The man with no name (updated 2014)

(This piece first appeared in a local newsletter in 2008. At that time I slightly censored my original text but restored the cuts and updated the content when it was first posted here in January 2010. Now I’ve briefly added more text in italics at the end which brings it up to date again! When it first appeared some readers wondered if the other person referred to was real, I can assure you he is).

I first met him on a psychiatric ward, I knew his name then but have forgotten it since. We lived in almost the same street for many years but rarely spoke, though we saw each other all the time. The last time I saw him, a few weeks ago, he passed briefly through the café before jumping the train. We have known each other now for nearly sixteen years, and it seems that there is a bond of shared experience that will never go away. Let me try to explain.

At times he seems like my mirror image. He’s certainly a benchmark by which to measure myself. On one occasion when we met (passed on the street) I was in a neighbouring town, and waiting for the bus home. I was sitting on the wall, staring in the direction the bus would come, looking south-west; the setting sun illuminating me, my body relaxed and my eyes rested naturally on the horizon. I saw him coming from the same direction, the perfect opportunity to ‘read’ him and therefore myself - the simplest of encounters with the minimum of ‘noise’. I knew his gaze had to past across the uprights of the bus shelter and that would clean his memory at the right moment. I remained motionless and allowed the gaze of my eyes to remain fixed. At the right moment I glanced away for a split second in recognition, then back to look directly and uncompromisingly into his eyes - demanding a response. It was then that something remarkable happened. For the first time in all those years he looked undeniably normal, and his expression, in response to mine, was one of sorrow and sympathy. With my seemingly fixed stare I looked distressed to him - he had misread me, in a way only an ordinary person, who cares but doesn’t understand, can do. He had lost, for a while, his capacity to be mad.

He’s a walker, night and day, and so am I. But he needs to be outside more often - he covers more miles. Those who are disturbed don’t wander, they walk with purpose, rhythm and speed. To the onlooker they may appear to be staring blankly ahead whilst taking an erratic course - they look crazy. But this is only because urban landscapes are artificially regular and regimented. The real walker, who moves swiftly but smoothly, is actually following the most efficient path through the real contoured landscape beneath his feet. The path of least effort up a slope is always curved. The apparently fixed staring eyes have in fact come to rest naturally on the horizon - seeing through the fixed artificial urban skyline. But they do blink from time to time, like a camera shutter recording fixed points for navigation. The so called ‘psychotic’ hopes to achieve a kind of walking meditation; whereby the hallucinations, which may be of sound, smell, taste, touch or vision, and the unwanted delusional thoughts that emerge to explain them, may be relieved. If he can stay ‘in the moment’, in the here and now, create nothing but constant change around him, know that all thoughts and feelings can only be about the past or future and let them go - then survival is possible. Finally he may be able to allow his unconscious mind to make all the decisions and find a few hours of peace whilst in constant movement.

By the time he comes to rest, his ‘balance’ (physical coordination) and ability to ‘navigate’ (be orientated in three dimensions of space and one of time) will be restored and his mental awareness as acute as his hunter-gatherer ancestors. Alas, opportunities to be alone and abroad at night are ever more restricted by modern society. When forced into the crowd then disaster may strike unless you are particularly confident and relaxed. You may even be able to ‘part the waves’ by walking briskly in a dead straight line through a crowded pedestrian precinct staring relentlessly ahead, not deviating nor giving way even for a moment. The first time, I did it by accident; I was pre-occupied with my own thoughts and didn’t realise until I was in it and saw its effect. It’s both frightening and amazing if you have the confidence to keep going. The crowd parts in front of you, you are like an arrow travelling through air, it gives a wonderful sensation of power. But you mustn’t take your eyes of the real horizon and make eye contact otherwise you will become rapidly disorientated and liable to fall. I must have gone a hundred yards without touching anyone. Afterwards you need to be able to switch realities; and must make eye contact to be balanced, and able to navigate in the landscape of others!

When we met on the hospital ward it was a crazy place, the staff occupied one mental universe, whilst we the patients had our own individual realities - well almost! There is a realm where two, at most three, psychotics can understand each other and therefore act together. We each define a situation differently and ascribe different meanings to it, reflected in the mutually incomprehensible content of our words - but how much real communication depends on language? He’s a bit of an artist and one day I helped him cover the walls of the music room with graffiti. The unit was attached to a general hospital, any part of which could be explored - if you had the confidence to act as though you had a right to be there. At night the grounds could be a playground too.

The fastest way out of a prison is usually the reverse of the way you came in - through the front door! You are never more than three keys away from freedom in the psychiatric system; one out of seclusion, another out of a secure ward on to an acute ward which is open at some point in the day, and the third which unlocks the transport taking you to and from units or the outside world. Physical methods are extremely slow, the psychological much faster - you have to get those who want you in, to want you out. Using what have become the 'black arts' of psychiatry and psychology, against those from whom you learnt them, can be fun; non-verbal behaviour, hypnotherapy and NLP - plus a little old-fashioned distraction and sleight of hand. Two of you can cause chaos, three of you can get one of you - out of anywhere. And it is a game. If you can understand the source of your distress in the system of care; see its rules, routines and the habits of the workers who reproduce it - then there is much to amuse. But it is addictive and I still can’t walk away from it all.

(Oops! I may have just self-diagnosed myself with an ‘anti-social personality disorder’).

(Now it is 20 years since we first met, and I haven’t seen him for a couple of years – which doesn’t necessarily mean he is not around, just that our awareness’s have changed. I know mine have and I suspect his have too. First there was the time I saw him working in an out-patient art therapy room, absorbed in a very elaborate large drawing. Then months later he had a dog in tow, he was still walking but obviously the pace and priority had changed. Then came the van, the woman and the child. One day the van was parked outside the café – the first time we had been stationary in the same space for more than fifteen minutes, ever! Finally the last time, all three were dressed as if part of a wedding party, on their way to a local music festival.)

Bus shelters are often effective barriers for forcing a 'pattern break' from one kind of a 'trance' like state to another involving more 'reality testing'.

'..the best is yet to come...'

It was my intention when I started this blog a little over a year ago to have said everything I wanted to say about mental health by now. Yet I still have a mountain of half-written material. And I must go on, what’s to come is my best work, and builds on the foundations of everything posted so far. I guess I still have about a year to go (assuming my other responsibilities stay the same) before I can leave here, cross to my other blog Hunter-gatherer - the past in us ( http://hunter-gathers.blogspot.com/ ) and begin on the subject that really drives me - evolutionary anthropology. So, I thought I’d just write a short piece about where all the previous posts are leading to.

What is still to come, is first The Recovery Movement (part three); the final article on the Recovery approach looking at two local attempts to put it into practice. That should be followed by my completing an essay (about 6000 words) on my last experience of being an inpatient in 2005, a period for which I have complete medical, nursing, ambulance and police records. It’s working title is I Know, Because I Was There - health records and personal recall, two versions of a ‘psychotic’ episode. Once completed it can then be reformatted into three or four (not too long) blog posts. Following that is another essay for which I’ve allowed my myself 6000 words, and called Challenging Expertise - my misadventures in mental health education; which charts and reflects upon my experience of being a service user in education, being a service user undertaking training in mental health work, and on how academia (at all levels) trains it’s workforce and researches it’s subject. Hopefully it too will convert to three or four reasonable sized posts. This should be rapidly followed by ‘the thesis that never was’, Ways Of Being With - rethinking expertise in mental health. This was the research project which was rejected by a local university and caused me not to complete my M.Sc in Mental Health. It will run to about 12,000 words (half that already) but, minus the stuff I’ve written about before, it should be dividable into six post-sized chunks. It explores the wealth of tacit knowledge involved with being with people in mental distress, then offers a radically different (compared with current practice that is) way of thinking and behaving when trying to be an effective helper. In fact if offers a lot of ancient heuristics which are being re-emphasised as a result of the findings of neuroscience. Then comes The Sound Of Water - on the possibility of an ecotherapy. This piece is a critical exploration of the idea that there can be an ecopsychology and by extension, ecotherapy. Though many practicing green care claim that it amounts to ecotherapy, very little has been written or researched about it. It will also include an application of the principles of Ways Of Being With. Again another four or so posts. Finally Natural Mental Health, a post which asserts that there is such a thing as normal, or better still natural, mental and physical fitness (you can’t really separate mind and body) and that there is excellence in living, which can and should be emulated. After all, imitation is, what is special about human learning.

Needless to say these six projects (amounting to about twenty more posts) have been progressing in parallel for sometime (they need to, if they’re all to fit together!) The final piece should, at one and the same time, become the first post on the new blog about pre-agricultural ‘forms of life’ - how we have spent 95% of our real history as hunter-gatherers, and how that legacy is still with us.

