Wednesday, February 27, 2008

In this Sikh family, schizophrenia was no bar to being an affectionate father

When Sathnam Sanghera was growing up in Wolverhampton his father suffered from undiagnosed schizophrenia and spent hours and hours just watching TV during the day. He never brought his son fishing or showed him how to ride a bike.

But, writes Sathnam in his book If you don't know me by now (Viking, 2008) "The best offering a fathe can make his children is himself, and in this respct mine was fantastic. He was always around. He was there at breakfast and at teatime.....And he also walked me to school every day. Several times a day, in fact: he would be with me on the ten-minute walk from home to school in the morning; on the ten-minute walk back from school to home at lunchtime; on the ten-minute walk from home to school at the end of lunchtime; and on the ten-minute walk back from school at the end of the day."

When, at the age of seven, he started primary school, "I was old enough to make my own way. But when, on my first day at primary school, Dad appeared at the front door as usual - five minutes early, staring at his watch, repeatedly checking his pockets for his housekeys, as usual - I took his hand gratefully."

The full title of the book - about growing up in a Sikh family - is If you don't know me by now: a memoir of love, secrets and lies in Wolverhampton and it is published on 6th March.

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Monday, February 25, 2008

A mindfulness approach to chronic pain

This is the text of my That's Men for You column published in The Irish Times on 19th February 2008:

I am always reluctant to write about chronic pain and about psychological approaches to coping with it. This is because it is so easy to patronise people who are in pain when you are not in pain yourself.

Chronic pain is pain that can only be managed – it isn’t going to go away completely. As a person who is a coward when it comes to pain, I cannot imagine what it is like to have to cope with this torment day in and day out.

There is some research into psychological approaches to pain which offer the possibility of improving one’s way of coping with pain and that may be of help to readers in this situation. These involve acceptance and meditative practices.

Why in Heaven’s name should you accept pain? You shouldn’t, in my opinion, if the doctor, the physiotherapist or the chemist can help you to get rid of it. But if the pain cannot be made to go completely, the methods described here may help.

People who are in pain can be said to suffer from two types of pain. The first is the pain which arises from their injury or illness. That pain is largely, perhaps completely, outside their control. The second is the emotional distress which they feel because of the physical pain. It is this second type of pain that acceptance and some meditative practices can help to reduce.

Last year, researchers from NUI Maynooth, NUI Galway and the University of Almeria, Spain, published research showing that people subjected (willingly) to electric shocks had a greater level of endurance if they accepted the shocks instead of trying to distract themselves from them. This, though a small scale study, seems to confirm what many have believed for a long time about the importance of acceptance in dealing with pain and, indeed, with much else in life. The report on their research appeared in the journal, Behaviour Research and Therapy.

Mindfulness meditation has been used for years now at the University of Massachusetts Medical Centre to help people live with chronic pain and stress while experiencing a higher quality of life than before. Dr Jon Kabat-Zinn, who runs the pain clinic, has published an account of his work in the widely-available paperback Full Catastrophe Living.

Mindfulness involves continually bringing your awareness back to what is going on right now whenever it strays off into the past, the future or into fantasy. It sounds easy but it takes more practice than you might think.

In mindfulness you accept the pain that is inevitably there while expanding your awareness of those parts of your body that are not in pain, of the room around you, of other people and so on. This is not a substitute for medical treatment – it is something you do alongside medical treatment.

Blue Sky based in Dublin and run by people with a Buddhist and medical background offers a low-cost course based on Kabat-Zinn’s work.

Here is a simple, four-part mindfulness exercise to give you an idea of what the use of a mindful approach might involve:

Notice your breathing. Notice your posture. Notice the points of contact between your body and the chair, floor, ground. Notice your clothes touching your body.
Every time you drift into thinking, just return to noticing your breathing.

If you feel pain, notice the pain without getting involved in thoughts about it. Notice how the intensity of pain rises and falls but rarely stays the same.

Notice the area of your body that surrounds the area of pain. Notice how that area is tensed up. Imagine that you are breathing into that area and allowing it to relax.

Now, as well as your body, notice the room you are in. Notice how your pain is part of your experience. It is not your total experience. Now notice your breathing again.

