healing – Page 2 – Our Happy Notes

Being Vulnerable

Posted on March 16, 2023 by Millie :)

Thought I’d share something a little different today. The text below is directly copied from ruminations in my diary about being vulnerable (specifically online). Half formed thoughts and unanswered questions, which is kind of the point of what I was writing about – allowing an ‘unfinished’ image of self to be seen. I’ve thought about it more and this quote in particular resonated with me: ‘Vulnerability is the least celebrated emotion in our society’ ~ Mohadesa Najumi. I’m a growing, changing person whose views will inevitably change, but I don’t think I want to live holding back because I may think differently in the future. All we’ve got is now right? So this post is a little less about mental health, and more about the process of learning to be a mental health advocate (if I can allow myself that title!). Please enjoy this copy of my wandering thoughts:

‘I think I naturally ‘overshare’ a lot, though keep some things very hidden. And it’s part defence mechanism, but also part not understanding what’s meant to be hidden. I don’t see my ‘personal life’ as any more personal or precious just because it’s mine. It doesn’t really bother me if more people know, in fact sometimes that makes it more special to me. But is that just a need for validation? Or am I broken, or missing something – because I don’t seem to understand the idea of personal life in the way the messaging of the world does??

And also, of course I’m afraid of judgement. The biggest fears being that sharing I’ve had problems with alcohol – for example – will stop me getting a job in the future. But if no one speaks openly about these things then they remain something to be feared or judged. Right? Social media is so often used to show the ‘end product’ of healing, discovery, creation etc… the polished, acceptable version. But that’s not life! I’m ok being a flawed, growing person. I have to be because I always will be. I want to show that too.

But is there a right and wrong way to do that? Or is that just more expectations? Or is social media in fact not suitable for that? Of course it will always be just a snapshot of life – does that mean we cannot snapshot the vulnerability too? Indeed – what is vulnerability? I feel we live in a culture where we are afraid to make mistakes, especially in changemaking settings. But mistakes are a part of life. It’s all very confusing, but I don’t want to be afraid of the journey of figuring it out. I choose to move forwards with love and acceptance.’

Advocacy, Managing Mental Health, Mental Health

Reframing Healing

Posted on March 13, 2023March 12, 2023 by Millie :)

We receive a lot of messages, consciously and subconsciously, about what healing is. I have my own opinions, some of which will be evident in this post, but I think one of the most important things to keep in mind is what does healing mean to you? There may be limitations to our ideas of a dream life, because we don’t live in a vacuum, but only you get to decide what your healing actually means and looks like. Unfortunately it’s something that is quite overlooked in a lot of mental health spaces, and we’re not often encouraged to really define it for ourselves. But that doesn’t mean we can’t.

Personally, an important part in redefining healing for myself has been understanding what I’ve been taught about healing. A lot of what I’ve learnt is to see ‘getting better’ as this hyper-individualistic thing. We’re told that ‘getting better’ is about becoming a productive member of society again, going back to work full time, having more output, and living up to the expectations placed on us. A lot of therapy is often about this idea – it’s about mitigating the factors that get in the way of productivity rather than fostering genuine happiness. The idea of compliance and non-compliance in the mental health system is a huge part of reinforcing this and getting in the way of anyone who needs to stop and question whether this striving for efficiency under societal norms is actually what they need.

We don’t live in a vacuum, so I think it’s only logical to suggest that we don’t heal in a vacuum either. And yes it is possible to have personal peace without those around you experiencing the same, but that’s not to say our healing is entirely individual. We are connected; we are even a part of nature. When bears hibernate or trees shed their leaves we don’t look at them and say they should be doing more, they should be doing better; we understand that they are in a season of their life. Yet we so often fail to extend this same understanding and grace to ourselves. We are a part of nature too, and so we are connected to those around us and every part of the world around us. It is only logical to think we should lean into this connection and these seasons to find peace. So I would say healing is community. Healing is working together. Not in order to fix or mend one broken individual, but to recognise what in our living, breathing system of life contributed to their pain in the first place, and to heal all of us. I’ve found that when I am held by a community, only then am I able to find my own inner peace.

We also seem to see healing as this end destination – we arrive at ‘healed’ and then we continue there as before… until maybe we need to be healed again. But I don’t see it like this. Healing is an ongoing, every day process for me. Just like I see myself as a continually ‘recovering’ alcoholic, I also see myself as a continually ‘healing’ person. Partly because there are new challenges to life every day; partly because I have chronic mental illness; and partly because I see healing in a larger sense too, one of societal healing. That can be hard to conceive sometimes, or to not get wrapped up in. But I see it as a source of hope rather than a drain of hope. A source of power. That healing, as an ongoing, everyday practice, also means trying to help others and be connected with their struggles. Trying to learn how we can all work together to do better, to build better infrastructure, to break the chains and patterns of the past, to move forwards.

So what does healing mean to you? Does healing mean connection? Does healing mean going back to the life you had before? Or is that just the easiest life to imagine? Does healing mean productivity, or does it mean inner happiness and peace? What do you need to see that realised? Is healing individual, or collective, or aided by the collective? Is healing a destination or a journey?

I’m not saying there’s one right way to redefine healing. It is personal in how it manifests in our lives, but the very fact that so many out there are healing and recovering shows that while it is personal, it is not individual. And I think the mental health system needs to recognise that too.

Sending all of my love and support to you today xxx

Glowing fluorescent blue triangles in a pattern

Advocacy, Mental Health, therapy

Issues with IAPT

Posted on February 24, 2023February 23, 2023 by Millie :)

Disclaimer: Before I dive into the issues with IAPT I just want to clarify that this blog is in no way intended to discredit anyone’s positive experience with IAPT or discourage anyone from using the service. IAPT could still be a piece in the puzzle of helping you find the right support. I am purely highlighting issues that some people face because everyone deserves to have a positive experience of mental health care – if the mental health system can’t adapt to different needs, then it needs to change. This post is about raising awareness of the gaps within that system, and the plaster solution that IAPT has become. Because we all deserve better – it could be you or any of your loved ones needing a more comprehensive, long term and personal care plan. And I would hope that the door was always wide open for you to receive the support you need.

