Saturday, 27 July 2013

Soul Calling

On my early morning walk today I bumped into three magpies in the park – one for a girl, two for a boy, three for sorrow….? Oh dear, I thought…where is that coming from I wonder? Didn’t have to wait too long to find out.

Magpies: the only bird to see its own reflection
Back at home, a call to a much loved friend immersed me in conversation about abandonment, bereavement and rejection. But this was not something new, it was old and deep~seated. “I can even feel it in my bones” she said. Those feelings had been triggered by a random incident.

Robert Johnson tells of the wounding of the masculine and feminine feeling function – a wounding of the soul – “probably the most painful wound which occurs in the Western world.  It is very dangerous when a wound is so common in a culture that hardly anyone knows that there is a problem. There is a general discontent with our way of life but almost no one knows specifically where to look for its origin”.[1]

The origin of the wound lay deep within the psyche. It is the grief of the broken heart separated from the Source. The sense of loss engenders an unbearable pain to which the ego cannot respond.

That conversation this morning brought me right back to the book I am writing and nearing completion: a radical interpretation of that old Greek myth of Eros and Psyche. Abandonment is a constant theme in Psyche’s journey to empowerment.

Desperately seeking to regain paradise lost
 In Abrams’ seminal compilation on Reclaiming the Inner Child, one contributor notes that “The experience of abandonment – actual, emotional and psychological – initiation into life.  It is a re~enactment of the fall from Eden, a loss of innocence, both a disappointment and a betrayal. Yet, it is a positive event because it sets us in motion on our journey, circling on our way in search of experience and identity”.

That haunting poignant voice of the soul speaks of the search for similarity; a longing for the beloved, for life itself.  It is a desire beyond ego needs, a yearning for what cannot be purchased in the physical world. It is akin to the experience that St John of the Cross described as the ‘dark night of the soul’. Each time that feeling returns it is stronger and deeper like the rising crescendo of Ravel’s Bolero.

The mournful call of the soul pushes through at unexpected and wholly inappropriate moments, reminding us of its enduring presence. “A calling may be postponed, avoided [or] intermittently missed” says Hillman, “It may also possess you completely. Whatever, eventually it will out. It makes its claim. The daimon does not go away.”[2]

When we abandon the soul, it goes berserk and generates a type of distress visited on the world in the form of depression, neuroses and often a level of psychosis. When we ignore the soul perhaps it appears symbolically as three magpies reminding us of its sorrowfulness.

There are of course different versions (I reverse 1/2 and 3/4) of the ‘magpie rhyme’ including:

One for sorrow,
Two for joy/for mirth
Three for a girl/funeral
Four for a boy/birth
Five for silver/heaven
Six for gold/hell
Seven for a secret never to be told OR (Seven’s the Devil his own self)

Sometimes additional lines are added:

One for Sorrow
Two for joy
Three for a girl
Four for a boy
Five for silver
Six for gold
Seven for a secret never to be told
Eight for a wish
Nine for a kiss
Ten a surprise you should be careful not to miss/a time of joyous bliss
Eleven for health
Twelve for wealth
Thirteen beware it's the devil himself.

[1] Fisher King and the Handless Maiden
[2] The Soul’s Code

Thursday, 25 July 2013

Who is the Real You?

I am still exercised by my recent foray into the underworld of psychiatry. Nowadays words such as 'mad' ‘insane’, ‘crazy’ and ‘lunatic’ refer to an extreme state of mind embedded in pathology, where the disintegration of our mental state causes the individual to manifest behaviour that is habitual, compulsive, maladaptive and anti~social.  

The above words are generally avoided as classifications of mental states in favour of  a broader classification of personality disorders which cover a range of dysfunctionality, including specific diagnosis of mental illness such as schizophrenia and bipolar. 

But who and where is the real person behind these medical classifications? How did they get here? Can they ever be reclaimed? Is what’s going on with Dean nature or nurture or both?

All children are indoctrinated by what they learn from significant adults in their lives – whether these adults are in government, churches, or in the home. They act out, or dramatize the terror held in their unconscious which the ego cannot contain. They do what their elders have done and continue to do.They kill indiscriminately; they kill because another person has something they want. They kill innocent people who have done no harm, just happen to be in the wrong place at the wrong time. We call this collateral damage.

