Issue 10 (Winter 2011) by Sanctuary magazine

Inner space for womenâ&#x20AC;&#x2122;s mental health & wellbeing (across Surrey and the south east)

issue 10 winter 2011

Being yourself

What it means to be transgender

X-cluded! Talent show bans contestant with mental ill health

Brainy food Eating to prevent dementia

One word

describes this issue: Change. It’s a funny thing. We don’t – so we think, are told or just assume – like change. And yet it runs through our lives as an unstoppable force. Just shifting through the growing up process brings many changes: going to school/uni, starting a job, not starting a job, becoming a parent or living alone, having different life experiences, different relationships, getting older. And of course anyone experiencing mental health problems is going to know all about change, sometimes to the extent that you might feel your entire personality, body and soul has undergone an unwelcome transformation. In this issue of Sanctuary we look at what can make a positive change in people’s lives. But we also look at areas where proposed changes need careful consideration and monitoring to ensure they won’t have a negative affect on people’s mental health and wellbeing. Assistant Editor Louisa has written about the anti-stigma campaign, Time to Change alongside a report on how

TV talent shows are showing their true colours when it comes to discriminating against people with mental health issues. She also looks at how the devastating changes that occur when someone develops Alzheimer’s are being constantly challenged by new research and findings, including how diet and healthy living may be routes to prevention. We look at what must be one of the ultimate changes someone can experience. We meet a pioneering transgender woman who spent her early years trapped in a male body. She underwent agonising physical and emotional change to become the woman on the outside she so desperately felt she was on the inside. Now a role model to help others, she challenges every pre-conception being transgender attracts, re-writing the rule book on how we should view – and treat – ‘gender dysphoria’. Over the page I outline national and local changes that will impact on mental health services in primary and secondary care. Being able to change your thinking, attitudes and

behaviour can be important to helping someone recover from mental health problems. One method we look at is ‘Focusing’, something that is described as ‘unlocking the wisdom of your body’ and which can help people gain better understanding of themselves. Whether change is desirable or necessary, we always hope it will be for the best in the long term. There is criticism that incumbent or successive governments bring in change just for the sake of it; to take a ‘new broom’ to sweep away the last government’s policies. But whether any real change for the better takes place is always up for lively debate! How about this quote to sum it all up? “There is a certain relief in change even though it be from bad to worse; as I have found in travelling in a stagecoach, it is often a comfort to shift one’s position and be bruised in a new place!” (Washington Irving, Tales of a Traveller)

Megan

Editorial comment

A recent survey organised by Platform 51 (previously the YWCA) reported that the equivalent of 15.2 million girls and women have experienced some kind of mental ill health, and that the situation is getting worse. A passage from the report states: ‘Traumatic events such as abuse or bullying can trigger mental health problems for girls and women. 29% of women we polled had been emotionally or physically abused. The symptoms experienced by those who had been abused included feeling sad and tearful (70%), having low self-esteem (66%) and feeling worthless (60%). Almost one in four admitted feeling suicidal (24%). Other triggers include events which many or most women will experience, such as changing school, getting into debt, being unemployed, leaving

home or getting pregnant. However, some events will trigger problems for a small minority but the impact can be significant. For example, the majority of girls and women regarded getting pregnant as a positive time in their lives but for almost one in ten (9%) it was not. For some girls and women it was the combination of these events which caused mental health problems. The cumulative effect of these events made it harder to cope with each new challenge.’ Behavioural consequences of the triggers for mental health problems include turning to alcohol or drugs, staying in bed for hours or even days at time, getting into debt, losing the support of friends and family, losing a job and/or always off sick and self harm. It is self destructive rather than lashing out at others and most women try and

hide their problems, thinking stoically that they can – and must - just carry on. So their suffering and struggle to cope can go undetected until if and when they topple over the edge. Support, when it is sought, can often mean courses of medication (the prescribing of anti-depressants has gone up by 95% over the last decade), with just 37% receiving counselling but even then after possibly over a year’s waiting. The survey suggests that one in three women ‘do not get any professional help when they face mental health problems.’ Many of those women believed their problems were not serious enough ‘to be worthy of any support’! To read the full report, go to www.platform51.org

Let’s hear your views! Sanctuary Magazine, Let’s Link, PO Box 533, Betchworth RH4 9FL. Text: 07824 364703. Email: info@letslinkmentalwellbeing.com. www.letslinkmentalwellbeing.com

Sanctuary is free to everyone. Managing Editor: Megan Aspel Assistant Editor: Louisa Daniels Sanctuary is commissioned by NHS Surrey

Design by Aspects: studio@aspectsgd.com www.aspectsgd.com Printed by Progression Print: www.progressionprint.co.uk No part of this magazine may be reproduced without prior permission of the publishers. Copyright © Aspects 2011.

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of new guidelines and legislation coming from the Coalition Government is heralding unprecedented reform in health, social and welfare care and legislation. GP commissioning, a new mental health strategy, a Health & Social Care Bill, Public Health Bill and a Welfare Reform Bill set out to shake up conventional approaches along with attitudes. Enthusiastic rhetoric from government accompanies the wordy documents. Here in Surrey many patients, carers and staff within mental health services are beginning to see changes – or developments – that will impact on how and where people are treated. National health reforms are placing as much importance on mental health as on physical health (‘no health without mental health’) which is to be applauded. Locally though, people are concerned to hear that secondary mental health services are undergoing a ‘re-design’. Will what is happening on the ground reflect the plaudits being expressed for what is set out on paper? Sanctuary is keeping a watching brief on the following major developments.

