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IT: Online CBT, Tea and Wii, MusicMixing @ the Clarendon

How to Improve Mental HealthBook reviewsDementia CaféEarly Intervention in PsychosisNina Black playNews & Arts Personality Plus - Leeds

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2009

Haringey magazine for mental health

editationanaging StressM &

equilibrium 2

www.haringey.gov.uk/equilibrium

Photo Copyright remains with all individual artists and Equilibrium. All rights reserved. 2009Front cover: istock image

Dogs – why not ‘psych dogs’ to help with daily life?, Clarendon focus – NVQ in catering – we talk to Sharon, interview with outgo-ing Mind champion of the year and patron of Equilibrium, Liz Miller, Chocolate factory news – quilting, and we catch up with the Richmond Fellowship.

Please email us at equilibriumteam@hotmail.co.uk if you would like an alert each time our magazine is published on the web: (www.haringey.gov.uk/equilibrium).

Coming up in the next issue:

We are now on the web!

Web alerts:

equi

libri

um

equilibrium 3

contact us

the team

contributions

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Equilibrium, Clarendon Centre, Clarendon Road, London, N8 ODJ. 02084894860, equilibriumteam@hotmail.co.uk. We are in the office on Wednesday mornings 9.45-11.45, but you can leave a message at other times and we’ll get back to you.

Wanted: contributions to Equilibrium! Please email us with your news, views, poems, photos, plus articles. Anonymity guaranteed if required.

If you wish to advertise in Equilibrium email us using the contact details above.

Facilitator: Polly Mortimer. Editorial team: Pumla Kisosonkole, Angela, Siham Beleh. Graphic designer: Anthony Parké (www.parkegraphics.co.uk). The views expressed in Equilibrium are those of the individual authors and do not necessarily reflect the opinions of the editorial team.

editorial

In this issue, we have two articles from a magazine

for young people “Exposure”; an event took place in

Leeds on a creativity day around the diagnosis

Personality Disorder. We look at Transcendental

Meditation- the benefits of conquering situations and

moods; an opening of an Alzheimer’s Society Café in

Muswell Hill.

contents4 -5 Four book reviewsHow to To conquer stress without even trying

6-7 Stress and its effect Transcendental Meditation

8-9 How to improve mental health and Cooltan walks.More exercise and enough sleep are good for you

10-11 Dementia CaféInformal drop-in for dementia sufferers and families

12-13 Nina Black playBooks, radio and art; a young person‘s recovery tale.

14-15- Carriageworks LeedsA creativity day around per-sonality disorder – our Northern correspondent reports

16-17 Cognitive Behavioural Therapy, Tetris, Wii and teaComputer therapy!

18-19 News & Arts Charlie Tyack’s recent pixof Japan

Children’s Society’s Good Childhood FindingChildren’s Society’s Good Childhood Findings from the Children’s Society’s Good Childhood inquiry says ‘the belief among adults that the prime duty of the individual is to make the most of their own life, rather than contribute to the good of others’ is partly to blame for rising levels of unhappiness and mental disorders among children and young people today. One in ten children between five and 16 has clini-cally significant mental health difficulties (Guardian: 18.2.09)

Black Dog institute, Sydney

‘Info: when the first antidepressant came on the market in the 1950s the company that marketed it did not think there were enough depressed people for the drugs to make a profit. By 2000 antidepressants were a 7$ business in the US alone….’

Upside down plant!

What an idea for the New Year! Plant an amaryllis upside down…I was having fun planting an amaryllis when few people re-alise it was not the right way up! Mind you it could have looked better the other way up with the flowers on show…Can you im-agine…? Now some red bright flowers have come out! How wonderful, they look so beautiful but on the other hand if I had kept the plant upside down would they have got the” blues”? What would have happened underground, without air or sun, can you just imagine the poor thing! No doubt wondering why there had been no WARNING on the la-bel! How sad! Siham Beleh & Pumla

News - Early intervention in psychosis

From a brief interview with Colette Turner, from the Early Intervention in Psychosis team:I talked to Colette about the scheme which hopes to achieve the heading off of full-blown psychosis in young people and adults. This is achieved by a combination of titration of medica-tion, a family intervention model, CBT, intensity of treatment and narrative therapy. Intervention comes at the first psychotic experience stage. This is a fascinating and hopeful newish service and we hope to feature a more detailed account in later Equilibriums. Polly Mortimer

News & Views:GlaxoSmithKline chair Andrew Witty is offering all its drugs to the poorest countries for at least 25% less than the typical price in rich countries, as well as providing free access to patents relating to neglected diseases. Also he has pledged to publish all trial results whether good or bad.

Bits

in b

rief

Carer’s week – Clarendon news. 8-12 June 2009-04-22. Trevor will prepare activities for our carers. These will include: Pampering, a trip to Margate, Dinner at the Clarendon, a visit to the Chocolate Factory to see textiles, ceramics and jewellery. Carers! Time to pamper your-selves! Take a trip out to the seaside – to Margate – and end up with dinner at the Clarendon. Visit the activities centred Chocolate Factory to see prints, jewellery, textiles and ceramics. Pumla

equilibrium 4

Sectioned: A Life Interrupted John O’Donohue, John Murray 16.99

‘It’s less a story of locked wards than of hostels, soup kitchens, sheltered housing, drug addicts, well meaning charity workers and relentless poverty. O’Donohue is honest about his own failings: misfortune is compounded by his capacity to f##k up. What saves him, in part, is poetry: he begins to write as a teenager and through most of his ordeals he keeps it up. Sectioned is too hard-edged for verse but it’s a triumph that it exists at all and a vindication of O’Donoghue’s faith: psychosis could easily have killed him, or the liquid cosh stunned him into silence, but here he is, against the odds, speaking loud and plain.’ From the Guardian 07.02 09, Blake Morrison

The Boy With The Topknot Sathnam Sangera – Penguin. Worth a read – Winner of the Mind book of the Year 2009!

