Tuesday, February 27, 2007

Battle of the Blogs...

Someone called Leesa is being very public spirited, and has organised a Battle for people who Blog. Its a rather complex voting system, based on something called baseball or basketball (not sure which) which is apparently an American sporting thingy. All you need to know is that you get to vote loads of times. So you can vote here for Ms Pants and Mr Ducky and the Lovely Caroline. You can vote here for Ms Baroque and Mr Zeddie. You can vote here for lots of people that I have never heard of. You can vote here for Signs and The Periodic Englishman. And this is where it gets really difficult because then you have to choose between me or the Lovely Nmj at Velo-Gubbed Legs. One option is that we scrap the contest altogether, and have a naked mud wrestle to decide the winner. Or alternatively, we could all just have a naked mud wrestle. Anwyay, if you decide to vote in the Western Bracket, just keep it under your hat, OK. Nmj and I don't need to know


Sunday, February 25, 2007

More Blogs I Like....

I was going to do a serious post today, but I find that my serious self stayed in bed this morning. So here are a few blogs that I have 'discovered' recently and am enjoying immensely.

La Que Sabe has a personal style that is both inviting and enjoyable, and she always responds to you if you comment which I am finding more and more important as I visit other blogs. Dialogue is a crucial part of blogging, don't you think?

Dandelion has just introduced herself over here, and her blog, Lonesome Ocean is a fascinating insight into the world of polyamory. A well written and stimulating 'personal experience' blog, which I will be visiting regularly from now on.

BoBo Hits Back is another psychotherapy blog, this time from a trainee therapist. Most psychotherapy blogs are extremely dry and impersonal, concentrating purely on theoretical discussion. I can see that therapists might feel the need to maintain a 'professional' stance and not share their personal stuff. But for me, this is the joy of blogging. I can afford to expose the personal side of being a therapist as I remain anonymous, and as long as I behave ethically (ie not discussing individual clients) I don't have a problem with mixing the personal and the professional. BoBo also takes this position and it makes for a funny, informative, well-written and sometimes challenging blog.

Los Angelista's Guide To The Pursuit Of Happiness is another lovely mix of the personal and the political from across the pond. I like the insight it offers into American culture(s) and it is a most enjoyable read.

Days With The Kids is quite a new blog, and although Boris is not blogging frequently I do have a particular soft spot for blokes who write personal style blogs. He describes himself as a 43 yr old whinge bag and works in alternative health care, so he must be a good guy. His blog is funny, political, personal and well-written.

PS. I have taken a couple of blogs off my blog roll because they don't allow comments. The more I blog, the more I think the dynamic nature of it is vital for me. In fact, I don't understand why people would bother to write a blog but not allow people to comment on it. I have made an exception for the eccentric but gorgeous Periodic Englishman, who regularly disables his comments and then hides in other people's blogs waiting to be found. He is surely the uber-commentator of the blogworld, and for that I will forgive his disabling habit.

Saturday, February 24, 2007

There Are Three Types Of Clothes In My Wardrobe:....

…night-clothes, which for me include a collection of Malaysian Kaftans and flannelette pyjamas; going-out-clothes, which are basically anything you would be willing to wear in public, and in-between-clothes, which are those snugly-buggly favourites that you wear around the house but would really prefer not to be seen out in.

I am enormously fond of my in-between-clothes. They mostly consist of jogging bottoms (haven’t jogged for the best part of eight years), old baggy t-shirts and a very embarrassing collection of velour leisure wear. I kid you not. I love that velour is just so tactile, and I like to think that I look like Pammy Anderson in them. (I don’t. I look nothing like her at all. But she went through a period of being papped in velour leisure wear and Ugg boots and I took it as an excuse to delude myself that I don’t look anything other than ridiculous in them.) I am so keen these days to get straight into my in-between-clothes that I start undressing the minute I get through the door. The Husband must think that I have lost my sartorial mind, because he only ever sees me in my in-between outfits. (Occasionally we go out together, and he always looks at me fondly when I am scrubbed up. I must be such a disappointment to him most of the time.)

My in-between-clothes are currently exceeding my going-out-clothes in number, which is something of a worry. And now I have been caught out doing the unthinkable: going outdoors looking like a total loon.

