Tag Archives: self harm

82. Euripides Trousers …

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Bees. They just get on with it.

Up until recently being a teenager was not regarded as a mental disorder. After David Cameron urged us to hug a hoodie, teenage angst was virtually eradicated from the  diagnostic landscape.  But now, some people seem to want to regard teenagers not just as sad victims of poor trouser design, but as Patients.

Someone’s looked at the lyrics of The Kids are Alright by The Who and recognised that they really meant the opposite. The Times is running a campaign about children’s mental health. A lot of assertions are being made that children are unhappy, that they are living through unusually stressful times, that they are victims of the modern world.

Horrible articles are being written about teenagers, suggesting they are unfathomable monsters and the National Theatre is running Medea again. I’m sorry, but this children’s mental health campaign feels like a moral panic. Who is stoking it up, and why?

Somehow or another, ‘subjective well being’ has become confused with becoming mentally ill. I’m a hypochondriac, but does that really affect my chances of getting ill?

Here’s a test of your subjective well being, the one used by the Children’s Society, the people who gave us the christingle:

Here are five sentences about how you feel about your life as a whole. Please tick a box to say how much you agree with each of the sentences: My life is going well; My life is just right; I have a good life; I have what I want in life; The things in my life are excellent.

Subjective well-being is arguably a test of how smug and complacent people are. How would John Lennon have scored? How would we have wanted him to score?

Before we go any further, how desirable is it for everyone to think the things in their lives are excellent?

Children are apparently scoring worse in such studies since 2008. And UK children are being dragged down the international league table by girls’ concerns about their appearance. British girls are second last, only South Koreans scoring lower, despite their excellent android phones.

It’s election time, so Nick Clegg is using the present tense when he should be using the future subjunctive, which apparently exists in Spanish. He’s claiming that stuff is happening, like expanding children’s services, that just might happen one day but probably won’t. He is comparing children’s mental health services to cancer services. If doctors did that they’d be accused of an absurd fixation with the medical model.

Libby Purves, still top of my list for head of state once we become a republic, compared children’s mental un-health to cholera, though admits that there is ‘no single pump handle’ to sort out.

To Libby’s credit, she soon recognises the problem is not like cholera at all.  She blames children’s unhappiness on: divorce, drug use, exam anxiety, peer pressure, early sexualisation, information overload, loss of contact with nature, ubiquitous screens, TV, games consoles…

Just like our generation suffered so much from CDs and colour TV. Just like our parents generation was thrown into abject misery by antibiotics and Walt Disney.

And she goes on to suggest a list of practical solutions: a smartphone ban in schools, art classes, choirs, safe outdoor spaces, park keepers, bus conductors, beat coppers and finally, ‘volunteering and youth groups to be made fashionable and fun’.

No doubt Libby is on the right track in terms of placing the issue firmly in the Sociology Department. There’s a squeeze on social capital and no sign of quantitative easing. That’s not to say that useful modern inventions like apps and text messaging are deleterious to social capital – quite the reverse is true judging from the queues in Costa and Macdonalds.

Very soon, the children’s mental health campaign will have to contact Blur to see if they can borrow the slogan Modern Life is Rubbish. But remember, that album was released in 1993, which to the under 18’s is somewhere between Roman times and Wolf Hall. Modern life really was rubbish then, before graphical user interfaces and flat screens. And it was probably rubbish in 1893, the year when the US Supreme Court declared the tomato officially to be a vegetable.

And isn’t the rest of The Times newspaper filled with all the stuff that Libby regards as a cholera fountain? The cholera in question being market-driven, intra-sexual competition. There’s a lot of stuff about girls who hate themselves and almost nothing about bus conductors or park keepers. In the fashion section all the items are unfeasibly expensive apart from one token item from Primark. Any article about anything whatsoever, such as which is the best digital tyre pressure device, will be accompanied by a picture of a thin female person, probably one of the tiny girls employed to make the DFS sofas look massive. If Libby finds that pump handle she ought sort out some of her co-workers with it.

People have been casting aspersions on younger generations throughout history. This is perhaps the first time that teenagers are being castigated by being labelled mentally unhealthy. It’s a change from being considered morally deficient or stupid, but just as fatuous.

Mostly, there is no sense in medicalising the problems children face. There are no specific treatments or therapies that will help them and no army of skilled professionals waiting for Clegg to deploy them.

Luckily, there is little evidence that youngsters are any more mentally unhealthy than any other age group. Mental illness, like most other illnesses, gets more likely when people get older, like rust on cars. Children don’t get mentally ill in the same way as adults, not very often anyway. Although it is unbelievably awful when a suicide occurs in a young person, teenage girls’ rates of suicide are three time lower than middle aged women and twenty times lower than middle aged men.

People are not growing huge thumbs as a result of texting or walking into traffic because of ear phones. A teacher asked me recently whether schools should have mindfulness programs. But surely, a school is a mindfulness program?

Attempts are being made to impose guilt on schools and companies for being competitive, with the aim of selling them mental health services to patch up any bruised egos. The Times is doing something similar within its internally contradicted hand-wringing departments of greed and anti-greed. Thankfully our children our savvy enough not to join the stampede down to CAMHS.

Anyway, they can’t run in those trousers.

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14. Finding the Chimps in the Armour.

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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.