The Looking Glass: Issue Five

THE LOOKING GLASS March 2014 Issue Five

Debate

There would be no genius without madness

Movie Madness

Portrayals of mental illness in the movies

Art as Therapy Spotlight on Dramatherapy

Art and Psychiatry special focus

Contents

March 2014

features 04

Art as therapy

Spotlight on dramatherapy

05

Movie madness

Portrayals of mental illness in the movies

09

Featured artists

Artwork from artists featured in previous SGDP exhibitions

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25 Stigma

Mental illness in the news

31

Spiritual experiences in epilepsy

Neuropsychiatric symptom or portal to the divine?

27

regulars 17

38th Maudsley debate

No genius without madness

34

19 Editorial

##

Making sense of experiences

21 Reviews

33

Shame

Mind Maps at the Science Museum

23

News and events

All the latest from around the IoP

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On the couch

Professor John Weinman Welcome from your editor Welcome to issue five, with another great selection of articles, reviews, debate, and interviews. This spring, we have decided to delve into the world of art and psychiatry. In producing the issue, we have become aware of a number of exhibitions and initiatives at the IoP and in SLAM that explore art and psychiatry.

Hopefully, we can whet your appetite, kindle your curiosity, and let you know about some of the fantastic events that you can attend (of course, if you attend any events, you can always submit a review of it to us!). As always, we welcome your feedback and input, so get in touch at our email address or Facebook page.

Enjoy!

Apology: A big apology for getting the spelling of Johanna Thea Farquha (Careers focus, page 3) wrong in our last issue! If you notice any errors, do let us know - we are always happy to receive feedback.

contact us submissions iopmag2012@gmail.com website www.iopmag.wix.com/thelookingglass facebook www.facebook.com/TheLookinGlass2012

Focus on

Art and Psychiatry

Focus Art and Psychiatry

Dr Stephen Ginn Psychiatrist and co-founder of the Art of Psychiatry Society One of the oldest known works of art was found in Baden-Württemberg, Germany in 2008. A Venus figurine, it dates to a period during the Stone Age 40,000 years ago. Why was the ancient German figurine made and how does it reflect the internal world of its creator?

Would he or she recognise what we now call schizophrenia, depression, or posttraumatic stress disorder? And if prehistoric humans did suffer mental disorder, how did they understand it?

The study, diagnosis, and treatment of mental disorder, which we call psychiatry, is a relatively new phenomenon. However, the exploration and communication of altered mental states via the creative arts has a much longer history. Classical playwrights such as Homer, Sophocles, and Euripides reflected contemporary beliefs when they wrote of characters driven insane by the gods. In King Lear, Shakespeare charts the deteriorating mental state of his protagonist. Lear’s incoherent speech in Act IV is reminiscent of thought disorder, a symptom not described by psychiatrists for another 200 years. (1)

is something in the medical approach that distances the practitioner from this.

We have a tendency to think of people in terms of their diseases and in research the individual is lost in an avalanche of data and statistics. Perhaps it is with the aim of countering this, that every month the otherwise determinedly scientific British Journal of Psychiatry publishes poems and displays artwork on its front cover. By celebrating the subjective, the arts can facilitate re-engagement of the practitioner with the subjective world of the patient.

For instance, how better to understand the experience of being a drug addict than to read William Burrough’s semi-autobiographical novel Junky?

Burrough’s prose description of mental disorder, using the language of everyday life, is no less valid than the more technical descriptions of the psychiatrist.

“Junk turns the user into a plant.

Plants do not feel pain since pain has no function in a stationary organism. Junk is a pain killer. A plant has no libido in the human or animal sense. Junk replaces the sex drive. Seeding is the sex of the plant and the function of opium is to delay seeding. Perhaps the intense discomfort of withdrawal is the transition from plant back to animal, from a painless, sexless, timeless state back to sex and pain and time, from death back to life.”

Art can also entertain and challenge us.

In his work, the novelist and journalist Will Self repeatedly questions the role of the psychiatrist in our culture and what the psychiatrist represents. His short story The Quantity Theory of Insanity is a ‘Nature’s above art in that respect. broad satire of academia, social science, There’s your press money. That and the treatment and understanding of fellow handles his bow like a crowmental disorder. The title refers to the keeper. Draw me a clothier’s yard. fictional discovery of a radical theory of Look, look a mouse!’ mental disorder whereby there is “only A good psychiatrist needs to understand a fixed proportion of sanity available to the world of their patient. A diagnosis any given society at any given time”. captures some of the symptoms of Self attempts to satirise approaches mental illness, but these symptoms that understand mental ill health in also interfere with relationships, and purely mechanistic terms and suggests with roles and responsibilities. They we are mistaken to think that people have emotional repercussions for both can be split between mentally ‘normal’ the sufferer and for those close to and ‘abnormal’ states. He also calls into them. Someone experiencing a ‘mental question the effectiveness of psychiatric disorder’ is in fact suffering from a treatments, including psychoanalysis: complicated state of ‘ill-being’. Yet there “Alkan’s analytic method ... was

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commonly termed ‘Implication’... instead of the analyst listening to the patient and then providing an interpretation ...

Alkan would say what he thought the analysand would say. The analysand was then obliged to furnish the interpretation he thought Alkan would make ... [T]he remarkable thing about Alkan’s method is that all the published case histories bear a startling resemblance to those of entirely conventional methods.”

We founded the Art of Psychiatry society in 2011 to examine and celebrate the shared space between psychiatry and the arts. In many ways, the aspirations of the artist and psychiatrist are similar. Both aim to offer understanding of suffering, provide solace and a degree of resolution.

Our meetings take place bimonthly.

During the past two years, we have screened a film on Paul Schreber, held readings with novelist Patrick McGrath and playwright Enda Walsh, as well as hosted events on Louise Bourgeois and Samuel Beckett.

Our informal meetings held at the Institute of Psychiatry are open to all.

Find out more online: www.artofpsychiatry.co.uk @artofpsychiatry theartofpsychiatry@gmail.com Ref: (1) http://bjp.rcpsych.org/ content/201/2/92.full?etoc

S136 Sarah Wardle If the police find someone ‘mentally disordered’ they can take them to a so-called ‘place of safety’ where you can be toxically medicated and detained for months without judge, or jury Today a man pissed in the dining room.

A patient downstairs is dealing crack.

A workman told me someone on observation hanged herself from a window latch.

From: A Knowable World (Bloodaxe Books, 2009)

Focus Art and Psychiatry

Art as therapy

Spotlight on dramatherapy Sarah Porter is a drama graduate who has worked for NHS Mental Health Services for a number of years, and is now studying to become a Dramatherapist. Here, she sheds light on what exactly Dramatherapy is and how it tries to make a difference for patients.

What is Dramatherapy?

Dramatherapy combines dramatic techniques with psychological theory to bring about personal growth and change for a client.

The Dramatherapist may lead a guided What is the difference between a drama meditation and then invite group members to share how they are feeling, which may class and a Dramatherapy session? naturally lead to a theme that the group In a drama class, a student may be can explore theatrically. This same ritual introduced to a variety of exercises and is used to close the group and mark the techniques to improve their representation transition back to reality. of reality and their performance. Within Dramatherapy, the same techniques What are the potential benefits of are used but the focus is on exploring a Dramatherapy over other therapies? client’s relationships. For example, the In Dramatherapy the entire body is trust required in the simple exercises of engaged in the work. Various areas of the a drama group, such as taking it in turns body can hold emotion and subconscious to be supported by the rest of the group, memories, which are difficult to access encourages performers to gel and work when only the mind is engaged. Veronica together. This same exercise when used in a Sherborne has spent a lifetime developing Dramatherapy setting can evoke powerful techniques that address the subconscious memories about the early relationship emotions and memories held by the body with the mother. from infancy before conscious thought The difference in the focus of the work is marked by the transition from the real to an alternate ‘play space’, where exploration is possible. This is encouraged by the structure of a Dramatherapy session, which uses ritual as a means of delineating this difference between reality and the alternate space used for personal exploration.

An example of the type of ritual used are those at the opening and closing of a session. A group therapy session may start with the clients sat in a circle.

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develops. This method of working can be beneficial for clients who may be having secondary symptoms, and who may not be aware of the cause. Alternatively, the cause may very traumatic and so cannot be addressed directly.

A common tool used to explore difficulties indirectly is story. The Dramatherapist will employ techniques, such as dramatic distancing, to enable a client to reflect on their experiences. Story provides characters and situations where similar but sufficiently different events can occur,

making work with a difficult experience possible. For example, potential insight can be gained by enacting a character and reflecting on the feelings evoked by the role or how the character could have behaved differently. These insights can then be taken back to reality.

What are the Dramatherapy?

limitations

of

Dramatherapy can be a costly intervention due to the space required for sessions and the number of clients treated. An average size for a Dramatherapy group is eight clients and one therapist. The therapy setting must also be sufficiently large in order for physical work to be possible.

When Dramatherapy is on an individual basis costs increase.

Where do Dramatherapists train and work?

There are two Dramatherapy courses in London, both at Master’s level. One is at Roehampton University and the other is at the Central School of Speech and Drama.

Dramatherapists work with a full range of client groups and settings including in forensics, child and adolescent services, mental health services, educational settings, and charities.

