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Early education for better mental health Renowned psychotherapist and author, JAN MARQUART, shares her Love + Learning Instruction Method in a new book series aimed at helping children retain information through image associations, artistic interactivity and positive reinforcement. Available in paperback and hardback
Ruth Myers Counselling
Based on my fields of experience and interests, I take a HumanCentered / Person-Centered approach, which focuses on what you feel your needs are and the direction you would like to take. It is a gentle approach with respect, genuineness and empathy and one which derives from the belief that you understand yourself the best. Contact me to book your first in‑person or online session. www.ruthmyerscounselling.com.au
“Humans’ ability to grow is infinite... when they feel safe.” Carl Rogers
a look inside ISS U E 5 10 94 topics featured in this issue 6 9 10 32 86 42 48
Welcome, from the Editor How we view mental health Art for Mindâ&#x20AC;&#x2122;s Sake Senior Management Involvement Peers in Community Mental Health About Borderline Personality Disorder Working with Borderline Personality Disorder
56 36 real people and real lives 18 22 26 36 56 64 70 94 100
The Words and Pictures of Ethar Niocolette is Feeling a Little Unwell Robyn Takes the Power Back Recollections of a Suicide Life And a Life Nearly Lost Diane is Sober, Stable and Sane Duaneâ&#x20AC;&#x2122;s Story in Neon Signs All in Violetâ&#x20AC;&#x2122;s Mind Rebecca Owns Her Mental Health
improve wellbeing every day 14 16 106 113 116
Colouring-in for Mindfulness Colouring-in with Clare The Power of Meditation Buddhist Psychotherapy Self-Efficacy with Mindful Meditation
from the editor
Better Mental Health Magazine Issue 4 6 August 2015 ISSN: 2204-1966 (print) ISSN: 2204-1974 (digital) Better Mental Health Magazine is published by Aporia Media Pty Ltd, PO Box 1579, Strawberry Hills, NSW 2012, Australia. While every effort has been made to ensure that the information in this magazine is accurate and up to date, it should not take the place of medical advice from your doctors or other medical professionals. The purpose of this magazine is to offer information of a general nature. This may or may not apply to you or your situation. The publishers believe all material in this magazine to be correct at the time of publication. They cannot, however, provide guarantee of this and do not accept liability in the event of any information later proven to be inaccurate. Personal submissions do not necessarily reflect the opinions of the publishers. This magazine is copyright. No part may be reproduced by any process without written consent of the publishes, other than any fair dealings for the purpose of private study, research, criticism or review, as permitted under the Copyright Act. Magazine design concept by Cyan Loves Magenta BMH Mag App developed by GGA Digital Australia. Subscriptions available through http://www.bmhmag.com Copyright © Aporia Media 2015 ACN: 154 564 100 contact, engage and share with us through: w: www.bmhmag.com e: email@example.com fb: facebook.com/bmhmag g+: google.com/+bmhmag tw: twitter.com/bmhmag p: pintrest.com/bmhmag li: linkedin.com/company/bmhmag
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In August 1995, David Gahan, lead singer of Depeche Mode (one of the most important bands of our time, in my opinion, but it’s my editorial), attempted to commit suicide. Thankfully, he was unsuccessful. I’m thankful for that because I find the band, and their music, incredibly inspirational. Many of their songs make up the soundtrack of my life. If Mr. Gahan had been successful, then that soundtrack would be incomplete. But also, his life would have been incomplete. And that would have been a tragic loss. Other musicians, however, including Del Shannon, Kurt Cobain (Nirvana), Ian Curtis (Joy Division), Bob Welch (Fleetwood Mac), Michael Hutchence (INXS), Paul Hester (Crowded House), and many others, all took their life. Add to that list those who died from substance or alcohol abuse or overdose. Howie Epstein (Tom Petty and the Heartbreakers), Shannon Hoon (Blind Melon), Mike Starr (Alice in Chains), John Entwistle (The Who), David McComb (The Triffids), Steve Clark (Def Leopard), Phil Lynott (Thin Lizzy), John Bonham (Led Zeppelin), Jim Morrison (The Doors), Bon Scott (AC/DC). These were just some that I thought about as I went through my CD shelf. Some are obscure, but I have their music. I enjoy it. Their life was important to me. More importantly, their life was important to their family and friends – regardless of how obscure or famous they were. In 1992, Iron Maiden recorded Fear is the Key in response to the AIDS epidemic and Mr Freddie Mercury’s death. It could have just as easily been fear of anything with a stigma. One line has always struck me: And nobody cares till somebody famous dies. And that one line has been resonating in my mind while putting this issue together.
We hear about famous deaths and suicide attempts – successful and unsuccessful. They are tragic. Every single one. And every time, it raises our awareness for a moment. Another famous person has died and it hits the news. It’s definitely important and it raises awareness if reported responsibly. In many, cases, however, it causes speculation, criticism and increases the stigma. All of that takes away the very important reality that these celebrities are, in fact, just normal people. People just like anyone else. Like so many other people, Mr Gahan said that, “It was definitely a suicide attempt, but it was also a cry for help. I made sure there were people who might find me”. He was still lucky that he was found in time and survived. Not every story ends this way. In June 2015, Martin Veal took his own life. In 2014, Suzanne Wrath tried to take her life. In 1985, Diane tried to end her life. In 2012, Violet Skinner wanted nothing more than to die. Who are these people? Just people. Not famous musicians or actors or sportspeople or celebrities. Just people. People like you and me. People for whom life just got much, for whom living seemed harder than the alternative. Mothers, daughters, fathers, sons, brothers, sisters, friends, colleagues… They – we – are all important.
dismiss it? I don’t have an answer; it’s just the thought that has troubled me as I put this issue together. Please take care of yourself and remember that you are important to someone. Each day brings with it the opportunity to be important to someone else. We don’t have to be or do something fabulous. It could be enough just to take an interst in another person that changes a life. Of course, there are other topics in this issue. We have personal accounts of other lives, of recovery, of understanding and owning our mental health. The importance of managerial mental health, that of their staff and their own. Art therapy and colouring-in at any age. We look at the often misunderstood borderline personality disorder and how it’s treated. There are also articles on also meditation, Buddhist based psychotherapy and some great recipes and celebrity gossip. There aren’t really any recipes or celebrities. But there are some great topics. I hope you enjoy reading it.
Luke Myers, Editor
These stories are in this issue. Thank you Violet, Suzanne and Christopher (Martin’s brother) for sharing about such a personal and difficult topic. Suzanne’s touched me personally. She sat on a hill that I can actually see from my bedroom window, as she drank wine and swallowed pills. I could have seen her that night, yet I was completely oblivious. How many times are we unaware of the pain of others? How well do they hide it? How well do we bmhmag.com
BMH Mag’s Mental Health what mental health means to us
Mental health is a broad topic that can mean different things to different people. Our own understanding or context will impact what it means to each of us. At BMH Mag, it covers the topics of mental illness, mental health and mental wellbeing. Mental Illness includes the diagnosable disorders. We use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the ICD-10 Classification of Mental and Behavioural Disorders for reference – sometimes one, sometimes both. Mental illnesses are the things that we’re trying to help people understand to reduce the stigma. These include disorders such as depression, bipolar, obsessive compulsive. They have been clinically defined. When we talk about Mental Health, we mean those things that affect everyone’s ability to thrive mentally, especially in the face of difficult events. Having good mental health is the equivalent of staying fit and exercising regularly so that we can get through our day as best as possible. It includes topics such as resilience and mindfulness. We also include Mental Wellbeing which, for some, may be the same as mental health. For us, we use mental wellbeing to include all things that give us an overall, holistic, better body and
mind to improve our mental health or reduce the impact of mental illness. Mental wellbeing means eating well, sleeping better, exercising, keeping our body healthy to ensure it can keep our brain – and our mind – performing well for as long as possible Better Mental Health Magazine is about all three. You may not have a disorder, but someone you know probably does. You might want to improve your general outlook and care about how you deal with stress or grief or trauma or just that annoying neighbour! You might want to ensure you keep your entire body and mind healthy. Your interest could be because you care about your family or friends or colleagues. We can’t include every mental health related topic in every issue, but we try to cover a broad range. Whatever your interest, Illness, Health, Wellbeing, we’ll try to cover it.
ART T h e r a p y In terms of counselling, therapy is generally considered to be the practice of meeting with a therapist to discuss issues or problems which concern and affect a person’s wellbeing. There are many ways in which an individual or group of people can participate in what is called therapy. One widely used form of therapy that can assist the individual to express themselves is Art Therapy.
Art Therapy is a form of psychotherapy involving the encouragement of free self-expression through the use of a range of art mediums. The goal of using this form of therapy is that through the process of creating art and reflecting on the art products and processes, people can increase their awareness of self and develop healthy ways to manage or cope with symptoms, stress and traumatic experiences. Art, in its many forms, has the power to evoke emotion and “speak” without using the tool of verbal language. The use of art has been used as a tool of communication and expression for thousands of years. How humans have used art as a means of communication has been studied for years by archaeologists in order to examine the lifestyle and behaviour of early humans and has given an amazing insight to our predecessors. bmhmag.com
In the early 20th century, psychiatrists became interested in the artwork created by their patients. Interestingly, at around the same time, educators were discovering that childrenâ&#x20AC;&#x2122;s art expressions reflected developmental, emotional, and cognitive growth. As a result of the combined interest, the study of art has played a significant role in seeking to understand human behaviour, with a focus on cognition and trauma, in particular.
Art Therapy is a health profession facilitated by a professional trained in both art and therapy
The profession of art therapy grew from the 1940s into an effective and important method of communication, assessment, and treatment with children, adults, couples, families, groups and communities. This is widely used in a variety of settings including schools, private practice, crisis centres, community centres, corrective services, hospitals, psychiatric and rehabilitation services. Today, Art Therapy is a health profession facilitated by a professional trained in both art and therapy. They are knowledgeable about human development, psychological theories, clinical practice, spiritual, multicultural and artistic
traditions, as well as the healing potential of art. They use art in treatment, assessment and research, and provide consultations to allied professionals. The beauty of Art Therapy is that you do not need to be an artist. Sounds good huh? You do not need to have had any experience of, or be good at, art. It is simply used as a medium for confronting difficult emotions and to help with awareness and self-development. And while it might feel a little daunting at first to explore the releasing of emotions through the use of art mediums, the “therapy” itself is not about the final product or producing works of art, it is about the process and what is felt during the process is what’s important. Just remember, no experience of art is needed, you can’t make a mistake in Art Therapy. Worth a try, don’t you think? Ruth Myers is a professional counsellor working in Sydney, Australia. She has worked in a range of roles involving family support, mental health, trauma, early childhood and disaster recovery. She also continues to study in the field of Psychotherapy with a particular interest in loss and grief. She enjoys bushwalking, yoga, long drives and good coffee.
Colouring for Mindfulness itâ&#x20AC;&#x2122;s more than childâ&#x20AC;&#x2122;s play Drawing and even colouring-in provides a lot more than a popular form of therapy. Psychologist Carl JĂźng started using colouringin to help reduce stress. Although he initially focussed on the intricate and repeated patterns of mandalas, any form of creative drawing, painting or colouring-in can have significant benefits. These are some of the great things about even the simplest artistic pursuits. Reduce Stress. By focussing on the drawing or colouring, our mind is taken away from other stressors in our life, making it easier to deal with those stressors once our mind is clearer. Cleanse the mind of noise. By focussing on just one activity, our mind can declutter, or be cleansed, of all the irrelevant and unhealthy stimulus that we are bombarded by, leaving what's actually important. Promote daily creativity. It isn't just about creating art but also helps train our brain to think more creatively, which helps find more creative solutions or approaches to other aspects of our life. Artful meditation. Despite how beneficial meditation can be, many people find it difficult to sit still and passively clear their mind, so colouring gives the mind a focus as it clears in active meditation. Peaceful family bonding. Instead of watching television or playing games, take time with the family, colour-in or draw, relax, chat, enjoy each the time together as a family and bond peacefully.
Take it anywhere. A colouring book or pad and some pencils. That's all you need, pack it up, take it with you, pull it out and get colouring when you need to clear your mind. The peace of low-tech. With so much time spent online or “tuned-in” to television or the internet, turning everything off can be a welcome and gentle relief to an overloaded and over stimulated mind. Being used to hi-tech. But if you do crave tech and dislike sharpening pencils, there are also colouring, drawing, and even finger painting apps on most devices, so you can colour-in anywhere. Enjoy some private time. You can enjoy your own company, away from anyone and everything else, even if only for a short time, without worrying about anyone else, taking all important “me-time”. A simple social activity. Like a knitting circle, pick up a colouring book with friends over a relaxing herbal tea and feel the difference it makes for a calmer and positive time when catching up with friends.
Clare is the mother of two girls and works full-time in Sydney, Australia. Sheâ&#x20AC;&#x2122;s a tech-geek and loves her dog almost as much as her children. Clare likes to go camping whenever she has time and lives with chronic pain from nerve compression in her neck.
