34. Calling International Rescue. Discreetly.

Image

After an extensive rebranding exercise, the chief executive is announcing a brilliant new name for the mental health service. ‘We are going to call it…’Emotional Rescue’…’  The applause is more muted than expected and there is muttering. Someone whispers to let him know it was a Rolling Stones album, and not one of the better ones, flirting a little too closely with Disco.

David Miliband has made a similar mistake in agreeing to be head of International Rescue. Doesn’t he realise he or his brother must spend half their time in space, monitoring all the radio frequencies, just in case there is a distress call?

Imagine just popping out into space for a cigarette and while you aren’t watching there is an earthquake or motorway pile up. How let-down would people feel? This never happened to the Tracey brothers –  puppets never need the bathroom.

The notion of being rescued, of someone watching over us, is a favourite one in fiction, popular culture (superheros) and religion (saviours). The gold standard for benign oversight is the catholic concept of the guardian angel. The nuns taught us we had one each.

Could that explain why some people seem very lucky? And might some guardian angels be better than others? Is each one newly created for each human, or are they deployed like the police, in a largely reactive role? Do they have a team leader, like social services, who will be vilified in the celestial media in case of a guardianship faux pas?

Do they confine their advice to moral matters, or would they for instance, stop you from buying shoes a size too small because they were in the sale, or attempting to hit a 3 wood out of a fairway bunker?

Might they have served other people in the past, like Kevin Costner’s character, Frank, in The Bodyguard? Don’t forget, last time Frank had a day off, Reagan was shot.

What a shame the real life Whitney Houston didn’t have such a person looking after her. Celebs seem to get much worse mental health care than ordinary folk. Perhaps it’s because they are surrounded by sycophants and parasites, rather than loyal and heroic servants.

Think about it. Say what you want about the NHS, we would never have gone round and given someone with severe insomnia a propofol injection, as happened to poor Michael Jackson, not even on a weekend shift.

I shudder to think what might have happened if Michael Jackson had been an NHS patient. In the USA a doctor was tried and convicted of involuntary manslaughter. In the NHS there would have been a serious incident inquiry lasting years and finally releasing a 9000 page report, criticising practically everyone involved, with particularly scathing mentions for Martin Bashir for his interviews, and Paul McCartney, for disputing  whether ‘the girl is mine’.

So many missed opportunities to prevent a tragedy. All those cosmetic operations. The accusations about children. That tea party when Bubbles took things too far. The controversial version of ‘They don’t Care about Us’. Where was the inter – agency working? Where was the properly completed Risk Assessment?

Where should celebrities turn when their lives get out of control? If they are lucky enough to be in a government or large corporation, there are people who can look out for them. In particular, people who can manage publicity and pull strings. There are lawyers and personal assistants, special advisors, coaches and trainers. Imagine having someone who comments on your actions very favourably and sends a glowing account to the media. How long would it take you to believe your own publicity? Not long in the case of people already prone to narcissism.

However many people there are in a ‘support network’ there is often no-one there when you really need them. Michael Jackson even had a full time personal physician present in his house, yet still died.

It takes a massive effort to be there for someone 24/7, which is why we invented the guardian angel, and why Trusts use grandiose titles like Crisis Teams to describe one bloke and two phones.

People who have the so-called borderline personality like to test the rescue services, both metaphorically and literally. You find out who your friends are when things go wrong, so why not test them out in advance, like a fire drill, by putting yourself in danger? Is David Miliband listening or not? This should get his attention…

Maybe NHS Trusts should set up special teams to protect celebs from the evil clutches of corporations and private healthcare.

At present, celebs with problems seem routinely directed toward spells in what gets called ‘rehab’. This means being admitted to an expensive private clinic, focussing on detoxification and abstinence programs for addiction.

No-one ever criticises such approaches as misguided or ineffective. When a movie character says, ‘I’m checking you into Rehab right now,’ no-one ever responds, ‘but the outcome after a year is no better than a control group who just see a counsellor’. It’s just not drama.

Residential drug misuse services are seldom provided in the NHS, because the cost benefit analysis for such treatment is very unfavourable. Perhaps showbiz types take a different perspective. They want a proper emotional rescue, not cosy chats, pottery and yoga.

Celebs never seem to get a social worker or CPN or get to attend the allotment project. They never seem to get taken shopping, by health care assistants, or make mosaics from broken car window glass.