It was Sunday morning, and I was nipping down to my local garage to buy a newspaper. I was wearing a pair of grey velour baggies, and an outsize pink fleece which had seen better days a decade ago. On my feet were my favourite pair of flowery fabric wedgey clogs and a beany hat on my head, as I hadn’t washed my hair. I looked like a bag lady who had forgotten her bags. As I queued for my newspaper I recognised the woman at the side of me, perusing the chocolate. I couldn’t quite place her, but I smiled anyway. She looked embarrassed because she clearly couldn’t place me either. I paid for my Observer and turned to leave, almost bumping into the woman whom I still hadn’t quite placed.

“Oh!” she said, with a look of incredulity. “It’s you!”

I placed her. She was an ex-client. I tried to say “hello” in a breezy and unconcerned way, but I don’t think she was convinced. She looked like she had just discovered the Queen going commando.

Note to self: in-between-clothes are not, and never will be, going-out-clothes.

Thursday, February 22, 2007

I Still Have The Memories....

Spot the fatal flaw in this argument:

Husband: “but it’s a lovely house, or at least it will look lovely when we have redecorated.”

Me: “It’s decorated entirely in blown vinyl, the kitchen is a disaster and the carpets make me feel sea-sick. I’m not sure I can live with it even for a few months, and it’s going to take at least a year to get it all redecorated.”

Husband: “But it has such potential….It’s just so old and lovely….”

Me: “Ok, you win….”

The previous owners had fucked it up with the most horrendous make-over you have ever seen renovated the house to their own taste, which was most definitely not mine. (Nor anyone else’s it seems, as they had to drastically drop the price to secure a sale.)

That was five years ago, and we are less than half-way through redecorating…

He was right, of course. It is a beautiful, old, creaky house with character that oozes from each nook and cranny. It is 230 years old and it’s huge oak beams and stone inglenook make me feel comfortably small. When it was built in 1776 it would have been a farmhouse, and still has the stone safe built into the wall in the kitchen where the farmer would’ve stored the farmhands’ wages. I love my house, despite the fact that the past 230 years have seen the village grow around it until it is no longer a farmhouse but a cottage sitting aside a very busy trunk road with lorries trundling past at all times of day and night. It doesn’t even have a garden. Looking out of my kitchen window now I can see only traffic and houses. Lunchtimes see school children sitting on my windowsill, watching the traffic and eating their chips whilst they flirt and banter with each other. Which, of course, is how come we could afford to buy it. Pick it up and transport it 15 miles into the Yorkshire National Park, and we couldn’t even have afforded to buy the disaster of a kitchen, let alone the house itself. But I love it, nonetheless.

We have rid the living room of it’s various patterns of blown-vinyl, the previous occupants having clearly disagreed in their choice of which particular pattern of blown vinyl to use, and so used them all on different walls and ceiling. The swirly orange carpet has been replaced by something altogether more quiet, but the kitchen and bathroom still look like they were decorated by someone’s aunty Mabel. At least I can sit quietly in my living room and enjoy its peace….

And then, this weekend, we had a small flood. All over the lovely living room carpet. The freezer ‘somehow’ defrosted (ie we inadvertently unplugged it) and, given that it is housed in the under stairs cupboard, water trickled all night through the cupboard and into my lovely living room.

We were both sanguine about it. These things happen. Nobody has died. The carpet will come clean. In the general scheme of things…. etc etc.

But then The Husband stepped gingerly into the kitchen carrying a large box. He said simply “I’m sorry…”.

I looked at the box. My collection of LPs (remember them?) which had also been stored in the under stairs cupboard – behind the offending freezer – waiting for the time when we win the lottery and buy a bigger house and they can come out of hiding. The water had trickled through my entire vinyl collection, on its way to the carpet. Twelve years of musical memories held in a couple of boxes, all completely ruined. To be fair, the records were probably unplayable anyway. They have been stored in boxes for too many years, carted from house to house, waiting for the time when there was a space for them to be shelved again. But I had hope that one day I would dance to them again…

So many memories: every Jam album; every XTC album up until 1989; The Clash; The Teardrop Explodes; Red Lorry Yellow Lorry; Pop Will Eat Itself; Iggy Pop; The Velvet Underground; The Slits; The Undertones; The Cure; The Dead Kennedys; Talking Heads; Television; Shriekback (remember them?); my entire Tom Waits collection (about 8 albums); idiosyncrasies like Dr Feelgood and Rickie Lee Jones; Joy Division; loads of blues classics and even a Crass album.

I was such a muso from about 12 onwards. I would try to impress my much older brother with my new purchases. I remember playing him All Mod Cons in 1978 when he came home from university, and bursting with pride that I had introduced him to something he later grew to love. I was 12. When all my friends were listening to Grease, I was reading the NME and listening to XTC (before they went poppy, of course.) At 16 I used to sit with my history teacher in the common room at lunch time and we would finish the NME crossword together. I quite fancied him. He was in the SWP and listened to punk.