Hurry Down Sunshine: A Father’s Memoir Of Love And MadnessMichael Greenberg, Bloomsbury 12.99

“Greenberg’s daughter Sally..is just 15 when a mental hurricane strikes…to her father her oracular frenzy is like ‘being in the presence of a rare force of nature, such as a great blizzard or flood, but in its way astounding too….’ Sally’s mania frightens him – her feral black eyes, with their strange new glitter, like polished coal. But so does her numbed catatonic state when she’s discharged and returns home…..though psychotic episodes have intermittently disrupted her life to date she tells her father she’s learnt to see them coming ‘so I can get out of the way or at least drop to the ground like you would when caught in the crossfire of a shootout’.”

There’s a fortitude in these books – an unceasing mental fight – that makes them redemptive. ..’ Whoever has been restored to health has almost always been restored to the capacity for serenity and joy, and this may be indemnity enough for having endured the despair beyond despair. William Styron’ From the Guardian 07.02 09, Blake Morrison

Recovery From Depression Using The Narrative Approach Jessica Kingsley Publishers, 18.99

It explores people’s experiences of depression, recovery and available ‘treatments’. The author explains how, by selecting a variety of ‘narrative tools’, such as talking therapies, yoga and complementary therapies , as well as conventional medical approaches, they can gain a greater insight into depression, self management and long-term recovery.

Resilience: How Your Inner Strength Can Get You Free From The Past Bruno Cyrulnik. Penguin 9.99.

How to build up resilience and overcome past traumas. The author escaped the Nazis aged 7, lost both parents in the Holocaust and managed to regain a life and teach others how to regain theirs.

equilibrium 5

Book Reviews

How to Conquer Stress ...

Without Even Trying

Transcendental Meditation

....

Readers can contact: 01843 841010 Or www.meditationtrust.com

An Alternative Therapy Although many

people have heard of transcendental

meditation surprisingly few amongst

those who have experienced mental

health problems have actually tried it.

Most people think it must be difficult to

learn or involve some lifestyle change

that would be inconvenient or not pos-

sible. Nothing could be further from the

truth. Although it must be learned from

a qualified teacher (it can’t be learned

from a book) it is a completely natural

technique that absolutely anyone can

learn in a simple 3 step course of instruc-

tion. Not only are the effects immediate

they are cumulative, so the longer you

go on practising the technique the bet-

ter it gets. During TM the mind settles to

its most silent and restful state and yet

remains fully alert. In this peaceful, often

blissful state of self-awareness, the body

also gains very deep rest, much deeper

than in sleep, (called by scientists a

‘restructuring state’) which allows the

body’s natural healing mechanisms to

function fully. Deep-rooted stresses and

tensions are spontaneously dissolved,

bringing relief to a wide range of health

problems. Mental Health is improved as

the conditioning caused by past experi-

ence is dissolved and we spontaneously

begin to life with joy and freedom in the

present moment. For me TM has been

the lifeline that has helped me cope

and given me the ability to overcome

mental health issues that prevented me

from fully participating in the commu-

nity. I can better with stress, and TM has

given me more confidence and clarity.

Because it is easy to learn I would

recommend it to anyone.

Ian Stewart

“Imagine if just sitting quietly in a comfortable chair for a few minutes of very enjoyable deep relaxation every day could leave you reeling physically and mentally refreshed, with a calmer and more alert mind, increased energy and clearer thinking. And as a result you found that you could achieve more with less effort, that your deepest desires be-gan to find fulfilment and that work, recreation, and relationships were more rewarding. These are some of the benefits gained by more than six million people worldwide practising Transcendental Meditation (‘TM’).

Director of the Trust and TM teacher Colin Beckley explains: “Many people say that they find it hard to make their mind still’, often having tried (or even taught) many different forms of medi-tation. They are surprised and delighted to find after learning TM that with the right technique and a proper understanding it is very easy, not to make the mind still, but to allow it to settle down towards peace. “If TM were a new drug, it would be hailed as a major break-through” Dr. Nicholas Argyle, consultant psychiatrist. Benefits indicated by scientific research include:Improved sleep, sports performance, memory, energy, creativity, intelligence, reduced use of alcohol, cigarettes and drugs, self-confidence, clearer thinking, reduced anxiety and depression, faster reactions, improved relationships, reduced risk of heart dis-ease, normalisation of weight, stronger immune system, relief from migraines, headaches and asthma, reduced cholesterol, reversal of ageing, normalisation of blood pressure, relief from fatigue.

“The overall benefits of regular TM are so staggering as to be almost unbelievable - in one 5 year study, half the number of inpa-tient admissions to hospital (87% fewer for heart disease and nerv-ous system disorders)...These findings are remarkable.” Dr James Le Fanu in the Sunday Telegraph. You might expect something with such wide-ranging benefits would be difficult to do, but TM is easy; so effortless it can be practised on a train or bus or in a busy airport. Absolutely anyone can do it, and the effects are immediate be-cause it is a completely natural technique. No change of lifestyle is needed. We carry on just as before.

The difference is that life starts to improve. The inner growth TM brings is like being released from prison - the prison of stress which affects us all, even if we regard ourselves as healthy. We become more our true selves as the distorting influence of stress is removed and we start to use more of our unlimited potential. TM is a very ancient technique, a restoration of the spiritual heart of the Yoga tradition of integration of life. Known as “Vedanta” or Supreme Knowledge, it is not a religion, but the science of subjective self-awareness, the most spiritual of all spiritual practices, without which objective knowledge is of very limited value.”

From www.meditation trust.com

How to Conquer Stress ...

Without Even Trying

Transcendental Meditation

....

Readers can contact: 01843 841010 Or www.meditationtrust.com

An Alternative Therapy Although many

people have heard of transcendental

meditation surprisingly few amongst

those who have experienced mental

health problems have actually tried it.