So what is wrong with me?

The short answer is that 16 years ago I was diagnosed as manic depressive (now Bipolar 1). If you’re satisfied with that as an explanation then either you are an official (who needs a label and no more) or a fool. Of course I had been diagnosed several times before that. In the seven years after my first meeting with a psychiatrist in 1987; it was first a reactive depression, then a psychotic episode, then severe depression, a short gap of normality, then schizoid affective disorder, and more depression before it settled upon Bipolar.

My perception of my problems, or acceptance of such labels, changed over the years too. Before entering the mental health system I was quite clear psychiatry was the ‘dismal science’, but within days of my first admission I’d lost track of what I felt my problems were. I’d entered a new world of psychological interpretations, but had also begun to be influenced by the clients around me. The end result was that over a period of a decade I became completely converted to defining who, and what I was, by the use of psychiatric labels. I came to the belief that ‘bipolar’ explained myself, to myself. And for a few years more, no doubt with much confirmation bias, I remained thoroughly dis-abled!

It wasn’t until six or seven years ago, when I radically changed my ‘world view’, that I had to then set about revising my view of myself. I began to view the world, from minute to minute, as well as over millions of years, from the point of view of Darwinian evolution by natural selection, and that let me step-out of ‘the preoccupation with self’ that seems to paralyse so many people in mental distress. Viewing all human activity in evolutionary terms, including all social and cultural activity, allows you to see ‘before your very eyes‘ the unfolding of human psychological behaviour on a daily basis - how the interaction between people (including mental health workers, clients and carers) usually reproduces, and only very occasionally transforms, relationships. All of which has led to what verges on contempt for the world of mental health, as evidenced by many of the previous posts on this blog.

Of course an expression of contempt is hugely powerful, if you see it in the face of a partner, then the relationship may as well to over. I haven’t been a client of mental health services for three years, I’ve ceased almost all ‘involvement in Involvement’ or participation, refused for six months now to meet with anyone in an official mental health building and severed links with mental health academics.

I’m now left with two kinds of explanation of myself, between which I flip from time to time. The less common one might be titled; ‘How the hell should I know what’s wrong with me?’ For the sorry facts are that I’ve spent my life not getting the jobs I wanted and being largely unemployed, and unemployable - unable to live to a set routine, accept authority or responsibility for others. A life of not sleeping with the women I really wanted to, but having a succession of short-term relationships with whoever would have me, plus long periods of living alone. And despite all the studying I’ve done, I still don‘t know why I’m largely ignored by the rest of the world. For example, not so long ago I wrote;

‘Just had one of those horrific moments of despair (thankfully they never last long) when I realise that by being honest and true to myself I’ve lived a life of broken relationships, unemployment, mental illness and academic rejection. As a result what blissful moments there have been have largely been experienced alone. And yet any outsider looking-on would conclude that although the day began and ended alone, it was full of good company and worthwhile activity. The more ‘well’ and socially skilled I become, the more angry and isolated I feel.’

So one kind of explanation is that insight has brought me nothing, but that should not be unexpected with someone so unable to understand others. In this sense the question: ‘So what is wrong with me?’ is for others to answer.

The second explanation is the academic one, the alternative to psychiatry, the more neuro-scientifically flavoured one:

a) There is natural variation in the limbic system (which regulates emotion) between the brains of individuals living in any particular environment; my inheritance is that I’m more highly sensitive to my environment than most others. Such sensitivity is occasionally useful, but when the majority in my environment are less sensitive, my emotional reactions look to others like rapid and consistent overreactions. Equally, I’m likely to quickly become over-stimulated and feel the need to socially withdraw. Such reactions occur over the whole range of emotions, which the crude psychiatric category of ‘mood’ hardly begins to encompass.

b) So when it comes to nurture (social learning) individuals bring their particular genetic inheritance to learning in particular environments. But whatever the background and context, the outcome is that we learn (using the inherited capacity to imitate) varying degrees of empathy (the ability to feel what others feel) and a ‘theory of mind’ (knowing how others think). Bringing the consequences of a) to my own particular environment, my ability for empathy and to a lesser extent to share a theory of mind were blocked. I even have problems recognising the universal facial expressions of emotion. So when psychiatry focuses on something called ‘depression’ they are attempting to treat the consequences (rejection or ejection from normal purposeful social interaction) rather than the cause.

c) Finally there is a third process which even neuroscience, let alone psychiatry, hardly recognises and about which I’m only aware of the consequences - and that is handedness. I am very left-handed, instinctively a southpaw, but I also want to move anti-clockwise, often transpose figures and letters - all in a world designed by right-handed people. But of course I’ve known no other world and I am well adapted. Nevertheless I have the horrible suspicion that these instinctive ‘reversals’ happen all the time when I try to relate emotionally to others - and if they do, what must others feel about me?

However one of the implications of the above, and much of the content of this blog, is that a search or journey for conscious explanation is merely a ‘story we tell ourselves’, after the fact and of no causal consequences, and so must be of no importance when attempting to transform one’s own, or anyone else’s behaviour - our routines, rituals, habits and addictions. One should of course be asking what does Nick Hewling do, and ‘how’ does he do it?

I like to think of myself as a mental health peer supporter. I have much greater confidence in my understanding of people when they’re crazy than when they’re together! I almost always know how to react in a useful way. I’ve done my 10,000 hours and some of that learning has become instinctual. On the one hand I’ve always despised those workers who don’t live in the area in which they work and therefore don’t know a client’s territory, who believe their work can be professionalised by impersonal rules of best practice and imagine therefore they can use some different psychology than in their ‘personal’ lives. But equally I’ve come to mistrust the kind of peer support that has been turned into work, formalised and made ‘intentional’ - which rapidly comes to resemble the kind of talking therapy it was intended to replace. I’m accountable only to myself, my rules of effective and ethical conduct have evolved over two decades. I can operate when I like, where I like. To my mind you cannot be an effective helper unless you can do it standing up in the street, or in a bus queue with an audience of ordinary people. What the person in mental distress needs, is support to feel at home in normal social spaces. And I don’t mind occasionally looking crazy to outsiders in order to build a rapport with someone who is being activity avoided by others. Confidences can be offered and received when necessary in the normal way, in close proximity with appropriately lowered voices. Of course such informal peer support is increasingly facilitated by web-based social networks.

What workers think they achieve in one hour in an isolated consulting room I cannot imagine, I’m often with clients before and after such an appointment and actively undoing their work. Having lived in my local area a long time I’m now quite conspicuous, but have come to know the routine of so many clients that I can have as many ‘chance’ encounters as I like. My activity is also purposeful in another sense, I do ‘set the stage’ a lot, contriving the time, location and activity - so as to create an atmosphere conducive to new learning. Motivation can only come from others, and in pursuing people one purses knowledge and skill, I practice social skills like I practice rolling and smoking a cigarette. I know what others want from me; warmth, confidence and competence, humour, to feel what strength I have so they can feel safe and good about themselves. They want my ability to be serious without making heavy talk. I do it by turning my fear and judgement into curiosity, confidence and competence, doubt into accurate assessment, the desire to control into the ability to live with change and uncertainty. I model, verbally and more importantly non-verbally, more effective ways of being with.

The answer... (updated 2023!)

What follows is an outrageous exercise in selecting half-quotes, which I’ve strung together into two paragraphs, all taken from the final chapter of Sue Blakemore’s The Meme Machine (see January post What are memes? Sue Blackmore explains) However they all appear in the order in which they were written, and I believe provide an accurate summary of the conclusion of the book. Indeed they are the passages and phrases that I have highlighted myself (in yellow!) on my own photocopy of the chapter which I carry in my satchel at all times.

‘..Only when we see a human being as a product of both natural and memetic selection can we bring all aspects of our lives together within one theoretical framework. ..Memes fight it out to get passed on into another brain or book or object, and in the process cultural and mental design comes about. ..There is no need to call on the creative ‘power of consciousness’, ..Free will, like the ‘self’ who has it, is an illusion. ..explanation adds nothing. It is just a story ..after the fact. ..all human actions, whether conscious or not, come from complex interactions between memes, genes and all their products, in complicated environments. ..by consciousness I mean subjectivity - what it’s like being me now. ..not a force, or a causal agent, that can make things happen. ..the most mindless and least conscious of our actions can be imitated just as easily as our most conscious ones. Cultural and social variation is guided by the replicators and their environment, ..new ideas came out of the combinations of the old. ..a combined product of the genes and memes playing out their competition in ..life. ..The creative achievements of human culture are the products of memetic evolution, ..selves can often do more harm than good, for creative acts often come about in a state of selflessness, or loss of self-consciousness, when the self seems to be out of the way. ..knowledge is a kind of adaptation. So is foresight. ..comes about by selection, only in this case it is selection between memes.’

