Tag Archives: Psychology

96. Watching their Rome burn.

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Sorry, I’ve not written anything for a while. The daily news has become so outlandish that the art of wry observation has been killed off. It’s like a weather report has been interrupted by an extinction event meteor strike.

People keep asking me to explain why the UK is shooting itself in the foot and I suppose the easy answer is that Britain hates itself deep down. Britain is one of the first industrial countries and is the first one to become sick of industrial endeavour. The jadedness is pervasive. No-one’s really facing it. Employment is historically at a high level, but most of what people do at work they freely accept is pointless.

If Britain turned up in outpatients we’d send it to the crisis café, where it would do breathing exercises and group drumming therapy. Britain is paranoid, but not in a psychotic way. Britain is using the primitive defence mechanism of projection to blame its problems on others, much as Gotham City eventually turned against Batman. Britain will not be given drugs and universal benefit; it will not be allocated to a care coordinator. Britain will be given a self help leaflet and ‘signposted’ to the Tuesday allotment project. Sadly there is no therapist designed to treat whole countries. Although we have Prince Harry ‘starting conversations’ and the government’s behavioural insights unit.

But will that be enough to rescue us from our angry self loathing? Or do we need a proper superhero? Or even a more universally hated enemy, now that ISIS is receding and Northern Rail have settled their strike?

Beneath paranoia lies a longing for there to be someone out there who is interested in us– preferably in a good way, like a guardian angel, or Nick Knowles from DIY SOS. If they care in a negative way, such as a stalker or the taxman, that is still better than the complete indifference of a dark, empty universe. If Brexit is a cry for help, rather than a death throe, it relies on someone taking notice.

We cannot rely on International Rescue since David Milliband took over. I seriously doubt whether David has got the time to monitor every radio network in the whole world 24/7 like the Tracey brothers used to do. The closest we can come to Thunderbirds is the Air Ambulance, which is why we love it so much and keep putting coins in the collecting tin.

Maybe the giant corporations will look after us. I know that Google Rewards checks up on me regularly, knowing which shops I have been into or near. Unlike my guardian angel or Nick Knowles, Google Rewards reveals itself to me regularly with short survey messages. At the moment it wants to know whether I have spent any money in the shops and in particular what means of payment I used. Quite often it asks me how I feel about Argos. I don’t think Google would come to my rescue in an emergency, but importantly it does pay a small fee for each bit of information I send in. It might only be 6p each time, but it means at last I can say I am a paid writer.

Up there somewhere, my imagination tells me, there’s a person at a monitoring station looking at a screen, looking at what I am doing, ready to beam me up out of any trouble spot – this is what I call the rescue fantasy.

If I break down in my car I will call the AA. If I’m in a road accident the ambucopter will arrive, circle overhead for a while and land in nearby school playing fields. If my tooth breaks off the dentist will fit me in the same day and fix it during the Ken Bruce Show on Radio 2, both of us muttering answers to the popmaster quiz.

The local GP surgery reached out to me recently, inviting me for my 5 yearly check up. It’s called Health Check with the Nurse, though it is a health check with a health care assistant nowadays. In some more prosperous parts of the world it’s maybe a Health Check with a Regional Dean of Internal Medicine, or an underemployed WHO ambassador like Robert Mugabe. Next time here I suspect it will be health check with youtube and a mirror.

Anyway, the point is there is someone out there who cares about you, even if they have ulterior motives, like targeted advertising or stopping you getting diabetes.

And we’ve looked upon our parliament and political leaders to take an overview and guard us from our own foolishness. In return for their efforts we scream ‘nanny state’. But now we find our elected leaders fighting among themselves. Our ambucopter has landed, only to reveal the pilot and paramedic beating each other unconscious in a fist fight.

Some good things are happening, like the minimum alcohol pricing in Scotland, limits on fixed-odds betting terminals and quiet carriages on LNER. The police are asking us to report motorcyclists without helmets, accepting they will be anywhere within a ninety mile radius by the time details have been taken on the non-urgent line.

If The Rescue Fantasy was a movie here’s how it could all still work out:

Prince Philip has a dream of a devastated Britain that looks ever more like the set of a Mad Max movie. No More Heroes by The Stranglers plays loudly in the background.

He sends for Harry and symbolically hands over the key to the Royal Land Rover and Harry’s old army pistol. ‘You’ve got exactly 40 days to save this country from its own danged-bone-headed foolishness. You’ve been talking a lot about starting conversations, Harry. (eyes narrow) Now I’m telling you to finish the conversation.’