Millon notes that in the antisocial personality “badness and madness” seem to converge to the extent that “sometimes antisocial crimes are so incomprehensible and morally repugnant that the act alone makes us doubt their sanity.” [1]

We all know and meet every day apparently normal people whom we might describe in the following terms:

Quick to counterattack and react with anger to perceived insults.
Bear grudges and are unwilling to forgive the insults, injuries or slight that they think they have received.  Minor slights rouse major hostility.

Need to have a high degree of control over those around them... 

Often rigid, critical of others, and unable to collaborate, although they have great difficult accepting criticism themselves. 

Tend to develop negative stereotypes of others, particular those from population groups distinct from their own.

The above actually describes the paranoid personality in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorder (DSM).  Those labelled as paranoid are usually medicated and often incarcerated, but it takes little stretch of the imagination to identify the above characteristics among apparently ‘normal’ or ‘sane’ people on the streets and in all society’s institutions. Perhaps madness is a perquisite to being human.

It was Professor Flora Rheta Schreiber who located the origins of dissociative identity disorder (known then as multiple personality disorder) in trauma. Her ground breaking book Sybil was published in 1973. Sybil’s sixteen personalities emerged one day to introduce themselves to her psychiatrist. 

Houston writes ‘if schizophrenia is the disease of the human condition then polyphrenia, the orchestration and integration of our many selves may be the health…If we can only recognise and encourage the healthy development and orchestration of our various selves, we will avoid much incipient neurosis and pathology.’[2]  

[1]Millon (ed). Personality Disorders in Modern Life
[2] Houston, Jean. In Search of the Beloved

Wednesday, 24 July 2013

A Contemporary Tower of Babel

            The mental health system is a contemporary symbol of the Tower of Babel, where individuals speak in tongues – the disorganised speech of the schizophrenic – that no one else can understand; they ‘hear voices’ that no one else can. The mental health system is essential in the mad and chaotic world we all, in one way or another, participate in creating.

            After two~and~a~half years of deep immersion in the wreckage of human capital, especially that of young people, evident in the South African townships, my ability to ‘hold it together’ came under enormous strain. The despicable and inhuman State~sanctioned apartheid system, which legitimised cruelty, torture and other violent abuse, appealed to humanity’s basest instincts.

            By the time I returned to the UK in 1998, I was mostly standing beside myself. I was suffering from post~traumatic stress. Instead of going into therapy, I decided to train as a therapist; much the same thing really, except that at the end of it I had a professional qualification.

            During the training I constantly said, to everyone’s amazement, that I did not want to be a psychotherapist. Why on earth are you spending all this time and money doing the training then, I was asked. I was doing it for me; I needed to put myself through an in~depth healing process, to clean out apartheid’s dung, as well as some of my own.

"Oh shut the duck up; you're getting on my nerves"

            In addition, I had little appetite for sitting in a room for between 7~9 hours each day, 4~5 days a week, 11 months of the year listening to the child, victim, saboteur and all the other screwball aspects of people’s personalities. I would get seriously pissed off. I would prefer to be a therapist in the world. What does that mean? God knows.
            Using my skills and knowledge to support Dean to confront his own self~sabotaging tendencies as well as to challenge areas of potential abuse and injustice in a mental health system, which rarely listens, gave me enormous satisfaction. Perhaps ‘Therapist in the World’ means using one’s knowledge of the psychology of human behaviour to challenge authority to effect social change. That is so much less stressful than getting angry and engaging, metaphorically, in hand-to-hand combat.

Tuesday, 23 July 2013

Psychiatrist, Avenger & Me

Dean in the Underworld, Act 2

Yesterday found me back in the mental health system, sitting in a room with Dean and his Advocate waiting for the consultant psychiatrist. I am impatient and curious. How many of my stereotype boxes will he fit? At last, there he is, 10 minutes late. His first words were addressed to Dean: you’re sitting in my chair.

I’m in observer mode today.

The doctor asks for introductions, he had not met me and Advocate before. He’s eyes linger on me for a few seconds. I can see that his curiosity has been peaked.  Dean had been immersed in the system since 1999 (which I didn't know until today) and he had never seen or heard of me before. Who am I? What is the nature of my relationship with Dean and/or his family? Why have I suddenly appeared after 14 years? The doc does not actually ask these questions but I can see them written on his forehead.

