Integrating Healthy Minds with Healthy Bodies by Jean Manahan

Over the past few weeks, it seems that mental health issues have never been out of the news. There was the OECD report highlighting our high teen suicide rate in Ireland, and the growing complaints about the problems faced by suicidal people trying to access emergency intervention in our hospital emergency departments.

Mental health is regularly in the news now, and we are all talking about it more. Thanks to those people who have made their own stories public, and to the advocates for better mental health services, it is now a constant topic for discussion in the media.

Thanks to the widening discussion about the importance of our mental health alongside our physical health, there is also a welcome recognition that resources for mental health services need to be properly ring fenced, to help improve the underdeveloped community-based services people face every day. Stories of people with suicidal tendencies being left in Accident and Emergency departments, or waiting unacceptably long times to be seen by a professional, are putting political pressure on political parties to find more resources for the mental health services here.

Our health is not just about a healthy body; a healthy mind is also essential. We cannot separate the mind from the body when considering our overall health.

 

Intervening skilfully

While the current openness in talking about mental health is positive, intervening skilfully when necessary is just as important. The state of our minds and our emotions contribute hugely to either negative or positive health including physical manifestations in our bodies. Therefore, skilled professionals who can work in depth across a range of mental and emotional issues are of paramount importance in building a healthy society.

So when someone goes to the GP with a pain, a good doctor asking the right questions and watching carefully can often discover the mental health problem underlying that physical pain. Family doctors can expect about one patient in seven to be depressed, according to the WHO. This can be one of the most challenging problems faced by family doctors in Ireland, due to the lack of a well-funded mental health service for public patients in particular.

 

A Central Role

Psychotherapy must play a central role within the health services. A move from a hospital-centric approach to a more community-based health service is a priority of the current Minister, Simon Harris TD. It will take time, but the discussion around a reformed health service, with more integrated care, must include the role of psychotherapy within the community-based mental health services.

For this reason the role of Psychotherapy in a healthy Ireland, which is the theme of the ICP Conference in October, is particularly timely.

Funded by Nessa Childers MEP in partnership with The Irish Council for Psychotherapy (ICP) the conference will be of interest to a national audience working in and supporting health across a range of services in Ireland.

The conference will be held on the 18th October 2017 in Dublin. Registration will open in early September.

Click HERE to find out more.

 

Jean Manahan is the CEO of the Irish Council for Psychotherapy

 

To contact over 1,500 highly trained psychotherapists go to www.psychotherapycouncil.ie.

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ICP Registrant’s Day 24th June 2017 – a reflection by CEO Ms Jean Manahan

The second annual ICP Registrants’ Day took place in the Red Cow Hotel on Saturday 24th June; the morning session with Joseph Knobel Freud on ‘The issue of diagnostic labels’ was both interesting and provocative. Plenty of time was given for questions and commentary from the audience which meant the session was lively and enriched with insights from participants and speaker alike.

I was particularly struck by the question whether labels can be either useful or abusive and the conclusion seems to be both. A further question needs to be asked when making a diagnosis – is it describing disorders or symptoms? It depends on the use we make of labels but what is clear is that when they describe symptoms, we need to understand the fluidity of those symptoms and the fact that change is always present therefore a diagnosis can never be static.  I liked the parsing of the word – ‘dia’, = through and ‘gnosis’ = knowledge.

Diagnosis

dia = through & gnosis=knowledge

This highlights the need to avoid a closed diagnosis which cuts off possibility and development. In summary a person is a person with all that that entails and not a label which stereotypes and predetermines outcomes or who that person is.

The afternoon session which involved group work asking the participants to answer a number of questions, was again a very lively affair. The feedback from the groups will feed in to the proposed White Paper to be presented to Government on the necessity for Psychotherapy to be easily available and accessible to people around the country based on need. Many thanks to all who contributed. The feedback will be circulated to participants shortly.

I’m looking forward to the ICP Conference in the Autumn – keep an eye on the ICP website Conference 2017 page for news.

