Don’t do it, Mr Collingwood …

I think I first noticed the man because he looked uncannily like a school teacher I’d had a positive relationship with. It didn’t seem to matter how many times I went to the supermarket, the man was always there. I’d say inside my head, ‘Good morning “Mr Collingwood”’ in that distinct rhythm we are all taught to address teachers by as school children.

Sometimes I’d meet ‘Mr Collingwood’ in one of the aisles; on other visits I’d see him, almost hunkered down, in the far corner of the car park, close to the railway line – my favourite parking spot.

When someone looks familiar, I think we signal something to the other person – perhaps we radiate a connection in the unconscious that they respond to.

Over the warm summer months it felt comfortable striking up a non-verbal, nodding acquaintance. When you see someone often enough on a regular route or passage, you begin to notice things about them. What I observed about ‘Mr Collingwood’ was that despite his slender frame he was always eating, but there were only ever two things he consumed: a large baguette pulled straight from the bread rack, cellophane wrapper rolled a little way down as he consumed it; or a family size bag of salt and vinegar chipsticks. Both the baguette and the chipsticks were eaten in a very similar manner – thumbs to the back of the packaging and fingers to the front. He would tilt his head down to a fixed position and then the packaging was raised close to his mouth as the food from within was consumed. It took a few observations before I was certain, but it became clear that bread was eaten inside the supermarket yet the salt and vinegar snacks were only ever eaten outside. In fact, the more often I saw him with the savoury snacks, the more I noticed he ate the sticks in a manner reminiscent of a horse with a nose bag, munching up the hay.

I’m not that certain how many times I actually saw ‘Mr Collingwood’ and I’m not sure how quickly I realised he had mental health issues, but we were exchanging a few words by the time the clocks went back in autumn. We never went beyond an ‘It’s warm today …’, ‘For the time of year …’ type of conversation, but it seemed appropriate, safe, friendly – respectful, even.

Shortly before Christmas, on my journey to the supermarket I was overtaken by a police car. At the roundabout, which is the entry road to the store, I could see, close to my parking spot, another police car. The traffic quickly began to back up at the railway crossing and it was clear that a late middle age man, stripped to the waist, was in major distress in the middle of the track. Those with mental health problems need to be treated sensitively and it is incumbent upon police officers to respond in such a manner. Being the first at a scene like this you’d hope the officers had extensive training in how to calm a situation and deal with the distress. But how can this really be expected of a service that was created for very different purposes? I took a look at the officers. They were young and I’m certain trying to do their best, but watching the scene from the car park it was apparent that every time a uniformed figure approached and shouted out to the half-naked figure, a wave of distress racked the figure’s body. He repeatedly raised his hand then smashed his fists on his body like a man boxing an internal shadow he was trying to rid himself of. I looked around for ‘Mr Collingwood’ and my heart leapt; for a moment I didn’t catch my breath and then a tear pricked my eye. It was poor ‘Mr Collingwood’ who was on the railway line. I pushed myself forward for a few metres and talked to the female officer closest to me.

‘I wonder if I can help?’ I asked.

‘No sir, we have to keep you back this side of the line,’ she replied.

‘I know this man a little; I’m a psychotherapist.’

What the hell am I saying!! This isn’t my line of work anymore. I’ve not worked in a hospital department since 2004.

‘We have called for an appropriate medical professional sir, if you could just stand back please.’ And I watched as three other officers tried to herd ‘Mr Collingwood’ like a farm animal.

I’ve not seen him since at the supermarket; I miss our nods and acknowledgements of the simple things we’ve noticed of the day. I hope you are well ‘Mr Collingwood’, I hope you are well.

All rights reserved © Copyright Duncan E. Stafford 2022. Unauthorized use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. (This article was originally published in 2019 as part of the Three Men with a Blog project.)

Walking with distress

Moving forward under our own steam on two legs is, in itself, an expressive thing. Look around as you move through the city or the country and you will see people doing it – using their bodies and expressing something about their actions, their direction – the stroller ambling along, the I’m late, I’m late followed by, or bumping into, the smart phone addict head down in a separate world, still checking social media on the way from one meeting to the next. But what’s happening with the inner voice? What past directions and journeys are being played in the inner self?

