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Psychosis online tutorial

Originally the #psychosis #webinar was set up to take only a single booking which has gone. So if you haven’t had a confirmation (if your initials aren’t ‘SD’) you haven’t booked. I’ve fixed it now. Please rebook by clicking the link below. Thanks, Stuart.

Glastonbury: Alternative therapy central… but is it real?

I’m fed up of coming across people, often with serious psychiatric or medical conditions who stop taking their evidence-based, imperfect but at least understood medications in favour of misunderstood, useless and even harmful ‘remedies’ from elsewhere. I’m sick and tired of reading adverts in theatres, hotels and social  clubs advertising psychic  mediums, faith healers and other woo practitioners who promise, without even a hint of embarrassment to be able to talk to dead people, to angels, to clean your soul, rebirth you, even to steam your womb, all for a small fee, of course.

My original plan was just to rant on my  Youtube  channel about it all but that seemed unfair. So I’ve come to the South West of England, to ‘woo central’ as one of my respondents described it to see if any of the practitioners here can convince me that what they do really is useful.

Even though I was very up front that I’m sceptical if not actually hostile to the very idea of alternative medicines because it either hasn’t been tested or has been shown not to work most people were friendly and had a great  deal to say about their beliefs and in defence of the treatments they offered, although only 4 agreed to be interviewed on camera.

It was fascinating to see what many Glastonbury people thought of as adequate evidence. For many it was merely to make a claim. If you can say it, if you can think it, that’s evidence.

For others, such as the lady I met on the street, simply stating the obvious was evidence enough.

One man in particular, Eddie the potter, whilst still having faith in some alternative therapies was clearly sick and tired of the woo merchants who spend their time ripping off ill people who really need help instead of exploitation.

I couldn’t help feeling that many of the people I spoke with, especially many of those who wouldn’t agree to be filmed are only too aware of the scam they’re engaged in. I won’t say all the healers are deliberate con artists. I met several who seemed sincere although their logic when trying to explain their work seemed confused. But I don’t doubt their sincerity.

Stoic joy

Stoicism isn’t only an antidote to anger and emotional distress. It’s a recipe for genuine joy – the kind of joy and wonder that comes from endless discovery and the satisfaction that ensues ‘just because’.

Stoics don’t need a reason to be joyful. It’s enough that we’re alive and able to be joyful.

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.

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It’s only 2017

Mental health recovery ‘past, present and future’

However we look at it mental health care has had a chequered past. From early demonization of anyone who was ‘different’ to the passive acceptance of ‘lunatics’ and ‘village idiots’ and even the high status of ‘Shamans’ and ‘seers’, society’s responses have been varied to say the least. Even today the social standing of those who hear voices differs greatly depending upon just whose voice the person claims to hear.

The voice-hearer who reports communing with aliens from Venus will be treated very differently from the medium who claims to interact with the dead. Yet their experiences may not be all that different – except, of course in the way that society responds to them.

The last few hundred years have seen massive changes throughout Europe and the rest of the Western world. The ‘asylum era’ operated a policy of ‘congregate and segregate’ in which people who didn’t quite ‘fit’ were segregated by sex and congregated in large, purpose built buildings away from the rest of society. The basic idea was ‘once a lunatic, always a lunatic’ and many people who would be fully integrated into modern society were written off as ‘hopeless’. But then it was only the middle of the nineteenth century.

The end of the asylum era really came about after world war one. Injured and shell-shocked troops needed hospital beds and the asylums were all but emptied to make room for them. The move back to the community had begun. The evidence of traumatised soldiers recovering (in part or on full) and returning either to active service or to civilian life changed the popular hopelessness about mental health to one of cautious optimism. Society began to rediscover the possibility of recovery. It was a beginning. It wasn’t the end of the journey – but then it was only 1918.

Not that everyone had entirely forgotten about recovery. Beginning in the late eighteenth century William Tuke, a Quaker philanthropist founded The York Retreat where he advocated Moral treatment with apparently remarkable results. Moral treatment was based upon the idea that dignity, social value and community involvement were the most important parts of rehabilitation. So everyone was given good food, clean quarters, fellowship and a clearly defined job, either on the retreat’s farm, helping to maintain the accommodation or some other worthwhile occupation. Tuke and others like him were rediscovering the value of social role in recovery.