Exercises like this do not, of course, get rid of the pain. Instead they are meant to help you to cope differently and to reclaim parts of your life and experience that the pain has overshadowed.

Saturday, February 23, 2008

Seven Weeks - a journey through new grief

Seven weeks today. A July wind
is tousling the trees, rumpling the garden.
I have written five letters, washed the sheets.
A mistake somewhere – I’ve not finished
the crossword. Sit with the sounds of Sunday.
Thrashing leaves. Cows. Planes. My own breath.

This is how Christine Webb's prize-winning poem Seven Weeks begins. The poem, about the death of a partner, won the 2007 Poetry London Competition and is worth your time. You can read her poem and the other winners here on the Poetry London website. Follow the Competition link on the menu on the left of the front page.

(This is the complete post. Ignore "Continue reading" link below.)

And here is the rest of it.

Thursday, February 21, 2008

Too easy to blame the internet for suicides in Wales

Photo by Guillermo Esteves (Flickr)

This is the text of my article in The Evening Herald on 20th February 2008:

The spate of teenage deaths by suicide in Wales has spurred speculation that the internet – especially tributes on social networking websites – has played a role in what has been going on.

The speculation has been rejected by the police. “They were all young people with big issues,” a police spokesman said. “There are a constellation of factors influencing these young people.”

So where has speculation about internet suicide pacts come from? Partly it comes from the belief that suicide pacts do exist and that the internet plays a role in these in some parts of the world.

Deaths arising from suicide pacts are a major source of concern in Japan where this phenomenon has been most reported. There, even complete strangers have taken their own lives as part of pacts made over the internet.

Closer to home, last summer saw the death of two young irish men who made a suicide pact over the internet.

Research in Britain suggests that about 12 couples a year take their lives in what might be called a suicide pact but this is not confined to teenagers and can be a response to depression or incurable illness.

But such pacts have existed since before the internet came along. So have copycat suicides. When singer Kurt Cobain took his own life in 1994, some fans also committed suicide. In 1994, hardly anybody used the internet, most people didn’t know what it was and social networking sites such as Bebo and My Space had not even been imagined.

There have been claims that tributes on the networking sites to those who killed themselves have led others to do the same. The theory sounds plausible until you consider that such tributes are only a part, indeed a small part, of the mourning that surrounds a death.

If you attend the funeral of somebody who has committed suicide, you will hear the same tributes that are heard at funerals for other people. There may be an underlying, unspoken sense of anger at the person who has destroyed the life of his or her family by committing this stupid act but a desperate attempt is made to act as though this is a normal funeral.

Such funerals are, needless to say, very emotional especially if a young person has died. I would suggest that they are far more emotional than a website tribute can be – yet I am unaware of any evidence that they lead to copycat deaths.

Similarly are we to say that the loving death notices placed in newspapers lead other people to think of suicide, even when we know that this is how the person died?

To work out whether the suicides in Wales are linked, we need to know whether these represent a rise in such deaths compared to previous periods or whether we are seeing a statistical cluster of largely unrelated deaths.

Suicides among young men in England and Wales are at their lowest level for three decades and among young women they are at their lowest level since 1968. This makes the deaths in Wales stand out even more.

The internet is open in the sense that suicide pacts made online are fairly easy for the police to uncover forensically . It is likely that such pacts, if behind the deaths in Wales, would have been discovered by now.

Following a death by suicide the question that haunts family and friends for years afterwards is, Why did he or she do it? Could we have prevented it? Usually there will never be a satisfactory answer to the question and families have to accept this fact before they can move on.

In the long run I suspect that there will never be a satisfactory explanation for these pointless deaths in Wales either.

Monday, February 18, 2008

Fall in the suicide rate for young men in the UK - but more young women use dangerous methods

When I read the headline on the BBC website about the fall in suicide among young men in the UK I thought I had come across a reason to hope that in one society, at least, a way had been found to tackle this painful problem.

Well, it has and it hasn't. The suicide rate for young men in England and Wales is at its lowest level for 30 years, the report says. But this isn't due to a change in attitudes. "One key factor has been a cut in toxins in vehicle exhaust fumes because of catalytic converters - making it harder for people to kill themselves," it says.

