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.)

Dying Twice

This year, and for the first time, the anniversary of my father’s death some years ago passed by without me remembering …

It had been a short drive to the nursing home my father had moved to eight days previously. My wife and I had been his primary carers for close to a decade but when, fourteen weeks earlier, he had fallen and broken his hip, his move away from his home and into the healthcare system sparked in him a serious decline. There was also a touch of guilt at the freedoms his move was affording to us.

As we neared the care home, an ambulance on an emergency call passed us. A minute later we drew up behind it and a paramedic vehicle already parked at the home. My wife said to me, ‘It’s for your father.’ I winced; I felt her to be right.

As we strode down the corridor of the second floor suite in which my father had taken residency, a member of staff addressed us: ‘Are you here to see Brian?’

‘Yes,’ we both smiled.

There was already a temporal shift occurring – odd, I thought, no one has addressed us in such a way before. A nurse blocked our path to my father’s room: ‘You’re Brian’s relatives?’ Somehow, in a moment, we were all in her office. My wife looked pale: ‘You’d better sit down Mrs Stafford.’ But there was a dreadful tension and confusion in the space. With my psychotherapist’s hat on I honed in on the emotion – there was huge anxiety being broadcast from this experienced nurse. After a few words she left us saying, ‘I’ll just check on your father’s condition.’ It hit my wife and me at the same moment and we rushed along the corridor.

Bundling into my father’s room we saw a paramedic ‘shouting’ at the prone and half naked figure: ‘Come on Brian … stay with us.’ My father’s chest heaved in physical distress as a bag covered his mouth and another medic prepared to shock him. His skin had the waxy hue and paleness I’d seen on my mother as she passed away.

In the small living space that had become my father’s whole world the paraphernalia of modern emergency support was strewn all around. My wife was first to enunciate her horror: ‘What are you doing this for?!’

For several weeks in three separate medical establishments my father, despite his communication difficulties caused by a stroke some years earlier, had made himself understood – he wanted to die. For the long years before he broke his hip my wife and I had cared for my father, it had been difficult to watch his almost daily decline; he had been a proud, principled and independent man, a teacher and an artist. At eighty, long overdue, he become a published poet. Difficult as it was to watch, we respected that this was a man fading out at his own request. And yet here we were, thrust into the most terrible of moments – a man who wanted to die being forced back into a world he no longer had an interest in. Our protestations that my father be allowed to pass away brought yet more tension into the room. The ‘shouting’ stopped, but our fourteen weeks of frustrations at the NHS care system were too much for me and my wife.

In counterpoint we made our cases aloud to the six medics about respect and civilised treatment. But apparently, my father’s DNR (do not resuscitate) wishes had not been recorded in the requisite manner. Procedure and regulation were in the way of care and welfare, and overrode my father’s desires.

For his entire adult life, my father voted for a system that respected people, treated them well; a welfare state, a national health service, free at the point of need – one of the marks of a civilised and mature society. Those entrusted to administer NHS continuing healthcare had already attempted piracy with his rights and, now, these paramedics were clearly having to apply procedure rather than the human care they so obviously wished to dispense.

My father was being denied his wish to die peacefully and with respect. This was a system seeking to revive him so that it might take him back to a hospital he had already refused to be taken to, in order that he could ‘die’ once more, probably on a trolly in a corridor in A&E.

Before all was lost, the senior paramedic took control and through several different stages and conversations that involved myself and my father’s GP the paramedics were allowed to ‘withdraw’. And then the room was quiet and my father once more calm. His beloved radio could be heard in the corner of his room and death once more began to claim his body. Peacefully and with us as comforters for his passage he was able to complete his life, with respect and dignity.

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 on Three men with a blog in 2018.)

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.)

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.

Living life by numbers … and the midlife crisis

Numbers_edited-1Living life by numbers … and the midlife crisis

May 7 2016

Conveniently, for lovers of statistics, the Canadian-born psychologist and social analyst Elliot Jaques – who coined the term “midlife crisis”* – died at the age of 86. I say ‘conveniently’ because his lifespan correlates so well with modern statistical expressions about the mid-point of life. As examples of this, the World Health Organization revealed in 2013 (the most recent figures available) that life expectancy for the average UK citizen is 83 years, and a 2015 report from the Economic Journal revealed that life satisfaction gradually declines throughout the early part of adulthood, reaching a low between the ages of 40 and 42 – so close to Dr Jaques’ midlife point.