“I think they have to go” said The Husband. “The sleeves are all ruined”.

He took them out into the courtyard and smashed them one by one, and tore up the lovely sleeves for the recycling box.

I stood in the kitchen making guacamole and cried a bucket.

Sister #1 came for tea. We had a very morose evening. I think it might have been the guacamole.

Monday, February 19, 2007

Who Is Defending Our Civil Liberties? (Pt II)

Today has seen the House of Lords effect more amendments to the government's Mental Health Bill, and some pretty poor reporting of it too on Radio 4. The principle of treatment is not something that the Lords are plucking from nowhere in order to elevate civil liberties over public safety, as you may think if you listened to the report on PM tonight. This principle is already enshrined in the 1983 Mental Health Act, and pretty damn important it is too. I refer you to a previous post on this bill. (And I also offer on a plate the opportunity for the Periodic Englishman to make his Tardive Dyskenisia joke....which is actually quite funny.)

Anyone For CBT...?

The government is proposing an expansion of psychotherapeutic services within the NHS. Fabulous news. Currently, the only modality being considered in this expansion is Cognitive Behavioural Therapy. Not so fabulous news. Please sign this petition, asking the government to give due consideration to other psychotherapeutic approaches and modalities. And then tell your friends.

PS. Following a lively debate with the lovely Clare at Boob Pencil some time ago, I promised a follow up post on the whys and wherefores of CBT and other therapeutic approaches. I still haven't got round to it. So in the absence of a post discussing why CBT is not necessarily a panacea for all mental distress, I refer you to the aforementioned discussion which just about covers the issues. I can only apologise for my inefficiency....

Sunday, February 18, 2007

Daniel Finkelstein And Me...

I am growing rather fond of Daniel Finkelstein, of Comment Central at The Times online. It all started with this post, which was supposed to be a sophisticated comment on the paradox of state funded therapy (societal problems should not be remedied with individual solutions etc.) but which was actually just a spontaneous and barely coherent sound-off about the ludicrous notion of giving women counselling in lieu of an early termination (waiting times for terminations being ridiculously long.) Mr Finkelstein picked up on my question of whether it is ‘the government’s job to help us to manage our emotional response to the world’ in his Web Grab section. I responded in a churlish fashion. I am a Guardian reader, after all, and was disconcerted by the fact that he quoted me directly after a damning piece on Oliver James’ new book, Affluenza, the thrust of which I have much sympathy with. I was secretly pleased with the link, of course, and I suspect Mr Finkelstein was aware that my churlish tongue was at least slightly in my cheek because he has followed this up with another link to this post, which I will be much less churlish about. Except that it follows yet another damning piece on Oliver James’ new book, and I now feel obliged to post in defence of Affluenza, despite the fact that I am not a big fan of Oliver James’ propensity for courting controversy. (Post coming soon, I promise.) I suspect that Mr Finkelstein is teasing me. And because of that, I repeat that I am growing rather fond of him.

Saturday, February 17, 2007

Good Deed For The Day...

Nmj has been feeling unwell of late. I suspect this news will bring her a little cheer...hope you feeling better soon, lovely x

Friday, February 16, 2007

Say No To Ugly People...

Launched today:


Why do we need this? Asked John Humphrys, on this morning's Today Programme on radio 4.

Because we'd much rather look at attractive people than unattractive people, replied Avril O'Connor.

I have never heard John Humphrys laugh quite so loudly.

Avril O'Connor is editor of Elixir. Not for much longer, I suspect...

Wednesday, February 14, 2007

Valentine's Day Update...

The Husband and I have just watched our neighbour's boyfriend arrive at her house armed with a huge bunch of flowers, a cute looking teddy bear and a box of expensive looking chocolates.

"Awhh!" we both said. "How sweet...."

She is 19 and has a great deal to learn about life and love, but I enjoyed the reminder of the joyous innocence of being 19 and in love for the first time.

"Love you lots..." said the Husband as he left for work. "Oh, and by the way, I nearly got you a card, but I knew you wouldn't get me one and I didn't want to make you feel guilty."

He is so thoughtful sometimes...

Sunday, February 11, 2007

Anti-Valentine's Day Special...

