A vacuum in the NHS.

When Saagar was ill, he filled out an online form and referred himself to IAPTs – Improving Access to Psychological Therapies. This programme  began in 2008 and has transformed treatment of adult anxiety disorders and depression in England. Over 900,000 people now access IAPT services each year. I have used this service in the past and found it useful. I suggested to him to fill out the form a second time and he did. They usually call back within a day or two. He didn’t hear back from them.

I recently found out that IAPTs does not look after suicidal people. I would like to know what they do when they read a self-referral form of this nature.

There is a vacuum in the NHS. There is little face to face support for those who feel life is no longer worth living. Why do most people with physical illnesses ask for help? Possibly because they trust they will receive appropriate help from the system. Why is it that many people with mental anguish don’t approach the medical services for help? Probably due to lack of trust.

The Listening Place works towards filling that vacuum. A few days ago I visited their premises, a short walk from Pimlico station, in the heart of London. This airy, green, warm and welcoming place felt ideal for anyone in need of care, support and understanding. Here, individuals can speak openly about their feelings without being judged. They receive on-going support from trained volunteers over a number of weeks as deemed appropriate. The volunteers help relieve emotional pain and stress and offer opportunities to consider alternatives to suicide. Anyone over 18 can be referred to them by themselves, other charities, NHS as well as health and social care organisations. They try to give continuity by facilitating you to speak with someone who knows you from before. They charge nothing and keep your information confidential. It is remarkable that they are open 9 am to 9 pm, 7 days a week.

Phone: +44 2039067676; Email: referrals@listeningplace.org.uk

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Sarah Anderson, who was once director at the largest call centre for the Samaritans, set up The Listening Place in 2016 and the service has since helped hundreds of individuals with its unique approach to care. During our chat, Sarah’s passion and dedication to the cause comes through, loud and clear.

The world needs more people who give a damn about other people.

(PS: Through the grapevine I hear the future funding of IAPTs is in jeopardy. The vacuum grows.)

 

 

 

What am I doing here?

Like a fusspot, I brought my tea-bags with me. I packed 6 in a flimsy little plastic square box, enough for three days. The nail on my right middle finger shouts out its fragility again. The file is tired of the rate at which the 20 possible keratinous beds declare their inability to cope. The mirror shows a lot of pale scalp shining through sparse, dyed, once thick curly hair.

I woke up in South Wales this morning, in a hillside country house, my window overlooking a valley. Meandering hedges partition the fields semi-geometrically, up and down the slopes. A scaly river shines at the bottom. Not too far, white lines on a newly washed country road glisten too. A few white houses with dark sloping roofs sit on ten shades of green at safe distances, like meditating sages. The panoramic horizon is a multi-coloured squiggly line, cutting right across my window. 6 wind- turbines merrily dance on the west-end of it. The long shadows give away the corner of the sun.

On the balcony a squirrel scrounges under hanging bird-feeders. This morning the birds seem more interested in conversation than food. An errant motor superimposes the chatter periodically. A few streaky feathers lie here and there. One of the twin kittens strolls across the keyboard of my laptop from left to right, following the direction of my sentences.

My mattress on the floor lies 3 feet away from a snazzy red and silver drum-kit and a Djembe. Percussion instruments trail behind me all over the world. I see them wherever I go.

Why am I here his weekend?
I am here to see a ‘medium’.
Never thought I’d hear myself utter those words. 

Day 974

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Yes, but…

‘Yes, but…’ essentially means “what you say is superlative, here’s the underlying truth.”
I am sorry but…
I like what you’ve done but…

The moment the ‘but’ appears, the previous half of the sentence gets completely negated. It sounds insincere or like blame or criticism.

I am shocked to discover how many times I use the word ‘but’ in one day. Recently I learnt that a simple and effective shift can be made if I replace ‘but’ with ‘and’. That way, this is true and that is true too. Multiple realities don’t need to compete. I don’t need to choose one.

‘I know you want more time to complete this book and the deadline is looming.’
‘You want my help here and I need to be in Wales for a few days.’
‘I’d like to help you and I need to make some difficult decisions.’

Feels and sounds better to both parties I think.
Multiple realities do not compete. They just exist.
You own a piece of truth and so do I. Let’s figure out what we can do.
Yes and, ‘NO BUT’!

Day 965

Guidelines, guidelines everywhere…

NICE guidelines on ‘Bipolar Disorder in Adults’ regarding the role of families and carers state:

“Quality standards recognise the important role families and carers have in supporting adults with bipolar disorder. If appropriate, health and social care practitioners should ensure that family members and carers are involved in the decision‑making process about investigations, treatment and care.”

