Metaphors Offer Meaning

 

“I had a black dog, his name was depression” is a video which make so much sense to so many people across the world. Depression does not discriminate and it comes in all shapes and sizes. Some may call their depression a black dog, others a slug or demon on their shoulder. The metaphor that someone uses for their depression can also be the thing which brings them closer to managing their symptoms. Metaphors can also be used within therapy to support changes in thinking. Steve Killick, Vicki Curry and Pamela Myles (2016) have collated some of the metaphors which clinicians  have used or have developed with clients to help overcome their difficulties, have a read of this one or the others in the paper and tell me which is your favourite.

This is my favourite;

Folding up paper to put in the bin- Young people and trauma

I was working with a 14-year-old boy with PTSD following some very traumatic events. We were about to embark on our third session of trauma-focused CBT and I wanted to remind him why it could be helpful to go through what happened and talk about the very thing that he had avoided talking about for 18 months.

I tried to explain that I wanted to help him to take the sensory information of the memories and ‘wrap them up in words’. I reminded him of two common metaphors that I had used in earlier sessions to explain how this processing of memories can lead to a reduction in symptoms: the wardrobe (Ehlers & Clark, 2000) and the factory (Richards & Lovell, 1999).

These two metaphors had been adapted and elaborated following the feedback from many clients (the revised versions are described in Trickey, 2013). The client listened patiently, nodding and encouraging me as I told him the stories. He then said ‘It’s a bit like that David, but actually, it’s more like this’. He filled up the waste paper bin with scrunched up pieces of paper until it was overflowing and said ‘These are all the bad things that have happened to me, and as I walk along the road to school [he made the bin walk along and bits of paper fell out of the top] they fall in front of my eyes. And as I go to sleep [he lay the bin down and more pieces of paper fell out] they fall into my dreams. But when I come here and talk to you, we take each piece of paper out [he took each of the pieces of paper out], un-scrunch them [he un-scrunched them], and we read them through carefully. Then we fold them up neatly and place them back in the bottom of the bin [he folded up each piece of paper neatly and placed it in the bottom of the bin]. This means that they don’t fall out the top, and I have more room in my head to think of different things’.

Not only is this a remarkably helpful metaphor, I love using it because it came from a client in the middle of trauma-focused therapy to explain his own experience of how it was helping. I have used this story many times since, and because it comes from a ‘fellow-client’ it has much more credibility. I am so grateful to the client for his help.

By DAVID TRICKEY

You can read the whole article here:

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/A2FDDEB0C9BA9B4FE7103A73C0455B6D/S1754470X16000210a.pdf/div-class-title-the-mighty-metaphor-a-collection-of-therapists-favourite-metaphors-and-analogies-div.pdf

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Community

Where You Belong, Who You Are, Who Supports You, Who Share Your Values

Defined as a group of people living in the same place, sharing certain beliefs, values, attitudes and interests, a community is surely something that we all belong to, or is it?

I have recently thought about my own sense of belonging. As a white British/Irish middle class post-graduate psychologist, living in central London, you might think that I might belong to lots of ‘groups’: ethnic, class, education… But do these make up my community?

I personally feel that certain ‘groups’ of people in London have lost or not been able to build a sense of community within the area they live. Perhaps it is the belief that one must not intrude on another’s business, or perhaps it is that many people in London have moved here to escape their own oppressive communities, or only stay for short periods of time in one place. But in all honesty within the ‘groups’ I belong I believe there is a sense of lost community; how many people who live in London know more than one of their neighbours?

It saddens me to think that by not being part of a community people can become lost, isolated and alone in a city full of so many people. A community can support each other in times of need and in times of great joy.

Whether you belong to any of the diverse communities in central London; Turkish, Black Caribbean, Orthodox Jewish or many many more, a community offers support to you in a way that extends beyond your family and friends.

Listening to people who live in London and who have a sense of belonging to a community has highlighted to me that it is something I currently do not have. But please don’t misunderstand me; I have an incredible family and wonderful friends, yet if I could not contact them or if I was not so fortunate to have these people in my life, would anyone remember me or notice if I hadn’t left the house in a week?

I believe that it is down to us to build a sense of community within London. Be that by just getting to know your neighbours, talking to people who live on your street or going to the local pub quiz on a Tuesday night. So maybe even if you aren’t feeling like throwing an extravagant street party, then just say hello to your neighbours and ask them their name… because we have to start somewhere.