Inspired by Mr Moon Topples anti-Valentine poem, here is an anti-Valentine's day treat (for me, not for you, dear readers.) I have allowed myself the indulgence of compiling my top ten melancholic, perverse and sometimes downright anti love songs.

10. Amy Winehouse at her straight-talking best. The Andrews Sisters meet a cussin' Billie Holliday. A heart-rending plea for fidelity.
What kind of fuckery are we?
Me and Mr Jones by Amy Winehouse

9. Gloria Jones' original version was heart-felt and soulful. A northern soul classic about the pain of an imperfect love.
Sometimes I feel I've got to [clap clap] run away
I've got to [clap clap] get away
From the pain you drive into the heart of me
Tainted Love by Gloria Jones

8. A tale of narcissism. Some would say the most perfect love of all.
Mirror in the bathroom recompense
For all my crimes of self defence
Cures you whisper make no sense
Drift gently into mental illness
Mirror In The Bathroom by The Beat

7. John Lydon in perverse rant. Just because it always makes me smile.
This is not a love song
This is not a love song
This is not a love song
This is not a love song
This Is Not A Love Song by Public Image Ltd

6. Denial, self-delusion and downright deception.
Hey Charley, for chrissakes,
Do you wanna know the truth of it?
I don't have a husband
He don't play the trombone
Christmas Card From A Hooker In Minneapolis by Tom Waits

5. Come on, admit it...haven't we all felt like this at the end of a relationship?
You know it, you show it
And the time has come to shoot you down
What a sound
When the day is done and it all works out
I'd love to do it and you know you've always had it coming
Shoot You Down by The Stone Roses

4. On breaking up. This is quite romantic, actually.
It's just the way it changes like the shoreline and the sea
But let's not talk of love and chains or things we can't untie
Your eyes are soft with sorrow
Hey, that's no way to say goodbye
Hey That's No Way To Say Goodbye by Leonard Cohen

3. On meaningless and shallow betrayal. One can only admire her brutal honesty.
I couldn't resist him
His eyes were like yours
His hair was exactly the shade of brown
He's just not as tall, but I couldn't tell
It was dark and I was lying down
I Heard Love Is Blind by Amy Winehouse

2. Perhaps the best anti-love song of all, but I wanted to end on a positive note. It is Valentine's day, after all.

When routine bites hard, and ambitions are low
And resentment rides high, but emotions won't grow
And we're changing our ways, taking different roads
Then love, love will tear us apart again
Love Will Tear Us Apart by Joy Division

1. And finally, Morrissey: the king of the perverse love song in a strangely optimistic mood.
So for once in my life
Let me, get what I want

Lord knows, it would be the first time

Please, Please, Please, Let Me Get What I Want by The Smiths

What psychoanalytic theory has to tell us about falling in love is that the person we choose is from the start intimately involved in our inner life (Skynner and Cleese, 1983). We choose partners on the basis of our own internal processes, and the partner is chosen because he or she seems to provide some sort of solution to our own internal difficulties or conflicts.......[G]iven that one certain thing about people is that they are different from each other, that they do not fit into each other like pieces of a jigsaw puzzle for any great length of time (at least not in a rapidly changing world), falling in love is bound to be followed by a degree of disillusion, and a likely sense of betrayal, possibly immense betrayal, when I discover that this other person will not play the role in my personality that I have assigned to her. In a homely and appropriate metaphor, Winnicott calls this the plate-throwing stage and suggests that the relationship will survive if the couple do not run out of plates....I am not saying that unhappiness should be borne or endured whatever; some relationships involve a clear, profound and mutually destructive unhappiness and would be better ended....If I have a personal attitude on this, it is that if I can break even, I'm not doing too badly. But this involves tolerating unhappiness for periods, or perhaps in some aspect of my life all the time.
Ian Craib (1994) The Importance of Disappointment p.125

On Mothers and Daughters (Pt III)

The telephone rang at 11.30 pm on Friday. The Husband was working a night shift and my son was at his father’s house. I know that when conducted with genuine cooperation shared care is best for the children of separated parents, and my son has shared his time between his father and myself since we separated eight years ago. For most of those eight years, however, I have felt as though something has been ripped from me when he is not around. I appreciate the opportunity for solitude -I am happy when in my own company - but the solitude is often tinged with an underlying fear for his safety: he is not with his mother and therefore he is not safe. (His father, I hasten to add, is a fabulous dad and I couldn’t wish for him a kinder step-mother. My fears are entirely irrational.) So when the telephone rings so late at night it means Something Terrible Has Happened.