GP Commissioning:

Practice based commissioning which basically devolves responsibility for commissioning (buying) health services from primary care trusts (PCTs) to GPs has been taking place over the last few years. So in theory there should be no surprise that all health – bar a few areas – will be wholly commissioned by GPs by 2013. All PCTs, along with Strategic Health Authorities (which oversee what PCTs do, along with other functions – of which some people have said they have difficulty identifying!) will disappear. Consortiums – groups of GP practices – will be handed the bulk of the NHS pot of money and will decide what services are purchased and maintained. Over the next two years the PCTs role will be to support the development of the consortiums. What will all this mean for patients of mental health services? A recent survey undertaken by Rethink the national mental health charity reported that by their own admission, 42% of GPs would be worried about commissioning services for more severe mental

illnesses. But, with the right support and guidance, GPs in charge of commissioning mental health services will put them on the same footing with physical health services. It could lead to greater patient-centred care and even reduce stigma.

better standards of recovery and management of mental ill health for the patients of Surrey. But we do know that patients, carers and staff alike are very concerned. They are witnessing at the sharp end what is being described as cuts to services and staff reductions.

To help those GPs less confident about commissioning mental health services, a new strategy might bring clarity and guidance about where to channel the billions of pounds. ‘No health without mental health’, consists of a four page 'call to action' with supporting documents of considerably greater length. The strategy states that mental health is to be given the same importance as the nation’s physical health. Paul Burstow, Minister of State for Care Services says “What we have at the moment is a system in terms of the NHS and social care that’s at the wrong end of the pipe. It’s managing the consequences of failing to intervene to provide the right support at the right time. It’s containing and coping with mental health problems when it could do so much better by providing that support at an earlier stage.” With early intervention and prevention the watchwords of the strategy, the government is making a financial commitment as well as a developmental one to providing talking therapies to children and young adults. Psychiatrists, psychologists and mental health charities are – with caution in some cases – welcoming the drive to help everyone see mental health as part of the whole picture, not some isolated phenomenon that some – well, one in four is still the figure quoted – people experience.

Welfare Reform Bill

New mental health strategy

Re-design of community mental health services Whilst the national big picture is unfolding, locally we are seeing a redesign of community mental health services. According to the local NHS mental health trust the aim now is ‘to focus on recovery and helping people to lead a full life’. At the time of going to press, we don’t know to what extent this new direction for community services will achieve, as it is being suggested,

Described by many as punitive, the new Welfare Reform Bill, as an Act, is certainly set to cause concern for people suffering mental ill health. However, there are promises in there that in theory ensure ‘protection to those with the greatest need’. How deep and far that protection goes is to be seen but locally there are organisations, particularly in the voluntary sector, that will endeavour to guide and support people in understanding the changes and what they might mean for individuals. The commitment from the government is stated as:  creating the right incentives to get more people into work by ensuring work always pays  protecting the most vulnerable in our society  delivering fairness to those claiming benefit and to the taxpayer Only in time will be know how and if these changes will bite, or if they will improve the way health and social care and welfare services are delivered. To that end, Sanctuary wants to know people’s views and to follow and highlight personal stories if and where we can. If you are a patient, carer or member of staff (in Surrey or across the south east), please write to us in confidence. We won’t print anything unless you give your consent and anything we do print will remain anonymous. We will feature the feedback, and developments, in the next issue. Please write to The Editor, Sanctuary magazine, Let’s Link, PO Box 533, Betchworth RH4 9FL Or email Megan at megan.aspel@sky.com

–cluded! Pick up

a newspaper and you will see that more often than not the topic of ‘mental health’ will be in reference to a negative situation. Whilst things have somewhat improved over the years, we still have a very long way to go until people with mental health problems are addressed with respect. Let’s cast our minds back to summer 2010, when a certain, hugely popular talent show that is watched by millions of people dismissed a contestant, a woman named Shirlena, apparently because she was too ‘unstable’ to handle the demands of fame due to a mental health problem. According to the press, the decision to question her mental health was provoked by her ‘unusual’ performances and the opinions of two doctors: the programme’s specialist and Shirlena’s GP. Worryingly, it was suggested that these were the ‘only underpinning factors in this decision’, and that they did not seek the opinion of Shirlena. In an interview with journalist Jen Blackburn, Shirlena is reported to have said, ‘They told me their doctor said I couldn’t do it, but why won’t they see me for themselves?’ Shirlena said herself that her performances were ‘unusual’, and that this was intended, after all being ‘different’ is a great basis for a music career. I can think of many hugely successful artists who have been perceived as ‘unusual’. Unfortunately for Shirlena, it appears her performances led the powers that be to delve into her private life and cut short her dream. It seems absurd that Shirlena could be punished for being her true self, as Shirlena said in one interview, ‘Give people who are wacky a chance’. Without knowing all of the details, it certainly seems as though Shirlena was treated unfairly, but this isn’t so much about the show’s decision, this is about what followed. After the gutting announcement that Shirlena was to be excluded from the competition, Shirlena then had to face the merciless media as they tore into her and described her as a ‘ticking time bomb’, ‘completely nuts’ and ‘crazy’.

