s autobiography which she had written (with the help of a professional writer) in just four months. A spokesman from her publishers, HarperCollins, said that Sarah had worked very hard. She was, he said, ‘very hands on.’ Edward then expressed the hope that I had been very hands on with my new book, Why We Lie that I had just delivered to HarperCollins. Edward also sent me a bundle of Alaskan newspapers, choosing ones that had articles on mental health. On September 20, the Fairbanks Daily News published a magazine called Parade in which ‘Top Doctors Solve Your Medical Problems’. One of these doctors,  Ranit Mishori, told readers how to ‘Cope with Depression’. Often, she said, people are depressed without realising that they are. However, 'The good news is that there are many effective treatments. More than 27 million Americans take some form of antidepressant. Most of these work by affecting the brain’s levels of serotonin, dopamine, and norepinephrine – chemicals that influence mood. The most popular are…

Supper with friends (Nov/Dec 09)

Friday, 01 April 2011 08:04
Dorothy Rowe on the Stuart Low Trust In August I gave a talk at one of the suppers at the Stuart Low Trust in Islington. This was the second time I had been there, and both occasions I enjoyed my visit enormously. Apart from the fact that everyone there was warm and friendly, my pleasure comes from seeing there how much ideas and practices have changed since I first arrived in Englandin 1968. I had been working in Sydney as a liaison psychologist between the children’s unit at the new psychiatric hospital at North Ryde and the schools. In Australia at that time many of the psychiatrists were interested in psychotherapy, and were concerned about understanding their individual patients rather than finding a diagnosis for each of them. Alas, now biological psychiatry is all the rage there, and ECT is regarded by many psychiatrists as the treatment of choice. Always remember, progress has to be guarded carefully because it can easily disappear. However, expecting that British psychiatrists would be like the psychiatrists I had been working with, I arrived in London and applied for a job as a clinical psychologist at Whiteley Woods Clinic in Sheffield. I got the job,…

Two books (Jul/Aug 09)

Friday, 01 April 2011 08:04
I have been reading Jean Davison’s The Dark Threads (Accent Press) about the time she spent as a patient at High Royds Psychiatric Hospital in Yorkshire when she was just eighteen. Jean waited forty years to complete writing this book, which was very wise because she was able to give an account of her experiences that showed a wealth of understanding rarely found in memoirs written when emotion is still very much alive. I found it a painful book to read, because I was a psychologist then at Whiteley Woods Clinic and Middlewood Psychiatric Hospital in Sheffield. I witnessed the kind of scenes in which Jean was a participant, and so her book took me back to those times when I saw the cruelties that passed themselves off as psychiatric care. I tried to deal with the awful helplessness of witnessing cruelty and being unable to prevent it by spending time talking with the patients. In so doing, I came to see the gap between the way psychiatrists and nurses thought and worked and the reality of the patients’ lives. In recounting her interactions with the people who were supposed to be looking after her, Jean shows just how great this gap was. She…

A day at the zoo (Mar/Apr 09)

Friday, 01 April 2011 08:04
Everything in our world is connected, says Dorothy Rowe One of the hardest jobs you can ever undertake is to persuade people to abandon comforting old ideas and accept challenging new ones. People resist new ideas, even when these new ideas might benefit them. Members of MIND have had some success in persuading some people that madness isn’t a mysterious malady that overcomes certain individuals and turns them into objects of no importance but is simply a desperate way of trying to survive when, overwhelmed by events past and present, we lose all confidence in ourselves. However, we haven’t persuaded everybody of this. Many psychiatrists and psychologists still use the language of illness, and many people in the throes of severe mental distress are led to see themselves as being degraded and valueless. Though individuals have told me that what I have written has helped them, I feel that I have made little difference to society generally. However, while visiting Taronga Zoo in Sydney, I realised that there are people who must feel the same about their work. Everyone who works at the zoo tries to educate their visitors about the importance of looking after the planet and all the…

See what you've made me do (Jan/Feb 09)

Friday, 01 April 2011 08:04
Dorothy Rowe on the comforts of being a victim BBC Radio 4 programme You and Yoursis aimed at helping people with the practical problems that can arise in their lives. Not surprisingly, at present the programme is examining the financial problems besetting many people. Amongst those being interviewed the other day was a man in danger of being made bankrupt by his council for non-payment of council tax. This is a terrible situation to be in and the presenter was very sympathetic, but she had to ask the question that everybody listening was asking, ‘Did you talk to the council about the financial difficulties you were in?’ He said that he hadn’t because he had other matters to attend to. But surely he knew that, when you can’t meet your payments, the first thing you should do is talk to your creditors to see if your payments can be adjusted so that you pay whatever you can manage to pay. Some creditors can be ruthless and hard-hearted, but councils have a policy of trying to help people well before the council resorts to bankruptcy, but they can’t do anything if people don’t get in touch with them as soon as…

