Another stint for BBC Radio Berkshire

I was kindly invited to do another brief radio interview with BBC Radio Berkshire on 7th May. This time they were interested in the impact of good weather and sunshine on mood. We chatted about how sunlight is important for producing a helpful neurotransmitter, called Serotonin, and to regulate another hormone, Melatonin, which influences our circadian rhythm or sleep-wake cycle. Ensuring you get some good sunlight in the Spring / Summer months is helpful for mood. When some people have a susceptibility to low mood in winter, otherwise termed winter blues or seasonal affective disorder (depression with a seasonal pattern), it can often be helped by having a special light box which emits very bright and broad spectrum light, mimicking sunshine.

I enjoy doing these radio interviews and it’s a great way of getting more information about positive psychological wellbeing out there.

London Bridge terrorist attacks

I’m offering FREE support and psychological therapy for anyone directly affected by the terrorist attacks in Westminster, Manchester, and most recently London Bridge. 

I can’t predict what the demand may be, but will do my best to assist anyone contacting me.

This will be dependent on clinic time availability and is offered for my clinics in Caversham, Reading (Tues, Thurs, Fri) and Mayfair in central London (Wednesday afternoons only). The number of sessions offered will have to remain at my discretion, but is negotiable. 

More details on how to contact me are via these websites:

http://www.thamesvalleypsychology.com

http://www.mayfairpsychology.com

Just…wait…

WAIT
Wait, for now.

Distrust everything, if you have to.

But trust the hours. Haven’t they

carried you everywhere, up to now?

Personal events will become interesting again.

Hair will become interesting.

Pain will become interesting.

Buds that open out of season will become lovely again.

Second-hand gloves will become lovely again,

their memories are what give them

the need for other hands. And the desolation

of lovers is the same: that enormous emptiness

carved out of such tiny beings as we are

asks to be filled; the need

for the new love is faithfulness to the old.
Wait.

Don’t go too early.

You’re tired. But everyone’s tired.

But no one is tired enough.

Only wait a while and listen.

Music of hair,

Music of pain,

music of looms weaving all our loves again.

Be there to hear it, it will be the only time,

most of all to hear,

the flute of your whole existence,

rehearsed by the sorrows, play itself into total exhaustion.

Galway Kinnell (February 1, 1927–October 28, 2014)

Some Thoughts on Grief and Loss

 “Grief is a place none of us knows until we reach it” Joan Didion

Hereʼs some thoughts following my interview with BBC Radio Berkshire earlier this week. Letʼs start by defining some terms:

Bereavement is to be ʻrobbedʼ of something valuable

Grieving refers to psychological aspects of loss – especially emotional suffering 

Mourning is the cultural expression of that loss 

George Bonanno – Clinical Psychologist at Columbia University studied grief for over 20 years. Surprisingly, 50 – 60 % of people show no outward signs of grief one month after their loss. 

Relevant psychological theories: 

 Bowlbyʼs attachment theory (1969 – 1980) 

– desire to be near the attachment figure

 – return to the attachment figure for comfort and safety

 – the attachment figure is the base for security (enables confident exploration)

 From the age of about 9 or 10 we can understand death as a permanent biological process. When attachments are broken or lost this understandably leads to distress and anxiety. 

Kubler-Ross Stages of Grief (1970s) -continues to be influential:
but we now know this is not rigid, nor do all people pass through all stages. Itʼs more like a complex shifting between states that feels like waves of emotions experienced.
– 

– Denial
– Anger
– Bargaining
– Depression
– Acceptance 

Silverman & Klass (1996):
Grieving is never fully resolved.
In learning to let go, the bereaved person negotiates and re-negotiates the meaning of their loss over time. The person is remembered and not forgotten.

 Stroebe & Schutt (1999):
Oscillation occurs between loss orientation and restoration. The grieving person will focus on restoration plans or activities when focusing on the loss becomes too much to bear. Coping or recovery means negotiating / seeking a meaningful life without the deceased. (Difficult to do if the person is missing or not proven deceased).

