Saturday 31 July 2010

A Boy Named Sue

I am back from an enjoyable but exhausting three days/two nights in North Wales. The healthy eating message from the excellent Wednesday event (see previous post) was followed through by our Learning Centre's key staff Irene Hogan and Anna Bellingham whom I introduce to the delights of Enoch's Fish and Chips in Llandudno Junction. Truly this is the Platonic paradigm of unpretentious cooking in contrast to the gastronomic desert of Llandudno itself. We eschew the "special" - grey mullet - fairly descibed as "earthy" but I'd call it "muddy" (I lived on grey mullet in more frugal times but it needs some disguising flavour - bacon strips work well). Following cod and chips the strawberries with ice-cream topped with whipped cream also hit the mark. Next evening we have the same again except fresh Conwy plaice this time. In my defence I did two longish walks each evening and two shorter jogs at 6am each morning so that's the net calorie equivalent of doing no exercise and living on cardboard Ryvita and rubbery cottage cheese.

We get down to business on Thursday looking at how N Wales can further contribute to the mission. Among other ideas we agree to take forward Vice-Chair Chris Eastwood's proposal to draw up advice for parents of patients with a serious mental illness on the dilemma of whether to offer their adult child a place to live in the family home. Of course there are no right answers on this one but staff describe the pressure applied by professionals (themselves under pressure to find a solution): one family worker witnessed how, when a mother dared to question the sense of her son coming to live with her, she was told impatiently "Oh well we'll have to find him a place in the night shelter". Parents can of course be compelled to issue formal notice to their child in order to trigger homelessness rights - not an easy thing to do to a vulnerable and possibly paranoid patient.

On Friday this conversation continues in Rhyl where Hafal's Caroline Jones has invaluable experience of organising tenancies for patients. We talk about the connected but (let's be clear here) distinct issue of the therapeutic or antitherapeutic effect of the family on people with serious illnesses. I have been rereading Oliver James' polemic "They F**** You Up" about the effect of families on mental health - he is selective with his evidence but offers an interesting contrast to the psycho-genetic focus of much modern psychiatry for which equally questionable claims are often made. One assertion he makes is that people with schizophrenia usually do better by not going back to the family home though he acknowledges that the best results are achieved where the patient does go home to a family which has fully taken on board how they need to relate in new ways to the patient. Unfortunately this means a lot more than understanding the illness though that, we know from experience, goes a long way. Of course this consideration is anyway only part of the equation - the parents/family also need to consider their own needs. Hafal's guide for carers can be seen on this link.

James takes for the title of his book the first line of Philip Larkin's poem "This Be The Verse" - you can hear him read it (swear-word warning) here but if you are new to the poet please don't judge him by this slight, two-dimensional piece. If you want a much more subtle analysis of the effects of parenting on a child's future listen to Johnny Cash's "A Boy Named Sue" (link here). Note how the son starts with homicidal anger at his father's unconventional strategy for parenting, then recognises the sense in it and forgives his father, almost resolves to adopt the same approach with his own children, but finally decides to break the cycle. I have a tenuous link with Sue having once stopped like him for a brew in Gatlinburg, Tennessee: however, unlike Sue I did not then go on to have a gun-fight with my long-lost father but I did have my first (and last) Subway takeaway roll there (meatballs with an odd sauce).