Yes, I accept that newspapers have to sell copies, but when will we stop making excuses for the way that people with mental health problems are described as monsters lurking in the dark waiting to explode? The effect of these stories on people with mental health problems has already been noted. One person on the internet described it as, ‘They (the media stories) makes me feel ill on a great day...you know, I’ll be feeling good and positive, and then when I walk into a shop and see that, I feel terrible. I’m not a dangerous person at all, but sometimes I question if I will become dangerous when everyone is saying that I will.’ That’s just great isn’t it? We live in an age that still makes people feel so excluded and feared by society that they become worried about themselves! Situations like this make it easy to understand why people are scared to talk about mental health for fear of stigma. Shirlena reflected on this saying, ‘this is why people hide mental illness and don’t get help, because it’s on their records and then something like this happens.’ Thankfully, there is some understanding out there. It is reported that 84% of the general public think that people with mental health problems have been subjected to discrimination for far too long (Ibid - Department of Health, 2007) and we are seeing more and more campaigns to tackle stigma, such as the Time to Change campaign on page 6. Such negative and deeply harming news coverage cannot be allowed to continue, and there is still much that we have yet to accomplish in terms of increased understanding of mental health, but there is support out there and there are many people who are ready to challenge the misconceptions in order to make society a better place. I guess the journey to that ideal is similar to the quest for stardom and fame, you can’t let the knock-backs stop you from trying.

Louisa

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Be Yourself Imagine living in a body that is alien to all your inner concepts and feelings about who you are. There are things about our bodies that virtually each and every one of us would change if we could – hair, nose, lips, body shape etc. But what about questioning the very essence of our being: our gender?

In 2010, around 12,500 people sought help and treatment for what is known as gender dysphoria – meaning that what you look like on the outside – male/ female – is opposite and alien to what and how you are feeling inside. Megan went to meet Kate Craig-Wood, Business Woman of the year, 2009. A beautiful young woman, Kate is an inspiration to and has a special message for anyone who is coming to terms with gender identity. “Let me be clear. Does anyone seriously think someone would go through the pain and torment of a transsexual transition, if it wasn’t absolutely for real and so deeply important for them?”

Had I any misgivings (which I hadn’t), Kate’s succinct comment would have left me in no doubt about the enormity of what it means to be transsexual. Talking to Kate over coffee at her and her brother’s successful IT business in Guildford, Surrey, where she is MD, I was humbled by her honesty and openness. However, neither I nor Kate wanted this to be an article purely about the trials and tribulations of changing gender, living life as male to female, female to male. Kate has a mission; “I want to educate people in the UK and campaign for the help and recognition afforded transgender people in Europe and America,” she says, “I believe such understanding is lacking in the UK. “There is never really a choice,” she continues “There are innate biological conditions that determine whether a person might be transgender. The choice lies in whether to go for ‘transition’ or continue to live in the body you

were born with: transition brings huge psychological challenges – it’s a gamble, it’s painful and it takes a long time. “When I decided to transition, I steeled myself for the worst. I was prepared to be an outcast and never be with anyone.” What Kate was prepared to sacrifice shows the true measure of the depth and intensity of her self knowledge – and, ultimately of her sense of self worth. To be that sure of who she really was and to do something about it took enormous courage. Kate’s ‘crusade’ for others is better understood within the context of her own story. Born Robert Hardy Craig-Wood, Kate was a happy little boy until puberty kicked in and, as she said, she saw her sister developing in a different way to her. Breasts and hips! As the young Robert started male puberty, the person deep within became horrified and worse, ashamed. Then began years of torment, hating seeing the male image reflected in the mirror when inside was someone else entirely different – well, that was the problem; not entirely. But conformity won – for a while. Married to a wife he loved, Robert played the role of good

son, good husband for several years. Yet deep inside the pain was building and living as Robert was becoming increasingly impossible. To help – so she thought at the time - ‘Kate’ was born online as a computer games player. Where her true identity and feelings were locked away in everyday life, over the internet, Kate could be herself. But in time, Kate online only exacerbated the despair of living a lie in real life and one night, driving home from work, Robert hit the peddle and, at 100mph, looked for a tree to crash into. At that epiphany moment ‘Kate’ truly emerged and thought “Either I live as a woman or I’m going to die.” There was now no going back. Kate was in a fortunate position in that she could afford to see a private specialist who put her on female hormones and later arranged the surgery (which took Kate as far away as Thailand) to

her face, breasts and genitals to ensure a full transition, and transformation. Since that time in 2006, being who she really is has helped Kate in her personal and professional life. “I’ve realised my full potential at work,” she says “and my business has really taken off. With the help of my quality management team, I feel I am really changing the mindset in IT that women don’t really ‘do’ technology!” And in her personal life, Kate has found a fulfilling and deep relationship with a man with whom she hopes to share a long and happy life. Her own success story has triggered the desire to help others, some of whom are suffering in silence about their gender identity. “So much pain could be saved,” Kate explains “if there were role models, if we talked more about it and let people explore if being a transsexual is really what they want.” One of the major ways she puts her desire to help into practice is through the website Gender Identity, Research & Education Society (GIRES). Here there is a wealth of information, advice and practical support. “As I said, this country is reluctant – for whatever reasons – to address the situation early on. It’s so important for children and pubescent youngsters to explore their feelings. I help families to find ways of doing that – going to the States if necessary. It’s vital to help people when they are young – it may just help avoid the pain and anguish they experience when, like me, it all became too much as an adult. Taking action earlier can allow someone to find their true identity and do something about it, rather than lead a life full of despair.”

