Issue 1 Michaelmas 2010
Managing stress
Tips for massage and sleep
Coming out about mental health Stories from Oxford students
Mental illness in culture Film, art and literature
Debate: what is mental health? A new magazine looking at the way mental health and wellbeing issues affect students at Oxford
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Open Minds CHIEF EDITOR Rachel Burns EDITOR Sally Dickinson EDITORIAL TEAM Sara Helen Binney Eleanor Fry Rachel Holden Seth Insua Emily Mercer Lauren Rapeport Andrea White DESIGN Masuma Ahuja Nina Dearden Jo Farmer Katherine Tandler
Editor’s Letter Four months ago the vision of a magazine about mental health and mental well-being difficulties was just settling into the form of ten people sat around a table in Exeter College. We were from different years, different subjects and different colleges, but we all shared an idea of building a visible community of students with an interest in mental health issues. Representing these students is a big problem in Oxford – often they don’t want to discuss their worries in detail, out of fear for how their friends, college or employer might react. Our aim is to stimulate discussion of mental health and well-being, to openly declare and normalise its existence in Oxford. In this issue, the focus is on ‘Coming Out’ about mental health, with articles from students and professionals touching on what it is to live with mental illness. We’re also talking about ways of managing the stress of starting a new year, with tips for selfmassage and getting better sleep. By exposing mental well-being as a spectrum that runs from
everyday stress to more serious illness, we hope to encourage our readers to take an interest in issues that may not directly affect them, but which taken broadly affect the lives of 1 in 4 of their friends. Enjoy our first issue, don’t hesitate to send feedback to open.minds.magazine@ googlemail.com Rachel Burns Thanks to... John Dickinson for our beautiful banner and logo. Somerville College JCR for their generous support. Dani Quinn and OUSU for their advice and resources.
Photo Attributions Cover Photo: ‘The Rose Garden Door’ Ron A. Parker www.flickr.com/photos/raparker p.6-7 ‘My Camera’ Paul Reynolds www.flickr.com/photos/bigtallguy/ p.9 ‘The Warm Shoulder’ Ted Goldring www.flickr.com/photos/tedgoldring pp.12-14 Araminta Wieloch Magdalen College p.16 ‘Free face of a child with eyes closed’ D Sharon Pruitt www.flickr.com/photos/pinksherbet p.17 ‘Four Candles’ Darren Hester www.flickr.com/photos/darrenhester p.20 * Brick Wall * Parée www.flickr.com/photos/8078381@ N03/2827005993/
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CONTENTS FOCUS ON STIGMA Why don’t we talk about mental illness? Nicola Byrom looks at the silence that surrounds mental illness.
Debate: what is mental health? We ask charities, professionals and students for their opinion.
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Do-it-yourself CBT An introduction to cognitive behavioural therapy – Andrea White interviews psychotherapist Julia Holden.
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TIME TO DE-STRESS Massage tips A guide to relieving aching muscles.
The Big Sleep From whale ‘music’ to white noise, we’ve road-tested strategies to help you nod off.
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STORIES FROM STUDENTS Living with anorexia A frank account of two sisters’ stuggle to over-come the illness.
‘Coming out’ A student describes the difficulty and relief of telling others about her OCD.
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ARTS AND CULTURE Shutter Island Does Scorsese’s controversial presentation of the ‘criminally insane’ simply reinforce stereotypes?
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A Streetcar Named Desire Lauren Rapeport explores the links between Tennesee Williams’ troubled life and his work.
The Inspired Illness Video artist Kim Noble proves the academics wrong at the Human Science Symposium.
A Very Medieval Madness? A look at Thomas Hoccleve, a medieval clerk with a very modern conception of mental illness.
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Lowry We look briefly at two of the artist’s most stark and disturbing portraits.
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Facing up to the problem: The thirteen Oxford students pictured here all had their own reasons for taking part in this photoshoot. But they agreed that we need to de-stigmatise mental illness. In a world in which a quarter of people suffer from some form of mental health problem, we should follow their example and bring it out into the open. 4
Why don’t we talk about mental illness? Nicola Byrom, Mind Student Journalist of the Year 2009 Did you know that fewer than 25% of people with a long-term mental illness have a job? And yet the Labour Force Survey, compiled for the office of National Statistics (2003) suggests that individuals with mental health problems have the highest “want to work” rate of any disability group. How could that be? A report recently published by the Mental Health Foundation suggests that the barriers to work opportunities arise from an inflexible benefits system, negative attitudes of employers and a culture of equating mental ill-health with hopelessness.
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such as stress, anxiety and depression. You don’t need to be a genius to realise that it makes financial sense to prevent problems such as stress, anxiety and depression. Yet a report by the Mental Health Foundation on treatment of depression in primary care (2005) highlights that while 55% of GPs believe that talking treatments are the most effective way to treat mild or moderate depression, 78% have
78% of GPs have prescribed an antidepressant while believing an alternative would have been preferable
The Layard LSE Depression Report, estimates that the loss of output attributed to mental illness is £12 billion per year with one third of all working days lost in the UK for health or other related reasons attributed to common mental health problems
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prescribed an antidepressant while believing an alternative would have been preferable. Why would you prescribe antidepressants when you believed talking therapies would have been more beneficial? The answer is long waiting times. It takes an average of six to nine months to receive
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psychological therapies. Approximately 18% of children referred to a child and adolescent mental health team wait over six months to be seen. If we were talking about physical health, the Mental Health Foundation report observes, waiting times and numbers of people on waiting lists would be a key measure of success and failure. However, collecting this information is patchy; for example, where services do not exist, nothing is recorded about who might benefit from them. This report also observes that “the stigma and prejudice that surrounds mental ill-health can affect people’s relationships and how they interact with people, or prevent them from participating in and enjoying activities they used to enjoy. This isolation reinforces the need for psychological therapy by reducing people’s opportunities to talk informally with friends and family.” As campaigns develop for improved treatment of mental health, we hope that the NHS will react and we will see an increase in professional support. It is clear that this change is essential. However, it is also clear that we should not be reliant upon professional support. If the necessity for psychological therapy is increased by individuals having reduced opportunity to talk informally to friends and family, can we not all do something to make a difference today? What if individuals did have the opportunity to talk informally? What if right now they felt that they could openly discuss the mental health issues they were facing? It would not be the solution, but it would be a start. This is where we are all to blame. It is not just the NHS; it is not just a lack of funding or insufficient resources. Despite the fact that we live in a society where we like to think that we talk about everything, mental health remains a taboo subject. We will debate the legalisation of prostitution in the Union, celebrate Queer week at Wadham College and discuss how aid should be distributed to third world countries. But would the Union debate whether mental illness exists? Would a “Mad” week be attended or viewed from a distance with scepticism and confusion? In reality, the questions that really matter are closer to home. How would you react if a friend told you they were struggling to eat? Would you know how best to help? What if you learnt your fellow tutee hears voices: would you think of them differently? It seems that many of us would not know how to react or how best to help and we would view our tutee from a different perspective. It would seem that mental health issues generally do scare us. The assumption people frequently make is that these individuals are fragile and so need to be treated with care. We would not have open debate in case the
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wrong thing was said. We would not want a “Mad” week because, surely, that would only be for those with mental health problems, and would not be for the rest of the student population to attend. Besides, you couldn’t call it “Mad week” - that would just be insensitive. If we cannot call a spade a spade, where do we begin? Care in choosing how we word “issues of mental health” and concern about getting the terminology right is ironic, since the issue that concerns many when they consider whether or not to “come out” about their problems is a fear that people will start to tip toe around them. This fear might be that tutors or supervisors will assume that they are weak and cannot cope; that the dynamics of their friendships will be changed; that future employers will be disinclined to hire them. There is a concern with being seen as “An orexic,” “Schizophrenic” or “Depressed” as opposed to “having anorexia,” “experiencing schizophrenic symptoms” or “suffering from depression.” It is not the words that matter. When I was ill, being called “barking mad” would have been fine if only people had understood that I was still me and that somewhere muddled up inside the illness, I still existed. What can we do about this situation? We should turn to discrimination laws. We should campaign for greater understanding. We should educate people so that they understand mental health and are better positioned to be of assistance. If only people were a
often refer to ‘my friend Ana.’ The phrase gives a sense of two people moving where one previously existed; parents see this new person move into the body their child once inhabited. The training session encouraged parents to keep looking out for their child, the one they used to know. In supporting someone with a mental health problem, it is crucial to do this as the individual suffering never wants to be the person they have become. They want to get back to that person they used to be. Every time you are seen as the illness as opposed to an individual, it makes it harder to keep a grip on the person you once were, the person you are behind the illness, the person you want to be. Unlike most physical illnesses, a little understanding, a touch of empathy and a friendly face can make a difference. We are not as helpless as it would seem, and yet the stigma surrounding mental health issues leaves individuals feeling isolated. The lack of empathy and understanding people encounter amplifies the problems caused by mental health issues and aggravates the situation.