Focus Art and Psychiatry

MOVIE MADNESS Portrayals of mental health in the film industry

By Marion Thibaudeau

The film industry has long been fascinated with mental illness. Psychiatry was first portrayed in 1906 in the silent Dr Dippy’s Sanatorium. In this film, maniacal inmates of a psychiatric asylum chase a newly hired guard before being distracted by pies provided by the director of the asylum. Soon after, in 1908, William N. Selig produced Dr Jekyll and Mr Hyde, a film adaptation of Robert Louis Stevenson’s famous novel. The portrayal of mental illness in films started early on with two basic set-ups: comedy and violence. Yet, over a century later, things are only just starting to change, despite a growing awareness and understanding of mental illness.

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I will not bore you with examples of more old, silent films, if anything because I myself have seen very few. Instead, let’s start with a classic: One Flew over the Cuckoo’s Nest. In this 1975 opus by Milos Forman, Randle McMurphy (played

by Jack Nicholson) pleads mental instability to avoid prison and ends up in a mental institution. The film is a glaring criticism of psychiatric care, portraying McMurphy and the other inpatients as increasingly sane, driven into insanity only

by Nurse Ratched’s overbearing control. Nevertheless, as critical of psychiatry as the film may seem, it remains laden with stereotypes surrounding mental illness and its care, and this can be seen again and again, in many films since.

Psycho (1960). Taxi Driver (1976). The Shining (1980). A Chainsaw Massacre (1 through to 6). Full Metal Jacket (1987). Misery (1990). Silence of the Lambs (1991). Saw (all 7 of them).

The list is long, but I hope by now you get the point I am trying to make: violence remains the most common stereotype associated with mental illness. All too often, a character is given a mental health problem as a crutch to justify excessive antisocial and violently aggressive behaviour.

A quick glance at Wikipedia’s ‘List of films featuring mental disorders’ quickly reveals that the majority fall under the ‘Antisocial Personality Disorder’ category. Indeed, if you try to recall as many ‘crazy’ characters as you can, you will soon realise that most are extremely violent.

“...characters with a mental illness were ‘10 to 20 times more violent during a two-week programming sample than real individuals with psychiatric diagnoses in the U.S. population were over an entire year’”

Time to Change, a campaign from the charity Mind, struggled to change the portrayal of mental health in popular media, aiming to dispel myths and improve understanding of mental health. Their 2009 report Screening Madness: A century of negative movie stereotypes of mental illness shows that mentally ill characters are usually seen as violent, weird, and likely to kill violently. Studies by Signorelli in 1989 (cited in Edney, 2004) in the United States revealed that 72.1% of mentally ill adult characters in shows or films aired during prime time were violent toward others, to the point of injuring or killing. Additionally, characters with a mental illness were “10 to 20 times more violent during a two-week programming sample than real individuals with psychiatric diagnoses in the U.S. population were over an entire year” (Edney, 2004).

Of course, an association between violence and mental illness is completely unfounded. Violence is often shown as a symptom of psychosis, when in reality it is but an incredibly rare co-occurrence. People who have mental health problems, apart from a substance addiction, are in no way more likely to be violent or commit crimes. In fact, a recent study in the UK has even shown that people with mental health problems are more likely to be victims of crime than the general population. The association of violence with mental health problems is particularly true

in the case of multiple personality disorder (commonly confused with schizophrenia). Even when tackled with humour (albeit Jim Carrey-esque humour), such as in Me, Myself and Irene (2000), a dissociative personality is still related to an aggressive personality.

This brings me to my second point: inaccuracy. Part of the reason mental health is so often associated with violence comes from a deep misunderstanding of the commonly portrayed mental disorders. The longest-standing misconception in mental health remains the concept that schizophrenia involves a split personality. For example, in Me, Myself and Irene, the script goes so far as to include a professionalsounding diagnosis of “advanced delusional schizophrenia with involuntary narcissistic rage”.

It may sound fancy, but it is completely factitious. However, inaccuracies within a film may not be as obvious as a misdiagnosis.

Subtle misrepresentation of an illness through a character’s attitude and behaviour can be even more damaging to those actually living with said illness. For example, Love, Ludlow (2006) tells the story of Ludlow who suffers from bipolar disorder and his sister Myra who has cared for him her entire life.

Throughout the film, Ludlow acts as an inexplicably immature man-child.

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Ludlow’s entire character revolves around his illness and the consequent childish attitude he displays. To any of us with a working understanding, if not a thorough knowledge, of this disease, we see no reason for a man suffering from bipolar disorder to be so immature. However, for someone with no previous knowledge of mental health, the natural conclusion would be that having bipolar disorder includes behavioural retardation and a child-like personality.

The character of Ludlow is a prime example of another major issue faced by many films: the character completely disappears beneath the disease. In many cases, having a mental health problem is a character’s entire reason of being, and the film would fall apart without said problem. Think of the TV series Monk (2002-2009), where the main character’s entire purpose relies on his obsessive-compulsive disorder. Remove Monk’s OCD, you remove Monk; remove Monk, you destroy the show. This lack of depth to characters can be very subtle, sometimes disguised under an alternative narrative point of view. By only presenting external points of view of the mental health problem, the character’s inner sense of being is removed, and nothing but the illness remains, thus reducing the character to his illness entirely.

Of course, not every film shares these flaws and some are surprisingly enjoyable and accurate. Mr Jones (1993) and the more recent Silver Linings Playbook (2013) share similarities, first and foremost in that their main character is a man suffering from bipolar disorder.

Both films portray the character as likeable, nothing out of the ordinary, and both end the film happily in love (though most critics agree that this comes as a disappointment in Mr Jones, but that is beside the point). In Silver Linings Playbook in particular, the protagonist Pat appears no more ‘crazy’ than anyone surrounding him. In fact, certain officially ‘sane’ 7

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characters around him show more extreme personality traits: his father is a superstitious, compulsive gambler prone to fits of anger, and Tiffany is a moody, extremely promiscuous grieving widow who lost her job after one too many flirts in her workplace.

Another film based on a true story is A Beautiful Mind (2001), in which the main character suffers from a mental health problem (schizophrenia, this time). This film goes a step further than others, by tricking the viewer into believing that the schizophrenic delusions are true. Though somewhat inaccurate in its representation of John Nash’s experience of schizophrenia, the film does succeed in portraying him in a positive way. Finally, We Need to Talk about Kevin (2011) is a powerful film, the premise of which I am very reluctant to spoil for anyone who may not have seen it. Suffice to say, this is a gripping portrayal of an uncommon but fascinating mental illness, and tackles some sensitive issues such as the relative importance of parenting versus genetically determined (and seemingly inevitable) outcomes in the context of mental health.

“...films and TV are now perhaps more important than books in driving popular opinion concerning complex matters such as mental health.”

Despite everything, the use of mental illness in entertainment, be it for dramatic or comedic effect, is understandable. It provides great opportunities for tension, character development, and unexpected twists… it can make a great story! It is also a prominent theme in many peoples’ lives and so it resonates with a large number of people. On balance, I would never advocate getting rid of it completely. This said, it is worth asking ourselves why so many films take the easy, stereotype-laden route. I think we are all at times guilty

of a little schadenfreude (literally ‘harm-joy’, the pleasure taken from someone else’s pain or misfortune), which no doubt plays a role in the popularity of some of these films. The appeal of violence and the macabre must also not be underestimated – I think the popularity of pure gore films like Saw attests to this. Equally, alienating a viciously cruel character by slapping a disease tag on them can placate and reassure many a viewer. It’s possible that simple ignorance may also be a root cause of misrepresentations of mental health in film. Nonetheless, I do have some faith in the film industry and I refuse to believe that every person involved in the creation of a film could be blind to the stereotypes and reluctant to verify their information… but perhaps I’m being naïve.

Mental health remains a common theme in films from many genres, from horror to romantic comedy. With more and more celebrities ‘coming out’ and sharing their diagnoses with the public, popular awareness of mental health problems is growing.

It is crucial for films and other popular media portraying mental illness to keep up with this expanding awareness and reduce their usage of negative stereotypes. At the risk of sounding like a grizzled old grump, films and TV are now perhaps more important than books in driving popular opinion concerning complex matters such as mental health. There has been significant progress in the past hundred years, and recent films have shown that success and good film-making can go hand in hand with scientific accuracy and stereotypefree content. However, the road to achieving an accurate and realistic representation of mental health still stretches in front of us and popular media has a long way to go to get there. But hopefully, along with racist, homophobic and other stereotypes, such discrimination is now starting to disappear from our popular media. At the least they are considered inappropriate, so maybe there is hope!

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THE BETHLEM GALLERY Beth Elliot, Bethlem Gallery Coordinator The Bethlem Gallery is a space where talented artists who have experienced mental health difficulties can exhibit their work. It holds a number of exhibitions, throughout the year. To find out more, we sent along Jorge Palacios to meet with the gallery’s coordinator, Beth Elliott.

How did the gallery get started?

It all started in 1997, the 750th Anniversary of the Bethlem Hospital. The art coordinator at the time, Karen Risby, wanted to do an art exhibition to celebrate, and put the word out for submissions on local radio and other outlets.

