Category Archives: psychosis

Online video training

“Very thorough and high quality…” Abi, Student nurse

Now less than half price. Lifetime access for only £12.99

Do you work in mental health services?

Are you a support worker, student nurse or just an interested person who’d like to know how to make more sense of mental health and disorder?

Do you find it hard to see how all the different disorders and peoples’ approaches to them fit together?

Do you have difficulty getting other professionals to see things as you do?

Would you like to be more effective in working with the people you care for?

Then this online video course is for you.

Picture on the box workbook: title page

People learn best when they have questions and they remember best when they have a ‘schema’, a ‘picture on the box’ to help make sense of what they’re taught. That’s what this training is all about. Over two and a half hours of video instruction alongside a range of information and exercises in the accompanying workbook help you to make sense of the seemingly overwhelming field of mental health and disorder.

And all for much less than the cost of a good night out.

Picture on the box workbook: Sample page (psychosis 1)

You can have all this for less than you’d pay for a take-away meal. But unlike a take-away, the benefits of this training will last your entire career.

Click the link below to get full access to the course videos and workbook.

https://www.tamtalking.co.uk/p/onlive-video-training-the-picture-on-the-box/

Webinar: Mental health recovery

What’s #recovery really about in #mentalhealth? For many it means so much more than a return to how we were. Join my one hour seminar to learn more.

https://tinyurl.com/recoversemi

The picture on the box

Making sense of mental health

Mental health work needn’t drive you up the wall!

Mental health work can seem so complicated… and not just for beginners. Many seasoned practitioners go on for years without a clear idea of how the different diagnoses, conditions and coping strategies fit together. It’s like trying to make sense of a 1,000 piece jigsaw without any real idea of what the overall picture is supposed to look like.

The confusion that arises can lead to workplace stress, unclear aims and difficulties in following care plans with different workers pulling in different directions whilst the service-user or client gets stuck in the middle of a whirlpool of confusion.

It’s always better when you can see the whole picture

This course is intended to provide the ‘picture on the box’. It shows clearly and simply exactly how the different types of diagnosis and conditions fit together and even maintain and exacerbate each other. Delivered either online or face to face (with appropriate distancing, of course) it’s available to staff teams anywhere in the world, just so long as they speak English and have a working internet connection.

The course involves…

Session 1

Anxiety (the gateway to mental disorder)

Freeze, flight and fight

Session 2

Depression (when you’re tired of trying)The opposite of the FIVE ‘F’S             

Psychosis (The Devil makes work for idle hands)

Session 3

Personality disorder (9 statements of vulnerability)

The symptom groups – are the same as the 3 clusters… are the same as the vulnerabilities    

3 models – All roads lead to the same destination   

Session 4

Dependence and self-reliance        

Therapeutic optimism Expressed emotion

Get in touch to book this training for your own staff. Go on, you know you want to!

Webinar: Psychosis and psychotic conditions

Thursday 18/2/2021 7pm GMT

Invitations by Email once £10 payment received.

Mention the word psychosis to most people and they immediately think of headline grabbing tragedies and untreatable, unmanageable people they’d rather not have anything to do with. This is inevitable given the way that the subject is covered in the press but it’s not really very accurate.

People diagnosed with psychosis, like people diagnosed with other mental health problems are more likely to harm themselves than others.

This hour long, online tutorial lifts the lid on the myths about psychosis and psychotic conditions like schizophrenia. It introduces participants to the practical, common sense things that they can do to support their relatives, their service-users and themselves. By breaking symptoms and problems down into manageable ‘chunks’ and by relating them to participants’ own experiences we build a clear understanding of what psychosis and schizophrenia really means.

The tutorial is open to anyone with an interest in the topic be they relatives, carers or, most importantly people with psychosis themselves.

https://www.tamtalking.co.uk/p/webinar-psychosis-and-psychotic-conditions-thursday-18-2-2021-7pm-gmt/

Video: Why I’m not anti-psychiatry

Regular followers of my stuff might be forgiven for thinking that I’m opposed to psychiatry and the biological model. After all I regularly complain about the standard medical approach with its reliance upon medication to treat mental disorder – especially relating to antipsychotics for people diagnosed with disorders like schizophrenia and bipolar disorder. But that doesn’t mean I’m ‘antipsychiatry’ – just that I’m cautious. This is especially true where medications are concerned.

The list of side effects (otherwise known as undesirable consequences) that accompany psychotropic drugs can be a major problem but the same is (and has always been) true of all medications from AZT to aspirin. If a particular person suffers side effects from a particular drug then there’s a case for trying a different drug or even a different dose but that, in itself, isn’t really a case for scrapping all antipsychotic medication. All we can really say is that we need to be cautious about medication and avoid the ‘hammer to crack a nut’ approaches of the past.