little less scared of mental health, things would be a lot easier. We must then ask: why are people scared of mental health? Perhaps it is because it seems outside of our control. We feel helpless in the face of mental health issues. Perhaps not knowing the trajectory of mental health problems scares us. We do not know whether problems are transient or permanent. Perhaps we struggle to understand that like cancer, mental health problems are something that people have. Yes, that does make sense. Yes, it is at times that simple. People “have” mental health problems. They are not themselves the mental health problem. Just as a cancer patient has cancer, if someone is experiencing mental health problems, they are still there; their identity has not changed. I will concede that this is not always easy to see. Mental health problems can change our personality and how we behave, so we do not know whether mental health problems are affecting an individual or whether the individual is changing. A few years back, however, I attended a powerful training day run by the Institute of Psychiatry. It was part of the carers project; they have (rather revolutionarily) decided that helping people care for friends and relatives with eating disorders is likely to improve the patient’s outcome.
This is a vicious circle. People do not talk about mental health problems because they do not feel they will receive the level of understanding that they need and deserve. They are most probably right: people in general do not understand. I believe there is one obvious way out of this situation. We have an obliga tion to our society to start talking about mental health. People are most likely to hear about mental health problems when a crisis strikes; when someone commits suicide or is forced to take time out to take care of themselves. Reporting of criminal offences has led to an assumption that most individuals with serious mental health problems are dangerous. In contrast to this misconception, the reality is that these individuals are more likely to be a danger to themselves than anyone else, and are far less of a danger than your average intoxicated individual. It is within our power to change this biased perspective on mental health. Exposing people to the less dramatic situations would dilute the bias. As individuals who have recovered from mental health problems we have a duty to talk about our experiences. We can help people understand what it is like to live with these difficulties. We can explain how friends can help improve a situation rather than cause discomfort. We can stand out as an example that recovery is possible and that mental health problems are manageable.
Anorexia is a useful example here because people
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Massage: six ways to deal Have you ever found yourself using pressure on an aching muscle, or rubbing your forehead when you have a headache? Massage is one of the easiest ways of maintaining good health, and something we all do naturally without ever thinking about it.
2) NECK
Working on your neck, apply circular pressure with your fingertips on either side of your spine. Move up the neck from your shoulders to the base of the skull. You can spend as much or as little time on each area as you feel necessary – if a certain area feels tighter, spend more time on it, and perhaps use slightly more pressure. Massage can have both physiological and On really tight areas, hold the pressure for 5 psychological benefits, including improved skin seconds before continuing the circular motion, tone and colour, and bodily and mental relaxation. as this can often help release the tension. It can reduce anxiety, encourage sleep, relieve tired muscles, alleviate tension and the effects of stress, and increase energy by reducing fatigue.
3) HEAD
If you can, get someone else to give you a massage, as this will allow you to completely switch off. If this is not possible, however, selfmassage can still soothe and relax, and can be done wherever and whenever suits you best. You do not have to undress for massage, but if you do, use oil to prevent friction burns.
When you reach the base of your skull, you should notice a ridge where your neck and skull join. This is called the occipital ridge, and travels round to behind your ears. Work with your fingertips all around this ridge, as it is an area which frequently gets tight and held with tension. This can help relieve headaches.
4) EARS
Here are some suggestions for massaging your shoulders, neck and head - often the areas where People generally don’t think about their ears, people notice tension most. but using massage here will help reduce stress, improve digestion and improve body temperature adjustment (so if you get cold easily this should be great for you!) Pull the ear backwards with For your shoulders, locate your trapezius muscle. a light force. Squeeze it between your thumb This starts across your shoulder and forms a and index finger, applying light pressure. Pull the triangular shape down between your shoulder earlobe downwards with a light force and then blades. release.
1) SHOULDERS
Cross one arm in front of your body and place the palm of your hand on the opposite shoulder (your right palm should end up on your left Start from between your eyebrows. Use your shoulder). index and middle fingers to rub, just above your eyebrows, out to the temporal bone (where Beginning at the base of your neck, knead your eyebrows end). When you reach this, the muscle rhythmically, gradually moving out search for a small, finger-sized area on either towards the shoulder. Squeeze it between your side (your temples), and apply pressure with fingers and palm of your hand, using enough your fingertips or thumb, in small circles. This is pressure to feel a difference. This is termed ‘the also an excellent weapon against headaches and good hurt’ in massage. fatigue.
5) FOREHEAD
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l with stress
Caitlin Stokes
6) HANDS
This is only a selection of very basic techniques that you can use on yourself or on someone else, If you are doing lots of writing, most likely at to help alleviate that exam stress and gain some exam time, you will probably find your hands relaxation time. If you enjoy these but still feel get very tight. If you can get someone else to stressed, I would seriously recommend going to a massage your hands, then you should really feel professional for a full body massage during exam the positive effects. time. Give yourself a little pampering and you will find you work better, are calmer, and have On the back of your hand, work from the wrist more concentration. Most of all, allow yourself to up towards your knuckles with your thumb. Use relax, and enjoy it! firm strokes, working between the bones. Then turn your hand over, and again use your thumb to work from the centre of your palm outwards, in smooth circular movements. The aim is to stretch the hand, so don’t be afraid to use quite a lot of pressure. To finish, place your hand around each of your fingers in turn and slide it slowly up from the knuckle to the tip, gently pulling. Don’t worry if any of them click – this shows that you’ve been effective and released some tension!