 The radio interview focused on ambiguous loss, where the grieving process would be incomplete. Here are some thoughts on this:
Ambiguous loss is a term that has been around since 1970s – first used by Pauline boss to describe the impact of grief on families of soldiers who went missing in action.
It can be an experience that is confusing and hard to comprehend.

There can be no ʻclosureʼ or understanding typically expected with the death of a loved one. This leaves the person searching even more for answers and this complicates or delays the process of grieving. It becomes harder to move towards acceptance of the loss.

Missing person or unrecovered body from a war or an extreme incident = physical loss and loss which is somewhat ʻfrozenʼ or incomplete.

Psychological loss can also occur when the person is still there e.g. with dementia, vegetative state or via brain injury.

Resilience and hope are important to encourage in ambiguous loss, as in other forms of grieving.

There are no social rituals to deal with such losses. This can leave the person feeling ʻstuckʼ or ʻin limboʼ. People can under-appreciate the unending absence, the void or opposite of meaning – the experience of meaninglessness itself. This is hard to share and communicate and also hard for others to tolerate and support.

The goal of psychological therapy does not equal attempting to find a state of closure, but rather to become more tolerant of the ʻstill-open doorʼ. Learning to hold a paradox in mind can help, i.e the person is both absent but also has a presence in the bereavedʼs life. Life goes on without that person, but has also massively changed.

Pauline Boss suggested guidelines for resilience in the face of such complicated and unresolved loss:

1. Finding meaning in the situation as it is

2. Tempering mastery, i.e. not feeling the need to have absolute certainty

3. Reconstructing identity – to a changed situation

4. Normalising ambivalence – e.g. the conflicting emotions that will be experienced of
sadness and missing, but perhaps relief or optimism

5. Revising attachment – recognising what has been lost but also what is still present about
that person in our lives. 

6. Discovering hope – often essential for psychological resilience

Personal rituals – often performed alone and in private – are often helpful.
Public mourning rituals have a clear purpose – to help mourners strengthen their social bonds and re-enter the social world after the loss.
Private rituals help provide emotional meaning, to feel less out of control (less helpless and less powerless), more connected to the lost person. Examples of these private rituals can be always having breakfast in bed on a Sunday, washing the car, going for a favourite walk, listening to a meaningful piece of music, keeping a favourite possession of the deceased and looking at it or using it. These things help to keep that personʼs memory alive and the attachment to that person. 

Grieving (of all kinds) can be an emotionally difficult and lonely process, but in looking after oneʼs resilience, mobilising personal support, expecting the waves of emotions, and keeping the memory of the deceased person alive, one can regain a footing in a world that has become a lot emptier than it was before.

On the radio again…

Just done another brief radio interview for BBC Radio Berkshire on the ambiguous and unresolved grief when people go missing. This was for the Sarah Walker show between 10:00 and 10:30 on 3rd May 2017.If you’d like to tune in to hear what we discussed, you can do so on BBC iPlayer. (Although I think it’s tagged under the Anne Diamond show).
Another very positive experience and nice to be asked back. I was joking with them that I was doing the ‘misery slot’ in between much lighter content (freezing herbs and the dissolution of parliament). Perhaps that’s why they asked me?
I’ll do another post related to the theme of grief shortly. It’s something we all face, but not in the same way. 

The Psychology of Lying

After my stint on BBC Berkshire Radio this week, it got me thinking about the role of lying in some mental health and personality issues that I encounter in my work as a Clinical Psychologist. Here are some thoughts:

Compulsive of pathological lying is about really out of control lying that is really difficult to stop. We aren’t talking here about lying for material gains, which is more dissocial. The lying is disproportionate to any end goals or gains. Such people are typically trying to make their lives seem more interesting and exciting, both to themselves and to others. The lies told are usually dazzling and fantastical, but never breach the limits of plausibility. The lies are not delusional or psychosis-related. The stories are always about portraying the liar in a favourable way.

I came across a case of a man who attended military parades dressed in Army uniform and wearing medals of valour. He was eventually found out when he was challenged about his military service and battles he had fought in, and discovered to have never had any military service.

