Saturday, 30 July 2011

Therapy can drive you mad??

UK newspaper The Independent published an article today describing how post-9/11 americans were left worse off after counselling.

According to the article's author, Guy Adams, a huge number of therapists "flooded in" to New York after the 9/11 attacks, "setting up shop" in various buildings. Adams's underlying suggestion seems to be that these therapists were self-serving profiteers. Some elements of the readership have responded by calling therapists "bloodsuckers" and accusing them of practicing "discredited" modalities.

The academics he's quoting are actually saying something different, in my view. They are saying that a blanket approach to large-scale incidents may have mixed results, because inevitably some people will find themselves talking to a counsellor when they're just not ready to do so.
If you haven't actually asked to talk to someone, and you end up kind-of-having-to, then you may be harmed rather than helped. No big surprise there....

I believe that the therapists who went to NY after 9/11 did so with good intentions; hoping to help in the healing of psychological wounds. Maybe the blanket response wasn't required, but it was uncharted territory for everyone.
Perhaps one of the lessons here is that after a critical incident, we need to attend to the basic survival needs first, and then allow those who are affected in their souls to approach the right people - in their own time, under their own steam.


Tuesday, 26 July 2011

Grief, Loss, and the Meme generation

The death of Amy Winehouse has sparked an understandable flood of tributes from friends, family, and fans. Undoubtedly she was a troubled soul, and I'm not intending to launch into an analysis of all that. Suffice it to say, she lost a battle that is all too common in our world.

I noticed that the tributes started to come in extremely early - mostly via the social networking site Twitter (with Facebook following closely behind). Wife of the former UK Prime Minister, Sarah Brown, was the first to be quoted on the BBC News channel; I couldn't think of any other reason to air her comments, other than perhaps being the first cleb-type to have tweeted in those first few hours. It seemed weird to me.

We have all become used to the more creative demonstrations of grief; the roadside shrine, the photo pinned to a tree, the coloured and pictured headstones. I guess that the 'new' way some people have of expressing their feelings is to tweet it, or add a comment on their Wall.
I'm curious about this, though. Will it lead to an individualized grief that precludes the face-to-face sharing of sadness?
Even more worrying is the thought that, in the future, the importance of tweeting something (for the world to see?) will come to outweigh the authenticity of the sentiment.


Monday, 18 July 2011

All Human Life is Here.....

Having a quick peek through the news pages today, wondering if anything would grab me enough to make a comment on my blog..... and.....

what strikes me today is the sheer diversity of stuff, maybe so much that I feel a bit wordless!

Newspapers, police, politicians.... heads rolling, scalps being claimed, the guilt-by-association that bleeds ever further, and yet a residual feeling of "it" not quite being resolved yet in our consciousness

The Space Shuttle program ends - and despite it being a huge white elephant, I have a very sad feeling, partly nostalgic and partly about the loss of hope and aspiration. What now will bring us a sense of faith in human potential?

The headline that, in the UK town of Kidderminster, researchers have found that "Patience lasts around 2.5 minutes" before people start huffing and puffing in grumpiness. The 'meme generation' (as I heard it said on the radio this morning), can also be read as the "Me-Me" generation....!

The world needs some therapy-thinking!


Friday, 8 July 2011

Recession and Mental Health

News today that, in the current recession, mental health of the public is suffering. Not just on the UK, either; this effect seems to be spreading across Europe.

Driving home today, as the news came that British Gas are hitching up their energy prices by a whopping 16-18%, I couldn't help but wonder how many people would be pushed a little closer to the edge by the sudden and marked rise in the cost of living.

I wonder what can be done, in the face of increasing pressure from external factors like this, to support people who feel they are struggling?


Tuesday, 5 July 2011

NICE and psychotherapy ... part 3

In this final instalment, I'd like to look at the conclusions drawn by the UKCP/Roehampton report on NICE's apparent attachment to CBT.

As we've already seen, NICE favours the RCT as the 'gold standard' of Evidence. So what's the problem with that? Well firstly, the RCT has been examined and discussed by academics who conclude that it may well NOT be the most useful methodology as far as psychotherapy is concerned. Secondly - although NICE acknowledges that other forms of research method exist - it seems to ignore them! (In TA terms, we might think of this as discounting on an organizational or political level).

So far, the bulk of Evidence that NICE has recognized comes from the CBT community. No surprise, since the methodology is very fitting to a modernist paradigm. But it is a world away from what the UKCP's document describes as "Therapy as dialogue". Other forms of therapy (particularly those which are longer-term, more analytical etc) are ill-suited to these trials - indeed, most practitioners of these modalities would shy away from RCTs (on well-thought-out ethical and theoretical grounds). There has been a sea-change in TA and other therapy communities recently, towards a more relational (and therefore postmodern) ethos. NICE and the RCT aren't geared up for this kind of approach - so inevitably, they stick with what they know.

The result, then, is that NICE has favoured CBT - by virtue of its use of a particular research method - and then blinkered itself to other methodologies and modalities. Politically, NICE's endorsement of a Quick, Cost-Effective and Evidence-Based approach fell right into the hands of a government who wanted to squeeze the welfare/mental health budget.

The economist Layard was looking at the budget and saw CBT as a way of saving money, by reducing the number of mental health welfare claimants. The government jumped onto this bandwagon, and sadly, so did the media - spreading the contamination, confusion, and mystification. As I've mentioned before, the constant use in the media of the catchprase "Psychological treatment such as CBT" is nothing short of product placement.
The public are misinformed about therapy as a whole; we have worked so hard to change this - but now the perception is being further warped, this time with the collaboration of some segments of the therapy community itself.

The NICE-CBT-IAPT collusion is damaging in so many ways - not least in the suggestion that the nation can be made Happier - by (in the words of Oliver James) "spreading a thin layer of CBT across the country".