The consequences, for some people stuck in an ‘in-between’ life, can be mental ill health; depression, anxiety, paranoia. Around 1 in 3 transsexuals self harm. Suicide or thoughts of suicide prevail in many who find the body they were born with unbearable to live in. And, as an adult, the changes that are necessary to show outwardly who they are inside, are not only expensive but incredibly intrusive, painful and long term. As Kate said, no-one goes into changing his/her gender lightly. “It is very de-stabilising; you doubt yourself constantly,” she recalls. Kate has what she agrees could be a controversial belief: she thinks transformation surgery should begin with the face. “Facial surgery is more important than genital and other body changes. When someone is struggling to let the opposite gender to what they appear, to be set free, it is heartbreaking to be going through the bodily changes – taking hormones etc – and to still see the ‘old’ you in the mirror!” It may be controversial. But think about it: we all present an image of ourselves, and the very first place people – mostly – look to discover a bit about us is our face. Our eyes, shape of face, hair, make-up, beard/no beard, glasses, contact lenses – whatever we choose to do, we are literally attempting to portray who we are. When people look at Kate, there can be no hesitation in their minds that she is a very attractive,

dynamic, clever and feminine woman. When people learn – if there is ever any need to know – that Kate is transgender, many barriers have already been broken because she looks like who she is. Kate believes she has gained significant leverage around transgender issues through the media coverage she has received on her success gaining the Businesswoman of the Year award. “I’ve had articles in the Financial Times, Daily Telegraph, Evening Standard, and they have all been very positive stories about myself as an individual and about transgender in general.” Through her campaigning, Kate is bringing a pragmatic, highly educational and refreshing approach to transgender issues. For people seeking help, for professionals needing guidance, and for families supporting transsexual children and young adults, she is not only a beacon of knowledge and support; she has become the very role model she wished she could have found when going through her own painful transition. “My message to anyone struggling with gender identity is – find out more, explore who you are and what you want - and well, just be yourself!” Find out more about gender dysphoria and about Kate’s work at www.gires.org.uk. Included on the website is in-depth educative information for individuals and professionals. There is also a list of useful website links including help / support for young people and families.

Directory Sanctuary magazine started in Surrey,

commissioned by Surrey PCT. With extra help from Care Services Improvement Partnership in the south east, the magazine has a small circulation across Kent, Sussex, Hampshire, Isle of Wight, Berkshire, Buckinghamshire and Oxfordshire and Milton Keynes, as well as Surrey. We will continue to list organisations and help lines in Surrey in this directory but we’ve added each mental health trust in the south east and will include other important contact details as we can and space permitting.

Mental health NHS trusts across the south east................................................

• Sussex Partnership NHS Foundation Trust. T: 01903 843000 • Kent & Medway NHS Social Care Partnership Trust. T. 01732 520400 • Isle Of Wight Healthcare NHS Trust. T. 01983 524081 • Hampshire Partnership NHS Foundation Trust. T. 023 8087 4300 • Berkshire Healthcare NHS Foundation Trust. T. 01344 415 600 • Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust. T. 01865 778911 • Milton Keynes PCT. T. 01908 243933 • Surrey & Borders Partnership NHS Foundation Trust. T. 01883 383838 • Age Concern Surrey – 01483 458732 www.acsurrey.org.uk

Alcohol and drugs........................................ • Drinkline, 0800 917 8282 • Al-Anon, support for family and friends of alcoholics, find a local group 020 7403 0888. • Alcoholics Anonymous, find a local group – 0845 769 7555 • Drugscope, for information, www.drugscope.org.uk • Frank (for young people and parents) www.talktofrank.com • Surrey Drug & Alcohol Action Team – for local services, www. surreydat.org.uk

We are building on this directory all the time. If you have anything to add that you think will benefit women’s mental health and wellbeing in Surrey, please let us know. You can contact Santuary magazine c/o Let's Link, PO Box 533, Betchworth, RH4 9FL. Tel. 07824 364703; email; meganaspel@sky.com

Bereavement and loss................................... • Cruse 08701671677 www.crusebereavementcare.org.uk

Counselling..................................................... (please note, waiting times can be long) • British Association of Counselling & Psychotherapy, 0870 443 5252 www.bacp.co.uk (for details of local practitioners) • Heads Together (young people 14-25) 01737 378481. No fees • Croydon Pastoral Foundation, 020 8760 0665. Negotiable rates according to means • North Surrey Community Counselling Partnership, 01932 244070 www.nsccp.co.uk A sliding scale fee basis operates (up to £40.00 per session) • Pathways Counselling Centre, Epsom, 01372 743338. Professional counselling, normal rates apply • Redhill Counselling Centre, 01737 772844. Negotiable rates • RELATE, relationship counselling, 0845 4561310 www.relate.org.uk, for a local branch. A fee is charged for appointments. • Relateen, Epsom (part of RELATE but for young people disturbed/worried about parent’s relationship problems) 01372 722976 • Seastone Possibilities, Trauma Resolution Treatment 01306 640073 / 01737 249364 email: seastone@talktalk.net

Debt counselling...........................................