When I take people for a walk-and-talk session they are curious about how it might work. They are often stuck in life, distressed with it or perhaps bereaved. Inner symbols reveal as you walk: things we pass trigger memories, and the pace and openness of not being trapped within four walls help some very difficult thoughts to make their way out of the unconscious into the conscious realm. And, of course, nature and the environment makes itself very much part of the work. This might make sense as to why therapists so often use tree imagery on their websites. Sometimes a rabbit really is a symbol – vitality and rebirth are never far when you take therapy for a walk …

Read on for some of my free verse triggered by the walking therapy I offer.

Pace: on walking with distress

Walking, walking, walking. Pacing things through. We are in the world right now.

Talking, listening, watching. Right at the very edge of life. ‘I remember how my father laughed at me as we drove down the hill. I was about to shit my pants and he was laughing, crying with pleasure … at my distress.’

Concrete, gravel, turf, tarmac, the water at our side. ‘If you add the negative moments up and you add the neutral and the positive, you don’t get what you expect.’

Walking, marching, ambling, pausing, listening, watching. ‘The whole marriage is lost.’ Loving and losing, kissing and hating. Steps pass by as seconds rotate in time. [Again] ‘Were more of them good than bad?’

A courting couple in the back of a car cuts like a knife. Pace, control and then, then, there is just loss. ‘An intense toothache. Everyone knows toothache. Through the whole body, the mind, to quiddity.’

Walking, walking, walking, talking, talking, talking, listening, listening, listening. ‘We finally managed to break down the door but he was already dead, squashed against the back of it.’

If we looked over the bridge once, what would happen? Twice? Would a third time make the pain greater or lessen it? ‘Would you jump?’ How much would I remember of my story?

Moving, moving, now always moving. ‘It helps with the pain; it stops that claustrophobic tightness in my head.’ ‘Are these things in your head or are they in your body?’ The sensation of the cradle rocking, the soft, soft murmuring song before I fell asleep.

Pain, pain, pain, stabbing at the pith. Not needing to let go today, not quite rocked, not stepping away just yet. Step, mirror, step, mirror, step, walking, talking, listening, ‘expressing?’.

What does the body say? ‘A question? What does the body say?’ ‘Feel?’ ‘Say!’ ‘Oh look, a rabbit! Lots of them.’ ‘And the body?’ [Slowly] ‘L-o-o-k, t-h-e-r-e-’s a r-a-b-b-i-t-?’ ‘Yes.’ ‘Yes.’

Walking, walking, walking, talking, talking, talking, listening, hearing, feeling, hearing?
‘Yes.’ Feeling? ‘Oh, look, another rabbit!’

***

I highly recommend taking therapy beyond the four walls of the consulting room out into the real world and seeing what happens for you. NB this idea makes many therapists anxious about controlling the situation and the space – but they can get help with that.

All rights reserved © Copyright Duncan E. Stafford 2022. Unauthorized use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. (This article was originally published in 2019 at part of the Three Men with a Blog project.)

Mother Nature

It’s pretty snug in the back of the café on the high street. Soft fried eggs are being popped by chips on most tables, washed down with builders’ strength teas while unapologetic white bread – spread with margarine – is busy mopping up baked bean sauce.

Across the aisle, to my right, a table of five sit talking – three young women in their mid-twenties, a giant of a man (probably thirty) and an angelic blonde child of about fifteen months who is sat in a high chair with her back towards me.

I’m not quite sure what first draws my attention to the group but I’m suddenly aware of something completely chilling. The woman closest to the child (who appears to be her mother) displays open anger and disgust, for no apparent reason, towards the child, who is finger feeding herself.

I am so tightly aligned with the mother’s eyes that I can’t believe she hasn’t seen me looking directly at their dyad. I’m unsettled. Here in the friendly atmosphere of my favourite greasy spoon, where I have never heard cross words spoken or seen tension displayed. Here in this friendly high street enclave I am deeply disconcerted at some momentary flashed expressions.

And now I’m no longer enjoying the acidic bite of the tinned tomatoes that accompany my eggs, chips and beans. My human ability to read two of the six universal emotions purported by Ekman and Friesen* have seen to that.

Mother is looking blankly at the child. Across the table engaged with her friends and partner she appears inconsistent: sometimes smiling and engaging but then turning to her child with poison and what I see as resentment. Father strokes the child’s head for a moment. Mother, checking to see the others are engaged away from her, flashes more disgust at her child. Mother’s upper lip is raised, the bridge of her nose wrinkles and her cheeks are high.