What Should I Believe? (Nov/Dec 08)

Friday, 01 April 2011 08:04
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Suffer Little Children (Sept/Oct 08)

Friday, 01 April 2011 08:03
Alex, aged two, and Rebecca, aged four, had three things in common. They had each been diagnosed as having bipolar disorder, each had spent most of her life taking the antipsychotic drugs that had been created for adults, and each suddenly dropped dead.[i] David Healy has told their stories in his latest book Mania: A Short History of Bipolar Disorder.[ii] This book is essential reading for anyone who wants to understand what is happening now in the marketing of mental illnesses and the drugs that supposedly treat them. Bipolar disorder has become fashionable, with 5 per cent of Americans having some form of the disorder. Now, according to Healy, there is ‘a mania for diagnosing bipolar disorder in children.’ Some children have been considered to show the first signs of the disorder when they kicked excessively in the womb and screamed when born. (For many mothers, being kicked in the womb might be very uncomfortable but it is evidence that your baby is alive and well.) For adults to be diagnosed as being bipolar they have to be depressed and manic for several weeks in each state, whereas children can earn such a diagnosis by having several changes of mood with…

Dog-heads from Mars (Jul/Aug 08)

Friday, 01 April 2011 08:03
BBC4 recently broadcast a series of four programmes called ‘Inside the Medieval Mind’. The series, presented by the historian Robert Bartlett, concerned ‘how medieval man understood the world’. What was implied by the series was that medieval men (and presumably women) saw the world very differently from us. But is this really true? During the Middle Ages, from the 9th to the 15th century, the Bible and the teachings of the Church were the only sources of knowledge. The world was seen to be ordered according to God’s plan. Everything that was discovered about the world had to be fitted into that plan. According to the Church, all living creatures belonged to one of four categories: animals, fishes, humans, and spirit beings, which could be angels or demons. Little was known about the lands that lay beyond the British Isles and its nearest neighbours, but that didn’t prevent the Church from teaching that in distant lands there were many strange creatures, some of whom are depicted on the 13th century Mappa Mundi, the map of the world which hangs in Hereford Cathedral. This shows the Dogs Heads, creatures with a human body and a dog’s head, which were frequently depicted in…

Saying Sorry (May/Jun 08)

Friday, 01 April 2011 08:03
I was in Sydney last February when the new Prime Minister Kevin Rudd made his ‘sorry’ speech where he apologised on the behalf of all non-indigenous Australians to the Stolen Generation of Aboriginal people for what they had suffered at the hands of previous Australian governments. He had spent much time in meeting members of the Stolen Generation, and he drew on what they had told him in writing his speech. Listeners were left in no doubt what he was apologising for. There was no hint of that patronising tone much loved by many politicians but a sensitive awareness of the kind and degree of suffering the Stolen Generation and their families had endured, and an honest regret for the actions by politicians before him. He set out a carefully thought through plan for righting the wrongs of the past. In the letters and diaries of the first English settlers at Sydney Cove in 1788, the tribes whose land the settlers were taking without recompense were described as being remarkably healthy. However, Aboriginal people soon began to succumb to the diseases the settlers brought with them. Within a few short years the representatives of the British government were reporting that…
Every Australian schoolchild learns Dorothy Mackellar’s poem My Country. We can all recite, I love a sunburnt country, A land of sweeping plains, Of ragged mountain ranges, Of droughts and flooding rains. I love her far horizons, I love her jewel sea, Her beauty and her terror, The wide brown land for me. Australia is a land which can defeat and destroy those who try to force it to be fruitful. Last December a drought which has lasted for ten years was interrupted, not just by rain, but by torrents of rain which produced wild floods, destroying livestock, fences, roads, bridges and buildings. Farmers who in the drought were barely surviving saw what little they owned swept away by the floods. Land in Australia is little suited to the English farming methods which have been imposed on it for the last two hundred years. As a result, much of the farming land is no longer fertile. Even without the drought, many farmers were struggling to make a livelihood. The suicide rate amongst Australian farmers is four times the national average. Despite government funded initiatives to support farmers financially through a difficult time, and to offer support from the mental health services,…

Scoundrel time (Jan/Feb 08)