The difficulty with reporting averages and statistics about human life is that it can obscure life-lived experience and meaning. If we expect a ‘midlife crisis’ to occur at a certain age, then we will be likely to attribute all negative experiences and challenges to that age rather than to the actual experience triggers and events we are living through at that point in time.

Our later 30s and 40s can be especially difficult times, not particularly because of our age, but because of the responsibility life tends to have assumed. In contrast to childhood – a time when the vast majority of people will have been nurtured, protected and cared for by other people – 35 to 50 year-olds generally have to work hard to support themselves and other family members. And with these struggles come other issues – including depression, anxiety and the realisation that time is passing quickly.

It seems that headline statistics as reported in the media tell us very little about the real nature of a person’s issues – although they do appear to make people feel unhappy when they don’t live up to the ideal average. And how do we, as individuals, ever know when midlife will be? For some, 50 will be the figure they never reached; for a few – take, for instance, therapist Hedda Bolgar** who, aged 102, still worked four days a week – that midpoint would not yet have been reached.

I remember sitting on the sofa with my mother listening to the radio on the eve of my 10th birthday, feeling sad that it didn’t matter how long I would go on to live “I could never count my life in single digits again”. While I didn’t realize it at the time, I was actually making an observation that the middle of life can only be seen on reflection, since the truth of it all is that we are actually continually positioned at the extreme end of our lives. This is as true today at the start of my 51st year as it was at the conclusion of my ninth.

Crises can happen at any time of life and it’s important to see each crisis for what it is – and act accordingly. Then, perhaps we can aim for 45 joyous, rather than a total of 90 miserable, years.

* Elliot Jaques (1965) Death and the Midlife Crisis

** http://www.today.com/id/45287411/ns/today-today_people/t/age-therapist-still-psyched/

Crying has an upside – for men and women alike

Cryblogsmall9 November 2015

It’s 8am on a cold early November morning and I’m not expecting to cry any time soon. In fact, I’m sat inside an incredible structure made from discarded and dormant materials, which itself sits inside the bombed-out remains of the 14th century Temple church in Bristol. Among a small group of people – some clearly on their way to work – my wife and I are listening to a band, toyface, who are part of Sanctum, a 24 hour-a-day, 24-day-long performance.

Visiting the city I was born and raised in – and still feel deeply tribal towards – there are always emotional triggers from my past to be found; the song being beautifully performed by the band suddenly triggers a deep emotion in me. And I want to cry. Despite the distractions of the fluxing audience, the music and lyrics of the powerful quartet of musicians speak deeply to something at my core. And yet, I’m still coded to my childhood upbringing half a century ago: ‘big boys don’t cry’.

I know the ‘big boy’s don’t…’ myth well, as men commonly apologise when their emotions release and they cry in my consulting room.

Although little is in fact known about the function of crying for humans, it appears that, according to Professor Ad Vingerhoets, a world leading expert on crying, on average women cry 30 to 64 times a year in comparison with 6 to 17 times a year for men.*

While I cry at the lowest end of the parameters of the quoted figures, I have rarely cried as an adult in a public setting and yet everything tells me this morning that toyface could do me a favour and offer a very therapeutic tear to slip out and relieve me of a few thoughts that the weekend has imposed on me.

A recent study by Asmir Gračanin** suggests that crying might indeed go a long way to making us feel better. The research team examined both the immediate and the delayed effect of crying on mood within a controlled laboratory setting. Immediately after watching two tear-jerking films, 28 participants who had cried and 32 who hadn’t were asked how they felt. They also had to rate their moods 20 and 90 minutes later.

The mood of the non-criers was unchanged and unaffected immediately after seeing the films. However, the mood of the group that cried was distinctively low. After 20 minutes, it was reported that their mood had returned to the level experienced before the screening. When asked again, after 90 minutes, the group that had cried reported a better mood than was the case before the films started.

