Day 592

Today’s question at Re-create Psychiatry was: What is therapeutic?

Everyone’s reality is different. Their stories are diverse. People have many thousands of different types of experiences. So, a generic label eg. depression, has to be false. Are diagnoses a western construct, enabling us to put people into neat and tidy little boxes? ‘What is happening to you?’ is surely a more appropriate question as opposed to ‘What is wrong with you?’

Medics need to extend their frame of reference beyond medical to social and psychological dimensions. We need to have various ways of understanding illness, not limiting ourselves to the biochemical imbalance model. When we hold very tightly to one way of thinking, then conflict arises.

For some horticulture is therapeutic, for others homeopathy or acupuncture or meditation or yoga or art therapy or music. However modern allopathic medicine has rubbished all other ancient modalities of treatment. The fact that these practices still exist could imply their value through many generations. There is enough evidence in their favour but unfortunately they do have the influence of the pharmaceutical industry behind them.

‘Connectedness’ is definitely therapeutic. Modern medicine doesn’t have time for that. It is much quicker to print out a prescription but often that is not what the soul needs. The ‘evidence base’ for the needs of an ailing soul may be a little bit harder to gather than that for a broken arm.

Day 585

Posted by kidsaregifts20

The Dragon Café is starting to feel like second home. Every Monday morning I look forward to going there for a cup of tea (and homemade banana bread) after work, meeting interesting people and being introduced to new dimensions of mind, body and spirit. Now I know some of the names and faces. I am turning into a regular and people are getting to know me too. It feels great.

This afternoon I attended a very simple but smart chess workshop and an art display by a Child and Adolescent psychiatrist and some of his patients. He talked about one of his patients with Selective Mutism, Megan Winton (self portrait above) who could not speak at all outside of her home but now does public talks on her artwork. He discussed their creativity process, the positivity of art and wellbeing and the crossover between service users and providers.

I also met with a passionate artist from a group called ‘Mental Spaghetti’ that brings together marginalised groups of society and the general public to help reduce stigma, enable social interaction and to encourage artistic practice in people of all abilities. They are working on an exhibition titled ‘Cross Pollination’ with the aim of blurring the lines of ‘Us vs Them’ (ie. service providers vs service users).

All those years I spent stuck inside a hospital building seem like such a waste now. We all are the same humans, yet there is a such a wide gap between the social model and the medical model of illnesses. I am intrigued to step out of my little world and see all these imaginative, inclusive and heart felt ways of dealing with people.

I wonder if Saagar would have enjoyed any of these things. I think he would have been a stunning percussionist and a very funny mimic. I think he would have had fun if he would have got this far. Oh! There I go again…

Day 579

Posted by kidsaregifts20

Hospitals can sometimes be a problem rather than a solution. They cannot provide the collaborative information sharing needed to care for today’s typical patients who may have multiple problems. This is especially true for the elderly and the mentally ill. Royal College of Physicians has proposed the concept of “hospital without walls” which aims at providing continuity of care for patients, coordinated and delivered by a single consultant-led clinical team. The hospital ceases to be “somewhere”. It becomes everywhere.

The little market town of Geel in Belgium is well known for its early de-medicalisation of care of the mentally ill. For at least 7 centuries, it’s inhabitants have been taking the mentally ill or disabled into their homes as ‘guests’ or ‘boarders’. These are people who, whatever their diagnosis, have come here because they’re unable to cope on their own, and because they have no family or friends who can look after them. When they meet their new families there is no clinical diagnosis. During the Renaissance, Geel became famous as a place of sanctuary for the ‘mad’, who arrived and stayed for reasons both spiritual and opportunistic.

A boarder is treated as a member of the family, involved in everything and particularly encouraged to form a strong bond with the children, a relationship that is seen as beneficial to both parties. They call it ‘family care’, possibly the best form of therapy. Often the boarder lives with the family till they die, first as a child, then a sibling and later on as an uncle or aunt. Doesn’t that fulfil a basic human need of relatedness with other beings? The tradition still exists albeit to a limited extent due to faster paced city life, fewer farms and more double income families. However, the main reason for its longevity is not just tolerance, but pride. “Half of Geel is crazy, and the rest is half crazy,” runs a local joke.