With that said, let me give you an introduction to what IAPT is. IAPT stands for Improving Access to Psychological Therapies. If you are an adult and go to the doctor with a mental health concern, you are likely to be referred to this service as one of the first ports of call. It was rolled out in 2006 and there are now around 220 IAPT services in the UK. It offers patients a limited number (usually 6, up to 12) of sessions with a counsellor using CBT – Cognitive Behaviour Therapy. And it’s true that rolling out this service greatly reduced the 8-12 month waiting time for psychological therapy in 2005, which is great, but that doesn’t mean it provides a greater level of care.

So let’s look at the information I’ve just noted. CBT focuses on changing thought patterns and behaviours of individuals – which by definition is not suitable for anyone who’s mental health is being impacted by the situation they are in. It’s true that CBT skills can be incredibly useful in helping us cope with day to day life, giving us the tools to reframe our experience so it becomes bearable and our thoughts less consuming. But that doesn’t mean it’s perfect by any means, nor suitable for everyone. For example many autistic people have likened the approach of CBT to gaslighting; it just isn’t suitable for application with neurodiverse thought patterns in many. For many others too it simply doesn’t provide the all round support they need – the therapy sessions are not designed to hold space for the person, explore route causes that will continue to be present, or brainstorm ways to change the situation they are in. It can provide people with a quick fix to a singular problem, but lacks a long term approach.

However, it’s the only framework offered with IAPT, already excluding many from the help they need. Especially because if someone goes through with IAPT treatment they may be seen as already having support and having to face longer waiting times; likewise if they refuse to continue this raises the issue of non-compliance. Non-compliance is a complicated label used in the mental health system sometimes that essentially labels patients as unwilling to try and help themselves and makes it harder for them to access support, simply because the support they refused was not suitable or accessible to them. This is a systematic issue of not providing individualised care, but instead it is labelled as a personal fault and the burden is borne by the individual.

Even for the people CBT framework does suit, the IAPT programme offers such limited sessions that it’s arguable how much long term support and healing they actually offer. 6 sessions is simply not enough in my eyes. What about the people with more complex issues? The people that learn slower? The people that need time to build a secure relationship with a therapist before they feel confident to start working with them? They are all being left behind by the existing IAPT service.

None of this is surprising when we look at the roots of how the IAPT service came to be. In 2005 Lord Layard – an economist by trade addressing the economic costs incurred due to mental health crisis – and David Clark – a professor of psychology championing CBT – pitched their idea for IAPT to a board room full of government officials. They pitched it through the economic benefits that providing a cheap service that got people back to work could reap, easing the £12 billion cost of depression each year. Though I understand why so often proposals have to be pitched through an economic lens rather than a moral or social one, I do think it’s very sad. And I think in many ways shows why this system isn’t working. We’re approaching the issue of the mental health crisis wrong if we’re approaching it from a perspective of getting people back to work. Mental health doesn’t exist in a vacuum and is deeply intertwined with all aspects of society which we cannot simply ignore addressing when looking to help mental health. Furthermore, healing is not actually about productivity – this is considering healing through the eyes of someone else looking in on a life trying to define quantifiable proof of them getting better in a way that is palatable to society. Healing is internal and personal; our current mental health system does not recognise or allow space for this in our society.

Nonetheless IAPT was heralded as an astounding success in the mental health sector worldwide for its quick rollout and wide reach. But in 2010 Dr Micheal Scott – a clinical psychologist at the University of Manchester – began to question the success of IAPT when assessing its patients. He was hearing many stories of patients with bad experiences of the programme who found it useless, dropped out, or pretended to be better to make it end quicker. He decided he needed to look further at how the effectiveness of IAPT therapy was being assessed in order to discover if it was really as great as it was claimed to be.

The first thing of interest he discovered was that IAPT was responsible for collecting all the data on its own performance – there were no external reviews or assessments taking place. I think many of us will know that this is a bad scientific practice for collecting and understanding data – there should always be peer reviews. So he conducted an assessment to discover the true recovery rates.

He began by reviewing the cases of 65 people. I’ll admit that’s not a lot, but stick with me here. Scott used various procedures for a robust review including in-depth interviews, diagnostic assessments, and evaluating medical records. His results showed that no matter the condition, only 16% could be considered as recovering. This is woefully below the 46% reported by IAPT themselves – and with good reason. IAPT’s method of assessing recovery rates only included those that completed treatment with them and neglected to count the half of patients who dropped out of treatment. The fact that half of patients drop out of treatment at all is a huge indicator that the programme is failing anyway, but the correct way to conduct research would be to include them in the data. By omitting them IAPT are artificially increasing their recovery rate. I would also add here that even their self-proclaimed 46% could be much higher with proper individualised, socio-culturally aware treatment plans.

Scott’s admittedly small study isn’t the only one either. The University of Chester’s larger study found a 23% recovery rate, still much lower than IAPT’s claim. And that’s before even considering what IAPT deems recovery to mean. I’ve already explained that IAPT was built around the idea of getting people back to work, and so it’s unsurprising that the programme focuses on getting people back to what are viewed as functioning members of society rather than personally happy with their healing journey.

This is seen reflected in how IAPT reviews patients progress. At the start of the therapy questionnaires are conducted that rate how depressed or anxious you are, and then again at the end of the therapy. If at the end of the therapy you score lower you are considered to have improved. If you scored just above the clinical threshold for depression at the start of the therapy (let’s say the threshold is 10 and you scored 11) and by the end of the therapy you score just below (let’s say 9) then you are considered recovered by IAPT. But in reality you’ve only dropped 2 points and are likely still experiencing emotional complications in your life! They’re now just not considered inconvenient enough to others to be clinically notable, but that doesn’t mean they aren’t hugely significant to you. You might not feel ‘recovered’ at all. And the scale is really sensitive anyway – you can move around 5-7 points simply by sleeping and concentrating a little better.

