Thursday, 31 March 2016

Healing Voices Movie: Glasgow & Perth: Frid 29 April 7pm #HealingVoicesGlasgow @VoicesMovie

Healing Voices Movie: Glasgow: Register for a Ticket 

[Storify of tweets: #HealingVoices movie Perth & Glasgow 29Apr16 @VoicesMovie @PLUS_Perth @UofGMHW]

"You are invited to be a part of the grass roots, non-theatrical release of HEALING VOICES, a social action documentary that asks the question: What are we talking about when we talk about 'mental illness'. This is a fully subsidised event financially supported by the Mental Health and Wellbeing Research Group, part of the Institute of Health and Wellbeing at the University of Glasgow.

There is no ticket charge but you must register to secure a place. 

The screening will be followed by a discussion with invited commentary from stakeholder groups and questions and comments from the floor.

Twitter: #HealingVoicesGlasgow and @VoicesMovie  
University Chapel - West Quadrangle, Glasgow G12 8QQ"


Healing Voices Movie: Perth

Monday, 28 March 2016

Cognitive Interpersonal Therapy #StayingWellAfterPsychosis: shared formulation, alliance, mutuality

Studying a few more pages of Chapter 4: Overview of Principles and Procedures, Staying Well After Psychosis, A Cognitive Interpersonal Approach to Recovery and Relapse Prevention by Professors Andrew Gumley and Matthias Schwannauer.  Alongside some knitting, gardening, reading Podvoll's Seduction of Madness and other everyday home stuff.

What stood out for me was the length and focus of cognitive interpersonal therapy, the level of commitment and collaborative approach, the willingness to adapt the therapy to suit the person, and the containment within a safe space or "safe interpersonal context".

I also noticed a tweet by Prof Gumley on 'Review of clinical and educational psychology training arrangements' and had a quick look through.

Then I noticed a tweet by Prof Gumley about the 'Review of clinical and educational psychology training arrangements', retweeted and commented:

link to Review

Sunday, 27 March 2016

IAPT outcomes post Critical Psychiatry 26Mar16; and my comment

'How do we know that IAPT outcomes are not just expectancy effects?' Critical Psychiatry blog post, 26 March 2016:

"It's some time since I commented on IAPT - Improving Access to Psychological Therapies, now often called Wellbeing Services (eg. see previous post). I've just looked at a recent lecture from David Clark (see video). He's still making claims about outcomes based on lack of comparative data. How do we know that so-called recoveries in the IAPT programme are not due to the placebo effect or spontaneous improvement?

For example, in the lecture Clark makes much of the changes in Buckinghamshire Healthy Minds following a review of notes of the unrecovered patients to identify themes and recurrent patterns in the data (see powerpoint presentation). National figures are that 46% of people are said to recover and a further 15% improve. These are average figures and there is considerable variability by Clinical Commissioning Groups (CCGs). Buckinghamshire was below 50% and by telling staff to increase recovery rates to 65%, lo and behold they did! Isn't this just a Hawthorne effect?

There's a lot of money invested in IAPT so I'm sure Clark doesn't want to think about whether IAPT therapists are mere placebologists. There will always be a problem with assessing the effectiveness of psychotherapy because of the issue of the adequacy of control groups (eg. see my BMJ letter). Psychotherapy trials cannot be conducted double-blind because subjects always know whether they have received the therapy under investigation or a control intervention"

and my comment:

"Thanks for blog post. I am keen to see psychological therapies offered on an equal basis to psychiatric drugs for people experiencing mental distress, altered mind states, psychoses and in emotional crises.  Therefore I want the research on talking therapies to be thorough and relevant, to focus on people's voices, their stories about recovery.

You say that there will "always be a problem assessing the effectiveness of psychotherapy". I can't see the BMJ letter because of paywall (got a copy from a colleague, see below).  However surely the testimony of the people receiving psychotherapy and other talking therapies has to be of value?  How they feel about the service, whether they have increased confidence and wellbeing.

I think that psychiatric drugs may appear effective in the short term by reducing symptoms but in the longer term are counter-productive.  I speak from personal experience, my own and many family members who have had to live with the side effects of the drugs.  Many of which cause anxiety and other disabling conditions.  Antipsychotics depressed me.  I had to taper and get off them to have a life.  And did so under my own steam.  Although in 2012 my youngest son was supported in the taper by a psychiatrist.  But we got NO other support from services.  We were left to get on with it.  Solo.  No CBT which we asked for.  So I had to support my son cognitively, helping him to work through negative thinking.  He did the work, I was a listener.

My son, who has a bipolar disorder diagnosis, is very gradually recovering from the psychiatric abuse of the locked seclusion room and other indignities.  The flashbacks in the first year after his discharge from hospital were terrible.  We did not expect the sub-human treatment, it was a shock.  And we are still living with it, coming to terms with it. 

Therefore I welcome your blog post and challenges about IAPT outcomes.  For we need valid, proven alternatives to drug "therapies" for mental health treatment.  And I believe we need research partnerships and co-collaborations between people who provide talking therapies and people who have survived psychoses, psychiatric treatment and mental illness prognoses.  A level playing field where life experience is of equal value to academic qualifications.  Although some of us who have survived psychiatry are academically qualified in other areas (community education, FE lecturing)."