Still, it's a good outcome but how long will it be before young men turn to more dangerous alternatives? Young women seem to be doing this already, with a dramatic rise in hanging. Could this, I wonder, be an unintended consequence of measures that made it more difficult to put together a large supply of paracetamol? Nevertheless, suicide rates among young women are at their lowest level since 1968.

Suicide is an extraordinarily complicated issue but the UK figures suggest that in Ireland we can hope to get the figures down by a variety of measures - even if those measures and their possible consequences are far from straightforward.

(This is the complete post. Ignore "Continue reading" link below.)

Saturday, February 16, 2008

The grim reality behind that rural retreat

Photo by Jasmic (Flickr)

This is the text of my article in The Evening Herald on 15th February 2008:

The rural retreat, complete with green fields, clear streams and singing birds seems idyllic when you’re stuck in urban traffic in the rain – but behind the pretty picture is a grimmer reality, judging by the latest comments from Dr Moosajee Bhamjee.

The Clare psychiatrist and former Labour Party TD has pointed to the demise of the rural pub and of other social facilities as a factor in suicide in country areas. The close-knit rural community of legend has, for too many people, become a thing of the past.

The link between the demise of the rural pub, depression and suicide is not necessarily to do with alcohol - it is to do with social contact. For men living alone, in particular, the pub provided a nightly or almost nightly immersion the affairs of the parish. It kept them connected. Drinking at home on your own is no substitute.

The concept of loneliness is one we are used to in the cities and towns. A city flat can be a very lonely place. So can a home in an urban housing estate where everybody else is at work all day. But at least in cities and towns you can go for a walk to the shops or to the post office and you can hope to meet somebody with whom you are at least on a nodding acquaintance. And if all else fails you can find a pub to go to at night.

There are still parts of rural Ireland in which there is a closeness between people that you will not find in cities and towns. Everybody living along a stretch of road knows each other; they have known each other for years and they look out for each other.

But if you live on the wrong road, if your nearest neighbours have gone, if you are unable to travel due to disability or if your local pub has shut down you can be utterly isolated in the countryside.

In any event, there is something wrong with the rural dream of the past. City people think of Clare as the quintessential rural county. In many respects I think it fair to say we were encouraged to think of the county of the De Valeras as more "real" than the cities. It was the home of traditional Irish music, of unforgettable sessions in the pubs, of poety, of wonderful natural scenery and of wonderful people.

Perhaps that was true and perhaps it is still true. Yet 17 people are thought to have taken their lives in Clare last year and two thirds of these lived in rural areas. Suicides in Clare outnumbered deaths from road accidents last year.

Six of these deaths were among men in their twenties and three were men in their thirties, forties and fifties. This suggests that suicide in Clare is not predominantly affecting elderly people. It is more likely that isolated, elderly people are prey to depression than to suicide.

More importantly, all of this suggests that the answer to rural depression involves social rather than medical measures. For example, there are roads in rural Ireland which a bus has never ever, ever passed down. If each rural area had an easily-accessible bus service even a couple of times a day the difference to the physical and mental health of rural dwellers would be enormous.

It seems highly unlikely that services like this can be run on a commercial basis. They would have to be subsidised out of taxes and, as far as I am concerned, it would be money well spent.

Meanwhile,though, I am for city and town living. The field and the stream may be attractive -but the lonely country road with the bus once a week definitely is not.

Friday, February 15, 2008

The common experience of feeling like an impostor

Photo by autoreverse tiramisu (Flickr)

Do you see an impostor when you look in the mirror?

You’d be surprised how many people do.

Most of us adopt or are thrust into roles in life that we think we are not up to. Other people might say you’re great at your job or you’re a great parent or a great partner.

But they are looking at you from the outside. You are looking at yourself from the inside and you “know” you are none of these things. What’s more, you think, if other people knew you as well as you know yourself, they would agree with your unspoken opinion.
This is the text of my That's Men for You column published in The Irish Times on Tuesdsay, 12th February 2008:

The so-called impostor phenomenon was first described in the late 1970s. Then, it referred to young women who were doing well in managerial and executive jobs in the workplace but could not give themselves credit for their own ability.