Training montage of Harry ploughing through piles of books: Freud, Durkheim, Nelson Mandela; exchanging ideas with world leaders; mindfulness exercises with the Beckhams; in the lab with Brian Cox; and finally, on the firing range with Prince Philip.

Cut to Parliament. Just like in Crimson Tide, at gunpoint, Harry relieves the prime minister of command, ‘You’re unfit for duty madam. And that’s the end of the conversation’.

Epilogue scene, the truth and reconciliation committee, chaired by Ant and Dec, symbolically reunited, takes evidence from the perpetrators. Harry, in the background allows himself a half smile.

Brief shot of angry Putin, smashing his vinyl copy of No More Heroes.

The End.

Post credits shot of the new Nissan X Trail, made in Sunderland after all.

13. Less is More, more or less.

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Another shop you don’t need to go in.

A sunny, windy Saturday morning. A queue of cars waits to turn right into a muddy field, creating a hold up on the A60. Each car is full of junk. The people from the cars unload their junk onto trestle tables and tarpaulins. People exchange items of junk and money. This is not a film crew re-making ‘Grapes of Wrath’ on location. It is a car boot sale, and it’s a tragedy.

You have a car that is 99.9% working. The part that isn’t working is a warning light that comes on when it shouldn’t. Ironically, the warning light is a faulty alarm, giving warning only of its own falsehood, but it is enough to fail the MOT test and render the car worthless.

The car must be recycled, and it is not a tragedy. Gordon Brown used to pay people to dispose of cars, successfully stimulating the Korean economy. For a while cars could be handed in for a bounty, like coyote pelts.

In our town centres, piles of junk are decanted into vacant shops under the guise of charities and sold on for slightly more than you might pay at Primark, if only you weren’t phobic and dared go in.

No disrespect to charities. It is just a pity that they have been sucked into the landfill business.

One of the best things you can do to help yourself is to throw away half your stuff. So, lots of lifestyle gurus have latched on to ‘decluttering’.

However, as Tony Blair didn’t say, its not enough just to fight clutter – we have to fight the causes of clutter also, otherwise it will merely return in a new and terrible form.

Why do we have so much tat?

The economic answer is that our society values economic growth above all other measures of civilisation.

The evolutionary answer is that for most of human existence it has really paid to hoard stuff away. Our grandparents, who lived through wars, failed to adapt to the disposable society and proved unable to dispose of their empty yogurt pots and biscuit tins. Many of them were killed in hoarded item landslides.

The psychodynamic answer is that we invest emotion in objects, so that they acquire a sentimental value. Under this heading we include whatever defence mechanism is responsible for Collecting Things.

The cognitive answer is that we hate waste. In particular we hate to lose stuff that we already have.

I don’t doubt for a moment that already there are huge land fill sites, and that a lot of land fill should really be recycled, and that land fill is problematic from an environmental point of view.

It’s just that, judging by the state of many people’s houses and sheds, the land fill sites should be so much bigger. Somewhere around the size of Bedfordshire, as a rough estimate.

Borrowing a bit from Escape from New York, why not declare an area – such as Bedfordshire – an official landfill site and build a tall fence around it? Gradually, Bedfordshire would grow taller and mountainous and probably beautiful in due course – if you could find it.

I would like to see a huge re-cycling plant for vinyl records where they can be turned into food by a special fungus.

I’d like to see all the remaining cathode ray televisions collected, melted into a giant saucepan and made into comfy chairs .

And all the books – after digitising – can be made into a new Hadrian’s bookcase along the entire Scottish border.

All the coins and money could be melted down and made into the kind of shiny foil clothing people in the 1960s imagined we would all be wearing by now.

And most of all, I’d like to see all those cardboard crowns that litter the window sills in Burger King, collected, pulped and made back into trees.

Architect and designer Mies Van der Rohe is credited with the saying ‘Less is More’. He would have been a little disappointed to find so little evidence of minimalism or even room to swing cats in our houses today. Though modernists would probably have expected people to swing their cats in verdant communal parkland between the high rise blocks, or in high quality piazza spaces, rather than indoors.

Some architects have even gone as far as to question whether cats need to be swung at all.

Digitisation seems to give us the opportunity to miniaturise the storage of all our music, video, art and documents to a card the size of a postage stamp. Using ‘the cloud’, we do not even need the little card any more.

Sadly, one has the impression that the space vacated by digitising records, books and pictures will quickly be filled by gym equipment and antiques.