“it allowed me to calm my mind ”
An Unlikely Friend by Ethar Hamid I know I will get electric shock therapy (ECT) one day. I think. I think I can trust myself on this. After all, my intuition told me in the eighth grade that I was developing a mental illness, and here I am. I knew because I was reading a book about a girl who had bipolar disorder, and though I didn’t know what having bipolar meant, and I am no psychic, I knew I had something similar. The character in the book I was reading experienced extreme changes in mood and behavior, throughout the story, and – almost in sync – I was starting to change too. I was becoming depressed, reserved, and starkly different from the happygo-lucky kid I had been. Admittedly, the thought of getting electric pulses sent through my brain and getting a mini-seizure is scary. But I’m not one to discriminate
against eccentric treatment (or eccentric anything, for that matter). The thought of having ECT may be scary, but so many other things in life are scary, too… and I somehow manage with all of those. ECT will treat my depression, but I heard (from viewing an Internet video by a brave sufferer of schizophrenia) that it can help with obsessive-compulsive disorder, too. Hopefully, if I do need it, the ECT will alleviate my mind’s fierce gnawing at itself, softening its pain at walking away from the stove or the car. Parts of me wish I could just stand by my kitchen stove and by my car for hours, checking to make sure the stove-top is turned off, and the car doors are locked. And hopefully, ECT will help with the feelings of being contaminated by dirt. When I wash my hands, I go
over-board, scratching the bar of soap with my fingernails to get onehundred per cent clean, washing and rinsing up to 6 or 7 times. I know I have a skewed perception of cleanliness, because I fantasize about soap, for Pete’s sake. This may seem wholly inappropriate, but when I was living in a dorm, my sophomore year of college, I was in love with my suitemate’s handsoap. I used to pump a few dollops of soap onto my eager hands when my suitemate wasn’t looking, and enjoy myself. The hand-soap had little blue beads, in it, and smelled like the ocean. Against my palms, the soap lathered into a terrific foam. The beads scrubbed against my hands, and dissolved into a sapphire liquid. Watching the whitish suds and the blue streams of melted beads running down the drain provided me with a comforting satisfaction. Since leaving my dorm, and my suitemate’s hand-soap, I feel like a small part of me has died. I believe I displayed signs of Obsessive-Compulsive Disorder when I was a little kid too. Like most things, this is easy to say, in retrospect. I remember that, if I were to be walking down the stairs in my house, and my right arm happened to brush against the wall, I would have to take a few steps back, up the stairs, and deliberately brush my left arm against the same spot my right arm had touched. Call it “needing better
more balance in the universe” or just a chemical flaw – it was what it was. And it was just a given – it was a nobrainer. And, what’s more, I thought everyone was like that. I am pretty sure that I’m also obsessive-compulsive over things that I don’t even think about. I’m probably obsessive-compulsive while watching TV. Subconsciously, I probably make sure the head of the remote faces the right corner of the TV, while sitting on the carpet, using invisible parallel lines, in space, as rough measurement. Why? Because. Just because. There is no logical answer. Despite every bad feeling that has come with it, I don’t want my disorder to go away. It taught me about myself; it made me a more compassionate person. It’s become a friend – more loyal than even some people who you’re “supposed” to have as friends. Unprovoked cruelty on the part of people-friends is part of my experiences. On the other hand, I have found that being cruel without reason is not a characteristic of OCD. OCD can be cruel, yes, but it has every right to be so. And as the cruelty it manifests painfully scrapes against my heart, it polishes it into something better than it was, before. This is more than can be said for the “friend” who has cold airs and spiteful insinuations to offer me.
people Ethar Hamid is an aspiring writer and draws to represent her mental health. Her writing draws heavily from her experiences with mental illness. She believes there is much beauty to be found in what is traditionally considered “ugliness,” like pain and distress. Ethar likes the poem The Love Song of J. Alfred Prufrock, by T.S. Eliot. The harmony of the verses “Shall I part my hair behind? Do I dare to eat a peach? I shall wear white flannel trousers, and walk upon the beach. I have heard the mermaids singing, each to each. I do not think that they will sing to me” often run through her mind. Ethar is a junior at George Mason University, pursuing a Bachelor of Fine Arts in creative writing.
Feeling A Little Unwell by Nicolette Ramsay Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. National Institute of Mental Health (www.nimh.nih.gov).
Treatment varies for each patient. For me, the method of choice by my doctors were antidepressants and mood stabilisers, paired with monthly therapy sessions; bi-monthly depending on the severity of things. I recall when I was first diagnosed. It felt surreal. A part of me always had a hunch that I could have perhaps been bipolar, but to actually be told that by medical professionals was a lot more difficult to come to terms with than expected. I reflected on the times my teenage self wore the label “bipolar” like a badge. People described me as explosive, with many mood swings and multiple personalities. They were in awe at how often my mood could toggle between really high, and extremely low. “Call me bipolar Barbie”, I’d joke, having not realised then the severity of what the illness really is. Although, it was not a form of mocking bipolar disorder and those who have it, but rather my way of acknowledging that I honestly believed there was something wrong with me.
Instead of running from the possibility that something could be wrong, I embraced it and sought help. There was always the deep fascination with how differently people’s minds can work as a result of mental illness. I’d research endlessly until I knew as much as I could about mental illness, mainly out of curiosity, and partially to compare myself to the symptoms. It was all so interesting; an obsession almost, that is until the day I learned that I was indeed suffering from bipolar (II) disorder. It’s a lot easier to see these things from a third-party point of view, but when you’re living it... when you’re aware of how and why you do things a certain way in comparison to other people, it makes you self-conscious. It makes you question your every action, every word you say; everything now comes into perspective. You may wonder, ‘Am I actually this way? Or is this my illness?’ Personally, my entire life went into question when I was diagnosed. When the disorder was a speculation, there was no shame bmhmag.com
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Am I actually this “way? Or is this my illness? ”
to say something could be wrong with me and causing me to behave the way I do; however, upon confirmation of it, I felt like I was less of a person. Nothing changed. I was still the same me I always had been. Except now with the opportunity to receive help to improve my mental health. Yet, there was fear and paranoia consuming me. Many worries about others warping the views they once had of me because a mental illness had been added to my medical record. Acceptance was very difficult for me, and still is. From the beginning, the thought that I am bipolar haunted me. Perhaps my mindset was one of my biggest mistakes; thinking that I “am” bipolar. I became consumed by the thought that I was bipolar, and that’s a common error many people make. We say that someone “is” bipolar, rather than they “have” bipolar disorder. By saying that someone “is” bipolar, you imply that they are the disorder; they are the problem, rather than suggesting that they are a normal person who is sick and requires medical attention like any other sick person. This is perhaps why I felt like I was less of a person, and why I struggled accepting the diagnosis. We should stop saying that people “are” bipolar, as though it defines better
the entirety of their existence. We are people. Bipolar disorder is a brain disorder. It is not a label. It cannot be written neatly on a nametag and pinned to the shirts of those who suffer with it. Upon introducing ourselves, we do not say, “Hi, I am bipolar!” We introduce ourselves by name; not by our illness. Why? Simple; because our illnesses do not define who we are as people. Bipolar disorder is nothing but an attribute I possess, and like many other attributes, it cannot stand alone as a definition of me. I have brown eyes, but I am not brown eyes. I have scoliosis, but I am not scoliosis. Similarly, I have bipolar disorder, but I am not bipolar disorder, nor will you see my name, or the names of other sufferers included in any definition of it. We treat mental health issues as though it’s a taboo topic, when the reality of the matter is that millions of people worldwide are affected by this. There are strains put on families, even jobs lost as a result of people going untreated. Yet, we continue to skirt around the topic when it’s brought up, and even shame those who admit they have a problem; sometimes without even realising it. People may say that it feels like they’re walking on eggshells around their loved ones or colleagues who have bipolar disorder (or any other mental illness), but have they ever considered what it feels like to be on the other side? Do they know what it’s like to be trying your best but feeling like it’s never good enough? Do they
people know how hurtful it is to maintain a treatment regime yet anytime you have an emotional response to things, you’re asked “are you taking your medication?” As far as I’m concerned, feelings are not directly proportional to mental illness. As human beings, it is natural to have feelings and to express them. The degree to which these feelings are experienced is what differentiates mental illness. Sometimes sadness is just that – sadness. It does not mean medication was stopped, nor does it mean we’re depressed. There are periods of stability experienced, and during this time, we don’t have to be hollow shells, so it would be nice to be able to express ourselves without people having their guard up. It would be nice to be seen as a human, and not as a monster. In the song Unwell, the band Matchbox 20 say, I’m not crazy; I’m just a little unwell, I know right now you can’t tell, but stay a while and maybe then you’ll see a different side of me. If this outlook was adopted, maybe then people who suffer from mental illness would not feel like they need to hide a part of who they are from others. Maybe then, people may become more accepting of treatment. When we stop marginalising the mentally ill, we may be able to see improvement in mental health worldwide.
We are all dynamic people, changing just as quickly as the seasons. We grow each day, sometimes without realising it. For years I’ve dealt with the symptoms of my mental disorders before I made the conscious decision to actually do something about it rather than becoming a victim to my own mind. With a good support system and proper medical care, I’ve been able to become at peace with myself once more. I look forward to my future now; to obtaining my degree, jumpstarting my writing career, and hopefully having a family someday. Once again, I’ve found hope for life.
Take Back the Power by Robyn Hall When I first began my recovery journey from Mental Illness, my partner told me: ‘I don’t care what illness you have; I will always stay by your side as long as you get some help’. So I did. When I went to the doctor, I thought that I would also address the breathing difficulty I’d been having. He told me it was anxiety, but I didn’t believe him. After all, I knew my body better than anyone else, right?
He did some tests and told me that I had depression, anxiety and stress. He prescribed me some medication and I went home. I threw myself on my bed and bawled. I didn’t want these labels or this illness. As time passed though, I realised I also didn’t want to have to hide something like this. It took me only a few weeks to begin telling people what was happening in my life. First, my family, and then my closest friends. Then, my roller derby team and my league. Finally, I wrote a blog post about it and told anyone who cared to read it. By then, I was already on my way to personally shedding the cloak of stigma surrounding my mental illness. So (believe it or not), the more people I told, the easier it got, and therein lays the biggest secret of all; the more at ease you are with your mental illness, the less you care what others think. When you no longer care at all that people know, you will feel that cloak slip off your shoulders and you’ll be all the more ready to step forward. Here’s where I start to talk about power. It’s such a strong word. For me, it carries notions of immense strength, leadership, respect, control, force, focus and success. To me, the idea of power is dichotomous: physical versus emotional. Physical power, for example the power possessed by the engine of a fighter plane, or in the leg muscles of a rugby player is the result of structure. Emotional power is given to the one who holds the power. There are many ways in which we can give someone power. If they are charismatic and full of ideas, we can give them our faith that they will produce what they claim they can; this is how influential leaders create such devoted masses of followers. If we stopped giving that leader our faith, if every single person let that faith dissolve, then that leader would feel their power drain away. bmhmag.com
It is with this idea in mind that I looked at my own mental health when I got sick of crying over my ‘labels’. I broke it down like this: Why do I hate these labels? Because I don’t want people to think I’m crazy. Why would I care what people think? Because I don’t want my friends and family to stop wanting to see me, I guess. But if they truly care about me, then they would accept me regardless of what’s going on. Well, yes I suppose that’s right, but I don’t want them to pity me, either. Why would they pity me? Because there is something the matter with me. So? Mental illness is a measurable, treatable thing, like my asthma, or my allergies. Yes, but mental illness is different… Oh yeah? How so? Well, it’s… mental… But the doctor told me it is a chemical imbalance in my brain and I get treatment for it… really, it’s all part of my general health and wellbeing. Hmm… that’s true. But there is so much social stigma surrounding mental illness! Caused by what? People who don’t understand, misconceptions and lack of information. So… I can educate people, starting with the people I know! I guess I could do that, but what about the people I don’t know? Who cares about them? Yeah! I’ll just do what I can, with the people I can reach. The more I normalise mental illness, the more people around me will realise that the stigma is bogus, AND I can lead by example to others with mental illness… when they see the strength I have gained by understanding, embracing and normalising my own mental illness, maybe they can draw strength from that for their own situations! better
have nothing to “ I be ashamed of ” And so it began. By reflecting, I realised that I can completely drain any power over me that the stigma has simply by holding my head high, not being embarrassed or ashamed and not hiding the fact that I suffer from mental illness. It’s amazing. Now, it doesn’t mean I go around grabbing random strangers by the arm and shouting ‘I’ve got mental illness and I’m not ashamed!’, because that would probably actually add to the stigma. What it means, for me, is that I view my mental illness (or mental health) as simply a small part of who I am, of what makes me me. Just like I don’t tell somebody I’m meeting for the first time ‘Hi, I’m Robyn; I’m a right-handed, gay, genderqueer asthmatic who loves robots and has a mental illness’, I also don’t hide any of those things, if they come up in conversation or if I am asked. I refuse to give something unseen any power over me or my thoughts. I make it very clear to people that I am not ‘funny’ about my mental health, and they really have no choice but to not be ‘funny’ either. So far, I have not come across anyone who is, anyway, and I attribute that to the fact that I took that power away the moment I showed them that I am ok with it. So, that’s it in a nutshell.
Once you shed the stigma, you have time for other things...
For me to be able to really begin my recovery journey, the first thing I had to do was realise that I have nothing to be ashamed of. It’s just part of me and I’ll deal with it, like anything else that comes along.
Robyn’s Tips for Being Okay Here are three quick tips for staring the journey to being ok with your mental illness. You’ll notice that they are all about what to do with other people. That’s because — in my opinion — the first step to being ok with your mental illness, and taking the power back is being able to openly tell people that you have it, and to not care if they know.
Practice Think of a scenario when someone has done or said something that had an impact on you, mental-health-wise. Think about how you reacted. Odds are, you said nothing and just tried to ‘let it go’, or ‘get past it’, because you felt embarrassed about having to bring up your mental health. Now, think of some ways that you could have said something. Try a bunch of different options. Try them in the mirror when nobody’s home. Try them out loud. You deserve to be able to let people know when they have stepped over a line. If they’re a true friend, they’ll apologise and try not to do it again.
Give people a heads up If you were a diabetic or allergic to wheat and a mate invited you over for dinner, you’d probably have no qualms about telling them your dietary requirements. It’s the same thing for mental health. I don’t like strangers touching me, and I especially hate meeting new people who feel they have to kiss me. So, I warn people. When I met my in-laws for the first time I told my partner: ‘They’re gunna want to touch me. I am not down with that; I’ll be stressed enough already. Please spread the word that I am a hand-shaker. Go ahead and tell them that I’ll get all awkward if they try to hug me, I don’t care.’ So, that’s what happened. I did end up getting a few hugs and awkward kisses, but far fewer than if I had’ve just gone into the situation cold. better
Find famous people with mental illness Most people have at least a handful of celebrities or sportspersons or other famous people that they admire. Even if you don’t subscribe to that whole Hollywood hubbub, I can pretty much guarantee that there will be at least one famous actor or musician that will have you saying ‘wow… he/she suffers from depression? I had no idea… but they’re still like, this awesome performer… how do they do it?’ It only takes a seed to grow inspiration, and where you get it from doesn’t matter. At the end of the day, mental illness is everywhere; you only have to Google the stats. We need to start being ok with it, because there’s no reason not to be. Once we take that power back, we can stop spending so much time stressing that people will judge us and start discovering all the amazing things about ourselves that we were too busy to notice.
Robyn is a Peer Support Worker, has two degrees in creative writing and believes that writing is invaluable for selfreflection and healing.
Why pose the same as everyone else?
