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…

Naughty Boys? (Sept/Oct 2005)

Friday, 01 April 2011 07:54
Openmind September/October 2005   Sami Timimi, a child psychiatrist in Lincolnshire, has written a book called Naughty Boys which everyone involved in the care of children should read. Sami was born in Iraq and came to the UK when he was fourteen. As I know from my own experience, even if you come to a foreign culture knowing the language, the history and the literature of that culture, you still don’t understand the subtleties not just of what you aren’t allowed to say but what you aren’t allowed to see. You soon find yourself like the boy in Hans Christian Anderson’s story The Emperor’s New Clothes. While the rest of the populace are admiring the sumptuous brilliance of the Emperor’s garb you’re saying, ‘But he’s naked.’ In Sami’s case the Emperor is his fellow psychiatrists, members of a profession which never forgets or forgives any member who betrays them. They haven’t forgotten or forgiven Ronnie Laing and they won’t forgive Sami. However, Sami considers that the fate of millions of children in the developed world being more important than his own career.   These are the children who, without their permission, have been made the subjects of an immense natural experiment, like the natural experiment…

Havent We Done Well? (May/June 2005)

Friday, 01 April 2011 07:53
OpenMind - Journal of the mental health association MIND May/June 2005 Haven’t We Done Well! Dorothy Rowe When I was preparing to go to Australia last winter a producer of a discussion series on an Australian TV channel contacted me about making a programme on depression. I suggested that the programme should be about those people who had devised their own methods for getting themselves out of the prison of depression. A few weeks later we recorded the programme and by then the producer had found a number of people who were prepared to talk about their own successful experiences. However, when I arrived at the studio I found that, in the interests of balance, the producer had invited a consultant psychiatrist. I shouldn’t have been surprised about this. In Australia mental health is dominated by psychiatrists who believe wholeheartedly in the medical model. As I had been told by my Australian psychologist colleagues, most Australian psychiatrists see mental disorders as physical illnesses best treated by drugs and ECT with the psychological therapies being no more than optional extras. There is no NHS in Australia, and, though each State supplies some mental health care, private medical insurance pays for visits…
OpenMind - Journal of the mental health association MIND March/April 2005 Happy Kids Make Happy Parents Dorothy Rowe I avoided the worst of the winter by visiting my son Edward in Sydney. On our way to the beach one day Edward pointed out to me a parked car which had a sticker on its rear window which read, ‘Smiles for Kids. Child psychologist’ followed by a mobile phone number. ‘You ought to have a sticker like that on your car,’ he said. I shall spare you the list of suggestions he then produced. Edward has never shown the respect for psychologists which we psychologists think we deserve. The slogan ‘Smiles for Kids’ worried me. In Australia most psychologists work privately and are allowed to advertise. There is keen competition for work. Some psychologists feel that their advertisements should include more than a statement of their qualifications and a list of the problems about which they have special expertise. But, if truth in advertising matters, can psychologists guarantee that their clients will live happily ever after? Advertising slogans are not necessarily aimed at the person who will use the product. They can be aimed at the person who will pay for…
OpenMind - Journal of the mental health association MIND Jan/Feb 2005 How Much Space Is Your Space? Dorothy Rowe A few weeks ago I caught a train from Bristol to Paddington. I’d booked an aisle seat at a table for four. Two women sat opposite me. The window seat beside me was booked but still empty when the train, now packed with commuters, pulled out of the station. At Bath more passengers crowded in. A man leaned over me to read the booking slip above the window seat, and indicated that he wanted to sit down there. I stood up to let him in and, without a please or thank you, he hurled himself into the seat. When the two women opposite and I had sat down each of us had been careful to take up no more than our quarter of the space. Small though the table was, when we placed our belongings on it we made sure they didn’t intrude into another person’s share of the table top and, if a danger of that happening arose, we apologised. But not this man. He was an average-sized, middle-aged man, yet his bum had no sooner hit the seat than…

My Friend Sundance and Me (Nov/Dec 2004)