 

 

 

The STIGMA of Mental Health Difficulties “We have come a long way but we still have a long way to go”

“Psycho” “Mad” and “Crazy” are just a few of the words that are pushed around when talking about mental health issues. Children, adolescents and adults, will often not speak of their difficulties due to the stigma that society has created around mental health. Resulting in many people suffering and battling with their difficulties alone. With increased access to google, ‘WebMd’ and Wikipedia children, adolescents and adults often misdiagnosis themselves or become haunted by the possibility of their symptoms never being alleviated. It is down to professionals to help to destigamise mental health illness.

But, we must also reflect on how far society has come in changing the perceptions of mental health issues. Scientific developments, social understanding and a reduction of discrimination led to de-institutionalization in the 19th century, when asylums like the notorious Bethlehem Hospital a.k.a. “Bedlam”, were transformed. Those who suffered, in what Foucault called, ‘the great incarceration’ of people with mental health issues, would not believe the progress that society has made in such a short amount of time. Lord Shaftesbury in 1851 spoke about how “madness constitutes a right … to treat people as vermin.” The historic abuse, neglect and inhumanity that people with mental health issues were victim to within society emphasises how far we have come.

Yet we still have a long way to go, as can one truly say that in modern society people with mental health difficulties are not still treated differently, and continue to be view as being weaker, less able and feeble individuals. Although much has change in how people with mental health issues are clinically treated, people are still challenged by the stereotypes and prejudice that result from misconceptions about mental illness. As a result of this people with mental illness are robbed of the opportunities that define a quality life: good jobs, safe housing, satisfactory health care and support, and their voice is often left unheard. It is hard to think about how these prejudice are still prominent within our society as it is estimated that 1 in 4 people in England will experience mental health problems in any given year. Corrigan and Watson spoke about how far we have come in developing our understanding of the brain, neurological development, cognitive functioning and ways to treat mental health issues, but research has only recently begun to explore stigma of mental illness.

Much work needs to be done to fully understand the breadth and scope of prejudice against people with mental illness. It is at this point professionals, teachers, families and society as a whole must work to understanding and change the prejudice and discrimination of people with mental health issues. It is important to consider how many children, adolescents and adults within modern society shy away from seeking help with their mental health difficulties due to the on-going stigma.

Steps are starting to be made to reduce prejudice, ensuring that people with mental health difficulties can receive the help and support they need without being shunned within society. Mental health professionals have begun to understand the paramount importance of early intervention in helping children and adolescents with mental health issues, reducing stigmatisation in the next generation. Many schools within the UK now have links with their local Child and Adolescent Health Service (CAMHS) who offer help and interventions for those children and adolescents with mental health difficulties. Moreover, they offer vital psycho-education to teaching staff and other local services to ensure that as key role models within society and educators of the next generation, they to can spread the message of destigmatising mental health difficulties. Celebrities and the Royal Family have begun to show their support for speaking out about mental health difficulties and reduce prejudice within society. Kate Middleton is the patron of the Anna Freud National Centre for Children and Families, whilst Prince Harry and Prince William have shown their backing for the charity ‘Heads Together’ who aims to eliminate stigma and change the conversation about mental health.

Recently Prince Harry spoke to some of Great Britain’s best athletes to hear about their own mental health difficulties. This work sparks the drive to increase awareness about mental health issues and help support society to promote a positive conversation about mental health. Watch the link below and tell me what you think:

 

Dear Dyslexia

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Dear Dyslexia

We have been through a lot, you and I. From the age of seven we have learnt to get used to each other. Faced challenge after challenge together, but now as I look back I think of everything you have taught me, and now I want to share those lessons with parents, teachers and the children who have still got a long journey to go on.

You are a part of who I am and who I have become, sometimes I have hated you and sometimes I have loved you. In exams you challenged the speed I thought at, the pace I wrote at, how I could remember details and spell every individual word. Whilst at other points in time, the way you have made me think has helped me see the world in a different way to others. We have become more creative and developed not just our academic skills like other children, but we learnt so much more.

Yes, we may have always been the bottom of the class, had extra ‘special’ lessons, have been teased for being slow and dumb. But, we did not let that bother us, we took our time and learnt ways that help us learn. The normal education system may not have been for us; no we could not learn lists, write quickly, spell ‘because’ and remember our timetables. But, we persisted and we had so many people that have helped us on our way; the teachers who realised that we could remember better if we wrote in colour; the SENCO who spent hours with us each week to help us learn through stories instead of just presenting us with facts; those friends that saw that we did not need to be conventionally ‘clever’ to be their best friend; the support and knowledge that our parents would be there for us even if we got an ‘E’ in a class test.

We made it through education, and we have excelled beyond our thoughts, and surpassed what our primary school teachers thought possible. But as I think back on our journey, I know that we are not alone, it is estimated that up to 1 in every 10 to 20 people in the UK have some degree of dyslexia.