Most people think it must be difficult to

learn or involve some lifestyle change

that would be inconvenient or not pos-

sible. Nothing could be further from the

truth. Although it must be learned from

a qualified teacher (it can’t be learned

from a book) it is a completely natural

technique that absolutely anyone can

learn in a simple 3 step course of instruc-

tion. Not only are the effects immediate

they are cumulative, so the longer you

go on practising the technique the bet-

ter it gets. During TM the mind settles to

its most silent and restful state and yet

remains fully alert. In this peaceful, often

blissful state of self-awareness, the body

also gains very deep rest, much deeper

than in sleep, (called by scientists a

‘restructuring state’) which allows the

body’s natural healing mechanisms to

function fully. Deep-rooted stresses and

tensions are spontaneously dissolved,

bringing relief to a wide range of health

problems. Mental Health is improved as

the conditioning caused by past experi-

ence is dissolved and we spontaneously

begin to life with joy and freedom in the

present moment. For me TM has been

the lifeline that has helped me cope

and given me the ability to overcome

mental health issues that prevented me

from fully participating in the commu-

nity. I can better with stress, and TM has

given me more confidence and clarity.

Because it is easy to learn I would

recommend it to anyone.

Ian Stewart

“Imagine if just sitting quietly in a comfortable chair for a few minutes of very enjoyable deep relaxation every day could leave you reeling physically and mentally refreshed, with a calmer and more alert mind, increased energy and clearer thinking. And as a result you found that you could achieve more with less effort, that your deepest desires be-gan to find fulfilment and that work, recreation, and relationships were more rewarding. These are some of the benefits gained by more than six million people worldwide practising Transcendental Meditation (‘TM’).

Director of the Trust and TM teacher Colin Beckley explains: “Many people say that they find it hard to make their mind still’, often having tried (or even taught) many different forms of medi-tation. They are surprised and delighted to find after learning TM that with the right technique and a proper understanding it is very easy, not to make the mind still, but to allow it to settle down towards peace. “If TM were a new drug, it would be hailed as a major break-through” Dr. Nicholas Argyle, consultant psychiatrist. Benefits indicated by scientific research include:Improved sleep, sports performance, memory, energy, creativity, intelligence, reduced use of alcohol, cigarettes and drugs, self-confidence, clearer thinking, reduced anxiety and depression, faster reactions, improved relationships, reduced risk of heart dis-ease, normalisation of weight, stronger immune system, relief from migraines, headaches and asthma, reduced cholesterol, reversal of ageing, normalisation of blood pressure, relief from fatigue.

“The overall benefits of regular TM are so staggering as to be almost unbelievable - in one 5 year study, half the number of inpa-tient admissions to hospital (87% fewer for heart disease and nerv-ous system disorders)...These findings are remarkable.” Dr James Le Fanu in the Sunday Telegraph. You might expect something with such wide-ranging benefits would be difficult to do, but TM is easy; so effortless it can be practised on a train or bus or in a busy airport. Absolutely anyone can do it, and the effects are immediate be-cause it is a completely natural technique. No change of lifestyle is needed. We carry on just as before.

The difference is that life starts to improve. The inner growth TM brings is like being released from prison - the prison of stress which affects us all, even if we regard ourselves as healthy. We become more our true selves as the distorting influence of stress is removed and we start to use more of our unlimited potential. TM is a very ancient technique, a restoration of the spiritual heart of the Yoga tradition of integration of life. Known as “Vedanta” or Supreme Knowledge, it is not a religion, but the science of subjective self-awareness, the most spiritual of all spiritual practices, without which objective knowledge is of very limited value.”

From www.meditation trust.com

equilibrium 7

“Take anyone with a psychiatric disorder and the chances are they don’t sleep well. The result of their illness, you might think. Now this long-standing assumption is being turned on its head, with the radi-cal suggestion that poor sleep might actually cause some psychiatric illnesses or lead people to behave in ways that doctor’s mistake for mental health prob-lems. The good news is that sleep treatments could help or even cure some of these patients. Shockingly, it also means that many people, including children, could be taking psychoactive drugs that cannot help them and might even be harmful….REM sleep refreshes our civilising emotional reactions… Sleep is essentially changing the magnetic north of your emotional compass.” Read more of this fascinating article on www.newscientist.com

CoolTan Arts

Sleep well, stay sane

CoolTan Arts is organising an inclusive community arts walk the Largactyl Shuffle “the CoolTan way” every third Saturday of the month with a different topic for each month, depending on the season or any important landmarks for this month.

These walks are open to the general public and they are becoming more and more popular, with 15 people attending the last walks, and we have been featured in Living South and TimeOut as one of 10 great Spring walks, These walks give a unique take on South London, how the Borough of Southwark is rich of history, art and architecture, and how it connects with mental health.

From the Madhouse to Modern Psychiatric Hospital: CoolTan Arts has been awarded money from the Herit-age Lottery Fund to take part in Mayor Boris Johnson’s ‘The Story of London’ Festival. CoolTan Arts will make a film about CoolTan Arts Largactyl Shuffle Summer Solstice Midnight walk, a guided geo-physical walk through Southwark hearing the voices of history from the Madhouse to Modern Psychiatric Hospital. This unique guided walk begins at Tate Modern at midnight on 20 June 2009, ending at dawn at the Maudsley Hospital on 21 June 2009. www.cooltanarts.org.uk

Camden Council

Camden Council has offered physical activities on prescription for the last five years for people with a range of issues including obesity, depression, anxiety and schizophrenia. Patients are referred to the Camden Active Health Team and assessed. The choice is extensive – tai chi, pilates, aqua aerobics, badminton, football and more. Patients are offered an initial three sessions a week over eight weeks with an option to continue if they find it helpful.

‘We know exercise can lift mood. The support that patients can get from others in a group activity can help with confidence and really lift spirits.’ Stephan van Schilling, manager of Camden’s clinical referral. Rushey Green surgery in South London has adopted time banking, a form of mutual volun-teering where people exchange skills, part of an emerging community build-ing approach to health and social care called co-production. (rgtb.org.uk) Mhf.org.uk/campaigns/exerciseanddepression

Exercise on prescription

T he moon is distant from the sea, And yet with amber hands She leads him, docile as a boy, Along appointed sands.

He never misses a degree;Obedient to her eye,He comes just so far toward the town,Just so far goes away.