Friday, 01 April 2011 07:52
OpenMind - Journal of the mental health association MIND Nov/Dec 2004 My Friend Sundance and Me Dorothy Rowe From infancy I’ve had a chronic disease, bronchiectasis, where the lungs produce a sticky mucus which, if not coughed up, accumulates and so destroys the tissues of the lungs. With a daily routine of antibiotics, inhaled steroids and postural drainage, and outpatient care from the Royal Brompton Hospital for Respiratory Disorders and my wonderful GP I’m able to lead a very busy life, but every two or three months the bacteria in my lungs go on a wild rampage and produce a number of symptoms which are hard to deal with. Because the oxygen is not getting easily from my lungs to my blood stream my body becomes suffused with a tiredness which no amount of sleep or rest can assuage. This tiredness doesn’t affect my mind. I can think, read demanding books, and get on with my writing. Staying in bed would be fine, but I live alone and need to work, so I have to drag my leaden body out of bed to shower, dress, shop, and keep my appointments. It’s not a happy time. I was in the midst…

Cartoons That Belittle (Sept/Oct 2004)

Friday, 01 April 2011 07:51
OpenMind - Journal of the mental health association MIND Sept/Oct 2004 Cartoons That Belittle Dorothy Rowe While travelling on a train I was forced to listen to a man who was using his mobile phone to instruct a member of his staff. I gathered that his firm was a printers and that he was giving instructions about the preparation of a flyer for a book published by a publisher who I knew specialized in self-help books. As he described how the flyer should be set out I expected him to say, ‘It needs an illustration. Do a droopy guy looking miserable.’ Such cartoons often appear on pamphlets advertising training courses for mental health professionals. Open a new copy of Openmind and out falls one or two. This kind of cartoon is supposed to help the mental health workers see the humorous side of mental disorders and their miserable sufferers. Many self-help books are illustrated with cartoon characters looking miserable and, once they have absorbed some cognitive therapy of the simple-minded kind, turning into smilies. These cartoons are supposed to show the sufferers that they should keep their troubles in proportion. Everything is not as bad as they think. Whenever I…
OpenMind - Journal of the mental health association MIND July/August 2004 Should We Put Our Faith in Drugs? Dorothy Rowe The basis of the debate over whether drugs or therapy is the best cure for mental distress seems to be quite clear. The benefits of therapy are hard to measure, and there are lots of different therapies and therapists, but drugs have been rigorously tested and their benefits and side effects are known. Go to a therapist and you don’t know what you’re getting. Take a prescribed drug and you’ll know it’s reliable because it’s been carefully researched. That’s the theory, but should we believe it? Researchers both in the UK and in the USA examined the published reports of studies where one drug was compared with another and found that when pharmaceutical companies fund the research that research usually produces results which favour the drug company’s own product but when a disinterested organisation funds the research the results are not so clear-cut. Somehow, who puts the money up for the research affects the outcome of the research. Research on the effectiveness of drugs can take place in two very different settings, in the academic setting of a university department…
OpenMind - Journal of the mental health association MIND March/April 2004 The Books We Want to Read Dorothy Rowe Since the publication of my first book in 1978 many people have asked me how they could get the book they were writing published. Almost all of these books were accounts of the writer’s life or the life of someone close to them. The writers felt that the life they described was unique and significant, and that a published account of this life would not only give them great satisfaction but it would be of great value to other people. It is extremely difficult to get a book published, especially if the author has never been published before. However, I would never tell anyone not to bother with writing their story. Indeed, I have often advised people to write, if not an autobiography, then a diary, a poem, or just a few sentences about ideas that are significant to them. When we take what is inside us, our thoughts and feelings, and put them outside us on paper or on a computer screen we are able to look at our experience from a distance, see it more clearly and so gain…

A Quick Fix (March/April 2004)