By the mid twentieth century however our understanding of mental health had taken a very different tack. Social inclusion was still present but it had largely taken a back seat behind the biomedical model of mental health – the idea of the chemical cure or ‘a pill for every ill’. Unfortunately, in the case of the most severe mental disorders such as schizophrenia and bipolar disorder this much sought after chemical cure remained out of reach for most people. Medication could certainly relieve distress and other symptoms but recovery statistics in UK are not much better today than they were in 1952 when the first antipsychotic was developed and they weren’t brilliant then. But it was only 1952.

Today we take a more inclusive approach. It’s clear that neither social concerns nor medical interventions are enough by themselves. True recovery involves a combination of different strategies, some medical, some social, some environmental and some psychological. That’s why we talk about ‘stress’ and ‘vulnerability’. Different people have different vulnerabilities and need different approaches to overcome their problems. For some that means medication. For others it means social value and meaningful occupation. For most it means both.

The World Health Organisation’s International Study of Schizophrenia made it clear that those countries with the greatest degree of social inclusion also had the highest recovery rates. Social care and social acceptance matter just as much as medication and psychotherapy.

That’s where social care comes in. Support workers’ role is not to become too distracted by medical concerns about a pill for every ill. That’s what the psychiatrist does – and psychiatrists do their jobs extremely well as it is. The task of social care is to work alongside the psychiatrist to help fulfil the social care needs of the individual. Social care workers create a safe and positive environment with opportunities for meaningful activity and they help people to find a valued place in the world.

I believe that the next few decades will see even greater emphasis upon collaboration between medical and social care workers. I believe that social care workers will continue to grow beyond the image of the doctor’s assistant in the community. They will develop into a clearly defined specialty in our own right, separate from doctors, nurses, psychologists and even social workers. And as the specialty of social care develops, service users’ prospects of recovery from serious mental disorder will develop along with it.

We haven’t finished the journey toward the perfect service yet but we’re working on it. After all – it’s only 2017.

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Woohoo! I won a top 10 blog award of 2017

vueliotop10badge2017 (002)1572211420..jpgIt’s good to be appreciated. Having restarted my mental health blog last March after a relative absence of several years I didn’t expect to get any sort of recognition so soon. When ‘The Care Guy’ fell victim to austerity back in 2010 I more or less stopped mental health blogging and focussed upon other things instead.

My previous mental health blog awards were all years ago so it was especially lovely this afternoon to receive the vuelio 2017 top 10 mental health blog award. In my head I’ve been back on the mental health online scene for a while but now, it seems others have noticed too.

Definitely time to celebrate this evening, I think. Is it beer O’Clock yet?

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But first…

For the last few weeks I’ve more or less abandoned my newly revitalised business and focused my time encouraging people to vote for Labour in the General Election. Some have warned me of damage to my livelihood if I get into politics on social media. They may be right. We’ll see.

Personally I think it’s worth the risk to help ensure a return to fairness, social justice and compassion in UK. But the election is over now and I plan to get back to my first love – mental health and social care. So most of my pre-election posts are no longer visible online but before I go I’d like to make a  few observations about the campaign, the result, the political engagement of new voters and my ownhopes for the future. Please bear with me – normal service really will be resumed after this… honest 😉

Campaign styles

it was clear from the outset that tory campaigning would be the same as it has been for many years now. Smears and lies seem to be the mainstay of the Tory battle-style. This time they went all out, aided and abetted by international media giants who shared their need to discredit the man most likely to stop them ripping off the majority here in UK. Their claims were outrageous.

IMG_20170516_105420Jeremy Corbyn is a terrorist sympathiser. The ‘evidence’ is that he held peace talks with Sinn Fein and he wants us to stop bombing other countries. He also objects to the way that the present government sells arms to Saudi Arabia (a country that has strong links  with ISIS) and turns a blind eye to the use of British weapons to slaughter innocent people in various states around the world.

Diane Abbott is a racist. The ‘evidence’ is that she’s a black woman with the audacity to think she can tell white people to stop discriminating against other races.