Furthermore , IAPT doesn’t even conduct a control group meaning there’s no way to know if the 23% ‘recovering’ would have improved slightly without IAPT at all. In fact a recent meta-analysis (meaning examination of lots of data from different individual studies) showed that a total 23% of people suffering with depression spontaneously overcame their symptoms within three months without receiving any treatment. Which aligns with the 23% recovering from IAPT exactly, suggesting that the service is totally irrelevant. Yet it is often the only service offered to those struggling, many of whom will continue to struggle unsupported. Real lives are in the balance, and the system is trying to stick a plaster over the issue that doesn’t even work.

This doesn’t even begin to touch on the deep issues for workers within the IAPT services, who are struggling hugely themselves and being crushed under a culture of form filling and goal hitting heralded above actually providing support. An ex-IAPT lead said, in an interview with James Davies: “To hit the waiting list targets we’d offer people some minor intervention but it was not what they really needed – it was what we could offer to get higher results”. And there lies the problem in a nutshell – people are not being offered the help they so desperately need. And how could they in a system that values goals, productivity and economy above people’s lives? How could they in a system that is built on societal expectations, harm, and conformity? How could they in a system that isn’t working to face the deep intersectional issues of the day? How could they in a system that is underfunded and in desperate need of reform?

I recognise that criticising the mental health system is a complicated thing to do, because it’s where we hope to find help. But the reality is that it falls short. I do have hope it can improve; I have hope in our communities and our efforts to see better care. And I do know that despite a failing system people can recover – by their own standards – and live bright lives. But I know too it shouldn’t be so hard to get support, for anyone.

So here are some calls to action! What you can do to help:

Most of the information in this post comes from James Davies’ book ‘Sedated: How Modern Capitalism Created Our Mental Health Crisis’. I would recommend that everyone read this book to educate themselves further
Sign up to Mind’s newsletter to find out about their campaigns for better mental health care
Write to your MP about the failing mental health system and demand care that is individually tailored, socio-culturally aware, and focuses on personal healing not productivity
Share this post and have conversations with people in your life about the mental health system – all change starts with a conversation

Thank you so much for reading! Please let me know any thoughts or questions you have in the comments below. Sending so much love and support to you all today 🙂

Sources:

https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt#:~:text=What%20is%20IAPT%3F,with%20anxiety%20disorders%20and%20depression.

‘Sedated: How Modern Capitalism Created Our Mental Health Crisis’ by James Davies

https://www.madinamerica.com/2022/06/uk-iapt-abject-failure/#:~:text=We%20identified%20a%20series%20of,of%20misdiagnosis%20and%20inappropriate%20treatment.

Layard, Richard (2005), ‘Mental Health: britain’s biggest social problem?’, paper presented at No. 10 strategy unit seminar on mental health, 20 January 2005

https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/cognitive-behavioural-therapy-cbt/

Griffith, Steve, Steen and Scott (2013), ‘Improving access to psychological therapies (IAPT) programme: setting key performance indicators in a more robust context: A new perspective’

Whitford, H et al, (2012), ‘Estimating remission from untreated major depression: a systematic review and meta-analysis’

Happy Notes, Notes, Personal Growth

22:47, A Poem

Posted on February 20, 2023 by Millie :)

You may or may not know this about me already, but aside from being a mental health advocate, I am also a very creative person. My biggest passion in life is theatre, and I adore all forms of creativity from writing poetry to banging pots and pans together to make a beat. I think that my passion for advocacy and my creativity go perfectly hand in hand, as does creativity and mental health recovery. So I thought today I’d try something a little different and post one of my poems that relates to my mental health journey. I only write poetry when I’m feeling an emotion intensely – whatever that may be. I find it the perfect form of writing for expressing deep and complex emotions or experiences. So here’s a little piece of my journey that I wrote about a year ago; a look into my heart. I hope you like it, please do let me know in the comments. Sending love and support to you all today!

22:47 – Letters to Friends

I have mismatched smiles

And unsettled expressions

I have tears that come unwarranted

-for most-

But perfectly

For me,

Though sometimes I may pretend they don’t

Till even I forget my tears are full of worth,

And most dangerous of masks

Are the ones we do not realise we wear.

So when your breath catches

Just above the safe tide mark,

When your ears hear the words

They want

So your mind can steal you

For your fears,

When everything is right, balanced in unbalanced juxtaposition, when it is perfect,

And so then it is wrong,

And when all you yearn for is to rest,

But all you can do is run,

How then do you tell them you are grateful?

How do you show

When you can’t feel,

And words will do no justice, of course they won’t, because the crooked smiles and the disorganised tone of voice will give away the

Fear?

Is it fear?

Or is it acceptance? That you are not, and cannot, but you belong in the silence between them.

Maybe you don’t. Maybe you can’t tell them.

Maybe it’s enough

That you know

And that you be

As you are

Until what you are is something new,

And you can glance at what was,

Content.

Happy Notes, Managing Mental Health, positivity

100 Good Things in The World

Posted on January 30, 2023January 30, 2023 by Millie :)

I’ve made a previous post on reasons to stay alive, which you can read here, but I wanted to create another list of good things in the world. It’s like a list of reasons to live, but also a list of reasons to be grateful (a very important practice in my life), and a list of reminders to see the little good things in life when things get rough or stressful. Use this list to find a moment of pause in your day to connect with some peace, and let yourself connect with the goodness in this world. There’s a lot of issues and sadness, and we can’t ignore that, but sometimes we do need a moment to escape the pressure.

