Archives for category: psychology

I was invited by The Psychologist to participate in a session about mental health at the Latitude Festival  last weekend. What a treat! I presented alongside the wonderful Dr Etta Bowden-Jones and ex-BPS president Prof Peter Kinderman in the Wellcome tent.

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Peter Kinderman, Etta Bowden-Jones and I in the Wellcome tent at Latitude, image courtesy @psychmag

My manifesto argued that we should place creativity at the heart of mental health care. The presentation is here

Earlier that day I stood in (gulp) for Bryony Gordon in the Speakeasy tent, in a session on reading for health. I loved meeting my wonderful fellow panellists: Di Spiers, the book editor from the BBC, the author and psychiatrist Jo Cannon and scientist Pippa Kennedy. It was Sunday morning, after a big night at Latitude. Still,  lots of people turned up and joined in, taking about which books are good (or not) for mental health, the science behind reading, and simply, the pleasure of books (and libraries). We were introduced by the awesome poet Michelle Madsen and I’m pleased that most people seem to prefer the ‘real thing’ i.e. paper books to Kindles. I even managed to channel Linton Kwesi Johnson‘s poetry on rumination and contemplation as an antidote to the digital revolution. It was a great chance to revisit the shortlists from previous  Wellcome book prizes and to think about books which have helped me and others. I always go back to Zola as I have huge affection for degeneration narratives and right now I’m enjoying my friend Jules Evans’ history of ecstatic experiences: The Art of Losing Control 

If you haven’t been to Latitude it really is magical. A beautifully curated festival of art, music, theatre, spoken word and dance. Plus great food, holistic activities, and yes, the stars of the show, the pink sheep (see below). My only criticism is that the crowd is very homogenous and middle class. A friend teased me beforehand about ‘doing Platitude’ and endorsing Latte-tude!! Still, it was lovely to be in such a charming, relaxed and safe space, I felt enriched for the experience.

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image credit: Ipswich Star

Today the All Party Parliamentary Group published a report: Creative Health: the arts for wellbeing, advising the wider use of arts to enhance health and wellbeing. Exciting times to be working in this field.

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I was invited to give a talk about dementia recently, but was asked to avoid the word dementia. It seems people are so afraid of the condition and the stigma is such that they don’t want to hear the word uttered. It’s true that dementia is the condition that people are most afraid of, and this is perpetuated by negative coverage in the media and beyond. Cinematic portrayals often foreground the ‘tragedy’ of the condition (Alzheimer’s Europe, 2013). As Zeilig (2014) suggests, dementia is often equated witha complex, unknowable world of doom, ageing, and a fate worse than death’. As someone said to me recently ‘If I get it [dementia] just buy me a one-way ticket to Dignitas’. Metaphors related to warfare are commonly used e.g. the ex Prime Minister David Cameron and now President of Alzheimer’s Research UK stated: We‘ve got to treat this like the national crisis it is. We need an all-out fightback against this disease, one that cuts across society. (PM Office, 2012). With old age the biggest risk to developing dementia, and an ever-growing ageing population, it’s unsurprising the public are scared.

Yet there is widespread confusion about dementia, e.g. dementia and Alzheimer’s Disease are commonly used interchangeably. Dementia describes a set of symptoms which impact on cognitive ability and behaviour, often leading to loss of independence. Most dementias (about 60-65%) are due to Alzheimer’s Disease, other rarer forms include vascular dementia, and dementia with Lewy bodies. Common symptoms include language difficulties, confusion, loss of memory and sometimes, behavioural disturbance such as wandering or disinhibition. Dementia is usually progressive (i.e. early, mid and late stage) however people will experience symptoms differently, at different times. The numbers of people living with dementia are high, as is the cost of providing care, currently 850 000 in the UK, costing £26 billion a year. The numbers of those diagnosed are predicted to rise higher, to over 1.1 million in 2025, and there’s no imminent cure on the horizon, despite what newspapers report.  