I offer the barest bones of information. All he needs to know is that I regard myself as an aunt of Dean’s (a very Caribbean tradition) and am now taking an active interest in his medical care and social arrangements as dictated by the system. I am here now because Dean asked for my support just a few weeks ago. I have a mental health qualification and have practised professionally.

An agenda is suggested for the conversation – housing, medication and laptop. The last item is easily dealt with, it’s simply a letter setting out the current situation and seeking a review of a previous decision (see Fuss and Frustration – 15/7) which doc will take away with him. The issue of housing, the reason why Dean asked for my help in the first place, is easily resolved in the direction that he wanted. So that is a satisfactory outcome.

Now we come to the knotty issue: Dean’s medication. Now the laser beam comes out and focuses on the doc; I note and analyse every expression on his face, every inflection in his voice. The psychiatrist is a very mild mannered man, obviously very comfortable in his own skin and has no need to use his power abusively. There are no veiled threats, no condescension. He remains very calm and patient when the automatic tape in Dean’s brain, the Victim/dark Avenger, switches on, heaping opprobrium on his head. The bottom line is that Dean wishes to stop taking his current medication, and proposes something else. The doctor disagrees, the one Dean suggests he has had before is not as effective.

Dean turns to me for advice. Did I approve of him not turning up for his next scheduled injection or not? He wants me to tell him what to do. I ask Dean what happened last time he did that. There’s no answer. He turns to the doctor and the dark Avenger tape begins to roll again. He wants a second opinion because the system is stopping him having a life. The doctor tells him that is his right and actively encourages him to do so.

Doc then hands me and Dean an 8~page summary of Dean’s experience in the system. A quick scan tells me that all Dean’s problems emerge as soon as he stops taking medication and this has happened every time before he is sectioned. I am interested in a) the dosage levels b) why is it so difficult to acquire the medication for side effects. Reasonable responses are made to my concerns, but I am not totally satisfied. I am concerned about the some of the side effects that Dean complains about.  We will have to take this further. I am not satisfied that Dean has been tested for contra~indicators to Haldol, given his heart problems.

Meeting now over, outside Dean asks me again to tell him what to do; he really does not want to turn up next month for the scheduled shot. I remind him of choice and consequences. I say that if he was my son, I would advise him to a) get his accommodation settled and move into his new home; b) enrol on an ITC course; c) try and find a part~time job and live a steady life without drama for the next six months; d) try to get more physically fit.  In the meantime we need to organise extensive medical tests, after which he will have the grounds to a second opinion on the medication and a formal review, getting a solicitor to represent him in a tribunal if necessary. The dark avenger pacified, Dean grins and nods his agreement with my proposal of how he should move forward. We head off for some lunch.

Any 'battle' with the underworld of psychiatry will take time and require solid evidence; and I was not sure that Dean had the patience. His warrior preferred to go head to head in the moment; that was not going to work in his favour because he had been well and truly tagged and documented.

Saturday, 20 July 2013

Far From the Madding Crowd

Health warnings issued (at 32.2C or 89.9F, normal for many places) but here roads melt, train lines buckle, grass fires erupt, and 650 dead in nine days. Oh my god is this really happening in Britain? Does this prolonged heat wave mean the globe is warming wonders sceptics? Nah; can’t be true, especially if you tell me its manmade…makes me feel guilty, so I have to go into denial. Anyway, it was as hot as this in the 1980s says sceptic.

After months of gloomy greyness, and limp summers, the glorious sunshine is welcomed by me.  And I am grateful for a Victorian brick house, which defies insulation, with its sash windows easily forming vectors of cool air. Nevertheless, the sun is blistering and quite treacherous from about 1100 to 1500. I’m not complaining but my body is, especially my heart.

Look forward to opportunity to get away from the heat~trapping concrete jungle that is inner London. Soon heading off to one of my two most favourite locations in England…Devon; the Lake District being the second.

Turnstile Cottage is in a secluded spot located a little way away from the other houses in a small hamlet nestling in the foothills of Dartmoor National Park, pictured above. The cottage is bordered by farmland to the north and a wood to the West, which leads directly on to the moors.
A few yards from the cottage is a river that lulls to sleep at night, then gurgles and gushes as it demands your attention at the merest hint of a return to consciousness. 

