Saturday, 11 November 2017

What shall we remember?

When I was a kid in primary school I remember volunteering to sell poppies for the Earl Haig fund. I knew it was important but in a typically childish way, it was exciting because I got to trawl the streets and pubs which is a big deal for an 8 year old. But I had no concept of what war really meant. It had not touched my life in a real or tangible way. We pulled apart war poems in school because they were part of the curriculum. We analysed the language and the structure and used words like horror and gore, but still, it was not real to me. It was stories, it was fiction, it was history. It was something we were taught to be proud of and the poppy was a representation of that.

Now, I'm filled with ambivalence about this iconic symbol. The public displays of national pride move me very deeply, but also stir up conflicting emotions of sorrow, anger and deep disappointment in the human race. Human beings have been fighting each other since the beginning of time - this is now an industry with unfathomable monetary cost, but the cost that moves me most is the human one. There are statistics about the most recent wars costing trillions and many thousands of lives, but statistics are numbers and almost impossible to get our heads around. The individual cost is something much more tangible.

I have worked with many veterans and active military personnel in a number of settings. I have heard their stories, I have heard their families stories. I have had both the honour and the horror of having them share their deepest pain and most disturbing nightmares and witnessed the impact of what haunts them daily. Most of their scars are not visible to the eye. They are internal amputees, with parts of them cut off, mangled and mutilated. The most unimaginable disturbing images burned into their brains causing the wiring to short-circuit and disrupt every part of their lives. Tortured to the point of the suicide.

"We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields." John McCrae

Should they be left to suffer with their wounds for the rest of their lives? What tiny fraction of the trillions of pounds and dollars invested in war actually contributes to their recovery, healing and rebuilding of their lives? Who takes responsibility for clearing up the mess that war has made of people's lives? Should more be invested in research into PTSD? Who is fighting for those who fought for us while we went about our lives and slept soundly in our beds? I can't begin to answer these questions without getting political, which is not the point of this blog, but it is mainly charities funding activities that aid the recovery of veterans. They are doing amazing work, but they have to fight for their funding. Is that right? Is that fair?

I consider it a privilege to have contributed a small part in trying to help people rebuild their minds and their lives, but it does feel like a single arrow being fired into a raging battlefield. I hold on to the fact that helping even one person fight for their mind, for their sanity is something that can make a difference.

The poppy became a symbol of war following the poem In Flanders Fields, written by John McCrae, inspired by the flowers that flourished in the soil churned up by shelling and fighting. How ironic that something so beautiful thrives in such an environment. Human beings are the same. Emerging research into post-traumatic growth shows that people are inevitably changed by the most terrible things, but they can also grow and transform into something else, into something incredible.

I shall remember. And I shall believe in the power of the human spirit.

Signing off. Dr M

Saturday, 28 October 2017

Faith in humanity restored to factory settings

So I had a bit of a wake up call last week. I realised that much of what I write about is on the darker side. Part of me thrives on that, but I don't think I've spent enough time thinking about the beams of light that shine out in the darkness. I felt the full force of that when I was attending a suicide prevention trainers conference in Canada recently.

I had the honour to meet and spend some time with Jonny Benjamin and Neil Laybourn. Yes, ironic that I should go all the way to Canada to meet a couple of English blokes. If the names sound familiar, it is because they are the men behind the story of the Stranger on the Bridge (link at the end). Short story, Neil finds Jonny on the Waterloo Bridge in London one morning, planning to end his life. Neil talks to Jonny and a transformation takes place, which results in Jonny's turning point towards life. Years later Jonny tracks Neil down to say thank you and the pair are now working together to raise awareness. Of course, there's much more to it than that, so watch their story. It is moving, powerful and inspiring.