Everyday, stories are published about possible risks for developing dementia, and on breakthroughs and even cures for the condition, that are likely many years from implementation, or that come to nothing. This reinforces public confusion and fear, and can create false reassurance and distress for families involved, as reported previously. Examples include recent reports on the benefits of Marmite, and cups of tea, and the risk of living on a busy road. Combined with the poor perception of those living with dementia, it is little wonder people are worried. The appetite for information suggests that the public do want to talk about dementia. I saw this recently at a Q&A I participated in after the excellent theatre production The Hearing Trumpet. The play finished at 1030pm on a weeknight, and I thought: surely no one will stay for the Q&A. But stay they did and there were many questions, moving testimonials from family carers and care staff, and lively discussion focusing on a desperate need for information, support, and hope that there may be effective ways to help someone living with dementia.

Research is progressing however dementia receives far less funding than cancer, which gets 13 times as much, despite the burden of care being far greater in dementia. My research focuses on dementia care, as compared to dementia cure, the latter of which receives the lion’s share of funding support, see for example the new £250 million UCL-led hub. People seem much more interested in eradicating dementia, rather than enhancing the care of those living with it. This stands to reason given the fear factor.

Dementia care research is at an early, albeit exciting stage. My focus is on arts and multi-sensory activities that provide stimulation, engagement and pleasure. This is aligned with Kitwood’s well-established notion of ‘person-centredness’ that focusses on provision of bespoke, individualised care. Activities involving art, drama and music are showing promising results and a recent conference saw over 100 delegates present inspiring evidence that is changing the dementia care landscape, globally. My research looks for ways to connect and communicate with people with dementia whose reality may be different from the norm. The results indicate not simply alleviation of symptoms but new learning, and moments of pleasure and joy, even in the later stages of dementia. These findings are inspiring and positive, countering the scare stories. The work involves collaboration with people from different disciplines, including art, design, music, architecture, nursing, psychology, even hospitality. This type of transdiscplinary work is offers exciting and novel opportunities, and underpins the ethos of a new Dementia Care Centre at University of West London. A similar approach is seen in the pioneering work being done by the Created Out of Mind team at the Wellcome Hub whose residents are challenging perceptions about dementia through art and science collaboration.

This Dementia Awareness Week, lets unite against dementia, talk about it, and focus on making lives better for those living with the condition, but also for all of us as we grow older. I and colleagues will be in the Old Market Square in Nottingham on the 15-16th May with The Imagination Café,  a pop-up space inspired by the artwork made by people with dementia as part of the project Dementia and Imagination.

jim for transparencyThe Café showcases the innovative research work that we’re doing, challenges negative perceptions, and gives the public a chance to visit to find out more about dementia. In the café there will be a range of activities for the public to try, specially designed for people with dementia including music, storytelling, drama and art, all underpinned by research. An afternoon tea menu specially designed for people with dementia will be served by Jane Clarke, and staff from Dementia UK and the Alzheimer’s Society will be on hand to offer advice and information. Come and visit.

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So speaks Nina or is it Lucy, or Emma? The protagonist (eventually revealed as Emma) in the powerful, harrowing addiction drama People, Places and Things is an actress, who breaks down during her role in Chekhov’s The Seagull. Her thwarted ambition, trauma and family dysfunction numbed by ‘living vividly’ through drink and drugs. This clever turn is played out as we try to decipher what is the truth and what is a lie, when is she real and when is it an act? These are salient issues for those working in the field of substance misuse.

Rehabilitation concept.

It’s hard to take your eyes off Denise Gough’s lead. She is astonishing and mesmerising, in turns loveable and hateful. Anyone familiar with addiction will recognise the complexities and contradictions involved, the love (requited, according to Emma) and pleasure that drugs offer, the destruction they wreak on themselves and those nearby, and the deep ambivalence of the user. Emma enters rehab drowning in psychical pain, the set neon-aglow in clean and pristine white tiles, with just enough time to snort a line of coke before admission. In turn the staff and fellow patients try hard to find a point of connection as Emma rebels, manipulates and seduces. We feel their pain and frustration. The demise of one (Foster) after the death of his dog and 7 years clean underlines the vulnerability of professional helpers, many of whom have their own demons to manage.