Pathological lying is difficult to treat with psychological therapy, which relies on a truthful collaborative stance by both client and therapist.

Addiction: Many people involved in problem alcohol use, gambling or illicit substance misuse will lie to others about their behaviour, e.g. Hiding empty bottles, not telling the truth about their whereabouts, spending money and denying it, or lying about disciplinary problems they have encountered at work. Mostly, this is about avoiding any interference in the addictive behaviour or the negative consequences of being confronted about it.

Psychopathy:  Psychopaths are people who do not experience emotions or concern for others, as do most of us. This is likely to be for neurodevelopmental reasons, as their brain development and early experiences as a consequence are different. Psychopaths lie extensively and easily to manipulate others and get the outcomes they want. They would feel no arousal, guilt or stress when lying in the way that most of us do. They may even gain pleasure from the manipulation of others or considering themselves as ‘winning’ or ‘being clever’.

Factitious disorder is where symptoms of illness are deliberately and knowingly induced, feigned or exaggerated. Also formerly known as Munchhausen’s Syndrome, after a German baron from the 18th century (both real and fictional) who was known to make up exaggerated tales. This can relate to the person themselves or by proxy, i.e. Relates to another person or commonly a child. The benefits of the lies are concern, care, attention, and sympathy, so can be thought of a compensatory for some personal deficits. People with such disorder can even go to the lengths of having invasive procedures, operations or inpatient treatment for deliberatelyfabricated illnesses.

Not to be confused with health anxiety, where a person genuinely believes they have a health problem and seek reassurance through assessments and treatment, to reduce their anxiety.

Malingering is where a person fabricates illness or disability in order to obtain material gains, e.g. claiming benefits they are not entitled to, or to avoid unpleasant demands, e.g. avoiding work or military duties. ‘Pulling a sickie’ or having a day off school, college, or work knowing that you are not unwell is a minor form of malingering, but it is also likely to be for positive mental health reasons, i.e. The need to withdraw for a short period of time to reduce or avoid demands being made of us that we might struggle with.

High functioning autistic spectrum disorder (Asperger’s Syndrome):  Such individuals tend not to be able to appreciate the socially positive aspects of small, kind lies, or at least the avoidance of deliberately offending others with harsh truths or brutal honesty. It’s a real problem in trying to improve relationships with others if someone tells you what they don’t like about you, your behaviour,or the physical attributes you have that they may not like!

Relationships: wow! Far too much to summarise here. If I were to write about lying in relationships, I could fill up this blog no problem. I’ll just leave it with Shakespeare…all is fair in love and war.

On the radio…

Just done a brief radio interview for BBC Radio Berkshire on the Psychology of Lying. This was for the Sarah Walker show between 10:00 and 10:30 on 6th March 2017.

If you’d like to tune in to hear what we discussed, you can do so on BBC iPlayer. (Although I think it’s tagged under the Anne Diamond Show).

It was a really positive experience but I will admit that doing live radio can be a bit nerve-wracking. I only said “bum” once and think I got away with it. 

To ruminate or not to ruminate…

I’ve had quite a few clients recently with difficulties with rumination. As I’ve been considering things to write about in this blog, that seemed a good place to re-start. By rumination, I mean dwelling on thoughts, memories or images either unproductively (i.e. no nearer finding a solution to a problem) or upsettingly (i.e. causing anxiety or distress).

The starting point is often an intrusive thought, memory or image – something that just pops into your mind involuntarily. We can’t do much about having such intrusive or spontaneous experiences, as this is how our brains work, particularly when unoccupied. These intrusions are really common in the general population.

It’s what happens next that can be important. Getting drawn in to thinking more about such an intrusive thought, or even deciding to spend more time on such a theme, can begin an unhelpful process of rumination.