She lives with her fiancé, two dogs and two cats. She loves to work on their house, write, draw, play ice hockey and be tattooed. She has been diagnosed with Depression and Anxiety with elements of social anxiety and has a weakness for Reebok Pumps. bmhmag.com
Senior Management Involvement Making Mental Health Matter in the Workplace by Keir Wells
“It’s pretty common to see people sitting at their desk crying. No one really gives them a second glance. It’s just par for the course because the stress is so extreme.” This was told to me by a contractor at the Sydney headquarters of one of the world’s largest IT companies. That company has numerous measures, programmes and policies in place to deal with mental health, bullying and stress, but the situation continues. better
featur e It’s much the same story at one of Victoria’s largest hospitals. All the measures and policies under the sun didn’t stop the endless – and reported – bullying of an employee, resulting in that person having to be admitted to a psychiatric care ward (of a different hospital). These stories are far from rare; and I hear them almost every day. It’s all the more frustrating when I talk to HR and Wellbeing programme managers whose efforts are being blocked by internal red tape and politics. All too frequently I’m told by such professionals that their organisations are doing little more than ticking the box when it comes to mental health in the workplace. A case in hand is an organisation with over 30,000 employees. When a mental health peer support programme was initially devised and implemented by a handful of volunteer staff members, the organisation was quick to boast “look at what we’ve done for our employees”. When it recently came to allocating $100,000 to fund a roll-out of the programme across the entire organisation, it became a different matter. Months of wrangling and lobbying have resulted in little more than inter-departmental buck passing. It seems that finding just over three dollars for each employee is something for the too hard basket. Anyway, the box had been ticked, hadn’t it?
Start at Senior Management Education of senior management is critical. CEOs, CFOs and Directors need to understand that mental health programmes demand a coordinated, cohesive and cooperative approach. They are the ones who should be leading the charge and allocating resources, ensuring relevant programme managers can work effectively on creating mentally healthy workplaces. The irony, of course, is that it’s the people at that senior level of management who often can benefit most from workplace mental health programmes. And this is where it becomes even more of a problem. In the course of my work at Fully ARMED Australia I regularly visit companies and present on the issue of mental illness. How often does senior management attend such sessions? Less than 50 per cent of the time. When I speak to senior managers about their non-attendance, I hear a range of excuses. Without exception, though, the most common is: “I believe my presence would inhibit the staff members from talking freely.” Quite frankly, that’s a load of garbage! Among the most open and mentally healthy workplace environments I’ve seen is the Australian operation of a high profile global software company. The operation’s senior executive is open about his own mental health issues and talks freely about them
in front of staff members. When he attended a workplace mental health presentation, his openness clearly encouraged others to share and communicate. That same senior executive works closely with his Human Resources manager, helping cut through the red tape that might otherwise hinder the implementation of workplace mental health initiatives. Just one of many clear examples where the active involvement of senior management contributes directly to greater workplace wellbeing.
Remember Small Business In the world of small business, things are worse. Significantly worse. During the course of a conversation with the CEO of an Australia-wide small business representative group, I was told that there was a marked imbalance between a focus on mental health of staff and that of the business owners.
This was brought home to me even more when, subsequent to that conversation, I visited an Australian Federal Government website that has dedicated resources for mental health in the small business environment. The entire content dealt with the mental health of staff. A faint glimmer of hope, though, arose when I saw a link to an external third-party programme.
“ my own mental
health comes first ” Again, I could find nothing that talked to the issue of the mental health of small business owners. It was all about the responsibility of the owner towards ensuring a mentally healthy workplace. There’s lots of talk of the impact on small business if just one team member experiences a mental health episode. But what about when the owner – the person who pays the bills, authorises payroll, and makes
featur e decisions has a problem? Isn’t the impact even more dire? Yes, I’ve been there. I used to run a moderately successful small business on the Central Coast of New South Wales. With a full-time staff of threeand-a-half, the business was doing quite well - until that point in time when a prolonged depressive episode helped ruin what was a pretty good wicket. While I was at work every day, I was a perfect example of presenteeism. My input into the business declined. I was unable to make decisions as effectively as should have been the case. Client projects weren’t being delivered on time. The list goes on. Ultimately, the business went under and with it, the jobs of my team members. I had done as much as I could towards ensuring the working environment for my staff was conducive to their wellbeing, but I had neglected myself. I’ve learnt a lot since then, and my
own mental health comes first and foremost. Well, most of the time. Again, it comes down to education of senior management, regardless of the business size. When I discussed some of these points with a local restaurant owner, the same issues were raised. Business leaders need to take on board: ü they are just as much responsible for workplace mental health initiatives as are the HR managers ü their visible involvement in such initiatives is a positive step forward rather than a hindrance their own mental wellbeing is every ü bit as important as that of their staff. In the world of Australian business we have definitely made major inroads into promoting and creating workplaces that support mental wellbeing. Even though we still have a long way to go, once we have the active buy-in from, and involvement of, senior management, the goal is definitely achievable.
Keir Wells is the founder and CEO of Fully ARMED Australia, a not-for-profit mental health action organisation. He has carried manic-depression since childhood and speaks openly of his lived experiences in trying to raise awareness and help others. He can be contacted through firstname.lastname@example.org or www.fullyarmed.org
DE I C I U S A F O S R ECOLLECTIO N r Veal e h p o t s i r h C y B
The four brothers, David, Christopher, Timothy, Mar better
My brother, Martin, was the youngest of four brothers. He was the youngest son to John and Dorothy Veal and Christopher, David and Timothy were his brothers. He was born on 15th December 1967 and at the time of his passing he was 48 years old. He is survived by his two sons Spencer and Cooper and his wife Mishelle. Growing up with three older brothers, Martin became very good at sports and was the leading cricketer and footballer of the local area. He excelled at any sport he attempted winning the Heidelberg Golf open against all comers at the age of 15. He played Gridiron for Australia and toured the USA with this team. He also won premierships with Banyule Cricket Club and Old Ivanhoe Football club.
Martin joined the Victoria Police Force at the age of 23. Before that he briefly tried primary school teaching, bookkeeping and assorted jobs. I believe the police force gave him stability and focus. He rose to the rank of Senior Sergeant and undertook numerous roles including manning the Victorian Police helicopter. Martin however found his role as an IT person very satisfying. He enjoyed all the computer jargon and loved the satisfaction of obtaining the correct answer for a problem that computers gave. Martin enjoyed putting things in order, accounting, book work,
computers all these topics allow for the exactitude which Martin loved. From the picture I am painting it would appear Martin enjoyed his life. A satisfying job, two lovely children, however Martin’s marriage wasn’t holding up and this is where the problem was. These words are not to dissect Martin’s marriage that would be unfair to Martin’s ex-wife. This is to examine why someone might kill themselves and the impact that is felt afterwards. Martin was a policeman and Martin used his police revolver to end his life. He also completed this act at a local school where he knew his ex-wife and son would be that morning. Martin deliberately used this act to punish his ex-wife and son and it was his 15 year old son who found his father dead. We will never know what ultimately led Martin to end his life. When the police attended his home later in the day with my brother, David, they found everything in the home in order.
David, Timothy, Christopher, Martin (Clockwise) better
Laid out on the kitchen bench were his keys, wallet, bank cards, bank details etc. The police who attended told David that this was the norm. All the receipts for mortgages, banking,
and utility bills were in a folder all ready to be examined and Martin had adjusted his will recently. All these tasks had been done in the lead up to that morning. Martin knew what he was doing and had planned the act for a while. To compound our familyâ&#x20AC;&#x2122;s pain, our mother had been admitted to hospital on the Sunday night (the day before the suicide). She had fallen and suffered a broken ankle. Martin killed himself at approximately 6.00am Monday morning and she was oblivious to all this until early Monday morning, my father and Timothy went to go to the hospital and told my mother that her youngest son had killed himself. Martin had spoken with her late on the Sunday night and said it was best that she was in hospital so she could get the attention necessary. Martin also had spoken to our father the night before in regards to mum. Martin had spoken to both of his parents the night before he suicided and both said they detected nothing wrong and will now have to live with the thought that that was the last time they ever spoke with him. My older brother Timothy said to me later that week, if Martin was sitting up in a tree looking down upon us, he would say â&#x20AC;&#x153;What have I done?â&#x20AC;? Two lovely houses have to be sold,
my father told my mother that her youngest son had killed himself two growing boys will never see their father again and he will never see them grow up. He has left a mother and father in grief and three brothers have no younger brother. Martin was also the local good sportsman and so many sporting teams will no longer be able to say hello to Martin. In my opinion the process of grieving is different with suicide as to car crashes (both sudden events). With suicide there is a lot of hurt, questions and anger. Why? Why? Why? What if he had come to me with his problem, what if? The funeral was an enormous event. In excess of 1,000 people attended the local town hall all wondering why this 48 year old man chose to end his life. Unfortunately that question will never be answered. The police presence was fantastic and credit goes to the Victoria Police with the due respect shown to my brother.
it’s a shock because it is never expected The Assistant Commissioner spoke to my family and I and it is a credit to her for taking the time to be present. At the commencement of the ceremony there was a strong police guard in which Martin was paraded by. All the men of our family marched behind the hearse and this cortege was very impressive with its community presence. As with any funeral of a well-known man, people came to pay their respects even though Martin had not seen them for a long time. Friends of the family and friends of the brothers also attended. It was great to see so many old faces that I haven’t seen for so long as I had moved out of the area 20 years ago. It was unfortunate that it had to happen at this time, but in life it is usually death that brings us together. Direct friends of Martin, friends of the family, distant cousins and longtime friends, everybody is always sympathetic and most people just said “sorry for your loss” and that is all that seems to be said. It was however very interesting to learn other stories of suicide and how many people have been touched by this very common
occurrence but the topic is never discussed. Some of the unpleasant tasks associated with my brother’s suicide had to be undertaken by my older brother, David. These tasks are never mentioned or thought about when someone commits suicide. I am unsure if Martin had thought of any of this. Martin drove his own car to the place. Consequently once the police had cleaned the car, David had to drive it back to Martin’s home. A task I am sure I could not have done. Martin had a motorbike as well and this and the car will have to be sold. Timothy and David, during the next week had to clean Martin’s house ready for sale. They went into the house and Timothy said it was very eerie, the rooms were clean and tidy, the fridge was full of food, and the beds were made. If you didn’t know, you would be expecting a person to walk in the front door. It was as if Martin was leaving it for someone else. You never think anybody in your family is going to die in a plane crash, car crash, die of cancer or commit suicide and when it does occur it’s a shock because it is never expected. You almost certainly never think about what you have to do afterwards. Old clothes, food in the fridge, car
registration, disconnect the electricity, water and gas. All these things need to be done and it is usually left to one person. In this case it was my brother David, and thank God for him. I live in Queensland and the rest of my family live in Melbourne so I was getting all this via telephone and during and after every conversation I was crying and feeling very inadequate. I eventually made it down to Melbourne (after organising my business) and the first meeting with myself and my other brothers and father was very difficult indeed. Then I had to go to the hospital to visit my mother which was an unpleasant experience. I don’t know if talking about it would have changed my brother’s mind. You must be very determined to do
something knowing the repercussion of such an act will lead to you never seeing your children again or see them grow up. This wasn’t teen bullying or suicide by pact, this was a 48 year old man who had established himself financially, had a successful career and two lovely boys but his marriage had broken down and I believe he took that to heart, (too much I think) and the consequences were drastic. I don’t know how long it will be for people to move on. My parents seem ok but I think Mum’s broken ankle lets her focus on something else and I know some of my brothers are moving on but others have not. I know I never had that much to do with Martin because I had moved away so young but I am still sad with such a tragic loss.
Christopher Veal has over 30 years’ nursing experience of which 20 years has been with mentally ill and disadvantaged people. Christopher has worked in regional and remote communities and prisons providing mental health care. Christopher currently operates his own business providing supported accommodation to mentally ill and disadvantaged people on Brisbane’s Southside.
taking a look at B orderline P ersonality D isorder The Brief Description Borderline personality disorder (BPD) is a serious mental illness that causes unstable moods, behaviour, and relationships. It affects nearly 6% of adults some time in their life and approximately 20% or all patients admitted to psychiatric treatment. Symptoms tend to display in late teens or early twenties and can subside in a person's forties. Like any mental disorder, however, these are generalisations and can be different amongst different people.
Typical BPD Characteristics Difficulty regulating emotions and thoughts with deep feelings of insecurity This may include difficulty coping with the fear of loss or abandonment, so continually needing reassurance, being inappropriately angry towards the people they think are responsible for their feelings, and a low sense of self-worth or their place in the world. This may include constant questioning of self, in all aspects of life, including relationships, goals, sexual orientation, or purpose. Impulsive or even reckless and harmful behaviour As a response to feeling emotionally overwhelmed, impulsive behaviours may include self-harm (such as alcohol or substance abuse, cutting, burning) or attempts at suicide. While self-harm may seem to bring short-term relief, it may have a far greater negative impact on the person in the longterm. Many, intense, or unstable relationships As a result of inappropriate thoughts and feelings, relationships are often extremely intense but minor perceived slights are seen as abandonment or rejection. This impacts the relationship, often with anger or aggressive behaviour, with irrational responses and irrecoverable actions that cause the relationship to end.
The term â&#x20AC;&#x153;borderlineâ&#x20AC;? was originally used for this disorder as it is considered to be on the borderline between psychosis and neurosis. Some people consider it to be an unsuitable name that increased misconception and stigma as it can sound quite volatile rather than simply being a clinical classification. Other terms have been considered but not yet adopted.
Being Diagnosed with BPD To be diagnosed with BPD, a person must experience at least five of the following symptoms. Like other disorders, these need to be at a level that impairs their ability to function or causes them harm. 1. Fear of abandonment 2. Unstable or changing relationships 3. Unstable self-image; struggles with identity or sense of self 4. Impulsive or self-damaging behaviours (such as excessive spending, unsafe sex, substance abuse, reckless driving, binge eating). 5. Suicidal behaviour or self-injury 6. Varied or random mood swings 7. Constant feelings of worthlessness or sadness 8. Problems with anger, including frequent loss of temper or physical fights 9. Stress-related paranoia or loss of contact with reality.
Causes of Borderline Personality Disorder Research on the causes and risk factors for BPD tends to agree that a combination of genetic and environmental influences are both likely to be factors. Again, similar to other disorders, it seems to be a biological predisposition to BPD and then environmental factors being a trigger to the onset of symptoms. Commonly, but not in all cases, environmental factors, particularly experienced during childhood could include emotional, physical, sexual abuse or a combination. Actual experiences of loss, neglect, trauma or victimisation may also be a factor.
BPD with other Disorders A NIMH funded National Comorbidity Survey Replication suggested that about 85 percent of people with BPD also suffer from another mental illness. This often makes diagnosis difficult, especially where symptoms overlap with those of other disorders. The following list of comorbid illnesses and their estimated percentage of people also with that illness are the most common. • Major Depressive Disorder: 60% • Dysthymia (a chronic type of depression): 70% • Substance abuse: 35% • Eating disorders (e.g. anorexia, bulimia, binge eating): 25% • Bipolar disorder: 15% • Antisocial Personality Disorder: 25% • Narcissistic Personality Disorder: 25% • Self-Injury: 55% – 85% Women with BPD are more likely to have comorbidity with disorders such as major depression, anxiety disorders, substance abuse or eating disorders. Men with BPD are more likely to have co-occurring disorders such as substance abuse or antisocial personality disorder.