There is an increasingly large gap between inpatient services like rehab clinics, and the next rung down, which is an appointment once a week in converted premises above Poundland. There is very little mental health care provided within the night-time economy, just the usual haunts – police station and A and E.

It’s comforting to imagine that an outfit like the A team or International Rescue would come and help you if you hit a downward spiral. That is perhaps why the ambucopter service attracts a lot of charitable support. It’s there when you need it – you hope. But should we have to put money in a pub collecting box to pay for the ambucopter, when we are paying £3.15 for a pint, most of which goes in tax?

Since tax on alcohol amounts to nine billion pounds annually, almost 2% of total revenue, perhaps we really could afford more Emotional Rescue, and even buy the phrase off Mick and Keith.

Just in case the Crisis Team needs more staff at night, i.e. more than one.

Just in case David Miliband is in the space station jacuzzi.

Just in case the nuns were wrong, and your angel can’t really fly.

14. Finding the Chimps in the Armour.

Image

Nice nails, nice hair, shame about the ears.

A chimpanzee dressed as a removals man takes a tea break with colleagues, only to have the piano they are moving crash downstairs.

The year is 2002, the last year Brooke Bond tea were able to use chimps as actors.

It is estimated that there are over 300 showbiz chimps in the USA. A study recently suggested that using chimps for advertising reduced people’s concern for them as an endangered species.

Perhaps the most famous showbiz chimp is Bubbles, who once belonged to Michael Jackson. Not many people know that Bubbles had a former career in research, from which he was ‘rescued’. Bubbles now lives in Florida. He has still not been told about Michael’s sad demise, so I hope he is not reading this.

It is reported that Bubbles has taken well to Florida, putting on a bit of weight and spending the day listening to music and watching television.

Peoples’ attitudes to anthropomorphism – projecting human attributes onto animals and vice versa – are pretty chaotic.

We no longer have TV shows such as Animal Magic, where a voice – over contrives to turn animal footage into mini – drama.

However, cut to 2012, where Ashleigh and Pudsy, a teenager and dancing dog, perform a slickly choreographed routine to the Flintstones theme, to win ‘Britain’s got talent’.

Simon Cowell remarked: ‘You know me, I love a dancing dog, and Pudsy is one of the best dancing dogs I’ve ever seen. My only criticism is I’d have put Pudsy in a prehistoric outfit as well’. (As well as himself perhaps?)

Nowhere have I read any suggestion that training Pudsy was unkind in any way. Contrast this with the kind of coverage with which circuses have had to contend.

Apparently, in the USA, there have been more than 35 dangerous incidents since 2000, where elephants have bolted from circuses, run amok through streets, crashed into buildings, attacked members of the public, and killed and injured handlers.

Time, surely, to send in Sting and maybe even Bono too, to set them free.

Psychiatrists are quite interested in animal behaviour. ‘Ethology’ features significantly in the membership exam multiple choice questions, being the ones that you throw dice to complete randomly, in the last minute.

Always looking out for similarities between animals and their owners, we expect, for instance, a Bubbles solo album in due course. More usefully, we know to beware entering the houses of people who have a) mental health issues and b) lots of pets.

Although, in such circumstances, most pets know that they should first bite the social worker, then the GP, before biting the psychiatrist. Its just a kind of ethological pecking order.

So, what counts as a day out for most people is a field trip for escaped psychiatrists.

Last week l visited a zoo, Newcastle, and my workplace, and its time to compare and contrast. First the zoo.

Nowhere is anthropomorphism more politically incorrect than the zoo.

One can only admire the dedication of the staff toward the welfare of the animals. The lions had loads of space, the lemurs got The Guardian delivered every morning and the reptiles were pampered, perfumed and stroked by two nice young ladies. Not for a moment did I wonder whether they had painted stripes on the snakes with nail varnish.

So, why was it I got this yearning for an old style zoo, where it was OK to throw currant buns at the elephants and dress the chimps up in tutus and cravats?

That kind of thing just isn’t allowed nowadays.

Surprisingly, London zoo haven’t dressed them like this since 1926. Though as late as 1962 Hints zoo dressed them up as decorators and gardeners and gave them bicycles to run round on.

I am sure if I tried to organise a chimpanzee’s tea party I would be struck off the medical register and censured by the district ethical committee.

It’s just that I get the feeling the animals are missing out on something too.