Friday, 01 April 2011 08:02
Being appointed by Gordon Brown as the first Muslim minister and invited to the USA by the Department of Homeland Security did not prevent Shahid Malik from being detained and searched at Washington DC airport. In the USA now, simply being a Muslim is enough to be regarded as a possible terrorist. Such paranoia in America is not new. What Muslims are experiencing there now is similar but worse than what anyone considered to be a communist experienced in the USA in the 1950s. The USA is a huge country containing many diverse people but they are held together by two ideas, that of God and the American people. Consequently, the great majority of Americans say that they believe in God. Moreover, it’s not enough to be American in citizenship or residence. You must be American in your thoughts. A lack of right thinking shows that you are un-American. (It’s impossible to be un-British because the British can’t agree on what being British is.) In 1938 Congress set up the House Committee on Un-American Activities, and in 1947 this committee was given extraordinary powers to examine witnesses who were suspected of un-American activities and to deny work to anyone whose answers to the…
When Pepper wrote about how, when she had asked a member of her church for help, he had told her, ‘You can’t be a proper Christian because Christians don’t get depressed,’ (September/October 2007) I was not surprised. I knew how a great many people, who describe themselves as having a faith, behave with little kindness, generosity or concern for those who aren’t seen as being suitable members of their community. When I was a child my mother insisted that I attended Presbyterian Church and Sunday school, even though she never attended and my teenage sister, who did attend, refused to acknowledge my existence. Every Sunday I learnt my catechism and listened to the sermon, and no one in the church recognised my loneliness and offered me companionship, not even the minister whose favourite theme in his sermons was faith, hope and charity. ‘Charity’, he explained, meant ‘love’. Years later, when different groups, interested in mental health, invited me to give talks and workshops, I found a similar lack of concern amongst most of the different religious groups who contacted me. Local associations of MIND and various mental health charities, all managing on a shoestring, would take it as a matter…

Mindfulness (Sept/Oct 2007)

Friday, 01 April 2011 08:02
Openmind Sept/Oct 2007 Just Looking When I was a child my mother made it clear to me that she regarded me as a peculiar child with odd habits. One of these habits was that I’d stand at the back door of our house, gaze across to the distant blue hills, and watch the sun set. Or I’d cross the road and disappear into the bush, re-appearing some time later with spray of gum nuts or a bunch of wildflowers. When I went to the beach I’d spend as much time peering into rock pools and watching the waves break as I’d spend swimming. Despite my mother’s disapproval, I persisted because I enjoyed just looking, and it gave me a respite from the boredom and misery of home and school. I was very pleased when I discovered that the poet William Henry Davies agreed with me. He had written, A poor life this if, full of care, We have no time to stand and stare. Many years later I realised that I was using an ability with which we’re born but which can so easily be taken from us by our upbringing. It’s the ability to look at the world around…

A Miracle (July/Aug 2007)