I answered in a panic. It was The Mother. My immediate thought was that The Terrible Thing had happened to The Father, who doesn’t enjoy the best of health.

“Don’t worry, nothing’s wrong,” were her first words. (She knows that late night phone calls generate panic. She should know, as it is one of the many faults she has filled me with.)

“I just wanted to know if you are okay?” she said.

This knocked me sideways. The Mother has not actively enquired after my well-being since I was old enough to change my own nappy, and that was approximately 38 years ago. So why on earth was she ringing me at 11.30 on a Friday evening to ask if I was OK? I rifled quickly through my mental filing cabinet to work out what the hell was going on. Nope, no joy there. In the absence of a framework with which to make sense of this strange occurrence, I chose silence. ( Thankfully, I stopped my sarcastic self from replying I’m fine thanks, B.…I managed to somehow leave school with four A levels and got myself into a Good University entirely by accident [I liked the fact that it had a beautiful Minster and a pretty town; I had absolutely no idea it was a Good University]; I have had disastrous relationships with a string of unsuitable men and women, serious bouts of depression, including post-natal depression that left me feeling suicidal at times, and have dealt with the utter terror I have felt at the responsibility of being a mother myself. I am now happy and settled with a beautiful family thanks to an extended period of psychotherapy that enabled me to resolve my deep seated insecurities and attachment issues. But thanks for asking, anyway.) Fortunately, The Mother is an expert at holding both sides of a conversation so she failed to notice that I hadn’t actually responded.

“Well, thank goodness you’re okay” she said, before launching into a long story about how Sister #1 has a new boyfriend and how he sounds very nice, unlike the last one, etc etc. One half of my brain was still desperately searching for a frame of reference for this conversation whilst the other was noting with amusement that she appeared to have all the facts about the new boyfriend entirely correct, suggesting that she does actually listen even though all the behavioural indications are to the contrary. I made a mental note to tell Sister #1.

“Thank goodness you are okay anyway,” she concluded. “I have been so worried about you.”

I grab my opportunity.“B – what have you been worrying about?” I ask.

“Well, the snow!” she exclaims, as if it is glaringly obvious.

I glance outside and there is a very light dusting of snow on the ground. This could only cause me problems if I had a serious snow-phobia (chionophobia, apparently) and a cruel and vicious husband who made me stand in it for kicks. Given that I have neither, I still couldn’t see the point.

“The snow?” I enquired.

“Yes, the snow!!” she repeated. “I was watching the news and the M62 was just terrible. Blizzards, freezing fog and probably black ice too. I’ve been so worried about you!”

Things started to fall very slowly into place.

I haven’t worked in Manchester for the past four years. But the thought was there, bless her.

Friday, February 09, 2007

Bird Flu Pandemic Imminent!!!

Overheard on tonight's Any Questions on radio 4 - John Selwyn Gummer complimenting the government on their handling of the bird 'flu outbreak at a Bernard Matthews turkey farm, and reassuring the public that they cannot catch the disease from eating poultry. Just one small thought: wasn't he the Minister for Agriculture during the BSE episode who attempted to convince the 'meat-eating public' that beef was safe by stuffing a hamburger down his unsuspecting daughter's mouth in front of a hastily assembled TV crew? Shortly before infected beef was found to cause Kreutzfeld-Jakob disease in humans? I'm not suggesting we panic, but the signs are not looking good.

Thursday, February 08, 2007

Short Hair Days...

On the coldest day of the year so far I find myself with the shortest haircut I have had since I was in my early 20s. I have been going to the same hairdresser for four years and have had broadly the same haircut in all that time. Short, but never too short. I like my hairdresser. She knows my profession and we have wordlessly developed a LETS scheme: she tells me her problems and I get a wet cut for a fiver, which is ridiculously cheap even by arse-end-of-Yorkshire standards. I visited yesterday. She launched into a long and complex tale involving her frail, elderly mother, a curling rug, A&E, the officious Duty Social Worker and the Kafkaesque hoops one must jump through in order to qualify for a modicum of social care. I was in my ex-trouble-making-social-worker element. I gave her a lengthy piece of advice on how to ensure that her mother gets some actual support, which involved citing the National Assistance Act (1948), the Disabled Person’s Act (1980) and the Carers (Recognition and Services) Act (1995): advice designed to make any social work team leader sigh in despair that here is someone who appears to know that she might actually be entitled to something.

This was swiftly followed by “D, what the hell are you doing to my hair?”

“Oh,” she said, “you don’t normally have it that short do you?”