She was overwhelmed by the quality and quantity of the response, and so decided there was to be a permanent space for these works. For the first years, we did exhibits on borrowed time and then we did a hugely successful 10th anniversary exhibit at London Bridge. From this, we bid for the Maudsley charity to fund a permanent gallery. We now do 10-12 exhibits a year. That means it’s constantly changing with service user artwork plus we have some permanent pieces in the museum.

creates a high pressure environment and our artists often struggle with stress and pressure. They therefore need support through these difficult periods of time. Our goal is to be somewhat in the background. We don’t represent or limit artists, but rather support them throughout the difficulties they face as they venture into the art world.

Do you believe there’s a link between mental illness and artistic talents?

No, and it doesn’t help to perpetuate these myths about madness and creativity. 1 in 4 people are to be diagnosed with a mental disorder during their lifetime and certainly not all become artists. But I have to say I do meet a lot of people who discover their creative voice when unwell.

Sometimes they then take it on as a career but oftentimes When did you get involved in the project? it just becomes a part of their life. For many people who are here in recovery in the hospital and engaging in art It was 10 years ago, back when we were juggling the gallery therapy, it is an amazing tool to help their recovery, just as and art room as best we could. When we got core funding, important as their medication and psychological therapy.

I became director. My background is in sculpture at the Camberwell College of Arts and afterwards I became Do you offer service users different forms of art to interested in art as therapy. I made contact with Karen express themselves? and as soon as I saw the wonderful exhibits in the gallery I We offer different mediums, yes. We also have highly skilled started working here and never looked back. technicians, who assist people and make them feel relaxed, Where do you see the Bethlem gallery heading? willing to make a mark, and be playful and experimental.

We train staff and nurses for this purpose.

We want to break down the barriers that our artists experience in exhibiting their work. We want to create From your experience, how do you see art as therapy? opportunities and collaborations with mainstream galleries For some people it’s simply an expression. For others, it’s a and museums. The aim is to support artists in their own way to leave their thoughts. Especially for patients dealing practice. We’re also moving to a larger building within the with psychosis, it serves to get that horrendous thought out Bethlem, which will allow for more art to be exhibited. We onto the page, to contain it. To look at it, see it there and have enough works to fill the Tate Modern! try to make sense of what on earth is going on internally.

Is stigma an issue for artists with mental illness in the Art is different things to different people – our artists find art world? value in whatever part of the process they like and the people who come to see it find value in the quality of the The art world I think is difficult even as it is. Artists often art. Winners all round! get through based on their educational portfolio. This The Bethlem Gallery is located within the site of the Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent. It’s open from Wednesday to Friday, 11am – 6pm. Find out more about the gallery and current exhibitions by visiting their website at bethlemgallery.com.

Focus Art and Psychiatry

stephen jackson selected works from ‘dead people on holiday’

arcad

The work of artist Stephen Jackson was exhibited at the SGDP in 2012. His work has since been released in a book that fuses art and poetry, entitled ‘Dead People on Holiday’. The work is a culmination of ten years effort, which the artist has described as ‘a private hell’, but that ultimately reaches acceptance and the promise of “hope, love, and a new life”.

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BUTTERFLIES In a slender sunlight bubble they live And, like all innocents, they suckle flowers.

In twilight’s umbral void they will not hide But merely cease to be – and resurrect Themselves, as bright day shines.

Capricious, and ephemeral as thought Their lives are serendipity, alchemic gold on gold.

They fly in measureless and buttered time, with magic’s Splendour and enchantment. The Innocent, knowing no Misfortune, does not sense his bliss. He loves as a toy loves: He returns no love: knowing nothing, no stab to the heart.

He lives and then is killed.

This is the kind of talk that we call, ‘Smoke’.

The thoughts crowd in on me like ogres.

The dawn is skin so pale that it could break from a glance; And it marks the time of vigils. Intense, it is, like the imminence Of death; prescient, and frail like soapsuds, or an old man’s cadaver Eyelid. A membrane upon causeless, imminent, imperturbable Decay, this feathered light: it is the cusp of night, of the heaviness of night, You’d say - no more. Of a rainy night, an alien place, and broken water.

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martha orbach selected images from ‘it’s all fine lines’

left you in the dust

Artist Martha Orbach studied at Camberwell College of Art and London College of Communication. In 2012, the SGDP featured artwork from ‘It’s all fine lines’, a collection of stories told through a variety of media, including drawing and text. Martha’s work has also been exhibited at the V&A as part of the “Inspired By....” Competition 2011, in which she won the Word and Image Prize. She has an upcoming exhibition at the Bethlem Gallery.

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sisters

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we’re adrift

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helen spiers selected images from ‘hidden depths’

Helen is currently a second year PhD student with a 1+3 studentship based at the SGDP centre. She studies the epigenome of human brain changes with development and aging.

She has previously worked as a medical writer and completed a degree in Biochemistry in 2009.

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psychiatry

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post-mortem

In October 2013 Helen organised an exhibition at the SGDP. Of the exhibition she said:

“When I started at the SGDP in 2011 it surprised me that, despite our exhibition space and amount of in-house creative talent, we had never held a faculty-produced exhibit. I organized the exhibition, ‘Hidden Depths’, which was held at the SGDP from October to December last year, to give students and staff an opportunity to share and celebrate their artistic side with their colleagues, and hopefully an incentive to produce more art!

I wouldn’t say there is one sole factor that inspires me to produce art, instead there are many reasons that range from the functional; such as producing an illustration for a magazine or commission, to the indulgent; for relaxation or the pleasure of creating something new and unique.”

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Focus Art and Psychiatry

There would be no genius without madness

DE DE The 38th Maudsley debate was chaired

by Dr James MacCabe and tackled the question of whether there is a link between genius and madness. Four experts were called upon to provide an opinion and here we present some of their arguments for and against the motion. Listen to the full podcast of this and all other previous debates by visiting the KCL webpages.

FOR

Professor Gordon Claridge is Emeritus Professor of Abnormal Psychology at Oxford University and Emeritus Fellow of Magdalen College.

I think the argument here is not about reconciling madness, with all its disability and incompetence, with creativity and the excellence and achievements it suggests. I would like to propose instead the idea of dimensionality in madness. The fact is that madness is not all or nothing: it has degrees, it lies in a continuum.

Compare for instance anxiety and schizophrenia.

Under an anxiety disorder, there is an anxious temperament, which, of course, can and does lead to an anxiety disorder if pushed to the extreme. It could be that schizophrenia, or other psychoses, are like that too. There could be a schizotypal temperament that is entirely healthy and only becomes a disorder at the extremes. You can therefore have a healthy set of dimensional traits, which might correlate with creativity, and we need not draw in the necessary connection to the madness or illness side of it. I am not suggesting here that creativity never occurs in the psychotic state or the clinically mad state, or that they never facilitate creative work, because that’s clearly not true, they do. But I think the crux of the argument is this idea of dimensionality in normal personality traits.

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Though it cannot directly be proven, I believe that we all possess madness-like traits, perhaps to a sub-illness degree, and that it is these traits that are linked to creativity. The more these traits are expressed, the more creative you get‌ and the more mad. If this is the case, though, there would have to be an evolutionary advantage in that genetic connection. There is a quotation from Carlson, who wrote Inheritance of Creative Intelligence, that without the gene of schizophrenia, man may still be living in caves.

BA T E “[I]t’s kind of fun to glamorise mental illness but the reality of it is that mental illnesses is associated with poverty, debt, morbidity and unemployment.”

Dr Liz Miller, General Practitioner, speaking against the motion

AGAINST

Professor Michael Trimble, Emeritus Professor of Behavioural Neurology and Consultant Physician, National Hospital Queen Square.

First of all, I should like to remind you of the question here. We are talking about “genius”, not “creativity", and “madness”, not "personality variables".

Now, what do these people have in common?

Beethoven, Brahms, Cherubini, Chopin, Davies, Gluck, Mendelssohn, Charlie Parker, Rossini, Schumann, Scriabin, Tchaikovsky… They all had a certain type of personality; they were within what’s called the “cyclothymic variant” -- though a number of them, it is quite clear, went beyond that and did have bipolar disorder. I submit that the majority of these people, while they may have had personality variance and may have been referred to in today's terminology as some part of the bipolar spectrum, were not mad.

Mendelssohn certainly goes down as having bipolar disorder, but there’s no link there between musical prodigy (which I would relate to a form of genius) and madness. It would appear that there is a cyclothymic variant of the personality, which aids creativity and appears to be linked with music, and I accept that, but it is not madness. There are no biographies that I can find of musicians with schizophrenia. The idea that somehow if you have schizophrenia, you have insight into creativity certainly does not come with musical skills.

Now, it's the same with poetry. Some had very severe bipolar disorder… and actually some killed themselves (so if there was a link between madness and creativity, it certainly does not last beyond the shotgun or the river).

It's the same with schizophrenia again, there are very few schizophrenic poets, though there are not none. But of course, what happens is, as soon as they develop their psychosis the quality and quantity of their poetry dries up completely.

So in conclusion, I do believe that the majority of creative artists certainly do not display insanity. I do believe that there is a possible link to bipolar disorder but the problem is when you become manic or you become depressed, your creativity ceases. It’s the bipolarity and the flexibility of the mood, which are more important.

“My sense is that there is an extraordinary richness in experiencing mental illness...Mental illnesses may well be the reason why we are Homo Sapiens sitting in this lecture theatre and not Neanderthal, it could be that the creativity and the art used by early man gave a genetic advantage to them.”