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self-massage can be done wherever and whenever suits you best.
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Debate: what is mental health? The terminology surrounding mental health is notoriously tricky. We weigh up the views of students against that of a representative of Mind, one of the UK’s foremost mental health charities. And we’ve thrown in an ‘official’ definition for good measure.
l: a n sio or s e f f ro t p t e e h k d t in ac m w e amy rdshir >> o oxf
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What is your first response to this question? Do you immediately think of mental illnesses such as schizophrenia or bipolar disorder? Mental hospitals? Or perhaps someone you’ve seen or know who is unwell? Compare this with your immediate response to the question, “What is health?” Do you think of fitness? Healthy eating? Staying well? Most people are quick to make these kinds of associations with health. So why is it that as soon as you put the word ‘mental’ in front of it, the word health becomes entirely negative? For some reason, what most people suddenly think of is mental ill health. Everyone has both health and mental health: good, bad or somewhere in between, and often closely linked with one another. We all get depressed or anxious from time to time, and it is surprisingly common for this to escalate to the point where it affects daily life. Statistics show that 1 in 4 of us will suffer from a mental health problem at some point in our lives. This in turn affects a wider network of family, friends and colleagues. So why do we continue to disassociate ourselves from the concept of mental health? The sad truth is that there is a lot of confusion and misunderstanding surrounding mental illness and, because of this, many people face prejudice and discrimination on top of dealing with the problems themselves. Perhaps this is part of the reason why many sufferers of mental illness prefer the term ‘mental distress’. Underlying misconceptions mean that terminology associated with mental ill health can quickly become stigmatised and its use become hurtful. Even now we see national headlines which words like ‘bonkers’ and ‘psycho’ used to describe people with mental problems. However, with appropriate support and treatment, most people can lead productive and fulfilling lives. Indeed, many of the people they come into contact with may never be aware of the mental health problems they are facing unless they choose to disclose them. Perhaps the most important thing to remember is that mental distress is not someone’s fault, it is not a sign of weakness, and it is not something to be ashamed of. Just like a physical illness, it can happen to anyone. There are, of course, ways to protect your mental health, just as you would your physical health: keeping active, healthy eating, a good support network and maintaining a good work-life balance can all help for a start. One of the most vital things is to seek support when you need it, or be there for someone else who needs support, and make sure you have the facts.
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Oxfordshire Mind provides a network of mental health community resource projects and other vital services across Oxfordshire for people who are experiencing mental and emotional health problems.
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“Mental health is when you react the way society expects people to react, see what society expects people to see, and do what society needs you to do.”
e
<< Th
“Mental health refers to a range of cognitive, emotional and behavioural disorders that interfere with people’s lives and their productivity.”
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s
nt e d u St
Mental health is a state of balanced being. It is when you are OK with you.
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“For me, mental health has three parts: emotional, social and cognitive. Emotionally, you are able to feel OK most of the time and to cope with life. Socially, you are able to interact with others in a way that that is not damaging to them or to you and are able to build constructive relationships if you choose to. Cognitively, you are able to share on some level the basic intersubjective understanding of reality and modes of accessing reality that others have.”
”Being sensitive about mental health issues isn’t the same as tip toeing around them. Open discussion, and not always being afraid of what words we should use, are both really important in making people feel less stigmatised.”
Mental health is more than the absence of mental disorders. Mental health can be conceptualized as a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. In this positive sense, mental health is the foundation for wellbeing and effective functioning for an individual and for a community.
>> The world health organisation
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My sister is still underweight. She is still ill, but she wants her life back.
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living with
anorexia
I found myself crying this weekend. I was crying because I felt I had exhausted everything; t h e r e w a s n o t h i n g I c o u l d d o b u t c r y. S o I a m w r i t i n g t h i s . M y r e s o l v e a f e w y e a r s a g o, w a s that if I am unable to change the situation that I fa c e , I c a n a t l e a s t t r y t o p r e v e n t o t h e r s f r o m ending up in the same place. My sister and I developed Anorexia Nervosa in our teenage years. I have recovered, she has not. Seven years on and she is still fighting. This weekend she phoned to let me know the results of her last blood test. They are not good. Her immune system seems to be shutting down. She has been ill since her early teenage years and so has been emaciated throughout years in which our bodies develop. Bones develop during our teenage years. Hers are very brittle; she is likely to suffer osteoporosis early in life. More worrying though, is the damage she has i n f l i c t e d o n t h e b o n e m a r r o w. T h i s p r o d u c e s white blood cells, and without normal levels of these our immune system is compromised. This i s t h e s i t u a t i o n m y s i s t e r i s fa c i n g . The question people have asked is, does she w a n t t o d i e ? I t i s a fa i r l y s i m p l e q u e s t i o n . S h e seems to have starved herself to the point of death and thus perhaps it seems a very logical
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p o i n t . T h e a n s w e r t h o u g h i s d e f i n i t e l y “ n o .” She does not want to die. She might have done, y e a r s a g o . Ye a r s a g o, s h e m i g h t h a v e b e e n s o lost and consumed by illness that death seemed a p r o m i s i n g o p t i o n . S h e h a s , h o w e v e r, n o w s p e n t y e a r s t r y i n g t o p u t h e r l i f e b a c k t o g e t h e r, t r y i n g t o c l a w b a c k a s e n s e o f n o r m a l i t y. S h e i s now a first year student at university and hopes to study medicine. She is still underweight, she is still ill, but she wants her life back. It has never been that simple. She wants to live, but I am not sure that she knows how to. I don’t think she knows how to get there. Anorexia has been so much a part of her life, she does not know how to let go. Even the thought of death, and she has looked death in t h e fa c e b e f o r e , i s n o t e n o u g h . T h e q u e s t i o n o f l i f e o r d e a t h i s ra t i o n a l , a n d a n o r e x i a d o e s n o t a n s w e r t o ra t i o n a l i t y. Yo u c a n ’ t s i m p l y e a t because you know you have to. W h y w a s I c r y i n g ? M y fa m i l y h a v e b a t t l e d m y s i s t e r ’s i l l n e s s f r o m e v e r y a n g l e . E v e n t u a l l y y o u reach a point where you realise that acceptance i s t h e o n l y o p t i o n . We h a v e t o a c c e p t t h a t u n l e s s my sister starts to work with determination and r e s o l v e , t h e r e i s n o t h i n g w e c a n d o . We c a n b e t h e r e f o r h e r, w e c a n s u p p o r t h e r, b u t i f
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You cannot argue with anorexia. You cannot try to rationalise.