Potatoes – they can be cooked in so many different ways!
The smell of the air after it’s rained
Crunchy leaves
Handwritten letters
Listening to the sound of the sea in seashells
Chameleons – they literally change colour, that’s insane!
The amazing activists and advocates trying to create a better world for us full of hope
The internet. It’s really quite incredible if you stop to think about it
Video calls allowing us to see each other and connect from afar
Really soft fluffy blankets
All the different kinds of music and how all of us can find different pieces beautiful
Board games
Deck of cards – how many different games and tricks you can do, and how they’re unlikely to ever be in the same order!
Snow under your feet
Sledding down a hill
Laughing until your belly hurts
Hats.
The northern lights – they’re like magic!
How many different languages exist
The top of ice cream before anyone takes a scoop
Really cold water on a hot day
A cat’s purring
Bluetooth
The smell of old books
The smell of new books
The smell of freshly mown grass
The smell of freshly baked bread
Pretty sparklers and fairy lights
The Fibonacci sequence
Those random acts of kindness from a stranger that brighten a day – like letting you go first in line, offering a tissue, holding a door
Dogs little paws and toe beans
Bubbles
How many different flowers there are!
The miracle of ecosystems in nature
The feeling of floating in the sea
Building sandcastles
Clouds at sunset when the light illuminates them
Hugs
The amazing scientific advancements being made every day
Shooting stars
Book clubs (or any kind of community club, it’s so lovely to get together over a shared love and interest)
Amateur dramatic theatre – it’s totally about doing what you love together, no other reason!
Magnets (just so fun to play with and the science is actually very cool)
Charity shops and thrift stores
People sharing their knowledge and encouragement on the internet
Pillow fights
Water fights (why stop doing the things you loved as a kid just because you’ve gotten older)
Electricity
Beautiful trees
Daisies close up at night like they’re going to sleep
Sunflowers turn to face the sun
The colours of leaves changing in autumn
Teddy bears
The infinity of imagination
Community gardens
People being brave enough to live their truth and share their stories every day even though it may be dangerous or stigmatised
Libraries (they offer the gift of reading to so many more people)
The word ‘serendipity’
Public transport linking us easier
Funky hair dyes (and the amazing things people do with them)
Fidget toys and logic puzzles
Hilarious movies we can bond over and laugh at
Free education (hopefully one day equal and free education will be available to all)
Poetry that reflects our own experiences and feelings
Funny animal videos
Free guided meditation videos
Peer support groups
Smiles
So much art and creativity in so many different forms that connects us, reflects and shapes culture, and inspires
Calculators you can type rude words on
AAC communication devices allowing nonverbal people to communicate easier
Medical and emotional assistance animals
Hot chocolate (or your other favourite warm drink)
Colour changing lights, they are so cool
Written letters
Messages of kindness from strangers posted online or scrawled in public everyday
Blue tac
Glasses and hearing aids – imagine what it was like before we had them!
Apps for so many different things, making knowledge and the world more accessible for many
Woodland walks
Friendships
Love is all around us in so many different forms
Dad jokes
People donate blood to save others every day
Audiobooks making reading more accessible
Picnics
Pizza – circle shape, in a square box, cut into triangles
Alcohol-free alternatives
Fluffy socks
Showing gratitude
Bird song in the morning
Finding a penny on the ground
Running through sprinklers
Feeling of popping bubble wrap
Hearing a song you used to love and had forgotten about \
Seeing an old friend for the first time in a while and picking up like you only saw them yesterday
When you have a really cool dream and you can remember it when you wake up
Eating breakfast food at night or dinner food in the morning
That cosy feeling when it’s rainy outside but you’re warm inside
There’s always more tomorrows

Managing Mental Health, Mental Health, Personal Growth, therapy

Types of Therapy

Posted on December 12, 2022 by Millie :)

Let’s start today’s post by busting some myths about therapy – scroll down to find out more about all the different kinds of therapy out there! (Spoiler alert – there’s lots of them!)

Myth: Therapy is only for people with a mental illness

Truth: While therapy can definitely help people facing mental illness, it can also be really helpful for anyone by providing a space to express and explore emotions and situations

Myth: There is only one kind of therapy

Truth: There are lots of different kinds of therapy that address different experiences, work better for different people, and approach therapy from a different angle. If you haven’t found what’s right for you yet, it doesn’t mean it isn’t out there!

Myth: Therapy is only in person

Truth: Some therapists provide online or telephone support instead or in addition to in person therapy!

Myth: All therapists are the same, it doesn’t matter who the therapist is

Truth: The individual therapist and your relationship with them is extremely important and can vary hugely – it took me a long time to find the right person for me

Myth: Going to therapy is something you should hide

Truth: there’s nothing shameful about going to therapy

Myth: Therapy is accessible to everyone

Truth: Currently therapy is not equally accessible to everyone, and this needs to change. It can depend on location, financial situation and identity (for example) as to how accessible it is. However the NHS, charities, insurances and local initiatives do offer certain kinds of therapy and support so it’s definitely worth looking into what’s available to you!

Now here’s an introduction to the kinds of therapy available. If one sounds appealing to you, or like it would be a good fit for you or a loved one, I would encourage you to do some more research on it and have a look to see who is available to deliver that kind of therapy in your area.

CBT

CBT stands for cognitive behavioural therapy and is one of the most popular/ available therapies out there – for example the IAPT services in England (Improving Access to Psychological Therapies) only offer CBT. It’s based on the idea that thoughts, emotions and physical sensations are linked and that negative thoughts lead to negative cycles. It centres around learning to break these thought patterns in practical ways, so is therefore more focused on changing the way you’re feeling in the present or with behaviours in a particular situation rather than a deep dive into past experiences, for example.

Many people find CBT to be of great help, but for some people it just doesn’t click. If you are neurodivergent and thinking of trying CBT I would definitely recommend trying to find a neuro-inclusive CBT service, as from personal experience the typical delivery of CBT is much more focused on a neurotypical thought pattern – however that is only my opinion!

