25. Taking a creative powder.

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The golden age of pharmacology.

There is probably a link between bipolar disorder and heightened creativity, but this occurs mainly during the periods of elated mood. One of the first things to go when the mood dips is concentration. For creative types that’s a major hazard.

There’s only one solution for writer’s block. And that’s to write about it.

I just checked with the local NHS and apparently there is no rapid response team for this problem, unlike, say, blocked drains or blocked arteries.

The mental health service is interested in ‘thought block’, but only in the context of schizophrenia.

What I’m envisaging is a group of experts, probably led by a retired army major, who would arrive in a pimped day van, set up their equipment and get to work straight away.

The first thing to do is to remove any loaded weapons and / or bottles of whisky from the writer’s desk.

Next comes a thorough examination of the writer’s body, particularly the orifices, just to check he has not begun ‘disappearing up himself’. If there are signs of this, a Dyson cleaner makes an ideal suction device.

That also includes checking his ego boundaries, to ensure he is still able to separate himself from his characters. Clues to this can include wearing a flying helmet or shoulder holster while he types.

Psychedelic drugs should be removed, keeping samples for the lab, except for science fiction or fantasy writers, when they should be cautiously continued and titrated with Bourbon if necessary.

There are no NICE guidelines for writer’s block, though the author is probably poised over his keyboard and has been for years. But there is some expert guidance on the subject.

Dan Brown for instance likes to hang upside down in gravity boots. This could explain some of his thinking, in terms of reduced cerebral blood flow. Lots of writers prefer to be horizontal when they write, and many others like to pace up and down. Some are quite obsessive about stationary and pens. Others like to chew their pencils. It’s important to ensure they put the right end in their mouths.

Having attended to posture, the team looks toward some kind of psychological jolt. Firing a gun is often helpful, and if there is space, the team like to set up a row of porcelain figurines to use as targets. Royal Doulton seems to work best.

Coercion, blackmail and torture don’t seem to work. This is probably because anxiety levels have gone just beyond the optimum level for concentration. Writer’s block is mainly a result of ‘performance anxiety’. It is when the automatic mind makes the mistake of calling in the reflective mind for advice. Whether it’s writing, sex, walking a tightrope or putting, self monitoring can be catastrophic. The interventions are mainly to create a distraction.

For instance, waving a wad of cash under the nose brings about a rapid reaction similar to smelling salts. Not only does money talk, it speaks most eloquently.

Claims are made for psycho-stimulants and antidepressants which some people think enhance performance. Thomas Hardy might have benefitted from a little light turbo-charging, for instance. I’d like to have seen more of an action thriller conclusion to Mayor of Casterbridge, possibly involving Farfrae and Henchard shooting at each other with blunderbusses, from hot air balloons.

More useful is a gentle workout for the parts of the brain that write. A trip to a gritty location such as a Ladbroke’s in Rotherham might bring just the change of emotional tone that’s needed, but obviously the danger is melancholic overload.

Sometimes a little ‘power pottering’ is necessary, such as re-organising the tea bags or melting a vinyl record to make a flower pot. An encounter with an overloaded kitchen sink has helped many angry young men keep it real.

The most difficult thing is finding an ending, if that’s where the block has happened. If all else fails, a revision test can serve as a makeshift conclusion, e.g

Which blockage is not a medical emergency?

Heart

Arteries

Thought

Writer’s

Intestines

Which endings are valid?

Reprising earlier parts of the piece

Suddenly dying of TB

A dream sequence with exploding figurines

Throwing a badge into San Francisco Bay

Reader, I married him.

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4. Getting over the mind brain problem

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What it looks like inside your mind.

One of the biggest barriers to tackling Depression is getting hung up on the Mind / Body, or more specifically the Mind / Brain problem. Its the mind part that’s the issue. As soon as the word ‘mental’ comes into play, people get all upset.

Its hard to adjust to the fact that we may be nothing more, or nothing less, than very clever machines. Its also hard to believe that consciousness can emerge gradually from a wiring network, providing that network is large enough.

Surely, if all you needed for consciousness was a massive wiring system, then British Telecom would be a god like super-creature bent on world domination. Hmm…

So can consciousness, or the mind, be considered a separate entity from the body? This argument still hangs heavily for many when they think about mental health problems.

The mind / brain issue did preoccupy philosophers for many centuries and still occupies a large section of Wikipedia. Some philosophers thought that mind and body were entirely separate devices. This idea is called ‘dualism’ and tends to persist in the way people think about the human control system.

If mind and body were different ‘dual’ entities altogether, like sound and light, then how could they interact? Some kind of transducer device, as proposed in the pineal gland by Descartes? Or simply, (cheating really) bringing God into it to solve the problem, God acting as a cosmic DJ, operating the twin turntables of mind and brain, making sure they were synchronised properly at all times?

(This school of thought was termed ‘occasionalism’ and probably did not influence the Faithless song ‘God is a DJ’ nor even Pink’s cover version. Pink was yet unknown in ninth century Iraq).

Glossing over Philosophy and Religion for a short moment, there is a lot to support the argument that the brain is a very sophisticated computer system.

For instance, nerve cells which make up the brain are long and thin and transmit electrical charge, just like wiring. The nerve pathways in the brain look a lot like the wiring loom in your Honda Civic. Damage to part of the wiring system, such as after a stroke, can clearly bring about symptoms, like loss of movement to a limb.