For a change of scenery just about 30 minutes drive away are some of the most beautiful beaches in the country (although nothing is as fabulous as the beach at Craster in Northumberland, which the locals insist visitors keep secret). But this one in Devon holds its own, far away from the madding crowds and arcades with their infernal slot machines.

Can’t come quick enough for me.

Friday, 19 July 2013

Taken your Reptile to a Football Match Lately?

My last post, A Racism that Lusts After the Kill, referred to the reptilian brain ~ one aspect of our Triune Brain [1] ~ and its powerful impulses. As the oldest and deepest section of the brain structure, akin to that of birds and lizards, the reptilian brain holds deep-seated ancestral or primordial memory; it harbours all our phobias and generates our greatest nightmares. It plays a crucial role in keeping us alive.

This primitive part of the brain controls our survival and reproductive instincts as well as our fear, vengeful, attack, anger and aggression responses. It governs our flight, fight and freeze (or hide) impulses. It is the home of the tribe and its territorial behaviour, where loyalty and tribal honour towers above all else, even love.

The reptilian brain's 'kill', revenge and retaliatory impulses are satisfied and indulged in ‘theatres’ of war, where it is ‘legitimate’ to defend ourselves against attack, even those perceived as only a future possibility, in order to protect the tribe’s way of life.
Much of that primitive ‘kill’ instinct is also carried out on the streets of our towns and cities, sometimes legitimised by law enforcement imperatives, or by gangs, including fundamentalists of all kind, as well as by the individual.

Those aggressive and tribal instincts are played out in tough contact spots, such as football and boxing – not far removed from the gladiatorial arena. They are also satisfied and disguised through competitiveness, even on the Monopoly or draught/checkers board. 

So when last did you take your reptile to a football match? Who and what tweaks your tail until you turn and snap?

It seems that the power structures of our world function according to the impulses of the reptilian or primitive brain – regressive and controlling – while a large section of the peoples of the world – specifically the Arab world, Greece, Turkey, Brazil, are demanding freedom and a kind of progress not dominated by the needs of rampant globalization.

The second part of the brain, the limbic system, the more ‘cuddly’ emotional side, we inherited from mammals.  It is said to be the source of some aspects of personal identity, and some critically important memory functions. It is much more engaged with the ‘here and now’ and our emotional response to immediate experience.
 So let your koala give your reptile a warm bath and a loving stroke.

The third and outer formation of the brain, the neocortex, is devoted to higher order thinking skills, reasoning and linguistic expression. A path of transformation follows a track that moves a definition of self from mere IQ through EQ to SQ – from basic through emotional to spiritual intelligence.

Thus we have a mind-brain (the past), an emotional-brain (present time), and a higher ordering or ‘transpersonal’ brain, that gives us the ability to perceive a Source greater than we are. On occasions when we are able to integrate the triune brain, it facilitates a rise in consciousness.

[1] P.D. Maclean. The Triune Brain

Wednesday, 17 July 2013

A Racism that Lusts After the Kill

In the wake of the Trayvon Martin/Zimmerman verdict, an image of Martin Luther King Jr. in a hoodie has been circulating on social media.  Said to have been tweeted by former Obama advisor, it has taken the internet by storm over the past few days, receiving over a thousand retweets.[1]

Compare the Zimmerman ‘not guilty’ verdict with that of a black woman in the very same State, sentenced to 20 years in prison for shooting her husband during a violent confrontation. Her lawyers invoked Florida's "Stand Your Ground" law (the Zimmerman defence) yet the jury sided with prosecutors in deciding the woman’s actions were not in self~defence. [2)]

It reminds me of an old and sometimes dark place, that I stepped away from some years back. I have ceased being actively engaged in, metaphorically speaking, hand~to~hand combat around racism, particularly with those key agencies (the 3 P’s) in the criminal justice system – police, prosecutors, and prisons; and I'm not forgetting the judges.  

There are so many horror stories rolling down the centuries of our lives where systemic racism and xenophobia ends in tragedy…

before and after America's First Nation buried its heart at Wounded Knee...

before and after The Middle Passage (the longest, hardest, most dangerous and horrific part of the journey of the slave ships)…and KKK lynchings...

before and after the Holocaust...and the massacre in Srebrenica...

before and after the deaths of Stephen Lawrence and Trayvon Martin, both of which have fallen into the category of cause célébre, for better or worse.