The great thing about CBT’s popularity is that the structured skills it provides to deal with thought patterns, along with its basic concepts are now widely available for free. So if therapy isn’t viable/ comfortable for you at the moment then you can still learn some skills to implement. My personal favourite app to learn CBT skills is called Woebot. It’s laid out in an easy to explore and pleasing format, and you learn the skills from a cute little robot therapist. Definitely worth a look if you’re thinking of learning some more about CBT.

DBT

This next acronym stands for dialectical behaviour therapy. It’s based on CBT, but it’s specially adapted for people who feel emotions very intensely. Personally I liked this therapy more than DBT not because I am someone who experiences intense emotions (which I definitely am) but because of the way it was structured. It just made more sense to me personally.

DBT is often used to treat personality disorders and was originally developed for borderline personality disorder (a somewhat controversial condition), and has had success helping mood disorders, self harm, and suicidal ideation. It works in a way like CBT to break negative cycles and make positive changes, but also focuses on accepting who you are at the same time. A DBT therapy programme can be more intensive and involve group sessions also, however individual therapists using DBT skills can also be found.

Counselling

Counselling is often seen as less ‘deep’ than therapy, but this isn’t necessarily the case. For some people (me included) the idea of counselling – talking with a therapist about an issue or your ongoing life, rather than focusing on specific structured skills – is really beneficial. With this kind of support though I think it’s perhaps even more important that you are comfortable talking to the counsellor, particularly if it is longer term, as your relationship with them is central to the strength of the conversations.

Many people also see counselling as a more short term therapy, but to me this is counterintuitive. Finding a therapist to build a long term, ongoing conversation with gives us a space to express our feelings about our daily lives and mitigate problems before they arise. Unfortunately ongoing therapy is rarely available through the NHS currently, but I hope to see that change soon!

Many therapists will be able to provide either counselling or more focused therapy, so it’s worth asking for a mixture of sessions/ approaches if you think that might work for you.

EMDR

EMDR stands for eye movement desensitisation and reprocessing. It is designed to help alleviate and process the distress caused by past traumatic memories and experiences, and is quite different from the other therapies mentioned already. During the therapy the patient will briefly revisit the traumatic memory in a sequential (and guided) way whilst also focusing on external stimuli. This external stimuli is often the therapist directing the patients eye movements laterally, but could also include other variations such as hand tapping and audio input. It’s thought that this allows accessing the traumatic memory network in a way that kickstarts further processing and new positive associations. It allows for total processing, relearning, better present memories and more by activating your natural healing process and removing blocks. The process is highly structured and includes evaluation for readiness for EMDR, exploration and explanation of current symptoms, and making sure you have several tools to handle emotional stress. EMDR was initially designed to help patients with PTSD, many from army settings, but is now helpful for a variety of people with different symptoms and experiences. If this sounds like it could be helpful for you I would definitely recommend researching this incredible form of therapy further!

Psychodynamic Therapy

This kind of therapy is derived from psychoanalysis and the theories of Freud. It focuses on helping you understand how your current feelings and behaviour are shaped by your past experiences, along with your unconscious mind and impulses. It could be said that this kind of therapy focuses more on interpretation and the perspective of the client than a singular ‘problem’ like in CBT. Like all therapy the relationship with the therapist is very important, but this is one of the therapies where it is even more pronounced as it may involve discussing childhood memories, relationship with parents, etc. Psychodynamic therapy may even be what comes to mind when you first think of therapy! It’s less structured than DBT or EMDR for example, and many therapists will allow for free association in sessions (discussing whatever comes to mind). Some therapists may also combine this approach with others, so it’s worth having a look at what’s offered.

Interpersonal Therapy

As the name might suggest, interpersonal therapy focuses on a patient’s relationships with those around them. It looks to improve relationships in their life to alleviate symptoms, because a central idea in interpersonal therapy is that psychological problems can be understood as a response to current everyday difficulties in relationships with other people. It is structured; time limited; focuses on the present; aims to improve interpersonal communication, functioning, and social support. If you are struggling with interpersonal relationships in general or specifically with family (for example) and you feel this is causing difficulties, then interpersonal therapy might be a good idea to help!

Gestalt Therapy

This is another kind of therapy that focuses on a client’s present life rather than past experiences, so will be more effective or relevant to some than others. It also revolves around taking responsibility rather than placing blame. Like psychodynamic therapy it involves the idea of perception – exploring how a person understands the world around them, and the context of their whole life. It operates on a basis that rather than purposefully digging up past experiences, as a client becomes more self aware they will start to overcome existing blocks. It is a less structured form of therapy.

Art/ Drama/ Music/ Animal Therapy

Ok I’ve lumped these all together because they essentially include a common theme of using a creative medium or a way of connection to work through difficulties. Art therapy involves expressing emotions and ideas through art for example, and animal therapy involves spending time around animals which can be very calming and help with empathy etc. Different therapists using another medium in therapy may have different approaches. For some it may just be about letting the patient self-direct and spend time engaging with music, animals etc. Others may still use structured approaches or conversational exploration in conjunction with mediums as an extra tool for expression, learning, or helping a client relax so that therapy is more accessible. Talking to a therapist to ask about their individual approach before starting is a good idea.

There are even more types of therapy than the ones mentioned above, and many things to think about when choosing a therapist or kind of therapy. Unfortunately therapy, or different kinds of therapy, are also not equally available. If you can please consider donating to local funds to support others on their healing journey, and write to your MP to demand change in the system. If you found this post informative or helpful please also follow this blog to support any work and get notified of future posts. Let me know if you have any questions in the comments below

Have a great day!