I think I raise my right hand to my mouth to try to cover the words I’d like to shout across the room. I want to stand up in the back of the café and address my fellow regular patrons. ‘Am I the only one who can see this?’ I’d shout. I want to race across the room and ask what is wrong with this friendship group that they do not challenge this mother, their friend. Why do they not want to protect the Angel from this storm?

I’ve lost my hunger and I am left in a universe of uncertainty. Did my own mother feel these emotions towards me when I was a child?

Angel, who has been so calm and contained for one this young, reaches over her plastic feeding bar and attempts to get to more food. Her father strokes her head gently once more. Mother stretches to the food, breaks off a crust of toast and drives it in the air past her daughter’s eyes to her own mouth, and drops it in. Every gesture aimed at Angel says, ‘I hate you; you disgust me.’

I deploy my inner therapist as my own referee against demonising this young mother.

Thankfully, mother and friends are ahead in their meals and don’t look as though they will sit and talk after they finish. Dad produces hand wipes for mum to clean Angel’shands. The three engage, and Angel is allowed to witness and absorb more of her mother’s bile. Mother’s eyes dart around her friends and partner. She places the first wipe, now dirty, on Angel’s head; it looks like she wants to humiliate Angel, turn her into a rubbish dump. She begins to roughly clean her other hand. Father’s long arm reaches over and removes the wipe from Angel’s head and places it on the table. Mother smiles at her partner in a sarcastically petulant manner, then turns a disgusted face once more towards Angel – dismissing her.

My inner therapist has decided he is watching the acting out of an envious attack from mother to the child who has stolen her lover. It is dangerous, raw and uncomfortable to see. How have I been able to be this voyeur? How have I not been seen watching in plain sight?

Father rises from the table, stoops and picks up Angel from her chair. He holds her lovingly in an embrace and I see, as they twist around, the brightest of faces, a smile and a giggle. Now moments later mother is manoeuvring the empty pushchair through the café. She looks depressed, abandoned, weighted by the world.

The observation is over. I am unsettled: ‘What could I have done?’

I so hope I will not read of a mother and child killed on the nearby railway crossing or of Angel battered and abused, then removed into care.

This breakfast has left me feeling empty; I’ll not forget it for a long time yet.

* Ekman, P. and Friesen, W.V. (1971). Constants across cultures in the face and emotion. Journal of Personality and Social Psychology, 17(2), 124–129.

All rights reserved © Copyright Duncan E. Stafford 2022. Unauthorized use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. (This article was originally published in 2018)

Helping men to help themselves 

Men2018

It’s been a little while since I blogged about men and therapy. So, at the start of the year, when many people decide to put things in order and turn to psychotherapy and counselling for some clarity about their lives, I thought I’d write something that might help men take a therapeutic step.

It’s a sad fact that, according to the latest 2016 release from the UK Office for National Statistics, men still make up around three-quarters of deaths by suicide and yet are only reported to make up just over one-third of referrals to NHS talking therapies. So, if that sobering statistic makes you think, read on …

Access to therapy isn’t about men vs. women. It’s much more about why, as men, we might find barriers to getting help.

The continued high suicide figures for men by comparison to women suggest there is definitely something going wrong for us men – but taking your life by your own hand is just the start of the male distress story. It’s also true that around three-quarters of adults who choose to ‘go missing’ from home are men, and close to 90 percent of rough sleepers are men. It’s men who are three times more likely to become dependent on alcohol and three times more likely to report frequent drug use. Men also make up two-thirds of drug deaths, 95 per cent of the prison population, and commit more than 85 per cent of violent crimes. Additionally, they are twice as likely as women to be victims of violent crime. Sadly, men have lower access than women to social support networks, and are 50 per cent more likely than women to be detained and compulsorily treated as psychiatric inpatients.

If we look at boys, then we see they perform less well than girls at all levels of education and that close to 80 per cent of children who are excluded permanently from schools are – you guessed it – boys.

While there might be a number of reasons that these gender differences exist, what’s really important to perceive is that, for a large number of men, life is difficult.

When it comes to depression we already know from practitioners’ reports and some academic research that the commonly recognised and described symptoms of depression – being tearful, withdrawn, lacking in motivation and energy – are a more typically female presentation of the issue. Men will actually often express symptoms in an externalized way that we call ‘acting out’. This might be through uncontrolled anger, addictive behaviours that are used as a cover up for the felt distress, or the use of physical aggression. And, of course, if you express your depression in these sorts of ways it tends to compound difficulties in the social world, and will often make family, friends and professional helpers less sympathetic in their response.