‘..the ‘me’ that could do the selecting is itself a memetic construct ..The choices made will all be a product of my genetic and memetic history in a given environment, not of some separate self that can ‘have’ a life purpose and overrule the memes that make it up. ..there is no room for anyone or anything to jump into the evolutionary process and stop it, direct it, or do anything to it. ..and no one watching. ..how can ‘I’ live as though I do not exist, and who would be choosing to do so? ..concentrate on the present moment - all the time - letting go of any thoughts that come up. ..kind of ‘meme weeding’ ..in any moment there is no observable self. ..Ideas will come up but these are all past- and future-orientated; so let them go, come back to the present. Just notice what is happening. ..pay attention to everything equally. ..attention is always being manipulated by things outside yourself rather than controlled by you. ..and created you. ..there is no distinction between myself and the things happening. It is only when ‘I’ want something, respond to something, believe something, decide to do something, that ‘I’ suddenly appear. ..‘I’ in the middle - me in charge, me responsible, me suffering. ..Learning to pay attention to everything equally stops self-related memes from grabbing the attention ..waking from the meme dream. ..accept that the selection of genes and memes will determine the action ..just get out of the way and allow decisions to make themselves. ..it is odd to observe that actions happen whether or not ‘I’ will them. A great sense of freedom to let so many decisions alone. You do not have to try to do anything or agonise about any decision. ..letting the false self get out of the way, and the decisions make themselves ..the whole process seems to do itself. ..hope and desire are based on the idea of an inner self who must be kept happy ..meet them all with a refusal to get involved ..life really is possible without hope. ..people become more decisive rather than less. ..the selfplex ..it is there for the propagation of the memes that make it up. Its demolition allows more spontaneous and appropriate action. Clever thinking brains, installed with plenty of memes, are quite capable of making sound decisions without a selfplex messing them up. ..you stop inflicting your own desires on the world around you and on the people you meet. ..giving up the illusion of a self in control. ..guilt, shame, embarrassment, self-doubt, and fear of failure ebb away and I become, contrary to expectation, a better neighbour. ..When there is no selfplex, there is no concern about the future of my inner self - whether people like me or whether I did the right thing or not ..free to notice other people more. ..easy to see what another person needs, or how to act in a given situation, ..stopping all the harm we normally do, ..there is no one to rebel.’

..the question of course was; how does cultural and social evolution work?

2023 - time moves on and I no longer carry a physical copy but a digital one on my mobile device, now even more simplified and arguably even more of a distortion of Sue's original!

Sex and mental health

The character and diversity of sexual relationships found amongst people in the mental health industry are much the same as in the wider world. This should surprise no one. Just as people often meet their future partners in the workplace, some relationships of enduring emotional and or sexual attachment have always existed - and will always exist - between clients, staff and carers.

However, even more than the neglect of client’s spiritual needs, mental health workers make no attempt to routinely address the problems their clients have in the conduct of sexual relationships. If you have had a useful and productive talk with a mental health worker about sexual concerns, then you are the exception. Most workers have a set of priorities for clients that place addressing sexual needs at the end of a very long list. Yet if the objective is to promote positive change; well, what does most to boost your self-confidence? What is one of the key motivations in life?

Much of what follows is obvious, but needs to be spelt-out, for one should never underestimate the capacity of mental health services to take the commonplace and complicate it with the dead-hand of specialist trainers, rules of ‘best practice’, and endless committees obstructing by arguing about appropriateness. I made the assumption many decades ago that when it came to the treatment of mental distress, I would come across those people with the best communication skills - how innocent of me!

(I’m reminded of the old story of the sociologist who wants to study prostitution spending years raising a grant of tens of thousands of pounds, hiring assistants to find and survey a random sample - when all he needed to do was take a train to the city of his choice, go to the first taxi on the rank, and tell the cabbie to drive him around for an hour. He might not even have had to ‘frame a question’ at all!)

The central problem for most clients is that they do not see successful personal and sexual relationships around them in their everyday lives - they have nothing to learn from, to model or imitate. Even the conversational conventions between men and women, whether partners or not, are often unobserved because clients spend so little time in ordinary social spaces. Equally within organised activities provided by mental health services, it is very rare to find a couple working together.

A person in mental distress is pre-occupied with self, and needs to let go of that a little before the reciprocity required in normal relationships can be ‘seen’. Equally they often don’t understand how relationships have to be made and negotiated, how giving your partner what they want, will get you what you want. Users of services often believe that ‘romance’ happens by chance and then proceeds in some automatic or natural way. They don’t know how much there is to learn and to practice in order to acquire social and physical skill.

Even more than the rest of humanity they have lived vicariously, but without trying to imitate and test, so retain the expectations of Hollywood and the media’s imagined world of celebrity - the dramatic contrasts between idealised romantic love, and varieties of extreme dysfunction. So, whilst it is true to say all clients have experienced the real world as traumatic in some way, often in close relationships, they may at one and the same time have an expectation of ‘more of the same’ coupled with - inevitably - unrealistic expectations of how different and successful the situation of others is. Like everyone else they grew-up believing what they witnessed in childhood was the norm and however well educated now, may still expect the same, sometimes playing-out a self-fulfilling prophecy. But in addition have a profoundly distorted fantasy as to what happiness, fulfilment, contentment or excitement are, or can be.

Most clients who are in the system for many years experience long periods of celibacy punctuated by a series of short, mutually unsatisfactory relationships most of which occur with other clients. As we know, what attracts people are perceived points of similarity, for those who’s social world is so restricted, it is often clients with similar problems who find each other - they share the same strengths, but also the same weaknesses. In such situations little that is new can be learnt - other than how to move in ever decreasing circles.

To achieve any kind of ‘recovery’ requires teaching in the possibilities of intimacy. And opportunities are forever being lost due to the fear and timidity of workers or their managers. A classic example is the so called ‘predatory male’ patient on a hospital ward. Imagine the following scenario. Staff notice a male patient taking a particular interest in a female member of staff; if she is noticeably younger than him and relatively inexperienced, alarm bells will ring. The woman concerned will report that she has noticed his attention because it does not lead to an ordinary two-way interaction, he is overtly interested but stand-offish, not demanding nor conversational, he just always seems to be around, which makes her uneasy. The behaviour is interpreted by staff as inappropriate and as possibly indicative of some covert sexual intent. The action taken is to separate the two people. The male patient then participates less in the activity of the ward, becomes less cooperative or positively hostile. This is seen as confirmation that the staff’s interpretation of the situation was correct and the right decision made.

Wrong. The male patient may well be less cooperative, he’s been rejected again. The staff reaction may well create more extreme behaviour in the future. The male patient looks menacing and predatory because of his incompetence, he’s never had the chance to learn the skills of normal social interaction, how to approach and begin to build an intimate relationship. A major opportunity is lost because the female member of staff is the person he feels most attracted by or attached to - he is motivated by her. In other words, she is the person in the most powerful position to affect change in him! She, whatever her job or status, should be the one to work with him. If the woman is confident enough in her sexuality, then she can enter into a contract with him, which stated crudely would say; you can’t have me, but we can spend a certain number of hours together. We can hang-around so you can get comfortable being around women, and I’ll teach you what a woman like me, wants and expects in a relationship - I’ll show you how to approach a woman like me.

Real outcomes have to be made, and in specific social situations; aggression, violence and abuse arise - like fun, happiness and contentment - as a result of the interaction between people. No one person is ever the sole cause of anything. Just as the way someone is treated in the first few hours of contact with mental health services may set the pattern for years to come, anyone who is trapped or confined by others will, sooner or later lash-out. But equally someone who is confident but non-threatening, can begin the process of change in others.

Eye movements and mental distress

Don’t you just love it when someone’s eye movements tell you what’s going on in the rest of the room and what they feel and think about it?

An outrageous claim? Yes, but only if you claim too much.

We take cues from everywhere, so quickly and usually unconsciously that the world around us seems seamless and our thoughts and feelings seem to come from within ourselves. But of course our mental map is not the territory itself, and whilst we can consciously cope with 40 pieces of information per second, our unconscious can handle 11 million. Our motivation to act and most of our learning comes from others. Facial expressions and tone of voice give us the vast majority of our information about others emotions. Language, spoken and accompanied by hand and other gestures, or written down, gives us all the cognitive stuff. Posture, our distance from others, and the degree of touch - tell us our relationship to another in any one moment. But all this information has to be structured in some way in order for us to navigate in the world, and there the eyes have it.