Treatment for BPD Research has shown that outcomes can be quite good for people with BPD, particularly if they are engaged in treatment. Diagnosis is generally made by a psychiatrist, with ongoing treatment managed by a psychiatrist, clinical psychologist or other mental health professional. With specialized therapy, most people with borderline personality disorder find their symptoms are reduced and their lives are improved. Under stress, some symptoms may come back or be heightened. When this happens, people with BPD should return to therapy and other kinds of support. The most effective treatmensts include: • A combination of psychological therapy, medication and support has been found to be the most effective treatment, rather than any one of these alone. • Interpersonal Psychotherapy (IPT) and Dialectical Behavioural Therapy (DBT) are currently considered the most effective therapies. In IPT, a person learns better ways to relate to other people. In DBT, they learn to better understand and manage emotions better and learn better ways to respond to other people and situations. • With the appropriate treatment and ongoing support, most people with BPD are able to lead full and productive lives.
Support of those who care Family and friends of people with any mental illness, including BPD often feel confused, angry and alone. Community support programs may include help with finding suitable work, accommodation, training and education, psychosocial rehabilitation and mutual support groups. Community and mental health services support is often available in person or online to those who are close to or support someone with BPD. Knowing you care enough to want to understand, can often be the greatest support possible. For more information about Borderline Personality Disorder, visit: National Education Alliance BPD www.borderlinepersonalitydisorder.com Treatment And Research Advancements for Borderline Personality Disorder http://www.tara4bpd.org/
Mental Health Warnings
and why we don’t include them
Like many other topics, mental health media coverage is governed by a number of voluntary codes of practice. These include how mental health should be presented, the use of certain terms, the way to refer to conditions or people and the recommendation to include contact numbers for services, particularly help lines. Most countries have one, sometimes more, codes of practice with somewhat similar guidelines. While we support these guidelines, and add our own, we decided not to include “warnings” in each article. The entire magazine is about mental health. It is not a glossy fashion, news or entertainment magazine with a random article about an unfortunate or inspirational life event. To include references to the relevant services for all international readers would make little sense and add no value. Listing all services for all countries would be a magazine in itself.
In very practical terms, we considered that if a person is at an extreme point and needs immediate support, they probably won’t be picking up a magazine for a light but informative read. If we’re wrong, and you are considering harming yourself or someone else, or are in danger of being harmed, then stop reading now and contact your local support line, medical practitioner or emergency services. Where practical, or where it exists, we try to include a website that has a comprehensive list of support organisations or groups for a particular topic. This is not always possible. We hope you understand our decision to take this approach. If you have any questions or concerns, please contact us at email@example.com. Luke Myers Editor, BMH Magazine
Safety First If at any time you are concerned about your safety or wellbeing, or that of your children, a friend, or a loved one… you NEED help and assistance. Your first point of call is to phone your local emergency number. You can also call your local hospital and ask to speak with the Psychiatric Team. Often, this will open the door for an individual or family receiving help, support and understanding. It’s not about “getting locked into a system”. Rather, try to think of it as “unlocking” what may be a very difficult and scary situation. Receiving help will shift things. Remember: NO-ONE deserves to be in an unsafe situation. bmhmag.com
Working with Borderline Personality Disorder by Mr Brett Novic We have all had them; whether in a community mental health, hospital, or private practice setting. Patients who have some tacit quirk that seems to reach under our professional faĂ§ade and frustrate us. Sometimes, we can figure out what the trait is and at other times we canâ&#x20AC;&#x2122;t quite put a finger on what it is that is creating the obstacle to joining. At other times, we may begin heading down the road of diagnosis of Borderline Personality Disorder. These patients represent one of the most difficult diagnosis in which to treat. As frustrating as this disorder may be for therapists it is perhaps one of the most debilitating for the patient and their family alike. Often these patients are desperate for help and yet, as desperate as they are, they struggle for a means to tread water in a world that they cannot understand or thrive in. bmhmag.com
Treating Borderline Personality Disorder The following are some highlights for treatment of Borderline Personality Disorder. Borderline Personality Disorders Tend To Bleed Together With Other Disorders When treating a patient with BPD it is important to assess and treat other potential mental health disorders that often accompany these patients. The diagnosis that are comorbid with this disorder tend to be Major Depression, Dysthymia, Substance Abuse and a concurrent disorder such as Narcissistic or Antisocial Personality Disorder. Therefore, any patient that seems to present with this possible disorder would strongly benefit from a comprehensive psychiatric evaluation. Underlying Assumptions of BPD Patients BPD patients tend to personify the concept of cognitive distortions in the area of “Black and White” thinking. They classify themselves and others as “good or bad” and can’t classify people in the areas of “shades of gray.” Those that are on the positive side should be rewarded while those on the negative side need be ostracized or punished. This “Black and White Thinking” must be addressed. A word of caution, if a BPD patient comes to you and states that you are the “best” therapist remember that they can swing to the very other side of the pendulum quickly and unpredictably. Look Towards Previous History to Find Current Reasons for Diagnosis Abuse, especially sexual (it accounts for as much as 70% of patient history), as a child seems to be a key trigger for development of this personality disorder. Parental separation or disengagement is also a co-occurring factor with these patients. better
There Are a Host of Misconceptions in the Therapy Arena About BPD Many believe that BPD is a “female” disorder while, in fact, it is more common in women it still occurs in men. Another myth is that BPD is ineffective to counseling. While it is true that BPD is resistant to many counseling paradigms; certain counseling models are more effective in working with these patients.
they classify “ themselves and others as good or bad
Responsibility is a Key Patients must begin to accept responsibility in all facets in their treatment. Though this is a common mantra for all recipients of counseling. This, however, is the key to successful counseling for patients with BPD. If they have substance abuse issues this precludes effective counseling for other issues and therefore they must seek substance abuse treatment. In all of their relationships they must seek to recognize their responsibility in development of maladaptive relational patterns. Responsibility in relationships must also be confronted directly as opposed to using maladaptive patterns of fleeing, blaming, going on the defense or using substances to dull the pain of relational issues. Seek to Look Under the Anger for the Larger Roots Patients who have BPD tend to recognize an overwhelming anger that comes in waves and often leads to impulsive waves of anger that jeopardize even the closest relationships. While patients may state they are in need of anger management; the truth is they must see a spectrum of emotions that are at the roots of this anger. Frustration, fear, anxiety, depression, jealousy are all at the roots of this anger. Therapists, therefore, are better off seeking to address these underlying emotions and making patient aware of these emotions in relational matters.
Cognitive Distortions and CBT are Important Elements Common cognitive distortions issues of â&#x20AC;&#x153;black and white thinking, generalization, blamingâ&#x20AC;? and the host of other distortions that are listed under distortions must be addressed in the sessions. Providing journaling through paper or in smartphone applications will help patients be aware when they are using cognitive distortional thinking and placing themselves on a healthy mental track when they are out of session. Dialectical Behavioral Therapy (DBT) is Determined to be An Effective Modality for BPD DBT recognizes that certain people tend to have particular sensitivities to and reactivity to situations that may present emotionally challenging circumstances. That being said, these people also tend to have an extremely difficult time in self-soothing and returning to a baseline level of emotional stability. Conversely, they also lack the coping skills for seeking a means of returning to a base level of emotional calm and need to be taught these strategies.
Developing an Outline for DBT Sessions DBT sessions ideally consist of weekly individual meetings with the therapist. On this order, a review of the past week’s issues that have occurred are addressed. A look into deeper issues that may have created the conditions for BPD.
Living with “someone who is diagnosed
PTSD and self-esteem issues that crop up with BPD from these discussions must be handled can be very accordingly. Finally, suicidal ideation difficult must always be assessed on a session to session basis. BPD patients can tend to be highly emotionally reactive and impulsive which creates an ideal environment for suicidal ideation. Therefore, a safety plan should also be discussed and, as necessary, have family members involved in this portion of the counseling.
Consider Counseling Therapy with a DBT Paradigm BPD patients tend to view their relationships in comparison to others. With this in mind, group counseling with a DBT paradigm can be an excellent modality to working with these patients. This is especially effective in addressing and role-modeling relational issues. Being “Mindful” BPD Patients are very quick to judge situations immediately and harshly Teaching them in session to look at a situation without any judgment but instead observing, learning and participating is key. Along with “staying present,” learning “self-sooth” and decrease stressors. Taking Care of One’s Self Due to a chronic lack of awareness of self and others, BPD Patients often do not know how to do self-care. Encouraging them to eat right, sleep right, avoid substance usage are important life skills that can go a long way to avoid aggravation of BPD symptomology.
Why It Is Not Bipolar Disorder Often BPD and Bipolar Disorder are confused as differential diagnosis. There are important distinctions, however, Bipolar Disorders will often cycle without any apparent social trigger. BPD patients tend to have mood cycles in reaction to an event often relational or perceived abandonment issues. BPD patients will often discuss these triggers in terms of “love-hate” relationships where Bipolar Disorder patients will not have a noted social trigger. Suicidality Assessment As Often As Possible Is Key: As mentioned before BPD patients tend to be impulsive and reactive. They have been demonstrated to have a greater level of suicide ideation and attempts more than any other diagnosis. When they are in pain they often describe wanting to find any and all means to escape this feeling (including unfortunately suicide). In knowing this, it is important to develop any immediate safety plan (even if there is no active suicidal threat). This may mean getting other family members involved to recognize psychiatric emergencies and know when and where to utilize resources accordingly. Family Counseling Living with someone who is diagnosed with BPD can be very difficult. They can be very close and loving one moments and demonstrated hatred and distancing the next. Family therapy therefore will not only help the family but will also help the patient as they will have support when they need it most and are most irritable and vulnerable. Again, they can also help find resources of a patient is having a psychiatric emergency. Marital Counseling Concurrent marital counseling may be suggested or needed as communication skills are BPD patients weakness. Learning “I” Messages, seeking realistic versus grandiose opinions of spouse as well as teamwork versus power struggles are all elements for marital counseling. better
featur e Often times, when a BPD patient comes in the doors of a therapy office they can be described as being “a pain.” They can be described as difficult, irritable, and demanding to therapist, receptionist’s and other’s that they come in contact with. This pain, however, is nothing compared to the pain that a BPD patient feels on a daily basis. These people are deathly afraid of abandonment and will grab whoever they can to avoid drowning in their own fears. Unfortunately, they often fulfill the prophesies that they so fear and thus
create even more anxiety. BPD patients often describe the pain of relationships of that as a fresh and raw sunburn that is aggravated with each perceived social slight that they inevitably feel on a daily basis. As therapists, we may be the only one who can apply a therapeutic salve to ease that pain. We can see beyond anger, irritability, and criticism to a vulnerable and hurting human being who is in desperate need of help but cannot find a means of getting a handle on the quicksand that is their constant thoughts of abandonment.
Mr Brett Novick is a State Certified School Social Worker, Principal, and Educational Administrator, and is licensed as a Marriage and Family Therapist. He holds degrees in Psychology and Family Therapy. He has qualifications in Psychology, Family Therapy and School Social work. His broad school and community experience includes school social worker, community and private mental health practices, working with individuals, groups and in-crisis children and families as well as a supervising a shelter for youth in State care and custody and families where a member has a developmental disability. Mr Novick has been published in several therapy and educational publications and received many State and Community educational and mental health awards over his career, including the NJSCA Ocean County Counsellor of the Year and NJDOE Commission on Holocaust Education Hela Young Human Rights Award. Brett can be contacted through firstname.lastname@example.org bmhmag.com
Life and a Life Nearly Lost
Suzanne Rath tells us about belonging, her life, a life nearly lost to depression and the work she has done as a film-maker since to help raise awareness and understanding of suicide.
Suzanne is a Sydney based writer, producer and founder of Idle Wrath Films. Originally trained as a physiotherapist, she has previously worked in mental health and has a strong interest in integrative medicine. She tweets as @Suzowriting and further work can be found at http://suzannerath.com
Belonging In November of 2014, I decided to kill myself. It was almost exactly a year to the day after an unobservant motorist’s Skoda had smashed my jaw into pieces. It was almost exactly a week to the day since I’d broken up with Jason, or as I’d thought of him for some time, ‘The One’. I couldn’t see a reason not to. There was a full bottle of liquid morphine in my bedside table, surrounded by four months worth of Sertraline (an antidepressant). A bottle of Bordeaux wine was ‘cellaring’ under the stairs, the souvenir of a pre- accident film-making trip to France. All of these went into my handbag and I marched down King Street towards Sydney Park, where I sat on a hill overlooking the city and took a large swig from the little brown medicine bottle. Street lights glimmered below and a misty rain started to fall as I played all the depressing songs from the Her film soundtrack
is a “ Belonging strange thing ” on repeat. A heated argument flew back and forth via text. ‘What’s so very wrong with our relationship?’, ‘Can’t you deal with any hardship?’, ‘If you really love me, why can’t we just try something, anything?’, ‘Please!’ ‘PLEASE??’. The answers landed like bullets, each one hurting just enough for me to pop another round of pills and a swig of wine. It was a good red; it really deserved a glass. And then Sydney became suddenly, inexplicably beautiful in a way I hadn’t noticed for some time. The opioids had kicked in; I was oblivious to the dampness of my hoodie, ambivalent about the death of my phone’s battery. I sipped on the wine until it was empty and then sat, staring into space. Jason arrived several hours later, with the police and an ambulance. That night in the Emergency department could have belonged to someone else; nurses telling me to breathe, or my shock as I finally noticed my own blood pressure readings. My memory is clearer on the painful times that followed: the locked psychiatric ward, moving out of our house in Erskineville, several weeks spent sleeping on various friends’ floors. And eventually, my own place to belong. Belonging is a strange thing. For some, it means busyness and large groups of friends and making plans and throwing dinner parties with a loved one. I saw that person, the person I had been, leave. I grieved for her through every stage that it’s possible to feel angry and hurt and disappointed at a great loss. And then I picked myself up off the bedroom floor and sat on the front porch, patting my new puppy and staring at a brick wall. I remembered where I’ve been and where I’m going to. I’m still here, on the merry-go-round. The ride has just changed its course. Editor: Suzanne sent two different perspectives of her experience, suggesting we choose one or combine them. Instead, we included both as they provide different insights, thoughts and feelings of the one experience; something we often experience ourselves. bmhmag.com
The Making of a Film why making a film about suicide is so important
Maybe it's the scientist in me, or perhaps it was my fear of painful convulsions and vomiting, but I wanted to observe how I felt as I took each round of pills.
the park, not least of all because the only keys in my bag were for the house I was still sharing with my ex and our housemate.