They should know that every single person learns differently. It took us twenty-three years to learn how we can revise, read and learn. They should not give up, just because the requirements of the education system enforce us to pass specific exams. It does not mean that they are ‘stupid’ or ‘thick’ if they cannot pass first time or if they need extra time, a laptop, or other support put in place to help them pass.

As neuroscience develops we learn more about how humans tend to learn. We also gain more understanding of how individualized humans are, how they function in different ways at a neurological level. So to all those parents, teachers and children that have begun the journey of dyslexia, you can do it! Everyone learns in different ways and you will make it to where you want to be, just keep trying new ways of learning and learn about what you love and aspire to do.

Here are some useful websites:

http://www.nessy.com/uk/

http://dyslexiahelp.umich.edu/tools/fun-games-for-dyslexics

http://dyslexickids.net/Welcome.html

Inside-Out- FILM REVIEW

 

inside out

 

Joy, Sadness, Anger, Disgust and Fear…some of the most important emotions that lead us to make decisions.

Inside Out follows the internal journey of Riley, we follow her from the moment she opens her eyes. In the depths of her mind we meet the emotions that make Riley, Riley. Joy, the positive energy that fuels Riley’s happiness; Fear, who keeps Riley safe; Disgust, who stops Riley from being embarrassed and poisoned; and Sadness, who helps Riley cope with change.

As we follow Riley’s journey through life she grows and develops her own personality. Her experiences and memories shape her personality. The genius design of this film links to neuropsychological theory in how our experiences define us and shape our cognition. Riley’s memories are stored in the long term memory bank, which has thousands and thousands of memories, from the president’s of the united states, to the names of all the my little pony characters. But her most important memories are her core memories, which are stored in the central headquarter of her mind.  These memories create her personality islands; Family Island, Goofball Island, Friendship Island, Hockey Island and Honesty Island.

Riley’s life is suddenly turned upside down as her family moves to San Francisco when she is 11. We begin to see the effect that a life event can have on Riley’s emotions; Fear, Disgust, Anger and Sadness are in disarray as Riley has to face this drastic change. But, Joy is there to help, she tries to smile and carry on. Riley tries to be as joyful and happy as possible. But within all the confusion Sadness begins to override the emotional headquarters in Riley’s mind.

Following a dramatic course of events with Riley’s personality islands beginning to be lost and deteriorate, we learn that every emotion is needed for Riley to be able to be truly happy again. She must embrace every emotion including Sadness. Joy accepts that Sadness plays an important role in every child’s life. To cope with changes and life events one must explore and befriend all of their feelings. This important message is threaded throughout this movie and invites every child  who watches it to be mindful and embrace all their emotions.

 

 

 

Getting It Down On Paper

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To think, to wonder, to learn, to make a change, we need to have something to grab hold of. An idea or a thought can become so much more once it is written down on paper.

Within clinical practice, psychologists often use drawings, timelines and genograms (family trees) to help their clients see their context and difficulties in a visual way. But why is this technique so helpful?

Gerald Oster’s recently published book- Using Drawings in Clinical Practice, emphasises some of key reasons why drawing is useful when working with children, families and adults.

He stresses that often drawings are an easy way to engage clients, especially those who are nervous or find it difficult to share some of their deeper concerns.

Oster’s book speaks about the benefits of using drawing in an initial session or assessment session with a client. As drawings and pictures can reveal so much about the intricacies of a person’s view on the world and their relationships with those around them.

By simply asking a client to draw their family, any difficulties or strained relationships soon become apparent. They might have drawn themselves very distant from their family, or made their partner look like the devil- whatever is put down on the page is valuable.

Having drawn a picture, clients will be able to see themselves that they have created a solid image in their mind. By having their own views on the world and their relationships with others, down on paper it can help a person become more reflective.

Their ideas, beliefs, emotions and thoughts become concrete when they are on the page. This means that they can be explored and looked at from lots of different ways. Fleeting thoughts can be held and looked at, stressful and scary images can be explored and altered. By seeing something in black and white (and colour if the NHS can afford pencils), you no longer have to be puzzled or pestered by intrusive thoughts.

Children find drawing and writing down thoughts particularly helpful. Oster writes about the importance of being able to help a child make connections between their drawings, and their emotions and thoughts.

Drawings, timelines, family trees, poems, stories, comic books, sculptures, paintings… all represent something about their creator. By seeing our own perspective on the world and relationships in front of us in a concrete and tangible way, we can begin to connect how our view of impacts our thoughts, emotions and behaviours.