Labour can’t manage money. The ‘evidence’ is that all previous Labour governments combined have had to borrow less money than the tory governments of the last 6 years.

Corbyn is unelectable. The ‘evidence’ is that he has been an elected MP for decades and has recently been overwhelmingly elected by the Labour party TWICE in recent years.

Labour can’t explain where the money will come from – there’s no ‘magic money tree’. The ‘evidence’ is that Labour’s manifesto was fully costed and workable with a £3.9 billion per annum cushion to protect us from unforeseen eventualities. This is in contrast to the tory budget which was not costed.


Labour is the party of high immigration. Immigration was lower under the last labour government and the manifesto laid out plans to reduce immigration again. The tories scrapped Labour’s main border controls under Home Secretary Theresa May, thus making it harder for UK to regulate immigration than it had been under Labour.

Labour’s corporation tax plans will drive companies away. In 2010 Corporation tax stood at 28% (lower than in any other G7 country). Labour planned to raise it back up to 26% (still lower than any other G7 country). Where exactly will these companies go?

Corbyn has no principles. The ‘evidence’ is that he has stuck firm to his principles of peace, equality and fairness throughout his career, even when his opposition to apartheid (whilst the tories were cosying up to the White supremacist South African regime) led to his arrest for protesting.


By way of contrast, Labour stuck to facts and policies. The Labour party advertised its policies well and highlighted the policies of other parties to ensure that people really understood the issues at hand. They highlighted hypocrisy and sleaze within the tory party only when they could back it up with facts – and there were many facts. Yet still – the main focus was not on the politics of hatred and smear but rather on information sharing and genuine concern for the democratic process. And the people responded to that.

Now that Theresa May has lost her majority, weakened her position and almost certainly made her position untenable within the tory party, embittered right wingers, disappointed at not having gained the promised tory majority in the House of Commons are desperately seeking to discredit the massive shift toward the left. They claim…

No Labour victory because Corbyn didn’t gain the most seats. Absolutely. Labour didn’t gain the most seats. That’s not the point. This election was supposed to consolidate the tory overall majority and consign Labour to electoral oblivion. Instead the tories have been humiliated and the Labour party has, in just 7 weeks done what the political pundits claimed was impossible. And they did this despite 2 years of media attack on Jeremy Corbyn and even attacks from within their own parliamentary party. Just imagine what would have happened had the General Election been planned for 2 weeks later? Just imagine what will happen when this weak and wobbly government falls and the next General Election is called (presumably before the end of 2017).

It’s just naïve children voting. What do they know? Actually that’s not the case. It’s true that young people have come to see the point of voting but so have many people from other age groups. British people of all ages have become increasingly disillusioned with politics ever since Blair watered down socialism so much that there was nothing left to choose between left and right. Jeremy Corbyn has revitalised British politics and the people have responded.

Age breakdown of the Labour vote GE2017

Socialism will never win another election in UK? Really? What political ideology just climbed over 20 percentage points in 7  weeks? And with that evidence behind him Jeremy Corbyn should easily unite the despairing Blairites who believed the neoliberal deception and persuade even more left wing voters to come out and vote next time. Prepare for a Labour landslide.

Socialists are just virtue-signallers. This is intended as an insult. Basically it means that anyone who shows compassion doesn’t really mean it and is only pretending to be compassionate for effect. Let’s think about what this means…

virtue signalling everywhere buzz lightyear

if someone believes that all compassion is insincere they must believe that all people are incapable of compassion. Since nobody can really know that about anyone except themselves the person using virtue-signalling as an insult is really just displaying their own lack of compassion, their own inability to empathise with the victims of tory ruthlessness. No wonder their electoral choices are beginning to fail. A nation built upon callousness and indifference cannot stand for long.

So thankyou to all who voted Labour this  week, especially those who voted for the first time. Together we have shown what can happen when people with integrity oppose the dis-virtuous and turnout in numbers. We’ll need to do this again soon but probably only once. Then we’ll have 5 years in which to see Labour rebuild our divided, despairing society.

Thankyou for restoring my faith in the Great British people.
Now then – where’s that book of Mental Health law got to?


Saviour fantasists in #socialcare

Don’t be a #socialcare saviour fantasist

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