Emily Dickinson, An ‘outsider poet’ from 19c USA - fine poet.And congratulations to Carol Ann Duffy on being made poet laureate.

Oh, Signor, thine the amber hand,And mine the distant sea, —Obedient to the least commandThine eyes impose on me.

Poemof the Issue

New Scientist 21 Feb 09

Photo: Anthony Parke — Emily Dickinson

equilibrium 8

“Take anyone with a psychiatric disorder and the chances are they don’t sleep well. The result of their illness, you might think. Now this long-standing assumption is being turned on its head, with the radi-cal suggestion that poor sleep might actually cause some psychiatric illnesses or lead people to behave in ways that doctor’s mistake for mental health prob-lems. The good news is that sleep treatments could help or even cure some of these patients. Shockingly, it also means that many people, including children, could be taking psychoactive drugs that cannot help them and might even be harmful….REM sleep refreshes our civilising emotional reactions… Sleep is essentially changing the magnetic north of your emotional compass.” Read more of this fascinating article on www.newscientist.com

CoolTan Arts

Sleep well, stay sane

CoolTan Arts is organising an inclusive community arts walk the Largactyl Shuffle “the CoolTan way” every third Saturday of the month with a different topic for each month, depending on the season or any important landmarks for this month.

These walks are open to the general public and they are becoming more and more popular, with 15 people attending the last walks, and we have been featured in Living South and TimeOut as one of 10 great Spring walks, These walks give a unique take on South London, how the Borough of Southwark is rich of history, art and architecture, and how it connects with mental health.

From the Madhouse to Modern Psychiatric Hospital: CoolTan Arts has been awarded money from the Herit-age Lottery Fund to take part in Mayor Boris Johnson’s ‘The Story of London’ Festival. CoolTan Arts will make a film about CoolTan Arts Largactyl Shuffle Summer Solstice Midnight walk, a guided geo-physical walk through Southwark hearing the voices of history from the Madhouse to Modern Psychiatric Hospital. This unique guided walk begins at Tate Modern at midnight on 20 June 2009, ending at dawn at the Maudsley Hospital on 21 June 2009. www.cooltanarts.org.uk

Camden Council

Camden Council has offered physical activities on prescription for the last five years for people with a range of issues including obesity, depression, anxiety and schizophrenia. Patients are referred to the Camden Active Health Team and assessed. The choice is extensive – tai chi, pilates, aqua aerobics, badminton, football and more. Patients are offered an initial three sessions a week over eight weeks with an option to continue if they find it helpful.

‘We know exercise can lift mood. The support that patients can get from others in a group activity can help with confidence and really lift spirits.’ Stephan van Schilling, manager of Camden’s clinical referral. Rushey Green surgery in South London has adopted time banking, a form of mutual volun-teering where people exchange skills, part of an emerging community build-ing approach to health and social care called co-production. (rgtb.org.uk) Mhf.org.uk/campaigns/exerciseanddepression

Exercise on prescription

T he moon is distant from the sea, And yet with amber hands She leads him, docile as a boy, Along appointed sands.

He never misses a degree;Obedient to her eye,He comes just so far toward the town,Just so far goes away.

Emily Dickinson, An ‘outsider poet’ from 19c USA - fine poet.And congratulations to Carol Ann Duffy on being made poet laureate.

Oh, Signor, thine the amber hand,And mine the distant sea, —Obedient to the least commandThine eyes impose on me.

Poemof the Issue

New Scientist 21 Feb 09

Photo: Anthony Parke — Emily Dickinson

A drop in centre for people with dementia and their carers has opened in Muswell Hill at the St Andrews Centre (Alexandra Park Road N10 2DD). Awareness is needed for this disease. The dementia sufferers, carers and the profes-

sionals can meet up on every second Monday from 2-4pm, to support each other. A talk was given by Andrew Chidgey who is the Head of Policy and Campaigns. The policy campaign looks at needs and support for the people with Alzheimer’s. He says that society’s perception of Alzheimer’s has changed and there is more understanding. This is due to financial impact and a small group of people started speaking out. Dementia is on the increase, and people need to be diagnosed earlier. At present we have limited sources of information. The incidence of Alzheimer’s increases with age. Andrew Chidgey has been campaigning for 5 years. The dementia strategy differs in different parts of the country. This includes:

Awareness of DementiaNational Public AwarenessDiagnosis and SupportMemory ClinicsLocal InformationService SupportNamed point of advisor contactTraining in NHS and Social Services

Government has spent 150 million on demen-tia. At present there are no plans for screening however victims can be referred to a memory clinic. St Ann’s has a good service but not a good pathway to GP’s. There is a waiting list for Memory Clinics, a mini test can be done in doctors surgery. When someone is suffer-ing from dementia it is usually the family that

notices first. There is a need to see the whole person. There is brain scan technology avail-able. The Alzheimer’s Society is leading care and research charity. – www.alzheimers.org.uk.

Alzheimer’s Society

There are already 700,000 people with demen-tia in the UK with numbers set to rise to one million by 2025. This society is involved in serv-ices, fundraising campaigning and research.

What is Alzheimer’s disease? Alzheimer’s disease is a physical disease affecting the brain. During the course of the disease ‘plaques’ and ‘tangles ‘ develop in the struc-ture of the brain, leading to the death of the brain cells. As the damage to the brain progresses patients will need more and more support from those who care for them. (Be Headstrong - leaflet - Alzheimer’s Society). A healthy lifestyle can reduce your chance of getting dementia. It is also important to send someone suffering from dementia to a good care home if necessary.

Admiral Nurses is an excellent service to support sufferers, families and carers of demen-tia. They are based in St Ann’s hospital. They also do home visits. They give information and support. A camera has been developed in Cambridge by Microsoft called a SenseCam. It is designed to boost the memory of Alzheimer’s sufferers. The sufferer looks at the images on the computer to remind them of events. There are over 7 million carers in the UK. Carers save the UK £57 billion each year. (Carers UK, 2003)

www. Fordementia.org.ukAdmiral nurses service 020 8 442 6149

ANGELA

DEMENTIA CAFÉ

FEATURE

Photos of Japan By Charlie Tyack. (See p.19)

equilibrium 10

The way we care for our children affects the size of different bits of their brains in later life, for good or ill. But it also profoundly influences the characteris-tic patterns of electrochemistry. In particular, if we give them a stressful time, depending on the form it takes, they can have elevated or lowered levels of the hormone cortisol. This is the chemical that prepares us for fight or flight in the face of threat. As children, if we have constantly felt in danger of attack or rejection or abandonment, eventually the system may just shut down. We have permanently low cortisol levels, blunted by habituation to risk.