I don’t. I haven’t worn my hair this short since I was a radical young thing in the early 90s, wearing old-style DMs, charity shop clothes and with cheekbones to die for.

I left feeling that I had held up my side of the bargain rather better than usual, but that she had left me looking like a tired extra from Bad Girls. I went to bed feeling very grumpy indeed.

This morning, however, I have had a wave of nostalgia for my Short Hair Days. I had my first short haircut at university, where I hung around with the Women’s Group (or Wimmin’s Group, as we preferred. Oh, Lordy!) The Women’s Group consisted largely of women with names like sheepdogs (Rax, Joo, Kez etc) who looked like they had been sheep-sheared by the farmer. We thought we were sooo cool. I quickly took to cutting my hair myself, and thought I looked quite the radical. The Mother despaired. Job well done, then.

I moved to Stoke Newington after I graduated, way before Stokey had been gentrified and when the Vortex Jazz Bar was the best night out in London. I worked in Camden and would catch the North London Line to Camden Rd: on a haircut day I would queue with the boys at the little Turkish barbers and get a short back and sides for £2.50. I have always been fond of a cheap haircut. A slick of brylcreem and then the bus up Camden Rd to work. Matt Lucas was often on the same bus, and I vaguely recognised him from the TV. He always sat in the disabled seats at the front and would look embarrassed if anyone smiled at him. He looked shy. I liked him for it. My boyfriend at the time had long hair and looked like Feargal Sharkey. We looked quite the couple.

I looked like a boy for years, and I liked my androgyny. But now I am a middle-aged women, a stone heavier and with more than a smattering of grey (which, in a man would look ‘distinguished’ but in a woman looks like she can’t be bothered to dye it. The Wimmin’s Group failed in that respect.) I have wrinkles, which I really can’t call laughter lines because I just don’t laugh that much. I am not sure if women my age can really carry off the Very Short Hair look. I think it makes me look hard, not sexily androgynous. So I will grow it out to its normal level of shortness. But I would like to thank D for the memories.

Sponsor Miss Tickle...

Miss Tickle is not a slattern, nor a charity case nor a crack addict (as far as I know.) She is an actor trying to raise money quickly for a new production and in a stroke of genius is asking the blog world to 'buy a word'. Find her here.

Sunday, February 04, 2007

Women Who Rant Too Much...

I have come across a couple of comments on blogs recently that have irked me. Blogs that I really like, by the way, and so I won’t link to them as I don’t want to hold the bloggers responsible for the views of some idiot readers. The comments are about therapy. Firstly, the comment that only white, young, wealthy, middle-class and self-indulgent people go to therapy; secondly, that therapists are exploiting people’s misery. I have felt most irked, before remembering that I have my own blog and therefore have a right of reply, of sorts. How exciting. Normally these things bug me for a few minutes before I remember to breathe out the anger and feel compassion for my fellow man/woman/mindless numpty. (I have just had to add ‘numpty’ to my Word dictionary, as I use it in almost every post and don’t want to be constantly reminded that there might be a better word.)

Time to hit back.

It seriously hacks me off when people suggest that therapy is self-indulgent toss for those who have more money than sense. Here is a breakdown of my client group for the past 6 months:

  • Clinical depression, including suicidal ideation or suicide attempts: 17%
  • Potential relationship breakdown (long-term relationships involving children): 15%
  • Self-defined ‘breakdown’, (depression or anxiety) resulting in long-term absence from work and loss of income: 12%
  • Self-harm (cutting - requiring hospital treatment in one case): 9%
  • Significant attachment issues, resulting in an absence of any meaningful relationships (sometimes called pathogenic autism) : 9%
  • Bi-polar illness: 9%
  • Borderline personality traits or disorder: 6%
  • Potential paedophile behaviour: 6%
  • Carer stress: 6%
  • Anger management: 6%
  • Body dysmorphia: 5%

Childhood sexual, physical or significant emotional abuse was a factor in all of the above cases. Only one client presented with issues that the uncharitable among you would call ‘self-indulgent’. I gave her two sessions, assured her she was entirely normal and told her she didn’t need therapy in order to accept that fact. 80% of this sample had approached their GP before coming to therapy, and had been offered medication and, occasionally, 6 sessions of counselling. (6 sessions of counselling is the equivalent of putting a sticking-plaster on a gaping wound for these people.) Those with bi-polar illness were seen by a psychiatrist and prescribed medication but no therapy. Only one of the above sample, aside from those with bi-polar illness, had been offered an appointment with a psychiatrist and 3 sessions with a nurse-therapist: he was offered this because he admitted to driving around with a shot-gun in the back of his car and had made a suicide plan. The psychiatrist prescribed him Prozac and the nurse-therapist said that she wished she could give him longer term therapy, but her case-load made it impossible. I know that the NHS employs psychotherapists, but I have absolutely no idea of the eligibility criteria. Everyone I see would benefit from it, and none have been offered it. I don’t think any of these people could be described as ‘self-indulgent’, and I know that therapy has made a significant difference to their quality of life (and in the case of those with suicidal ideation has prevented them from further suicide attempts.)