They saw themselves as succeeding either because they were lucky or because they worked harder than anybody else – but not because they were intrinsically good at what they did.

Subsequent research has shown that the term can be applied equally to men.

The odd thing about the impostor phenomenon is that it seems to affect people who are genuinely successful rather than people who fail. The “impostor” may gain promotions, may be praised by colleagues, may be in demand among customers yet her or she feels like a fake.

Instead of basking in this praise and approval, the affected person lives in fear of being found out.

Another curious thing about people who feel like impostors is that they are less likely than others to behave like real impostors. For example, a study of college students found that those who felt like impostors were less likely than other students to cheat.

“Impostors” seem to dread the arrival of the day when their work will be judged, so they have developed ways to put off the evil hour.

One is to put off starting tasks for as long as possible, always completing them just before the deadline.

The other is to start work on a project long before everyone else, perhaps dragging out the preparations interminably and continuing to work beyond the point at which others are finished.

What’s the payoff for these strategies? The first – putting the work off until the deadline is nigh, as I have done with this article – allows the “impostor” to say the work was so rushed it was pure luck that it was any good. This neatly avoids the question of whether the person is inherently good at the job.

The strategy of working interminably on the project allows the “impostor” to assert that anybody who put in this amount of work would be bound to succeed – again, the “impostor” avoids the issue of his or her personal qualities.

The research on the impostor phenomenon has mainly concerned itself with the workplace and with college studies.

However, I have no doubt that it implies also to relationships. The person who cannot take a compliment may be an example of someone who feels like an impostor.

My own phrase for this is “the ah shure syndrome.”

“Aren’t you really marvellous to have rescued your aunt from that burning building?”
“Ah shure, I was heading in the direction of the door anyway and she just kind of clung on to me.”

If you feel like an impostor and someone expresses love and admiration for you, you will conclude instantly that they don’t know what they are talking about. And you will make sure they don’t get close enough to find out what you are really like.

You believe that if they find out what you are really like, they will no longer admire or love you. To avoid this fate you may have rows with people when they get too close. Indeed, you may even walk away from them altogether.

It’s a painful phenomenon and one that may be more prevalent at home and at work than we realise. I think it is also very difficult to get rid of but awareness is the first step to reducing its influence on our lives.

Wednesday, February 13, 2008

Grieving the death of a child - help from parents who have had the experience

Photo by ericadwoodson (Flickr)

If your child has died, the only person who can really understand your loss is someone who has experienced such a loss, according to Anam Cara, a new website set up by bereaved parents. The website is full of information of people going through this dreadful experience and has links to good, international websites.

"There are no solutions or answers to your grief or pain on this website, but there is a huge amount of understanding and empathy. Everyone copes with the loss of their child in different ways," it says.

"No matter how your child has died, through an accident or long term illness, at Anam Cara we respect that your grief is your own. It also does not matter how old your child was, they could have only been minutes on this earth or grown up to be adults with a family of their own. What matters is that they are your child and the bond between a parent and child is the strongest bond of all and the breaking of that bond the hardest grief to come to terms with and accept."

Anam Cara means "soul friend" in Irish.

(This is the complete post. Ignore "Continue reading" link below.)

Saturday, February 9, 2008

Ambivalence towards violence keeps it thriving

Photo by Pro-Zak (Flickr)

This is the text of my That's Men for You column in The Irish Times on Tuesday 5th February 2008:

The state pathologist, Professor Marie Cassidy, referred on a recent TV programme to a chilling aspect of violence today.

This is the tendency, when a group of young people attack a victim, to intensify the attack after the victim is on the ground, stunned and unable to protect himself in any way.

It is when the victim is in that defenceless condition that the attack really starts. By the time it is over he can count himself fortunate if he gets back to normal functioning.

I say ‘he’ because the victims are almost always male, as are the perpetrators. Indeed, we now live in a society in which parents worry far more about the safety of teenage boys than of teenage girls when they go out at the night.

Back in what I call the John Wayne days, there were certain taboos. You didn’t shoot a man in the back. You didn’t kick a man on the ground. Silly stuff? Maybe. But it beats getting some young fellow down on the ground, rendering him unconscious and then kicking him into rehab.

