Tuesday, 14 January 2014

Seedy Golf Club



There is some consternation about Channel 4's new documentary Benefits Street - see our story including onward links here.

Colleagues in the Who Benefits? campaign which Hafal supports are calling on Channel 4 to clean up its act and avoid misrepresenting people who receive benefits. Follow the link and you can express your view on-line.

I watched last night's programme with a heavy heart - expecting it to be unambiguously unhelpful - but actually I think the effect is mixed.

Our colleagues are right that the examples are unrepresentative. It is particularly unfortunate that the programme links the "benefits culture" which it purports to portray so directly with criminality. That's not fair because it's not typical for people receiving benefits to be involved in any crime, let alone some of the more unpleasant dishonesty and drug use which the programme seems to delight in reporting.

The reason I say the effect is mixed is because the programme does at least convey that there are real people behind the statistics and every person on benefits has a unique and different experience and a particular set of challenges. The trouble is they have chosen the people with more colourful stories which will provoke those who are inclined already to be unsympathetic.

Personally I thought the programme ran even greater risks in creating hostility towards people who have come from elsewhere. It was mysterious that in a programme supposedly about benefits they included stories about immigrant workers who were not actually claiming benefits, a conflation of alleged "social problems" that belongs in a prejudiced and mean-spirited discussion in some seedy golf club, not on mainstream television.

Sunday, 12 January 2014

Triangulation


View south from Dinefwr Castle at 9 a.m. yesterday

A welcome break yesterday in the miserable weather - sunshine and quite warm, rare indeed in January - allows for a long walk up and around the Towy Valley, though it is necessary to stick to high ground as the valley floor is treacherously boggy having spent much of the last few weeks under water.

I reach the top of Dinefwr Castle when the sun comes up but hasn't yet chased away the mist in the flat valley bottom, giving a primeval impression to the south (see picture above) with scarcely a visible sign of human influence on the landscape. You could imagine a dinosaur roaming into view.

Looking west (see picture below) you can see signs of human cultivation but there is nothing which would have surprised Rev John Dyer (1699 - 1757) whose poem Grongar Hill arguably kicked off the Romantic Movement - certainly Wordsworth gave the Welshman much credit.

In his poem Dyer describes his view looking straight back at me (except 300 years earlier) from Grongar Hill - the bluff to the right in my photo - including how

Old castles on the cliffs arise
Proudly towering in the skies!


Castles presumably is plural because he also glances west to see the ruins of Dryslwyn.



Cue a third viewer to complete a sort of triangulation, the engraver who captured Grongar from Dryslwyn Castle about 50 years after Dyer. I have an original print (worth about £5 - these are fun to collect and very cheap) hanging in my sitting room. You can see Dinefwr in the distance dead centre, while Grongar is largely hidden behind the ruin in the left foreground...



Incidentally I published a picture in summer 2011 of me clambering over precisely that bit of ruin (the outer gatehouse) here.

Dyer might have liked this combined literary and pictorial exposition as he was a painter as well as a poet. However, churlish though it may be to say so, he actually wasn't much good at either. Judge for yourself here and here.

One of his paintings is of his brother's wife, a member of the ancient Croft family, one of whose ancestors married Owain Glyndŵr's daughter Janet...but let's stop there, it's nearly time for lunch.








Friday, 10 January 2014

Pulp Fiction



Doubt has been expressed by a new study about the effectiveness of CBT (cognitive behavioural therapy) in helping people with schizophrenia - see the story here.

This is not conclusive and, though I think the benefits of CBT have been exaggerated compared with in-depth therapies, I'm inclined to agree with Paul Jenkins from our English sister charity Rethink that you have got to listen to the patients who report that they have been helped.

But I suspect there is a bigger issue here which is a general prejudice against talking therapies for those who are very ill. This prejudice is shared overtly by some old fashioned clinicians ("What's the point of bothering them with a lot of words when they are out of touch with reality?"), by woolly "progressives" whose antipsychiatric position makes it too uncomfortable to face up to the need to use both medical and psychological treatments so they just steer clear (and campaign for talking treatments in primary care without mentioning those who have a more severe illness), and by doctrinaire practitioners who want patients to conform and match with their precious methodology rather than the other way round ("It's no use using my brilliant technique on these people because they are too ill to benefit from it").