Domestic abuse...............................................

Other useful contacts.................................

• Surrey Domestic Abuse Helpline (24hr) – 01483 776822 • East Surrey Domestic Abuse Services (covering Reigate & Banstead, Mole Valley & Tandridge) - 01737 771350 Email: support@esdas.org.uk Website: www.esdas.org.uk 9am – 4pm, Monday to Friday, confidential answer phone out of hours. • North West Surrey Outreach Service (covering Woking, Runnymede & Surrey Heath) run by Surrey Women’s Aid 01483 776822 (24hr) • North Surrey Outreach Service (covering Epsom & Ewell, Elmbridge & Spelthorne) run by Walton & Hersham Citizen’s Advice Bureau - 01932 260690 Email: nsdvoutreach.walton@cabnet.org.uk Website: www.waltonadvice.demon.co.uk 9.30 am – 4.30 pm Monday to Friday, confidential answer phone out of hours • South West Surrey Outreach Service (covering Guildford & Waverley) run by CAHA - 01483 577392 9.00 am - 3.00pm Monday – Friday, confidential answer phone out of hours

Crisis numbers; • Samaritans, 08457 909090 www.samaritans.org.uk • Sane Line (12noon – 2am daily) 08457 678000. National out of hours helpline for anyone coping with mental illness – sufferers, carers, relatives or friends. • Surrey & Borders Partnership NHS Trust, 0300 456 83 42; text for hard of hearing – 07717 989024 (24hrs) • Childline; 0800 1111

Survivors of childhood abuse................... • C.I.S.‘ters for adult women sexually abused as children Run by survivors for survivors – helpline Saturdays 10am – midday 023 80 338080

Eating disorders........................................... anorexia, bulimia • Eating Disorders Associations, 0845 634 1414 www.eduk.com

Employment For people who do or have suffered mental ill health: • Employment, Support, Re-training Agency (ESRA) for East Surrey area: 2nd Floor, Rawlinson House, 9 London Road, Redhill RH1 1LY. Tel/Fax: 01737 772115 Richmond Fellowship covering the whole of Surrey: • Mid Surrey (and queries re West Surrey) RF, Manor House, 19 Church Street, Leatherhead KT22 8DN. T. 01372 363934 • East Surrey RF, Rawlinson House, 9 London Road, Redhill RH1 1LY. T. 01737 771 282

Hearing Voices................................................

Primary Care Mental Health Teams (PCMHTs) • for long term and complex mental health needs and for referral to specialist services such as Crisis Assessment & Treatment Team, Eating Disorders service, Continuing Needs services. Open Monday – Friday 9am – 5pm • East Elmbridge PCMHT – 020 8873 4300 • Epsom, Ewell & Banstead PCMHT – 01372 204000 • Mole Valley PCMHT – 01306 502400 • Redhill PCMHT – 01737 272301 • Tandridge PCMHT – 01883 385481

• Rethink, 020 8974 6814 www.rethink.org

Anger.................................................................

• Christians Against Poverty; freephone 0800 328 0006 www.capuk.org

• British Association of Anger Management, 0845 1300 286 www.angermanage.co.uk

Depression.......................................................

Anxiety.............................................................

• Depression Alliance, 0845 123 2320 www.depressionalliance.org

• Association for Postnatal Illness, 0207 3860 868. www.apni.org; www.surrey.nhs.uk; www.babycentre.co.uk; www.netmums.com

Direct Payments.............................................

Self harm.........................................................

this is money allocated directly to a patient/service user to enable them to have more choice and independence about the support/facilities they can access in the community. For more information contact: • Surrey Independent Living Council (SILC), Astolat, Coniers Way, Burpham, Guildford GU4 7HL. T. 01483 458111

• www.selfharm.org.uk; www.lifesigns.org.uk; • www.rcpsych.ac.uk/cru/auditselfharm • Bristol Crisis Service for women (national helpline); 0117 925 1119. Friday/Saturday evenings 9pm – 12.30am. Sunday 6-9pm

• No Panic, 0808 808 0545. www.nopanic.org.uk; • National Phobics Society, 0870 7700 456 www.phobics-society.org.uk; • First Steps to Freedom, 0845 120 2916 www.first-steps.org; www.anxietycare.org.uk (enquiries@anxietycare.org.uk to find out about accessing free advice and support)

Community Mental Health Teams (CMHTs) • Spelthorne CMHT 01784 440204 • West Elmbridge CMHT 01932 266900 • Runneymede CMHT 01932 723392 • Woking CMHT 01483 756318 • Hollies CMHT 01252 312788 (8.30-5.30 Mon -Fri) • Surrey Heath CMHT 01276 671102 • Guildford CMHT 01483 443551 • Waverley CMHT 01483 517200 • Godalming CMHT 01483 415155 • Haslemere CMHT 01483 783090 • Farnham CMHT 01483 782095 • Conifers CMHT – cove, Fleet & Yateley area, 01483 783555 • Early Intervention in Psychosis, 01372 206262. For 14 – 35 year olds who have had a first episode of psychosis within recent years. • MIND, national organisation for mental health with local branches – www.mind.org.uk Infoline 0845 766 0163. Mind produce booklets on various mental health issues and campaign for better services • Mental Health Foundation, national organisation for information, campaigns, news, interaction, including information on the relation between diet and mental health; www.mentalhealth.org.uk

Post natal depression pregnancy and birth issues.......................