As adults it may mean we are depressed or prone to be very unresponsive to our surroundings. At its most extreme, we occupy a state of flat emptiness

so that a mad axeman could run into the room and we would not be startled or react.

Alternatively, if the childhood stress is more acute, with sporadic occasions of severe maltreatment, cortisol levels are jammed high. In this sort of house-hold, you might be lashed out at by parents or siblings for no reason, witness sudden outbursts of extreme parental discord, perhaps be suddenly dumped with complete strangers before you are old enough to cope.

As adults, that makes us hyper, perhaps with poor concentration and a tendency not to be able to sit still and relax. Overly sensitive, someone dropping a teaspoon or just making a harmless remark could lead to a massive overreaction, possibly including violence.

However, the good news is that in most cases, once the cortisol level has been set, like a thermostat, it can still be changed by subsequent experience.

Studies of extreme cases illustrate the basic cause of abnormal cortisol levels. In three studies of chil-dren in orphanages where care entailed institution-alised neglect (no one-to-one care, left to cope on their own for hours on end, in some cases from soon after birth), all the children had blunted responses to threat and low cortisol.

But they were not permanently jammed low. Tested three years later, after adoption into good homes, not one had low cortisol. Furthermore, in studies where the levels are measured several times imme-diately after adoption and in succeeding months, it seems that the better care steadily raises the cortisol levels to normal ones, achieving this fully around the eighth month.

It seems to be only the most extreme cases that are hard to reverse, where the child was severely maltreated for a prolonged period in their origi-nal family. In studies of families with exposure to parental violence, threats of abandonment and in which attempts by the child to express affection are rejected, children’s cortisol levels are sky high. Sadly, adoption and good quality care does not completely normalise the levels even years later.

Whether too high or too low, abnormal cortisol levels damage growth of key regions of the brain and are associated with a host of psychiatric prob-lems. Unfortunately, it is not just care provided in severely dysfunctional families that can cause abnor-mal levels, much commoner problems and practices can also do so. There is widespread ignorance of this evidence, even among educated parents. For example, as I shall explore in next week’s column, common problems in the early years such as paren-tal depression or inadequate substitute care cause abnormal cortisol. While realising this may be worry-ing for parents, the upside is that you can significantly reverse the harm by changing the pattern of care. If the harm is already done and the child is in middle childhood you can still achieve a great deal by giving the child extra love.

• Cortisol research: Kertes, DA et al, 2008, Development and Psychopathology, 20, 473-91.

OliverFeature - From the news: Oliver James The Guardian Family Section February 21 2009

FEATURE

James

Photos of Japan By Charlie Tyack. (See p.19)

equilibrium 11

Nina Black- directed by Melanie Harris. A Cross-lab production for BBC Radio 3.

Nina Black has a diagnosis of adult ADHD, adult attention deficit hyperactivity disorder. Nina Black is the main character; she is travelling from Scan-dinavia to Glasgow by train. Nina is encountering difficulties during the journey, and seems confused. She is not sure where she is going, if she has a trav-elling ticket or if she is carrying any money to pay for one. Nina appears very worried and lost. Meanwhile a young man tries to assist her.

At the beginning it is sad, “Who am I, am I doing right or wrong?” Nina says ,

expressing her worries and concerns about her personality, not being sure what sort of person she is and how people feel about her. Nina says “Felt haunting and haunted”, and her mother adds” everything was wrong, went wrong”. Also, Nina Black senses being quite different compared to others, a feeling of being insecure within herself. This is appealing from the start. The play is engag-ing, although sometimes you could be confused in terms of who is who, partly because it is based on fact and fiction. I believe the characters have performed professionally and very well. Despite some sadness, the play is amusing and funny throughout. Siham Beleh

Norah Vincent Norah Vincent seems to enjoy her moments, and

long periods of time as a “voluntary” patient in a

mental hospital…what a fabulous time! And how

wonderful and marvellous unusual place to be

in for a comedian challenging her role…What a

laugh!! How can such environment be so inspir-

ing! Well the truth behind the scenes at times, isn’t

always reality…Haven’t thought and said that

nowadays has any truth been true? For instant

holding on to that thought, is there anything we

should believe in? I mean how, what and how

much can we believe? But to be perfectly sincere

and honest there must be some kind of truth in

what is behind the scenes…Well otherwise what

and why would directors, actors want to bother

and go to the extreme? And how would certain

people keep pretending and trying so hard to

convince some people it is the whole truth, only

the truth but the real truth. Although the charac-

ters described and mentioned by Nora Vincent

are mentally unstable, however the writer tends to

show compassion throughout. She describes the

patient characters and how they perceive them-

selves. “By far the safest bet in dining, for qui-

etude, was the Yemeni woman, who didn’t speak

English, didn’t talk to herself, and hardly ever ate

any of her specially ordered halal meals…” “The

unit chief was stupid in that way. Not genuinely

stupid, she seemed bright enough. Doctorly stu-

pid, I mean. Stupid because cut off and rendered

arrogant by her profession and her position. She

was in charge, and she sat there in her sovereign-

ty with unnerving entitlement…” Siham Beleh

Nina BlackPh

oto

: Fre

drik

Bro

de

n

BOOK

RADIO

equilibrium 12

ARTICLE

Imagine yourself balancing on a tight rope, high above the ground, with absolutely no way down. That’s how I felt at the beginning of my second year doing ‘A’ levels. At the time I just remember thinking I was having a terrible phase and it was that would pass on its own, but it didn’t. It took me a total of five years to realise what was actually happening to me.