It is tempting to hold the media – particularly the Sunday Times – responsible for the clutter epidemic. For instance, yesterday, the paper carried an article about buying a Victorian bidet, allegedly haunted, for £325. ‘Its sad to part with it,’ the article concluded, ‘but I’m downsizing’. What, do without a bidet! However will you manage?

In truth the blame lies closer to home. Yes, psychiatrists are to blame for the landfill explosion and thus, soon, losing one of our treasured counties. This is the reason:

Some how or other, psychiatrists have convinced the world that tidy people have something wrong with them. Tidy people are called ‘anankastic’, which sounds suspiciously like ‘antichrist’.

The word ‘anankastic’ means something similar to obsessive.

Psychiatrists have not explained very well that the anankastic personality is not the same thing at all as obsessive compulsive disorder.

Implicit in OCD is the acceptance that the thinking and behaviour is silly. Whereas the anankastic person does not think there is anything wrong with what he regards as being extremely well organised.

Psychiatrists have hinted that tidy people are repressed in some way. Something to do with anal retentiveness.

Tidy people will never be competent painters, jazz musicians or good at sex.

Look at how they are portrayed in movies and television. Radar, from Mash; Dwight, from The Office; Mr Gradgrind, from Hard Times.

Psychiatrists have been generating bad press for tidy people for over a century. There is no range of perfume called Anankast, not even in Superdrug.

There is no Anankastics charity shop in town, though by now  it would have been renamed Spick and Span, to reduce stigma.

In the Mr Men series – pretty much the bible when it comes to personality classification – Mr Neat and Mr Tidy are only minor characters in the book devoted to Mr Messy.

Looking back to the late 19th / early 20th century context, when the analysts were most active, perhaps this is more understandable.

Freud and his colleagues had no PIN numbers to remember, no car insurance to renew, no DVDs to take back to the library.

They did not have to use mobile phones to pay for parking. They did not even have land lines. They had no need to keep a range of spare batteries, chargers and light bulbs, or gas cartridges for their Braun Independent beard curlers.

They had no need to use their Tesco voucher within a specific 7 day window.

Freud never had to find a 13mm ring spanner or a 30 amp fuse.

He never had to worry that Jung had hacked his facebook page.

Today’s world is so different. The need for organisation is so acute some households should think about appointing their own executive boards, complete with Venn diagrams and Mission Statements.

As a psychiatrist I feel guilty about what we have done to besmirch tidy folk, and offer the following solution:

Since we have invested a lot of emotion in objects, we cannot simply dispose of them as the de-cluttering guru suggests.

No, each item really needs a decent send- off, with a few kind words and reprisal of happy memories. This way the grief can be channelled and worked through.

The actual process would be quite like Antiques Road Show, but featuring a conveyor belt and incinerator.

That way Bedfordshire can be saved.

12. Grappling with the wrong trousers.

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What the well dressed tree is wearing this year.

A procession of girls moves jauntily down Oxford Street. Each girl carries an identical Gap carrier bag and wears brightly coloured skinny trousers. The legwear ranges through many colours and materials – there are 23 different types in the shop.

It took me a while to realise it was an advertising event. Initially I just assumed that ‘Jeggings’ had really taken London by storm, either that or Mayor Boris had passed a new bye-law banning big trousers.

How tempting was it to join that line? So called ‘modelling’ is one of the strongest determinants of human behaviour. But by the time I had got into those trousers the line would have reached Tottenham Court Road and disappeared.

Some animals are hard-wired to behave exactly the same as their neighbour, making possible formations like shoals of fish and flocks of starlings. Someone explained to me that starlings and fish do not need to be particularly clever to pull off this trick. All they need is the instruction ‘do the same as the one next to you’.

Humans like to create this effect too, in Busby Berkely movies for instance or the Red Arrows air display team.

We are used to seeing similarly clad people in other contexts, such as children in school uniform and North Koreans in boiler suits. We like to be wearing the right things.

A demonstration of modelling behaviour is one of many attractions to be found in the local shopping centre. Since social services closed all the day care facilities, shopping malls and libraries are the best places to hang out to keep warm.

Compared with the library, the shopping centre is quieter and more studious in atmosphere. Also there are more books to read.

This part is vital – before you visit the shopping centre – establish the goal. On this occasion the target is: 1.To experience the sensation of being out of place; 2. Not to respond to this sensation by buying something.

For your day out, start by re-framing the shopping centre as a kind of art gallery.

All the familiar shops / exhibits are there (not you Woolworths). There are lots of things you can do free: try out the mattresses in John Lewis, try on lots of jeggings, use the computers in PC world to look up reviews on the same model you are trying, so you can spurn the attentions of the salesperson, use the cameras to take pictures of other people testing cameras on you, try on tester perfumes and marvel at their interesting names.