Friday, 01 April 2011 07:50
OpenMind - Journal of the mental health association MIND March/April 2004 A Quick Fix Dorothy Rowe I’ve been in Australia meeting clinical psychologists, school counsellors, therapists and counsellors. I found that they were keenly interested in everything I had to say about mental distress, especially depression. There’s a high rate of suicide in Australia, and the suicide rate for young men is amongst the highest in the world. The Federal and state governments take the problems of depression and suicide very seriously and so everyone who works in the mental health field is under intense pressure to achieve results. The managers in the government health and education systems see organising mental health services in the same way as they see organising physical health services, that is, identify a problem and create a solution. If a person is ill apply a treatment to cure the illness. Consequently people who are suffering mental distress are said to be ill and given a diagnosis. People are given labels – ‘She’s a bipolar’, ‘He’s got ADHD’, ‘She’s a BPD’ – and their personal experience is ignored. Private health insurers (there’s no NHS in Australia) give only extremely limited financing to psychotherapy, and so clinical…
OpenMind - Journal of the mental health association MIND Jan / Feb 2004 HOW'S YOUR SUPPLY OF SELF ESTEEM? Dorothy Rowe Low self esteem bad: high self esteem good. This has been the mantra of many people, myself included, for the last twenty years or more. Nowadays there are many people who may say they’ve got lots of self esteem, perhaps because they’ve been in therapy and have learned not to denigrate themselves, or perhaps because they’ve been born to parents who have always told them how wonderful they were. It’s marvellous when someone who’s been leading a miserable life manages to blossom into a happy, confident person. Such people are usually a joy to be with. However, when I encounter people who claim to possess lots of self esteem, I quite often find myself thinking, ‘This isn’t high self esteem. It’s just plain vanity and bad manners.’ In Jonathan Franzen’s novel The Corrections there’s a character, Melissa, a student, who was always telling people about her high self esteem. When she was talking to her teacher Chip she said, ‘I like myself. You don’t seem to like yourself very much.’ Chip replied, ‘”Your parents seem very fond of themselves.…

Blame the Child (Nov/Dec 2003)

Friday, 01 April 2011 07:49
OpenMind - Journal of the mental health association MIND Openmind November / December 2003 BLAME THE CHILD Dorothy Rowe In Jonathan Calder’s excellent article on ADHD and Ritalin (issue 123) space didn’t allow for a discussion of the role of boredom and fear in the behaviour of those boys given the diagnosis of ADHD. When they are bored or fearful, both children and adults become restless and inattentive. We become bored or fearful in response to the situation we find ourselves in. Those professionals who believe that ADHD is a real medical condition seem little interested in the child’s situation the child, and in how that child sees that situation. In the early 1960s before ADHD and Ritalin were invented, I was an educational psychologist working in Sydney. If a teacher felt concerned about the behaviour of a particular child I would be summoned to examine the child and decide whether the child had some emotional need which was not being met by the school. By far the majority of my referrals were boys aged between 6 and 14 who would not or could not conduct themselves in the orderly, obedient, hard-working manner which the teachers required. I was able…

The Key to the Prison (May 2003)

Friday, 01 April 2011 07:47
OpenMind - Journal of the mental health association MIND May 2003 THE KEY TO THE PRISON Dorothy Rowe Isn’t it curious how a small event can change your life? In 1983 I was asked to give a lecture, and after it someone asked me a question, and, as a consequence my life, and the lives of some other people, changed. At that time I was head of the Lincolnshire Department of Clinical Psychology and had written two books, both rather academic. These books were a result of my research into depression, something which interested me because I had been born to a depressed mother whose difficult behaviour had been the bane of my childhood. When I’d first trained as a clinical psychologist I’d been prepared to accept the medical view of depression, that it was a physical illness, but as I listened to my depressed clients, came to realise that they, like my mother, had certain strongly held beliefs which predisposed them to becoming depressed. I had reached a stage in my work where I could see a direct connection between these beliefs, a disaster in a person’s life and subsequent depression. Such a view of depression wasn’t acceptable to…

Watching You Watching Me (March 2003)

Friday, 01 April 2011 07:47
OpenMind - Journal of the mental health association MIND March 2003 WATCHING YOU WATCHING ME Dorothy Rowe The Metaphysical Poets were a group of seventeenth century poets, including John Donne and George Herbert, who wrote complex, beautiful poems about life, death, God and salvation. In the BBC television drama Wit Emma Thompson played the role of Vivian Bearing, the 50-year-old Professor of Metaphysical Poetry who learns that she has advanced ovarian cancer which her surgeon proposes to treat with a new and ‘aggressive’ procedure. Vivian is always very calm, very rational, a woman of very few words. No matter how much pain and discomfort she is in, when her doctors ask, ‘How are you?’, she always replies, ‘I’m fine.’ However, she confides in us, the audience, and we see the interweaving of her experience of her progress towards death with her increasing appreciation of the wisdom of the poets whose work she knew so well. We also see her face as she watches the doctors as they assess the progress of the cancer and the effects of their treatment while ignoring her. Just from her face we get a good idea of what she thinks of these men. However, these…