Dr Duncan Double's BMJ Letter, mentioned in blog post:
EDITOR—In discussing the future of psychotherapy, Goldbeck-Wood and Fonagy comment on the difficulties in providing meaningful evidence about efficacy.1 However, they do not explain that the specific problem is about the adequacy of control groups.2
Comparison of active with control treatment in psychotherapy cannot be conducted double blind as subjects inevitably know to which group they have been allocated. Drug trials may seem to have an advantage over psychotherapy trials in claims for scientific legitimacy because they can be conducted double blind by using placebo drugs. However, the degree of bias remaining in apparently double blind trials should not be underestimated.3 4
Goldbeck-Wood and Fonagy may have focused too much on evidence as factual without acknowledging the importance of interpretation and have therefore not spelt out the role of ideology in assessing efficacy. Evaluation of psychotherapy is controversial. Psychotherapy may be in conflict with biomedical psychiatry in its conceptualisation of mental illness. Moreover, statutory responsibilities under the Mental Health Act take precedence within mental health services over psychotherapy, which is a voluntary activity. Psychotherapy therefore struggles against the hegemony of biological psychiatry.
For reasons such as this, psychotherapy has established itself primarily outside the state sector, as Goldbeck-Wood and Fonagy note. Their solution is for the NHS to create a proper career structure for psychotherapists. Politically this may be less likely to be successful than taking advantage of the government policy for choice in the NHS.5Primary care trusts need to look for alternative providers to meet the public demand for psychological therapies. Psychotherapists could organise themselves into provider organisations. These alternative providers should meet standards of training approved by such bodies as the UK Council for Psychotherapy and the British Confederation of Psychotherapists.
  • Competing interests None declared.
  1. 1.
    1. Goldbeck-Wood  S
    2. Fonagy  P
    .The future of psychotherapy in the NHS: more evidence based services are taking shape to meet growing demand.BMJ2004329:2456 (31 July.)
  2. 2.
    1. Bergin  AE
    2. Garfield  S
    .Handbook of psychotherapy and behaviour change. 4th ed. New York:John Wiley,1994.
  3. 3.
    1. Fergusson  D
    2. Glass  KC
    3. Waring  D
    4. Shapiro  S
    .Turning a blind eye: the success of blinding reported in a random sample of randomised, placebo controlled trials.BMJ2004328:432.
  4. 4.
    1. Moncrieff  J
    2. Double  DB
    .Double blind random bluff.Mental Health Today2003;Nov: 246.
  5. 5.
    1. Department of Health
    .Building on the best: choice, responsiveness and equity in the NHS.London:DoH,2003.

Christ is Risen!

All Heaven Declares the Glory of the Risen Lord:

Friday, 25 March 2016

remembering Foxy

Our cat who died last Saturday, on our street, hit by a car which didn't stop.  

Happy memories of a cat who came to us as a kitten early 2013, a few months after our old cat Zena died, befriended our older cats Sooty and Gypsy, and helped us through their passing.  A top cat and one of a kind.

March 2015
March 2015

March 2015

March 2015

July 2015

Sooty Gypsy Foxy August 2013
November 2014
April 2013

November 2015

October 2015

Gypsy Foxy July 2015

November 2015
March 2016

Wednesday, 23 March 2016

the inequalities #mhscot: the entitlement of some; the Peter principle

A tweet from yesterday after seeing stuff about Scottish mental health "celebrities" being praised for doing their job:

Equally galling is the entitlement - the belief that one is inherently deserving of privileges or special treatment - displayed by some of these "celebrities".  I call it hierarchical shenanigans. 

People who are paid to do a job.  Some/many of them not very good at it, in my opinion.  The Peter Principle: "managers rise to the level of their incompetence" (thanks to a ScotGov worker at Monday's MH Strategy meeting in Edinburgh who told me the term).

But the serious point about all of this is the marginalisation of many juxtaposed with the raising to power and position of a few.  That gets my goat.  It's not fair and the well-off or better-off high heid yins shouldn't be lording it over others or going about as if they deserve the privilege.  Bullying, taking to task or excluding anyone who criticises them or their methods.  That's unacceptable.  

They are fostering the inequalities and keeping themselves at the top of the pile. 

Saturday, 19 March 2016

"it has been difficult on the margins, being bullied for speaking out" @ChrysMuirhead #RethinkingPsychiatry

Yesterday a Facebook friend sent me a link to a blipfoto piece on Rethinking Psychiatry in Portland, Oregon, which told of a Truth and Reconciliation meeting held on Wednesday night.  It resonated with me and this morning I wrote a comment.  

Here is the piece by kendallishere on blipfoto:

"Thanks to Cindi Fisher, Portland now has a thriving community called Rethinking Psychiatry. It offers a radical approach to what has been called “mental illness.” That community speaks of “extreme emotional states,” rather than "illness," and they met Wednesday night for a three-hour Truth and Reconciliation exercise. Those who have extreme emotional states were invited to sit in an inner circle and briefly describe their experiences of treatment. The outer circle was composed of mental health professionals, allies, and friends. 