The pleasure-pain paradigm is graphically presented in the earth-shattering clubbing and cold-turkey scenes. It’s hard to tell one scenario from the other as Emma explodes, hallucinating and dissociating, multiple figures of her writhing, pacing, dancing, collapsing, retching over the toilet bowl, and arising from the mattress like a scene from The Exorcist. She utters a primal scream and we all want to join in-what the hell causes her pain and must she reveal it to be free?

The 12-steps loom large, foregrounding the ‘one day at a time’ mindfully, socially and spiritually engaged approach to abstinence. Zealous submission to this higher power isn’t for everyone and Emma initially rages against it. In one scene staff and patients ‘the group’ join hands and recite the ‘Serenity Prayer’, see below. Sometimes the jokes wear as thin as the ‘f****ing boring, orange squash’ culture of rehab that Emma resents as she screams for a ‘real drink’. Emma eventually submits for she has no choice, no other recovery model is presented, nor is family therapy offered. This is a critical omission, as it is routinely part of rehab and is particularly relevant here, given the toxic influence of Emma’s parents.

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The family issues are laid bare in the play’s most harrowing scene after Emma’s graduation from rehab, returning to the family home, vulnerable and back in her childhood bedroom. ‘Our family is broken’ states her mother, played by Barbara Marten, cold and victorious. The same actress plays her psychiatrist and her therapist, disorienting us and providing further scope for projection. Her mother, resigned, is her nemesis and her mirror. For Emma, her mother is the greatest risk to relapse, and this is no paranoid delusion as she has stashed drugs and drug paraphernalia under her daughter’s bed, daring her to come clean or to leave, forever. Emma picks up the phone to call her sponsor, checking when the next (12-step) meeting is, praying to be rescued from herself, her family, and the box under the bed. This scene explains better than any words, how abstinence is precarious and relapse is ever-near to people, places and things, especially at times of stress.

One-day-at-a-time.

People, Places, and Things is at the Wyndhams Theatre until 18 June 2016.

 

freeimages.co.uk light and pattern imagesChildren are naturally creative. They explore, experiment and fantasise, unconstrained by formalised artistic training and convention. Children do not typically censor the content of their artwork hence it reveals insights into their thoughts, feelings and experiences. Elements including symbolism, size and colour offer important clues and cues to those around them. As children develop verbal language, artwork can be considered a form of graphic articulation. This concept is useful when communication is challenging and as a route to unconscious exploration.

Many artists seek to recapture the raw emotionality of unconstrained childlike creativity. Professional primitivists incorporate the aesthetic of naiveté and there is much interest in the work of untrained or outsider artists, some who are considered naïve, folkloric or tribal in style.

The Fair

An installation The Child’s Hand at the Outsider Art Fair, Paris will explore relationships between art produced by children and work made by artists who reference a childlike worldview, stylistically or in content matter.

A panel (including an artist, psychologist, and curator) will gather during the fair to consider the role and significance of children’s art and what it may reveal to us about the work and practice of contemporary artists.

Call for artwork

We invite submissions of art made by children. We seek work on paper made spontaneously (i.e. without adult instruction) by your child/ren that you find especially interesting. 2-3 (maximum) high quality images of work may be submitted, along with the age and gender of the artist and the name and contact details of the parent or guardian of the child artist. Explanatory or accompanying text should not be included.

A panel of artists and curators will consider the work submitted. The permission of parents/guardians will be sought should their child’s work be selected for exhibition. Please note that submission of work is no guarantee of inclusion in the installation.

Please send submissions or queries via email only to thechildshand@gmail.com by 1700 29th June 2016.