The eyes constantly make small scanning movements, the brain seamlessly puts the composite picture together so we have the complete illusion rather than the more prosaic view seen down a pair of binoculars. But those kind of eye movements can for most practical purposes be ignored, what concerns us here are two types of eye movements which we make in response to the actions of others - both involuntary and initially unconscious but which we habitually tell ourselves, after the fact, were a deliberate choice that ‘I’ made.

Trust your unconscious, it knows more and better than ‘you’ do. Whatever you are thinking and feeling in any given moment is being cued by something in the environment around you. (Remember, sensory deprivation is the fastest way to create madness!)

So, first your eyes will notice (recognise) something in the environment of others and track it before you are conscious of it. You feel a sudden emotion and may even have time to wonder why, before realising who has walked into the room ‘unnoticed’ by you a few seconds earlier. You may think about something from the past, little realising you are watching it happening to others in the present moment. (Afterwards many people will consciously attribute magical or other-worldly explanations to these real, commonplace, and mundane activities of the unconscious parts of the brain).

When observing others eye movements we can see what they notice, consciously and unconsciously, but those movements are overlaid with a second set which indicate their response to what they have noticed.

And it’s at this point that I must be especially careful about what I write, since people have got into all sorts of trouble by overstating the meaning of such phenomena which have been observed over many thousands of years. The problem is that many have wanted to explain the ‘what’ and ‘why’, rather than stick to questions of ‘how’. For the meaning of these second kind of eye movements, often called ‘eye accessing cues’ are almost entirely context specific, dependant on the how well you actually know the person you’re looking at, and of course how well you know yourself - since you are, by virtue of your very presence, cueing them!

The claim is that once you’ve controlled for eye movements in response to activity in the environment, then other movements will indicate how an individual is responding cognitively and emotional to the action around them - how they are thinking and feeling about you!

Now, what follows is my version, and compared with many others, a mild and tentative version, but it’s what my experience tells me is reasonable to claim. First is the observation that there is a marked tendency for people’s eyes to move in one direction (left or right) when trying to access memories, and in the opposite when constructing a thought - imagining some future action. The second observation has been that eye movements tend to stay either level or rise in an upward direction when thinking (particularly visualising), whilst tending to drop below the horizontal when feeling emotions (as bodily sensations, but also as felt in the sounds of the human voice).

When you combine the two elements you get a tendency to visualise thoughts about the future looking up in one direction and about the past in the other. A tendency to imagine future feelings through constructed internal dialogue when looking down in one direction, and remember emotions through the sounds of others speech when looking down in the opposite direction - both with, or without bodily sensations.

If you are in a normal state, that is not mentally distressed, these processes may be so seamless, unconscious, complete and taken-for-granted that you would wish to question their existence. But then you probably exist very efficiently in the world and are genuinely bewildered by the apparent psychological troubles of others. However if you have experienced periods of intense stress and consequent distress, or been witness to them over an extended period of time, and perhaps empathised with those around you a little too much, then you may have noticed the gap, or window that can open-up. Brief moments in which the very construction of social interaction can be seen and felt. The ‘digitised’ bites of which they are made up. A bit like those classic illusions used when being taught about visual perception, or when tiredness late at night causes you to loose the ability to synchronise the pictures and sounds coming from your TV.

But that’s as far as I go, others have and do claim a lot more - as a simple search of the web will reveal. Needless to say that with a lot of testing and matching with both the content of speech and the universal emotions all sorts of possibilities open-up.

Oh! I almost forget - if you are genuinely left-handed (one of the 10 to 13%) then all the above may be reversed, and happen in the opposite direction to the majority! Incidentally, did you know that it you have a diagnosis of Bipolar you are 3 times more likely to be left-handed than the general population…

A Desired Outcome

What will you feel, see, hear, smell and taste when you have achieved it?

You can bet your life a mental health worker won’t frame the question in such a way, although an NLP practitioner might - that is, what would be the sensory or experiential evidence? Rather your average worker would want some rational, cognitive (rather than emotional), probably written, description of a desired outcome to a well defined problem, which can then be made a measurable target - whether it be on a care plan, a WRAP or as a homework assignment for CBT.

But the real issue however, when trying to help someone in mental distress by asking them to set goals, aims or outcomes, is what I call the ‘future orientation’ problem. The worker is desperate to give hope (the promise of better times to come) and is often relentlessly positive. They ‘see’ the client’s negativity and respond by setting expectations which are too high for the client - today. The client then thinks I cannot possibly achieve that, I could barely get through the door to the appointment. Expectations or future tasks, like the skills and demands of any job, have to be set at just above the person’s current level of functioning. Something that is doable tomorrow!

At 17 (in 1976) I saw the world like Reggie Perrin. In his great speech to the British Fruit Association at Bilberry Hall, Reggie declares:

‘I know that I don’t know and believe in not believing. …Would the sun shine less brightly if there was no purpose in life? Would the nightingale sing less sweetly? Would we love each other less deeply? Man’s the only species neurotic enough to need a purpose in life.’ (David Nobbs 1975 The Fall and Rise of Reginald Perrin)

The problem is that if a mental health worker asks a client outright about their aims and goals they are likely to receive the reply; ‘I don’t have any’, or ‘I don’t know’. For every client I’ve ever met has been preoccupied with the near future - they don’t believe they have a long-term future - and equally have never been able to live ‘in the moment’. It is the potential disasters of the next week and their inability to get out of bed tomorrow which concern them. And with good reason. Mental health has been slow to understand the underlying rationale of positive psychologies. The point being that a normal person sees life a little too positively, with a level of optimism high enough to ride the waves of unpredictable events, but always believing in a brighter future and their ability to influence the outcome. The depressed person (all clients are a little depressed, whatever their diagnosis, due to their isolated situation) is actually more realistic, stares life in the face - is distressed because they see only too clearly. A situation in which the client may see their objective circumstances and limited opportunities more readily than the worker. It is with such basic insights that some experimental psychologists have embarked on ‘happiness’ research - and been blithely ignored by mental health services.

However, a virtue of the ‘define your desired outcome’ approach is that it may allow the brain to better identify anything which might bring you closer to it - opportunities only exist after they’ve first been recognised as opportunities!

Also if you know the who, what, when, how and why - then you can start to rehearse for it. Equally you should be able to identify someone who already has what you want and begin to imitate them. It is certainly easier to move towards something you want, than away from what you don't want (where your attention will inevitably stay on the undesired).

So how does one get around the paralysing belief of not knowing what you want? Easy. Outcomes are invented and if you don’t already have one, you make one up. (The real objective after all is the pay-off that comes from purposeful activity itself). Desired outcomes are just plans and fantasies about the future - conceits, albeit occasionally useful ones. They become useful (potentially real) if you can already see a series of actions you would need to take to bring them closer, rather than needing others to act for you. Is there something you can do tomorrow which will bring the desired outcome closer?

But it all starts to unpack when you consider achievability - or indeed ask yourself, how would I know when I had achieved my outcome? (Hence the question at the beginning of this post). The future is unknowable, you are not in control of the environment of others - now is actually all there is. The effective helper is one who acts today to make it easier for the client to get up tomorrow. The idea of ‘outcomes’ is only useful beyond today if it is flexible enough for a particular outcome to be changed in the light of unpredictable events (which occur often) but in the face of which other people’s response will, from habit, be to try to reproduce today, the world as it was yesterday.

Much better to follow an evolutionary social model of human behaviour as argued for elsewhere on this blog and understand that as social animals our motivation can only come from others. Seek movement and change, be always in the moment, let go of both the past and the future. Travel in the hope of never arriving, allow the brain and body to take you where it pleases. And never for a moment believe that the ‘I’ or ‘me’ of the so-called ‘self ’ is fixed forever. Outcomes? Like the past, the future is just an evolving story we tell yourselves about a person on a journey.

Walking Through Life - how mental distress is caught and taught

As a child you watched how parents or siblings walked and then you began to copy them. So it was with everything else you learnt, as peers and other adults entered your environment. Experience and learning are inseparable. The more you practice existing skills, the more you try to reproduce today, the world as it was yesterday. All learning consists of first imitating (copying or modelling) how others behave, then repeated practice (trial and error) - both mentally and physically - until you gain a skill. All behaviours are habits. And the only way to overcome an unwanted habit is to copy a better one from someone else. We are social animals with a social brain.

At some point you learnt to walk down the street and avoid eye contact with someone (the invitation to normal social interaction), if that became a habit, not just towards those you disliked for a reason, but a practice applied to the whole social world of others you acquired a mental 'illness'. The classic way of avoiding eye contact is to look down and away (a gesture normally reserved for the occasional experience of shame), but if you stare at the pavement for a lifetime - rather than naturally allowing the eyes to return to the horizon giving an automatic upright posture - then you become a physical cripple because of your social isolation.