Medications are biological tools. They are chemical preparations designed to make chemical changes in the physical body. This is because of an assumption that mental disorders are caused by physical (specifically chemical) problems. But is this always true?

Combat veterans are known to develop psychotic disorders as a result of their experiences spending time in active service. It seems ridiculous to assume that all these men and women (who had passed psychological evaluation before entering the battlefield) suffer from organic brain disorders. Yet their symptoms are similar, if not identical to those experienced by many of their civilian counterparts who are diagnosed with major psychotic disorders and treated with chemicals.

Combat veterans suffer a form of psychosis that is caused not by biology but by stress.

For these people I think that there is an excellent case for using medication to treat their distress and to provide a degree of respite from their symptoms but that’s not the same as cure. That’s one thing I do disagree with traditional psychiatry about. I believe that recovery is attainable for many more people than the drug companies would have us believe. Happily though, so do many modern psychiatrists. People like me who advocate recovery aren’t so much joining the mainstream as the mainstream is catching up. That’s a nice feeling.

There are, of course many people who argue vehemently that psychiatry is flawed and that medication should never be ‘used on’ mentally ill people. However, sincere though I’m sure these people are, they may well fall into the same trap as the overly zealous arguments in favour of using too much medication. They may be too general.

Just as not all cases of psychosis seem likely to be chemical, so not all cases need necessarily be purely stress related. Whether the argument is in favour of medication or against it there is a real problem with polarisation and over-generalisation in mental health care. The disadvantage of these ‘black or white’ arguments is that they assume that everyone is the same and that everyone needs the same sort of intervention.

This sort of one-sidedness can feel easy and comfortable for those doing the arguing but there’s a price to be paid for superficial reasoning. The price is poor treatment because of flawed assumptions that compare chalk and cheese and assume that they are the same thing.

And that price is not generally paid by the individuals doing the arguing. It’s paid by the mental health service-user whose options for recovery are limited not by lack of knowledge but by stubborn refusal on both sides of the argument to look beyond their own, pet theories.

If I seem a little hard-nosed about this it’s for good reason. I was trained in the traditional way where medication and unquestioning acceptance of the biological hypothesis were everything. I was at the extreme ‘medical’ end of the continuum.

Then I was lucky enough to be selected by the NHS for further training at the Post Graduate level. I spent two years part time being exposed to the other side of the argument and, like many of my peers, became just as rabid in my defence of social and psychological perspectives instead. I was for a while the typical antipsychiatrist (or more accurately ‘antipsychiatric nurse’). And that felt good.

Today I’ve moved on a little from either of those two positions. Now I am able to see past the partisan posturing of either side and I try to walk the middle line. It seems to me that balance is everything. Isn’t that usually the case in the real world?

I no longer see much of a place for extremism in mental health care – especially when those who pay the price are not the ones making the arguments.

Please don’t misunderstand me though. I am far from an apologist for the biomedical status quo. I believe that medicine may well have something very positive to offer in relation to symptom management but in most cases that’s about all. I think that true recovery is generally achievable in other ways. But that’s for a later video.

To arrange training for your staff please complete the contact form below…

Carers in mind: It’s real for them

Caring for people with psychosis can be both stressful and mystifying. People who hear voices and respond to visions that the carer can neither hear nor see present particular problems and frustrations. It’s distressing for the individual voice-hearer and, for different reasons it’s distressing for their relatives and other carers as well.

“It’s real for them” is a common expression intended to promote empathy and understanding but there are very real drawbacks if that’s as far as it goes. We all know it’s real for them – that’s why they’re distressed, but if we simply accept that without question we give up a vital part of the recovery process.

In this video we explore the positive benefits that can come from refusing to accept that ‘it’s real for them’ whilst still accepting the other person’s experience. We look at the power of attribution in psychosis, especially in relation to hallucinations and consider the benefits of helping people to change their view about their hallucinations. It isn’t trivialising the problem to see it for what it is. A voice has no power unless the voice-hearer gives it some. However distressing and disturbing voices are they’re still only voices.

By helping people to reframe their interpretation of voices they hear we can reduce the power, the distress and the disruption of those voices.

Please feel free to comment either here on the blog or by using the contact form below and let me know how helpful or otherwise this video has been for you. Please also let me know if you’d like me to cover any other issues facing carers and relatives. I can’t promise to cover everything but I’ll do my best to help if I can.