The lights of Sydney glimmered in the distance and a misty rain started to fall as I played all the depressing songs from the soundtrack from the film Her on repeat (I can never listen to Lavender Diamond's beautiful, 'Everybody's Heart's Breaking Now' in the same way since).
Caught in limbo between my fractured life and the desire to fade away, I Googled the fatal dose for Sertraline. It's high: much higher than what I'd taken, but combined with oxynorm and wine and my small frame, I wasn't sure if it was quite enough.
As the text conversation between my ex and I spiralled downhill, I used each tsunami of emotion as a cue to palm down more tablets, followed by a bottle of Bordeaux we'd been cellaring since our trip to France. Eventually, I figured, I would just go to sleep and it would all be over. Suddenly, Sydney started to look beautiful again. Here's the thing about taking a large dose of opioids â&#x20AC;&#x201C; it makes you very, very relaxed. Combined with the natural waning of intense emotion, I finally started to calm down. Still, I sat, drinking more slowly. I was oblivious to the rain and still didn't want to leave better
Just before my phone's battery ran out, I texted my ex a list of the medications I'd brought with me. In my stunted logic, I figured that if I was going to die, I didn't want it to hurt, so if I was unable to move yet still alive and suffering in some fashion, it might be ok for somebody to find me. But then, if I did happen to peacefully pass away in the interim, that would also be fine by me. I realised I was pretty ambivalent about the death thing; I just didn't know what else to do. This story still shocks people when I tell them. From the outside, my life looked like it was on an upward trajectory. Several months before, I'd wrapped up
Last year I decided to kill myself. I was thirty years old, had just broken up with 'The One' and I couldn't see a reason not to. Broken and distressed, I took a bottle of Oxynorm, red wine and four months worth of Sertraline (an anti- depressant) to Sydney Park, sat on a hill top and started my overdose with a large swig of morphine-based pain meds.
my first professional short film which I wrote and produced, with my ex as director. In the immediate aftermath, I met Phil Middleton, who asked me to produce his upcoming short, The Noose, a fictional story about a â&#x20AC;&#x153;guyâ&#x20AC;? who finds himself caught in an infinite loop of depression. Creatively, we've turned it into an exciting project, with a talented and dedicated team on-board. Personally, my relationship with the character began mostly as a clinical one: I'd spent several years working in a psychiatric hospital back in Ireland and, in that wonderful way healthcare professionals have of maintaining a distance from their patients, I was familiar with 'people like that.' 'People like what?' you should ask. Figures state that 1 in 2 people experience suicidal ideations at some point in their lives. Other sources tell us that one million Australians are depressed each year. That's fewer than 5% of the population who are actively depressed: even working under an bmhmag.com
assumption that many suicidal people are untreated or undiagnosed, there's a massive discrepancy in the figures. Yet many of us live under the illusion that death by suicide is the inevitable end product of a lifetime of chronic depression, or at the very least, the result of a breakdown after a huge, unthinkable tragedy. How wrong we are, as the fictional story of our guy, me and countless other people can show. I first felt suicidal in 2013, rendered mute and in severe, constant pain
by the medieval torture device put in place to fix a broken jaw I'd sustained in a serious accident. I'm a trained physiotherapist, and so I know that bones heal, pain subsides and joints move more over time. I wasn't going to be one of 'those people' who gave into the psychological trauma of what I dismissed as a reasonably small event in the grand scheme of the world. After all: terrible things happen all the time â&#x20AC;&#x201C; what right did I have to be upset when there are child soldiers in Africa and women being raped nightly and people without the basic human needs of food and housing? I didn't understand then that this is what we do. We invalidate our own 'petty' grievances and emotions, or allow others to do it for us. As our guy in The Noose contemplates his life, a soundscape will illuminate the painful thoughts he carries with him. None of these will be unfamiliar to viewers: people lose jobs, they argue with their loved ones, they get their hearts broken, they fail and, mostly, they pick themselves up and try again. Yet our guy has reached a point where he feels like he can't go on. The stories he tells himself have become toxic and they play on repeat in his mind. If you've ever convinced yourself that a relationship ended because you weren't worth it, or you were made redundant because you weren't good enough, or your parents would love you that little bit more if you just did better in your exams, then you know what it's like to tell yourself these stories.
people We all like to exert some control over our lives. The trouble with the mind is that, when it attempts to 'fix' a situation, it allows us to tell ourselves unhelpful facts on repeat. Because we can't manage what others say or do, it's easier to blame ourselves and try to control our own behaviours. Psychological therapies offer many tools and techniques for management of such stories, all of which amount to the depressed individual coming to a conclusion: this too shall pass. After I spent a night in RPA's emergency department, my blood pressure and respiratory rate dropping to dangerously low levels, I was transferred to a psychiatric ward for two nights. I can honestly say it was the worst time of my life – locked in, under half hourly 'checks', without the means to contact my friends, a tablet for writing or even a decent book. I needed to leave, to do something proactive. I spoke to my wonderful psychologist over the phone and we worked out a system where I would plan my day out, hour by hour, making sure I had ample time to rest, to exercise for pain management and to connect with friends. My life ‘after’ had begun: I saw this as an immense privilege then and I still do. I decided to live.
story still shocks “ This people when I tell them ” In breakdowns, as in life, people are different: none of us expect, or want, the audience to watch The Noose and see our guy as a poster figure for depression. This is art, and at its very core art should make us question the world around us. It should make us feel something, anything. It can inspire us to understand others, or to be brave, or even just to be real. You may relate to our guy in many ways, or you may find yourself at odds with every facet of his being: such is the world of film characters. Whatever the intensity of emotions affecting him, or the decision he comes to at the end, it's the choice of a fictional character, not of the entire depressed population. For him, for me, for almost all of us, there have been, there are, or there will be times when we are overcome by a grief that seems almost too painful to bear. This too shall pass. We're giving you this guy's story. Take it.
The Noose is a short film starring Leon Cain and directed by Phillip Middleton. Currently in post-production, it's due for festival release in early 2016. Follow http://www.facebook.com/thenoosemovie or @thenoosemovie on Twitter for updates bmhmag.com
Sober, Stable, and Sane
By Diane Mintz
I learned that I had a problem with addiction in a mental hospital. I finally agreed to commit myself after two months of battling a debilitating depression. I simply saw myself as a fun-loving woman who enjoyed a good party. Besides, I was twenty-two and legal to drink. I ignored the fact that it had been a big part of my life since I was sixteen. Ultimately, it was painful broken marriage engagement that landed me in the hospital. It was actually the second time we had called off the wedding. Well, the third time if you count when the church burnt down.
Diane Mintz resides in Northern California with her husband and two children. She owns and operates an IT business with her husband and is active in her community. As a speaker and mental health advocate, she is passionate about changing the way our culture perceives mental illness. By sharing her story of hope and recovery, she strives to empower others so that more of the silent successful wonâ&#x20AC;&#x2122;t be ashamed to tell the world that recovery happens. You can find more information and mental health resources by visiting her website at http://www.dianemintzauthor.com bmhmag.com
Suicidal thoughts weighed heavily on my tortured mind. It got worse in the hospital because I felt like I would forever have “mental patient” branded on my forehead. A mental patient with a secondary serious problem without a solution! You see, they didn’t provide treatment for addiction on the psych ward. They left me to figure that one out on my own. My solution was to end my life. I stole my dad’s pain pills and went to a hotel room. If the combination of capsules and Coors didn’t kill me, they would get me numb enough to carry out my main plan — to slash my wrist. It was a genuine miracle that I survived. It was no surprise that I returned to the temporary fix of illicit substances and alcohol. But this time I had other chemicals on board. The antidepressants together with the drug potpourri sent me soaring into my first manic episode.
dual diagnosis... was “unheard of at the time
The tornado ride went on for ten relentless years. I still wasn’t sure if I was a real alcoholic because I was able to control my drinking when my moods weren’t running amok. Fortunately, the only requirement for Alcoholics Anonymous was a desire to stop drinking. So I attended meetings. Then I encountered twelvesteppers who tried to convince me not to take my mood stabilizing psychotropic medications. They believed, “A drug is a drug.” I was in and out of AA, skipping steps, missing steps, side-stepping, and half-stepping on a rapidly revolving dance floor that spun me round and round. I was alternately drinking, using, depressed or manic. I inevitably wound up back where I started. Dual diagnosis treatment was what I needed, but it was unheard of at the time. I wish I had realized that I needed to be sober whether or not I was an alcoholic because drinking was dangerous with my brain chemistry. I simply could not balance my moods when I drank and did drugs. An AA member helped me to say that I had a kind of allergy to alcohol and drugs before I could say I was an alcoholic. That helped me stay away from friends who didn’t respect my allergy. Everyone knows to be careful around someone with peanut allergies because bad things happen to them when they come in direct contact. It was the same with me and alcohol. The other significant key sounded simple, but it was hard! Honesty. It may seem hopeless to suffer from an incurable mental disorder and the disease of addiction, but the big book of Alcoholics Anonymous told me I could recover if I could be rigorously honest. It was true. bmhmag.com
After many failed attempts, I got sober in AA in 1991. I have taken my medication faithfully and have stayed within a manageable mood zone ever since. No more hospitals or life-disrupting chaos.
Today Greg and I “have a ridiculously good life together
For the first six months of sobriety, invitations to drink bombarded me daily. Billboards, commercials, and waiters beckoned me to join in the all-American past-time. Everyday-life as a sober, sane person took some getting used to after ten years of being in an altered state of mind from drugs, alcohol, or exploding brain chemistry. It was a terribly uncomfortable awakening to real life. When my compulsion to drink finally lifted and the stink of monkey’s breath got out of my face, I felt liberated. But my struggles weren’t over. Two years sane and sober, I met Greg in a twelve-step program. Greg had a ‘mysterious’ mental illness that was not correctly diagnosed until after we were married. But, that’s another story. One so unique I had to commit to full disclosure so I could publish our story, In Sickness and in Mental Health. I am now proud to share what was once shameful. Today Greg and I have a ridiculously good life together despite our history with dual diagnoses. We have overcome many challenges. We have two awesome kids, a beautiful home, many close friends and a loving family. We own and operate an IT company, which we started in 2005. We are very active in our community and our church.
people Our wellness is all about balance. Greg and I both require medicine and therapy along with spiritual development and growth to remain sober and sane. Recovery from these very complex illnesses requires full commitment to every aspect of treatment because there is no cure. We are always grateful for our sobriety. Some people can’t fathom the notion of living without alcohol. They ask, “Surely you can have a little celebratory champagne at a wedding, right?” Nope. For me, “One is too many and a thousand is never enough.” It is the way my brain is wired. They make it very clear in AA that once we become a pickle, we can never go back to being a cucumber. I’m not embarrassed to be a pickle. Today I am active with various mental health organizations and on three national speaker’s bureaus. I am committed to saying proudly there is no shame in having my conditions. Mine is not a dreary life sentence. There is hope. Recovery does happen. With the right treatment and support, even pickles with mental illness like me can live full abundant lives. Diane Mintz’s book “In Sickness and in Mental Health” is available on http://www.amazon.com/ dp/B00FY2ZO64
Portions of this article have been previously published on the Frank Ridge Memorial Foundation website. Established in December, 2013, in New York, the Frank Ridge Memorial Foundation is dedicated to living well with mental health conditions through awareness and understanding. https://frankridgememorialfoundation.org
r eading the
Ne o n Signs My name is Duane Katene. I have been married for almost twelve years. I have three daughters. I was born in New Zealand in 1977 and moved to Australia in 1985 to the Gold Coast and have pretty much lived here since then. I have an undergraduate degree in Psychology and a postgraduate certificates in Arts/Media and English Language Teaching. I have worked within the ESL sector, the student services sector, as a manager, a case worker and a child safety officer. I love shopping, watching movies, reading, eating out, hanging with my family and of course writing. My goal in life is to eradicate the stigma towards mental health by raising awareness in my writing. And this is my story. So farâ&#x20AC;Ś
When I was a young boy, I was sexually abused. I was twelve years old. I was out-going, imaginative and kind… then everything changed. I knew who abused me. He wasn’t a stranger. In fact he was a family friend; a few years older than me. He wasn’t weird looking. He didn’t have any strange mannerisms. He didn’t fit the so called stereotype. He was a kid himself and looked and acted like any other kid with one difference; he was a predator; a wolf in sheep’s clothing. The abuse happened in very public places.
It didn’t happen in some dark alleyway. You see, abuse can happen in seconds; a hug along with a quick grope, a flash of a pornographic magazine, even a car ride home can be an excuse for an unwanted touch. Of course being young and innocent, I didn’t know how to respond. My body did but, inside, my mind was reeling, trying to make sense of these horrendous acts. Unfortunately this predator witnessed my first stages into puberty. He inspected me like I was some prized bull. He explained to me how my body worked. He enjoyed having control over the most intimate parts of me.
people Before this happened, there was the ‘grooming process’. You can read about this in books. The process involves taking an interest in the ‘target’. You know, taking part in their hobbies, listening to them, being for there for them.
There were no clubs for me. I was a spectre; trying to make sense of the world around me from the bottom of a black pit. At home, I felt safer. I had my writing.
That’s how the predator gained my trust.
Let me digress here for a moment.
Then came the pictures of pornography; only a few at first, but many more were to come.
I became interested in writing when I first heard The Magician’s Nephew, by C.S.Lewis in grade three.
This was to ‘normalise’ what he was about to do to me. Bit by bit, this grooming process pulled out my true identity. Then when the actual intercourse started, the rest of me was pulled. The true me no longer existed. This played out in every area of my life, but especially at high school. I was a part of the school basketball team in year nine. I withdrew because I could no longer stand contact with other boys. I had a large group of friends; all boys. I left the group to become a nomad for the rest of my miserable high school years. I still liked girls. I even had a few girlfriends, but for the most part I was confused. My sexual identity had been mutilated, so I was left in a kind of no man’s land.
A substitute teacher read it to us in class. From the very first line, I knew I was spellbound. I’m not sure if it was the way the substitute teacher read the words or the words themselves, but from that moment on, I knew I wanted to become a writer. I will always be grateful for that substitute teacher. I can still see her face in my mind. I can still see her great big smile and the way she held the book as she read from its pages. It was a magical experience and one I will never forget as long as I live. Now let us return back to my account.
I was barely passing.