Jonathan Naess, Director of Stand To Reason, speaking for the motion

The 50th Maudsley Debate will take place on Wednesday 2nd April at the Institute of Psychiatry.

"This House believes that CBT for psychosis has been oversold" Chaired by Professor Sir Robin Murray, the debate will see Peter McKenna, Research Psychiatrist from Barcelona and Keith Laws, Professor of Cognitive Neuropsychology from University of Hertfordshire speaking for the motion and David Kingdon, Professor of Mental Health Care Delivery at University of Southampton speaking against.

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EDITORIAL

ART AND PSYCHOLOGY MAKING SENSE OF EXPERIENCES Rhianna Goozée

I believe that art and psychology, in their broadest terms, share some common properties. Certainly, they are both pervasive influences in our lives. Art is everywhere, if you take a moment to stop and look for it. It is in the buildings we walk amongst, the pictures adorning their walls, the books, plays and poetry we read, and even (though not always in its highest form) in our popular media, films and television shows.

I would argue that psychology is just as present in all of these, implicit in the narratives that underlie or inform their creation. They reveal aspects of the state of mind of their creators and in turn, our reactions to them will be determined by our own psychological state. In the most literal sense, they tell the stories of our psychological experiences and often of the occasions in which we suffer psychological distress.

In addition to these shared properties, I would argue that art and psychology also share a common purpose or use, although they may achieve this in different ways. There is perhaps a fuzzy border where the subjectivity of art and the objectivity of scientific psychology merge to form a grey area, and each in its own way can play a role in helping us make sense of our experiences.

More than simply sorting and describing, art and psychology aid us to understand, interpret and communicate a huge breadth of human experience. Works of art can be a window into another’s experience, illustrating the story of their suffering, their joy or a multitude of other emotions.

Similarly, research in psychology attempts to understand and explain experiences from our usual and everyday lives, whilst clinical psychology and psychiatry detail, explain, and manage extremes of experience, distress, and suffering. However, both art and psych-related disciplines can provide useful frameworks from which to understand the vastness of human experience, and at times offer tools to ease the distress that affects many of us. Essentially, they attempt to find meaning and sense in a bewildering world.

Perhaps this is why people choose to work or study in psychological and psychiatric research, and in scientific disciplines more widely. Perhaps it offers a way to try to exert control over the otherwise seemingly random and chaotic natural world, in much the same way that religion and philosophy offered such comfort prior to the Enlightenment. Equally, we can find solace and order in art, whether this in its creation or simply in its contemplation.

“MORE THAN SIMPLY SORTING Can art inform psychological science and vice versa? Does art have a therapeutic role to play in the treatment of psychological distress and disorder? Is psychology, AND DESCRIBING, ART AND in its multiple incarnations, from cognitive neuroscience to psychoanalysis PSYCHOLOGY AID US TO relevant matter for artistic creation? What relationship is there between the UNDERSTAND, INTERPRET AND creative arts and the mind, in both its ordered and disordered states?

COMMUNICATE A HUGE BREADTH The questions that one can ask are almost endless and it would not be possible to OF HUMAN EXPERIENCE.” discuss all of them here. I think that some of the most interesting questions lie in the links and interactions of the fields and are applicable not only to psychology as a science but to sciences more generally.

Recognising the ways in which each influences the other, and the important benefits of fostering collaboration between the arts and sciences, may lead to unexpected benefits. For example, considering the efficacy of art or drama therapy may lead to new treatments for patients with mental health problems, aiding their recovery and providing meaning and purpose at a time when these qualities in their lives might be evasive. Or perhaps, we can harness the creativity in the production of art at the fringes of science, where state-of-the-art, new advances are made.

Perhaps, quite simply we can make science more accessible and find new ways to communicate science to a wider audience by collaborating with artists, writers, filmmakers, and designers.

And it works in the other direction too. Psychologists, psychiatrists, and scientists can work with artists to help tell the stories inherent in the very human activities of research, clinical work, and therapy. Plus, there is so much beauty in science that is ripe for artistic representation, interpretation, and inspiration. Everything from the representations of white matter produced from DTI imaging to nature photography to maps of the movements of celestial bodies.

Sometimes we forget these wider perspectives, caught up in the day-to-day spreadsheets, the bitterness of rejected papers, and the battle for funding.

In fact, the more you consider it and the more examples that are thought of, the more that it seems we need a range of approaches to help us make sense of our lives and the world around us.

I wonder, what good would science or art be by themselves?

I’ll end with words from someone wiser than me, which sum up the importance of both the arts and the sciences in understanding the world we live in and how we experience it. As Albert Einstein is quoted as saying: “It would be possible to describe everything scientifically, but it would make no sense; it would be without meaning, as if you described a Beethoven symphony as a variation of wave pressure.”

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REVIEWS Films Shame Exhibitions Mind Maps at the Science Museum Mind Maps: Stories from Psychology Science Museum, 10th December 2013 until 12 August 2014 Mon - Sun (10:00 - 18:00), free admission I will admit that I’m a fan of the Science Museum with its great variety of thematic angles, plentiful interesting exhibits, and exploratory spirit.

So, when I heard that they were organising a psychology section called Mind Maps, I was immediately intrigued. Their video trailer heralded big insights and enticed me even further (http:// youtu.be/C2Cv4uWrrI8).

I made my visit with two friends who aren’t psychologists. Encountering a PET scanner, an EEG cap, a blown-up print-out of a DTI brainscan and even a TMS coil near the entrance certainly provided room for discussion. Nevertheless, I still left the exhibit disappointed.

Not because the information was not correct and up-to-date but because, unfortunately, the title ‘Stories from Psychology’ was a bit of a misnomer.

My friends and I wandered past exhibits telling of the rudimentary

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beginnings of neurophysiology, early apparatuses for the conduction of electricity through the human body (including ECT), and a variety of psychopharmacological drugs.

I was beginning to wonder where the psychology and the critical discourse was in all of this. Yes, there was a mention of Freud, CBT, and avatar therapy for psychosis, but that was as far as it went.

Overall, the exhibition hadn’t been given a lot of space, the assembly of items seemed somewhat haphazard, and each device, no matter how complex, was typically described in about three paragraphs. Testament to this was my friends’ favourite object, the socalled ‘frog pistol’. This was a tool previously used in medical schools to demonstrate the function of muscles through the conduction of small electrical signals, and it also happened to be shaped like a handgun. Whilst this reminded me of an Intro to Neurobiology class, it did not relate to any of my previous

psychology lectures. Reflecting on the experience, I could understand the concept of the exhibition being laid out like a Mind Map, but for me personally, the dots were not connecting. I was left wanting and looked for more. What I found was a shelf with self-help books – among them some good titles, mind you, but no further resources.

In the end, I would describe Mind Maps: Stories from Psychology as a teaser. For someone from within the profession, it could be an interesting reminder of the history of neuroscience and how far we’ve come. However, the uninitiated could be forgiven for coming away with the impression that psychology is about nerves and prodding people. To those, I would instead recommend the Wellcome Trust exhibiton Who am I? on the psychology of the self towards the other end of the Science Museum for a more in-depth, engaging, and interactive experience.

Reviewed by Steffen Nestler

Shame (2011) Director: Steve McQueen Starring: Michael Fassbender and Carey Mulligan While praise is being quite justly heaped on 12 Years a Slave, it is an opportune time to reflect upon the merits of director Steve McQueen’s sophomore effort, Shame.

Thought of by critics as the weaker offering in his short but already impressive career, it is nonetheless a gruelling and rewarding watch; an overlooked masterpiece of uncomfortable anguish.

Cinematographer Sean Bobbitt, McQueen’s regular collaborator, frames each scene with a clean, lush aesthetic, complementing the Bressonian economy of McQueen’s long takes and mostly static shots. This simplicity of style facilitates and encourages multiple interpretations of the film’s subject matter. It can be viewed simply as a personal story, a clinically informed morality tale or even an indictment Shame centres around Brandon of Western modernity.

(Michael Fassbender), who in addition to being a handsome, Interestingly, sex addiction was successful advertising executive in rejected for inclusion into the New York, is compulsively drawn DSM-5, apparently due to a lack of to sex. Whether masturbating in a empirical evidence showing that the toilet stall at work, staring blankly phenomenon conforms to clinical into the void while sleeping with definitions of addiction. The film, prostitutes or trying to seduce too, appears to treat sex addiction married women on his morning less as a clear-cut condition than as commute, it is clear he has gone a prism through which to examine beyond vapid consumption and troubling facets of the protagonist’s into much more self-destructive existence. territory.

Some criticised the choice to have Serving as a perfect counterpoint to the main character be a successful his aloof, slick persona, Brandon’s white male living in a fashionable sister Sissy (Carey Mulligan) is a city, as though this might be carefree lounge singer. A gregarious, unrepresentative of sex addiction misguidedly earnest individual, she as a whole. In fact, such a character leaves chaos in her wake. Both are allows for an examination of clearly damaged people, navigating what McQueen has referred to in the world in differing but equally interviews as the “access to excess” maladaptive ways. We follow their and sense of “entitlement” haunting lives through a series of unblinking modern culture. A theme central scenes throughout which shame, to the film is a deep rejection disgust, and self-loathing feature. of intimacy. In a break from his casual beddings, Brandon meets Facilitating an otherwise an intelligent woman he actually punishing viewing experience is connects with, but when the two the sheer visual beauty on display.

escape work for an impromptu tryst, he is unable to perform, the raw intimacy of their love-making having pierced the veneer of his pornographic sensibilities.