Higher up the brain, the nerve networks get more complicated and seem to provide for various different types of mental activity. There is the completely automatic type that controls basic physical functions like the operations of the lungs, heart and gut. Then there’s the largely automatic thinking system that does things like drive you to work and make toast. And then there is the reflective part of the mind that chooses what to think and do, or thinks it does, or you think it does.

Computer speak has given us a new ‘dualist’ model to consider, the division between hardware and software. Sometimes it can be helpful to think of the brain as the computer and the mind as the operating system. As an analogy it is both helpful and unhelpful.

The plus points are that factors such as social learning and experiences and memory can be seen as software, running within the brains basic wiring network, which starts off as a largely empty system and gradually fills up. The mind’s ability to process information and store it, or create actions, are similar to an operating system.

There is also a nice computer analogy to be made between the mind’s two main memory systems, long term and short term. Stored memory can be seen as similar to a computer’s hard drive, whereas short term or ‘working memory’ has features similar to RAM. Working memory is far more limited than long term and easily exceeded by multiple or complex tasks, such as chewing gum and walking at the same time.

Many memory problems, such as those found in Depression, occur within the process of moving memory between the two systems. Depression very often reduces the power of concentration, which is needed to retrieve information from the storage system, and also to file memories away.

Against the software / hardware model however is the following problem; the brain is not a fixed system like your PC or Mac. It can create, remove or change its physical structure as it goes along. The changes are not just electrical, as in hardware, or even just chemical – the brain is continually creating new connections. This is why the brain is called ‘Plastic’ – the term is used to mean flexible and open to structural change.

In babies and children there is a huge and continuous rebuilding program of nerve cells. In adults there is a much more limited program of nerve cell slum clearance but sadly not much in the way of inner city regeneration. Depressed people may lose their ability to generate new nerve connections in certain parts of the brain. In fact an attractive theory of antidepressant therapy (both drugs and psychological therapy) is that these may work by stimulating nerve cell growth in certain key areas.

And this brings us, a little early, to the punch line. Which is that structure and function are inseparable features of our control system. They are so interactive that it make no sense to identify two entities called Mind and Brain.

In practical thinking this dilemma presents itself frequently in thinking about mental disorders. For instance in thinking of some illnesses as either mind based or brain based. In particular illnesses that were once considered to be ‘psychosomatic’ such as bowel or fatigue syndromes. Within Fatigue Syndrome there have been heated arguments by some sufferers that they should not be regarded as mental health patients, even though CBT may well be very helpful, as it can be in ‘physical’ illnesses like chronic pain.

The law has frequently got itself into a pickle by trying to separate what is due to the mind and what is due to the brain. We have seen concepts such as ‘non insane automatism’ invented to illustrate this area. The newish Mental Capacity Act speaks of a disorder of ‘mind or brain’, to get over the possible argument about which one was disordered. Could one ever be disordered without affecting the other?

Within Education, we have seen concepts such as ‘Brain Based Learning’, or ‘Mind Brain Constructivism’ as it is more properly known. Here again the proponents are careful to use the term mind/brain as a portmanteau concept. Strangely, educators have been rather uncritical about the supposed ‘Brain’ aspects, such as improving food and water consumption for students. The ‘healthy mind in a healthy body’ notion has been about for a long time in schools. Before Michael Gove, and in fact before even Socrates, neither of whom would have seen the mind as a wiring loom.

One of the more interesting findings from Brain Imaging has been the recognition that psychotherapy may bring about structural brain changes. For instance, changes have been found to the mid-brain serotonin transporter system, after psycho-dynamic psychotherapy. A much larger number of studies have shown changes to nerve cell functioning during and after therapy.

It could be argued that these sorts of changes are not actually ‘causal’ but rather just a secondary indicator of mood change. Nevertheless, there is clearly a mood control system in the brain that is represented in physical structures.

So we have the Fatigue Syndrome lobby who resent being considered as having a mental health problem, and we have the ‘anti-psychiatry’ lobby who hate the so called ‘biological’ model of Depression.

The fatigue lobby would be delighted if one day a clear biological cause is shown for the illness – presumably then it becomes like MS or any other ‘proper’ illness?

And the anti- psychiatrists would be delighted if absolutely no biological change could be found in the brains of depressed people. They have been similarly delighted by the findings that antidepressants are not as effective as people used to think. Their response is not at all to suggest finding a more effective antidepressant, but rather to debunk the whole concept of Depression.

If you need to ask how can simple chemicals substances change the way people think and behave, then you have (wisely) not visited Nottingham city centre at 11pm. If you doubt that faults can occur in complicated electronic control systems, and that such faults are impossible to diagnose and treat, try using a 10 year old Beko washing machine. It has a mind of its own.

It seems the learning point is never to try and assign a problem to mind / or body, and always to recognise that the two are one. If that makes us just a brilliant machine or merely thirty nine dollars worth of chemicals dressed in a suit of similar value, so what?

Well, for one thing, less stigma, and less guilt. If we have defective mood control systems, whatever the basis, then this is a health problem and not shameful.

I was taught by Irish Nuns that ‘man thou art dust and to dust you will return’. (Its the kind of thing Rugby Forwards say to each other before a game). The dust cost less than thirty nine dollars in those days.

And if God is really acting as DJ, is he playing enough soul?