At around sixteen years of age, the predator moved away, thus freeing me from what he had inflicted on me for four long years.
I didn’t participate in any extracurricular activities.
After he had left, I forced it to the back of my mind; however it never went away
My grades slipped as well.
That’s how the predator gained my trust
In 1998, I returned to the Gold Coast to live with my family. That’s when I finally revealed to them what had happened. I don’t like to think about that year. It was dark and extremely painful. Still I manage to finish some short courses to help with my self-confidence; I saw a psychologist and I gave up drinking.
of course. Unknown to me, it influenced my every thought and action. You see, the abuse had become a living entity, bent on my destruction. It had become my identity. I began binge drinking every weekend to escape who I had forcefully become. How I managed to graduate from high school, I don’t know, but lucky for me, I did.
In the beginning of 1999, I felt like I could function again so I continued my studies in psychology and transferred to a local university. I went from strength to strength that year. I was active in my church. I had a great group of friends (mostly girls) I was writing more than ever before. I felt happier than I had in years.
While I excelled in English, of course, I didn’t do so well in my other subjects. Still I was accepted into The University of Southern Queensland in Toowoomba to study a Bachelor of Business.
About half way through 2000, I made a decision to serve a full time proselyting mission for the Church of Jesus Christ of Latter-day Saints. For two years I served in Japan. I grew in every way possible, but I think the most important change of all was my identity as a male was strengthened.
That was in 1996. I was happy with this, because it was two hours away from where I lived on the Gold Coast so I ended up staying in one of the residential colleges. Unfortunately, my habit of binge drinking followed me there and I failed most of my subjects in the first semester. Then with the second semester, the abuse began to seep into my subconscious. In my second year, I decided to change from a Bachelor of Business to a Bachelor Arts in Psychology to make sense of the abuse and how it was affecting me. I didn’t last out that year. I was struggling in every way possible and continued binge drinking to dull the pain. It never did. better
When I came back in July 2002, I continued my studies, worked part time and again, formed a large group of friends, mostly males. I was happy with this, because I believed the abuse I suffered had interfered with my friendships with males and I missed that. In December 2002, I meet my future wife at a convention for young single adults in my church. In January 2003, while both still pursuing our tertiary studies, we started dating. It was very hard for me. I had to learn how to let another person in, especially on a level that was personal and
people intimidate. Lucky for me, the woman of my dreams had the patience and compassion. Although at times I pulled away from her, she never pulled away from me. That alone earned my trust. As months passed, we grew closer. There was talk of marriage. That was another challenge for me. We saw each other as much as we could, however I knew when he were married, we would share a life together. That frightened me. I had always been an independent person. I had always done my own thing. Now there would be another person to think about. On November, 29th 2003 we were married in a church service in Brisbane. The first of our three daughters came along in May of 2005. By then we were living with my in laws. I found it
overwhelming to let more people into my life. I struggled every day. In addition to this, though I graduated with a BA in Psychology, a few weeks after my wedding, I had found no work.. Lucky for me, my father in law found me my first ‘grown up’ job as an English Language Teacher for international students. He had sold a house to a man who managed the school for international students. I loved the work. I didn’t have much experience, but I learnt fast and was good with people, mainly due to the skills I learnt while serving a proselyting mission. However by 2005, I was tired of living on the Gold Coast. Also, since my teaching job was only part time, I needed a larger income to support my
by 2005, I was tired of living on the Gold Coast growing family. Fortunately for me, I secured another teaching job towards the end of 2005 in Brisbane city. It was full time. We moved to Tanah Merah; a suburb of Logan about thirty minutes from the city. I loved my job. I commuted by bus there and back. I didn’t mind the travel because I knew my wife and baby girl would be waiting for me at the other end. Then in 2006, I grew tired of teaching. During this time, another teacher left and I was able to take over her class. She prepared international students to study at a tertiary level. It was only two of my five days teaching, but it was enough to keep me satisfied. Towards the end of 2006, we found out we were expecting our second girl. I was over the moon. Then due to me no longer wanting to commute we moved to a northern suburb of Brisbane. It was only fifteen minutes by train. I loved it there as well. However, 2007 was a stressful year. I became dissatisfied at work and began to exercise at night as a form of coping mechanism. At first it was only a few days a week for thirty minutes. Then gradually it became six days a week for forty minutes, sometimes a full hour. better
I began to lose weight. I liked the feeling of losing weight. In retrospect, it gave me control over my life because I felt like I had lost control through being stuck in a job I had by now lost interest in. For me, control was everything. Remember, as a young boy, I had lost control at the hands of that predator. Exercising and the act of losing weight, was my way of regaining control, even though at that time, I didn’t see it that way. I continued to lose weight for much of that year, even though I didn’t really need to. Soon however, I became dissatisfied with the weight I was losing so I began to limit what I ate. I threw out my work lunches; I halved my breakfast and dinner. I refused to attend to go to any restaurants or friends’ birthday
people parties or family events, knowing there would be food in abundance. This took a toll on my wife, heavily pregnant and a toddler at home. What finally ‘broke the camel’s back’ was when I refused to eat any birthday cake at our daughter’s second birthday party. It was then my wife made me realise I had a problem. It still took the rest of the year to return to eating normally and even then I slipped up now and again. During this time, our second daughter was born on the 24th June and I received a promotion at work to assistant manager of the English language school. However I needed to get my masters in English language teaching, so I applied at The Queensland University of Technology
and was accepted. By the end of 2007, my wife wasn’t happy. She was literally bringing up our two girls alone, because I worked during the day, had night classes twice a week and studied on the weekends. I wasn’t happy either. My weight had plummeted from 95kg to 69kgs. I was self-harming, I hated studying. I hated my job. I was over it. I decided to apply to work in student services. In April 2008, I was hired as manager of the student services at a university campus. Most the students were international students, with English as their second language. I was happy at first. It was in a new environment with new people. I wasn’t teaching. I was supervising the staff. The problem was, I had been hired to manage an already established team, some who had even applied for my job. I was resented from the beginning. This lead to a lot of conflict where I was harassed and mistreated by the team, however I had one ally. He was hired at the same time as me as my assistant. With his support I was able to fire the entire team, one by one, except him. During this time, I felt like I was on the reality program, Survivor. It was tough. I had to keep my wits about me as well as still do my job. My time there did get better. I hired a fresh, new team. We got along great. Morale bmhmag.com
My wife was happier. I was too… at first.
in 2008 ... I applied for positions back on the Gold Coast improved. So did productivity, but I was broken inside. Although my team and I received positive feedback from uppermanagement, I couldn’t continue in my position. I had been hurt. I had been betrayed. I had been double crossed. It had wrecked me. Towards the end of 2008, with my wife’s encouragement, I applied for positions back on the Gold Coast. The last few years had tired her out as well. She needed more family support. That was the only reason why I relented and moved back; for my wife.
While the team was friendly, they soon showed their true colours. The first half of 2009 was another terrible time. Don’t get me wrong. I loved my job. I was good at my job. However just like the last team, this one too had been long established and I was on the outside once again. Yet unlike the last team, this team’s ‘attack’ was more subtle and devious. They blindsided me into a false sense of security and come May of that year I was fired. I was humiliated. I was hurt. I was broken. I was defeated. I needed to somehow support my family still. I applied for different positions again.
It only took me two months to find me another position.
I contacted old work colleagues, but nothing.
This time, as a manager of the student services within the Law faculty of another university.
I became desperate.
We found a town house nearby.
I decided to return to full time study.
My parents and older sister and her family just lived up the street. My wife’s family lived less than fifteen minutes away. I also had two brothers and their families who lived nearby too. better
I started my usual over-exercise/under eat/self-harm routine again. My brother-in-law moved in to help with the rent. I began studying a Postgraduate course in Education (Middle years) at The Queensland University of Technology, which meant I was commuting to Brisbane.
people I loved being at QUT. I loved the environment. I made lots of new friends. That has never been one of my problems. I have always made lots of friends in whatever environment I have found myself. Not that I consider myself entirely an extroverted person. I am also an introverted person when the moment calls for it.
I think in some way the tutors teaching style didnâ&#x20AC;&#x2122;t help. He was demanding. He didnâ&#x20AC;&#x2122;t ask for volunteers when solving a problem. He made you solve it or try to solve it in my case in front of the class. I hated it. So I changed to teaching early years. While I felt better, it was still challenging.
At first I enjoyed the course.
Then came the practicum.
Then the mathematics component came and I lost it.
First I observed a teacher in the prep year and after a few weeks I had to teach a few sessions.
I have always been bad at mathematics, but now I suddenly realised I would have to actually teach it to those students in the middle years. I freaked out.
I hated it. I felt exposed and vulnerable. I had no confidence in myself and I didnâ&#x20AC;&#x2122;t feel comfortable.
Around October studying.
I was lost. I was hurt. I was under pressure. I started the over-exercise/ under eating/self-harm routine again. I was also depressed that I stopped functioning. We had to move out of our townhouse. In November we moved into my in lawâ&#x20AC;&#x2122;s house. They moved downstairs. We had upstairs. In December I applied for a Postgraduate in Social Work at Griffith University, a twenty minute car ride. I was accepted and started my classes over the summer
and continued into 2010. By then we were pregnant with our third girl. I started an internship with a not for profit organisation in March as part of the postgraduate. I hated it. In April I left the course. It wasnâ&#x20AC;&#x2122;t until August of that year that I found work again. On the 4th of August our third girl was born. A few days later, I began work within the State Government in child protection. I hated the work from the start. I hated working with vulnerable kids. It brought back unwanted memories of my abuse since these kids had been abused as well. Still I had no choice but to carry on. Around January 2011, I was done. This time, however, I had no idea what to do. I had exhausted my options. Again, the over-exercising / under eating / self-harming/feeling hopeless routine began, until I decided to study
people creative writing. I had continued to write through all of my ‘adventures’. By now, I had written whole novels of the fantasy genre. I applied for the postgraduate program and was accepted in February and started my first class.
I was humiliated I was hurt I was broken
I absolutely loved my program from the start. I had finally found the right program for me. I was on fire. April of that year, I had the opportunity to write a novella for one of my classes. I wanted to write a fantasy one. My tutor challenged me to write outside my chosen genre. So I did. I decided to write about my experiences with childhood sexual abuse and how that had affected me in my life so far. It was an excruciating experience; however a cathartic experienced as well. I based the only character on me. I wrote the novella as a series of journal entries and finished it around May. No words can describe how much I grew in this time. I achieved unbelievable growth. To this day, I have no regrets with what I did. Come July 2011, while I achieved high grades, I didn’t have the financial means to continue on to second semester and had to graduate. The rest of the year, I kept myself above dark waters by lengthening Neon Signs into a short story and self-publishing in November of 2011 after received at least fifth rejections during that time. I also published another novel named Fury’s Daughter; a fantasy book and number one in a series. I had
been working on that once since 2008. Fury’s Daughter had also received the same number of rejections. In retrospect, receiving all those rejections, especially for Neon Signs was the beginning of my mental breakdown. I had put everything into Neon Signs and every single one of those fifty rejections, devastated me. In January of 2012 I found work a not for profit organisation. I was miserable and broken, more so this time. I had been through a lot and it was taking its toll. In April 2012, I found another job within another not for profit organisation. I managed a number of foster carers who cared for kids who could no longer stay with their own parents due to abuse. That was the beginning of the end for me. The team there was wonderful. I genuinely liked working with every single one of them. The work was the killer. I managed to stay there full time until July of 2013, after that I worked part time.
but I was mentally dying within.
however after further education; I am more comfortable with the diagnosis. The psychiatrist continued with the Lexapro and prescribed me Ritalin for the ADHD.
That took the pressure off, but I was mentally dying within.
By June I was put on a mood stabiliser as well and by July I left my position at work for good. Lucky for me my wife had full time employment to enable me to take time out to get better.
August 2013 I began to stop functioning with everyday life.
That’s what I did for the rest of that year to this day.
I was under eating.
I have am also looking after my daughter and taking care of the household duties.
By then the girls were old enough for my wife to work part time as well.
I was anxious. I rarely left the house, except for work. I withdraw into myself. I was depressed. I self-harmed. I started to see a psychologist in November 2013. I was at the lowest I had ever been. In January 2014, I went to a local GP. I was put on a Mental Health Care Plan. He referred me to a local psychologist and psychiatrist. I was given Lexapro while I waited. In March 2014 I had my first session with the psychologist and psychiatrist. In April 2014, I was diagnosed with ADHD, depression and anxiety. I wasn’t surprised about being diagnosed depression and anxiety. I was about being diagnosed with ADHD, better
I write in my spare time. I have improved a lot mentally and emotionally. I still have times where I struggle, however I no longer over-exercise, under eat or self-harm. I still have a long way to go, but I take each day as it comes, even though it’s hard. Both my psychologist and my psychiatrist attribute my childhood sexual abuse as a possible cause for the depression and anxiety while the ADHD is more organic in nature. I am still looking to get published. I wrote many other books during 2014. I have developed into a character writer with books about the character’s struggles to manage their mental health. I will never give up on the becoming a paid writer. I will always write with the goal of raising
the awareness of what mental health looks like and eradicating stigma.
This helps know that I am not alone, because we aren’t.
While my story hasn’t ended yet, I would like to end this article with what has helped me in hopes they can help other as well.
You, who is reading this, remember, you are not alone. I am with you.
Sessions with a psychologist. These can occur when needed. I see mine psychologist monthly and it really helps. It gives me a safe place to express myself and learn how to manage my mental health better. Sessions with a psychiatrist. These can occur when needed. I see mine bimonthly just to check my medication is still helping me. Healthy diet. I try to eat as much fresh fruit and vegetables as I can. I also try to stay away from fast food and other junk food. Exercise. I exercise six days a week for around twenty minutes. I run, jog or swim. Engaging in a hobby. I take time out to write every day. I find it clears my thoughts and strengths my ability to cope. Spending time outside. I love going to the beach. There is something about the sand, salt breeze and waves that I find therapeutic. Learning to accept yourself while you are in crisis. This is a biggie. Yes we are going to have bad days, but we should try to not react to them in a negative way. We need to accept them as a part of our ongoing recovery. Having a trusted group of friends for ongoing support when needed.
Make sure you visit Duane’s website for more information or to purchase a copy of Neon Signs www.duanekatene.com Also search for ‘Duane Katene’ on YouTube for videos of his personal experiences and perspectives.