• Psychotherapy Service (Surrey & Borders Partnership NHS Trust). • Referral only but you can access an information leaflet; contact the Psychotherapy Service at Shaw’s Corner, Blackborough Road, Reigate RH2 7DG. T. 01737 277706 • Samaritans; 08457 909090 • Surrey & Borders Partnership NHS Trust, for mental health and learning disabilities services - 01883 383838 • Surrey Police; 0845 125 2222

Going undercover In today’s

fast paced world, it is common for many of us to push ourselves to our limits. For some that results in our minds going out of control. We have a breakdown, we become depressed or anxious or both, or become seriously mentally unwell. Some suggest we are more likely to become ill when we lose touch with our inner self. In Sanctuary we have looked at how our bodies react to emotional upheaval; at the link between physical upset and mental instability. A phenomenon called ‘Focusing’ looks at this correlation between mind and body in more depth. It is a way of ‘going undercover’, and listening to what your body, not the words in your head, are telling you. ‘Focusing’ began in the United States in the ‘60s/’70s and was the brainchild of Dr Eugene Gendlin. A philosopher and

psychotherapist he describes ‘Focusing’ as something he learned about, rather than ‘invented’ because it is within us all to be able to have a ‘dialogue between our mind and our body’. ‘Focusing’ is described by another exponent of the theory, Ann Weiser Cornwall (AWC) as ‘ a skill of awareness that involves sensing inwardly, sensing a certain kind of inner experience that everyone has but that we haven’t recognised as being important’. Basically our bodies send us messages – all the time but we mostly just ignore them. In ‘Focusing’ what people are striving towards is what is known as the ‘felt sense’, a body awareness that can be a real clue to what is going on for you. For instance, you might be in a situation and start to feel uncomfortable. You might experience a tightening in the chest, but

will just tell yourself to get over it even though something in you is saying, ‘Run’! The signs are just symptoms of something more complex that your body is alerting you to. What Gendlin discovered was that bodily sensations like ‘butterflies’ in the stomach, tightness in the chest or a dry throat and sweating for instance are carrying messages. To tap into those messages, AWC describes, is like reaching ‘a kind of holistic inner awareness’. ‘Focusing’ was developed initially to help clients in psychotherapy. It can help someone who is ‘stuck’. This can be in the sense of going over and over the ‘problem’ and not finding a way through or round or out of it, or it might mean someone is forever using up the supply of tissues, weeping and not getting anywhere. By ‘going undercover’ and ‘Focusing’ they reach down, with the

help of the therapist, to a deeper level of awareness; to the ‘felt sense’. By ‘listening’ to this ‘felt sense’, clients can reach a more profound and meaningful understanding of the problems they are encountering. Think about the times you have been in a situation and when trying to describe your feelings, you can’t quite find the words. You might be somewhere and something/someone has made you angry. You are aware of the anger but unaware of why you feel so angry. Your anger seems to be way too excessive for what happened. ‘Focusing’ is a way of looking beyond the emotion. The anger could be the ‘cover’ for other things going on. Perhaps the person or place triggers a painful memory. Anger might be your first response (‘I don’t want to be reminded of that!’) but look deeper and

it may be pain and loss you are feeling. Or do you find yourself in two minds sometimes? As though one part of you wants one thing – like a quiet life – and another wants to party all the time! You end up neither here nor there. People who practice ‘Focusing’ would say you need to go down a level or two to the reality. Perhaps your gut instinct is to party, but you think you shouldn’t or can’t – or the other way round, you don’t want to admit to wanting a quiet, uncomplicated life because it seems boring. At the end of the day ‘Focusing’ is about being true to your Self. It may have begun as a thought, an idea in the hippy hippy shake shake days of the ‘60s/’70s but today it is gaining recognition of a quite serious nature, in neurobiology no less. What is being discovered is a connection with the phenomenon of

‘Focusing’ and the nervous system. It is way too complex to start trying to describe here. Suffice to say our nervous system which has voluntary and involuntary components, links our body and mind. What happens in the mind is enacted, displayed, felt etc in the body. By using the ‘felt’ sensations, we can unravel and expose what is really going on for us at a very deep level. Imagine walking into a dark room. You see nothing. You feel confused. But in time you start to make out the shapes of the furniture and can feel and find your way around. Eventually you begin to see the light. That’s ‘Focusing’. On page 21, we describe how ‘Focusing’ works in practice. For more information visit www.focusing.org.uk, or just enter Eugene Gendlin into your search engine.