Are You Suitable For Therapy? (Jan 2003)

Friday, 01 April 2011 07:46
OpenMind - Journal of the mental health association MIND January 2003 ARE YOU SUITABLE FOR THERAPY? Dorothy Rowe Jonathan, who’d read one of my books, wrote to me to tell me what had happened to him when he’d asked his GP to refer him to an NHS psychology department for therapy. He was sent an appointment, but when he went along he was told that this was an assessment, not the start of psychotherapy. A week later he was sent a letter which stated that he was ‘not suitable for psychotherapy’. He was very distressed by this and wrote to me to ask, ‘Does this mean I can never get any psychotherapy?’ This happened about four years ago, and I hope that by now all psychology departments have worked out much kinder ways of letting some of the people referred to them know that they will not be offered an appointment because they, the psychologists, don’t have anything to offer them. However, there is a long tradition in the psychiatric system of blaming the patient for the failures of the professionals. Nowadays psychiatrists call those patients who fail to respond to the psychiatrists’ treatment ‘treatment-resistant patients’. In the olden days,…
OpenMind - Journal of the mental health association MIND November 2002 RECOVERY AND ILLNESS IN THE PSYCHIATRIC SYSTEM Dorothy Rowe I am old enough now to be an historian of the psychiatric system. Ask me how it has changed since 1965 and I can tell you. I first encountered the psychiatric system when I went to work as a liaison psychologist linking Sydney schools and the children’s ward in a psychiatric hospital. This hospital had recently been built, and was simply an array of single storied wards, all light, airy and clean, set in large grounds overlooking the Parramatta River. This place did not prepare me for the horror of Middlewood Hospital in Sheffield, nor the other psychiatric hospitals I came know only too well after I arrived in the UK in 1968. All of these were dark, miserable, dirty prisons, where their inhabitants, the patients, were shown very clearly by the buildings themselves and by the staff that they were the scum of the earth. I wrote about these horrible places in my book Beyond Fear which was published in 1987. By then I knew that all those forms of mental distress which psychiatrists called mental disorder had the…
OpenMind - Journal of the mental health association MIND March/April 2002 CHILDREN ARE UNBEATABLE Dorothy Rowe Why do the British want to beat their children? In 1979 Sweden prohibited all corporal punishment of children, and since then Norway, Latvia, Croatia, Cyprus, Finland, Denmark and Israel followed suit. In 2000 the German government passed a German Civil Law which stated, ‘Children have the right to be brought up without the use of force. Physical punishment, the causing of psychological harm and other degrading measures are forbidden.’ German lawmakers were impressed by the body of research which shows a clear link between childhood experiences of physical punishment and violence and other forms of anti-social behaviour in adult life. In 2000 a study of the impact of Sweden’s ban on physical punishment showed that over the preceding thirty years crime, drug use and alcoholism in young people declined significantly. Moreover, between 1980 and 1996 only four children died at the hands of an adult, and, of that four, only one at the hands of a parent. Each year in the UK some 68 children die at the hands of an adult, usually a close relative. In the UK individuals and organisations concerned with…

Sweet Dreams (Nov/Dec 2001)

Friday, 01 April 2011 07:45
OpenMind - Journal of the mental health association MIND Nov/Dec 2001 SWEET DREAMS Dorothy Rowe On September 4 television news pictures of the Ardoyne in Northern Ireland showed terrified young girls being ushered by their parents along a path lined by troops in riot gear, behind whom were men and women screaming abuse and threats and throwing bottles and planks embedded with nails at the soldiers, the children and their parents. I wondered how long it would take for memories of this to cease to inhabit the dreams and nightmares of these girls. Memories of events which aroused intense fear can last a very long time. In Australia when I was eight years old nothing stood between us and the advancing Japanese army. When I went to the beach I stepped over the only defence my home had – a single strand of barbed wire. At the cinema I saw newsreels of Japanese planes dropping bombs and strafing refugees. I was in my thirties before my ‘the Japs are coming’ nightmares ceased to trouble me, but another nightmare garnered in my early twenties competed with them and finally took their place. This was a dream where the class I was…
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