she does not want that support, if she does n o t w a n t t o t r y, t h e r e i s n o t h i n g w e c a n d o . This is about the hardest lesson any carer can l e a r n . Yo u c a n ’ t s i m p l y f i x m e n t a l i l l n e s s . T h e sufferer has to do the hard work. And so I am fa c e d w i t h t h e k n o w l e d g e t h a t i f m y s i s t e r d o e s not decide that she has a little more energy somewhere, a little more determination, I can do nothing but know that her lifespan is going to be severely curtailed. W h y d i d I w a n t t o w r i t e s u c h a m i s e ra b l e article? I want to say three things in response to this situation. First I want to let people know that recovery is possible. I recovered after being ill for a few years. It took more effort than anything in my life has ever taken
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since. I would strongly urge anyone currently battling with an eating disorder to keep working o n r e c o v e r y. D o n ’ t g i v e . I t i s n o t s o m e t h i n g t h a t w i l l m a g i c a l l y g o a w a y w i t h t i m e . I n fa c t as time passes, and damage to our bodies a c c r u e s , r e c o v e r y b e c o m e s h a r d e r. Wo r k i n g t h r o u g h r e c o v e r y h a s b e e n t h e m o s t t e r r i fy i n g thing that I have done, but it has equally been the most rewarding. Don’t be put off by the s i z e o f t h e m o u n t a i n y o u n e e d t o c l i m b, j u s t start climbing. S e c o n d l y, I k n o w t h a t I r e c o v e r e d b e c a u s e people did not let me accept my illness. My friends stayed with me. Despite the efforts I made to shut them out of my life, they did not give up. No one let me ignore how real
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a n d d e va s t a t i n g m y s i t u a t i o n w a s . I d o n ’ t f e e l p e o p l e s h o u l d b e a f ra i d o f c o n f r o n t i n g p e o p l e they believe to be ill. It is a delicate issue, but giving someone time will most likely only give anorexia the opportunity to sink its roots in and take hold of that life. F i n a l l y, I h o p e m y s i t u a t i o n s p e a k s o u t t o t h o s e who are friends of sufferers, or perhaps siblings. Learning to accept that sense of helplessness is very difficult. I don’t think it is something I have quite achieved. I have run from my sister in the past, I have tried to avoid the situation because the inability to actually do anything is unnerving. It is hard to stand back and yet, until they wish to make a difference, you can do n o t h i n g b u t l i s t e n . Yo u c a n n o t c h a n g e s o m e o n e e l s e ’s b e h a v i o u r a l o n e . Yo u c a n n o t a r g u e w i t h a n o r e x i a . Yo u c a n n o t t r y t o ra t i o n a l i s e .
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Recovery is possible
So what about my situation? My response to my s i s t e r w a s t o b u l l y h e r. I r e m i n d e d h e r t h a t i t w a s not much use having a degree if she was dead. Sometimes, when it comes to achievement, she gets her priorities muddled. Then I suggested w e s p e n t a d a y t o g e t h e r, p e r h a p s a s h o p p i n g t r i p . I ’ m t h e r e f o r h e r, b u t I c a n ’ t d o a n y m o r e .
If you want advice or support regarding eating d i s o r d e r s , B - e a t r u n a ra n g e o f s e r v i c e s f o r s u f f e r e r s a n d f o r c a r e r s . w w w. B - e a t . c o . u k
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Into the Madhouse Sally Dickinson takes a look into the murky depths of Martin Scorsese’s Shutter Island
It is 1954. Aboard a small boat, rocking on the queasy sea, a troubled US Marshal called Teddy Daniels approaches Shutter Island, an isolated, storm-beaten fortress which houses an asylum for the so-called ‘criminally insane’. The stark grandeur of the scenery, the Hitchcockian camera work and the oppressive score combine to create an atmosphere of almost unbearable foreboding. This is the ominous opening sequence of Martin Scorsese’s most recent film, Shutter Island. Sent to the island to investigate the inexplicable disappearance of one of its inmates, Daniels (Leonardo DiCaprio) soon begins to suspect that those in charge may not be telling him the whole truth. Trapped on the island by a sudden storm, and convinced that unspeakable experiments are being carried out on the asylum’s vulnerable inmates, his emotions start to unravel as he becomes more and more involved in the case. Behind the strut and swagger of his marshal’s uniform lies a man traumatised by the death of his wife and by horrors witnessed at Dachau, and the stripping back of his troubled psyche increasingly becomes the focus of the film. Shutter Island confronts the historical criminalisation and brutalisation of mental patients head on. The psychiatrist in charge of the asylum, Dr. Cawley (Ben Kingsley) seems to be a proponent of the radical idea that talking to the patients might be more productive than beating them. Yet he describes how ‘the kind of patients we deal with here were shackled and left in their own filth. They were beaten, as if whipping them bloody would drive the psychosis out. We drove screws into their brains, we submerged them
in icy water until they lost consciousness or... drowned.’ The film derives much of its tension from hints that such atrocities are not entirely confined to the past. Mental institutions of incredibly poor standards did exist in the 1940s and 50s, frontal lobotomies certainly took place, and the cruelty and neglect described by Dr. Cawley is no exaggeration. The Snake Pit (1948), which tells the story of a young woman confined to a state mental hospital for eight months, was one of the first films to expose the awful conditions in these institutions, and by the early 1950s it had become a hotly debated issue. The film does, to an extent, demonise the island’s severely ill inhabitants and, as in so many films dealing with mental illness, they at times become as much a part of the horror-show as the asylum itself. But this stigmatisation reflects the prevailing attitudes of 1954, not those of the film’s creators. With its abundance of B-movie clichés, it would be easy to dismiss Shutter Island as pure melodrama, and it is true that there are moments when it borders on the ridiculous. But although it is far from subtle, it is masterfully constructed. The setting is magnificent; the dismal island is a potent character in itself – like the human mind, it is both isolated and painfully exposed. Its events are gradually pieced together through a series of surreal dream sequences and waking nightmares, but the jigsaw puzzle is left intriguingly unfinished, and we never feel as though we really have the full picture.
Shutter Island is out on DVD now.
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The Big Sleep Whether it's exam season or just a stressful week, there are times when many of us could use some help dropping off to sleep. Rachel Holden and Andrea White try out some unusual remedies.