Friday, 01 April 2011 08:02
Openmind July/August 2007 A Miracle in Northern Ireland I still can’t believe that I’ve seen Ian Paisley and Gerry Adams sitting down together and agreeing to share power in Northern Ireland. Some years ago Gerry Adams, Martin McGuinness and their colleagues in Sinn Fein saw that that they had to exchange the gun for the ballot box, but Ian Paisley wouldn’t budge an inch until Sinn Fein IRA, as he always called them, admitted defeat and publicly repented of their sins. I was very familiar with this degree of intransigence. I’d been brought up in the Presbyterian Church and, though members of my family were not great church-goers, most of them, particularly on my mother’s side, had that Presbyterian ability to believe that they were absolutely right, and that compromise and reconciliation were signs of weakness, not strength. They also shared Paisley’s views about the utter wickedness of the Catholic Church. The Australia I grew up in before and during World War Two, was, like Northern Ireland, divided into Catholics and Protestants. Catholic children went to Catholic schools: Protestant children went to state schools. Outside of school, each group hurled abuse at one another and never met to play together.…
Openmind May/June 2007 Conversations between Ordinary People They happened to be sitting side by side at the workshop I was running in Australia, he, Barry, a consultant psychiatrist and she, Miriam, a visitor to a long-stay psychiatric hospital, and, so she told us, no stranger to depression herself. Barry said, ‘At my hospital a colleague and I will spend up to two hours on an intake interview. There’ll be other discussions with other professionals. I don’t think patients realise how much time we spend talking about them.’ Miriam said, ‘I have specific tasks I need to do, but whenever I can I’ll just sit with a patient. We don’t talk about anything special – it might be that we just talk about what fruit’s in season – and when I get up to go the person thanks me for talking to them. I think that’s so sad, that they thank me for talking to them.’ If you’re a professional in the psychiatric system, whether in a hospital or in the community, you have to spend time talking with your colleagues about the patients. Information needs to be passed on and programmes of care drawn up. Pooling knowledge is essential to…
A Most Important Attachment Openmind March/April 2007 Twenty years ago, when I was working in Lincolnshire, one of my clients was a young married woman who was deeply depressed. There was certainly much in her life to trouble her. Her husband worked long hours and she was at home with their three small children. Her account of her childhood showed her parents to be authoritarian and punitive, and, living nearby, they still demanded much of her attention. I felt that there was something more in her background that played a major part in her distress. In fact I was searching for some secret when the problem was right there, staring me in the face had I the wit to see it. At least it was the kind of problem that vast numbers of psychologists had overlooked. We all knew a great deal about Attachment Theory, how babies form an attachment to their mother and how the response of the mother to the baby determines the nature of that attachment. What we ignored was that most children have siblings, and that these relationships can be very important, if not the most important, in a person’s life. My client was the eldest…
Openmind January/February 2007 Farewell to Chemical Imbalance How often have you heard that a chemical imbalance is the cause of depression? A hundred times? If you’re as old as me you’ve heard it a thousand times, and said by psychiatrists in tones of absolute certainty. It’s why the SSRI drugs were made specifically to put serotonin in the brain and thus right the imbalance. However, without telling the rest of us, psychiatrists have changed their minds. A few weeks ago I was browsing the Royal College of Psychiatrists’ website. The pamphlet on bipolar disorder had been removed and I wanted to see if a new one was in place. It was, and some curious changes had been made. I then looked at their pamphlet on depression. It’s a very long pamphlet, written in a chatty way. Under the heading, ‘Why does it [depression] happen?’ is a statement which says that sometimes there’s an obvious reason for becoming depressed and sometimes there isn’t. It’s different for different people. Then there’s a list of the things that can lead you to be depressed. These are: things that happen in our lives; circumstances; physical illness; personality (‘This may be because of our genes,…
Bringing Out the Best in a Psychiatrist Published in Openmind Magazine November/December 2006 When I first arrived in England in 1968 I went to work in Whiteley Wood Clinic which was the professional clinic for the Department of Psychiatry at Sheffield University. The professor who had established both the department and the clinic, Professor Erwin Stengel, had just retired and Alec Jenner had come in his place. Stengel (no one called him Erwin) still spent a good deal of time at the clinic and would interview every new arrival, including my nine-year-old son Edward when he played in the clinic’s garden during the school holidays. I soon learned that when the matron of the clinic mentioned, ‘the professor’ she didn’t mean Alec who seemed in her eyes not to be maintaining the standards which Stengel had set. One of the junior doctors told me about how Stengel had conducted his ward round. First Matron would inspect each ward to see that every patient had made his or her bed to the highest standard of neatness. Then, with the patients standing at attention beside their beds, Stengel, with his senior and junior registrars, Matron and a bevy of nurses following behind,…
Openmind September/October 2006   The more things change the more they remain the same. The news pages of the last issue of Openmind carried a report which read, ‘Mental health nurses should spend more of their time in direct clinical contact with patients and cut back on administrative duties, a government review has urged. . . Sophie Corlett, Mind’s Policy Director, said she was “delighted” at the review’s encouragement of a more active role for nurses engaging with patients. “Too often we hear of a lack of interaction between the two, particularly on wards where patients may feel alone and abandoned,” she said.’   Sophie could have said the same thing in the years between 1968 and 1986 when I was working in large psychiatric hospitals. Walk on any ward and what you would have found were the patients sitting somnolently in well-worn chairs and in the office the nurses talking and drinking coffee. Whether you were a patient or a psychologist you approached the door of the office at your peril. You would knock timidly, and eventually one of the nurses would glance up, annoyed at being interrupted. A few of the nurses liked the psychologists, and these were usually the…

An Unsung Hero (July/Aug 2006)

Friday, 01 April 2011 07:58
Openmind July/August 2006   Colwyn Trevarthen is an unsung hero to recent generations of babies who were born to parents who, from the moment of their birth, talked to them, played with them, and saw them as people in their own right. Colwyn and his colleagues showed that babies are born ready to engage in conversations, discover the world and act on it. This isn’t how babies have traditionally been seen. The Christian Church has always taught that babies were conceived in sin, born bad, and have to have the devil beaten out of them. Nowadays children might not be beaten as frequently as children were in the past, but they are oppressed by a series of competitive exams so onerous that a beating might seem more acceptable. For Freud original sin became the id, and babies were born, in his words, polymorphously sexually perverse. For Jung, babies were inhabited by The Shadow. For Melanie Klein, babies thought of nothing but the good breast and the bad breast, and spent their time being in the depressed or paranoid position. So-called sensible adults saw babies as unpleasant objects producing nothing but yells and smells, and best left with women foolish enough to find them…