This is immensely frustrating. Isn't it time to develop psychological therapies which help people with schizophrenia and other serious illnesses rather than try out existing trendy therapies and then give up if they don't work? Isn't it time to end the prejudice which says there is no point in engaging closely and methodically, one human to another, with people who are very ill? And who seriously believes that this would not work better than leaving them alone with their distress and hoping the drugs by themselves will sort them out?

Oddly I think the public would be shocked to learn that talking therapies are so scantly used for in-patients. Most of the public have a vision of mental hospitals from literature, films and telly where there may well be medication involved but there is also a busy regime of patients experiencing psychological therapy individually or in group sessions - and that, they imagine, is the main purpose and routine daily activity for a mental hospital. Similarly many members of the public believe that the primary occupation of psychiatrists is to deliver in-depth psychoanalytical therapy (probably with the patient on a couch!).

Of course it's easy for mental health insiders to sneer at the public's illusion which is largely based on pulp fiction - but isn't the public's perception as it relates to the availability of therapy (as opposed to any lurid view of how wicked mental health services might be) actually much closer to what we should want in reality?

Thursday, 9 January 2014

Reasonable Bloke Or Grumpy Git?



Readers of this Blog will know that last summer in the midst of the extreme heat I developed a scary heart problem and then experienced severe pain from a slipped disk (or more accurately a "spinal disc herniation"). These are both now more or less resolved without treatment - aside from some awkward exercises which I'm still doing intermittently.

Spooky then to read A M Homes' novel This Book Will Change Your Life, recommended to me by Hafal's health and safety consultant Amanda Trimble (not in her official capacity!) who had read my post about Homes' more recent book May We Be Forgiven.

Spooky because the novel's hero also suffers a cardiac episode followed by severe pain in the height of summer which appear to resolve themselves without treatment. It is never fully explained but his problems seem to have been extreme physical manifestations of a mental breakdown caused by social isolation and a dreary life of unsatisfactory routines. In my case I did consider psychological causes and indeed these can be behind heart arrhythmias and some back pain problems, although my symptoms were so specific as to tip the matter more in the direction of physical causes.

Unlike me the novel's hero lives in Los Angeles and, also unlike me, his response to his health episode is to embark on a relentless, warm and friendly engagement with everybody he runs into, ranging from a doughnut salesman to a Hollywood megastar. I'm afraid by contrast I just returned to my normal persona of reasonable bloke or grumpy git according to mood and provocation.

In spite of its title this isn't a self-improvement book (apparently the publishers had some trouble because people didn't want to be seen reading it) but there again maybe it is obliquely - it's brilliant and uplifting, in some ways quite like May We Be Forgiven because it is about redemption and a sort of reignition of joyous life.

Maybe I should have read it before my rehabilitation commenced at the end of last summer?

Wednesday, 8 January 2014

Enlightened


Can't think of a picture to illustrate this post so here's a gratuitous one

There is a big news story today about improper use of antibiotics (both by doctors and the public) and the risk this poses as bugs develop immunity. We might even see the return of TB as a major scourge of poor and vulnerable people, as it used to be in the living memory of those over about 70 years old.

Earlier in the week the somewhat similar matter of the improper use of anti-depressants came up. A study indicates that these drugs are being used for problems which are not mental health-related and for minor mental health problems which should not be treated with drugs - something I have been banging on about in this Blog for years. See the story here.

At the heart of this is the debate about what constitutes a mental health problem. The important thing to bear in mind is that this is not something defined by severity. So, for example, there are life problems like bereavement or unemployment which don't necessarily cause mental health problems but may be much more difficult things to experience than a minor mental health problem. Put simply, you can be extremely unhappy but, if that is a proportionate response to the reality of your external experience, then it's not a mental health problem.

It is absolutely wrong for mental health interventions to get in the way of people resolving such life problems and it is an insidious and dangerous trend of our times that mental health busybodies are making work for themselves by redefining life's problems as mental health ones. This leads to improper use of drugs - which can inhibit people from addressing their problems - as well as all that disempowerment which goes along with the typical mental health approach.

Incidentally, it is not just drugs which can be inappropriately deployed. Psychological therapy is a distraction and a waste of resources if provided to somebody whose problems are not mental health ones - they need to get on with fixing their problems through practical steps and the support of friends, family, or appropriate non-mental health agencies.

I recollect some years ago an unusually enlightened therapist explaining to me how much can be achieved by simply changing the language we use away from mental health terminology and towards the words used by ordinary people. For example, if you substitute the over-used and misused mental health word "stressed" with the ordinary words "anxious" or "frightened" they automatically lead you towards the questions "what are you anxious about?" or "what are you frightened of?", and the answers to these questions lead you on towards the challenge of what you are going to do about the problems you identify. You can experiment similarly with the substitution of the over-used and misused word "depressed" with ordinary words like "unhappy".