No doubt the horror stories will continue well after I’m dead, and into the lives of my great~grand children; of that I have little doubt. It appears that we all need some sort of scapegoat on which to project the darkness in the human psyche.
Kwame Kwei~Armah, British actor, playwright and broadcaster, now Artistic Director of the CentreStage Theatre in Baltimore, Maryland, USA, wrote the following about how he should respond to his young ones’ question about why Trayvon Martin had to die:

Spent the day talking to my sons and daughter, nephews and nieces about the Trayvon Martin case. It was hard on the heart, hard on the mind, but even harder to hear the younger ones ask in their under ten curious fashion – "So is this racism then?"

One of the hardest parts of raising a black child is this moment. 'To use, or not to use the dreaded R-word?'

The question is however is there any protection in not naming it, or rather in doing so does it single them out? Raise their head above an already shallow parapet? I've been thru this three times already; this fourth is whipping my ass.
Maybe because I'm older, maybe because when I was younger I was hoping that it would be done by now, at least in this most blatant form. Or maybe it's because I feel a little embarrassed that my generation failed to solve the problem and that I am handing it down to them to fix, in ALMOST the exact the same fashion as it was handed to me.

And I know how angry I was at the previous generation for that. End of soul purge.

Systemic racism was never going to be 'solved' by your generation Kwame, nor will it be by the next, given what is right now. It therefore goes without saying that the previous generation had neither a hope in hell nor a prayer in heaven of finding a solution.
For now, what we can all do is teach our children to love, and to aim always for the best that they can be. It also seems to me that the descendants of the Middle Passage era deserve a platinum medal for long distance running and the peace prize for non~retaliation.
While - like the Hundredth Monkey Effect theory of social change - the Kennedys, Kings and Mandelas can spearhead the revolution, but something more is needed. The solution has to come from the very heart and soul of those who hate and fear, those who collude and condone, and the silent majority who, in their many and different ways, pass by on the other side.
At the end of the day the solution can only come from a growth in human consciousness. Right now the Reptilian Coping Brain is in control, and a racism that lusts after the kill gets a free pass.
An interesting question for debate though is what do we make of CNN commentator Abigail Thernstrom’s view that Obama’s response was a mistake - Opinion: Obama's mistake on Trayvon Martin case -


Shadow of the Wounded Healer

Dean in the Underworld: Act I Scene 5

            In the previous scene the Caregiver, now turned Gatekeeper, had just indicated that there were no medics around to give Dean a prescription for lessening the after effects of anti~psychotic drugs. The Mediator must now move offstage, and make way for the Clinician to deal with the situation.

            In medical terms a ‘gatekeeper’ is a health care professional, such as a GP, who is the patient's first point of contact with the health care system; they assess the degree of urgency of a patient’s needs and facilitates the individual's further access to the system.

The gatekeeper to Dean’s access needs some encouragement to do the right thing. It’s time for the Clinician to engage and use her specialist knowledge as leverage. Her manner is deceptively mild and unruffled.

            Since this is a psychiatric hospital you must have a doctor on site or on call somewhere in the vicinity, Clinician says. All anti~psychotic drugs act on the part of the central nervous system located in the brain, said the Clinician, surely it's not your intention that the patient's brains get fried, she continues with a smile. Gatekeeper’s eyes widen.

            Gatekeeper turns to Dean and says: If you agree to take the injection, I will then find the duty doctor. (Oh, there is one about then). Dean agrees. But it seems the duty doctor is assessing a patient just brought in by the police and simply does not have time to read Dean’s file, and the off~site doctor’s phone goes to voicemail.

            Caregiver/Gatekeeper looks at me helplessly.

            It’s not your fault I say, I know you are not in charge here (speaking to Caregiver)…but nevertheless we are not leaving this place today without Dean’s prescription (speaking to Gatekeeper). If he has a massive reaction to Haldol Depot in the next few days, then this hospital will be responsible

          I guess he is on the highest possible dosage, the Clinician asks? Caregiver nods. Have you checked him out for any physiological contra~indicators for this drug, given the high dosage prescribed, Clinician asks? Or is the system a little cavalier with patients who have the propensity to become psychotic? No, of course not replies Caregiver, now a little distressed. I’ll see what I can do, says the Gatekeeper as she hurries away. 