Another form of isolation is when we look through people, being physically present but mentally somewhere else. But that leaves the person terribly exposed, you can't do two things at once - fantasise and be in the present moment. Very quickly others notice that your speech simply doesn't fit the situation. The so-called 'psychotic' person follows an erratic path and easily becomes disorientated because they are disorganised. Eventually, they too will look down and away.

Sometimes people come to believe that hanging-on to familiar, habitual, well understood, fears will keep them safe, not just from occasional real physical danger, but from other anxieties in everyday living. The desire to be in control too much - causes more isolation from others. But when you make eye contact with others, when you operate your body in the same way as someone else, you begin to have the same kinds of thoughts (though the content may be different). The desire to belong, which is in all of us, is rewarded.

(See previous posts on meditation, and physical therapy for the 'up' side of the story. The acquisition of new social skills and better habits will be discussed in future posts).

Acceptance is the hardest 'skill' to learn

It’s a skill because it doesn’t come naturally.

I once asked a friend of mine who is a senior mental health worker, and almost universally liked by everyone: ‘Isn’t the idea of “unconditional positive regard” totally unrealistic - it implies you can like anyone who walks through the door?’ He then claimed that he did like almost every client. I think he was fooling himself, and what he meant with the benefit of hindsight, was that he came to like almost every client - that the more he understood someone the more he liked them.

Carl Rogers started it when he asserted the possibility of unconditional positive regard towards others, built on the idea of accepting oneself:

‘I find I am more effective when I can listen acceptantly to myself, and can be myself.’ (Roger 1967:17)

‘…the curious paradox is that when I accept myself as I am, then I change.’

‘If I can accept the fact that I am annoyed at or bored with this client or this student, then I am also much more likely to be able to accept his feelings in response.’ (p.18)

‘I have found it highly rewarding when I can accept another person.’ (p.20)

The post-war humanist perspective in psychology lost touch with the biology of the human animal - as indeed did the cognitive revolution that followed it. Anxiety should rise when meeting strangers or outsiders, they are a potential threat, you should be cautiously testing each other. We do have very strong first impressions; it is called intuition, and relies on fast emotional responses - it is what keeps us alive. The only question on first meeting someone is: ‘Do I feel safe with this person?’ So the effective helper knows that they must appear safe and non-threatening, but what if you don‘t feel that? We can all be aggressive and violent, if we need to be. It’s not a matter of accepting people as they are, it’s about creating useful encounters where mutual learning can take place and that depends on establishing a relationship of trust. Sometimes it can happen very fast if there is a mutual liking, if there isn’t then it will never happen.

When asked, people self-report that what makes the best first impression is a sense of ‘warmth’ and ‘competence’ in the other person ( www.scientificamerican.com/article.cfm?id=mixed-impressions ), but I think what they really mean is someone who is non-threatening and can deliver something they need. Because first impressions are emotional responses they have very little to do with what is actually said, more with how it is said and the rest of our non-verbal behaviour. We trust those emotions displayed through facial expression much more than the accepting words.

The client is present because they know there is something wrong with them, whether they state it or not, something that stops them functioning in the social world as they would wish. That is why they are seeking help, they’re not looking for acceptance but action, on the assumption that they are meeting with someone with skills and expertise.

But what of Rogers’ underlying point that accepting oneself and others as we are now, is in some sense a precondition of change? Wrong. The preconditions are self-awareness and a willingness to learn new things! And the speed at which it can be done depends on the rapport between the people involved.

One barrier to rapport (effective communication) is the myth that the helper can be accepting as part of their professional role, setting aside their personal feelings. This is obviously ridiculous because feelings always leak-out through facial expression and tone of voice. This first becomes apparent when a prospective helper is still a student and at some point becomes aware of a conflict between their developing intellectual understanding and their emotional response in a given situation. The trick is integrating the two. If I believe in the knowledge I have acquired then I must live that way, the mistake is thinking that one is work and the other a private concern. The answer comes in two parts, firstly in terms of organisation there has to be proper team working - teams purposefully constructed of different kinds of people with different skills, hence giving the client choice!

Secondly, any kind of therapy is the learning of new social and psychological skills and the helper is the model. Acceptance is the skill of tolerating what we cannot change. Now if either or both, client and worker have it in their heads that the client is suffering an illness for which there is no cure… Even the Recovery approach leaves the medical model in place, telling the client to expect occasional relapse. So often both client and worker set each other up to fail. But if your model is one of adaptation in a particular social environment you have two choices, neither of which require acceptance of anything. Either you change yourself (learn new skills) to fit the environment you find yourself in, or you move on and live in a new environment.

It is a belief in people‘s lack of capacity to change which makes acceptance, so unnatural as it is, such a hard skill to learn - requiring decades of practice by the helper!

(See also my post, The ‘therapeutic relationship’ explained - Jan 2010)

Rogers, C (1967) On Becoming a Person: A Therapist’s View of Psychotherapy (Constable: London)

It's Groundhog Day - again!

Groundhog Day (1993) director Harold Ramis, based on a story by Danny Rubin, staring Bill Murray and Andie MacDowell. Murray plays Phil Connors an egocentric Pittsburgh TV weatherman who, during a hated assignment covering the annual Groundhog Day event in Punxsutawney on the 2nd February, finds himself repeating the same day over and over again…

Over the last ten years or so I’ve got into the habit of re-watching this movie on the 2nd February, it reminds me of what my life has felt like in times past, and could become again, if I get too preoccupied with myself.

It’s one of those movies which leads audiences to endlessly speculate on it’s meaning. Perhaps the dominant view is that it’s about an individual over concerned with ‘self’, leading to unpleasant situations that continually repeat, until he can transcend them and let go - putting other people rather than himself at the centre of his universe. A tale of self-improvement that looks outward, rather than being focused on one’s own need to be ‘in control’. It’s also a hilarious comedy!

Ryan Gilbey writing in The Observer 1.2.04:

‘While Groundhog Day is undeniably charming, it shares a certain stubbornness of purpose with its star. From the moment Rubin typed the first line of his first draft, he resolved to withhold all explanations about how Connors came to be stuck in a time-loop. Co-written and directed by Harry Ramis, the finished film exploits the witty device of a narrative that achieves momentum without moving forward. Rubin refused to surrender the enigma at the movie's core; the absence of narrative exposition remains the most audacious element of Groundhog Day, not to mention one of the most daring ellipses in Hollywood cinema.’

…As well as making its impact on cinema and language, Groundhog Day has exerted a strong influence on religious thinking. Rubin and Ramis continue to receive letters congratulating them on a positive representation of Buddhism. Presumably they file such correspondence alongside similar messages in which the film is claimed by Jesuit priests, rabbis, and followers of the Chinese spiritual movement Falun Dafa, aka Falun Gong. All the letters are characterised by a singleminded belief that the movie endorses the author's faith. 'At first, I would get mail saying, "You must be a Christian, because the movie so beautifully expresses Christian belief,"'Ramis said recently. 'Then rabbis started calling, saying they were preaching the film as their next sermon.'

Roger Ebert writing in the Chicago Sun 30.1.05:

‘Tomorrow and tomorrow and tomorrow, in his case, doesn't creep in at its petty pace from day to day, but gets stuck like a broken record. After the third or fourth day, the enormity of his predicament is forced upon him. He is free to change what he says and does from one Feb. 2 to the next, but it will always be Feb. 2 for everyone else in the world, and he will always start from the same place. They will repeat themselves unless he changes the script, but tomorrow they will have forgotten their new lines and be back to the first draft of Feb. 2.

...One night in a bowling alley, sitting at the bar, he says almost to himself: “What would you do if you were stuck in one place, and everything that you did was the same, and nothing mattered?” The sad sack next to him at the bar overhears him and answers: “That about sums it up for me.” Slowly, inexpertly, Phil begins to learn from his trial runs through Feb. 2'.

Motivation and acting 'as if'

'Evolutionary theorists argue that social intelligence was the primordial talent of the human brain, reflected in our outsize cortex, and that what we now think of as “intelligence” piggybacked on neural systems used for getting along in a complex group' (Goleman 2007:334).

Given the social model I’ve been pursuing on this blog, then in what sense can an individual act purposefully and ‘make something happen’? Fulfil a fantasy about an imagined future - a ‘desired outcome’? Change and adaptation provokes anxiety for anyone who has become isolated. But to find a different way of being in the world requires getting back into some form of social involvement, navigating and negotiating a way back into public spaces in order to gain acceptance from others, some mutuality and sense of social belonging despite the overt and covert negative messages that come from society at large. And in what has become an unknown environment you have no choice but to jump in at the deep end, and act ‘as if’ you already have a competence you don’t yet feel. Once in a new environment however, motivated by others who have become important to you, you can begin to acquire new skills in living, by taking risks and acting as if you were already the person others desire you to be.