Ultimately, the film provides much food for thought without resorting to simplistic moral lessons. Is Brandon’s cold, compulsive sexual behaviour a fundamental personality trait, a symptom of deeper wounds or is such behaviour incentivised by the masculine, superficial world of capitalism Brandon inhabits?

Whatever the cause, the outcome appears to be the equating of intimacy and vulnerability with weakness.

Indeed, Brandon is viscerally repulsed by his sister Sissy’s neediness and readiness to become dependent on others for emotional support, and it is suggested she reminds him of a shared past trauma he has strived to suppress.

It’s a thoroughly alienating mindset to which only a small glimmer of hope is offered near the film’s close.

Perhaps, it is this insight that is most relevant to understanding mental illness as a whole. The vulnerability implied in having mental health difficulties can result in profound self-stigma, and the ensuing isolation simply exacerbates the problem. The modern world, Steve McQueen seems to suggest, makes the essential human experience of connecting with others, very difficult indeed.

Reviewed by Raphael Underwood

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News and Events Edward Adamson Festival various artists In celebration of the life and work of visionary art therapy pioneer Edward Adamson (1911-1996), the South London and Maudsley NHS Foundation Trust are running The Adamson Festival.

This festival will feature exhibitions of works from the Adamson Collection, an Adamson Film Night, and a series of academic and educational events.

The latter will explore Adamson’s approach and practice of using art and creativity to enable people’s recovery and healing.

Additionally, to mark the 30th anniversary of the publication of Adamson’s book Art of Healing (1984), a limited facsimile edition will be reprinted.

Where: various locations When: now until July 2014 Contact: richard.morley@slam.nhs. uk

http://w w w.slam.nhs.uk/ab outus/art-and-history/the-adamsoncollection/edward-adamson-festival

Rwanda in Photographs: Death Then, Life Now various artists Twenty years after the Rwandan genocide that led to the deaths of an estimated one million people, this exhibition brings together works by Rwandan photographers, presenting them to an international audience for the first time.

The photographs are the result of a workshop led by award-winning international photographers Andrew Esiebo (Nigeria) and Brendan Bannon (US and Kenya), in which photographers from Rwanda questioned the ways in which their country is portrayed internationally.

The resulting images reveal a nation in the midst of profound change.

By listening to Rwandan narratives and viewing the country through Rwandan images we can take a step

closer to understanding the scale and scope of the country’s journey.

Please note that admission is free and the exhibition is open until 20:00 on Thursdays.

Where: Inigo Rooms, Somerset House East Wing, Strand Campus When: now until 30th April 2014 Contact: sophie.cornell@kcl.ac.uk http : / / w w w. kc l . a c . u k / c u ltu r a l / culturalinstitute/showcase/current/ whatson/exhibitions/rwanda.aspx

Photo 51 – From DNA to the Brain various artists Photo 51 invites the public into a historically charged moment in the DNA story to witness both its impact on contemporary neuroscience and the future of biomedical research.

From the first glimpse of DNA, the exhibition and an accompanying series of free public events and science demonstrations, will explore

how DNA allows science to see the structures, processes, and beauty of the developing brain.

On the eve of the redevelopment of the spaces on the Strand in which DNA was first photographed, the photography and installations of Christine Donnier-Valentin and Shelley James, working with archivists and x-ray crystallographers, witness the traces of the pioneering science that took place in these disappearing post-war spaces.

Their work is contrasted with spectacular images that explore the ubiquitous application of DNA as a tool in the contemporary laboratory in a collaboration that brings photographer Marcus Lyon together with neuroscientists in the MRC Centre of Developmental Neurobiology.

Where: Inigo Rooms, Somerset House East Wing, Strand Campus When: 25th June until 27th July 2014

Imaginary Planes - Transforming Windsor Walk Nuala Hamilton Photographer Nuala Hamilton has been documenting the recent renovation of No.s 6-11 Windsor Walk. This Victorian terrace belonged to the Maudsley Charity and was converted into new homes plus a Ronald McDonald centre providing accommodation for the families of children being treated at nearby King's College Hospital.

Out of the building's dereliction and renovation, she has created stunningly colourful photography. "Some of my photographs are documentary. Some are abstract colours and shapes. Over time the dilapidated building became a playground for the imagination."

Where: ORTUS Learning and Events centre, 82-96 Grove Lane, Camberwell When: now until 28th March 2014 http://www.maudsleylearning.com

www.marthaorbach.co.uk Martha Orbach was one of our featured artists in this issue. Check out pages 11- 13 for a taster of her work.

Celebrate Women in Science Royal Institution The Royal Institution is celebrating women in science throughout the whole of 2014. This year, their Friday evening discourses are showcasing their first ever all-female line up! They are also highlighting the achievements of women associated with the RI with a blog by Frank James, Professor of the History of Science and Head of Collections at the RI.

This Skin We’re In Martha Orbach Once upon a time there was an idea, which grew in to a project, about telling a story about what it’s like to go about daily life in the face of chaos or in the aftermath of disaster.

A plan was drawn up, alongside a collection of people who would be needed to come along for the expedition, and here we are.

There have been some workshops and some conversations, working towards a story, and the stories that we might tell…

Where: The Bethlem Gallery, Bethlem Royal Hospital, Monks Orchard Road, BR3 3BX When: 2nd July 2014 until 25th July 2014 There are workshops planned for 29th March, 12th April, and 26th April 2014 at The Create Place, 29 Old Ford Road, Bethnal Green

Next in the line up is Professor Sophie Scott from Institute of Cognitive Neuroscience, University College London, in April. For details and to see who else will be speaking see the link below.

Where: various locations When: various dates until the end of 2014 http://www.rigb.org/home/press/ press-2014/celebrating-women-inscience

If you know of an event taking place that our readers may be interested in an attending, or if you have a news story relevant for students at the IoP, please send them to the submissions address: iopmag2012@gmail.com

What if I told you that in a recent review the following findings were reported?

One in five said "anyone with a history of African descent should be excluded from taking public office".

One in ten said "it is frightening to think of AfricanAmericans living in residential neighbourhoods".

One in ten said "A woman would be foolish to marry an AfricanAmerican man, even though he seems fully sociable".

One in ten said "AfricanAmericans should not be given any responsibility".

STI

By Marion Thibaudeau

Hopefully, such numbers should be shocking, even inconceivable, to most of us today. We are well beyond such ludicrous statements and beliefs based on ethnicity, aren’t we? That mind-set is a thing of the past, right? We no longer let ignorance and stereotyping guide our judgement of others...surely?

Sadly, this may not be so.

The statements above were modified to replace "people suffering from mental health" with "African-Americans" and the statistics were taken from a 2011 study of 1741 adults conducted by the NHS. In the UK, prejudice, ignorance, and fear about other ethnicities, genders or sexual orientations are more widely recognised and becoming socially unacceptable. So why is this not also the case for mental health?

Mental illnesses are just another kind of illness and a startlingly common one at that. It is estimated that, in any given year, up to 1 in 4 people will be suffering from some kind of mental illness, and that 1 in 6 experience a mental illness at any given time (Mental Health Foundation).

Yet, people trying to talk about their illness and share their feelings with those around them are often met with disbelief, labelling, lowered expectations or even abandonment and social exclusion.

Most of those suffering from mental health issues will show a full recovery if the adequate treatment and support

be apprehensive about approaching most trivial ways. "Mental Patient Fancy professionals for help and treatment.

Dress costume", the name of a Halloween costume "comprising a torn bloodTime To Change is a campaign led by stained shirt, blood-stained plastic meat mental health charities to change the cleaver and gory face mask" sold by ASDA way our society perceives mental health in September 20132,3,4,5, is yet another and those who suffer from mental example of the flippant application of health problems. According to their stigmatising attitudes to mental health. data, over a 3 month period, 63% of The item was removed from sale as soon references to mental health in TV soaps as the complaints started flowing in, but and drama were "pejorative, flippant or not every company reacts as swiftly and unsympathetic" and often associated favourably. with violence towards others or selfharm. This relation has no real-life basis, Thorpe Park, a popular theme park based because evidence shows that mental in Surrey, has been urged to remove or health problems are not consistently rename its attraction called the ‘Asylum associated with violence. As a matter of horror maze’. This features prominently fact, recent studies have actually shown in its Halloween event ‘Fright Night’ that those suffering from mental health and includes scary chainsaw-wielding are more likely to be victims of a crime “patients”. When called upon by a rather than perpetrators. Indeed, women student-led petition, Thorpe Park suffering from mental health are 10 times officials have replied the following: more likely to be victims of assault and "Unlike Tesco and Asda, the maze is not up to 62% have been victims of sexual something you happen upon when out assault as adults1. shopping. […] It is not intended, nor is it deemed to be by those who have actually Yet, despite these statistics, those experienced it, to be in any way offensive suffering from mental health issues seem or to be a realistic portrayal of a mental to be repeatedly connected to incidents health or indeed any other institution." of violence. "1200 killed by mental Yet this issue provides us another patients", read the Sun’s front page on example of popular culture associating Monday 7 October 2013 in a misleading patients suffering from mental illnesses headline deemed “unjournalistic”, with violence. "disappointing", "disgraceful", "harmful", and even "irresponsible" by a number of Despite campaigns and petitions, the sources. problem remains: people suffering from mental health problems are viewed as Paul Bristow of the Mental Health a danger to society, as perpetrators of Foundation, said: “Sensationalist violence, and as a group of persons to be wary of even though figures do not support such assertions.