I'd like to share what hearing their story meant to me. I spend a lot of time listening to other people's pain, listening to the terrible things that have happened to them and the terrible things that other people have done to them. It's fair to say that gives me a somewhat jaded opinion of the human race. It gives me a stark awareness of the ugly side of humanity and the devastation that other people can inflict - sometimes intentional, often not. Of course, I also see people's incredible ability to survive these things and am continually fascinated by human beings' creative ways of making their way through the most horrendous events. But essentially it is impossible not to think about the evil that men do - to each other.

This brings me to what touched me most about Jonny and Neil's story. I've spent a huge chunk of my life talking about suicide, helping people understand it, teaching them what to do, helping others deal with their thoughts about suicide. But Neil was just a 23 year old bloke. He hadn't been on training courses, or worked in mental health, or spent years stuck in psychology books. He just knew what to do. He maybe didn't feel like it at the time, but what he said and what he did made a difference. It saved someone's life. It saved Jonny's life. He was just a human being who saw the flicker of life force in another human being.

“You must not lose faith in humanity. Humanity is like an ocean; if a few drops of the ocean are dirty, the ocean does not become dirty.” 

I was 30 when I lost my best friend to suicide. She wasn't a stranger. I talked to her all the time. I knew she was struggling, but I still didn't know how to help her. I know very well that it's much more complicated, but still all these years later, I wish and I wonder. Sitting in a room, with tears streaming down my face, listening to Neil and Jonny - I was the most humbled I have ever felt. I have this image in my head of two life forces being drawn to each other - the universe propelling them together. And it gives me hope. It makes me believe again that humans can be amazing, selfless, compassionate, courageous, instinctive and incredible. And yes, it does even up the balance of light and darkness in the world.

Jonny has the most incredible force of courage inside him. He shares his story and the raw humanity is palpable. The shadows of shame that have long cloaked mental health issues visibly falls away when talks. His determination to find the man who didn't have to stop that day is a part of the story that has touched the lives of millions of people - their story went viral and it has spread throughout the world. It reminds all of us that we can never really know the full implications of our actions.

Bonus - Jonny and Neil are top blokes. Funny, smart, sharp and interesting as well as brilliant advocates for mental health awareness. If you ever get a chance to go hear them talk - take it. They are transforming the world around them with every step, everywhere they go. They both have some really important things to teach all of us.

Humbled and in gratitude. Signing off Dr M.

Tuesday, 10 October 2017

Raw - avoiding the pain of grief and loss

Someone asked me recently why my blog posts had become so sparse over the past year or so. I humbly and finally admit that it's a classic case of avoidance. Yes, that self-protective panacea that we are all so familiar with, but our clever little brains always find a good excuse for. I remain ambivalent about sharing this, which leads me to my own good excuse.

Grief strips a layer off you. And when you experience several losses one after the other, the layers drip off so fast that you quickly find a way to stop looking at yourself. You peek out the corner of your eye, you catch sight of your shadow and shirk away from it, you step away from your own reflection - especially when you see it in the eyes of other people.

Sympathy nips like vinegar on raw flesh. It feels like the worst possible thing you could put on a wound. But no one knows what to do or say, they have little to offer except sympathy. What does that really mean? They feel sorry for you and they're glad it's not them. I know I sound ungrateful, but maybe I am just voicing the unspeakable truth that actually there isn't anything that takes the pain away and often other people make it worse.

As a therapist, I regularly "deal with" grief. It's different. There's a process. There's time. There's space. To just sit with the pain, so someone doesn't have to sit with it alone. Outside of the therapy room there isn't time and space or the willingness to tolerate another person's bottomless pit of distress. Even people sharing the same grief, it's not sharing. It's different for each of them. Loss is so very personal and individual that we struggle to comfort each other and mostly just feel alone with what we are feeling. The ripping away of an attachment is so basic and core that we can never fully explain what a person meant to us and what their absence means.

There's a reason why traditionally we wore black for eons while in mourning. It's off-putting. By nature, we are not drawn towards it. Black is so solid, so immovable, so permanently black. There's also a reason why every guideline ever says it's not a good idea to try and therapise the grief out of people, why people should wait before accessing grief counselling. We are supposed to be sad when someone dies. If we loved them, it's supposed to hurt. It's what makes us human. It sucks. it really really does. But it's supposed to.

