An introduction to Mindfulness – the first of a new series on ‘let’s talk!’

miranda

Miranda Bevis

Miranda Bevis, our expert Mindfulness practitioner has prepared some articles on how we can all take advantage of the benefits the practice of Mindfulness offers. As she will make clear in teh coming weeks, it does take practice, it is no quick fix. But that is what it is all about – taking that time to add it, gradually, into our lives….

Mindfulness is very much in the news these days, as means of finding a bit of tranquillity in our increasingly stressful world.  We are all subjected to pressures from many different sources, including work, relationships, family, money worries and information overload. Often the strain may prove too much, and problems arise. A high proportion of illnesses are now thought to be stress related, and there are no ‘quick fix’ medical answers.

Many people struggle with anxiety, panic attacks and depression. Social isolation, lack of confidence and low self esteem are common and they may leave us feeling exhausted, trying to find solutions in our lives, and feeling powerless to change things. A lot of time is spent wishing we were somewhere, or someone, else. Energy may be invested in ruminating over unwanted thoughts.

The idea behind mindfulness is very simple. It is just to be fully in the present, moment by moment. We learn to focus on what is happening right now, and cultivate a kind and non- judgmental attitude to ourselves. This is not an intellectual exercise, but requires a fair amount of practice. Over time, we develop a different relationship with what distresses us. What exactly are we focussing on? It is often the breath, an anchor for our attention. It may be our body sensations, or what we can hear or see. We learn to be aware of what we are doing, while we are doing it. We observe thoughts and emotions, and learn to let them pass by, instead of getting hooked into them. Gradually, we realize there are different and more constructive ways of responding to difficulties, instead of reacting in old, often unhelpful, automatic patterns.

The approach was developed by Jon Kabat-Zinn in the late 1970’s. It draws from ancient eastern philosophies, but is delivered in an entirely secular way. Research, over three decades, supports Mindfulness, and it mindfulness_oneday_6_1_1_1_1_1_1_2_1_1has been shown to increase feelings of well being, and decrease the impact of living in a stressful world. It is now taught widely in many different settings including schools, the mental health services, hospitals and hospices, prisons and government agencies

Over the next few weeks I am going to explore what we mean by Mindfulness, and how we can use it to navigate whatever stresses may come our way, not be blown away. I will also include some wonderful poetry, which can help focus our minds and support our practice.

“It may be that when we no longer know what to do,

we have come to our real work,

and when we no longer know which way to go,

we have begun our real journey.”

Wendell Berry

Miranda has some new Mindfulness workshops and courses starting in the New Year. Follow us on Facebook to find out more or see www.the-terrace.co.uk

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‘let’s talk!’ about ‘parity of esteem’ in mental health

esteemOver the past few weeks we have heard the term ‘parity of esteem’ used a lot, in relation to mental and physical health. It is an important phrase with an important meaning, but how many of us really know what it means? And would parity of esteem actually improve the way mental health services are delivered?
The NHS defines the term as meaning:

“My family and I all have access to services which enable us to maintain both our mental and physical wellbeing.”
“If I become unwell I use services which assess and treat mental health disorders or conditions on a par with physical health illnesses.”

Professor Sir Simon Wesseley, incoming president of the Royal College of Psychiatrists, has highlighted this issue in The Guardian recently, as he took up his post, challenging Health Secretary Jeremy Hunt on his pledge to ensure mental health services achieve the same level of provision as physical health services . He believes the gap is already so great that finances will never be able to close the gap. If less than a third of people with cancer received any treatment at all, wouldn’t we be up in arms? What if they had to wait 6 months for a scan? These are the figures for those suffering with depression, a condition that can worsen, result in life-threatening illnesses and at its most severe, death.

On the Radio 4 programme ‘All in the Mind’ yesterday, Clinical Psychologist Martin Seager, who spoke so eloquently at the Taunton Association for Psychotherapy Conference in 2013, said that the well-known statistic that 1 in 4 of us will experience mental ill-health is misleading, and could even increase stigma. He feels that this discussion on parity of esteem hides the real issue – that we all experience mental and physical health or ill-health. There is a mental health aspect to physical health, and vice versa. Looking at those two NHS definitions above therefore, the first seems more appropriate, and is one that many therapists would endorse.

Simon Wesseley continued:

Professor Simon Wesseley

Professor Simon Wesseley

“The whole of our healthcare system is about separating mental and physical. You couldn’t devise a system better suited to separating the mental and the physical if you tried……..Most people have quite complicated views of their illness anyway…….They are not resistant to doctors offering cardiac tests and counselling for a recent divorce at the same time.” He has seen psychiatrists on general medical wards work with great success.