IGMA

Educating people about mental health problems is one way in which societal misconceptions around mental health could be reduced. In the same way an understanding that, for instance, ethnicity has no impact on intelligence, has been communicated and generally widely accepted, we now have to promote journalism like this contributes to stigma a better understanding of mental health and discrimination in order to sell and mental health problems. newspapers, and makes the anti-stigma More and more, the opinion that mental work of the Mental Health Foundation health should be discussed in schools and other mental health charities even is gaining popularity. There are several more challenging. Mental health is potential benefits to such a scheme. It is a seriously under-resourced area of commonly accepted that teenagers have healthcare with people often not getting ‘ups and downs’, and that their moods the treatment and support they need in a are prey to their hormones. While this timely manner.” is partially true, mental health problems This frequent association of mental in teenagers do occur but are often health with violence is portrayed in the disregarded or ignored, which may have

Mental illness in the news are provided, but some may require ongoing, long-term care, and their illness will affect many aspects of their life and those around them. Finding and keeping a job, forming and maintaining friendships, even simply going out and performing everyday tasks that require social contact, can be areas of life that are damaged by the stigma associated with mental health. People are reluctant to disclose their illness to others and more dangerously, some might even

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severe repercussions for the troubled teen.

Up to 1 in 10 people under the age of 15 suffer from a mental health problem, and yet mental health issues in young people remain a taboo subject in health care, perhaps through shame. Parents are often held responsible for their children’s personalities and successes at a young age, and mental health issues in a child or teenager can be wrongly seen as a flaw in parenting.

Young age, lack of experience and the fear of being ignored or accused of attention seeking may lead many young people to isolate themselves and avoid seeking help. This could have drastic consequences such as inclining teenagers towards self-harm. Statistics surrounding self-harm are hard to come by, as many cases go unreported, and some forms of self-harm are not always recognised as such – like punching walls in anger. For instance, 90% of self-harm cases treated in A&E are caused by overdoses while the major method used for self-harm remains cutting, suggesting that most of those who self-harm are never officially recognised.

A 2011 survey by UNICEF Ireland reported that 50% of 16 – 20 year olds interviewed had suffered from depression in the past and 20% had selfharmed. The most alarming statistic uncovered in this report remains the 82% of young people suffering some sort of mental health illness and not receiving any kind of help.

Pejorative language to refer to ethnic groups or sexual orientations are mostly considered unacceptable in a school courtyard and one hopes that teachers will react when students use these in conversation. However, when children use words which show a pejorative attitude towards those suffering from mental health problems, it may be less likely that teachers approach them, possibly because they do not know how to approach the subject of mental health with pupils. School policies do not often cover the issue of mental health discrimination directly. It is therefore recommendable that schools start addressing the topic of mental health both in and out of classrooms.

Scientific explanations of mental health problems will allow pupils to understand the medical reality of these illnesses, as 27

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opposed to being a flaw of personality. what you're going through is not your Teachers should also take the time to fault and you do not have to go through explain to pupils why certain words are it alone. not acceptable to use due to the pejorative connotations they carry. Education of the younger generations is typically key Need to talk? to changing how society thinks and acts If you are having difficulties and you towards misunderstood groups. This will would like to talk to someone then not only remove barriers to help-seeking there are a number of resources in in these young people but hopefully will place for students. The following is also decrease rates of discrimination and a selection of services that can offer stigma in the future. advice and support: So, are you prejudiced regarding mental health? As open-minded and educated London Nightline offer confidential as you may be, stereotypes and prejudice listening, support and practical are hard to escape. Stigma is often so information for students, during omnipresent around us that it is nigh term time between 6pm and 8am. on impossible not to have been affected.

Talk in confidence with one of their I mean, I am sitting here writing to you trained volunteers on 0207 631 0101 about stigma in mental health, and even or listening@nightline.org.uk I have to admit that it has affected me.

But this can change. We can fight. Fight Samaritans offer support 24 hours a for the awareness of the stigma, fight day, 365 days a year. Call 08457 90 90 to educate people and explain mental 90 or email at jo@samaritans.org health, fight to rebuke fallacies and debunk popular myths, and fight to The university offers its own provoke a debate on a uselessly taboo counselling and support services. subject.

If you’re struggling, then get in contact on 020 7848 1731 or email Stephen Fry, who suffers from manic counselling@kcl.ac.uk. You can also depressive (or bipolar) disorder, said “1 read more on the KCL webpages in 4 people, like me, have a mental health at kcl.ac.uk/campuslife/services/ problem. Many more have a problem counselling with that.” Truly, it is time to change, and you can help.

I would like to end by quickly addressing those of you out there suffering from mental health problems in silence, especially in the student population. Go talk to someone. If the thought of talking to friends or family is still scary, there are many other options open to you.

The Nightline. The Samaritans. Student Counselling. Please, get help. No matter what anyone would have you believe,

References 1 http://www.kcl.ac.uk/iop/news/records/2013/ October/People-with-mental-health-problems-athigh-risk-of-being-victims-of-crime.aspx 2 http://www.bbc.co.uk/news/uk-24278768 3 http://www.itv.com/news/2013-09-25/asda-underfire-over-mental-patient-fancy-dress-costume/ 4 http://news.sky.com/story/1146563/mental-costumes-asda-and-tesco-apologise 5 http://www.theguardian.com/business/2013/ sep/26/asda-mental-patient-costume

THE BEST FROM THE WEB #SixWordPeerReview In recent weeks, science has been trending on Twitter again with another tongue in cheek look at the realities of academic life. #6WordPeerReview was started by @shaka_lulu, and turned into a mass Twitter event for academics citing the ups and downs of the peer review process, including reviews we’d love to give, and reviews we’d hate to receive… Emma Palmer shares her pick of the best. @shaka_lulu New game inspired by Princeton astro’s morning arXiv discussion: #SixWordPeerReview! “It’s a long and idiosyncratic paper.” YOUR TURN! @Leon_Fonville I didn’t hate it. Major revision.

@zeynep Did you read what you cited?

@edyong209 Arsenic, you say? Sounds plausible. Accept.

@David_Dobbs Contradicts my findings. Can’t be true.

@tarspet1 I love it. I really do.

@threadtangler Taking my time. Love, your Competitor.

@Dr24hours Finally somebody did it right. Thanks.

@sjblakemore ‘Behaviour’ is missing a ‘u’ throughout.

@HopeJahren You should not be citing Wikipedia.

@DrMRFrancis You didn’t cite my paper: reject.

@garwboy I’ve researched this. So you shouldn’t.

@easternblot Author made all required revisions. Reject.

@SciTriGrrl Your conclusions contradict your actual results.

@MyTChondria Could be suited for specialty journal.

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Five, six, seven, eight...

The benefits of dance for your mental health Analucia Alegria

Dance is a form of art - a performing art - that civilizations throughout the ages have used as an instrument to communicate emotions, concepts or stories. It has also been employed as a channel to facilitate social interaction and as means of physical exercise. It is unquestionable that dance is part of human experience. Moving to a rhythm is indeed the most natural thing to do. Such as when you listen to a tune and after a couple of seconds, you find yourself tapping your feet or fingers to the rhythm of the music!

The activity of dancing promotes psychosocial well-being in all kinds of people: young, old, healthy or less well. The beneficial effect of dancing on psychological well-being arises from various avenues.

Dance is the perfect source and outlet of energy, all in one.

Dance is actually a workout and as such it increases the release of endorphins in our system to generate a “dancer’s high”. By dancing to a fast beat or to your favourite music, you can be sure that you will soon feel not only more energetic but also happier! Can you remember that good feeling you have after a Zumba class (combination of lively dance music with high-energy exercises)? Yes, dance is a physical exercise in which you can enjoy yourself. It is definitely my choice of physical exertion when I need a way to release stress and overcome sad feelings.

Dancing can be the ultimate connection of mind and body.

Learning the steps in a particular dance sequence is physically and cognitively demanding to the dancer. It requires them to concentrate in order to understand, organize, and memorize the steps before trying them out physically, which at the same time involves making hundreds of split-second decisions! No surprise then that a study by Verghese and colleagues (2003) found dancing to be the activity that was most strongly associated with decreased risk of dementia (more so than reading or doing crosswords puzzles)! All exercise is said to have beneficial effects on the brain, but dancing is mentally stimulating and improves metal acuity.

moving through space can give a sense of belonging. In dancing, there is a special connection to others that allows you to move in a more coordinated way than in any other activity. Your movements may be synced to another person’s movement or inspire a reaction from them. Put simply, you become aware of how you influence and are influenced by others leading to sense of community and acceptance.

Dance is the hidden language of the soul.

Although dance can be seen as a therapeutic experience in itself, dance (or movement) can be used in psychotherapy. Dance/movement psychotherapy (DMP) is a psychodynamic psychotherapy involving the use and analysis of body movement to express or interpret feelings in order to facilitate change. DMP is rooted in the belief that there is a vital connection between the quality of our movements and our personality. Body movement is seen as a way to externalize emotional experiences that have been “embodied” and are difficult to verbalize.