“I will not say: do not weep; for not all tears are an evil.”  J.R.R. TolkienThe Return of the King

So I've been hiding. Otherwise known as avoidance. Normally I'm not an advocate, it's not the most helpful response and can get us in a right mess. But it's what I needed. I can do lots of other things and be sad at the same time, but I can't write when I'm sad. I can suspend sadness while I'm in the therapy room, while I'm doing training, while I'm laughing with my friends and my family. But I cannot write when I'm sad. I'm still sad, so maybe the blog drought will last a bit longer. For now, this is a tiny drop of moisture that wasn't quite a tear.

Till the next time. Dr M

Tuesday, 23 May 2017

13 Reasons Why - one reason to live

I haven't posted for a while, I'm not sure if anyone noticed - maybe it does not matter as like a lot of bloggers I've used this as a space to make sense of things for myself, and maybe at times that can be helpful for others too. I haven't written for a while and there are specific reasons for that, which I won't go into now, maybe another post. The reason for this revival is to make some comments and put down some thoughts after a binge-watch of 13 Reasons Why.

Many colleagues and friends in my line of work have been talking about this Netflix series, which focuses around the story of a teenage girl, who takes her own life. I avoided watching it for quite some time. Part of my avoidance was that rebellious streak of not wanting to follow the mainstream, not be drawn in to hype or any of the moral outrage that I was reading about.

However, one quiet Saturday I got under my blanket and watched all 13 episodes in one go. Whether or not binge-watching a TV series is a mentally healthy thing to do, is probably another blog post. I've read a lot of comments about this series - outrage at a graphic suicide scene, claims of glamourising or encouraging suicide, dangers of putting the topic of suicide out there so openly.

Maybe talking about this subject for the past 14 years has given me a very different view. I'm not sure that no go areas are very helpful when it comes to things like this, although I completely acknowledge that when it comes to the teenage brain, some different things are happening. The teenage brain has had less opportunity to experience adversity and to recover from it, to know that we have the capacity to endure, to recreate ourselves, to grow from tragedy. It feels like whatever you are going through is going to last forever. So of course, even more so suicide will be considered an option to end unbearable pain. Even more reason for this not to be a no go area.

I did not find the suicide scene shocking, even though it was graphic. What I did find deeply disturbing was the cruelty with which human beings can attack each other, the torture we can inflict on each other. It is not shocking. It is what I already know to be true. It just deeply saddens me.
"But things as fragile as a thought, a dream, a legend, they can go on and on. If you can change the way people think. The way they see themselves. The way they see the world. You can change the way people live their lives. That’s the only lasting thing you can create.”  
~Chuck Palahniuk, Choke

What I found squirmingly cringeworthy was the inability for anyone around a clearly struggling young person to have an open and honest conversation about suicide. The most painful thing for me to watch was the conversation with the school counsellor. He couldn't talk about rape, he couldn't talk about suicide, he couldn't talk about pain - without dodging or avoiding, he was not able to sit with the pain.

I'm not here to judge - and it is a TV show after all - these are not easy conversations to have. Some people might talk about training issues, but I think it's really about courage. Talking to someone about suicide is scary. It's as scary as a surgeon holding a scalpel over someone's brain. It is life or death. You feel like every word you say matters, that you could easily say the wrong thing and make everything worse. So yes, it takes courage. 

It also takes courage to choose to live - when pain is overwhelming, when life feels unbearable, when you are drowning and can't breathe. 

What I saw in that final conversation was someone desperately saying - I want to live, but I don't know how any more. I want to live, but I need a reason why. I just need one. I need to know that it makes a difference if I live or die and that my life can make more of a difference than my death can. How can we turn away from this, how can we not see it?