A NEW ROUTINE Many of us can’t sleep when we need to. If I have an exam the next morning, a job interview or even a tutorial, I can guarantee that I’ll be awake all night. So, for the benefit of anyone who shares this problem, I decided to try out a variety of activities just before bed. What turned out to be useful? Whale noises Unless you find the sound of cows giving birth calming, this one is best avoided. I listened for about five minutes before turning it off feeling angry rather than soothed. 1/5 White noise This is the sound an old analogue TV makes when it isn’t tuned. After a few minutes I didn’t notice it at all. It didn’t help me to fall asleep, but once I was asleep I slept very deeply. Perhaps it had some effect? 2/5 Lavender The spray I tried was quite powerful, so I would recommend testing first and perhaps using this the morning before you fancy a good night’s sleep. It’s quite a pleasant smell and I felt my sleep anxiety had calmed a bit. 2/5 Yoga I have been a big fan of yoga for ages. I did a soothing 10 minute bedtime routine that I found on Youtube. It was great, but as soon as my head was on the pillow all my concerns came rushing back into my head. I would always recommend using yoga to alleviate stress but I’m not convinced that it’s always useful at bedtime. 2/5 Meditation Making a forty-five minute slot of time for meditation when you’re revising furiously can seem like a waste of time, but I figured that I’d only be tossing and turning in bed anyway. Clearing my mind was a real relief – sadly I didn’t have any Zen moments of total mind blank, but it did quell my feelings of directionless panic and I got to sleep pretty quickly afterwards. 4/5 A banana and a glass of milk I don’t really like milk which was a bad starting point and I’m never that hungry just before bed, but I think it maybe made me slightly sleepier. This might be quite good in combination, maybe better if you like the food... 2/5
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Overall, I think what helped me most was the routine that went with each of these trials. I feel a bit like Supernanny saying this, but it’s good to have ritual when trying to sleep, like doing 10 minutes of yoga and then going straight to bed. I also find it helpful to think about something inane. Try listing everyone who was in your sixth form, or naming every character in EastEnders. There may not be a perfect solution, and lying in bed worrying about getting to sleep can be horrible – but you’re not alone and with a bit of experimentation you’ll find what works for you. Good luck! Rachel Holden
THE SCENT OF SLEEP We’ve all experienced the way a smell can take you back to a moment from your past, faster than a sight or a sound. A whiff of cut grass and before you know it you’re lying in the sun making daisy chains; an odour of burning wood and you’re throwing sticks on the bonfire with your dad. There’s no doubt scents are delightfully redolent, but what else can they do? Aromatherapists have long used essential oils to change people’s mood. And recently research into smells has turned up some interesting results. Fragrant plants can improve subjective ratings of calmness, alertness and mood (Weber & Heuberger, 2008), certain scents can increase female sexual arousal (Graham, Janssen & Sanders, 2000), and in a study by Susan C. Knasko, we’ve discovered that lemon can make you feel healthier, and lavender can make you feel happier. So perhaps aromatherapists are onto the right idea.
although I am not fond of the taste: too sweet for me. In fact the smell was a bit too sweet as well. But if you’ve got less of an aversion to sweet things, this scent is probably pretty good. 6/10 Bergamot Now this is a scent I like. Refreshing and sensual. Think earl grey tea and warm summer nights. Just my sort of thing. As for it’s sleep-inducing powers, bergamot was a little too stimulating for a good sleep, but a lovely smell all the same. 7/10 Sandalwood Supposedly this is a calming scent, but sadly it was not to my taste at all. It made the air seem thick and heavy, kind of like a spinster’s attic. 4/10
Each night for the past week, I have abandoned my usual bedtime routine (browsing Topshop online and/or reading spy novels until beckoned into the land of nod) for quiet contemplation with the aid of a scented candle. What follows is my review of five scents, all thought to help with sleep.
Mandarin Quite similar to the bergamot, but a bit more fruity. I love citrusy scents, but to me they seem much more of a wake-me-up smell than a send-me-to-sleep smell. I would prefer to have this scent infusing my room in the morning to awaken my brain, rather than at night when I want my brain to shut down. 3/10
Lavender Rumoured to be good at calming the nervous system and acting as an anti-depressant. In fact, I found it quite relaxing. And very clean feeling. The only drawback was a little of that elderly smell! But here’s a good tip for taking off the geriatric edge: team the lavender with some lime. 8/10
I chose scented candles, but a few drops of essential oil in your bath is just as good. Or you could mix the essential oils in a base oil (or in a moisturiser) and have a lovely comforting moisturise before bedtime. Very relaxing, very indulgent. Makes you smell nice and feel great, and hopefully get a bit of shut-eye.
Chamomile As a tea, chamomile is good for settling upset stomachs – and in this regard, I have found chamomile quite useful,
Andrea White
Darrren Hester on flickr.com
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A Streetcar Named
Desire
Tennessee Williams found writing an escape from the chasmic divide that he felt from other people: as an artist, a homosexual and a man suffering from the trauma of his childhood relationships. Lauren Rapeport explores how one of his best-known creations, Blanche Dubois, reflects many of Williams’ own preoccupations, and why her enigmatic presence on stage continues to bewitch modern audiences.
Vivien Leigh, Rachel Weisz, Cate Blanchett and Jessica Lange – these are just a few of many notable actresses to assume the character of Blanche Dubois on stage and film. Each invested their portrayal with individual nuance and style, guided in many cases by the strong leadership of the director. Blanche has thus been as often maligned for her affectations as she has been admired for her sophistication; both condemned and victimised, her exit at the close of the play is a triumphant declaration of Stanley Kowalski’s superiority and a tragic emblem of an increasingly amoral society. How can one woman engender such diverse interpretations? The enduring dichotomy of her character is one which magnetises audiences; however, it is to the life of Mr Williams himself that we must turn in order to pick our way through the minefield of ambiguities. Tennessee Williams is well-known to have led a life fragmented by dysfunctional relationships and blighted by depression and addiction. His homosexuality was a constant source of tension between him and his father, whose attitude towards not only Williams but the whole family was one of aggressive disappointment tempered by disinterest. A particularly damaging incident came in Williams’ twenties when a prefrontal lobotomy was performed on his beloved elder sister in his absence, a decision taken by his father. The treatment, now extremely rare, was once a common procedure used to deal with a range of mental problems, such as bipolar disorders, obsessive compulsions, schizophrenia and paranoia. It often led to a ‘blunting of the personality’, the patient being left somewhat ‘quieter’, and occasionally resulted in severe convulsions and death. In the case of Rose, Williams’ sister, the operation caused her to be incapacitated for the rest of her life. As a young boy, he became aware of the remedial power of literature: ‘At the age of fourteen I discovered writing as an escape from a world of reality in which I felt acutely uncom-
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fortable. It immediately became my place of retreat, my cave, my refuge.’ (Foreword to Sweet Bird of Youth) As a result, we see in his plays manifold reresentations of the difficult experiences which led to this turmoil and isolation: from Stanley Kowalski’s belligerent, uncompromising patriarchy to Laura Wingfield, the slightly crippled sister of the protagonist of The Glass Menagerie, whose collection of glass animals is as fragile as her state of mind. Williams openly acknowledged the vivid autobiographical resonances in his plays, writing, ‘I must find characters who correspond to my own tensions’, while also admitting the limitations of this need. What, then, are the ‘tensions’ he is exploring through Blanche’s gradual destruction? In the year of 1946, the year before Streetcar was first performed in Boston, Williams spent several months convinced that he had an incurable pancreatic cancer. Consumed by a terrible, looming sense of his mortality and horrified by the tumour he imagined had taken control of him, Williams began to write the play. It is not difficult to see how the play and Blanche in particular illustrate his morbid state of mind at that time. Even the title nods to the themes of decay which permeate the play: the inspiration for it came from a streetcar track in New Orleans, where he had lived much of his life. Williams describes two streetcars running back and forth across this track down the main street of his quarter, one called ‘Desire’, the other ‘Cemetery’. He saw this as an allegory for life – an indiscriminate, unceasing journey from desire to death, from death to desire, each an antidote to the other. Blanche perfectly encapsulates this desperate way of life. When her family, her beauty, her expectations of marriage, security and love have all crumbled, consigned to the dusty recesses of memory, she copes by entering into a series of degrading and sordid liaisons, veiling her shame with anachronistic pretensions of refinement and modesty, like a paper lantern shrouding a naked bulb. Williams once wrote in a letter to his friend Donald Windham:
‘As the world grows worse, it seems more necessary to grasp what pleasure you can, to be selfish and blind...’ This almost hedonistic approach to life, the need to submerge oneself in pleasure in order to survive the bitter truths of reality, regardless of cost, is painfully expressed by Blanche herself. When challenged to offer a true account of herself by her suitor, Mitch, she cries, ‘I’ll tell you what I want. Magic! ...I don’t tell truth, I tell what ought to be truth. And if that is sinful, then let me be damned for it!’ Blanche’s arrival into her sister and brother-in-law’s home asserts her status as an ‘outsider’. She is at odds with the philosophy of the industrial, capitalist America emerging out of the ashes of the slave trade of the South, symbolised by the contrast between the glow of her sister’s pregnancy and her own fading looks. Stella has found a virile and hard-working husband in Stanley; he is the leader of his group of friends and an
‘‘
Consumed by a terrible, looming sense of his mortality and horrified by the tumour he imagined had taken control of him, Williams began to write the play.