Hopefully, I’ve convinced you that there are many ways in which dance can be used to promote psychological wellbeing. Perhaps it is a good time for you to try this out.

So, you think you CAN’T dance? Peter Lovatt, from the Dance Psychology Laboratory at Hertfordshire University, explains that the reason some people can’t feel this natural Dance promotes self-awareness and a sense of community. rhythm is because of anxiety, muscle tension or lack of Remember the last time you danced like no one was confidence. If you are shy, remember: nobody cares if you looking? Allowing movements to flow with the music and can't dance well. Just get up and dance! losing yourself in the beat can give you a sensation of being free to show your personality or whatever you feel in that If you want to experience all the benefits of dance yourself, moment. All of this can remind you that you are alive. In the KCL dance society offeres cheap dance classes (from that instant, you are truly connected with yourself, and salsa to ballet) at Guy’s campus. See http://kcldancesoc. yet when dancing in a group setting or with a partner, the co.uk/ for details. experience of social contact and interaction with others REFERENCES Verghese, J., et al. (2003) Leisure Activities and the Risk of Dementia in the Elderly. New England Journal of Medicine, 348, 2508-2516 Koch, S.C., et al. (2007) The joy dance: Specific effects of a single dance intervention on psychiatric patients with depression. The Arts in Psychotherapy, 34, 340–349 Levy, F. J. (1995) Dance and Other Expressive Art Therapies: When Words Are Not Enough. New York, US: Routledge http://www.peterlovatt.com/dance-psychology-lab/

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Spiritual experiences in temporal lobe epilepsy Neuropsychiatric symptom or portal to the divine?

What causes religious experiences? Kate Merritt attended a seminar at Goldsmiths to try and find out. Here she explores the observation that some people with complex partial medial temporal lobe epilepsy (MTLE) experience profound spiritual revelations, and how this may offer us an alluring solution to this age-old question.

On 5th February at Goldsmiths University, Niall McCrae posed the question of whether religious experiences are a neuropsychiatric syndrome or a portal to the divine. In MTLE, the period before an epileptic fit (or the ‘aura’) may be accompanied by feelings of ecstasy and transcendence perhaps akin to religious experiences. This is illustrated in the works of Dostoyevsky, in the experiences of several of his (semiautobiographical) characters. It was also verified by a member of the audience who described it as an experience so intense that without them, she fears she would slip into a depression.

In his talk, McCrae examined the perspective of three schools of thought regarding the causes of religiosity; psychiatry, psychology, and neurology.

Any kind of consensus seemed elusive amongst these disciplines. Historically, psychiatry may have been the first to acknowledge the phenomenon, due to the number of MTLE patients living in asylums who reported spiritual experiences. The presentation of these patients with psychiatric co-morbidities does little to clear the picture, as Thomas Szasz famously noted; “If you talk to God, you are praying; If God talks to you, you have schizophrenia”, (The Second Sin, 1973).

Looking to psychology for a more qualitative approach, many psychologists have denied religion as a ‘true experience’ and instead have seen religion and related spiritual experiences in terms of regression (Freud), irrational thoughts (Ellis), fear of punishment (Skinner) or have promoted distance from the 31

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collective conscious inherent in religion by emphasizing the self in humanistic approaches (Rogers). The somatisation of this phenomenon by neurologists has led to some interesting experiments, but equally may have elicited more questions than answers.

In the 19th Century, John Hughlings Jackson was instrumental in shifting the focus of epilepsy from psychiatric explanations of neuroticism and hysteria, to an organic perspective of excessive neuronal discharges. The argument for an organic basis of spiritual experience continued through the ground-breaking experiments of Wilder Penfield, who elicited a range of experiences, including spiritual phenomena, by directly stimulating the medial temporal lobe during neurosurgery. This led to the optimistic invention of the ‘God Helmet’

by Michael Persinger, which generates weak fluctuating magnetic fields over the temporal lobes in an attempt to induce mystical experiences and altered states.

just an accessory to a religiosity already present. It would be reductionist to state that Dostoyevsky’s finest work was the mere by-product of an ecstatic aura, but this may have served to fuel the already troubled mind it was kindled in.

In his talk, McCrae only outlined the stances of these three disciplines, offering no concrete argument for whether experiences in MTLE are a neuropsychiatric symptom or a portal to the divine. It was not made clear how the physical sciences would approach this question, as the assumption that organic processes underlie all mental experience does not clarify whether the event is a neuropsychiatric symptom (with activation causing the experience) or a true religious experience (with activation conferring the stimulus of experience, akin to a colour stimulus activating the visual cortex). Indeed, the question of what makes a religious experience ‘true’ needs further exploration. Many religious groups would be offended at the suggestion that religiosity is the result of abnormal brain activity, so would they too reject the assertion that experiences of MTLE patients are true religious encounters?

However, not all MTLE patients experience an expanded consciousness, not all patients touched by Penfield’s electrode were greeted by God, and there is much to be desired in selling Persinger’s contraption as an alternative Religious experience is subjective and to religious pilgrimage. qualitative; it cannot be measured and its presence cannot be verified nor denied.

Ultimately, we must ask whether a If a religious experience in MTLE is a religious experience can be reduced to neuropsychiatric symptom, does this paroxysms of neuronal discharge. For make it any less of a real experience? example, was Mohammed’s revelation Whilst the talk served as a stimulus instructed by a haywire neuronal for these questions, in such a vast and network? McCrae argues that a holistic intricate field it barely touched upon the approach is needed. Indeed, it is not assumptions muddying the waters of this clear whether a burst of neuronal activity philosophical debate. causes religiosity de novo or perhaps is

On the couch with...

Professor John Weinman

Professor John Weinman, viewed by many as one of the ‘Godfathers of Health Psychology’ for his contributions, has been influential in research focusing on illness perceptions, wound healing, and adherence. John determined the content of UK Health Psychology training, creating one of the first three accredited Health Psychology courses in 1988 with colleagues. He has also been instrumental in steering the development of the profession more generally, including setting up the first Health Psychology Division in the BPS and acting as the founding editor-in-chief of Psychology and Health. Anthony Harrison met with Professor Weinman to find out more.

Tell us a bit about your research here at why patients varied so much in the way Guy’s and the IoP more generally. they responded to and managed their condition. I remember quite a number When I first came to Guy’s, I brought with of clinicians early on were interested and me my clinical psychology training, PhD approached me because I was the first and post-doctoral research experience ever psychologist appointed in what was in cognitive neuropsychology. At first, then Guy’s Hospital Medical School.

I focused very much in the area of cognitive neuropsychology, particularly My response for about several years was, in individual differences in perceptual “Oh sorry, I’m a neuropsychologist, I don’t processing and reasoning and the effects really do that stuff. You probably want to of brain injury on those mechanisms. talk to a social psychologist.” I really didn’t During this time many clinicians came see that as my thing until I took a couple to me asking why their patients were of months off to really try and rethink behaving in different ways. I remember my research. The questions clinicians or very early on surgeons saying they couldn’t surgeons had asked kept coming back understand why patients varied so much to haunt me. I’d later ask them how their in their recovery from surgery and was projects had fared. Typically, they would there anything that psychologists could tell me they never approached these offer? Similarly, I had people from the questions because they were unable to world of asthma and heart disease asking find suitable collaborators. I thought the

questions they were asking were really interesting, so I started to move towards what we now call ‘Health Psychology’.

My interest over the last twenty years has focused on understanding why people vary so much in their response to, and recovery from, a major health episode.

At the very beginning of this journey, my way of getting to grips with this question was very much guided by Leventhal’s SelfRegulation Model. Though not a million miles from some of theories I’d previously been interested in, such as individual differences in cognitive processing, Leventhal was demonstrating that people had very different ways of processing health risk, symptoms and illness. The idea that people form their own representations of these health risks or illnesses chimed exactly with my previous research and The Looking Glass

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small-scale projects where I’d been searching for a theoretical framework. For me defining the theoretical framework is crucial and the rest follows. I applied Leventhal’s model very early on in small-scale interview-based studies with either medical students or psychology students trying to understand people’s differences in perceptions of their illness and recovery in a range of patient groups.

processes of working with PhD students, world, as something that has interest which is why I’ve ended up supervising and value. Then do the best possible so many. On January the 16th 2014, my work you can in the time that you have. current PhD student will be my 50th.

What challenges have you faced and what “I regret not paying more adversity have you had to contend with?

I quickly realised qualitative research wasn’t quite my thing and I wanted to do large scale studies to quantify some of these factors, but back then there was no questionnaire! The early part of that research involved developing an illness perceptions questionnaire. One of the drivers for this work came from a period of time I spent in New Zealand visiting my main co-collaborator, Professor Keith Petrie at the University of Auckland. He was a fairly young, newly appointed lecturer in the department and we agreed to join forces and work together. Coincidentally, one of Keith’s Masters students, Rona Moss-Morris (now a Professor and Head of Health Psychology at the IoP), was about to go on to become a PhD student.

The main themes in our research were to develop ways of assessing and investigating illness perception and then using that as a basis for understanding the huge variation in recovery and outcome from a variety of major long-term illnesses. This remains an on-going interest in my research today.