Sources:

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/

Sedated: How modern capitalism created our mental health crisis, by James Davies

https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/dialectical-behaviour-therapy-dbt/

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/types-of-talking-therapies/

https://www.emdr.com/what-is-emdr/

https://www.bacp.co.uk/about-therapy/types-of-therapy/eye-movement-desensitisation-and-reprocessing-emdr/

https://www.bacp.co.uk/about-therapy/types-of-therapy/psychodynamic-therapy/

https://positivepsychology.com/psychodynamic-therapy/

https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/interpersonal-psychotherapy https://www.verywellmind.com/what-is-gestalt-therapy-4584583#:~:text=Gestalt%20therapy%20is%20a%20form,considering%20the%20challenges%20they%20face.

Advocacy, Managing Mental Health, Mental Health, Personal Growth

Journey Through Panic Attacks

Posted on July 3, 2022 by Millie :)

The first time I experienced a panic attack I was 11 years old. I had come home early from school that day with a headache and some other physical symptoms I now know were anxiety, and I had gone upstairs to have a nap before dinner. My mum came to wake me up when it was time to eat, but I must have been in the wrong phase of my sleep cycle because I awoke disoriented, thinking it was the morning. We’ve all been there when we wake up not quite sure what’s going on. So I thought it was the morning, and when my mum told me it was time to eat I responded asking about breakfast. There was some confused back and forth with my mum trying to convince me it was in fact dinner time, and still the day before, and I suddenly spiralled into my first panic attack. I don’t remember a whole lot of the details while it was happening, but I do remember how terrifying it was. I remember feeling like I couldn’t breathe; I simply could not get the air into my lungs. I felt faint, and sick, I thought my legs couldn’t hold me up. I don’t know if I had the thought that can come alongside panic attacks where you think you’re going to die, but I knew something was very, very wrong; I definitely thought I was going to faint. Somehow I ended up at the bottom of the stairs, gasping for air and sipping water out of a bottle cap (I think that was the only way I could manage to do it?) as it subsided, and I can still recall the exhaustion after that first one and how foreign it felt. My mum suggested it had been a panic attack, and at that point I didn’t know what that meant. I had no idea they would become such a huge part of my life.

I have had many panic attacks since this day. I’ve also had some anxiety attacks, which are more prolonged and less intense, and I experience sensory overload too as an autistic young person. Sometimes sensory overload meltdowns and panic attacks can be hard for me to distinguish, and sometimes they overlap or morph into the other, but it’s helpful sometimes to figure out which is which as it can aid in the recovery process both long and short term – for example in a panic attack changing my jumper probably isn’t going to help and may not even be a possibility, but with sensory overload changing the material of my clothing or my environment may help it to subside or avoid it altogether when I feel it building. This year I have felt the strongest mentally overall that I have in a very long time, but I still have panic attacks. Some months I have none; others I have many. For example in May I had seven.

It’s important to note that while I find the label panic attacks useful, it is a pathologised word. That means there is a certain medical connotation attached to it. However panic attacks are a total overload of our nervous systems; an explosion of tension and anxiety. We cannot talk about expressions of mental distress without recognising that they are often responses to a traumatic and stressful world, whether immediate results of a specific trigger or a build up over time. For example in May I was dealing with exam stress, difficult atmospheres at home, grief for my safe place, and more time on my hands. These all contributed to my spike in panic attacks I have no doubt. Other times I may make it to the other side of a stressful event and then experience panic attacks, almost like a hangover of emotions. It’s not an individual failure, but an understandable reaction to a difficult world. You are not broken for experiencing anxiety. You are not shameful for having panic attacks.

I am a firm believer that to appreciate life fully we need to be able to laugh, even at the bad stuff. There are certain events surrounding some of my panic attacks that I find kind of hilarious looking back on and that helps me to deal with any embarrassment or regret surrounding them I may have. For example, I have terrible stage fright (despite being an actress, ironic I know). Before the final dress rehearsal for Bugsy Malone – my first show in a proper theatre – I had a panic attack in the wings. I was crouched behind a prop box in heels I could barely walk in and my tailored sparkly dress writhing my legs in pain and sobbing without air. It was a pretty desperate moment, though the juxtaposition itself is amusing looking back. The next thing I remember is a stagehand saying into their walkie talkie ‘can someone please come and remove the fire hazard from the wings?’. I was the fire hazard because I couldn’t move myself out of the way, and I was carried back to my dressing room by my director. Talk about a diva moment. Looking back I cannot help but laugh at the absurdity of the experience.

That particular panic attack also showed me how loving people can be. I hope that someday everyone experiencing mental health issues gets to experience the pure love and support that I did that day. I had to go on stage just after recovering to do a mic check. I was so exhausted – my bones were heavy; the exhaustion of a panic attack travels to your core and can make you feel like your body isn’t your own – so all I could do was stand centre stage. The rest of the cast sat in the audience as I weakly sang ‘My Name is Tallulah’. Half way through the song I raised my eyes and saw that they were all swaying along, waving their hands in the air; at the end of the song they stood up and cheered and called out encouragement. It was beautiful. No one judged, no one whispered or pointed. They rallied and supported me. That’s what we all deserve.

Another amusing panic memory was when I fell on my face in the mud on a rainy day trying to escape prying eyes and instead drawing them all to me; again, it wasn’t as embarrassing or well remembered as I feared it would be. Or when my teacher gave me their scarf to wrap around me and help me feel safer and I immediately snotted into it – I got to keep that for a while rather than immediately returning it. Or the time I went to get help while having a panic attack but there was already a girl in the office having a panic attack and it became like a queue for a very strange and unwanted product.

I’ve been alone on bathroom floors, writhed my legs, hit my chest, backed myself into literal corners to try and feel a bit safer, thought I was going to die, taken off most of my clothes because I thought my skin was going to burn, and just general cried and made weird sounds while trying to breathe. Point of all of this is – I survived. And each one has become a little easier to recover from. The worst a panic attack will do is make you pass out; it cannot kill you. Remember that – it cannot kill you. If you are having one, it is horrible and tiring and painful, but you are safe. And if you are with someone experiencing one it’s ok to remind them of that; if you can recognise what it is and call it what it is. Tell them it’s a panic attack and that they are safe. Often it helps not to try and suppress it either but rather to ride it out, let it be. Because they are not the end of the world, but they are super scary and it’s ok to recognise that too.