I moved to England in 2003 and found it diffi-cult. I began cutting myself and life seemed worse than ever. I tried telling people how upset I was but I wasn’t able to commu-nicate it clearly as it’s difficult to describe a feel-ing. Bad relation-ships and a close friend’s death made things worse. I had diffi-culty concentrat-ing at school and started to miss deadlines; my teachers become increasingly disap-pointed with me.

Then it happened. I had to let it out, this cry for help that had been building up inside.

I went to my dad and broke down saying “I want to die”. It felt like someone was inside my mind controlling me and squeezing my brain until I could take no more. My dad spoke to a doctor and I was referred to Children and Adolescent Mental Health Service (CAMHS). I was assessed by a psychiatrist. She asked me “have you ever thought you may be suffer-

ing from depression?” I hadn’t, it sounded outlandish. I remember thinking “is this why I am struggling with everything?” I found it difficult to wake up in morning, I struggled to concen-trate on anything for any length of time and I isolated myself from family and friends. I often thought that if I died it would all be over with. It was depression and I was wading through it, struggling to find an escape route.

Then one day the best person I have ever met arrived on my doorstep. Without her I would have given in to depression; I Surely wouldn’t be here at Exposure telling you my story now. This lady was sent from CAMHS and she coun-selled me for six months, I was also prescribed anti-depressants. I was given Cognitive Behav-iour Therapy (CBT), which helped me changehow I thought about life and the way I reacted to situations. It helped me focus on the ‘here and now’ rather than the causes of my distress. It gave me a plan of how to start every day and make it through to the end.

Therapy is an important treatment to ease you through the realms of depression. Origi-nally I was sent to a psychotherapist I felt like I was being forced to confront my demons face-to-face. This wasn’t going to work for me (although it does for some people). Choos-ing the right therapist is important, as different methods work better for some than others. There is no miracle cure for mental illness; find-ing the right one for you is crucial to recovery. Since I recovered I decided to resit my final year at college and take it slowly. I managed to complete one A’ level successfully. This year I’ve applied to go to university and already have a four conditional offers.

Despite the severity of this experience, I’m happy that it happened. It sounds cheesy, but it made me stronger. Going through something like this toughens you up, and prepares you for problems in the future. It’s a cliché, but “what ever doesn’t break you, makes you stronger”; that makes perfect sense to me.

Beaten

from Exposure Issue 97www.exposure.org.uk

Depression Can Be...

Photos of Japan By Charlie Tyack (See p.19)

BOOK

RADIO

equilibrium 13

THE CARRIAGEWORKS

In the words of the organizers, ‘the P+ event at Carriageworks is part of a project aimed at using art as a means in understanding and communicating personality disorders’. As the name Personality Plus suggests, I found it to be a day of overwhelming positivity, as well as a space for analysis and critique of the prejudices surrounding a diagnosis that is largely seen as ‘negative’ or ‘abnormal’. What became apparent was that ‘disor-der’ seemed a problematic taxonomy for the condition that led to those diagnosed with it feeling that they were in some way disordered and malfunctioning, therefore often feeling isolated and ostracized. P+ was organized to bring those with diagnosed Personality Disorder (PD) together in an envi-ronment for mutual discussion, sharing and solidarity, and in the aim of shifting public perception and ignorance towards knowl-edge and understanding.

The day was structured into talks, workshops, screenings and theatre performances. A recurrent theme was in stories of shared experience, often told by those with PD who have found themselves feeling lost and alone and completely at the mercy of doctors who refuse to engage and explain in any other way than medical jargon.

Its seems that the medical staff encountered by those sharing stories on the day do not have the time, or allow the time for talking through the implications, possible solutions or

coping mechanisms associated with such a diagnosis. In many of the creative works on show, this critique was underpinned by the shared experience that the act of attending art classes, art therapy or becoming involved in a creative hobby had helped not only as a form of self expression, but as a means to form a network of supportive people and friends.

Having identified this creative approach as having had a positive effect on those diagnosed with PD, it seems important that this ability to cope with such a diagnosis be accepted and explored by the provided services. Artists and writers of the pieces displayed and performed on the day were no longer convinced by a diagnosis curable only by more drugs and felt deeply the impor-tance of forming communities of others who themselves are working through similar diag-nosis, or have an understanding.

In starting my day by going to a creative writ-ing workshop with Clare Shaw I was encour-aged and excited. I have never felt freer than when I abandoned my fears and insecurities to the process of putting pen to paper quickly and without thinking. Clare was fascinating and inspiring and had also written a play called That’s Not the Way To Do It! that was staged later on in the day; the performance centred on the disordered personalities and varying diagnoses offered by medical staff to Punch and Judy. It was both exuberantly

funny and informative in terms of understand-

ing the implications of the diagnosis, offering

a satirical critique of the obstacles encoun-

tered by those with PD. Another remarkably

enlightening performance came from ‘Thea-

tre Tonic’ with their piece, The Story So Far, in

which the words of people with Personality

Disorder were brought to life, it has also been

staged in London’s Tate Modern. The artwork

on display brightened up the entire venue

and the photographically documented instal-

lation work of artist Lilian Kwok stood out in

particular.

I learned a great deal from my day as well as having a thoroughly enjoyable time, but the main thing I came away with was a real sense of community and the importance of this. It made me want to go to drawing classes and writing workshops and share endlessly with others, and made me feel sad for the individu-alistic society that I understood as normal. As long as there are community and creative initiatives, it appears that there will always be a great support and coping strategy available, but perhaps not always accessible, for those who find themselves endlessly isolated, and for whom the drugs alone do not work.

Creativity and art review - Leeds 30th January 2009

ARTS

Susanna Davies-Crook

equilibrium 14

THE CARRIAGEWORKS

In the words of the organizers, ‘the P+ event at Carriageworks is part of a project aimed at using art as a means in understanding and communicating personality disorders’. As the name Personality Plus suggests, I found it to be a day of overwhelming positivity, as well as a space for analysis and critique of the prejudices surrounding a diagnosis that is largely seen as ‘negative’ or ‘abnormal’. What became apparent was that ‘disor-der’ seemed a problematic taxonomy for the condition that led to those diagnosed with it feeling that they were in some way disordered and malfunctioning, therefore often feeling isolated and ostracized. P+ was organized to bring those with diagnosed Personality Disorder (PD) together in an envi-ronment for mutual discussion, sharing and solidarity, and in the aim of shifting public perception and ignorance towards knowl-edge and understanding.