So IS hit us in the grey zone, those areas where we live, work and play. The places we go about our everyday business, where we usually feel safe. Spaces that aren’t usually patrolled or subject to checks and security measures. The shock and horror is magnified as the attack was not in a warzone but a Western capital city, in our neighbourhood. President Hollande referred to the atrocities in Paris attack as an act of war such is the injustice and invasive nature of the implosion. His words signpost retribution.

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credit:mysterymartin.wikia.com

 

 

Social psychology offers some clues to help us comprehend the almost inexplicable terrorist attacks that have occurred. Our sense of safety, fundamental to our physical and psychological wellbeing, has been shattered. Feeling unsafe means that it is barely possible to do anything else. Everyday tasks become almost impossible. Our sense of normality, the schema representing business as usual is fractured. Feelings of numbness, a sense of paralysis, and extreme anger are all normal responses to devastating trauma. Whoever committed the recent attacks or why, IS represents a modern day bogeyman. A terrifying, barely plausible, and nightmarish vision from a storybook. Such characters are all the more frightening as we cannot get a handle on them, they exist in the shadows, making it harder to defeat them. Even if not directly impacted by recent terrorist atrocities, we are subject to social contagion, the term for the influence of expressions of anger and fear that circulate amongst us, given easy passage via the universal spread of social media.

 

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credit:slimber.com

Over the weekend I experienced terror vicariously and tended to the fear and distress of others, afraid that they would be next; that the terrorists were coming for them. These thoughts that may have seemed irrational a week ago, overnight became a rational response to traumatic events. We know in grim detail what those subject to the attacks experienced, as we were exposed to it round the clock via 24/7 media reports. Bystanders can experience vicarious traumatisation simply by witnessing or hearing about a terrifying event. Graphic images of the traumatic event are now available to all at any time. The resulting fear and subjugation are modes of control, used to great effect in dictatorial regimes.

How can human beings harm others so violently? We all identify as part of a group (or multiple groups) and by definition if you’re not in my in-group, you’re in the out-group. Such simple identification is reinforced through socialisation, custom and ritual. People commit themselves to a cause, one that may be good or evil. This leads us to see people outside our groups as others. In extreme cases the others are dehumanised to the extent that they are considered sub-human. This enables and justifies horrendous behaviour by one group towards another, whether the defining factor is religion, politics, geography, gender, sexuality or socio-economics, to name but a few examples.

 

The process of radicalisation reinforces these divisions and emphasises them. If you come to believe that there is but one truth then everyone else must be wrong. Charismatic leaders successfully convince those within their group of their supreme position. Effective leaders encourage a sense of belonging and keep members on task and working towards a goal, whatever that may be. Vulnerable and disaffected individuals are especially susceptible to such persuasive individuals. Group members are also known to experience groupthink, a phenomenon that occurs when faulty and immoral decisions are made due to the desire to conform with others in their in-group.

Most of us empathise with others, we develop this skill through normal human development. As we mature we go through a process of social conditioning where we learn right from wrong, the so-called norms of behaviour that enable us to live in society in relative harmony. We learn that bad (and good) behaviour has consequences. We understand that what we do impacts on others, and that other people experience pain and distress. Most of us support the notion that it is right and correct to be kind to others and not to harm them, even if they identify with a different group, or if their beliefs are different to ours.

Although life-changing and earth-shattering, traumatic events can have positive consequences. Post Traumatic Growth theories indicate that survivors of terrorist attacks can experience affirmative outcomes. These include re-evaluating one’s life, reconsidering priorities, and empathising with others.

 

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credit:clivedavis.net

 

At this time of sorrow and pain it worth remembering the power of empathy. If we imagine the lives of those in war zones, individuals who have experienced trauma, and people suffering adversity, we acknowledge their humanity, we appreciate that terror can be felt by us all. The colour grey represents the blending of black and white, it is superficially dull yet nebulous and complex. In the aftermath of terror grey illustrates a scenario where all is not as it seems, where there is not one answer to a question. We peer through the grey mist to search for reasons, and a way forward through understanding, hope and resilience.