Voyeurs of Suffering (May/June 2006)

Friday, 01 April 2011 07:57
Openmind May/June 2006   ‘Misery memoirs’ is the latest catchphrase in publishing. Ever since Dave Pelzer’s book A Child Called It became a best seller publishers have been keen to publish personal accounts of horrific childhoods. But why are these books so popular? Writing about this in the Observer Tim Adams listed 11 such books and commented, ‘Since Pelzer sold many million copies of his books, there has been a kind of arms race of this kind of extreme confession.’ Adams went on to point out how Oprah Winfrey in the USA and Richard Madeley and Judy Finnegan in the UK have promoted such books on their book shows. The talk shows Oprah and Richard and Judy purport not just to entertain us but in some way do us good. Reading books is good for us. Reading books about other people’s extreme misery not only informs us about the terrible things that can happen in the world but it allows us to run through the gamut of emotions from shock and horror, through disgust, to the heart-warming happiness that comes when we discover that the narrator has survived such terrible suffering and is doing well. Feeling emotions does us good.  Or so we are…

As the Twig Is Bent (March/April 2006)

Friday, 01 April 2011 07:57
Openmind March/April 2006  On the lower deck of London buses there is a space for wheelchairs, prams and pushchairs. Sometimes this space becomes a stage where all kinds of dramas are acted out. I was in the audience for one of these dramas when I was sitting facing this space and two women, locked in an intense conversation got on the bus. They had with them a baby in a pushchair and three children, boys aged, about eight, seven and six. Whatever these children did, they couldn’t interrupt the women’s conversation for more than a moment. The baby became restless and cried, and one woman, whom I took to be the mother, extracted a bottle from her bag and pushed it in the baby’s mouth, all without ceasing to talk to her friend. However, the baby did get more of her attention than the oldest boy who pressed himself against her and tried to interrupt her conversation with a repeated question, but she ignored him and several times pushed him away. The bus was crowded and the three boys had to cram themselves into small spaces in order to stay near the women. They soon tired of this, and, as…

The Meaning of Illness (Jan/Feb 2006)

Friday, 01 April 2011 07:56
Openmind January/February 2006   It is extraordinary that, at a time when there is less disease and people live longer than at any other time in our history, amongst those who seek medical help, up to forty per cent of them have illnesses which may be given names like irritable bowel syndrome or fibromyalgia (niggling pains and tender areas in the large muscles of the back, neck and shoulders) but for which there is no identifiable cause. ‘Literally millions of people are racked by back pain, tormented by abdominal gripes, alarmed by ringing in the ears, tortured by headaches, exhausted by sleep deprivation, frustrated with constipation, debilitated with nausea or faintness or anorexia, overwhelmed by the burden of obesity, terrified by shortness of breath or palpitations or just too sick and too tired to cope.’  This is how the consultant physician and psychoanalytical psychotherapist Nick Read described what might be called an epidemic of functional illnesses. Doctors divide illnesses into functional and organic. Organic illnesses have a clearly defined pathology, each with a particular set of symptoms and organic changes which can be demonstrated in reliable tests. Functional illnesses have a wide variety of symptoms varying from person to person and in…
Openmind November/December 2005   Don’t you find that every item of health news always ends up telling you that you’ve got something wrong? Your favourite food is killing you, the exercise you do isn’t enough or it’s doing you damage, where you live is the worse area for pollution, your level of stress will lead to a heart attack, and what ever has gone wrong is worse at your age, whatever your age is. It’s impossible for me to read a newspaper without the words ‘ageing’ and ‘getting old’ leaping out of the page at me. There was no way I was going to miss the words ‘old age’ in the Guardian’s report on the British Association of Science conference in September, but when I read the headline I was amazed. It said, ‘Old age starts at 80 as brains keep getting younger’.   This report went on to say that, according to Ian Robertson, the dean of research at Trinity College Institute of Neuroscience, biologically and psychologically old age starts at eighty. Writing this on September 12, I have got 5 years, 3 months, and 5 days to go to old age. This cheers me up greatly.  However, all of…
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