Some described their “treatment” as “assault” or “incarceration and torture.” All had been forced to take psycho-active drugs, and not one person in the circle reported a positive experience with those drugs. Instead they described disorientation, confusion, seizures, rashes, vomiting, and lasting brain damage. Most had been isolated, left without human touch or contact for weeks at a time. One said she never wants to hear the term “non-compliant” again because every attempt she made to take control of her own body and her healing was interpreted as “non-compliance” and was punished. 

People in the outer circle sat in silence, some visibly moved, all grave. After a short break, “providers”--nurses, therapists, and some physicians, took their places in the inner circle and expressed anger, grief, rage, and shame. A physician said the field of mental health treatment as she has known it is a “cult.” A nurse said she thinks the pharmaceutical industry is the only group that profits from “this broken system.” A therapist apologized for the harm he has done. An emergency room nurse said she always has at least four patients at a time to care for, making it impossible for her to give adequate care to any of the four if one of them is having a mental health crisis. Several elders in the group said the quality of care declined sharply during the Reagan years and has gone steadily downhill since.

Finally all of us sat in a large circle and said what we will take with us from the exercise. Empathy and compassion. Rage. Awareness of the ways the system abuses both patients and carers. Commitment to strengthen the community of those who seek alternatives to drugs, electro-shock treatments, and punitive incarceration of people who report having extreme emotional states.

The man in the photograph was jogging through the streets of Portland carrying a heavily weighted ball on his shoulder, part of his exercise regimen. Most people’s weights are less visible."


And here is my comment:

"A facebook friend from Fife in Scotland where I live shared your story in a private message and I'm glad she did.  I joined blipfoto and it is encouraging to read about the Truth and Reconciliation exercise at Rethinking Psychiatry (had heard of this before through Rufus May). I'm a psychiatric survivor and carer, 63 years young and a granny, having supported my 3 sons in and through psychiatric treatment, and write in blogs and through social networks from the survivor perspective.

I like that there were professionals or providers at the meeting who were willing to take part, sharing their own emotions and feelings. In Scotland this would not be likely to happen.  Rather I've been at meetings where the anger from paid workers has been directed at me for speaking out about psychiatric abuse, coercive drug treatment and the long-term disabling effects of psych drugs.  I think the issue is to do with expressing the anger and rage without it becoming, or resulting in, bullying and aggression.  

I got "meaningfully involved" in Scotland's mental health world in 2008 because of the so-called "peer support" movement, sharing my story on Scottish Recovery Network, and set up Peer Support Fife (Jan08-Nov12).  However it wasn't long before I found myself excluded from inner circles and bullied for speaking out from the psychiatric survivor perspective.  My voice silenced.  Which turned me into a writer, to have a voice, and in Jan12 I became a "foreign correspondent" on Mad in America (until Sep15), having invited Bob Whitaker to speak in Cupar, Scotland, Nov11.

I have since had to become a human rights campaigner in mental health/psychiatry because my youngest son was locked in a seclusion room with no toilet, drinking water, in the dark, for hours on end, unobserved, in Feb12.  Human rights abuse.  I did get an apology, if grudging, from our health board in Fife, and Scottish Government gave £4.4million for a new build Intensive Psychiatric Care Unit, nearly complete.  However it has been difficult on the margins, being bullied for speaking out.  And at the same time caring for my son 24/7, with no other support, after the abuse from psychiatric treatment.  

The challenge for me is not to become too angry or bitter at the injustice of a system which silences critical and distressed voices.  I will keep speaking out and can do no other, at the same time taking care of my own mental and physical health, as best I can.  Fighting for justice and to be heard.  All the best to Cindi Fisher in her campaigning work. 

Thank you, Chrys.

Friday, 18 March 2016

Psychiatric abuse. No justice. Coming to terms with it. Or not.

The other day I wrote an Email about psychiatric abuse, no justice and coming to terms with it.  Doing therapeutic activities, hobbies, exercise, fitness, to keep well.  Living with the fact that the perpetrators of the abuse got away with it.  My campaigning would help others but wasn't benefitting me, financially or otherwise.  I'm not interested in empire medals or keeping in with the powers that be.

However the reality is that I won't ever be coming to terms with the injustice of psychiatric abuse, the "family history of" labels justifying stigma, discrimination and coercive drug treatment.  Going voluntarily into psychiatric settings only to be forcibly injected with antipsychotics or mental health acts used to make me swallow the pills.  It's just not good enough.  

So I will continue to speak out, wherever and whenever.  Promoting alternative ways of working with people in psychoses and mental distress.  Persisting.

Thursday, 17 March 2016

Psychological factors in vulnerability #StayingWellAfterPsychosis: Benefits of conversing with a "close other"

Studying the book Staying Well After Psychosis by Professors Andrew Gumley and Matthias Schwannauer on bus to and from Glenrothes today.  Chapter 3 and beginning of next one.  

Points which stood out for me: significance of life events, the impact of trauma whether prior to or in a psychosis or because of the psychiatric treatment, confiding therapeutic relationships, "specific personal meanings attached to psychotic experiences", emotional recovery.