People like mysteries and not the idea that psychological abilities can be learnt as a set of skills. But the mastery of a skill brings joy, flow or happiness. That loss of self-consciousness first experienced in childhood play. Improvisation is innovation in one’s own behaviour. The traditional ‘four stages of competence’ learning model on the psychological states associated with the acquisition of skill (the origins of which are unknown) can be adapted for self-awareness in general. Unconscious incompetence (I don’t know, what I don’t know), conscious incompetence (I know I don’t know, but can’t do), conscious competence (I know, I can do, but others can see I’ve not mastered the skill) and unconscious competence (I and others take my competence for granted).

I learnt how to be crazy from imitating the psychologically troubled and becoming progressively isolated from the mental healthy - and I learnt to be sane through others ‘taking me by the hand’ and placing me in new social environments where I was forced to act in novel ways, and realise the way to mental wellbeing is to imitate the mental healthy.

Goleman, D (2007) Social Intelligence: The New Science of Human Relationships Arrow: London

My first time as a 'peer supporter'

...Earlier in the year I had moved into a flat of my own. It was located in a multi-ethnic, working class area of the city. I set about the process of applying for nurse training. I discovered that if I could get accepted there were two hospitals within reasonable distance which had an intake the following May. I thought about doing some voluntary work in the meantime. It turned out that there was a day-centre for the mentally ill within ten minutes walk, I offered my services.

You can’t imagine a grimmer place to live, the centre was in the middle of a concrete shopping centre surrounded by high-rise residential tower blocks, but located underneath the concrete ‘piazza’ style shopping area. The entrance to the day centre itself was through what should have been the fire exit. (The main entrance was the ‘front office’ of the charity which ran it). The centre had just over thirty regular attendees, about half of whom lived in residential units supervised by the charity. It was a ‘social maintenance’ centre for ‘chronically mentally ill clients’ who had become ‘socially impaired’. My first challenge was to get to grips with the language.

In the vernacular of the centre, people were not ‘mentally ill’ they had ‘mental health problems’. They were not patients but either ‘clients’ or ‘service users’. In practice the users were ex-psychiatric patients who had spent long periods in hospital, been to various degrees institutionalised, and were now trying to live something like a stable existence ‘in the community’. There were three staff; a psychology graduate, a social worker and an art therapist. They were anxious to provide a safe and stable environment, but worried about recreating the kind of dependence that clients had developed in hospital.

Early on, I think the manager must have asked me to write down what I saw as my role as volunteer, for I found the following rough draft in my file:

‘1/ Objectives; a) help users/clients to help themselves, cope with
day to day problems, greater independence in the community. b) participate as a member of staff in promoting user-led service.
2/ How?; being there for clients, befriending, listening, providing information and practical assistance.
3/ Problems; clients reluctance to take responsibility, lack of motivation, confidence, dependence.
4/ Tasking problems; being with them and participating in their attempts to undertake new tasks.’
The document is not dated but must have been from the end of 1989. I was a volunteer there for six months. It feels strange reading it now, for since then, over the last twenty years several people have provided exactly the same service for me!

Strictly speaking it was not a ‘drop-in’ centre, but it felt like one. There were the constant changing faces of clients and their friends. Undoubtedly the atmosphere was dominated by the oldest client, he must have been approaching seventy, had been in hospital for many years, been diagnosed with paranoid schizophrenia, but now refused all medication, and was very thin. He was such a presence because he never stopped moving, mostly pacing up and down, sitting only for a minute or two at a time and even then swinging his legs rhythmically. Often, though the centre didn’t open to clients till ten in the morning, he would be pacing outside by nine when the staff arrived. Every day he walked six miles to and from his room in a ‘bed and breakfast’ that took DHSS clients. He appeared to ‘hear voices’ constantly and would mumble, or occasionally shout back at them. He looked mad, (sorry, ‘damaged’) and knew others thought he was. When he had to move, one of the staff helped out and said his entire possessions only filled two black bin bags. The centre was a kind of sanctuary for him, he was the first to arrive and the last to leave. He was at one and the same time a pathetic example of neglect, and a monument to endurance and the determination to survive.

The guy I came to know best lived down the street from me and had also been labelled a paranoid schizophrenic, but was very different. About thirty-five, very outward going and sociable. He took medication but was often drowsy in the mornings and a little overweight. I asked him many months later when I was a nursing student, (and had an essay to write on: ‘Is mental health a valid concept?’) ‘What does mental health mean to you?’ He replied; ‘…being in control…having my own thoughts, no alien thoughts’. His mental condition had become obvious to himself and others when he was in prison, but he had been lucky enough to serve the last six months of his sentence in a regional secure unit, a small scale unit for offenders with mental health problems. It was while we were sitting drinking coffee in my flat one day that I witnessed for the first time someone rapidly becoming psychotic, and then just as rapidly normal again. I must have inadvertently ‘cued’ him, for half way through a sentence he interrupted me and began speaking much faster in the voice of an evangelical preacher about his own sins and those of others. The contrast with his normal voice was striking, not just the speed, but volume, passion and incoherence. I thought for a moment, realised what had set him off, then choosing my moment said something about the topic we’d been discussing much earlier. Just as easily he came back to normal speech quite unselfconsciously. I’m afraid my curiosity and enquiring mind got the better of me. I deliberately cued him again, then brought him back as quickly as I could. That satisfied me, anymore would have seemed unethical…

…One of the activities open to clients was to attend the ‘health shop’ run by the local health authority and take part in the ‘stress clinic’. This was a course run by a young man who was later to become well known for developing ‘laughter therapy’ in Britain, based on the Indian practice of a group of people going to piece of open ground in the early morning or evening and deliberately making themselves laugh together for a while. One of the exercises in the stress clinic was to write one’s own ‘obituary’ and part of my attempt survives; it’s a bit embarrassing really, but perhaps it illustrates how I was thinking at the time:

‘Nick Hewling died this week at his farm in Provence aged seventy-four, where he spent the last twenty years of his life cultivating his vineyard and promoting his own wine. He moved to France after a distinguished career in the National Health Service, first as a psychiatric nurse and lecturer, then as a psychotherapist. However he will probably be best remembered for his best selling books on mental health. Although widely respected as an innovator in psychiatric care, he didn’t enter the profession until his early thirties, previously he had been… Later he was a professor at the University of … He leaves a widow and two children.’

Also I find a copy of a ‘life events’ stress questionnaire, where you mark up and score stressful events from the previous two years. (This was early 1990). Low stress started at one, fifty being the average or medium(?) and one hundred being high stress - I scored one hundred and five! (I think it must have been some sort of ‘adaptation’ of the Holmes-Rahe Life Stress Inventory). The facilitator also tried getting us to use what he called ‘stress meters’ to monitor our levels throughout sessions (as in Galvanic skin response, polygraph etc.), but with us monitoring ourselves - as the needle swung back and forth one quickly became anxious about what was making one anxious!...

Psychological Skill

Psychology is best understood as a set of physical skills. Now I suspect that sentence will seem odd to most readers, but a small minority will be thinking, ‘tell me something I don’t know!’

Unfortunately as my writing gets better, along with my confidence in understanding our social world, there seems to be an ever greater risk of losing what modest readership I already have. Perhaps one should just practice psychological skills, rather than try to write about them.

You see the problem is, there is this strange phenomenon of people liking mysteries and not wanting them explained. A lot of modern magicians have experimented with building explanation into their acts, but have sooner or later hit a wall - and it‘s not just a need to maintain trade secrets in order to earn a living. People want to be amazed, in awe of, and frightened (up to a point). In the world of mental health it often appears that someone in distress, does not want, nor responds to, either explicit explanation of their difficulties, or to training in techniques to relieve them. It’s even got to the point in our individualistic society where many will argue that there are no universal ways of understanding or helping - apart from the mysterious ‘love conquers all’! And the more knowledgeable person certainly doesn’t want to end up suffering the emotional isolation of what I call Sherlock Holmes Syndrome - of going to the trouble to explain (about inductive and deductive reasoning, how he built-up his library, apprenticed himself to learn about such things as horses and dogs, the logic of railway operations and timetabling, etc, etc) only for Watson to call it all inborn ‘talent’ and ‘genius‘, the police to call it ‘luck‘, and the public ‘…well when you put it like Mr Holmes, I can see it really is so simple anyone could…’ It was others who set him apart. People fear something is lost in explanation when in fact the reverse is true - it only adds to the wonder of the world.