My own call to personal emotional catharsis, while sitting in the Sanctum space, finally caused my eyes to fill but not to spill. For that to happen, I needed to be a man alone in the company of the downloaded track and my own safe space. I’m adding the track Motherlover to my iPod emotional triggers list. I encourage anyone to experience the purgation of a personal cry list. Think how good you might feel in 90 minutes’ time.

*Professor Vingerhoets also claims that women cry for an average of 6 minutes, while men cry for only 2 to 3 minutes.

**Gračanin, A. et al (2015). Why crying does and sometimes does not seem to alleviate mood: A quasiexperimental study, Motivation and Emotion.

——————-

Why not visit my therapy website – therapy place – where you can contact me or find further information about the therapies I provide for women, men and couples.

Finding a good therapist

Blogfind2002 June 2015

I remember reading Canadian educationalist Allen Tough’s pioneering thoughts in the area of self-directed growth in adults and being inspired at the way most adult learning occurred in informal settings and ways. You could say that adults learn on a need-to-know basis. When you need to get a new car you read magazines, check the Internet, ask around your friends and family for their views, and if you are lucky enough to know a professional in the area you are ‘researching’ then you tend to ask them.

I’m tempted to say that the above pretty much all holds true for finding a therapist as well. But if I think back 20 years or so when I needed therapeutic help myself, I can all too easily remember how difficult it was to talk to people about such issues. Back in the early 90s society was still too wary of therapeutic help. It was also the pre-Internet world when counsellors and psychotherapists were more difficult to find. So, should you just rely on the Internet? Is it good enough to simply look someone up on a website and then hand over your emotional wellbeing to them?

If I were looking for a therapist today here’s what would be on my checklist before I started any sessions with them:
Are they registered and accredited by a respected professional organisation such as the BACP, UKCP or BPS?
Will they talk to you on the phone, by Skype or email before you book a session?
Are they experienced in working with the issues you want to work with? (This is particularly important in areas like sexual difficulties, as few general trainings offer enough input in this area.)
Is the therapist used to working with people in short-, medium- and/or long-term encounters? This might be very helpful in matching your needs with the therapist’s skill set.
Has your prospective therapist had their own therapy? (It might seem odd but not all models of therapy require therapists to undertake their own therapy, while some will simply have done the minimum required by a training course. I’d find it odd to have therapy with someone who hadn’t been in the chair themselves.)

Above all, don’t be persuaded that someone is a good therapist because they have a lot of letters after their name. Studies show that once core requirements of education and training have been met, the effectiveness of the therapist is not dictated by their qualifications.

To my mind, all therapists should be looking to make a good match to the people they are going to work with. Again, studies support the view that it is the quality of the relationship that really helps therapy work. So, it follows that I always offer a no-obligation initial session.

Finally, go with your gut feeling and, if it doesn’t feel right in the room, shop around.

Suicide rates: can you get the men in your life talking?

BlogSuicide

Suicide rates: can you get the men in your life talking?

22 April 2015

Seven years ago I wrote on the men’s page for Therapy-space Cambridge that ‘thankfully, (with the exception of 2008) in the UK male suicide rates have been falling since 1998’. However, the latest figures released in 2015 by the Office for National Statistics make for sobering reading, given it reports that the number of suicides in the UK has once again risen and the rate for males is the highest it has been for 14 years.

Since I wrote that previous men’s page, male suicide rates have increased significantly, while female rates have stayed relatively constant and have remained lower than those for men.

Looking at past statistics shows that rates for male suicide in 1981 stood at 63% of the total UK rate, but in 2013 the figure had risen to 78%. The increase in the male figure has been a steady one by comparison to female rates.

If you are a male, aged between 30 and 74 but particularly if you are between 45 and 59, then it’s time to start talking because suicide rates in your age group are the highest in the UK. If you are the partner of a man who is depressed, now would be a good time to get him to realise that there’s no stigma in asking for help. Whether it’s talking online or on the telephone to the Samaritans, visiting the family GP or booking a session with a therapist (face to face or via Skype), let’s get men talking: it might just save a life.