Self-indulgent toss? You, anonymous commenter, have absolutely no idea of the depth of pain that some people manage in their day to day lives.

Do I, and other therapists, exploit people’s misery? If you agree that bakers exploit people’s need for bread and builders exploit people’s need for houses then perhaps we do. I think the real charge is that we make huge sums of money out of people’s unhappiness. That we are cynically exploiting people’s unhappiness to line our pockets with easy money. Let me disabuse you of this idea. Nobody goes into this profession to make money. There are much easier ways of making a much better living, and so we do it for very personal reasons. Perhaps I will blog about why we do it another time. But we don’t do it to make our fortune. Had I stayed in social work I would be earning half as much again as I earn now. I have friends in teaching who earn almost twice my average earnings. If I worked in the NHS I would be earning far more than I earn privately. God, I feel like I am moaning now about how little I earn, so trust me I am not. I earn a comfortable living. I agree that it is prohibitively expensive for many, many people. But in the serious absence of NHS therapy for those who want it, private therapists provide a much needed service. Surprisingly, there are many people on low incomes who choose to come to therapy because they feel its benefit. (And most of us offer a number of 'subsidised' places for those on low incomes.)

I think I understand the criticism of ‘therapy culture’; I blogged about it recently. I dislike the hurry to remedy any negative emotion and the implication that we should treat emotional dis-ease as an illness. Personally I blame the self-help industry (all those dreadful books and motivational seminars) which truly is a child of late modern capitalism. Create a hitherto unrecognised need, and then persuade people to part with vast amounts of cash to meet the newly acquired need. I loathe the self-help industry with a vengeance, and so do most serious psychotherapists, actually. The discourse of self-help implies:

  • Emotional distress is unacceptable and should be treated as an illness requiring treatment.
  • We all have an absolute right to be free from emotional pain, discomfort, disappointment or disillusionment….
  • …and we therefore have an absolute right to have the world meet our need for self-gratification. I have a right to have my needs met.
Yuch! We have many rights, but this isn’t one of them.

Ian Craib’s The Importance of Disappointment is a fantastic critique of this cultural trend.

I do think that we need to differentiate between this and the very desperate circumstances and personal despair that drive some people into psychotherapy. So please think again before making casually offensive remarks about those who seek professional help and those of us who provide it.

PS. Some people come to therapy because they simply want to explore who they are, what they want from themselves and others, and how come they feel/think/act the way they do. I don't include them in the 'self-indulgent' bracket. I think it is just fine to explore one's internal world to find a place of self-acceptance. Just to say.

Friday, February 02, 2007

Sprat To Catch A Mackeral, Anyone...?

On today's PM programme on Radio 4, Eddie Mair interviewed a US military official (or some such like) regarding the death in Iraq of Lance Corporal Matty Hull, who died when the convoy of armoured vehicles he was travelling in came under fire from US aircraft. The US official began the interview by offering his sincere condolences to Matty Hull's family. To which Mr Mair replied, quite bizarrely, "fine words butter no parsnips." There was a pause, before the US official admitted that he had never before heard this particular phrase. The correct response was, of course, "Mr Mair, you are nobbut a donkey's whippet." But we couldn't expect him to have known that.

Thursday, February 01, 2007

Why Psychotherapy Needs Regulating...

Apparently the Barefoot Doctor is in a bit of a pickle at the moment. Mr Barefoot is a self-styled guru who dispenses advice on health and well-being, via his website, various self-help books, newspaper columns (formerly for the Observer), TV appearances and his touring circus (sorry, that should read public appearances.) As far as I can ascertain he is a yoga-teacher with an incredible knack for making money (which, as any yoga-teacher will tell you, is actually quite a remarkable achievement.) I used to enjoy Mr Barefoot’s column in the Observer. His advice is sound and his Taoist approach to life is one that I mostly admire. The Observer reported on Sunday that the patient group Witness have received complaints against him for ‘making sexual overtures to patients in treatment.’ Mr Barefoot denies the claim, but admits to ‘sexual tensions’ with ex-patients and others whom he implies are ‘Barefoot groupies’ (my words, not yours, don’t sue.) He has made a statement on his website, disputing the claims but apologising for ‘salacious emails’. I can’t check it out because he has a ‘membership fee’ to enter the site which I am loathed to pay: I refer you back to his incredible knack for making money.