Alzheimer’s disease is the most common cause of dementia in humans and it currently affects around 465,000 people in the UK. This figure is likely to increase as we all live longer, and in 2007 the UN predicted that Alzheimer’s will affect 1 in 85 people globally by 2050. Alzheimer’s was first described in 1906 by German neurologist Alois Alzheimer. The disease is progressive and it affects cognitive function by way of ‘plagues’ and ‘tingles’ developing in the structure of the brain, ultimately leading to the death of brain cells. As we all know, the brain is the control centre for everything that our bodies do, and our hearts provide the fuel (blood) needed for the brain to function. In biology there is a system known as the Heart and Head Connection. This is explained by the fact that every heartbeat pumps 20 to 25 percent of blood to the brain, and the brain cells use at least 20 per cent of the food and oxygen that is carried in the blood. So clearly, what we put into our blood (food and oxygen) and how strong our hearts are, will directly affect our brains. In addition, the importance of the heart and head connection in relation to Alzheimer’s is highlighted further by the Alzheimer’s Association who suggest that some autopsy studies have shown that around 80 percent of individuals with Alzheimer’s disease also have cardiovascular disease. (www.alz.org) However, heart problems do not guarantee the development of Alzheimer’s, and like many other health

conditions, it is agreed by experts that Alzheimer’s probably develops as a result of many contributing factors including age, genetics, lifestyle and environment. Symptoms of Alzheimer’s include forgetfulness, confusion and frustration, and eventually a sufferer will require help with all daily tasks. Unfortunately there is no cure for this dreadful disease, and whilst some medicines can slow down the rate at which cognition depletes, they will only work for a limited time; they cannot stop the progression of the disease. Despite that there are a number of studies and suggestions about how best we can protect our brain cells by improving our lifestyle choices, and yes, you guessed it, by diet and exercise. A study by Carl W. Cotman, Ph.D., found that exercise and diet can have amazingly positive effects on brain function, because as mentioned earlier, what we eat and how our hearts perform has a direct impact on the brain. Cotman explains in his video on The Alzheimer’s Association website that when we exercise regularly the levels of a brain protein named Brain Derived Neurotrophic Factor (BDNF) are increased. BDNF acts as a nutrient to the neurons in our brains, in a sense it feeds our brain cells, like ‘fertiliser’, to make them healthier. In particular, BDNF is increased in the area of the brain most vulnerable to Alzheimer’s. Cotman goes on to comment that the benefits of exercise on brain function are more than any medicine can offer.

To accompany the exercise, Cotman also suggests that we need to eat a diet rich in antioxidants in order to combat the oxidative damage that takes place in our brains. Oxidative damage is the by-product of the burning of oxygen in our brains, which leads to a ‘rusting of our cells’, and this causes them to dysfunction, and for cognition to decline. The main food group for antioxidants is fruit and vegetables, particularly blueberries, strawberries, broccoli and spinach, and as Cotman advises, humans need to eat a combination of fruit and vegetables to get the right amount of different antioxidants. It is the variety of antioxidants working together that helps to protect our brain cells and keep them healthy. Cotman admits that further study is needed, and that it is difficult to transfer the results from animals to humans because humans ‘won’t eat the same foods every day for 3 years in a row’ like the dogs in his experiment, or run on a wheel every night like the mice, but the results have led him to change his lifestyle because, as he so clearly put it, he had to do something; he simply couldn’t ‘afford not to’.

Louisa To find out more about Alzheimer’s disease, please visit www.alzheimers.org.uk and www.alz.org See page 20 for more about food for the brain.

Alzheimer’s Prevention

Authors Event Epsom Mental Health Week

During Epsom Mental Health Week in October 2010, Sanctuary visited some of the events taking place and we were thrilled to see people everywhere talking about mental health. Of all the events, one that particularly stood out for us was ‘Window on the Mind’ held at the Ebbisham Centre in Epsom. The event involved acclaimed authors discussing the psychological themes in their books. One of the writers was the PEN/J Ackerley Award winning Gabriel Weston, author of Direct Red. Gabriel discussed her semi-fictionalised memoir about her career as a surgeon. Gabriel talked about what it is like to be a female surgeon in a traditionally male medical world, and how this affected her psychologically. Gabriel also pointed out that as a surgeon she must cut people open, which ‘in any other setting might point me in the direction of an asylum.’ When discussing the effects of juggling two personas, the surgeon and the mother, Gabriel said, “I was this ludicrous person who was trying to be aggressive at work and then come home and force the children to make fairy cakes so that I could feel like a good mother.’ The other author present was The Sunday Times Young Writer of the Year 2008, Adam Foulds. Adam talked about his book The Quickening Maze, a story about ‘madness’, involving the great poets Alfred Lord Tennyson and John Clare. Adam spoke about the idea of ‘madness’ and how he blended truth and imagination to write about it. The presence of the authors and the content of the books was one thing; both are very good stories and have been written by two respected writers; this was a privilege in itself. But the real pleasure was in witnessing a room of people engaging in the subject of mental health in a positive and imaginative way. Truly inspiring!