But there is a more fundamental problem about explanation, learning and skill. For those of us who did not learn our social skills unconsciously and naturally in early childhood, it is a cause of fascination to watch the socially skilled finding themselves quite incapable of describing what they do so self-evidently well! Conversely it is alarming to watch one’s own continuing incompetence at the same time as knowing exactly what one is doing wrong. The old truism that those who find a subject or skill difficult to learn make the best teachers, often holds-up. Now we are into the domain of tacit knowledge, the knowledge and skills we know others have, know to be vital to much social interaction, whether work or leisure, which have proved impossible to write about or codify in other ways?

There is a huge body of knowledge (useful or otherwise, effective or harmful) that one knows is learnt, over long periods of time, possibly quite unconsciously, when alongside the most experienced of practitioners. You know they have ‘it’, that’s why you place yourself alongside them; they know they have ‘it’ but can’t articulate it to you.

Consider the following. The range of human emotions are universal and so is the way they are expressed. Human emotion is communicated through facial expression and tone of voice. (Whilst thoughts are communicated through the content of speech and hand gestures). There is relatively little individual variation. Emotion is felt as your facial muscles react to what you see or hear in the other person. Emotion comes first, thoughts follow.

Some of you will be thinking ‘well that’s bleedin’ obvious’, for others it may be a ‘bolt from the blue’.

I don’t do empathy (the ability to feel what others feel). At least not very well, and not most of the time. I didn’t learn that basic human skill in early life, which most people acquire so un-self-consciously that they don’t even name it. It’s not a ‘learning disability’ - I have the capacity, it simply became blocked. Hence my adult life has been one long painful process of mechanically acquiring the skill. And I’m not fluent in it - others can see the joins, often become fearful of me, and turn away. (Doing one of Paul Ekman’s tests I correctly guessed only 3 out of the 8 universal emotional expressions - and that was with 30 seconds to think about it!)

As for a ‘theory of mind’ (knowing how others think) well, a long time ago when I was a patient on a ward a student nurse demonstrated a few NLP basics, such as the reasoning behind ‘eye accessing cues’ - you see I’m profoundly left-handed, I’ll move anti-clockwise when 90% of the population are moving clockwise.

Twenty wasted years in the psychiatric system. Being diagnosed with depression, schizoid affective disorder and manic depression - actual taught me nothing. They only described, rather inaccurately, how my limbic system reacted to such dodgy data!

Psychiatry, clinical psychology and mental health nursing don’t know they are stuck at the end of a cul de sac - ramming each other out of road rage, whilst the rest of the world passes on the main road. Paul Ekman’s Facial Action Coding System has been available since 1978 but I know of no mental health worker who has ever learnt it. And of course any part of NLP has been thought ‘beyond the pale’ for the last twenty years.

There is much that is not mysterious. Simple laws can lead to massive complexity. Complexity does not mean something is necessarily complicated to understand. Darwin taught us that 150 years ago - he also guessed right about facial expressions!

Meditation techniques for mental health

Meditation is about being more physically relaxed at the same time as gaining greater mental awareness - throughout the day and with your eyes open! It’s about being in the present moment and therefore more grounded in reality. Despite the rather naive acceptance by some psychiatric authorities of mystical claims about ‘altered states of consciousness’; misunderstanding over an apparent connection with trance, dream like states and psychosis; and the timid approval by the NHS of just one aspect of meditation known as Mindfulness (sometimes referred to as ‘kitchen-sink meditation’) - it is, once stripped of its religious elements, the most important tool I have against madness. It’s the best anti-psychotic there is.

Untangling the myth however is not easy, you need to ‘suspend your disbelief’ and consider for a moment that the meditator is more in touch with reality than you are. You may imagine someone on a mountainside, eyes closed in the lotus position, but the real practitioners may be passing you in the street unnoticed - they blend into the social landscape because they are in the here and now, whilst you are preoccupied with your own thoughts. Your conscious thoughts can only be about the past or future, in the present you only have your senses with which to literally ‘feel’ your way around. Realise your emotions come from the data your senses are giving you now - then you’ll have it! It’s a shock, like waking up from a dream, you are back in the real world for the first time since - when? Suddenly self-consciousness, anxiety and fear can be put to their proper use; of spotting the occasional occurrence of real danger. You can get back to the proper use of your time, finding activities that match your skills and can become absorbed in, achieving some degree of ‘flow’, that sense of happiness that comes from the loss of self-consciousness - something we all felt in childhood play.

The first ‘pay off’ from meditation is the awareness of where you feel fear in your body, what in the environment has triggered or cued your brain to remember some past unpleasant association. It may be an unwelcome series of sensations to begin with, but it soon becomes a useful revelation. This is followed by learning to let go of unwanted thoughts and feelings about the past and future. In the process you can stare life in the face - as it is now.

One of the things meditation tackles well is our ‘illusion of self-control’. We like to think we are consciously in control of ourselves all the time. We distrust our basic, spontaneous impulsive actions. We must be constantly choosing all the time as free independent individuals. As a result we have become acutely self-conscious. Yet there is only so much we can keep at the forefront of our minds at any one time. We come to consider it a failure or lapse in our own standards when we inevitably end up following the impulses of biology, and the learning we unconsciously achieved earlier in our lives. Meditation, by placing us back in the present moment and allowing us to feel what cues us, what stimulates our senses, shows us just how unnecessary the time and trouble we spent on worrying about decisions really was. Decisions are all about an unpredictable future over which we can exert little control. However, we can learn to trust our own brains to get on with it, become grounded in the environment of the present, reconnected to the social world of others, and just be.

Objectives

- to concentrate on the present moment all the time; let go of any thoughts that come up (knowing they can only be about the past or future), know too that in any one moment there is no observable ‘self’; to notice what is happening (not a series of events but continuous change), to pay equal attention to all that can be seen and therefore know what habitually cues you to feel or respond in a particular way (your attention, reactions, emotions, and the ‘story’ you tell yourself about who you are) - and so ultimately realise that it is the actions of others that is creating you.

- to understand that the ‘I’ or ‘me’ that appears when you want something is an obstacle to your sense of wellbeing; to allow decisions to make themselves (unconsciously) since the conscious self is not in control and actions happen whether or not you will them - sense the freedom that comes from knowing you don’t have to try to do anything!

- to refuse to get involved in desires and hopes (about an unknowable future), to know that it is quite possible to live without hope (now is all there is), that in the world of the present you can stop inflicting your desires on others, stop the harm we often do and be able to notice others more.

Finding A Focus

At the core of meditation is the ability to focus on something; whether it be within the body, an external object or a mental image. Focus is not concentration as such, but a fixed point of reference, something you always come back to. A fixed point, baseline or benchmark from which you can navigate your mental interpretation of the physical world. Physical relaxation must come first and the easiest way in is to focus on the breath - not control it, just ‘watch’ it. Once relaxed you can begin to focus away from yourself towards the environment you find yourself in. In a natural environment it makes sense to let your gaze rest on the horizon and make that your focus. Whether we like it or not our attention will be constantly distracted by whatever our senses pick up from the environment and the internal thoughts and feelings prompted by those cues. The ‘trick’ is to always come back to the focus, again and again. You acknowledge the thought or perception, and let it go in the act of always returning to the focus. When truly focused, for however shorter time that may be, you think of nothing else. However the choice of focus at any one time does need to be something that holds your interest - something you enjoy exploring. Good focusing is a joy, as you begin to learn to let go you can start to recapture that childhood sensing and feeling, which never required conscious thought and has a fascination all of it’s own.

Balance

There is however a need to create a balance, between physical relaxation (too much of which leads to sleep) and greater mental awareness (which if not matched with the right degree of relaxation, may provoke a degree of anxiety about ‘what’s going on’ and increase self-consciousness). Stress is not an external force, but occurs within the body, our attention is usually directed outwards so we don’t recognise it in our bodies. In the process of physically relaxing we can identify stress and let it go; so our increasing awareness becomes a tool with which to see the world rather than a product of anxiety that may cause us to turn away.

Relaxation

If the first requirement is physical relaxation, and that is dependant on focused breathing, then an unrestricted diaphragm is a precondition of meditation - it is not the choice of posture itself that matters, but how you hold yourself in it. You can meditate whilst sitting, lying down or walking. The breath naturally changes throughout the day and from minute to minute, if you can learn to watch it and not seek to control it, you notice how it automatically adjusts itself. After meditating for a while you realise it was your conscious attempts to control it that caused the problems in the first place. Unrestricted breathing then allows you to ‘listen’ to the body. Normally when we relax our minds have a tendency to wander, to fantasise or free associate, leading to sleep. Meditation usually has the opposite intention, beginning with the kind of self-knowledge that arises from a greater awareness of the body. You can literally feel mental stress as physical pain - as you begin to relax. Much mental distress is a shutting-off of awareness, of stopping feeling. Becoming more aware of the body begins to put you back in ‘touch’! Much of the tension in our bodies is an attempt to suppress unacceptable emotional responses. The technique known as a ‘body scan’ starts with an awareness of the breath, followed by deliberately focusing bit by bit on every area of the body, identifying tension, gently flexing the muscles, at the same time as noticing the thoughts and feelings that arise. And in the act of physically letting go, it’s a shock to realise just how much mental preoccupation seems to float away. Fear, anger, sorrow and desire all disappear when we are truly relaxed.