The Observer article went on to talk about the importance of regulation for ‘alternative therapies’, including counselling and psychotherapy. I have to say I am quite uncomfortable with psychotherapy being lumped in with crystal healing, meridian-tapping and aura-reading, and I think they should be treated as quite separate entities. I can see no great benefit to hippy-dippy therapies being more formally regulated: if people want to spend their hard-earned cash on the left-field end of alternative therapies, that is undoubtedly their right, and I don’t think these therapies create a patient-therapist relationship that requires sanctifying. But I do happen to think that the counselling and psychotherapy world requires government regulation, and that this should happen sooner rather than later. This is a matter very close to my heart, and one on which I have a selection of opinions, so I turned eagerly to page 24 for the Focus special: sex and betrayal in the consulting room.

The Focus special turned out to be a focus on medics, in particular gynaecologists and GPs who, let’s face it, have unparalleled opportunities to abuse their patients. Given that all of the professionals cited belong to an already well-regulated profession, the argument that we need urgent regulation to prevent psychotherapists from molesting their clients seemed to have lost its internal cohesion. So, in a spirit of public service I will give you the information that the Observer should have published, outlining why regulation for psychotherapists and counsellors is a Very Good Thing Indeed.

It is something of a misconception that the therapy industry is entirely unregulated. There are 2 main governing bodies, UKCP and BACP, both of which have stringent accreditation criteria. UKCP requires:

  • Minimum 900 hours of advanced training/supervision over a period of not less than 4 years
  • An appropriate psychiatric placement
  • Minimum 450 hours supervised clinical practice
  • Supervision at a ratio of 1 hour per 6 hours of client contact on no fewer than 450 client contact hours
  • A minimum of 40 hours of personal therapy for 4 years

And to maintain registration:

  • Evidence of Continuous Professional Development
  • Continued client contact (eg, if a therapist takes a year out of practice there are steps s/he must take to re-register before permitted to practice again)
  • A minimum of 8 supervision contacts a year

Both governing bodies have their own ethical codes that registered practitioners must abide by, and pay particular attention to the nature of the therapist/client relationship. Needless to say, sex is a no-no. In addition to this, most practising therapists/counsellors will also be members of their own modality’s professional body, which will have its own code of ethics and professional requirements. Technically, I can be taken to two different ethics boards for the same transgression.

So far, so tough. Except that registration with a governing body is optional, and indeed membership of your own professional body remains optional. Which means any Tom, Dick or Harriet can put a brass plaque on their door saying ‘Tea and Sympathy’ and they are good to go. It is currently incumbent upon the client to check out the practitioner’s professional credentials. And this is the really shocking part: in 10 years of practice I have been asked four times for my qualifications and registration details. Just four times: less than 1% of clients seen (and two of those were practising therapists who knew what they were asking for.)

I have no doubt that the government will make it a legal requirement for psychotherapists and counsellors to be a member of a regulatory body before they can practice, with exemptions for trainee therapists practising under supervision. And homeopathy, acupuncture, osteopathy, hypnotherapy and other ‘respectable’ complementary therapies are going the same way. I don’t imagine this will stop some therapists having sexual relationships with their clients. Sexual predators will do it regardless of the rules – look at the medical profession – and there will always be some who ‘fall in love’ and don’t feel able to hold the boundary. But registration will certainly sift out most of those who are incompetent, poorly trained or just well-meaning individuals who once did a ‘skills to counselling’ course at their local tech.

Until then it is the client’s responsibility, unfortunately, to check out the practitioner. Suggestions:

  • Ask for their qualifications, but don’t be put off if they say ‘trainee therapist under supervision’ – they have to be deemed competent to practice by their trainer and supervisor, but they are obliged to inform any clients so be suspicious if they haven’t volunteered that information right at the beginning.
  • Ask whether they are a member of UKCP or BACP. If not, why not?
  • Ask about their supervision arrangements and their commitment to their own Continuous Professional Development.

And if they refuse to answer any of the above, then go somewhere else.

Here endeth the lesson.