Speaking at ICP's Registrants' Day 2017

Speaking at ICP’s Registrants’ Day 2017

Resilience and the Manchester Bombing by Gerry Myers

The British people have shown great resilience over the last few days in coping with the Manchester bombing. For the most part they have kept true to their values and their way of life. We hear of Mancunians pulling together in the midst of the crisis, offering practical support, food, shelter, care. We read the story of a homeless man overcoming his own difficult circumstances and rushing in to help in the immediate aftermath of the bomb, we read of families offering bed and board to strangers who were searching for missing relatives. And whilst there are those who were quick off the blocks to stoke hate for Muslims and immigrants, the vast majority of people were having none of it. Our TV screens showed soccer fans holding a dignified minute’s silence at a match, and there were vox pop interviews on news programmes where ordinary people spoke out against hate, including hatred of immigrants and Muslims. There was also no shortage of Muslim voices saying “Not in our name” to any of their faith who were thinking of launching any attacks in Britain. It is clear that for some time members of the Islamic community have been co-operating with the police to identify threats to the people of Britain. Those of us who were in London at the height of the troubles will well remember the great Irish demonstration in Hyde Park when many thousands of Irish people said “Not in our name” to our fellow countrymen who wanted to bomb Britain. Back then, as now, the people who make up the great melting pot that is Britain dipped into their resilience and were not cowed by bombers. So what is this thing called resilience? It could be described as communities and individuals successfully adjusting to very difficult circumstances, through psychological, emotional, practical and spiritual means. One of the most important facets of resilience is the capacity for meaning-making. In the midst of the carnage in Manchester this week, and despite a small minority urging hatred, the community remembered what is important to them, they kept to their values and meaning, found solidarity in communal care, rejected hatred and continued to do what they always do. Resilience isn’t just continuing to do what we always do, it is also knowing the meaning, values and philosophy of life that drive us to continue.

What We Know by Helen Jones

Robert Redford’s son is a filmmaker and his latest film is called Resilience. Roughly it’s about the negative impact of difficult childhood experiences….which last a lifetime. He was inspired by research carried out in 1998 by Vincent Felitti and Robert Anda into adverse childhood experiences. Examples of these range from witnessing substance abuse; marital breakdown; family mental distress; conflict in the home; being shouted at; physically and / or sexually abused and on and on. These create stress in children which they do not have the capacity to manage. They often have no safe place or person to comfort them. This creates a lifetime of difficulties including learning difficulties; anxiety; depression and on and on. Artists and Writers often develop this theme in their work. I just read an excellent book by J.D. Vance called Hillbilly Elegy which discusses this with great clarity.

Why am I writing this? Why am I exercised enough to do this? Because I am a Psychotherapist and have been hearing about these experiences for over 20 yrs. And I think that we need to be more vocal about what we know and not leave it to writers and Filmmakers.

I am not interested in Blame. However, given what is known about child development going back as far as Freud, Melanie Klein, Winnicott, John Bowlby to mention only a few, we could expand our influence further than the practice room.

The two areas we could increase our influence and stimulate thinking is in Education and Parenting. There are no perfect parents. We all falter and make mistakes but I believe that if every person who becomes a parent had an opportunity to explore their own experience of childhood and how it might unconsciously affect how they parent, that would be a good thing. We may have the best of intentions as parents but it is impossible to deny the unconscious where our repressed and split off memories lie. Parents need support. Single Parents need extra support. Where is it? What are the priorities of our Politicians? Helping the Property Developers get richer for a start. Come on Psychotherapists!

Here’s my list for today:

Decent practical support for all parents no matter what family configuration they live in …. they are minding the future.

Education …for parents, present or future, in schools, colleges, church halls, communities, articles and cultural events.

The Complexity of our Sexual Lives by Trish Murphy

We are all intensely interested in reading about other people’s sexual lives and it is even more compelling to compare ourselves to what appears to be the ‘average’.  On the one hand none of us like to consider ourselves average but there is a comfort in knowing that we are not as strange or weird as we might think.  The Irish Times sex survey offers us a glimpse into the lives of our fellow citizens and compatriots in the western world and some of the results are surprising in that what we imagine to be normal may in fact be wide of the mark.

We often think, particularly when warning younger people of the dangers of sex that our world has become over-ridden with sex, porn and fantasy but this survey shows perhaps that we are having as much sex as our parents and grandparents.  For couples who are together more than a year, the average amount of sex is once a week and it seems that most couples experience orgasm and satisfaction and they almost all rate trust and communication as vital to good intimacy.  This sounds very sane and yet it can provide longevity as those couples who are in a relationship for over thirty years report having a good sex life. There is some truth to the maxim ‘use it or lose it’ and staying sexually active throughout life can keep us open to the world, engaged with the human side of us and keep us generous and kind.  Habit can however be boring and it seems that men (and homosexual and bisexuals in particular) seek to keep the sex interesting and varied and this might be worth noting as desire and intimacy keeps us on the edge of life.

People report that talking about the difficulties appears to be the best way of solving them and this survey shows that dysfunction is not just an experience of aging but is common across all age groups.  That talking and communication can improve your sex life is something that deserves consideration  as many people would hesitate before discussing their intimate lives with friends or family and yet this might be the road to understanding and success.  We often talk to our partners but can find that fear of upsetting or causing hurt can limit our conversations and so perhaps we could risk opening up to other people and we might find perspective and compassion there.