Or go into Superdrug, and ask for a super drug, such as beta interferon. Ask why they call themselves Superdrug when the best drug they have is ibuprofen.

My hypothesis is that shopping behaviour is a sublimated form of hunting, or at least gathering. The important thing to remember is that all the fun is in the hunt, and once the quarry is cornered then the fun is over. It is all about the expectation of reward – pulling the trigger on a purchase is entirely unnecessary.

Buying something is like coming home from a day’s fishing with a small trout you could have bought in Morrison’s for £3. The trout’s dead eyes communicate to you: So what?

You should have thrown it back in.

Things are not always what they seem, and shopping malls allegedly have a purpose beyond amusement or art.

Shopping malls are meant to part people with their money, rather than act as a recreational facility for escaped psychiatrists. The architects and designers have put in some subtle influences to work on your mind.

One of these is the so-called ‘Gruen Transfer’. This is a place, within the centre, that is designed to disorientate people, by using a combination of unusual shapes and textures and lighting, often accompanied by Muzak.

Apparently the effect is similar to a unit of alcohol or other anxiolytic. People slow down through the Transfer, and co-incidentally this is where the higher priced items are located.

I am not convinced that there is a strong evidence base for the Gruen Transfer, or other devices perpetrated by the advertising industry. Certain low budget shops seem to generate the same emotional disruption.

The oddly named B and M store, sometimes sub-headed ‘Bargain Madness’ can induce such profound despair that it could probably be used as a testing lab for possible new antidepressant compounds. Here the store has been less discreet about its use of disorientation – the clue perhaps is in the word ‘madness’.

Agoraphobics, who tend to have panic attacks in shops, seem to dislike places where there is no clear sightline to the exit. The entrapment induces a sense of doom. Though Morrison’s have an excellent range of vegetables, the way they are laid out can set a person on edge.

Individually, fruit and veg items are not threatening, but when they gang up like this, piled high on all sides, it creates a kind of jungle effect reminiscent of Apocalypse Now.

Another piece of (probably bogus) psychology I have read, relating to supermarkets, is that people have an ‘innate tendency’ to gravitate anti – clockwise. This led to supermarkets placing their main entrances on the right hand side of the shop.

If it was on the left, people would just drift further leftwards into the vegetables section and beach themselves in the courgettes.

Staff would come out to spin customers into the next section, like fairground attendants on a waltzer.

I wonder if it is different in the southern hemisphere, or for the left handed?

It is perhaps a little frightening to think that someone has manipulated the environment in such a way that you have unwittingly bought yourself an expensive, weirdly named perfume.

I am not just referring to ‘Obsession’. What about ‘Hypnotic Poison’, ‘Crazy in Love’ and ‘Thallium’? The internet tells me there is a perfume called M-75, which is the name of the rocket Hamas fires into Israel.

Perfumes, like the Gruen transfer, and the clockwise supermarket, are designed to create an altered state, but what exactly is the state of mind called? In the case of perfume, if it isn’t the name, it is probably solvent intoxication.

Or perhaps it is the feeling of being out of one’s element, or out of step with others. A warning that you are on unfamiliar territory.

Behaviourally, it is supposed to trigger a purchase decision.

The purchase decision is a learned behaviour that creates comfort, possibly by stimulating the ‘anticipation of reward’ section of the mind. The unsettled feeling is briefly quelled, only to be replaced by regret that you have suddenly become poorer and the shop richer.

How comforting is it to be in a herd of people all dressed appropriately and behaving in the same way? Enough people must love formations of soldiers to make it worthwhile dressing thousands of people this way and arranging them in large city parks. Everyone seemed to love the Olympic opening ceremonies.

Lots of people like to be in queues, and will probably join the end of any queue if they find one. If other people are after something, instinct says there is probably something there to have.

There is often not much to be found at the end of a motorway queue, which is formed by the pulsatile dynamics of traffic flow rather than obstacles, but the queuing instinct has evolved over the lengthy period of human history before tarmac and has not yet abated.

The instinct to behave like the person to the left of you is deeply rooted and possibly imprinted at an early age. Experiencing the feeling of being in the wrong place or in the wrong outfit is deeply discomforting.

Many people hate the moment in a restaurant when they have to set out to find the toilets. The fear is not that they will never find the toilet, but rather they will make them-self look foolish to others by dithering round the restaurant.

That is why I think it is a very tall order for CBT to try and get people to fight the idea that it matters a lot what other people think of you.