It is really important I believe to make those substitutions if your problems - however severe - are not in fact mental health ones, in other words to actively steer well clear of the smothering and disempowering language of mental health. But in many cases such substitutions can be helpful even where the problems are mental health ones. It's good therapy! None of this of course is to deny that there are mental illnesses for which the term depression and other mental health diagnoses are appropriate.

Mental health organisations and professionals are much to blame for infecting society with the wrong language and wrong strategies for dealing with the challenges of life. They would do better to concentrate on improving their woeful record of poor practice in helping those whom they should be helping - people with a mental illness.

Sunday, 5 January 2014

Black Shorts



Another day another dollar. I am back in work tomorrow, refreshed after an enjoyable and varied break.

Like last year we spent Christmas in Bristol including a marathon walk up to posh Georgian Clifton, across the Suspension Bridge into Somerset, along the rough path in the woods on the west bank of the Avon, and back through the old docks.

I am fond of Bristol and I like its people. To judge by their museums and tourist information the local authority is quite exercised by the fact that the sumptuous municipal, commercial, ecclesiastical and academic infrastructure of the city was built on the proceeds first of slavery and latterly tobacco. But the population seems unworried, not unreasonably as they can hardly be held responsible. Of course Bristol has modern problems to address (see this post) but that's another matter.



On Boxing Day I look around the sales in Broadmead. This quickly begins to feel like a mistake as I join crowds of depressed families roaming endless racks of shoes and frocks, most of it just so much dross.

But then I stumble on a small independent outdoors specialist who has in stock a pair of size 13 Brasher Hillmaster walking boots. My old pair of Brashers - the Rolls Royce of boots - is over 20 years old and has, I calculate, enabled me to walk about 8,000 miles, or from St David's to Constantinople and back twice, but they are now finally falling apart. I didn't want to buy on-line in case they didn't fit so this discovery was heaven-sent (and they were on offer too). It seems disloyal to chuck the old ones away but perhaps I could hang them outside and plant flowers in them?

On to London where we enjoy lunch at Jewish deli Mishkin's just off Covent Garden (embarrassing that I didn't know what a "slider" was - apparently it's a small hamburger but you probably knew that - although I did know that a "sandwich" in American English is the filling between the bread and not the whole thing like here).



Mrs Blog has the strongest Old Fashioned in the history of cocktails (a Mishkin's speciality) which helps her to enjoy the show afterwards.

Jeeves and Wooster with Stephen Mangan and Matthew Macfadyen starts a bit clunkily as they set the scene improbably with Bertie putting on a stage show to describe his recent experience at Totleigh Towers. This awkward Brechtian moment is swiftly forgotten as we get into the familiar plot about the cow-creamer, enlivened by a memorable Roderick Spode, leader of the fascist Black Shorts (they had run out of shirts).

I reckon I can easily spot the amendments and links added to the inimitable P G Wodehouse material even though I last read the books years ago but, for all that, it is a lot of fun with good visual gags enhancing the writing. Rather like Downton Abbey except well-written, well-acted, and funny (actually I haven't seen Downton so that's just a guess).

Finally to West Wittering on New Year's Day where the tradition of barbecuing on the beach with my friend Nick Jarman is tested to the very limit by torrential rain, hurricane force wind and surf spraying half a mile inland.


Selfie on the beach

But we succeed in front of an incredulous audience of passing walkers...


The Director of Social Services for Neath Port Talbot cooks sausages on a Sussex beach

Wednesday, 25 December 2013

Old vs New Testament



Happy Christmas, readers, and special greetings to Hafal's Members, clients, and staff - not least those working today - and I hope you enjoy the festivities and are looking forward to a great New Year!

The weather has been distinctly Old Testament in the last few days, Noah's Ark seemingly a more useful asset than any spare stable in Bethlehem (the Welsh Bethlehem in Carmarthenshire narrowly escaped complete isolation in yesterday's flood - a curious echo of the isolation of the original Bethlehem, on the telly yesterday for seasonal celebrations but visibly hemmed in by the infamous Israeli wall).

But the forecast looks a bit better today and I am about to do a huge walk as a kind of advance justification for eating Christmas dinner, the centrepiece of which is a Coop Elmwood "Very Small Turkey" (£10) - highly commended by independent reviewers.