Also, the survey suggests that people have become more flexible in their sexual practices, with oral, anal and fantasy sex becoming part of the sexual fabric and the internet has become both a source for information and a sexual satisfaction tool for many people.  The survey could have gone further here and investigated how much and what type of porn is used and what effect it has on people as individuals and on their relationships.  That porn has become the hidden underbelly of modern sexuality is not in doubt but how this affects us and our choices would be a good subject for discussion across all ages.  Most young people report having a reasonable relationship with porn in that they know it is fantasy and that real human beings behave differently but there are those who become obsessed with it and find that they are having difficulty with reconciling their fantasies with real life relationships.   This can lead to hiding their real desires and the possibility of intimacy with a real person becomes remote as revealing the truth might bring shame and condemnation.  If this is not tackled quickly then the habit can become hardened and it is more difficult to solve when the person eventually meets someone they want to be intimate with. So again talking and opening up at an early stage is the way to go but this might be a very difficult ask of a vulnerable person.  Further surveys on this topic of porn and sexuality might allow people to feel more normal and less alone in their situations but we need information that is more detailed and varied.

The survey reports that the average age of the first sexual experience is 19 (slightly younger for girls) and this something that might take pressure off young people who feel their virginity to be a burden to be gotten rid of.  Most teenagers report that they think the age of loss of virginity is much younger than this and this might offer some relief.  Added to this is the information of the average numbers of sexual partners in a lifetime is also lower than expected (10 on average) and this might also give people time to allow themselves to experience this across the lifespan rather than trying to gather experience in a few short years.

That younger people report satisfaction in the sex education they receive is also heartening as this is new for Ireland and it might mean that there will be a new openness and lightness about sexuality that has not been available heretofore.  However, with the onslaught of internet porn there is no doubt that we will need more knowledge and support than has been required previously.  Having sex surveys that are done by an independent, credible source offers a wonderful alternative to going to the internet for information.  However, we need information that is more in-depth as this merely whets our appetite for more of what is usual, normal and acceptable in our intimate lives.  That there are many people and couples who have no sex in their lives need also to be acknowledged and their experiences and attitudes validated.  Our sexuality in core to our being and it continues to be relevant for the entirety of our lives – this survey validates this notion and further research is needed as the complexity of our sexuality is revealed.

Does truth matter by Jean Manahan

Over two thousand years ago a certain Pontius Pilate asked the question ‘what is truth?’ a hugely important question for so many reasons. In the current so called ‘post –truth’ era, it takes on a new importance and it behoves us to ask does truth actually matter?

I believe it matters in a fundamental way as it is the foundation of relationships, of States, of law and of institutions. If the opposite of truth – that is lies – is to hold sway then all our relationships, both personal and civic are in jeopardy. Not only will we not trust our loved ones and rulers but we will lose out on the security which that trust brings.

The problem for ‘truth’ lies in a subjectivism which often rules the day ie the idea that there is no objective truth and therefore everything that comes out of our heads (and mouths) is valid as truth. This is palpably not the case and yet we can act as though it is. The evidence is seen in the power of social and mainstream media which can peddle any sort of lies that can be picked up and believed by millions.

Many people report experiencing deepanxietysome of which may be described as a type of existential angst or dread. How much of that anxiety is caused by uncertainty and distrust in a world where we cannot rely on others by taking them at their word. At the deepest level of an ‘I – Thou’* intimate relationship, be it lover, friend, child/parent, much of who we are is to be found. It’s no coincidence that the grooming of children for sexual abuse is all about lies and dissimulation. The more we are disconnected from ourselves, the greater the vulnerability to abuse and destructiveness.

On the world stage the consequences of lying is seen in the destruction of nations and their peoples,  in the injustice that binds many to the yoke of poverty, in the erosion of the planet through irresponsible usage and so on. The case for objective verifiable truth is essential for personal and collective well-being at both an existential and planetary level.

Truthcan encompass the objective scientific method of building on verifiable evidence as well as the inner subjective truth which is built on observation and experience. To distort the truth for any reason – be it egomania or the end justifying the means – never ends well. History, experience and hard facts teach us that lesson time and time again.

I believe we should be looking at teaching critical thinking, logic and the capacity to ask why in addition to what and how in our schools. We need to be engaging our youth with high level thinking which includes an understanding of the interplay between the intellect, will and our emotions, the ideal being the engagement of all three. Like a three legged stool, if one is missing, our capacity to access truth is compromised and the risk of being blind fodder for megalomaniacs increases exponentially.