Meditating for sleep is different, with the eyes closed you may wish to initially focus on the breath, and body scan. But you shouldn’t seek greater awareness nor be tempted to move on and fantasise in a controlled, ‘story making’ way. Rather think of how dreams are when you’re asleep - less coherent, more a free association of thoughts. One technique is to explore a single visual image rather than imaging a movie.

The link between mental and physical relaxation becomes obvious when you see what great physical performers can do, and realise they could never do what they do unless they were relaxed in a holistic sense. But an even greater revelation comes when you see and hear those same people interviewed! If you want exemplary examples of ‘mental health’ look to the great dancers.

Awareness

Many people equate being alert with conscious thinking. But we can only be conscious of a very small amount of the brain’s activity at any one time and much of it we are never aware of. And we don’t need to be. What is useful is to educate ourselves from time to time about those things that habitually cue us to behave in a certain way. Not so much in order to change, but to stop ‘beating ourselves up’ over those things we have consciously decided should not be part of our self, our ‘I’ or ‘me’. Indeed with a lot of practice you can have consciousness, but no consciousness of self - just awareness!

Mindfulness is a basic technique to help you move from motionless meditation at an allotted time, to incorporating it into what should be continuous movement throughout the day. It’s about focusing on, and paying close attention to the detail of what we are doing in any given moment. Being very aware of the sights, sounds, smells, tastes and textures of the moment, becoming awake and tranquil by focusing intently on minute details. (There are obvious parallels here with being absorbed in the physical practice of a skill, but without the prescribed outcome). When eating just eat, when walking just walk. Walking is a good way to face each day a fresh, when you walk you ‘own’ nothing, you’re in constant movement and there is nothing but change around you, it feels natural to be nomadic - or it should do!

Mentally letting go again and again, brings greater awareness in the hear and now. It is the greatest reward of meditation to be suddenly flooded with insight, an intense feeling or a change of mood. To wonder where it came from, stop, look around, and then be amazed a second time to realise what cued that change. Understanding, and acceptance, of how things just are - in the same moment. And then to let go again. To borrow from Wordsworth: ‘Surprised by joy - impatient as the Wind …’. You lose nothing by letting go of good, as well as bad thoughts and feelings, because as you change, the ones that are useful and real will come back time and time again. Equally tranquillity comes not from changing the world, but from allowing the moments of emotional pain to die a natural death. Sometimes we don’t want to let go of our worries and fantasies, the conflicts that preoccupy us, they become part of our identity and maintain the world as it is, giving the illusion of self-control - the feeling that we can predict the future. But if we can be relaxed and aware in the present, all that falls away - we forget what used to preoccupy us.

When out and about the focus may switch from the breath to a visual object, a fixed point for navigation, but equally there is visualisation, an imagined image for still periods, usually with the eyes closed. But then there are transition states too, for example, ‘body asleep, mind awake’ which can have a better quality than sleep alone. You gain the benefit of an asleep body, but the mind, rather than having the chaos and illogical thoughts of dreaming, stays clear and focused.

And there are the times when it doesn’t matter if what we are sensing, tasting, touching with our bodies is pleasant or not! You just don’t feel the need to explain, understand, or solve, but simply watch and feel - then the realisation of the ‘right thing to do’ will occur at the time when it is appropriate to act. If we are open to the world, not preoccupied with ourselves, then our instinctive responses (which we have been taught to mistrust or contain) will fit the facts and we just feel the appropriate response in a given situation.

To Be More ‘Grounded’

Once grounded, we change and move on automatically. A connectedness to the physical world around us should be our moment to moment preoccupation. We cannot see others in our environment as they are, without it. When we are not preoccupied with ourselves, then we can see the needs of others. And it is in this state that we can approach an understanding of what may be the true basis of what is called spirituality or religious experience. Making others, and or, other things, rather than oneself, the central focus of our lives, allowing transcendent experiences - going beyond our usually limited perception of others. But it is equally valid to assert that in the past there must have been a time when we were all very effective at meditation. That in some sense it must be a natural state, for it is hard to imagine our hunter-gatherer ancestors being able to survive without such skills. Think of hunting, of long hours on one’s feet, of the constant gentle movements needed to pick up a trail, to track and stalk, feel movement in the air, the physical coordination, the ability to navigate, feel the sudden stress of real danger, but be able to let go when it passes, the need for so much stillness, and the quick flowing response. And afterwards, to squat for a while under a tree, to be within the only real temple there is - not enclosed by the buttressing of the branches, but open to the vaulting of the sky beyond. Later, the making of fire - the focus of community and collective narrative.

'To see a world in a grain of sand
And a heaven in a wild flower
Hold infinity in the palm of your hand
And eternity in an hour.'
William Blake 1757-1827: ‘Auguries of Innocence’ (c.1803)

That might well serve as a description of the potential of meditation and truly being in the moment. And Blake of course, experienced visual hallucinations from early childhood onwards. Meditation is a discipline that takes time and effort; though the more competent one becomes the more effortless it feels! Nonetheless like any set of skills, if you don’t practice then you lose them. It’s often when you feel at your lousiest, and have to ‘try’ the hardest that the most rewarding meditations follow. It is not unusual to suddenly feel worse as you relax and become more aware - you realise what’s been going on! This is the crucial moment to learn to continue meditating and not turn away - it is when the benefits really begin. At its best meditation gives a series of ongoing, ever deepening natural ‘highs’ based solely on increasing awareness of the fascination of the world around you. But don’t become a ‘bliss junkie’; stuck in a particular form of meditation, confined by time, place and routine or ritual - with a fixed set of beliefs about what is happening to you and your state of mind, seeking a continuous high, but effectively isolated from the rest of the world.

Meditation offers greater enjoyment of the sense world, deeper more varied emotional experiences and a sense of there being enough time. It feels like life with the ‘blinkers’ off, of a mental fog having lifted, in which we no longer fantasise - but then you catch yourself losing the focus again! But that’s as it should be, when navigating your way around a world of continuous change. Scientists and researchers in search of an ‘evidence base’ for meditation may object that whilst you can demonstrate a link with physical relaxation, the idea of greater mental awareness is not amenable to experimentation. Perhaps they are looking in the wrong place. I would wish to argue that it is the heightened awareness that comes with sudden stress or anxiety, and which to some extent has been measured, which through the discipline of meditation, is being harnessed by an individual who nonetheless remains physically relaxed.
　
Catch Tomorrow Now
　
Can you stop?
Let go of thoughts and feelings
Of the past and future
And just be in the present moment.
Now is all there is.
Reattach your emotions to your senses
In the real physical world of the present.
Notice what cues your thoughts now
Acknowledge them and let them go
Good or bad.
Allow yourself to feel the bad when it happens
Then it passes quickly.
Allow yourself to be ‘surprised by joy’
And let go those feelings too.
Knowing they will return unbidden.
Think of yourself as having no fixed self.
Able to construct a self anew every day
Attentive to others, unconcern for an ‘I’ or a ‘me’.
Aware of the others who make you what you are.
You learn most by imitation.
You only remain fixed
When you remake yourself today
As you were yesterday.
You imagine the past must persist into the future
But only because you reproduce it afresh everyday.
Don’t look forward or back, but around.
Seek to be more relaxed and aware.
Absorb what’s around you
And catch tomorrow now!
　
The Rules
　
Can you stop?
Let go of the past and future - again and again
Be in the present moment
Pay equal attention to everything
Notice in the moment what cues your thoughts and emotions
Now is all there is
Let decisions make themselves
Refuse to get involved in hopes and expectations
Physically relax yourself continuously
Always have a focus

Catch Tomorrow Now - part 2

Can you replace your assumptions about others,
With curiosity and fascination?
And can you unlearn as you let go?
Your routines should be made to work for you,
Habits should be unconscious,
Leaving you free to notice other things.
There is no such thing as a mistake, only new learning.
And the meaning of any communication,
Is always the message received.
Every thought comes with an emotion attached
And rationalising is just a way,
Of putting emotions on hold!
Experiences just make you feel good or bad,
Meanings become attached afterwards;
And meanings never started anything!
Motivation for action can only come,
From an emotional attachment to others.
But it’s a misplaced fear of others,
That is the consequence of mental disorder!