Today, in London we aim to provide ‘Community Care’ in the absence of a community and no understanding of the word ‘care’. It’s obviously not working because the basic values on which it is based are wrong ie. cost saving.

We, the people need to educate ourselves, open our hearts and develop a deeper understanding of our human condition.

To kick off the Mental Health Awareness week, here are a couple of attempts on my part:

18 Months on…

Podcast from Croydon Radio

Day 573

Posted by kidsaregifts20

In the summer of 2012, Saagar attended a formal family lunch to which he was invited by his friend. His friend’s grandmother turned to him and asked, ”How does it feel to be the only foreign person to be sitting down?” (Hidden message: All the other foreign persons present there were waiters.) He was a bit shocked by that but just laughed it off. I wonder how many times he had faced such occasions where he had no choice but to do that.

Microaggressions are the everyday verbal, nonverbal, and environmental slights, snubs, or insults, whether intentional or unintentional, which communicate hostile, derogatory, or negative messages to target persons based solely upon their marginalised group membership. This term was coined by social scientists at Harvard in the 1970s to describe an inequitable treatment of another person in a manner that is not overtly “aggressive”, yet which might stem from negligence, ignorance, or what we now call unconscious bias. Eventually, the term came to encompass the casual degradation of any socially marginalised group, such as the poor and the disabled.

Recently I watched a short film called STOP (trailer) by Green brothers. It very cleverly portrayed a vulnerable young black man’s position in his society.

Here are some other examples of microaggressions:

A White man or woman clutches their purse or checks their wallet as a Black or Latino man approaches or passes them. (Hidden message: You and your group are criminals.)
A female physician wearing a stethoscope is mistaken as a nurse. (Hidden message: Women should occupy nurturing and not decision-making roles. Women are less capable than men. Happens with me a lot.)
The outfit worn by a TV reality-show mom is described as “classless and trashy.” (Hidden message: Lower-class people are tasteless and unsophisticated.)

Microaggressions are active manifestations and/or a reflection of our worldviews of inclusion/exclusion, superiority/inferiority, normality/abnormality, and desirability/undesirability. Even though these biases are implicit, they can be deeply damaging. The deaths of African-Americans at the hands of the police in Ferguson, Cleveland and on Staten Island have reignited a debate about race.

Is it a pure co-incidence that people from black and minority ethnic groups living in the UK are:

more likely to be diagnosed with mental health problems
more likely to be diagnosed and admitted to hospital
more likely to experience a poor outcome from treatment
more likely to disengage from mainstream mental health services, leading to social exclusion and a deterioration in their mental health?

Day 571

Posted by kidsaregifts20

Two things tend to greatly suffer in mental illness- creativity and human relationships. Sarah Wheeler believed this as she lived with Borderline Personality Disorder and Depression. She set out to create a space that was open-hearted, connecting, non-judgemental, creative and safe – The Dragon Cafe on Borough High Street in London. And it is exactly that – a little bit of heaven for those who’ve been in hell.

Sarah set up “Mental Fight club”. It’s mission is to put on imaginative events for people of all mental health experiences. Every event seeks to connect our inner and outer world and ourselves to one another, whoever we may be. It is no wonder that I intended to be there only for a couple of hours but ended up spending more than double that time, feeling totally relaxed and quite happy.

All visitors are called patrons. Each one is important. You don’t have to do anything. You may do some art, read poetry, dance, sit around and chat, drink tea, have some heavily subsidized, freshly cooked vegetarian food or have a nap on a bean-bag in the Quiet Room.
I will definitely be back there next Monday.

From our conversations it was clear that it is the focal point of many lives. It gives them hope, some thing to look forward to and a strong sense of acceptance and belonging. These are basic human needs that are so often unfulfilled.

Maybe mental illness is not a disease of the brain, but that of society.

This poem by Ben Okri is one of Sarah’s inspirations:

An illusion by which we can become
More real.
A moment unremarked by the Universe,
By nature, the seasons or stars.
Moment we have marked out
In timelessness.
Human moment.
Making a ritual, a drama, a tear
On eternity.
Domesticating the infinite.
Contemplating the quantum questions,
Time, death, new beginnings,
Regenerations, cycles, the unknown.