Chimps seemed to like using tools and being silly with paint. Dolphins seem to like acrobatic leaps out of the sea and splashing people in boats. Parrots seem to like riding a unicycle and squawking ‘Hello Keith’.

Maybe the problem is in the phrase ‘seem to like’. Critics might say the animals are trained to act this way by behavioural methods, such as rewarding a desired behaviour with a Malteser or a small fish. Not to say punishing an unwanted behaviour with devastating sarcasm.

Could it be that Pudsy’s seemingly ecstatic enthusiasm is simply a series of learned behaviours, conditioned and chained together during lengthy and gruelling training sessions, each new move heavily reinforced by food pellets? How closely does Pudsy’s behaviour resemble the naturalistic behaviour of dogs in their ‘normal’ habitat?

Possibly animals no more like to ‘go showbiz’ than your washing machine likes to spin at 1400rpm all day.

Pudsy is not an elephant, so is unlikely to pull off a break-out one day, or be rescued by Sting.

Its been said that dogs grow to resemble their owners, but chimps are the animals humans most resemble in terms of appearance and genetic code.

Chimps, like jazz, went their own way 4 million years ago, the split apparently caused by ‘creative differences’.

Chimps were being discussed at the Royal College of Psychiatrists Addiction Specialists conference in Newcastle last week. Though Escaped Psychiatrist is not an addiction specialist, he managed to infiltrate by not shaving for a few days beforehand.

Steve Peters was the big name speaker. His work in elite sport has generated a lot of interest, and his book, The Chimp Paradox, has become a bestseller.

Steve is a psychiatrist rather than a psychologist, yet has eclipsed sports psychologists with his recent high profile successes in cycling, snooker, several other sports and now football.

That’s gratifying for a psychiatrist – we secretly think we would be brilliant at any other career we tried, from hosting a chat show (like Anthony Clare) to chancellor of the exchequer. (Seriously, how hard can it be?)

In person, Steve is charismatic yet self effacing. He has been working on the Chimp model for many years and gradually refined it. Clearly he has incorporated it into his own thinking, resulting in well deserved fame and acknowledgement.

I think Steve has come up with the right model at just the right time, like the iPhone in 2007. The CBT bubble is bursting to some extent and people are hungry for a model with more practical bite.

The name Steve Peters is exactly right for a sports coaching guru. If you were to write a novel about a successful footballer or boxer you would probably call him Steve Peters.

Secondly, he looks fit and healthy, as though he belongs in the world of sport, which is unusual for a psychiatrist.

Most importantly, his ‘chimp’ model of the mind provides a useful metaphor to help understand aspects of human behaviour.

There is a certain amount of overlap with other models, such as Eric Berne’s Parent / Adult / Child system , the ‘seven kinds of smart’ from Emotional Intelligence and even Freud’s concept of the Id. In response to a question, Peters explained that the Chimp went way beyond what Freud would have expected of the Id, in terms of perceptiveness, calculation and dominance.

He also contrasted his model with the Type 1 / Type 2 scheme established by cognitive psychologists, in particular his construction of the part of the mind he calls ‘the computer’, which is paramount in sports performance .

Since Escaped Psychiatrist is mainly concerned with Depression, I am thinking about what this model could bring to the battle.

My first thoughts are that Depression is often associated with poor decision-making.

Whether this is cause, effect or co-incidence varies, but there is certainly a large group of depressed people who have suffered from internal sabotage.

Much of this self destructive behaviour is associated with poor impulse control- behaviours such as overeating, substance misuse, poor anger control and a failure to delay gratification.

A lot of the young people we work with seem to have made a series of terrible decisions, leading to the conclusion that sometimes, ‘misery is the wages of sin’. OK, for sin read ‘dysfunctional behaviour’.

This morning the Today program reported that deliberate self – poisoning in young people had increased by 40% over the last decade.  It looks as though the new generation are struggling with their inner chimps more than ever.

Though I struggled with a significant proportion of Peters’ book, particularly the notion of the psychological universe, made up of planets and moons, there are lots of useful behavioural strategies dotted around the chapters. Peters thinks that children ‘get’ the chimp model quite easily, which means it might suit schools and children’s services.

I guess my concern here is that there is a group of chimps somewhere discussing this, probably  wearing tutus and cravats, drinking tea out of china cups, concluding that what is wrong with chimps nowadays is that they just can’t keep their human side under control.