“Why is it that some psychiatrists sometimes don’t fully appreciate the views of carers and involve them in the care of a patient when NICE guidelines clearly state that it should be otherwise?” I asked a senior psychiatrist casually during a recent conversation. “Traditionally” he said, “doctors were sons and daughters of doctors, their friends and spouses were often doctors and those were the people they spoke with. Carers didn’t fit into that box. It’s a cultural thing, still lingering. Hardest thing to change – a mindset.”

India gets criticised for its caste system. In other countries it exists in other forms – the power dynamic between different groups of people in different strata of society. As the Grenfell tragedy unfolds, I see how the management didn’t  take the resident’s concerns seriously. What is the nature of Tenant-Management relationship? Who is disadvantaged?

Any number of guidelines cannot change deep-rooted, unconscious biases. Only humanity can.

Mrs May visited the site but couldn’t speak with the residents for ‘security’ reasons and because she is very tired after her recent election campaign. Being with them would have taken compassion. And humanity. I wonder if this was a Mayfair tower wether she would have felt more secure and less tired. 

 

 

 

Day 942

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My optimism is foolish

For more than 25 years, I have practised anaesthesia. One would think that by now I would know for sure that procedures take much longer than they are scheduled for and that every list these days is overbooked. Still, foolishly I hope to finish in time every day. Even though I have had to cancel after-work plans on many occasions, at every new opportunity I want to give a chance to the possibility of a desirable outcome.

When Saagar was ill, I was optimistic. I believed that he would get better. That it was only a matter of time. The messages I got from professionals reaffirmed that belief. My faith in life and confidence in Saagar and myself kept that belief strong.

Now when I am with worried parents and friends, I hold their uncertainty and mine. Things can go one of many ways. We don’t know. We just need to be with that uncomfortable uncertainty with positivity. That is compassion. Understanding.

In quantum physics, Heisenberg’s principle of Uncertainty says that there is an inherent uncertainty in the amount of energy involved in quantum processes and in the time it takes for those processes to happen. Vacuums are often defined as the absence of everything. But not so in quantum theory. It is possible that for very, very short periods of time, a quantum system’s energy can be highly uncertain, so much that particles can appear out of a vacuum. This is well within the laws of quantum physics, as long as the particles only exist fleetingly and disappear when their time is up. Uncertainty, then, is nothing to worry about in quantum physics and, in fact, we wouldn’t be here if this principle didn’t exist.

“One misconception is that entrepreneurs love risk. Actually, we all want things to go as we expect. What you need is a blind optimism and a tolerance for uncertainty.”

-Drew Houston

 

 

Day 935

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Defeated as a dead dog

At the end of my meditation, I don’t want to open my eyes. There is nothing more to see. I don’t want to open my mouth. There is nothing more to say. All is done. There isn’t much more. It would be ok to have a quite existence in an obscure little place that no one has heard of.

At the end of my meditation, the word ‘acceptance’ hits me like an arrow right in the middle of my forehead. What is the distinction between ‘acceptance’ and ‘resignation’? How can either be experienced without a sense of defeat?

Where is the need to wake up to an alarm every morning?  Where is the need to wade through the London traffic every day? What for? There are more peaceful ways to get through time. I long for them.

The last bit of Liz Lochhead’s poem ‘Favourite Place’ written in memory of her husband:

“But tonight you are three months dead
and I must pull down the bed and lie in it alone.
Tomorrow, and every day in this place
these words of Sorley MacLean’s will echo
through me:
The world is still beautiful, though you are not in it.
And this will not be a consolation
but a further desolation.”

Day 934

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Rikka

The custom of placing flowers on an alter is an ancient one. In the sixth century, Ikebana was founded in Kyoto as an offering to the Goddess of Mercy. Flower arranging contests were held at the imperial court where aristocrats and monks competed with each other at festivals.

In the early 16th century people tried to give a deeper meaning to the thoughts accompanying flower arranging. They wished to arrange rather than casually placing them in a vase. An earlier attitude of passive appreciation developed into a more deeply considered approach.

Rikka is the oldest style of Ikebana. Trees symbolise mountains while grasses and flowers suggest water. A natural landscape is expressed in a single vase. Indeed, all things in nature are reflected. In Rikka it is important to know the laws of nature through harmony of trees and plants.

It is my good fortune that I have the opportunity to be very intimate with Mother Nature in this concrete jungle of London. I have a teacher who is dedicated to passing this ancient tradition on to future generations. Her school has generated a number of teachers who inspire many people like me. Arranging flowers is like meditation in motion. The right brain can express itself to the fullest. The intuitive decision making, the textures, smells and colours of materials, the elegant shapes, the spatial organisation and the movement within bring peace and satisfaction. It is creative within a set of rules. It is aesthetically appealing to the subtle sensibilities. It is a gentle experience of being one with nature.

Maybe one day beauty will save the world.