Data drawn from population level studies suggest that men who are in psychological distress are more likely than women to choose coping strategies that don’t help them adjust adequately or appropriately to the environment or situation. A popular strategy might be to self-medicate through alcohol, drugs, or porn and/or sexual addictions. Of course, generalised data about gender is just that: general! And so it doesn’t tell us about any one individual. But my experience since joining this profession at the beginning of the 21st century certainly adds up with the data.

This blog hasn’t sought to offer a quick fix or a set of tools to use. What it has done is outline to anyone who reads it that we might need to approach men and their problems in a different way. Men need a space that will reflect their male nature in a positive frame. Sometimes that means that a male therapist can be a good starting point – although it is suggested by some research that as long as the  space takes a ‘male positive’ stance men make better progress. For other men it might be the environment in which they access their therapy that helps them to make progress – for example, men can thrive during online sessions or walk-and-talk sessions where the therapist is alongside them rather than sitting face-to-face.

——–

In my own practice, I see more men than women (excluding couples work) and I offer face-to-face sessions as well as online video-based counselling, psychotherapy and coaching through FaceTime or What’sApp. I also provide single-session therapy and one-off walk-and-talk therapy sessions (on particular days throughout the year) in Cambridge, Bath and Bristol. And, of course, a one-off session can become a gateway to deeper ongoing work …

Statistics for this blog were drawn from sources reporting between 2014 and 2016, including those from the Office for National Statistics.

There’s something about anxiety right now (2017)

stressBoth the West and the UK as a nation have had a difficult couple of years – from terror attacks in major European cities that many of us know well, to the Brexit vote and result, quickly followed by the political fall-out and Trump’s control of the USA. Just when we thought it couldn’t get worse, terror came back to the streets of the United Kingdom in the middle of yet more political uncertainty during the 2017 general election. Then, most recently, we witnessed the unprecedented loss of life in the Grenfell Tower horror.

For most of us, these events are stories we digest through the various forms of news and political and social media coverage – something happening in the outside world, well away from us. But these events have been quite triggering for people with worked-through and unworked-through trauma in their life stories.

At my own practice, contacts from people experiencing anxieties appear to have risen dramatically since the June 2016 Brexit vote; 2017’s events have done nothing to quell this near tide.*

Anxiety can be an extremely difficult and life-restricting thing to experience or have to live with. The professions of psychiatry, psychology and psychotherapy have created many working models of anxiety and many labels with which to subdivide or associate types of anxiety. Social Anxiety, Panic Disorders, Obsessive-Compulsive Disorder (OCD), Post-traumatic Stress Disorder (PTSD), Acute Stress Disorder and Generalised Anxiety Disorder form the kaleidoscope of disorders humans feel when anxiety gets overplayed and out of hand. And yet, anxiety is a natural thing to experience. Indeed it is the body’s response to danger. You can think of it like a monitor or alarm that is set to be triggered if you are put in the position of feeling threatened, under pressure or when you are facing a stressful situation.

In small amounts, anxiety is often a very good thing and in some situations it can even be the thing that saves your life. However, get too much of it happening inside a human being for too long a duration, and it can cause problems with pretty much any area of your life. At that point, we start to think of it not as a friend that can help us to feel alert, motivated and push us into action, but as a disorder that can control and even ruin our life.

If you find that you have – in addition to the primary anxiety symptoms of irrational and excessive fear or worry – other common emotional symptoms such as feelings of dread or apprehension, vigilance for danger signs, expectation of the worst, difficulty with concentration, feeling irritable or tense and jumpy, or that you experience mind fade (where your thoughts just go blank), then it might be time to think about taking steps to talk through your anxiety issues with a professional or, at the least, take some positive actions which might include things like mindfulness practice or regular exercise. And, if you don’t feel like being confined to a room to work through your issues with a therapist, then you might want to consider taking your anxiety to an outside environment with some walk and talk therapy – such as the type I offer within my Cambridge or Bristol practice.**

* There has been a reported five-fold increase in traffic to the Mental Health Foundation’s online anxiety page since July last year (Therapy Today Magazine May 2017)

** Walk and talk therapy will be the subject of a future post on this blog site.