Life isn’t supposed to be an all or nothing battle between misery and bliss. Life isn’t supposed to be a battle at all. And when it comes to happiness, well, sometimes life is just okay, sometimes it’s comfortable, sometimes wonderful, sometimes boring, sometimes unpleasant. When your day’s not perfect, it’s not a failure or a terrible loss. It’s just another day. Barbara Sher
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A Peer Approach for Community Mental Health by William Mace, PhD Today, an estimated 60% of American adults experiencing a mental health condition donâ&#x20AC;&#x2122;t seek professional help. Stigma poses the greatest barrier, but our goal of community mental health depends on more than just removing the stigma. We need to talk the talk of everyday citizens, and, more importantly, create an effective delivery system, without which, we go nowhere.
Noting the lack of significant improvement in community mental health over the past 50 years compared with breakthroughs in medical health, the National Institute of Mental Health (NIMH) recently abandoned the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is based upon symptoms. NIMH is looking to understand mental illness from basic biological mechanisms, such as genes, cells, and brain circuits â&#x20AC;&#x201D; but it also supports trans-diagnostic psychotherapies that can be measured by behavioral constructs such as positive and negative valence.
What has been missing is a reformulation of the DSM model of mental illness with its emphasis on labels (symptomatic categories) to a more self-empowering functional approach. Self-empowerment in this instance means coming to terms with oneâ&#x20AC;&#x2122;s unresolved intrapersonal conflict, which most often manifests itself as unresolved anger. Unresolved anger gives rise to anxiety, depression, and a multitude of self-defeating behaviors. Unresolved anger takes excessive psychic energy to suppress for fear of expressing recklessly. It also leads to a lack of psychological resilience when things go awry.
PsychResilience Therapy PsychResilience Therapy (PRT) is a trans-diagnostic approach for the prevention and treatment of depression and anxiety. PRT is based upon psychological resilience as a self-referential process that can be learned to maintain a positive sense of self under prolonged stress. It is successful because an individual with a positive sense of self cannot simultaneously experience high levels of anxiety or depression. Almost everyone carries unresolved anger. The problem with unresolved anger is that, periodically and often unexpectedly, the lid blows off and uncontrollable rage surfaces. In spite of our rational will, the power of better
featur e our angry feelings temporarily takes control. Our rage may be out of proportion to the immediate situation yet, along with this rage, we may momentarily experience a sense of personal liberation and exhilaration. This explosive power, of course, reflects our animal side. It’s like a Bengal tiger pouncing out of a cage, with its massive paws; orange fur with black stripes; and long, arched tail. Nearly everyone carries a tiger inside. It’s the part that has all the anger, yet also has all the fun. Our tiger represents our honest emotions minus any restraints. We want to liberate our honest feelings to take charge of our lives. Yet it’s important to not just release our tiger and allow him or her to run wild — limits must be set. Our tiger won’t listen to the embedded voice of authority inside our heads, much less to authority outside our heads. Embedded authority and the tiger have been at odds all of our lives; the two are incompatible and frequently in conflict, which manifests itself in periods of depression, anxiety, and low self-esteem. PRT supports the concept of free will as being necessary for responsible decision-making, but not a world view of mechanical cause-effect or other’s social values and norms being imposed upon our emotional lives. Life would not be worth living without the freedom to love, have fun, and
think our own thoughts. When we connect the vitality of our tiger with the rational power of our own beliefs and values, nothing can stop us from resolving the intrapersonal conflicts that prevent us from being the best we can be.
Almost everyone carries unresolved anger At first blush, the tiger metaphor may seem frivolous. Yet, this metaphor is easily accessible as the source of anger and love, enabling us to feel some good about our inner selves, not to be suppressed out of disgust, revulsion or fear. Nearly everyone can connect with his or her tiger as a metaphor for one’s innermost feelings. The tiger metaphor gives rise to openness and congeniality with others.
How it works The proposed etiology for mental disorders involves a two-step process:
As children we are socialized
to adopt values and norms that are dysfunctional for us as adults, which lead to unresolved intrapersonal conflict; and
Unresolved intrapersonal conflict gives rise to anxiety, depression and a multitude of self-defeating behaviors.
Behavioral change is brought about by accessing and dealing with our unresolved anger from the past, which most often is toward authority figures, whether justified or not. Setting the frame: Our rational mind has two voices: our own voice and the voice of authority figures embedded in our minds from childhood (e.g. “You must look before crossing the street,” “You need to follow directions,” “You have to do your homework.”) This embedded voice often is mistaken for our own voice but recognizable when we tell ourselves “I have to do this,” “I need
to do that,” or “I must do the other.” Have-tos always are mandatory, without choice. These early taught have-tos soon become habit of mind, controlling our emotional life with either-or value judgments: good or bad, right or wrong, moral or immoral. We begin to screen out our honest emotions not just to hide them from others but also to hide them from ourselves. We become anxious about inadvertently revealing our true feelings. Suppressing this anxiety leads to dysphoria and depression. We can recognize our own voice by its use of want-tos, like-tos, and wishtos. Want-tos provide the freedom to change our minds. Want-tos don’t necessarily dispel all have-tos as without merit, since our own voice can independently determine merit based on our own self-interest. Wanttos place us in charge of our lives. Those who refuse to let go of havetos must default to embedded or outside authority to make decisions for them. Submitting to authority, however, can lead to powerlessness, anxiety, and depression. It’s difficult to feel good about yourself when someone else is pulling the strings, and you’re only reacting. Suppose someone points a gun at your head and says, “Jump!” There’s a difference whether you just jump, or consider the consequences and decide to jump. The difference is that by just jumping, you are not in
featur e charge. The guy with the gun is in charge and you are simply reacting. But by consciously deciding to jump, you are in charge because you could also have decided not to jump. How do we change have-tos to wanttos? “I have to work to make a living” can become “I want to work to make a living” and “I have to exercise to stay healthy” can become “I want to exercise because I want to stay healthy.” We always have a choice as long as we are willing to accept the consequences — in short, taking personal responsibility for our innermost feelings, which, when suppressed, can become our most formidable enemy. Or, as put by an ancient proverb, “If there is no enemy within, the enemy outside can do us no harm.” Helping others: The success of PRT is largely dependent upon the individual’s taking personal responsibility early during the first session. If the individual begins to blame others or drift off-point, we can simply ask, “Do you want to continue being controlled by others (or past events) for the rest of your life or do you want to take charge and be your own person?” By confirming he or she wants to be one’s own person, the individual has committed to becoming selfempowered. The quickest way to access the
individual’s nonrational domain is to ask about the individual’s unresolved anger in the present, back through high-school and grade school to preschool, if necessary, to hear when the individual was first aware of feeling anxious, depressed, compulsive or whatever.
We always have a choice as long as we are willing to accept the consequences This enables the individual, who already has committed to taking charge of his or her life, to focus on the precipitating event or circumstance that initiated the disabling feeling. Once uncovered, the individual will see the event from a current perspective and reclaim his or her sense of self-efficacy. The advantage of not having focused on individual’s current malaise before this point is that we must first establish rapport and trust between the individual’s emotional domain and our rational guidance. Also, from this point forward, the individual has been empowered to openly reflect, without resistance from the individual’s emotional domain, upon the suppressed anger that underlies his or her current emotional distress.
Measuring successful treatment The Positive and Negative Affect Schedule (PANAS: Watson, et al., 1988) is a brief, reliable, and valid self-report measure across mental disorders. You can find more information about the PANAS Questionnaire at the American Psychological Association website. Although anxiety and depression cannot be directly measured, a positive attitude, incompatible with anxiety and depression, can be measured. It should be noted, however, that a decrease in negativity does not necessarily translate into an
increase in a positive attitude — the two scales are independent of one another. The features of Cognitive Behavioral Therapy, which follows the DSM symptomatic template, can be compared with the PRT transdiagnostic approach for treating depression as follows:
Feature CBT PsychResilience Therapy Cause:
Negative symptoms suppressed anger Method: Reduce symptoms legitimate anger Sessions: 8 – 12 3–5 Change: Decrease negative increase positive Delivery: Office visits peer to peer The number of sessions is based upon turn-around time, before significant change can be noted via the PANAS. But whatever the etiology of the mental disorder, what really matters is what the individual is going to do about it. The first order of business with PRT is to have the individual challenge the embedded voice of authority by validating his or her tiger’s unresolved anger. One way we can encourage the individual to acknowledge this anger, is to suggest, “You may have
featur e abandoned your tiger, but you’re lucky your tiger didn’t abandon you.” We are asked why aren’t papers given to read and assignments to take home. We advise the individual that the process becomes self-enforcing because self-empowerment and resolving issues can build upon one another without all the effort, hard work, and self-blame. “Self-liberation can be fun!”
Applying PsychResilience PRT offers a new and credible approach for anxiety and depression. It recognizes intrapersonal conflict as the primary cause of psychological mental disorders. It promotes personal responsibility by emphasizing proactive decision-
A positive attitude, incompatible with anxiety and depression, can be measured making. And with the help of social networking and peer groups, PRT can provide greater efficacy for improving mental health in communities across the world. Remember to test yourself on the PANAS Questionnaire to validate your positive affect versus your negativity. It’s difficult to help others deal with their unresolved anger if you have not successfully resolved your own pentup angers.
William Mace, Ph.D. is a clinical psychologist, neuropsychologist, and medical sociologist, specializing in adult depression and anxiety disorders. While conducting field trials for the DSM-5 of out-patients at the Department of Psychiatry, University of Pennsylvania, he began to question the validity and reliability of the DMS categories and began work on a transdiagnostic alternative. PsychResilience Therapy offers an effective intervention for prevention and treatment of depression and anxiety disorders for adults. It empowers the client with the resilience necessary to face down life’s inevitable setbacks and losses Dr Mace can be contacted at email@example.com
All In The Mind Violet Skinner tells us about her experience living with mental health issues, her fall and fantastic recovery with the help of family and a local charity I've been diagnosed with mental health problems for about 7 years, although I've lived with them for a lot longer. At the time of my diagnosis I wanted nothing more than to die. My mind was consumed with self-hatred. I used to cry myself to sleep at night wishing with every fibre of my being that I wouldn't wake up and have to face another day. I was in constant pain. It wasn't a physical pain yet to this day it is still the most painful thing I have ever experienced. Unlike a physical pain there was no quick fix. If you have a physical injury they can give you painkillers that will almost immediately take away the pain. You can't do that with emotional pain. There is medication like antidepressants but you have to take them for a couple of weeks before you feel the benefit. When every day is agony that seems like an eternity. I didn't believe anyone when they said I could get better. I looked at others that had improved and thought that would never be me. I didn't want to get better because I bmhmag.com
thought I deserved the pain for being a horrible person. I tried to keep working but I couldn't do the simplest of tasks. I couldn't understand instructions, was unable to concentrate, and felt exhausted all the time. Finally in 2012 after having several long absences from work I had to give up my job. My colleagues were very supportive but that did nothing to soften the blow. Without a job there was no way I could afford the rent on my flat, or any of my other bills, even if I claimed benefits. I felt like my world was falling apart and there was nothing I could do to stop it. Luckily, this is where my parents came to my rescue by saying I could move back in with them. If it wasn't for them I would've been homeless. When I moved back in with my parents, I heard about Mind (a mental health charity) that was local to my new home in Rushden. I was terrified of reaching out for help but with the encouragement of my parents I took the leap into the unknown. There is no way I can put into words how anxious I was going to one of Rushden Mind's groups for the first time. It was terrifying. I stood in the doorway of the room with my back pressed against the door frame wishing I would disappear. But then people started to talk to me. They were so friendly, and it felt good to talk to people
I thought I deserved â&#x20AC;&#x153; the pain for being a horrible person â&#x20AC;? in a similar situation to myself. Every time I went to Rushden Mind my anxiety reduced, and eventually going there did not make me anxious. In fact, I looked forward to it. The support groups were a safe place for me and alongside counseling, also at Rushden Mind, my mental health problems greatly improved. I regained control of my life. I truly believe Rushden Mind saved my life. Without them I would've had no help and probably would have ended up taking my own life. Instead I am a confident person who is working toward my dreams. I am now a volunteer at Rushden Mind, and I help run the groups I once attended. I am also a trustee, and manage the social media accounts. I have recently concluded a year of working on a national campaign with Mind, where I talked to politicians about mental health, including visiting the houses of parliament. Outside of Mind I have developed several hobbies and made new friends. I have applied to university and will begin studying Psychology and Counselling in September. I am now looking forward to the future, and I finally have a happy life.
Rushden Mind is a UK mental health charity affiliated with National Mind, serving Rushden, Northamptonshire and the surrounding area. For more information visit www.rushdenmind.co.uk or www.mind.org.uk bmhmag.com
If you are patient in one moment of anger, you will avoid one hundred days of sorrow Chinese Proverb
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owning my Mental Health to help others By Rebecca Potts It’s time for me to be honest. No more holding back because my family’s in the room. No more altering my story because I’m afraid of how people will look at me. Two years ago, I was diagnosed with depression and anxiety with panic attacks, a week before I was set to compete in the Miss Pennsylvania stage. The diagnosis itself didn’t surprise me much, but I didn’t think I was depressed. I knew what depression felt like because I lived with it years before that as a child. I was 12 years old the first time I cut myself. It was the only time, because it hurt and I hated it, and it only added physical pain to the emotional pain. As I grew into adulthood, I didn’t think I was “depressed” anymore. I simply felt sad. Lonely, but not depressed. I had a difficult time controlling my panic attacks, and they were new to me. They would come when I was in line to buy food, or when I was waiting for reservations, or when I had to go babysit. I couldn’t explain it and I didn’t want to accept that I was suffering from a mental illness. I spent months at the doctor, getting blood tests and procedures for ailments that couldn’t explain my symptoms, and the doctor kept telling me, “there is nothing wrong with you”. I finally accepted on my own that I had anxiety and these were panic attacks, so I asked my doctor for medication. bmhmag.com
I started to talk to someone, I took my medication every day, and gradually, I started to feel better. I was happier and less afraid of myself. Before, everywhere I went I was terrified that I would have a panic attack and not be able to function. I avoided things because of that fear and as a result, I didn’t make many friends in college. I always felt like I was set apart from everyone else, but when I started taking the medication and talking about my illness, I began to go out more and finally started to integrate myself into the college environment. Soon after that, I met a really fun guy who made me feel happier than I’d ever been. I was completely convinced that I was “cured” of my anxiety, so I stopped taking my medication because I didn’t feel that I needed it. About 5 months into my relationship with this wonderful man, things took a complete turn. He turned into a jealous, possessive, emotionally abusive boyfriend and I was so brainwashed that I believed it was my fault that he was hurting me. Eventually, he left me, and when he did, the night before my college graduation, I was so isolated and destroyed that I had almost no one to go to. He had, I assume unintentionally, forced me to make him, his friends, and his family my entire life to the point where I cut off the people who were important to me. I fell into the deepest depression I’d felt since I was 12, and I don’t remember the couple of months that came after. My attacks slowly began to come back, but with less frequency. Five months after he left, I competed in a scholarship program for a local Miss America title with a platform of “Breaking the Silence Surrounding Mental Illness”. I had no idea how people would receive better
I would have a “panic attack and not be able to function
me openly talking about my mental illness and the struggle associated with it, but I won the title and was able to open up about my journey with anxiety and depression.