I think this TV show showed courage. Yes, it has stirred up some controversy. Yes it's uncomfortable. Yes, some of it is difficult to watch. Yes, we wish that certain environments didn't bring out the worst in people, but they can and ignoring it won't stop any of that. Ignoring that some young people want to end their lives is not going to stop suicides, but talking about it might.

Have courage my friends.

Signing off
Dr M

Sunday, 8 November 2015

Who am I and why am I here?

Ah, the good old existential crisis rears its head. Suddenly the world does not make sense. The beliefs that you build your world upon are shattered and you find yourself questioning everything. This can creep up on you slowly or smack you in the face.

This can happen for many different reasons. Death touches your life, the betrayal of someone close, being let down by someone you trusted and valued, the moment where you wake up in the middle of the night and realise you cannot breathe because you are only existing and not living. It can happen because of a lie or a truth you uncover, it can be other people’s unfathomable behaviour, it can be a traumatic event or an everyday pattern.

Something bewilders us, confuses us, dumbfounds us and suddenly, the world does not make sense. The very core of our being stumbles upon a shifting surface as we flail desperately for something solid to cling to.

“Every person must choose how much truth he can stand.” Irvin D Yalom, When Nietzsche Wept

What do we do with this? The human mind and its meaning-making instinct will do a number of things with this. We can develop a seemingly robust system of cognitive dissonance where we find a deep dark chasm of our minds to launch those messy things which do not fit with what we believe and we carry on our lives as though they never existed. This tends to have the effect of ill-fitting underwear. It is slightly uncomfortable, but bearable. Over time, the chaffing can become more than an irritation or an inconvenient thought, it can become unbearable. The box we put things in begins to spill over.

We might also just develop a new set of beliefs. Ah, this is how to make sense of the world. It’s because of…if everyone would just do this…then the world would work better. And as a shortcut, we might just use the clich├ęs and banal little greeting card sayings that get plastered up on facebook or so easily drool out the mouths of the masses. After all, that’s much easier than thinking for yourself, isn’t it?

“One should not search for an abstract meaning of life. Everyone has his own specific vocation or mission in life to carry out a concrete assignment which demands fulfilment. Therein he cannot be replaced, nor can his life be repeated. Thus, everyone’s task is as unique as is his specific opportunity to implement it.”   Victor Frankl, Man’s search for Meaning.

It could be said that this place of uncertainty, not-knowing the answers, of not being able to come up with logical rational explanation for what is going on, is the most uncomfortable place a human being finds themselves. I think this is true. I also think that this is magical place of opportunity where pain and grief and hurt and anger and disbelief can be transformed into something else.

But transformation is not some nice neat comfortable process. Because sometimes things cannot co-exist. Sometimes one thing has to die for another to live. This is also true of ideas, thoughts and beliefs. When you are writing, you must choose one word over another, you have to let some go. And you always, no exceptions, begin with a stark white blank page. Somehow that gets transformed into something else.

As we, moment-by-moment, write the story of our lives, there will always be blank pages, words which have to discarded, characters who are painfully sliced away. The end product is beautiful, unique, sometimes bizarre, sometimes tragic and painful, sometimes hilarious and often, so very often, sometimes does not make sense – until the final word.

Dr Murphy - signing off

Wednesday, 9 September 2015

Standing together

To mark suicide prevention day, I would like to pay tribute to the numerous individuals I have met who have dedicated their lives and their work to helping to save lives. These are also people who have touched my life in ways they will never know. They are part of my story, as are the people I have lost to suicide, and the people I have spoken to who have not been lost to suicide. 

To stand alongside someone at the edge of their abyss and help them to avert their gaze for long enough to look at the light, is both an honour and a challenge.

Anyone who has loved and cared for or worked alongside a person who tried to end their life also experiences pain, suffering and trauma. There is no relief in suicide – for anyone. This echo of pain that is left behind can often be used in an unhelpful way to guilt-trip people out of suicide. This just makes the person feel like more of a burden and gives them even more reason to not want to be here anymore.