Louisa

Brainy food! In the article on page 16, the connection between certain foods and how they might help – with exercise and other interventions – prevent Alzheimers was highlighted. Brainy food isn’t just for dementia prevention; it can help reduce the risk of some cancers and heart disease. Try some of these clever edibles. Top 10 – we should know about these by now, but here’s a reminder: 1) Berries – blue, black, red; they all possess antioxidants and research into blueberries suggests they may have anti-age related properties 2) Broccoli plus cauliflower and Brussels sprouts; 3) Tomatoes – add maintaining mental function to the long list of a tomato’s attributes; 4) Red grapes – the fruit or in red wine in moderation; 5) Garlic and onions - ward off all kinds of disease (and maybe a few friends but they’ll understand); 6) Spinach – it’s not just for Popeye; 7) Carrots – cooked, they have a higher level of antioxidants than uncooked;

8) Soy – you can buy frozen soy beans or soy mince; it can lower cholesterol; 9) Whole grains – all whole grains are good; try bulgur wheat and brown rice in soups and stews. 10) And lest we forget – Tea! That bastion of English society, the cuppa, is full of antioxidants and may even be one of the best ways to fight a number of degenerative diseases. Cut out the sugar, go easy on the milk and you have one of the simplest, and most delicious of health foods. Footnote: for those of us who remember once having a waist but simply can’t locate it these days, lentils are supposed to help combat what is known as the ‘visceral’ – deep down – fat that accumulates around the middle. They also help lower cholesterol.

Continued...

According to research in America, in Alzheimer’s disease, inflammation and insulin resistance injure neurons and inhibit communication between brain cells. Therefore to follow a diet that reduces inflammation and keeps your blood sugar levels constant may, with the exercise also so essential to brain function, be a positive step to preventing the disease.

Some eating habits that we should be getting into:

Follow a Mediterranean diet – foods rich in Omega 3 fatty acids can control inflammation; oily fish, nuts, whole grains and fresh vegetables and fruit form the diet, with a glass of red wine and some dark chocolate (in moderation) adding an extra treat; Eat small meals – maybe six throughout the day to maintain consistent levels of insulin and blood sugar; Follow the rainbow – foods, mainly fruit and veg that are colourful and varied are the ones with the highest content of antioxidants; Drink your tea! – one of the best detoxes you can have and cheaper and tastier, arguably, than some of the elaborate detox regimes we see advertised. Consider taking supplements, but be cautious; always stick to the recommended daily allowance and consult your doctor if you are on medication. In theory if we eat properly, we shouldn’t need supplements, but in times of illness – mental or physical – we may just need a boost. For anyone suffering a mental illness, or just recovering, magnesium and the B vitamins are particularly helpful. For more information about brainy foods, visit www.webmd.com – a pop up will take you to the UK site.

Going the art of ‘Focusing’ undercover The ‘Focusing’ process involves coming into the body and finding the ‘felt sense’, put simply ‘a body sensation that has meaning’. Here’s an example of how ‘Focusing’ works. Imagine a close friend is applying for a job you have just left. In theory you feel okay about that, why shouldn’t you, no skin off your nose etc. Yet there is something that is niggling at you, a heavy feeling you’ve been carting around since she told you. Now if you were to begin ‘Focusing’ you would start by taking yourself off to a quiet, comfortable place, a favourite chair maybe, to search for what is really going on. As you take some deep breaths and focus on what it is that is ‘niggling’ at you, you become aware of certain sensations in your body. You feel a tight, heavy feeling in your chest. You describe what it feels like and perhaps ask ‘Okay, what’s that telling me?’ As you let your body do the talking, and wait, you sense there is anger. ‘How could she go for my job’ you might be saying, quite irrationally. But because you are ‘Focusing’, you just pay it attention and let the stages unfold. And then, as you go deeper you are aware that there is sadness too. This is another emotion you can’t equate with the fact that your friend is going for your job. But you sense it is

something more than that. You wait. You start to recognise that you feel sad because you were not believed by your friend. You had given your friend all the reasons you were leaving the job. The fact she has gone for it anyway feels like she didn’t believe you when you told her it was boring, the boss was a bully or whatever. That might make you question your friendship. Why didn’t she pay attention to what you were telling her? What you have been doing is suppressing your real ‘gut’ feelings. ‘Focusing’ has made you aware of them. Being aware, you can deal with the situation (maybe one day you’ll be able to say to her ‘I told you so’! Or perhaps you will feel that she is still your friend and you understand that a job that drove you mad might just suit her). You are now very likely to feel a sense of relief. The term is ‘Focusing’ but it could equally be known as ‘searching your soul’ or going by your ‘gut feelings’. Whatever you want to call it, just stopping and in a meditative state, listening to our bodies, can help us better understand what is in and on our minds. Sanctuary is going to explore ‘Focusing’ and will let readers know if we can hold some groups in the future.

…thought it was very informative…” Mental health patient – Milton Keynes – Inner space for women’s mental health and well-being

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whereby ‘facial movements provide sufficient peripheral information to deduce emotional experience’ (Bernstein et al, 2000). So, there you have it, when you smile, the muscles in your face tell your brain that you are happy, the brain then releases endorphins and serotonin, and so you feel happier! This is by no means suggesting that in order to get happy you simply have to grin like a Cheshire cat, but if anything can possibly help then it’s worth a try, especially if it’s free! So, in 2011, get smiling, and by doing so we might get others smiling, and perhaps improve their moods too... who knows, it could be the start of a smile revolution!

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