            I feel a little sorry for her. National Health Service staff are stressed and harassed all the time. They are overworked, underpaid and undervalued. People like this lady do the best they can under enormous pressure, but she is the gatekeeper and the gate needs to open.

          Twenty minutes later Caregiver returns with the appropriate prescription. Apparently Dr Bedlam’s junior had miraculously appeared. He must have skived off from his training course.

            Something is going on here; something that I have missed or is not being said, but I am going to get to the bottom of it. I’ll be calling on the Detective’s forensic skills. For now this mad, chaotic day is over. What a relief, at last I can go home. It’s 4 p.m.

            Dean has an appointment with Dr Bedlam in about 10 days time; that should be fun.


Tuesday, 16 July 2013

The Wounded Healer

Dean in the Underworld: Act I Scene 4

            Symbolic of the archetype of the Wounded Healer, the National Health Service (NHS) is not only incapable of healing itself; it is also unable to heal others. It can only cut away the diseased parts, while allopathic drugs help to manage, but mainly mask, symptoms.

In Greek mythology Chiron, renowned for his skills and art as a healer and physician (which made him the patron saint of these vocations) was unable to treat an incurable wound.  He was therefore known as the 'wounded healer'.
Down in the psychiatric under-world, where I have been with Dean, Caregiver is about to administer his medication. He seeks assurance as to whether the prescription for the drug to counteract the side effects of the anti-psychotic medication –dizzyspells, extreme drowsiness, cramp, stiffness, and weight gain – is ready.

            Caregiver says there is none scheduled for him today, and she expected him to have some left over from the previous month. Caregiver wants to know whether Dean wishes not to take his medication – Haloperidol long-acting injection (Haldol Decanoate) |

            Dean is on to her immediately. He has choice, but there are also consequences. If I don’t, he says, you will note it as a refusal on my part, and not that you were unable to meet all the conditions of my medical care, and that means you can re-section me anytime you wish. That’s m’boy; quick learner.

            Caregiver looks at me; I say nothing but the laser is scanning. Only a doctor can write a prescription and Dr Bedlam is not in the Unit today, she says. But you have the drug here in the hospital, says Dean; you give it to others, and I got some last time.

            Caregiver looks at me again; the laser is fixed on her. She will try to locate Dr Bedlam’s deputy and sort it out, she says. About ten minutes later Caregiver returns; both Bedlam and his junior doctor are on a course today.

            That’s it; I’ve had enough. Apparently, while she was out, Caregiver switched her mask (or archetypal pattern of behaviour) and therefore her role; but the laser has picked up on it. Caregiver has now become Gatekeeper; her objectives have changed.

            In that case the Mediator must move off-stage and be replaced by another character in order to move this thing forward. One thing I know, we will not be leaving here today without Dean’s prescription.

Monday, 15 July 2013

Fuss and Frustration

Dean in the Underworld: Act I Scene 3

            The psychiatric hospital has morphed into the Underworld; that’s more fitting to the darkness that has engulfed Dean, a world full of shadows.

            Dean’s Avenger aspect of personality is filled with righteous indignation, with some justification. The NHS bureaucracy has reneged on its stated intent to replace his laptop apparently damaged by another patient on the ward when he was last sectioned. There’s a story here but we won’t pursue it for now; maybe some other time.

            As far as I am concerned, replacement of the laptop had not ever been in doubt, only the manner of payment. I had agreed that payment could be made to my bank account and, as requested by the NHS, Dean had provided written authorisation for this to be done. Apparently Dean’s Post Office account is only valid for receipt of his benefits, and no other payments. Why? I’m sure there’s a good reason other than a dysfunctional bureaucracy making life unnecessarily wearisome and frustrating.

            I wonder what is in it for the system in fuelling a paranoid state of mind. Are there any kickbacks from the drugs companies? Well yes, I do sometimes tend towards conspiracy theory. But it was only the other day that doctors were defending the obscenely lavish hospitality (with gifts?) they were afforded by pharmaceutical companies at a conference held in a plush hotel to market their drugs. And what about the lobbying power of the industry?

