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…

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)

Minimum Qualifications (for helpers and supporters)

If I feel I need help.

If I can ask for help.

If I can lift the phone.

If I can open my door to you, or get through your door, or meet you in a public place.

Then

Can I feel safe with you?

Can I talk to you?

Are there words to describe my feelings and thoughts?

Can you see how I feel?

Can I trust you (does what you say, match the way you act)?

Can you show some understanding?

Can you do something today, that will allow me to act tomorrow (hope)?

Are we both in the present moment?

The 'therapeutic relationship' explained

...or rather, how it comes about that often the relationships between mental health workers and their clients aren’t beneficial to either party.

We become clients of mental health services because we find it impossible to maintain happy social relationships - we may never have experienced them, or experienced trauma when they breakdown, or had difficulties in making new ones.

We then enter a system of care which doesn’t offer us ordinary relationships, or training in how to conduct and maintain them, but instead involves a form of social interaction based on the worker playing out two roles; that of bureaucrat on the one hand, and counsellor on the other.

Firstly, there is always the aspect of a ‘paid friendship’, so you can never be sure of the genuineness of the worker, their feelings about you are always hidden to a greater or lesser extent. They are not choosing to be with us. What are we to conclude when we see a mismatch between what they say and what they display non-verbally? They are of course observing the same in us, but usually concluding it’s an aspect of our character, rather than a reflection of their behaviour!

If the relationship should turn out to be a good one it is quickly terminated by the worker; if it is less successful it may persist for decades.

We usually meet them at a time and place of their choosing, often in a specially designated building isolated from normal social life. This is presented as an aspect of confidentiality and freedom to disclose. However, whilst the location often feels familiar and safe to the worker, for us it may be quite the opposite.

Given the isolating nature of mental distress, and the fact that the worker has many other clients, they are almost always (for good or bad) more important in our lives than we are in their's.

They assess us, and even if they accept our conception of our problems, even if we are able to assert our rights and entitlements, they remain the gatekeepers to care. We are promised confidentiality, but also told that when they deem it necessary they will consult others.

We are told the encounter is our space, ours to control or direct. Yet because they do not self-disclose - we are expected to talk about the most intimate, and therefore most difficult to articulate, aspects of our lives to someone who always remains a stranger.

Since the assumption is that we are the ones who bring our problems to the encounter, what is actually happening in the room is either ignored or grossly misinterpreted because of an unconsidered factor - what years of meeting everyday with a variety of people in mental distress has done to the health and perceptions of the worker! (Remember, they get their supervision from even more experienced workers).

Normal, healthy encounters are as follows. We meet as strangers, often have strong first impressions of like or dislike, intuitions of threat or safety (which we ought to follow, leaving immediately if necessary). It is only after some time that we reveal confidences, when some trust has been established based on both parties willingness to mirror and match the other with minor disclosures about themselves. Equality and reciprocity are built-in to normal social encounters. We are attracted by points of similarity between ourselves and the other person. Friendship may or may not follow. If it does, then it becomes appropriate to give advice or instruct. You earn the right to say - ‘don’t do that, I know what happened last time, even if you have forgotten’. When on the receiving end, you may not like what is being said, but by now you have undeniable evidence that the person cares about your wellbeing. And of course, all this time you have been meeting at a time and place negotiated between yourselves.

So how can these abnormal encounters with workers actually improve practical opportunities for more and better social interaction in the real world? You walk away from a meeting with a mental health professional and within a few hours, like all encounters, you remember little of what was said rather the atmosphere that was created. We leave with a feeling of whether it was a good or bad experience. But we should go further and ask ourselves, have I learnt something practical today which will make it easier to get up tomorrow?

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!

Psychiatrists - they don't know, they don't know!

Encounters with mental health workers still tend to take place in locations and contexts of their choosing. They see us when we are unwell, with the tacit agreement that we will talk about what distresses us and find difficult to articulate - not about those areas of our lives where we have demonstrable skills and competences. Even at the height of a crises they are alongside us for at most an hour out of every twenty-four. But as a peer, I may have been talking to the client before they meet with a worker, and again later in the day, know more about that person’s daily life than the worker, and sometimes find myself intentionally trying to undo their work. The ‘trap of the consulting room’ can lead the worker to imagine their training, delivered in a controlled environment, allows them to see client’s problems clearly, and their therapeutic responses as having an impact quite out of proportion with reality. Equally there is the assumption that the motivation to act, in a routine or novel way, is intrinsic to the individual. But the uncomfortable fact is that it is the behaviour of the worker when interacting with the client, rather than the prescribed model or approach pursued, which will or will not, lead to a rapport that may allow a positive outcome for the few weeks or months the relationship lasts.

The mental health professional works only with that part of the client’s ‘personal story’ they feel able to share with this relative stranger, who in their turn is even less inclined to ‘self-disclose’, adding to the existing power imbalance. The imagined ‘client centred-ness’ of their approach may well leave the service user ready to act on a specific issue - the previewed mental health problem - only to find its implementation leaves them exposed to a cascade of social consequences, requiring many more changes than either they or the worker have begun to contemplate. The individualism in nearly all approaches to mental health ignores our social nature and emphasises cognitive tools rather than the emotional foundations of human action. But when a form of counselling works, it is because the client has come to know and trust the worker enough to find their advice credible (and it is a process of advocacy about better ways to live) based on the degree to which the worker embodies what they assert. The client then acts as much for the worker as for themselves. The only problem is the worker is about to ‘ditch them’ - not because the relationship was a failure, but because it was a success!

Despite being involved in Involvement (participating in the giving of feedback to services, and the training of staff) for the last four years or so, it was only six months ago that myself and others got an opportunity to meet with a group of psychiatrists - and that session took over two years to set up. As the reader might imagine they were less than forthcoming, but one thing they seemed clear about, they were confident that when they see us, they see us the way we really are!

Back in 2007 I penned the following under the title A Few Of The Things A Psychiatrist Should Know - by a Service User, it seems they all still apply!

1/ that to ‘suspend your disbelief’ brings rewards; time spent with the same client when they are well, in addition to when they are distressed, in hospital and in the community, outside the atmosphere of the consulting room and the ward, is the only way to ‘see’ what ‘illness’ might be.

2/ all clients have difficultly explaining to themselves the strange things that have been happening to them, their thoughts and feelings - let alone finding the language to explain them to others. But, though they may be ‘inarticulate’ about their madness, they may not be about other areas of their lives.

3/ whatever the causes of mental distress/disorder/illness, the principal consequence is a ‘misplaced fear of others’, and a subsequent inability to make new and lasting personal relationships, leading to emotional isolation.

4/ despite the above, and often as the result of long experience, a client’s ‘fear of madness’ is probably less than yours!

5/ the client’s need is not for longer consultations, but to be seen by the same doctor over an extended period of time; by the same person in the hospital as in the community - how else can trust be established and the doctor acquire what he/she needs most - accurate information.

6/ what is needed is communication skills, don’t waste time trying to empathise with or ‘get inside the head’ of the client, just try to build a rapport; whereby they can tell you what they think it is important, and you can get the information you need.

7/ clients are afraid, if they don’t feel safe they will appear in worse shape than they really are, and not tell you anything.

8/ the most common complaint of clients is ‘why is this person asking irrelevant questions?’ Unless you can address their concerns, and demonstrate the relevance of yours, you get nowhere.

9/ the fastest way to improve someone’s mental health is to re-establish a regular sleep pattern, healthy diet, daily exercise plus learning to physically relax.

10/ very subtle changes in medication make a real difference to side effects, degrees of sedation and therefore compliance!