The day was structured into talks, workshops, screenings and theatre performances. A recurrent theme was in stories of shared experience, often told by those with PD who have found themselves feeling lost and alone and completely at the mercy of doctors who refuse to engage and explain in any other way than medical jargon.

Its seems that the medical staff encountered by those sharing stories on the day do not have the time, or allow the time for talking through the implications, possible solutions or

coping mechanisms associated with such a diagnosis. In many of the creative works on show, this critique was underpinned by the shared experience that the act of attending art classes, art therapy or becoming involved in a creative hobby had helped not only as a form of self expression, but as a means to form a network of supportive people and friends.

Having identified this creative approach as having had a positive effect on those diagnosed with PD, it seems important that this ability to cope with such a diagnosis be accepted and explored by the provided services. Artists and writers of the pieces displayed and performed on the day were no longer convinced by a diagnosis curable only by more drugs and felt deeply the impor-tance of forming communities of others who themselves are working through similar diag-nosis, or have an understanding.

In starting my day by going to a creative writ-ing workshop with Clare Shaw I was encour-aged and excited. I have never felt freer than when I abandoned my fears and insecurities to the process of putting pen to paper quickly and without thinking. Clare was fascinating and inspiring and had also written a play called That’s Not the Way To Do It! that was staged later on in the day; the performance centred on the disordered personalities and varying diagnoses offered by medical staff to Punch and Judy. It was both exuberantly

funny and informative in terms of understand-

ing the implications of the diagnosis, offering

a satirical critique of the obstacles encoun-

tered by those with PD. Another remarkably

enlightening performance came from ‘Thea-

tre Tonic’ with their piece, The Story So Far, in

which the words of people with Personality

Disorder were brought to life, it has also been

staged in London’s Tate Modern. The artwork

on display brightened up the entire venue

and the photographically documented instal-

lation work of artist Lilian Kwok stood out in

particular.

I learned a great deal from my day as well as having a thoroughly enjoyable time, but the main thing I came away with was a real sense of community and the importance of this. It made me want to go to drawing classes and writing workshops and share endlessly with others, and made me feel sad for the individu-alistic society that I understood as normal. As long as there are community and creative initiatives, it appears that there will always be a great support and coping strategy available, but perhaps not always accessible, for those who find themselves endlessly isolated, and for whom the drugs alone do not work.

Creativity and art review - Leeds 30th January 2009

ARTS

Susanna Davies-Crook

equilibrium 15

World of Warcraft is a computer game: a fantasy world where you battle with friends and against foes, a colourful place full of beautiful scenery and mystical creatures. It’s a somewhere for you to escape your problems and meet new people and do things that are not possible in real life. But behind all this fun is a serious problem: addiction. Once you start you’ll want to play the game for hours on end. You escape into that fantasy world, you forget about real issues and just concentrate on the screen. The game compels you to continue playing by rewarding your efforts with items for your char-acter which gains experience, thus making it more powerful and able to do more interesting things, like search unexplored areas. To make the character as powerful as possible it might take over 100 hours of playing.

I’ve been playing World of Warcraft for six months and I’ve accepted that I’m addicted, obsessed even. Playing Warcraft is more enjoyable than doing homework, or going to school. Sometimes in ‘real life’ it isn’t easy to make friends, but in the game it’s easy because everyone has the same thing in common: World of Warcraft. And working together with these friends is a part of the addiction – it spreads from player to player.

There is plenty of research going into discovering whether gaming addiction is a genuine affliction. The Smith and Jones Clinic of Holland recently became the first facility in Europe to offer a residen-

tial treatment programme for compulsive gamers, so that would suggest this is an international prob-lem. Furthermore there are plenty of testimonies from worried parents all over the internet claiming their children are addicted to gaming. In South Korea and China there have been numerous deaths linked to exhaustion and dehydration from marathon gaming sessions.

World of Warcraft has over eight million gamers playing regularly – all potential victims of gaming addiction. There are stories in newspapers all over the world that report how the game destroys fami-lies and the minds of teenagers: Sydney Herald in Australia tells of a boy in Australia who is playing the game for up to 16 hours daily. His mother cries constantly, comparing his addiction to heroin. The article told of how “he’d smashed his keyboard and put holes in walls to sedate his rage, brought on by the game”.

For me it consumes all my free time, and then some more. I often don’t do anything else but spend time playing. I find it very hard to find anything else as entertaining as playing World of Warcraft. I’m constantly thinking about the game when I’m not playing it. It can get upsetting knowing that I’ve been doing nothing but playing all day. I’ve come to the conclusion that while I love Warcraft it really is nothing more than entertainment. It might set you free rom your troubles in the real world, but doesn’t mean those troubles are gone. People have to find a balance between playing the game and doing productive things in real life. Since writing this arti-cle I have found a balance for myself. To break my addiction I now take two-week breaks from play-ing. When my break is over I will play it again, but I enjoy it more knowing that I don’t need to play it; I just can if I want. If you feel you are addicted you should visit your GP who can refer you to people who can help. You don’t want to waste your youth inside a computer game.

Make sure you don’t give out personal identifying details online without knowing who’ll see them.