I’m currently an advocate for mental health reform and I speak to people across my state to bring attention to the kinds of symptoms people with mental illness face every day, and to encourage people to open up and seek help. With my crown, I’m finally able to speak for people like me and fight for their rights to comprehensive mental health care, and it has drastically improved my mental health. My panic attacks have greatly lessened to the point where they have almost disappeared, and my depression is taking a break for now. I do not plan to go back to taking medicine, but I’ve learned about the connection between body and mind and the importance of putting healthy things into the body, and I have changed my diet accordingly. The most therapeutic element of my experience with mental illness was the opportunity to be open about what I went through, and I hope through sharing my story, I will inspire compassion in others and willingness to share their own. And maybe someday, we will be able to talk about mental illness the way we talk about any other illness, and we will no longer need to be afraid of who we are.
Poetry by Rebecca Potts Caged The tremor of a shaking voice, a river running dry. The scream upon a bitten tongue, a bitter, forced goodbye. Of all the things he could’ve known, he knows the very worst. A sickness feeds his broken mind, infected with this curse. Resentment fills the empty space, inside his little cell. He’ll not forget you put him there, won’t know that you meant well. The dreams that swirl around him come to life with every breath. Invective words escape his lips; pretend you can’t care less. Mistakes were adventitious, caused by visions through his eyes. You tried to keep him safe, but you misjudged his need for life. Retreating in his loneliness, he turns away from light. His morals disappearing, he engages hellish night. You try to beg for clemency; he will not be assuaged. Too late, you’ve found the verity – you cannot keep things caged. better
I wrote this poem about my grandfather, who spent most of his adult life in a mental institution because he had schizophrenia. As most of you know, mental health hospital in the 70s and 80s were less rehabilitative than they were restrictive and oppressive, which is why I refer to his room as a “cell” and a “cage”. I also describe the resentment he felt towards the “people” who put him in the hospital, which happened to be the courts. He was the first individual within the state to be found not guilty by reason of insanity.
I Live With Demons I wrote this poem in some of my darkest times dealing with my anxiety, panic attacks, and depression. I thought I could never beat it and that I'd never get better. It took a long time to understand that others didn't hate me like I thought they did, that I was my own worst enemy and I had to stop vilifying myself and get help. I'm still struggling to remember that there is nothing wrong with me and I don't have to resent myself.
I live with demons, and when they play, they rip my limbs and slice my face. Their laughter rings like poison flames. It rises up and swallows day. I live with demons, and when they laugh, their cackling voices rise and attack. The noise decays, but intent still stays; a tacit reminder of better days. I live with demons, and when they cry, their violent weeping splits the sky. They set my mind to burning flame, they cradle my conscience and lay the blame. I live with demons, and when they sleep, I dream of the ways that Iâ&#x20AC;&#x2122;ll run from these beasts. Theyâ&#x20AC;&#x2122;ll devour my mind until I see, the only demon left is me.
Rebecca is a 2014 graduate of Albright College in Reading, Pennsylvania, a local titleholder in the Miss America system, and a mental health advocate. She holds two bachelor's degrees in Psychology and Sociology with a track in Criminology. In 2012, she was diagnosed with anxiety, depression, and panic disorder. Rebecca hopes to change the way that people view mental illness and help make it easier for those in need to receive comprehensive mental health care. The photograph is Rebecca with her dad! Follow Rebecca on www.instagram.com/rebeccapotts2309 or www.youtube.com/cloudyheaven2309 bmhmag.com
the POWER of M E D I TAT I O N By Merle Conyer
Life is all about navigating curve balls. Some we catch deftly and then make our way through tricky situations with dexterity and skill. Others trip us up and we respond with turmoil and confusion. How we react and cope with life events depends to a large extent on the state of our mental health. And this, according to the World Health Organisation, is determined by multiple psychological, biological and social factors. Meditation has the potential to positively impact each of these factors, leading to more freedom for how we choose to live and respond to what is happening around us.
M E D ITAT E O R M ED I C AT E A primary purpose of meditation is to understand how our mind works, and to change the underlying causes of our discontent. This makes meditation quite different from other coping mechanisms that many of us utilise. Take a moment to consider the extent to which you use medication and recreational drugs to manage the ups and downs. What about socially accepted coping mechanisms such as sugar, shopping and television? Whatever your drug of choice, there is the need to keep going back for more as the transitory feel-good feelings wear off. In sharp contrast, the changes arising from the practice of meditation are sustainable and long-term, with multiple benefits substantiated by committed practitioners and compelling scientific evidence.
M IND C H ATT E R For much of our time we dash from one thought to the next. Relentless mind chatter keeps us hooked into past events and imagined future scenarios. We get trapped in our own melodramas and swinging emotions. Sometimes we feel so
â&#x20AC;&#x153; meditation is the pause button â&#x20AC;? overwhelmed, fearful or pressured that we can hardly think straight. More often than not our self-talk is negative â&#x20AC;&#x201C; we are not good enough, not smart enough, not attractive enough, not strong enough. This exacts a heavy toll on our mental health as it moulds our self-esteem and detrimentally impacts relationships. Meditation is the pause button, one of the most effective tools to bring us consciously into the present moment. Like finding a lost jewel in a pond once the swirling waters have settled, stilling the mind enables us to think more clearly, to step out of the delusional mind-games, and to consider more realistically the situation at hand. Instead of focussing our energies on trying to change the way other people behave or perceive us, our attention begins to turn inwards, towards accepting and addressing our own needs and feelings. Insight into how and why we think and react the way we do opens possibilities to work more creatively with our strengths and limitations.
EM O T I O N AL EQ UI LIB RIU M We tend to respond to people and situations in habitual ways, particularly when feeling stressed. Perhaps your pattern is with anger and frustration, anxiety and fear, or criticism and judgement. Uncontrolled recurring bouts of such behaviours negatively impacts mental health. Meditation is an antidote, nurturing stabilising states such as serenity, equanimity, concentration and discernment. Emotional expression becomes more in tune with individual circumstances, and we experience greater choice about the extent to which we allow our emotional equilibrium to be destabilised. Over time we develop the ultimate freedom of choosing how to respond to whatever we encounter. bmhmag.com
Meditation also stimulates the release of pleasure hormones and activity in areas of the brain associated with relaxation and happiness. It is a recommended intervention for people experiencing depression and has been proven to reduce the likelihood of relapse following a major depressive episode.
M IND - E M O TI ON - BO D Y C O N N EC T ION Our thoughts, feelings and body are intimately related. When we don't feel physically well, our spirits tend to sag. Things that would not otherwise be a big deal take on greater significance, and we do not respond or react as we normally would. A regular meditation practice improves physical wellbeing, which automatically leads to improved emotional and mental health.
also stimulates the â&#x20AC;&#x153; meditation release of pleasure hormones
Stress and hypertension linked with cardiovascular disease respond to the therapeutic effects of meditation. As breathing slows down, so does the heart rate and blood pressure, along with a lessening of tension in the muscles and organs. Corresponding with this, research demonstrates that adults who experience the greatest mental health also have the lowest rates of cardiovascular disease. Other examples of positive physical outcomes include stimulation of the immune system to fight infection, reduced number and intensity of migraines, improved sleep, and less airway constriction in asthmatics. Meditation is now included in treatment protocols for conditions such as cancer, pain management, depression and chronic diseases, with new technologies substantiating the effects of practices more than 2,500 years old. An eightweek program of "participatory medicine" is available in better
wellbeing hundreds of hospitals and healthcare environments around the world, described by Jon Kabat-Zinn in Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness.
SO C I AL I M PAC T S Meditation is not just about inner work. Ultimately its purpose is to cultivate qualities that are reflected in our attitudes, actions and relationships. Greater internal stability results in an increased capacity to be open, considerate and empathetic towards other people and the wider natural world. Supportive social relationships have been linked to positive mental health. Through meditation we learn to become more sensitive and emotionally available to other people. In conversation we give our full attention to what the other person is saying without thinking ahead about our response, and choose our words more mindfully. This attentive presence is noticeable and can qualitatively change the outcome of otherwise difficult conversations.
Neuroscience research has demonstrated that when a person specifically meditates on compassion and unconditional love for other beings, this substantially activates high-frequency gamma waves and areas of the brain associated with feel-good emotions. Moreover, this activation is highest in people who have meditated the longest. Therefore cultivating such qualities not only helps us to feel happier and act more thoughtfully, it also contributes to building a wiser and kinder society, which in turn promotes the mental health of all who live within it.
E LI X IR F OR S USTAI N ABLE C HAN GE Meditation has been proven to change the wiring of our brains, known as neuroplasticity, and over time these positive changes become part of us and permeate all aspects of our life. If meditation could be bottled as an elixir, no doubt it would outsell all the other drugs we use to cope, and without any of the toxic side effects. Why not give it a try? After all, the most you risk losing are the thoughts, feelings and habits that hinder you from experiencing life to its full positive potential.
B UD D H IST P SYC H O THERAPY There has been an upsurge of interest in Buddhism in Western societies in recent decades. The natural affinity between Buddhist frameworks and aspects of psychotherapy has resulted in the emergence of a blended practice that is making a meaningful difference in people’s lives.
B u d d h ist Ps ychother a p y I s U nique People come to psychotherapy for various reasons. There may be a trigger such as a relationship challenge, death of a loved one, or diagnosis of an illness that causes a person to think about their life in a different way. Others come with existential questions about how to live life with more meaning. Clients with similar concerns seek the support of Megan Thorpe, an experienced psychotherapist with Buddhist leanings who has worked for many years in hospitals, hospices and private practice in Sydney. “What makes Buddhist psychotherapy different to other forms of psychotherapy is that it starts working with the premise that within each of us we have a part that is already inherently whole, healthy and free, that is seeking to be realised.” bmhmag.com
Whilst concepts and practices that come directly from Buddhist teachings are utilised, it is not necessary to understand Buddhism nor to be a spiritual person to benefit. An example is teaching clients mindfulness, which supports them to become more aware of their feelings and reactions, and which strengthens the development of a calm inner core. Another aspect is the Brahma Viharas, which are the attitudes of loving-kindness, compassion, empathetic joy and equanimity. These are a very useful therapeutic foundation as they help to create an environment which is conducive for people to more readily discuss their concerns. It is also important for therapists to develop these qualities in themselves as they cultivate effectiveness and authenticity.
Buddhist Psychotherapy In Practice Central to this type of work is supporting clients to come into the present moment, focussing on what is most important for them here and now. There is not much delving into childhood experiences and past events, other than in ways these might echo in the present moment. Bringing mindfulness to the body is also vital, as it is the body which provides clues about emotions that might be held. Supporting the client to be with and observe their body sensations and emotions, and notice how these
Megan Thorpe is a past president of AABCAP. To find a Buddhist psychotherapist, or information about professional training, see the Australian Association of Buddhist Counsellors and Psychotherapists (AABCAP) website: http://www.buddhismandpsychotherapy.org
wellbeing change, is also a direct experience of the impermanence of everything. “It is important to work with people in a gentle way, respecting their capacity to know what they are capable of exploring and dealing with now, and what is too hard. There are no right or wrong ways, it is all about an exploration.” Professional masks and roles can be easy to hide behind at times and letting go of these is another aspect that differentiates a Buddhist psychotherapist. “We are two people, two authentic beings trying to be who we are, engaged in a journey together, with as much lovingkindness, compassion and curiosity as we can. It is not about one person being the expert and another having problems. It is a learning space for both of us.” Megan has journeyed with people holding fears about dying and death, including people in the last months of their life. She observes that people die as they live. If a person has been able to live a life where they respect themselves and are connected to other people in a respectful way, then this is incorporated into their approaching death. Others seem to go fighting right to the end – fighting with themselves, fighting with friends and family, fighting against the illness. “If we can learn to live well, perhaps we can learn to die well.” This aspiration is at the heart of what Buddhist psychotherapy is all about.
Merle Conyer is a counsellor, trainer and consultant who supports people and communities to recover from trauma, and strengthens the organisations and service providers who assist them.
Building Self-Ef ficacy with M i n d f u l Meditation By Elizabeth Pessin
According to social scientist Albert Bandura, selfefficacy is oneâ&#x20AC;&#x2122;s belief in his or her capability to execute behaviors, and control oneâ&#x20AC;&#x2122;s motivation, which reflects confidence. Self-efficacy is vital concerning mental health, and it is important to know we can build our self-efficacy through different strategies. One strategy is mindful-meditation. Stigma surrounding mental health has caused this topic to be a private matter, which leads to ignorance facing the reality of mental health today. What are the stats? A 21-year longitudinal study examined adolescents (ages 14-16) with depression to determine the psychosocial outcomes in young adulthood better
incorporate confidence, hope, and mindfulness into your daily lives
(ages 16-21). Results suggest that young people with depression in adolescence were significantly more likely (p<.05) to have major depression, anxiety disorders, nicotine dependence, alcohol abuse, suicide attempts, educational underachievement, unemployment, and early parenthood later in life. Researchers Marques et al. (2015) evaluated 682 adolescents (ages 11-17) levels of hope, school engagement, life satisfaction, self-worth, and mental health. Scores of hope were divided into three groups including extremely low hope (bottom 10%), average hope (middle 25%), and extremely high hope (upper 10%). Adolescents with extremely high hope differed on all measures, supporting the association between hope and mental health benefits. What are the solutions? Find ways to incorporate confidence, hope, and mindfulness into your daily lives. Meditation involves ways in which a person focuses their attention. According to the National Center for Complementary and Integrative Health (2014), meditation is a mind and body practice that increases relaxation, and improves coping with illness and overall well-being. Meditation has been shown scientifically to reduce high blood pressure, pain, and symptoms of anxiety, depression, insomnia, and acute respiratory illnesses. Furthermore, by practicing mindful meditation, you can increase your self-efficacy and your overall mental health.
Elizabeth Pessin is currently pursuing her Ed.D. in Health Education at Teachers College, Columbia University. Her ongoing research interests are in mindfulness, mental health, and spirituality, as her passion is in holistic, culturally competent healing. Elizabeth also provides health education workshops in low-income New York City neighborhoods to combat health disparities and inequalities. bmhmag.com
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