Of course, terrible things happened in those days, the abuse of children in institutions and in their own homes being a prime example. But the practice of going out on a weekend night to hunt down some poor sod who happens to be in the wrong place at the wrong time and to kill or disable him did not exist then.

The taste for violence is not confined to those who carry out these vicious attacks on the street.

Some years ago, I escaped into a cinema out of a wet afternoon in Paris to watch the then newly-released movie Casino. The violence in the movie really shocked me – but when the lights came on again I was intrigued to see that the afternoon audience of respectable pensioners appeared quite unmoved by the whole thing.

I shouldn’t have been surprised. “It is Sunday afternoon, preferably before the war,” wrote George Orwell in his 1946 essay, Decline of the English Murder. “The wife is already asleep in the armchair, and the children have been sent out for a nice long walk. You put your feet up on the sofa, settle your spectacles on your nose, and open the News of the World…..what is it that you want to read about? Naturally, about a murder.”

There it is, then. A vicarious enjoyment of violence has become so commonplace we barely notice it. We hardly even register how extreme it has become – the violence on The Sopranos is just an example.

When it comes to real life, the terrible behaviour we see on our streets owes much to the influence of groups. When you are in a group you are capable of doing things which you would never do if you were on your own.

Research suggests that murders which follow disagreements and an exchange of insults are often carried out in the presence of an audience made up of friends and acquaintances of the killer. The need to play up to an audience can make murderers of us all.

But we are caught in a double bind about violence. On the one hand none of us wants our son and daughter to be the target of a vicious attack; and most of us would not want our son or daughter to be the perpetrator of such an attack.

On the other hand, society wants its members to be capable of and willing to go to war where necessary. Even in this neutral country of ours many of us demand that countries such as the US, Britain or multinational entities such as the UN or the EU should intervene in Darfur or other places where terrible events are happening. We know that such intervention may involve the use of violence – but we are all for it.

So we are ambivalent about violence – we want it and we don’t want it.

And that’s a major part of the reason why we may never come to grips with the violence that kills and maims our sons on the streets today.

Tuesday, February 5, 2008

Cardinal Connell takes sex abuse tribunal to court - an unwelcome blast from the past

This is the text of my article in the Evening Herald on Friday 1st February on Cardinal Connell's (pictured above) surprise High Court intervention in the work of the tribunal investigating sex abuse by clergy in the Dublin archdiocese. Since then, on Monday 4th, the High Court adjourned the case for a week. Hopefully the Inquisition is working on Cardinal Connell in the meantime.

Update: On Monday 11th February, Connell withdrew his High Court action. I guess the Inquisition did its work alright.

“Saddened but not surprised” has so far been the reaction of victims of clerical sex abuse in Dublin to the court challenge by Cardinal Desmond Connell to the examination of files over which he claims privilege.

The files, reported as numbering 5,000, could help Judge Yvonne Murphy and her Archdiocese Commission of Investigation to arrive at the full truth of clerical child abuse in Dublin. Perhaps more importantly, they will reveal just what the Church did and did not do about the abuse when it learned what was going on.

The Archdiocese of Dublin has a great deal to fear from the inquiry headed by Judge Murphy. Those who have had dealings with her are aware that she has an incisive mind, capable of homing in on the relevant details in a mass of documents – even in 5,000 documents. The former journalist expresses herself with a sort of clarity that is foreign to the Church and especially to the Church of Cardinal Connell.

We know the general nature of the details that will hurt the Church when her report is eventually published. They will concern priests moved from parish to parish and therefore put in positions of moral authority despite their misbehaviour. They will also concern the legalistic response to abuse victims and their families which left them frustrated, angry and hurt.

As a journalist who attempted to cover such issues in the 1990s, I still recall the pain of people who believed the Archdiocese had little or no interest in them except to make their allegations go away. Their experience of dealing with the Church deepened the hurt already done.

I expect those in charge of the affairs of the Archdiocese at the time believed they were acting in the best interests of the Church and that their handling of these cases was entirely in accordance with the law.

But anyone who saw the pain of victims and their families at facing what they perceived to be a closed door when it came to having their complaints dealt with could only have welcomed a searching inquiry into the actions of those churchmen.