I hope that maybe reading this has helped someone feel a little less alone in their experience. If you’d like a more in depth guide on how I deal with my panic attacks let me know in the comments below! Sending love and support to you all today! Xx

Advocacy, Mental Health

Over Pathologisation of Mental Health

Posted on June 10, 2022 by Millie :)

We hear a lot nowadays about removing the stigma from mental illness, and that is incredibly important. After all, we all have mental health. But I also I think it’s essential while advocating in mental health spaces that we not only call for destigmatisation, but we also question the systems; call out the injustices of the systems meant to care for us. We must question whether medicalisation of mental health really helps us. Would it be necessary if our society wasn’t structured the way it is in the west? Does it further the link between mental illness and criminalisation? Because destigmatising mental distress isn’t only recognising that it exists, it’s asking why it exists, is the language we use to describe mental illness helpful, what does healing really mean, and how are we failing to learn the lessons from our madness? So here are some of my musings on the over pathologisation of mental health:

It individualises our pain without individualising our care – that is to say it tells us we are broken, it is our individual chemistry that is flawed, and we are to blame, yet also not putting us at the forefront of understanding our pain and choosing how we heal. It tells us we are too sick to know what’s really good for us, or that we don’t know ourselves well enough. It doesn’t allow us to learn who we are and what’s really at the root of our pain; doesn’t encourage us to put it into a sociopolitical context, and the context of what has informed our life. Doesn’t allow us to heal with others.

There is no community. No value given to peer support, to healing with others who are experiencing the same things or similar things or completely different things, but feel safe to heal with. Doesn’t encourage the connections that are vital to long term healing and alternative methods of care. If you want proof that peer support methods of healing work, look at AA – it revolutionised care for alcoholics. What was a death sentence became an opportunity for hope and healing.

Our pain is shunned and labelled, pathologised. Instead of learning to embrace the madness as part of who we are, we learn shame which in turn births more pain. Instead of learning to see mental distress as a natural human reaction, however difficult, we learn to be afraid of it. Language that could be used to free us is instead weaponised against us to strip us of our wholeness and our identity through clinical rotes.

But it doesn’t have to be that way. I don’t have all the answers. I listen to psychiatric abolitionists and I think, yeah, they have the answer. I listen to amazing healers in other cultures outside of the west and am filled with inspiration and hope. Then I look back at the world as it is and wonder if we don’t need to adapt our goals to be a little more realistic within the current frame of society here in the UK. I don’t have the answer nor a clear label for my ideology surrounding this all. But I do have hope. And I do know things are already changing.

We don’t have to wait to build communities. We don’t have to wait to create new ways of healing. We don’t have to wait to find hope.

You can also find a version of this post on my Instagram @our.happy.notes

Advocacy, autism, Mental Health

Diagnosis – Good, Bad, or Dependant on the System?

Posted on March 10, 2022 by Millie :)

Validation:

It can be very hard to access treatments and be validated by ‘professionals‘ within this system without a diagnosis. Budget issues and a mental health system based in oppression that seeks to produce productivity rather than healing and often doesn’t recognise its intrinsic links to all other aspects of capitalist society doesn’t help this. However, more importantly, without a diagnosis it can be hard to validate ourselves – to give ourselves permission to display certain symptoms, feel what we feel, and believe that it’s real.

Getting a diagnosis can be a validating and liberating experience for many people – my autism diagnosis certainly was for me. It helped me understand myself, put my entire life into context, and connect with other people going through similar experiences. That was incredibly useful with all my diagnoses – finding people going through the same thing and learning how they were managing in a world often not built for us which helped me find ways to define and facilitate my own healing. Community truly is a powerful force. It teaches us that we are not alone, and is one of the most invigorating tools in supporting mental health; my diagnoses are helping me find mine.

But we must ask the question – why do we lack validation without a diagnosis? Why have we not been taught validation and community by the systems surrounding us? If human experience was universally understood as fluid and acceptable, would we need diagnoses at all?

Stigma and Stereotyping:

However, diagnoses have also been used as oppressive tools throughout history, and being given a diagnosis can be a terrifying experience. For example women could be put into mental institutions if their husbands thought they weren’t living up to their duties and this was justified under the label of hysteria. Nowadays Black women are significantly more likely to be diagnosed with BPD – this may be a misdiagnosis of a neurodivergency (chronically under recognised in Black people) or due to how their traits and emotions are perceived so different within the system. Black people are also four times more likely to be detained under the Mental Health Act in the Uk – a hugely oppressive tool that twins criminal incarceration.

It may feel like a condemnation to receive a diagnosis due to preconceived notions of stigmatised mental illnesses, and lack of care options. Sometimes it can seem like a lifetime of suffering and inevitable failures lie ahead. It may even be harder to be taken seriously within the system – especially in psychiatry wards where any legitimate complaints can be brushed off as ‘symptoms’. Telling family and friends may elicit negative reactions due to their preconceived ideas, regardless of how positive the experience was for the individual

Stuck in a Box:

Although it can be liberating to understand your behaviour through the lens of a diagnoses, it can also be challenging when dealing with others and interpreting your own experience. It can be difficult to know where you start and where the illness ends, or to what extent you should view yourself as your illness. It can be difficult to know whether an emotional reaction is ‘natural’ or a symptom or a potential warning for future issues. It can be difficult to be heard and seen as anything but your diagnosis and your experiences as anything separate or unrelated to it by others.

Diagnosing a mental illness is not straight forward. No one person presents the same, and often two psychiatrists will have completely different opinions leading to misdiagnosis/ confusion for the individual trying to grapple with many opinions and find understanding.