In the golden era of CBT, pioneers tried to attack this set of cognitions using grand behavioural tasks.

Albert Ellis, pioneer of CBT and our hero, in his list of the top 12 Irrational Ideas, included this as number one:

‘the idea that it is a dire necessity for an adult human being to be loved or approved by virtually every significant other person in his community’

Loved? Maybe not. Approved? Maybe not? But thought to be wearing the wrong trousers? I’m afraid it’s a deal breaker.

Maybe it shouldn’t matter. Maybe not as much. Certainly try and test how much it matters. Certainly try and get it back into proportion.

But it just does.

That leaves us with a burning question. If it is so important to blend in with everyone, why do certain people do everything they can to attract attention to themselves? For instance by dying their hair a florescent colour?

This is perhaps the exception that proves the rule, since these people are relatively few in number, especially in professional groups like accountants or dentists.

Several answers to this – you choose the one you like best:

So that they are visible in traffic?

Reaction to feeling left out or insecure?

Mating ritual?

Group or gang identity?

Genuine lack of insight about how they look?

They are doing a CBT assignment to reduce the irrational cognition that it matters what people think about them?

1. The War on Depression Starts Today

Car parks can be beautiful if you look at them the right way

 Don’t be frightened – it’s only a car park.

 

The War on Depression: where is the enemy weak?

These pages are mainly about Depression. The starting point is to understand how Depression comes about and the finishing point is dealing with it better.

As an individual psychiatrist it may not be possible to make much of an impact on the wider problem of Depression, which affects so many millions of people.

But there are many fronts to fight on, outside the hospital.

There are a few themes to these pieces. One is to do with how toxic modern life has become. One is to do with how the mind works and in particular how people make choices. And a third one is to explain how health systems such as the NHS operate for (or sometimes against) people with mental health problems.

However we regard Depression, as an illness, as wear and tear, as a reaction to loss or as a social barometer, there is always another perspective to take.

Rather than ask the question, ‘why do some people get depressed?’ we might just as well ask why everyone isn’t depressed all the time.

Lets get the bad news out of the way right now: people get older. Generally when they get older they get more ill, and (don’t say it, please) eventually die.

In some ways that fact, the D word, is a potential party – pooper, even when we are young and have a fabulous future to look forward to.

Worse than that, even younger people can get ill, and they certainly can be subjected to terrible events (such as school).

Its been said that all political careers end in failure. Partly that’s because of the scoring system in politics, which tends to be ‘sudden death’, either by way of an election, or by way of sudden death.

But the same is not true of most sportsmen and women, who are somehow able to retire at the right time. In boxing, that’s while the brain is still working. For the rest of us, its a matter of recognising changes and adjusting to them .

If we adjust too much too quickly we are hypochondriacs and wimps. If we adjust too late we are foolhardy and in denial.

Life is very complicated and dangerous and a lot of us don’t make it, either in terms of quality or quantity of life. Some of us spend a lot of time ‘off the road,’ on the hard shoulder of life, but that doesn’t make us burned out ruins.

In seeing Depression as a wear and tear or stress related illness, we are not really explaining it very much. I prefer to see it as a natural phenomenon that is also an enemy, like rust. Or, at times, Gravity. Black ice. Wind. Electricity. Biscuits. Etc

All necessary but dangerous when out of control.

Depression happens when the system that controls mood is defective. The system has failed to calibrate correctly, or feed back on itself, or stay at a level. Most of what we do in treating Depression, one way or another, is to try and get the control system working better.

Often that’s a matter of seeing the situation differently: reflecting, reframing, resetting, recalibrating. (4 Rs. Much better than 3.)

The way we see Depression, in its widest contexts, affects very much how we deal with it. Depression is a very isolating experience, both in terms of reduced social contact, and reduced range and quality of thinking.

But if Depression was inevitable, or even an overwhelming likelihood, why is it that many people never get depressed, whatever happens? Do they have a very sophisticated chemical control mechanism? Or do they reflect upon the world in a different way? Or do they have some protective factor, like a guardian angel?

After this length of time, over 50 years of antidepressant and drug therapy, it doesn’t look as though we have a breakthrough solution, at least by way of a tablet. It would be nice to think a magic bullet would get discovered, much as saltwater killed the Triffids in one of the Day of the Triffids films, or the Common Cold killed the Martians in War of the Worlds.

While we wait to find the enemy’s weak spot, we continue to fight on all fronts. Depression’s Achilles Heal is in fact the thing that makes it strong, its incoherence as a diagnostic concept.

Could Depression fall apart under the weight of its own complexity, like the coalition government?

More to follow.