“But we know people with physical health problems who also have mental health problems cost about 45% more than those who don’t. That’s absolutely and unequivocally clear. The cost of their care goes up. They comply less with treatment, they come back more often, they have lower satisfaction and they have more complications.”

So the President of the Royal College of Psychiatrists is calling for more holistic treatment across the health service, which could achieve significant savings if implemented. Parity of esteem is surely all about keeping physical and mental health separate, thereby perpetuating the myth that we can be mentally ill but physically healthy, or physically ill but without mental health needs. Doesn’t this, as Seager suggests, increase the possibility that mental ill-health will remain stigmatised and disconnected from, and in competition with (for resources, time etc) with other health services?

We would love to know your views!

Shell Shocked Britain – The First World War & inter-generational trauma

Shell Shocked jacket high res jpegAs we approach the first Remembrance or Armistice Day commemorations of the First World War centenary  it is appropriate to be mindful of what exactly we are marking on Sunday, and on the 11th of November 2014. Yes, we are offering up our thanks to those who gave their lives in the Great War and subsequent conflicts, but we must also remember those who survived, lived, and are living with the aftermath of the war.

In Shell Shocked Britain: The First World War’s legacy for Britain’s mental health, Suzie Grogan looks at the impact of the First World War on the men, women and children who survived it. How did those four years of conflict affect the way we view the mental health of those traumatised by their experience of war, whether directly or indirectly?

Dr Peter Heinl, in Splintered Innocence and others have long studied how ‘neuroses’ can be transmitted from parent to child, replicating traits down the generations.  It has not been easy, as data is limited and follow-on studies of those diagnosed with shell shock or what we would now refer to as ‘combat stress’  is very limited, or non-existent.  Work with Holocaust survivors, however, has offered greater consistency in the results of studies into the intergenerational effects of parents’ traumas. Published work has suggested greater vulnerabilities to Post Traumatic Stress Disorder (PTSD) in second and third generation survivors. Responses to a traumatic event – whether in conflict situations or a personal trauma such as bereavement or serious illness can be more marked in the children of traumatised parents.

Arthur Addison, shell shocked soldier

Arthur Addison, shell shocked soldier

Suzie Grogan was inspired to write this book when she discovered that her shell shocked great-uncle Alfred Hardiman had killed his ex-girlfriend and himself in 1922. His act sent shock waves through his community and through the generations of his own family, but it was not an isolated case. She discovered that her grandfather had also suffered from shell shock, along with tens of thousands of other men who fought in the First World War. Identifying other members of her family who had subsequently experienced mental health issues, and acknowledging her own periods of depression and acute anxiety,  Grogan was keen to examine how the events of 1914-18 continue to resonate with us 100 years on and in doing so she uncovered new material to chart the many tragedies with their roots in the conflict.

Shell Shocked Britain looks at:

  • the direct effects of shell shock on the troops and their families,
  • the different medical approaches to ‘cure’ shell shock, including electric shock treatment, hypnotism and the talking therapies, as well as ‘miracle’ cures.
  • The impact of the1922 Committee Report on Shell Shock that was supposed to change the way men were treated in future conflicts.
  • the devastating air raids that brought the war, literally, into the domestic lives of the Home Front, killing civilians as they stood in the streets and wrecking the Upper North St school in Poplar, East London, killing 18 children.
  • The lingering after –effects of the Spanish influenza virus and the horrors of an outbreak that killed 200,000 in Britain alone as war continued to rage.
  • why thousands turned to séances and spiritualist church and how the rise of the Eugenics Society had direct links to the conflict, with leading thinkers supporting unthinkable responses.
  • how tragedies such as that perpetrated by Alfred Hardiman and suicides in general increased even into the 1930s.
  • the legacy of shell shock and lessons for future conflicts – 1914 to 2014

In the book Suzie Grogan asks tough questions of her 21st Century audience. We are told not to attribute modern views on historical events, but, she maintains, these are our close kin – parents, grandparents and great grandparents. For hundreds of thousands of people the trauma of the Great War never left them, and in the modern army highly trained men and women still break down, coming back to a civilian life for which they are ill-prepared.

To ensure children are protected from the higher levels of family breakdown, substance misuse, domestic violence and homelessness  that affect troops now as they did 100 years ago, it is important, as this book highlights, to use the next four years of commemorative events to remember those who continue to struggle with the fallout of war, and support them.

Suzie Grogan is talking at the Taunton Literary Festival on 11th November 2014 and for Taunton Association for Psychotherapy on the 14th November . See suziegrogan.co.uk for more details