            The Avenger, in full indignant flow, is now naming all those who will be implicated in his lawsuit. The Mediator intervenes:

            Yo, I say to Avenger, take a breath; just chill. You know what, there are 5 strikes against you: you’re male, big and black, you’re tagged as paranoid and on SCT – supervised community treatment - (Compulsory Hospitalisation | Doctor | How long do you think it will be before you are assessed as threatening the safety of others, and get your butt hauled back in here? 

            That communicates. Avenger retreats. Caregiver and student (or bodyguard) look a little disconcerted and uncomfortable. None of the players had expected that, they shift uneasily in their chairs. Its fine, mutters victim, I don’t need you to replace my laptop.

            Well, we’re not giving up as easily as that. It’s time to go to a higher power, Dr Bedlam himself. He is the Healer supposedly. I’ve never met him, but psychiatrists are a powerful bunch and some seem a bit shadowy to my mind.

            Dean needs his laptop because he intends to enrol on a course to brush up on maths and update his ICT skills. In “real life” Dean has a professional qualification. At age 13 he passed GCSE maths and received a MENSA commendation. How the duck he managed to get himself entangled with the mental health system in the first place, is simply beyond me; or maybe it’s not really if I stop to think about it.

            And the drama is not yet over for the day.

Sunday, 14 July 2013

Masks and Personality

Dean at the Psychiatric Hospital: Act I Scene 2

I am still here with Dean and I am watching the various masks of his personality emerge in relationship with the masks (representing archetypal patterns of behaviour) others are wearing. 

In early theatrical productions masks were used to depict the different ‘persona’ portrayed by the players. As such this represented a pretence, not the true character of the person.  Nowadays the term persona has lost its connotation of pretence and illusion and has come to symbolize the individual’s observable or explicit personality traits.

            Our inner mental states can show up in the world as other people, and some of us end up caring for or getting entangled with our various selves through other people. It is a salutary lesson for the healer, teacher or caregiver, in their various guises, to identify their own wounded soul in another person, or group of people, or section of society. So our masks wear us and, they turn up in the world wearing other people!

            In his assignation with the Underworld of psychiatry, or perhaps bedlam, Dean is very much in Victim mode, he is being persecuted. The Advocate has shown up, but he is not of much direct help. He stands on the sidelines supporting as best as he can. Then a Mediator turns up and her name is Amari. She and the Victim are about to meet up with the Caregiver.

            Dean’s medication is to be administered by his NHS care-coordinator. She is accompanied by a male who she introduces as a student who is going to observe; maybe. Caregiver has bad news. Her manager has vetoed the purchase of a laptop as replacement for one which was apparently destroyed by another patient when Dean was resident in the hospital. There has been quite a bit of too-ing and fro-ing about this, via several phone calls and at least two face-to-face conversations. And here is the reversal.

            Needless to say, Dean goes ballistic. The Avenger comes on stream, big time; he is outraged at yet further evidence of Victim’s persecution. The Avenger roars his frustration and threatens to sue the hospital. The Caregiver, clearly on Dean’s side but obviously overruled by her Manager, begins to suggest a way round this.

            Dean is beyond hearing; he is in the grip of a persecution complex. Avenger is now leaning forward in full flow.

            The tension coming from the alleged student observer person is palpable; he’s probably a G4S escort (G4S faces damages claim over killing of Jimmy Mubenga) supposedly versed in appropriate restraint methods.

            Jesus, is this paranoia or what? Still, in the current climate of righteously indignant xenophobia (fear of other) especially towards all deemed to be Muslim, anything is possible. We have also awoken to the fact that some Muslims are black (white too, but we won’t worry about that for now; it’s a fact that causes cognitive dissonance – a level of anxiety that occurs when you deny a truth that contradicts what you believe). So, I rule nothing out.

It’s time for the Mediator to intervene.

Saturday, 13 July 2013

Bedlam Begins

Dean at the Psychiatric Hospital: Act I Scene 1
A few days ago, I was on my way to meet Dean at his residence in order to accompany him to the psychiatric hospital, from which he was released a few months ago after being sectioned, yet again.  Dean has issues with everyone in the mental health system: his doctor, those who did his assessments, his care co-ordinator, his advocate, and even the solicitor who represented him in a tribunal case against the system. I smile; I had better gird my loins then.