"But I have found that in the simple act of living with hope, and in the daily
effort to have a positive impact in the world, the days I do have are made all the more meaningful and precious. And for that I am grateful."    Elizabeth Edwards

This seems to be a common thread for the way we interact with people in general – with threats and fear and guilt and shame. Wouldn’t it be more helpful to let each other know what we value, what we treasure, appreciate, admire in the other? So much of our lives, especially in our work, we do not feel valued and our contribution is not acknowledged. 

Those in society who do not have a traditional job are not valued for the silent, unpaid contributions that they make to society – as carers, home-makers, neighbours and generally the people who are around to help others because they are not hidden away in an office all day. In fact, why isn’t the government training all unemployed people in suicide awareness and intervention skills? Something that would show their contribution as a human being is valued.

Today, like every other day in Scotland, two people will end their own lives. This will have a ripple effect on their family, their friends, their neighbours, their colleagues and anyone who tried to help them. We need to stand alongside each other, look out for each other and value each other’s lives. Let's have hope. Because, one day, it might be us struggling to stay alive.

Dr Murphy - signing off

Sunday, 22 February 2015

The ties that bind

Many words have been written about attachment – theories related to personality, relationships, patterns of employment and even hoarding. Some of the most famous psychology experiments have used children to help us understand our attachment styles. And unsurprisingly some researchers have linked attachment style to suicide.

So what exactly do we mean by attachment? It is more than connection, which can change from moment to moment, but a connection that is time-bound – to the present, past and future. We remain attached to people, things, ideologies and places because of the memories they hold, or the future hopes they nurture.

The Future is something which everyone reaches at the rate of sixty minutes an hour, whatever he does, whoever he is."  C.S. Lewis

Our whole identities can become intertwined with the things we become attached to. We can also become attached to the idea of past or the idea of future. In Philip Zimbardo and John Boyd’s book The Time Paradox, they play with some interesting theories about mental health, behaviour and human beings’ relationship with time. It is a fascinating exploration of how our attitude towards time affects so much of what we do.

Being away from home recently, at times I became acutely aware of my attachments – a mug I always drink out of, a pair of shoes I forgot to pack, the river that runs through my town, the people that I love. We all have to spend time being away from the things and people we are attached to and generally our attachments are secure enough to sustain some coming and going. However, we can clearly see that when a person’s mental health becomes fragile, attachment behaviour can become extreme.

People can become obsessive about not leaving the house without some object or talisman – not just because they would miss it, but because they come to develop a belief that something terrible will happen to them if they don’t have it. Those with borderline personality disorder traits can often become this way about their relationships, needing constant contact with a loved one, without which they suffer unbearable feelings of abandonment. A person experiencing high levels of anxiety might always need to know their loved ones are safe and can become attached to certain rituals which make them feel safe.

For someone considering suicide, attachments add weight to the push and pull between life and death. Excruciating loss of attachment can make life meaningless and the anticipation of loss can feel like so much of a threat that death offers peace from this constant torture. Taking this to its extreme, loss of attachment to your own life, your meaning, your purpose and your future can all lead to thoughts of suicide.

Our need to belong – to something or someone is instinctive. Some philosophies maintain that our lives would be more peaceful if we were less attached. I agree with that on some level because loss is painful and disruptive. But these attachments, the love of anything or anyone is what keeps us connected to life, to our own lives. Loss only hurts because we love the thing we lost.

“The world is a fine place and worth the fighting for and I hate very much to leave it.”      Ernest Hemmingway

A life without any attachment can become a life without love. I’d rather take the risk. I’d rather love a favourite mug, even though one day it might break. I’d rather love the people I care about, even though I have no control over when they might be taken away from me.

Part of our work, is about helping people to become attached to their own lives again. It matters. It matters how we spend our time because none of us have an infinite supply.

Dr Murphy - signing off. Oh and if you are interested in The Time Paradox you can check it out here