 

Labelling, recovery and therapeutic optimism

 Back in 1963, researcher David L. Rosenhan masterminded an elaborate hoax. It was a scam designed to study the effects of labelling upon clinical practice and to determine whether psychiatric diagnosis is based upon professional skill or simple expectation and prejudice. It was a bold experiment with profound implications for clinical practice even now almost half a century later.

The idea was simple enough. Rosenhan persuaded a group of confederates to approach state hospitals in America and request a consultation. Each told the psychiatrist who assessed them that they had begun to hear a voice which said “Empty”, “Hollow” or “Thud”. That was enough to secure them a bed in the local psychiatric hospital. But that wasn’t all, bad though that low threshold for admission might be, in itself.

Once admitted on to the ward Rosenhan’s confederates ceased any pretence of voice-hearing. They behaved perfectly normally and showed no symptoms of mental disorder at all. At this point we might expect the staff running the ward to smell a rat but that’s not what happened. Whilst the fellow patients could tell very quickly that their fellow patients weren’t actually ill, the staff apparently could not.

Even perfectly ordinary activities such as writing was seen as pathological. Pacing up and down through boredom in this secure, low-stimulus environment was interpreted as a sign of illness. It seems that once the label of ‘mentally ill patient’ was applied everything the confederate did was interpreted by those lights.

The staff saw precisely what they expected to see.

This mirrors an earlier study by Rosenhan and his colleague, Jacobson who examined teachers’ attitudes to students who had arbitrarily been tagged either as ‘bright’ or ‘not bright’ by the researchers. The school, known as ‘Oak school’ to protect the identities of all concerned, also lived up to expectations of labelling theory. Not only did teachers interact with children in accordance with the labels they had been assigned, but the children also began to live up or down to the expectations of the teachers – even though their actual test scores had been ignored when they were randomly assigned ‘bright’ or ‘not bright’ status. Each child took on the behaviours and traits of the label, regardless of their actual abilities and achievements.

This is why it is so important that we understand labelling in our work with people who have mental disorders. Whatever we believe and expect is likely to come true.

If you want the people you work with to recover you need to start believing that they can, and you need to act upon that belief. Remember that recovery is built upon lots of little steps in the right direction and we can encourage that simply and effectively by doing relatively simple things, things like offering praise, acknowledgement, recognition and practical help, repeatedly and well.

That’s hardly rocket science, is it?

Complete the contact form below to arrange training for your staff.

Schizophrenia, social care and the tripartite recovery model

What is schizophrenia? How do reasonable attempts to cope with symptoms like voice-hearing come to be thought of as symptoms of illness in themselves? Why is it so easy to get diagnosed with schizophrenia? More importantly, how can we use an understanding of the diagnostic process to aid recovery?

In this short video Stuart Sorensen introduces the basic idea behind the tripartite recovery model and shows how meaningful recovery is really all about coping. It’s not magical and it’s not complicated. Like most of mental health work in social care it’s about doing relatively simple things, repeatedly and well. Do the things that help people to feel valued and to cope with their experiences and you’re more than half way there.

Complete the contact form below to arrange training for your staff.

The ‘family tree’ of mental health exercise

This is a simple exercise intended to be completed either individually or preferably by a group (up to around 16 people) in discussion. The idea is to help care workers to overcome the perception that mental health is difficult to understand by asking them to arrange these 21 cards as they think they should go. Click the link below to download the PDF…

Mental disorders family tree exercise

Give them the blanked out key to work from as though it’s a jigsaw with the key taking the place of the picture on the box. 

mh family tree diagnosis symptoms exercise training

Most groups are able to do this correctly without any help at all – just by process of elimination, the application of the things they already know and the clues they can glean from the key (length of blacked out words, number of items in each column etc). I’ve done this little exercise with countless groups and only rarely do they need any assistance. Those few groups that have needed help didn’t need much. 

The advantage of this exercise is that it works as a warm up, it gets participants talking early on and it boosts their confidence. It also provides the participants with a rough and ready mental schema to hang the rest of the day’s training on to. 

Follow it up with a discussion about the fact that, whilst mental health work might seem very complicated, at its most basic level it’s really just about these categories and symptom groups. There is, of course much more to learn but this little overview really is a damn good start!

Complete the contact form below to arrange training for your staff.

Mental health training – a short sample

This abridged, edited audio (& video slideshow) is taken from the introductory session of a 2012 mental health training day in Glasgow. Although not all of the session is included it gives a flavour of the day, the topics to be considered, the training aims and the insights to be expected throughout the day.

You can find a longer version (26 minutes) by clicking below…

Training courses

Complete the contact form below to arrange training for your staff.