Such an inquiry, as we all know, can only be effective if it has access to documents outlining the actions and opinions of these churchmen at the time.

The Church already faces some very dark days indeed when Judge Murphy’s report is finally published. It is unlikely that the details of what went on will differ greatly from what we know already. It is the scale of abuse and the inadequacy of the Church’s response that will deepen the harm already done to its reputation.

To weather this storm in any fashion, the Church needs an archbishop like Diarmuid Martin who can demonstrate full cooperation with the inquiry and who represents a break with the past.

But now along comes Cardinal Connell who, by his legal challenge, will lead sceptics – and even those who are not sceptics – to believe that little has changed when it comes to the Church’s attitude to attempts to clear up this mess.

More importantly, his challenge reopens old wounds and old memories for victims of clerical abuse and their families. It is like a challenge from the past to the present. But Cardinal Connell is not in the past. Like the other men who ran the affairs of the Archdiocese when he was its head, he is very much in the present. Moreover, he is a man of authority in the Church, outranking Archbishop Martin.

When Judge Murphy’s report is published, this challenge will loom large in the minds of an outraged public. It will render more difficult the job of Archbishop Martin in convincing us all that the old Church has been replaced by a new one that deserves our trust.

Monday, February 4, 2008

The pain of shyness and the mistakes shy people make

Photo by Sukanto Debnath (Flickr)

This is the text of my That's Men for You column which appeared in The Irish Times on Tuesday 29th January 2008:

I was much shyer when I was in my late teens than I am today and one of the great discoveries of my life was that other people didn’t know what I was going through. I found this out when a colleague casually remarked that I was “as cool as a cucumber.” In reality, I was experiencing agonies of shyness but the discovery that other people interpreted this as confidence helped me to take the risk of social involvement.

And shyness is, indeed, an agony when at its most intense. I suspect that the agony is greater for men than for women. This is because even in the 21st century it is the men who are expected to approach the women for dates and dances.

Indeed, you don’t have to be shy to have experienced the “will she, won’t she, will I make a fool of myself?” drama that can go on in the head of a man trying to pluck up the courage to ask a woman for a date.

If anything, the business of asking for a dance is worse – that walk across the floor can seem as long and as daunting as a journey to the Antarctic.

There are certain errors that shy people make and which worsen this wretched condition.

First, they assume that other people can see how shy they are. That is why it can be liberating to realise that this is not so, as I mentioned at the start of this article.

The second error is to assume that other people are thinking about you to the exclusion of almost anything else. A shy person will walk past a bus queue and assume that he or she is being scrutinised by everybody standing there. In reality, the others are almost certainly preoccupied with themselves and some of them wouldn’t notice if you stood on your head. Similarly, shy people at a party assume that everybody in the room is looking at them and judging them – a horrible feeling – when nothing of the sort is going on.

Shy people tend to compare themselves to the most outgoing person in the room. They could make life easier for themselves by aiming to be average – instead they curl up in a ball because they know they can’t measure up to the biggest party animal in the place.

This tendency to demand more of themselves than is reasonable is a major source of pain to shy people. Worse, they tend to assume that other people expect perfection from them when in fact other people, with the exception of a few bullies, are more tolerant and easy-going than the shy person can imagine.

Paradoxically, the shy person is the star in his or her own drama. That can be said of any of us but the shy person takes it to an extreme. To the shy person, nobody on the street, in the nightclub or at the party has eyes for anyone else. The shy person, therefore, imagines himself or herself to be under intense examination at all times.

This can begin to change if the shy person somehow manages to get involved with other people or allows other people to drag him or her along with them. Of course, it will still all be agony at first but gradually the shy person’s comfort zone will expand. Maybe the shy ones won’t ever be the life and soul of the party – though some people hide their shyness behind a fa├žade of confidence – but at least they can be at the party and can function socially with a few people at a time.

If you know somebody who is shy, there is no point in berating them for failing to fight this socially crippling illness. Such criticism will simply drive them further into isolation.

It is far better to involve them in things and to accept that they will be the quiet ones in the crowd. This will help them to begin to accept themselves and acceptance of how they are is perhaps the most important first step on the road out of isolation.