Over the last ten years I’ve been involved in developing interventions guided by models of illness or health threats for patients to help them develop more adaptive ways of coping and improve outcome.

What would you say have been the highlights of your career for you personally? What is your biggest achievement?

What motivates you?

What motivates me is the possibility of understanding complex processes and trying to uncover the steps and stages involved. It’s the process of gaining a better understanding of whatever you’re looking at. What motivates me is how we can use theory to understand processes and mechanisms, whether that is adaptation and recovery from a major disease or wound healing. So, the intrinsic development of a better understanding is one of my main motivators.

The second motivator is very much about working with other people. I’m someone who enjoys working with people and particularly in research I enjoy watching other people develop competence and being part of that process. I enjoy teaching generally but I really enjoy the 33

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attention to science at school... ‘gross under-achiever’ was frequently stated in most of my school reports”

I suppose I’m proud of being one of a handful of people who developed Health Psychology in the UK and Europe.

Being a part of that pioneer group has left a very strong legacy both in the UK and Europe. Starting the first European Journal in Health Psychology singlehandedly is something I’m also proud of.

More recently, I’ve gained recognition from various respected professional organisations for my work over the years.

I’m an honorary fellow of the BPS, which is a very small and unbelievably prestigious group of people, so I feel extremely honoured to be part of that. I’m also a fellow of the European Health Psychology Society and the American Academy of Behavioural Medicine research, as well as an Academician of the Academy of Social Sciences. It’s the recognition by major professional bodies that I’m particularly proud of, because ultimately it comes from peer nominations.

Oh yeah, quite a lot of challenges, especially early on when I made the migration from Cognitive Neuropsychology into a void that didn’t even have the label ‘Health Psychology’. It was called ‘Psychology as Applied to Medicine’ and was a vague area.

At the time of making that transition I got quite a lot of flak from colleagues saying that I’d gone soft in the head and was abandoning the ‘hard science’ of cog-neuro for this wafty area, which didn’t even have a disciplinary name. Once we got Health Psychology up and running in the UK it was fine for a few years when it was just a discipline, a ‘Section’ of Health Psychology with the BPS. Once we wanted to make it a ‘Division’ it took on a very different role. It began to acknowledge people in Health Psychology as professionals who could play some sort of practitioner role.

The challenge came initially from Clinical Psychology who were less than gracious in allowing other people in. They’re probably still a bit less than gracious, but we are beginning to work out how to co-exist.

Do you have any regrets about your professional past?

I regret not paying more attention to science at school. I messed about a lot, and ‘gross under-achiever’ was frequently stated in most of my school reports.

You played an instrumental role in I really like science now, and wish I’d setting up the BPS Health Psychology got the foundations of physics and Division in 1988 and organising one chemistry under my belt at an early age. of the first three accredited UK Health Psychology courses. Can you tell us to As someone involved in the development what you think you owe your success? of Health Psychology I have one regret.

What words of advice would you offer Originally, I thought of Health Psychology young researchers and clinicians today as a discipline where I developed at the IoP who may walk a similar path? greater understanding and designed interventions. But as we’ve moved more Undoubtedly, there’s an element of luck: In into a interventional phase over the last many ways, I was the right person, in the ten years we’ve always suggested to our right place at the right time - well placed MSc and PhD Health Psychology students for the UK and Europe’s development of that they may have improved prospects Health Psychology. I suppose the thing I in practitioner roles. Especially since would pass on to anybody is that if there we have the Stage 2 training in Health is an area you really passionately believe Psychology, which means that the graduate in, that you think is an important area is recognised as an HCPC registered even though a lot of other people around practitioner. My regret is that we’ve never you are saying ‘what’s the point?’, stick really been able to create a proper training with it. There’s a sort of tenacity factor. track for Health Psychologists within our I think you have to be really, crucially health care system in interventional roles interested in the topic. You need to alongside other health care professionals. believe in the topic for yourself, for the There are many very impressive people

out there who have developed these roles themselves, and they have got into those places and are recognised because of the work they have done. But unlike Clinical Psychology we still don’t have a funded training course and a career path for Health Psychologists who want to practice. I have at various times formed part of working groups to try and define some of the steps and stages. Other colleagues I’ve worked with have tried to liaise with the NHS to do that. I think Scotland are further ahead currently, having some funded training posts earmarked for Health Psychologists but they still don’t have a career track, so there’s more work to be done.

You briefly mentioned your work as the founding editor of Psychology and Health. Can you offer any words of wisdom to Looking Glass readers in terms of publishing their own work, editing others work or starting out in the world of scientific journalism?

My view is don’t try to publish everything that moves. The world probably has too many journals, and frankly, too many papers that no one will ever read. So hang fire… submit the good stuff that is unique, interesting and original. Aim as high as you possibly can. Perhaps it’s no surprise to hear that? Ultimately, I think it’s about being bold, challenging and thoughtful in one’s research.

“What motivates me is the possibility of understanding complex processes and trying to uncover the steps and stages involved” Unfortunately, what I often see is quite interesting studies not being presented in a way that’s very appealing or interesting.

Sometimes it seems as if people can’t see their own research question or the point of what they’re doing. I do a lot of journal reviewing and I review many papers that seem to be a bit aimless. So creating clarity about what you’re trying to achieve and focusing on the core research questions you set yourself, while placing them in a really accessible context, so others can see why and how that research is relevant is key. These things may seem straightforward but they are fundamental.

My advice is have other people read your paper, present your ideas in small meetings and conferences, and use all that feedback to create papers that interest and stimulate other people. Don’t just produce yet another cross-sectional study

on the role of therapy or whatever. Tell me about it were psychological. Things like something about that which is key to me. eyewitness testimony, motive, and why people behaved the way they did. There As for those students wanting to get into were so many interesting psychological journal editing, my inclination is to say questions you could see in the law don’t! [Laughing] It’s very time consuming courts. At the time I didn’t even know and actually I’m not convinced about the you could study psychology and so that rewards these days academically. In the got me reading. Then I withdrew my law old days it was regarded as a really good application and made a late application thing to do; nowadays there is so much for psychology at Reading. So law was pressure on people to publish. That said the thing I might have ended up doing, I would certainly encourage people to do either that or blues harmonica [Laughing]. two things. Firstly, get actively involved in reviewing for journals, because every Finally, what do you believe to be the journal needs good reviewers. Learn about most interesting unanswered research the skills of reviewing, dissecting papers question in Health Psychology? and getting to the essence of what is good and what is not so good. I think this can be I’ll pick one, but there are quite a number done as part of one’s postgraduate research, I could come up with! There are so by attending really good journal clubs, many unanswered questions in health organising shared co-reviewing of fellow psychology - it’s still an embryonic field. In students’ papers and giving feedback. practical terms, I think the most important Ideally, that should be part and parcel of unanswered question is around the most what good researchers do. If you want to effective behaviour change interventions, do more, offer your services to a journal. whether they are for preventive health Once you get more established, perhaps behaviour change or for people with when you’re working with more senior health problems to promote better selfpeople on journal editorial boards, you’ll management. What the constituents notice most are actively involved in a lot are that make up effective behaviour of reviewing. However, a cautionary note, change interventions is probably the try not to take on too much and become most important practical question. overwhelmed. I think that’s the way to start out and then if you really enjoy it try The most important theoretical question to get on the editorial panels of journals. probably regards the nature of the translation process, by which I mean how What career might you have chosen if you do psychological processes like emotions, had not gone into Health Psychology? thoughts and expectancies translate into hard biological outcomes such as speed Once I committed to a degree in of wound healing, or influence cause and psychology, my original aspiration was to progression of disease? Now we know some become a Clinical Psychologist working of the component mechanisms involved, with the deaf. I was brought up in a which obviously includes at some level family with two brothers who were deaf. the central and autonomic nervous and I’m fluent in sign language and did my immune systems. There is an accumulation undergraduate thesis on developmental of evidence that the immune plays a changes in cognitive processing in key role, but how exactly? For example, congenitally deaf children. Perhaps out of how stress influences health and illness a sense of wanting to give something back, whether it is through behavioural routes or having grown up in a family with two deaf emotional routes - that’s the key question. brothers, I wanted to use the unique skills and insights from my own experience, but it never worked out. I tried to do a PhD Read more... in this area and couldn’t get funding, so I ended up doing cognitive neuropsychology.

If you want to go back before that, my original intention when I left school was to study law and it was only during my gap year that I withdrew my application to law school and decided to do psychology.

This was mainly because I spent quite a lot of time in the London law courts observing the law in action during my gap year. All the things that interested me

Extended interviews will soon appear on our website (www.iopmag.wix.com/ thelookingglass). So keep an eye out for more from Professor Weinman and previous occupants of our couch.

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Editor-in-chief Rhianna Goozée Assistant Editors Steffen Nestler Andres Herane Vives Anthony Harrison Jorge Palacios Analucia Alegria Contributing writers Dr Stephen Ginn Kate Merritt Emma Palmer Sarah Porter Marion Thibaudeau Raphael Underwood With thanks to Beth Elliott John Weinman Sarah Wardle Artwork and images Art Focus Artists Stephen Jackson Helen Spiers Martha Orbach Front Cover Detail of Dream by Martha Orbach Pages 17 and 19 Rhianna Goozée Photographs of John Weinman were provided by the subject Unless otherwise stated all other images are used with the permission of Microsoft®.