ex-soldier – all in all, a solid example of a good American citizen. She recognises her husband’s chauvinistic and brutish behaviour but refuses to condemn it, claiming rather that she is ‘thrilled’ by it, citing the passion of their relationship as justification of the subordinate role she has inevitably assumed. Blanche, on the other hand, married very young for love of a rather more poetic nature. However, what she originally noticed in the boy as ‘a nervousness, a softness and tenderness which wasn’t like a man’s’ ultimately revealed itself to be homosexuality, and her shocked discovery of this caused her young husband to commit suicide. Williams’ homosexuality was never something about which he was secretive (although his mother made no reference to it in her memoirs) and it is a hugely important part of his life. In Blanche’s marriage, he was not only commenting on the impotence of the South, he may also have been expressing his own insecurities about his sexuality and how people would react or had reacted. As with many of Williams’ characters, Blanche manages
’’
to be both jarringly unique yet uniquely representative. Plumbing the depths of misery and loneliness and making choices with which, while we may not approve, we may at least sympathise, she is a relic of a romantic past from which she has become disentangled. If we needed further proof that her tragedy is central to the meaning of the play and that she more than any other character expresses the ‘tensions’ Williams so desired to expunge, it is the (often overlooked) epigraph: ‘And so it was I entered the broken world To trace the visionary company of love, its voice An instant in the wind [I know not whither hurled] But not for long to hold each desperate choice’
‘The Broken Tower’, Hart Crane The ‘I’ of this extract without a doubt belongs to Blanche. Above all, it recognises her as a victim of her own fragility in a world which does not have the time or patience to understand her.
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coming out about
Mental illness is an incredibly personal experience. It can also be incredibly funny, incredibly awkward, incredibly draining. But one of the largest parts of any illness, however personal, is other people. How do we tell our families? How do we tell our friends? Will it stop us getting jobs, or make our colleges put checks on us? If we join a solidarity group on Facebook, how many of our co-workers / mates / relatives / casual acquaintances / future boyfriends are going to notice and (crucially) not understand? I was fifteen before I knew I had OCD, even though I had been avoiding stains on the pavement and spending hours washing my hands for years. I expected at first that it would be a terrible thing for people to know. My whole person would be codified into three letters. I resisted help, I feared the judgement of my friends and family and teachers. But before I went into Sixth Form, I knew that I would have to do something about it. I knew I had to tell the people closest to me, and I knew I had to seek out support.
Job applications; university health declarations; equal opportunity surveys – to tell or not to tell? I admit that even after five years of coming to terms with OCD, I never feel comfortable enough to tell an employer. At least not until I’ve been given the job. There is an immense amount of spoken and unspoken prejudice against those with mental difficulties, and students can be forgiven for feeling that ticking the ‘Mental illness’ box under the Disabilities heading might cost them the job, even if it is technically untrue. It’s an invasion into something very sensitive, and something that has often been kept secret for a long, long time.
And on the whole, it did seem better. It was certainly helpful for my friends, who now understood that some of the overtly neurotic games I played had a root cause. Telling meant I got counselling too, in varying degrees of quality. Once at Oxford, I felt that the counselling was better than ever, and having joined in with the Counselling Service’s trial run of Mindfulness classes, I was feeling more than ever that I could at least conceive of having a real grip on my condition.
I was most disappointed after informing my college. In material terms, my quality of life rose – I got counseling, I handed in more essays, I felt more comfortable at home. But on the administrative level, I felt endlessly toyed with. Discussions about my welfare were held in my absence, I felt afraid to recommend things I thought might help myself, and in meetings where I was present, a lack of support from someone qualified left me feeling dominated by others in the room. My college has some truly wonderful, caring and sensitive support staff, but I felt at all times as though the treatment of people like me, like so many others, was handled awkwardly, because colleges don’t really understand mental illness. They don’t know whether it’s like breaking your leg, or like misbehaving on purpose. And accordingly, the communal attitude struggles to find its ground between support and punishment.
There are times when coming out has been hard. Sometimes people won’t believe you – they think you must be exaggerating, or that you’re being egotistical. In these cases (and this has included some of my closest friends) I have found that the slow road is best: we explain what we have, we explain what that means. And in the face of disbelief, we demonstrate over time the existence of the real difficulties we face. Eventually, a person’s real friends will wake up to what is going on.
If there’s one things Oxford students with mental difficulties need, it’s a unified strategy that protects the interests of students, while allowing colleges to have their say. OUSU is working on just such a project, but there’s some way to go yet in getting our federal system to sign up. We should aim to sort out difficulties as they arise in a cohesive and collaborative manner, so that people will feel less intimidated about coming out as mentally ill. A problem shared is a problem partially dealt with.
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The Inspired Illness K i m N o b l e s p e a k s at the H u m a n S c i e n c e s 40th A n n ive r s a r y S y m p osium It was a shock to the Oxford system. The Human Sciences Symposium, entitled The Inspired ‘Illness’, was supposed to be “exploring the links between mental disorders and creativity in society”. Two academic speakers sandwiched the only real ‘exploration’ of the subject, which came from Mr Kim Noble. He, as the programme told us, “is a performance and video artist working across theatre, TV, film, art and comedy.” What it didn’t tell us was the effect his personal experiences of bi-polar disorder and art could have on the audience.
Immediately after his performance there was a break. We filed out of the auditorium. We queued sedately for tea and biscuits. I almost cried. I haven’t cut for four years – I can control my emotions now. I relearned other coping strategies. But I was on the edge. Not of self-harming, but of emotions and impulses I haven’t felt that strongly for years. I wanted to run, I wanted to break out of the mass of people, I wanted to cry and scream, I wanted a hug. I sipped my tea and listened to the conversations around me.
His presentation began with music. He asked an audience member to phone his mother and discuss his illness with her (which she obediently did). He put his own contact details, as well as phone numbers for other people in his life, on the screen. He put on a video clip then went out for a cigarette. He broke down the barriers between himself and the audience, offering us anti-depressants if we needed them. He showed videos of himself ejaculating into a cup marked ‘for sale’, having a breakdown following the end of a relationship, going to a funeral. He showed videos of other people: his ex-girlfriend; a woman called Hilary who committed suicide last year, self-harming.