And yet once given a diagnosis we are often stuck in a box or a more rigid understanding of who we are and how me must think and will behave. Does that seem logical? It doesn’t to me. But it’s understandable within a system that looks for easy processing, and profit – both achieved through the over medicalisation of human distress.

When the DSM was first released in 1952 there were 102 diagnoses in it. By 2000 there were 365. This has since reduced again – but you can see how inexact and dramatic the medicalisation has been.

Nonetheless, getting a diagnosis, finding community and comfort it in, can be a very positive experience. My autism diagnosis certainly was for me, and being able to say I’m bipolar helps me feel whole and proud of everything I’ve been through. But getting those diagnoses, navigating conversations, therapy, and life with them has been challenging and complicated. And I am privileged in many ways. Bottom line – receiving a diagnosis is not something to be afraid of, and if your experience was good then that is amazing, and valid! But negative experiences are just as valid too. Perhaps even more so because they often fall on the more marginalised. And everyone’s emotions, pain, and trauma are valid with or without a label. We deserve a society that teaches us that.

Sources

Sedated: How modern capitalism created our mental health crisis by James Davies
verywellmind.com
mind.org.uk
Phenomenology of Borderline Personality Disorder, The Role of Race and Socioeconomic Status, Natacha M. De Genna, PhD and Ulrike Feske, PhD
My brain

Managing Mental Health, Mental Health

How to Support Someone With Mental Health Issues

Posted on July 15, 2021August 10, 2021 by Millie :)

It can be extremely hard to watch someone you love and care about going through a tough time regarding their mental health. It can also be painful if someone close to you discloses their mental illness or mental health struggles and you had no idea about it. You may feel like a failure yourself, like there’s nothing you can do, like you are useless. Essentially it may start to impact your mental health as well. That’s why the most important thing to remember when supporting someone with mental health issues is that you need to look after yourself as well. You have to.

1. Look after yourself

Sometimes we want to rush in and save the whole world – fix everything – but this simply isn’t possible. Perhaps at first it may seem like a good idea to try and take on the other person’s issues entirely as your own, without giving yourself the space needed to process your own emotions. In fact for a short while this may actually help the other person – but that’s not sustainable; long term it will lead to you burning out, struggling yourself or becoming resentful, likely making the entire situation worse. That’s why it’s so important to look after yourself, even if this is just journaling at the end of the day to help you sort out the feelings of the day, or doing a hobby once a week, the possibilities are limitless and you have to find what works for you. The important thing is that you do find it. And putting in boundaries with the person you are supporting can also help this, and most likely will help them in the long run too.

2. Listen to them

Many people with mental health issues, especially when they are first opening up about them, doubt themselves, feel ashamed or invalidated. By listening to them with an open mind you can help lessen these feelings. And by listening, I mean just that. Not everyone wants (nor even needs) advice or solutions all the time, sometimes they just need to be heard so they feel a little less alone. When having a conversation about their emotions/ experience it can be really helpful to ask the question ‘would you like me to offer advice or just listen to you?’. Validating their experience through listening to them can have a huge impact for someone struggling and give them confidence and reassurance. Remember that they are the one that lives in their brain, and they know what they are going through better than anyone else; it’s not your job to dictate to them what they are undergoing. However, linking to my last point, it is important that you don’t take on all of their feelings for yourself, so placing boundaries can be really helpful – for example requesting that before they talk to you, they ask you if you are in a place to have that conversation.

3. Involve them

Going through a tough time mentally can feel very isolating, and our brains can make us feel very lonely and rejected. That’s why it’s important to continue to involve someone who is struggling mentally. This could mean continuing to invite them to social events while making clear there is no pressure or expectations placed upon them to attend. If they accept and invitation, it might then mean making some accommodations for them, like helping them order food if that’s a point of anxiety for them or giving them some space if they need it for example. It might also mean offering to meet them one on one for a while if that’s easier for them, or talking with them about plans to keep them safe and checking in with them regularly. To relate to my last point, if you’re unsure of what to do, you can always ask them if they have any ideas or if there’s a way you can accommodate them better. This is a huge sign that you care for and accept them still.

4. Research their experience

If the person you are supporting has a diagnosis or has disclosed to you specific symptoms, it can be helpful for your own knowledge to research this. A quick google search will bring up symptoms lists and examples of how these might affect them, but I would also encourage you to look beyond this and read up on the personal experience of different people from different walks of life to get a clearer picture. This can help you understand the person you are supporting better without the worry that you are prying to much, and it can help them to feel seen as this informs how you support them.

5. Make them a happy kit

I’ve made a previous post on this, which you can read here. A happy kit is essentially a little collection of things that can help someone process their emotions, get through a crisis moment, or just generally cheer them up. It can include some things that they find calming or cheering, and maybe a list of distractions and mini coping exercises to try. Distractions are also a really great way to help someone with a mental health issue – it’s not a long term fix but it can help them escape their brain for a minute and feel more ready to face the day. If a distraction is creative it could also be a way of helping them to express themselves, and feel less alone if you’re doing it together.

6. Help with small tasks

Small tasks such as cleaning, ordering food, or remembering deadlines can become seemingly impossible for someone experiencing a mental health struggle. If you feel up to it you can offer to help them with these small tasks, even if that’s just by doing it with them (for example cleaning together one afternoon, or going food shopping together). As always, asking them how best to help is always a good idea, and if they’re not sure offering something specific – such as sending them a reminder text – might appeal to them.

7. Show them you care

It’s simple, but one of the most helpful and meaningful things anyone has ever done for me during my own struggles has been showing me they cared. This could mean writing someone a supportive letter, or making them a playlist. Just something simple that lets them know you care.

7. Be patient

We all have mental health and it can be a long term challenge to face for many. Someone in the midsts of a struggle isn’t going to overcome it overnight, but with amazing people like you willing to support them, they can find their way through. Keep in mind that you need to be patient – one of the reasons why looking after yourself is so important – and that their struggles are not a comment on you, ever. Eventually the sun will come shining through!