 

 

*‘I and Thou’ – Martin Buber

Loneliness by Trish Murphy

Loneliness is a natural phenomenon that we all experience at various points throughout life: when we leave home, we have a break-up, someone we love dies, when our children leave, at retirement and in old age when we experience the loss of our friends and partners.  We have a sense of the normality of this but loneliness can also develop into something permanent, a type of ever-present companion and this requires action and attention.  Loneliness pushes us to move out of our self-protected spaces and urges us to make meaningful connections in the world.  It involves taking risks as only genuine connection satisfies.  Most of us have experienced loneliness in the middle of crowed rooms or indeed in the middle of pseudo relationships and we know that this is not what fulfills and ultimately it will not satisfy.  The road to meaningful relationships and friendships is not an easy one and it will require courage, perseverance and faith.

Spending time with people is a basic step.  Initially this might feel fraudulent as you are on the edges of the group but with time, the boundary of being on the outside become more permeable as acceptance and belonging grow.  Say ‘Yes’ to any and all invitations as the practice of mingling and turning up for events becomes more comfortable and endurable.  Ask people to events or coffee and initially make these short so that your endurance is not stretched too far.  If we spend enough time with people and particularly if we do something for them, care and friendship arise naturally.  If joining a club or group is too difficult, think of volunteering or helping out at an event.  This takes the pressure off socialising as working together creates a natural fellowship.

Look at your living situation.  Is it conducive to social living?  We need to balance the need for refuge in our homes with the need for connection.  If the people/person you are living with are not good for you, what are the possibilities for change? If you are living alone, could you consider taking a room in a shared house?  There is no doubt that if you are lonely, something needs to change and this can start with your living situation or your social situation.  The prediction is that many of us will live alone in the future and if we are to thrive we will need strong social and friendship connections and the time to foster these is now.

One of the factors of loneliness is self- consciousness or self-absorption.  This is where all the attention is focused inwards due to fear of rejection or fear of being thought needy.  If we are to overcome loneliness, this inward focus needs to be turned completely outwards so that we are open to connecting with others.  Be interested in the other person, ask questions and let your intelligence tell you when either you or they have had enough.  Be brave enough to ask to meet again and do not engage in post-mortems as going back over conversations only results in misery for you.  Take the first step outward and begin the journey towards connection.

Panic Attacks

Panic Attacks 

by Thomas Larkin

Panic attacks are rushes or spikes in anxiety. We get flooded with it. But the key thing is it comes from inside us, not from the outside.

People often come to psychotherapy saying ‘I get panic attacks but there is nothing to be frightened of’. They are right, nothing is happening externally to make them anxious. What we are afraid of is the appearance of the anxiety itself from within ourselves. We are anxious about being anxious.

Anxiety beginnings

We either grew up in an anxious household or we experienced something in our lives that made us frightened, such as a car accident or health worries or any manner of frightening experience. If these experiences remain unprocessed the anxiety stays with us.

The longer it remains unprocessed, the more anxious it becomes. For example, if we were in a car accident with a red car, after some time, we can react with a lot of anxiety to the colour red. We get a spike of anxiety from the part of us that experienced the accident.

Soon our anxious self becomes more anxious about more things as it seeks to protect itself. As a reaction, people often make their worlds smaller and smaller to avoid the anxiety, for example, they won’t go shopping. But the anxiety is within and it doesn’t matter what we stop doing, the unprocessed anxiety remains.

Psychotherapy for Panic Attacks

Psychotherapy is particularly effective for panic attacks. In the therapeutic setting, space is given to the anxiety itself and, as it becomes processed, we feel less and less anxious about more and more things. Until we reach a stage where our anxiety is the more natural alarm bell for real external danger.

As our anxiety goes down, confidence goes up in exact relation, the two are interlinked.

Thomas Larkin is a registered therapist with ICP, available at www.thomaslarkin.ie

Working with Difficult People

Working with difficult people – what to do if you are in this situation:

By Trish Murphy

Working with difficult people is one of the certainties of life and it is well worth learning how to mind yourself in a situation such as this.  The effects can be very serious and many people end up leaving work and struggling with confidence for a long time after such an experience. Most people try to manage the situation by speaking calmly and reasonably and are shocked to find that this does not work.  They continue to try to communicate in this manner to little or no change and then resort to commenting about their difficult person to colleagues, friends and family.  Initially it is a relief to sound-off about the colleague but it changes nothing and helplessness and frustration settle in.  Often obsessive thinking about the difficult person takes over and it is hard to let go even when you are not at work.