WORLD OF WOECRAFT

FEATURE

Photos of Japan By Charlie Tyack. See p.19

Victoria Opyrchal

Addiction Isn’t a Game

Techy S

pecial

equilibriumequilibrium 16

Beating the Blues and Fear Fighter: available in HaringeyThese are two CBT-based packages for people with mild to moderate depression and anxiety, available from the Laurels and Roland Hill with a third planned for the West of Haringey in Pages Lane. Beating the Blues, a CDROM, is eight one hour interactive computer sessions, organised weekly, with homework projects between sessions. Weekly progress reports are made to the GP or other healthcare professional at the end of each session. The programmes can also be accessed by clients from their own homes, libraries or anywhere with an internet connection. Fear Fighter is a CBT-based package for phobic, panic and anxiety disorders. It is divided into nine steps with sup-port being provided by trained support workers by phone or email. www.fearfighter.com

Computer aided Cognitive Behavioural Therapy (CBT)

Tetris ”I can confirm, from personal experience, that post-traumatic stress can be moderately alleviated by Tetris (17 January, p 12). Having had two nervous break-downs in the last five years, I needed (and still need) to find some way of suppressing my thoughts, memories and flashbacks of trauma. Not being a drinker and being too middle-class to have access to illegal drugs - and finding prescription drugs ineffec-tive - I was fortunate to stumble across the distraction of Tetris - which I played day and night for many months. I played to the extent that I acquired repetitive strain injury. I

find it requires such extensive spatial and visual brainpower that it disengages my capacity for ver-bal thought and brings relief from anxiety and flashbacks - until such time as exhaustion overtakes me. Upon waking from my restless sleep, disturbed by nightmares borne of terrible memories, I turn immedi-ately to the Tetris I keep on my bedside table, which provides further relief until I pass out once again.

More stress busting tips...

As a student nurse in late 1980s, and then working as a bank nurse and TA nursing officer in 1990s, I found “weekend cleaning” could be useful in winding down after stressful situations. It was neither cleaning, nor did it happen just at weekends , rather it was a series of tasks, mainly sorting equipment, monitoring stock levels etc. However, there are times when 30 mins sorting packets of bandages and dressings or stacking bedpans and bottles, alone, or with a colleague (and sometimes a patient would come and chat, too) was just what you needed. When involved in major rescue events later in life, I found the same sort of behaviour was best for me, along with sharing mugs of tea and beer with cakes / bananas / tortillas with friends (depending on loca-tion and nationality of friends , including Swedes and Israelis in Mexico, and New Zealanders in Kaikoura)”. From the New Scientist

IT Silver surfing Age Concern Hackney started Silver Surfers seven years ago with lottery funding and they provide free tuition and free access to 21 state-of-the-art PCs. It fulfils a social purpose and gives older people a sense of interaction and participation in the community, as well as keeping up with far-flung family members. Role models act as teachers and everyone understands people’s problems as they start to use the web.

Wii and tea The aim of Wii and Tea sessions is to encourage older people to engage in physical activity using the Nintendo Wii gaming con-sole. West Country, UK. Wii and Tea session on Silver Surfers day: it proved so popular that the session overran by nearly an hour. Before the introduc-tory session, many of the seniors had seen their grandchildren using the Wii but had never tried it out. Bowling is the most popular game played amongst the older people. It is always played in conjunction with the reg-

ular Internet session. The Wii is now a standard slot in the weekly Silver Surfers session. The concept of using the Wii to encourage physical activity is catching on in the area, and local groups such as the Bangladeshi women’s group and another sheltered housing unit are expressing an interest to use the games console to engage with their service users.

equilibrium 17

equilibrium 18

Haringey NHS have secured funds to employ ten new therapists, with more in the pipeline. It is a partnership with the voluntary sector (ACLC – African counselling service and Derman – Turkish /Kurdish advocacy and counselling services). More information: www.iapt.nhs.ukIncreasing Access to Psychological Therapies. Haringey IAPt pledges:• An inclusive service• A service to meet the wide and varied cultural needs of the people of Haringey• People to be a ble to access the service at a place and time that is convenient for them• High quality, up to date and evidence basedIf you want to access primary care talking therapy for depression or anxiety contact IAPT service on: 0208 8275 4032 or Dorian.cole@haringey.nhs.uk. Self referrals can also be made in person at Marcus Garvey or Wood Green libraries. Any referral requiring specialist mental health services includ-ing referral for specialist psychological therapies continue to contact START 020 8442 6714 or 6706

Sure start

Funds to employ ten new therapists,

Giving babies and children a good start in life – sensitive emotionally responsive care and security– is essential for their future mental health. Emotional attachments play a crucial part in the foundations of good mental health. www.ness.bbk.ac.uk/impact.asp

Jobs! New initiative:• hmg.gov.uk/newopportunites.aspxHave a look at• mentalhealthfirstaid.csip.org.uk for a train-ing package for ordinary people in workplaces and the community.Health work and wellbeing• Workingforhealth.gov.ukA website run by mental health service users for people •with mental health issues. It provides a place where you can feel safe and can share experiences and opinions without fear of judgment or criticism. www.florid.org.uk.

Former Equilibrium team member, Neil Walton (pictured left), •now has his own website www.bipolar-expedition.co.uk

Websites of the month

Fascinating exhibitions nr Euston. MADNESS AND MODERNITY: til the 28th of June. Focus on fin-de-siecle Vienna, Freud et al. Bobby Baker’s diary drawings til 2 August.www.wellcome.ac.uk – open daily except Mondays. Late night Thursday til 22.00.

RADIOInteresting, if medically slanted, set of programmes on radio 3 lately - Robert Winston exploring the lives of composers with episodes of mental distress – Schumann, Ivor Gurney et al. Rather heavy on genetics-as-explanation, but good to listen to, and lovely music, and I admired the presenter Stephen Johnson coming out as bipolar on air. Polly Mortimer

Art news: Madness And Modernity

BITS INBRIEF

equilibrium 19

GALLERY23

Charlie Tyack: Photographer

Charlie Tyack recently visited

Japan for the wedding

of his friends in the bleak,

snowy wilderness of Aomori

Prefecture. Most of the

featured photos are from

the monstrous conurbation

of Tokyo, which exists in stark

contrast to the emptiness

and relative poverty of the

northern countryside. The

wedding itself took place in

a UNESCO world heritage

site – Towadako, a volcanic

caldera some three hundred

metres above sea level.

Despite the wide range of

environments, Japan is a

consistently photogenic

country, and Charlie hopes

you enjoy his photos.

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