            Dean says he does not necessarily want me to resolve his problems with the mental health system; he wants a witness to observe his treatment, to see that he is not as paranoid as he is labelled. Dean has been embattled, and on his own within the system for several years. It’s fair to say he is quite angry.

            Today, we are going to meet the advocacy support person; Dean also wants me to be present when he has his monthly anti-psychotic medication via injection.  No big deal, that’s pretty straightforward. I have approached the day as if it is ordinary and have not anticipated the chaos about to rain down on me. Today is a day for madness, and as it starts to unfold, I feel calm and oddly detached.

            The first thing that goes wrong is the oft maligned Central line. We have been holed up in a tunnel for 15 minutes because of a breakdown further down the line. Halfway between Liverpool Street and Bank we reverse back into the station because the train I’m on had also developed some fault, and everyone is turfed out. The next train is rammed, there is no way I can board, and time is leaving me behind.

            Ok I say to Life, is this what the day is going to be about, reversal and delay?
I head out of the station; at street level I call Dean. We now arrange to meet at a specific point at Victoria Station. The first appointment is at noon; its now 1105, plenty of time. Unfortunately, I have no choice but to get on a bus. Except for rare pockets, traffic in central London is log-jammed, as if in constant rush hour mode; and what happened to bus lanes.

            Arriving at Victoria, I call Dean, who says he is on a bus at Hyde Park. Ok, here we go again. Its now 1140 and the bus will take at least another 30 minutes to reach Victoria. Dean lives about 10 minutes away from Victoria via underground, what is he doing on a bus? Dean says his train line is having problems. I tell him to text his advocacy person about late arrival; in the meantime I’ll head to the hospital to hold the fort. 

            Thinking I was meeting Dean, I omitted to check the exact location of the hospital. Of course, no one in the vicinity – not even the information desk at the station – knew the hospital; and none had heard of that street name. I ring a friend, thank god for Google maps; the hospital is less than 10 minutes walk away from where I am.

            At the hospital Dean’s advocacy person, to whom I’ve spoken on the phone a couple of times already, is missing. I’d already labelled him as a bit of a flake. He has not been seen at the office today, and his phone goes to voice mail. When he eventually turns up Advocate says he was stuck on the underground, and anyway he has the appointment down for 1230 not 1200. It’s now 1250, and I left my home just after 1000 this morning.

            Advocate is attentive and reasonably helpful in the meeting, and turns out not to be as flaky as I had assumed. I suspect he is just a tad unmotivated by his job. In the middle of a sentence, Dean’s voice begins to falter, his eyes closes and in no time he begins to snore gently.

            Well, we’re half way through the day, and we’ve had the delay, I’m waiting for the reversal….

Friday, 12 July 2013

Madness and Human Chaos

During my time training and then practising as a psychotherapist, I have studiously avoided engaging with the chaotic world of those diagnosed with a serious mental health problem, especially those who are prone to psychosis.

To tell the truth I am alarmed and unsettled by the personality that has become so fragmented that it tends towards pathology. I think this stems from the fact that my own brother was diagnosed as schizophrenic and we had no choice but to have him sectioned. Unfortunately he died at the age of 20 something after having thrown himself in front of an oncoming train. Thank god our mother had died by then, or that would surely have killed her.

The event was so disturbing, even the thought was traumatising, that I was simply unable to go to the morgue to identify his body. I remember the Sunday morning when two policemen knocked at the front door to tell me that Zan had commited suicide and how it had happened.  I stood staring at them for a good few minutes, said thank you for letting me know and then closed the door.

A few minutes later my partner asked who was at the door.  When I told him, he rushed to reopen the door, to find the two policemen still standing there. God only knows what happened next and who did what because I was simply out of it. I left the planet for a time.  I don’t believe I have really dealt with that experience, but life has a way of settling unfinished business.

A few weeks ago a young man I have known all his life, I’ll call him Dean, asked for my help to resolve some issues he is having with the mental health service, during and after his own sectioning.

Oh Life, you cannot really be doing this to me again. What the hell is it with you? Life chuckles….so yesterday I found myself spending the entire day at the psychiatric hospital with Dean and to my horror I wanted to laugh sometimes, but then that’s the Clown in my personality, he loves the absurd.

I need to write about this experience, but need to digest it first…so wait for the next episode.