It’s really very difficult to stop thinking about something and it has been known for many years that trying to suppress unwanted thoughts, just makes them stronger. So what can you do? Here are some ideas to try:

  • Moving your attention on to another topic or task can be helpful. You are then occupying your mind with competing activity. It might need to have some mental effort involved (something that gets your brain working) in order to really help you re-focus your thoughts, e.g. counting, reciting poetry, study something, do something creative.
  • Mindfulness involves noticing the experiences that you have but also allowing things to move on and not get stuck to such thoughts. Imagine your thoughts floating down a stream like leaves. As they move on we allow other thoughts to take their place and also to move on.
  • You may find you are getting stuck on “Why?” questions, such as “why me?” or “why did this have to happen?”. There is often not an easy answer to ‘why’, which is how our thoughts can get stuck on a bit of a loop. If there is some way of considering a problem as “how?” or “what?”, for example “what do I need to do next?” or “how can I get some help for that problem?”, you may find it helps to move closer to a solution that can work for you and therefore you can feel more comfortable that you don’t need to keep thinking about the problem.
  • Rumination is often about doubt. Doubting yourself and your ability to cope or solve a problem. Doubt tends to increase anxiety and more anxiety often means more rumination. Try to have a little more faith in your capabilities and resourcefulness and try to answer your doubts with reassurance and calming thoughts. “It’ll be ok”, “I’ll be alright”
  • If you are dwelling on things at a time when you cannot possibly solve a problem or do anything constructive, e.g. at night when you are trying to sleep, try to ‘park’ such issues until another time when you will be more able to consider them productively. Try writing on a post-it note so that you can come back to it another time.
  • Pay attention to and look after the emotional response you are having to your rumination. If you are getting more tense or anxious, try to do some activity that is calming or relaxing. If you are getting distressed or low in mood, can you find a gentle activity to lift your spirits a little?
  • Ruminations are often private thoughts which are not shared with others. If you can talk to someone and share such thoughts or problems, you may find that this reduces rumination as you are enlisting help from someone. Even if you can’t share you thoughts, being engaged in conversation or having someone’s company can help
  • Sometimes rumination is about old grudges and grievances. This probably means you are treating something from the past like it is happening in the present and this is out of context. Letting go or forgiving is never easy, but dwelling on the past will not change it either.
  • Remember that a bit of intrusive thinking and rumination can help us to process events and emotions, or to solve problems.

Sad news…

I received some very sad news today.

My colleague from Hampshire, Ms Pat Clancy, Forensic and Clinical Psychologist, passed away suddenly, but apparently peacefully at her home this week. Pat was an experienced and wise colleague who had great attention to detail and thoroughness. She had worked in NHS services throughout her career as a Psychologist and many will have been trained, supervised and guided by her. Many people will have been helped by her clinical skills. She enjoyed the last few years of her retirement travelling to far flung places in her passion for wildlife and nature. She was always quick with a chuckle and loved the office gossip. Rest in peace, Pat.

Paris

I’m moved to write something about the events in Paris over this weekend.

My own response is one shared by many, which is of immense sadness and horror that innocent people going about their business could be murdered so brutally. Eating in a restaurant, going to a gig, watching sport, seeing friends or family. These are freedoms we must protect and not let a small number of people take away from us or restrict. My heart goes out to all the survivors, the injured, the bereaved and the traumatised.

Does psychology have anything to offer at such times?

The answer is most definitely ‘yes’ when it comes to the mental health consequences that will become apparent for those affected by these events in the next few weeks and months. A great deal of support, compassion and treatment will be needed.

But what of the murderers themselves? What can we learn about their psychology and behaviour that will be of help? It may be tempting to write them off as mindless, but my instinct is that this would not be accurate. They were well-trained, organised, and cunning. They are also absolutely sure they are right to destroy Western values, people they view as non-believers and worthless, and to commit suicide for the promise of martyrdom. We talk about radicalisation now but we used to talk about ‘brainwashing’ of people who belonged to cults. Their world view would become so distorted that they would be prepared to act in ways most other people would reject. This is a process that takes time, which means we can bring people back from such extremes if they are receptive. Most people would understand that Islam is love, and that most religions promote peace. The corrupted ideas and narratives of these cults can be challenged within our communities and families. Change the ideas and you change the behaviour.

So now, more than ever, promote the values of France:

Egalite, fraternite, liberte.