We filed back in, took our seats, shuffled feet and coats and bags. The third speaker told us he didn’t believe in creativity. It felt incongruous to be listening to a calm scientific explanation of the subject when I was aware of the arm I used to cut years ago. The feelings were the same; but now I can recognise and control them.
That paragraph was easy to write. Noble’s performance was not easy to watch. I self-harmed, and the montage of a psychedelic supermarket trip to buy meat interspersed with graphic self-mutilation affected me in a way that normal sentences shouldn’t be able to describe. I felt the pain I caused myself, again, in my right arm. I ran my hand along it and was almost surprised to find it smooth, with no cuts, and without the extra pain of contact with the broken skin.
So did I. I don’t know if I respect or resent him for ‘coming out’ so publicly, so subjectively, so effectively. I don’t like the way those images made me feel, but I can write here that it was successful – as art. Putting such images under the banner of art makes them acceptable, somehow. They certainly gave the audience a glimpse into another consciousness; it made them consider, and pushed them towards stronger emotions. It almost made me cry; but perhaps that was the point.
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He knew what he was talking about in a way no psychologist ever could
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There was a question and answer session at the end, full of eager thesis-writers beginning their questions to Mr Noble with “I’ve read that...” He disagreed with most of them. He knew what he was talking about in a way no psychologist ever could.
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Be your own therapist >> Andrea White questions Julia Holden, psychotherapist, on DIY therapy << The exam period is tough for everyone, but it can be particularly stressful for those already suffering from a mental disorder. For some, seeing a therapist can be helpful. But as time and money are in scarce supply for most Oxford students, is there any way to be your own therapist? CBT (Cognitive Behavioural Therapy) has become a popular therapeutic technique. The theory behind it states that there are causal connections between thoughts and behaviour in both directions, and both contribute to how you feel. Put simply, to change your mood you have to change both your thinking and your behaviour. So, if you are feeling irrationally anxious about exams, taking lessons from CBT could be just the thing. But do you have to see a therapist to reap the benefits of CBT? I quizzed Julia Holden, a UKCP psychotherapeutic counsellor, on her thoughts about stigma, psychotherapy, CBT and how you can take the techniques developed by therapists and use them yourself.
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Andrea White: What are your opinions on the stigma attached to mental health? Julia Holden: The stigma is very definitely there and like all prejudices, it is fear based. I think the fear that underlies the stigma is essentially, a fear of losing control. Sufferers themselves fear that a mental health referral will appear on their medical records and blight their future if accessed by an insurance company or employer. And I often see individuals who feel shame at “not being able to cope” or being unable “to pull myself together”. They really want and need help, but feel a tremendous sense of failure at having to come to see a therapist. No such qualms if they need a dentist or physiotherapist. And what with with headlines on violent crimes and mental health, and the fact that we live in a less therapy orientated culture than say, America, losing sanity is a worry that many carry around, quite unnecessarily. AW: What are psychotherapy and counselling? JH: Both counsellors and psychotherapists offer a safe confidential space to explore distress and/or emotional difficulties. They facilitate change and help alleviate confusion. But it is the complexity and depth of the work which distinguishes psychotherapy from the closely related role of counselling. People with a lot of curiosity might start by reading the websites of UKCP (UK Council for Psychotherapy) and BACP (British Association for Counsellors and Psychotherapists). Either website provides a good starting point for those considering therapy and wanting to access a trained and qualified therapist. AW: Why do you think CBT has become so popular? JH: To understand the emphasis on and popularity of CBT over the past few years, you have to look at the mental health strategies of the NHS, the input of NICE (National Institute for Health and Clinical Excellence) and the current rollout of the IAPT (Improving Access to Psychological Therapies) project. The NHS is very aware of the need for many more people to access talking therapies for the treatment of depression and anxiety. They turned to NICE for guidance and NICE requires that treatment be evidence based, in other words, rigorously tested to show proven, cost effective results. And considering that CBT therapists have been most proactive
in their research and testing, CBT fills this requirement nicely. The IAPT project has been piloted in a few centres and has encouraged the recruitment of therapists to deliver CBT for anxiety and depression across the country. AW: What do you personally think about CBT? JH: My experience using it has been very good, and I tend to use it in an integrative style. In other words, I use a range of tools that I think may best suit the individual and amongst my strategies will be some CBT style exercises or tasks. What I value most about CBT is that it is collaborative. By that I mean the tasks and experiments that CBT uses to facilitate change are designed with the client; it is focused on the here and now; and most importantly, it helps clients to externalise some of their
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moods to help regulate stress. Signs of stress-overload include: changes in appetite, energy levels and sleep pattern, and irritability and becoming socially avoidant. Also, take note of your inner dialogue, which may change: lots of scathing self criticism is not helpful. Rather talk to yourself as if you were talking to a best friend. When stress is unavoidable, having good coping strategies can make all the difference. There are two types of coping strategy: healthy and unhealthy. Unhealthy: • Binge eating • Self harming • Drinking alcohol too frequently or alone • Avoiding friends and family
To avoid stress overload, it is important to a) monitor the amount of stress, b) get to know your system’s stress tolerance and c) monitor warning symptoms of overload.
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distress. By putting thoughts and moods on a piece of paper, they are “out there” rather than locked inside, which makes shifts in perspective easier. However, CBT is not for everybody and is not the first choice when dealing with someone presenting problems. If, for example, I am seeing someone who has been abused or is self harming then I would not necessarily use CBT.
Healthy: • Talking through issues with a friend / peer support worker • Exercise like swimming, walking briskly. • Meditation and/or breathing exercises • Creative outlet like dance or playing music • Writing a journal
AW: What advice do you have for students coping with exam stress?
These healthy coping strategies are simple but can be extremely beneficial. Also, try to eat a balanced diet, watch caffeine intake and get some fresh air and sunlight every day.
JH: We need some stress in our lives to motivate us and stressors are with us all the time. But when we are under too much stress, our coping skills are challenged. To avoid stress overload, it is important to a) monitor the amount of stress, b) get to know your system’s stress tolerance and c) monitor warning symptoms of overload. I’ll say a little more about a, b & c and then go on to coping strategies and self help. a) Recognise and monitor the stress you are under. I often meet people who have minimised what they are dealing with. It is important to be realistic about your workload and other contributing factors. b) Get to know your own stress tolerance. Some people simply have more resilient nervous systems than others. It does not do to compare or measure yourself with someone else who seems to be coping better with the same stressors. Firstly, you do not really know how well they are coping; secondly, they may not have the same peripheral stressors to contend with. c) Monitor warning systems of overload. Drivers of cars pay attention to warning lights on the dashboard. We need to pay attention to changes in our thinking, behaviour and
AW: Is there self-help CBT to use for depression and anxiety? JH: For depression or anxiety there are CBT services online like Mind Gym which was developed in an Australian University for use by students. However if the online program does not seem helpful do speak to someone like a peer support worker or your student counselling service. CBT and particularly self help CBT is not for everyone. Two very useful books that are easy to work through are: Mind over Mood by Dennis Greenberger, PhD and Christine Padesky, PhD. Published by Guildford press. Stress by Rochelle Simmons, published as a Vega guide.