It is worth having a look at the overall picture:  The facts are that a colleague or boss can be both eminent and respected but may be a poor manager and are probably completely unaware of the effects they having on you and on your ability to work well.  They may also think that threatening and belittling you will somehow get better results whereas in fact the very opposite is happening.  Your reaction to this person can be full of fear, resentment and intimidation.  Every time you try to deal with them you are communicating through your own negative emotions and the chances of them responding positively to this are almost negligible.  If they are not listening or are totally lacking in self-awareness, it is unlikely that anything you are saying is getting through.  Your frustration and dread rises and their inability to manage grows also – this is a very stuck situation

The reason most people do not take a disciplinary case against their bosses or colleague is that they fear a) that it will tarnish their own reputations and positions and b) there is a left over fear from school of being ‘the rat’.  However, if you try everything and are not succeeding it seems pointless to continue doing the same thing over and over again.    You need to have them listen to you and for that to happen you need to get their attention. Some people will not listen until they are challenged and though you may not want to be the one to do this, it is a fact nonetheless that this is what has to happen if the situation is to change.

It may be that they will only listen if there are a number of staff standing together in front of them; if they are faced with a disciplinary procedure or if their own boss or board challenge them.   There is no doubt that everyone would benefit from the challenge: they would be a better manager, the organisation would benefit from happier staff and you would benefit from having stood up for yourself and demanded that you be treated with respect.  The main cause of not taking such steps is fear.

Fear curtails our intelligence and makes us tense, withdrawn and negative.  If it becomes part of our everyday lives it can make us bitter and small minded.  No-one wants this.  What you need in this situation is courage and self-belief but it is important to tackle this in small stages as otherwise it might send you into panic.  Start by speaking clearly and strongly that you need the situation to change.  Follow up with an email to keep track and verify your position.  If there is no positive response, go to someone higher up and do not be afraid to use the organisation’s procedures.  Your boss or colleague is not now and never has been in charge of how you feel – only you have that privilege.

MUSIC AS SELF-SOOTHING by Anne Colgan

In a world full of demands on our time it is important to give time to self-care. One way of doing this is self-soothing through music.  This can be through listening, humming, chanting or singing.  Music takes us in to the right side of our brain where our creativity lies and helps to create balance.  Responsibility and growing demands on our time often leave us depleted.  Music is healing and we can do it for ourselves.  Join me.

We begin with breathing.  Do you notice that when you are stressed your hold your breath?  This exercise will help you to cope with stress and better address your anxieties.  Breathe out and pull your navel in towards your spine.    Let go.  Your lungs will naturally fill up when you let go. You may breathe this way already.  Throughout the day when you get a chance, breathe out.  When you get used to it, you can pull your navel in more and make sure you get all of the air out of your lungs.  The more air you are able to blow out, the more will go in to your lungs.  One of the best ways practice this is by lying flat.  We tend to breathe this way naturally when we are lying down.

Now make a sound when you breathe out.  You can make any sound you like, it can be purring, chanting, gurgling our singing.   You can make baby sounds. You don’t have to be a professional singer to do this.  I believe that if you speak you can sing (except where you may have a medical condition).  If you don’t do this naturally I find that it can be like learning how to drive, so many things to remember.  Take it easy.  One piece at a time.  Practice a little at a time, gently.  You need to be careful if this is new to you.  Take it easy.

The rewards are wonderful.  When you do this exercise it can take you away from the everyday stresses and bring you in to yourself.  The deep breathing contributes to further grounding and relaxation.  This way of breathing and singing works for everybody.  If you are a singer already it will benefit your singing.

Music can be exhilarating and great fun.  Maybe revisit nursery rhymes.  Have fun.  Also, we all have songs which touch us, bring us to places of wonderment.  We can treat ourselves with these experiences.  When you make a sound the vibration massages all of the cells in your body. The effort of making the sound and using your breath in this way is good for your lungs and your organs.  You can pick out a play list for yourself to use as you go about your day. Sing along with your favourite songs and sing in the shower and the car.   Beginning the day with uplifting music will enhance your wellbeing.

There are times when breathing like this and making sounds can bring you to a sad place. Sometimes we are afraid to explore those feelings which we have tried to suppress.  Other feelings could be of anger or frustration or loss of direction.

If music brings you to a place where you need support and understanding Psychotherapy can help in working with feelings in order to get to a better place.  The Psychotherapist can hold the fears and anxieties with us as we figure it out for ourselves.  The work is non-judgemental and empathic.  The quality of the relationship with the Psychotherapist and the feeling of safety in the room enables the client to move through the obstacles which prevent us from having a better life.