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A Very Medieval Madness? Dr. Annie Sutherland, Somerville College
The relationship between ‘madness’ and literature has long held a fascination for readers. Can works of fiction depict insanity? Can the insane write coherent texts? Is, in fact, an element of insanity a prerequisite of literary creativity? I raise these questions rhetorically, not because I am able to answer them. What I would like to do, however, is consider them as they relate to one very specific author – Thomas Hoccleve. Thomas Hoccleve (1368-1426) was a bureaucrat and poet who lived and worked in London in the late Middle Ages. He has attracted the attention of many readers because his verse is unusually and overtly preoccupied by questions of mental health – specifically that of his own self. Appearing to have suffered from a type of nervous breakdown at some point in his life, Hoccleve places discussion of his own ‘madness’ at the centre of much of his writing. In some ways, Hoccleve’s understanding of his breakdown and its causes is peculiarly medieval. According to widely held contemporary belief, sanity was a gift of God and could be confiscated by him as a punishment for sin – and this is exactly how Hoccleve categorises his ‘madness’:
trying to perfect an apparently ‘sane’ expression (and also, perhaps, trying to recognize and reconcile his own divided self): Many a saute made I to this mirror, Thinking, ‘If that I looke in this manere Amonge folke as I nowe do, noon errour Of suspecte look may in my face appere.’ (I made many a leap to this mirror, thinking ‘If I can look as I do now when I am among other people, no suspicious expressions will appear on my face.’) And yet, for all this anxiously expended effort, Hoccleve’s conclusion is that one can never truly know an individual by perceiving him from the outside. In the end, the only true judge of individual sanity is the individual himself. The challenge for the fragile Hoccleve, and for all of us, is the careful bridging of the gap between his awareness of himself as internally consistent ‘I’ and as multiple ‘you’, identified subjectively by others and by himself, looking in the mirror.
[God] gaf me wit and he tooke it away Whanne that he sy that I it mis dispente, And gaf agein whanne it was to his pay. ([God] gave me wit and he took it away / when he saw that I used it amiss / and gave it again when it was to his profit.) But in other very striking ways, the anxious self-doubt that informs Hoccleve’s account of his insanity sounds remarkably modern. He articulates it vividly as a division of the self, referring to his breakdown as a ‘wilde infirmite’ which ‘me oute of mysilfe caste and threwe’ (a wild infirmity which caught and threw me from myself). Divorced from his own powers of recollection, he tells us that the ‘substaunce of my memorie / Went to pleie as for a certain space’ (the essence of my memory went to play for a time). It is this divided self which really troubles Hoccleve, for not only does it involve him losing control of himself but he also fears it will lead him to lose control of his own reputation – of the perceptions of others. To this end, he tells us that he spends hours in front of the mirror
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Portrait of Chaucer by Thomas Hoccleve
Man with Red Eyes 1938
Lowry
Part of his ‘Horrible Heads’ series, this self-portrait was painted not long before the death of Lowry’s mother. He was her sole carer during her bedridden illness, his father having died some years earlier. It has been argued that when x-rayed, the portrait of a woman is revealed beneath the present painting. In his discussion of Lowry’s troubled life, Tim Adams from The Observer demonstrates the dark images of obsession and depression hidden within Lowry’s art and exposed by x-rays following his death. He says: “An innocent looking street scene revealed a version of a mannequin; stilettos and bodices emerged half-submerged in seascapes”. Lowry struggled with depression and isolation throughout his life.
The starkness of Lowry’s art is the mark of a man haunted by depression in the late years of his life. Rachel Burns and Sally Dickinson take a look at two of his most iconic protraits.
Portrait of Ann 1957 Opinion has long been divided as to the identity of ‘Ann’, and her significance for Lowry. Throughout his life, the painter continually depicted the same stylised girl - always with a similar look, and a long black plait. The paintings reflect, perhaps, a series of non-sexual relationships with young girls who Lowry mentored and tutored - girls who all looked strangely alike, and seemed to be constantly replaced by younger versions of themselves. Lowry’s ‘Ann’ seems to be a fictionalised version of all these girls: an idealised, mythologised image of eternal youth and innocence. For an artist of the bleak inner city, she represented an escape - even if he never found her real-life counterpart.
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Helplines and Web-Support If youâ&#x20AC;&#x2122;re looking for specialist advice, or find it difficult to confide in someone face to face, then a helpline or website may be the best place to ask questions and do some background reading. To help you find the support you need, Open Minds has compiled this list of helplines and websites on issues related to mental health or general well being. GENERAL / HEALTH ADVICE Oxford Nightline 01865 270 270 Oxford Student Counselling 01865 270300 www.admin.ox.ac.uk/shw/counserv.shtml Samaritans 08457 90 90 90 www.samaritans.org NHS sexual health advice www.nhs.uk/worthtalkingabout MENTAL HEALTH ISSUES MIND 0845 766 0163 www.mind.org.uk SANE 0845 767 8000 www.sane.org.uk Oxfordshire Mental Health Matters 01865 247 788 www.oxford-mentalhealth.org PAPYRUS (suicide prevention) 0800 068 41 41 www.papyrus-uk.org beat (eating disorders) 0845 634 1414 www.b-eat.co.uk The National Autistic Society 0845 070 4004 www.autism.org.uk British Dyslexia Association 0845 251 9002 www.bdadyslexia.org.uk OCD Action 0845 390 6232 www.ocdaction.org.uk Anxiety UK 0844 477 5774 www.anxietyuk.org.uk GENDER AND SEXUALITY Stonewall 0800 050 2020 www.stonewall.org.uk The Gender Trust (Gender identity issues) 0845 231 0505
www.gendertrust.org.uk Oxford Friend 01865 726 893 www.oxfordfriend.co.uk Broken Rainbow (Sexuality-related domestic violence) 0845 260 4460 www.broken-rainbow.org.uk DRUGS AND ADDICTION FRANK 0800 77 66 00 Or text: 82111 www.talktofrank.com Alcoholics Anonymous 0854 769 7555 www.alcoholics-anonymous.org.uk Release (Drugs, the Law, and Human Rights) 0845 4500 215 www.release.org.uk Narcotics Anonymous 0300 999 12 12 www.ukna.org GamCare (Gambling Problems) 0845 6000 133 www.gamcare.org.uk ABUSE Womenâ&#x20AC;&#x2122;s Aid National Domestic Violence helpline: 0808 2000 247 www.womensaid.org.uk Oxford Sexual Abuse and Rape Crisis Centre 01865 726 295 0800 783 6294 www.oxfordrapecrisis.net Rape And Abuse Line Answered by women: 0808 8000 123 Answered by men: 0808 8000 122 www.rapeandabuseline.co.uk EDUCATION UK Council for International Student Affairs 020 7107 9922 www.ukcisa.org.uk Mencap 0808 808 1111 www.mencap.org.uk
Thoughts? Questions? Open Minds wants your feedback. This is the first issue of Open Minds Magazine, and we want to hear what students have to say about mental health and mental well-being resources at Oxford University. Are there important topics you think we should be covering? Other helplines we should be giving? Would you like to write an article for us, based either on your own experiences, or an area of your study? Email open.minds.magazine@googlemail.com with your ideas, or for further information. 26