Tag Archives: Stuart Sorensen

Stoicism for mental health 2: What can we control?

Today we consider the very first principle of Stoicism as defined by Epictetus in his handbook, The Enchiridion. What can we control and what can’t we control?

This means understanding the difference between problems and facts.

Stoics choose not to waste energy or emotional effort on facts that they cannot change – it’s pointless. Instead they work on things they can change, control or influence. That means they work on (and worry about) surprisingly little.

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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.

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Depression? What depression?

We all have good days and bad days. That’s part of being human. We call it normal mood fluctuation. Sometimes we feel great. Other times… not so much.

It’s important to understand what this normal mood fluctuation is about. And what it’s not. Feeling fed up or ‘a bit sad’ is NOT a depressive illness. If your mood has been low for a few days, or even less because of a personal tragedy, or even without a tragedy, that’s not depression.


Depression lasts weeks and months.

Depression is an illness with physiological symptoms.

Depressed people have trouble with sleep… With appetite… With concentration… With movement… It’s much more than just a low mood.

So when you feel a bit sad don’t assume you need antidepressants and run off to the the doctor to get some. It’s OK to have good days and bad days That’s part of the human condition It’s part of being who we are.

And when you meet someone who really is depressed, understand that they’re experiencing something far more profound than being ‘a bit sad’. They’re not about to pull themselves together, howeer much you tell them to. If they could have done that they would have done so already.

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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

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Depression part 2: The psychology of depression

The cognitive or psychological symptoms of depression (what we think about) are just as important as the physiological ones. Some people believe that psychological symptoms are more important but this is not necessarily true. After all there is no such thing as the ‘mind/body split’.

Depressed people tend to think in a particular way. They tell themselves the same sort of gloomy, pessimistic things over and over again. This is what psychologists call negative thinking. After a while this pattern of thinking becomes a habit. When that happens it is described as automatic negative thinking. This habit formation is one of the most damaging aspects of depression as it locks the sufferer into a downward spiral which drags them deeper and deeper into despair.

Thinking errors 2General thinking errors

There are three ‘general’ thinking errors that are important to understand not only for depression but many forms of mental ill health. The three ‘general thinking errors’ are…

Ignoring the positive

People seem much more likely to focus upon bad things that happen to them than they are upon the good.

Exaggerating the negative

Having focussed upon bad stuff many people then seem to blow it out of all proportion until it overwhelms them.


One swallow doesn’t make a summer. One difficult conversation doesn’t mean it’s going to be one of those days and a couple of frustrations this week don’t mean you’ll never succeed at anything.

Let’s look at some more precise forms of depressed thinking.

Things will never get any better

If we believe this then we also believe that there’s no point in trying to improve things. This one thought stops depressed people from joining in with their treatment plans. These people become lethargic and apathetic. Not the most helpful start to recovery.

People would be better off without me

It’s not difficult to see where this thought pattern is leading. Many depressed people are so convinced of their own worthlessness that they come to see themselves as nothing more than a burden to others. This idea can lead to withdrawal, social isolation, shame and even self-harm or suicide. Once again this is not a helpful way to think about oneself.

I can’t help being depressed after what I’ve been through

This is a remarkably common depressive thought. It also seems quite reasonable at first glance. People who’ve been through difficult times are almost expected to become depressed. The problem is that such a belief system takes away the individual’s choices. If you believe depression is inevitable you won’t really struggle against it and so you won’t change it until you believe you’ve suffered enough. It’s often interesting to ask people how much suffering will be enough.

Some people ‘wear’ their depression like a badge. It’s as though they think they’ve earned it and no one’s going to take it away from them. Of course it’s true that they have a perfect right to feel as depressed as they like for as long as they like. The question is – why would they want to?

Depression runs in my family – it’s genetic

This attitude is called determinism. That’s the idea that people are helpless victims of fate. They believe that because their parents suffered from depression they also must. Of course it’s true that depressive illness does often run in families but that’s not always because of genetics. Sometimes it’s simply because of the coping skills we learn from our parents. Skills which can be unlearned or altered – often with surprisingly little effort. Even those people whose depression does appear to be genetic can be helped considerably once they let go of their deterministic attitudes. Any thought that implies helplessness is deterministic and extremely damaging.

What can depressed people do to help themselves?

  • Avoid alcohol – particularly in excess;
  • Don’t smoke – it starves the tissues and brain of oxygen and causes lethargy;
  • Eat a healthy diet designed to provide plenty of energy;
  • Take regular aerobic exercise. A brisk walk is usually sufficient;
  • Stop talking/thinking about depression and concentrate on doing things instead. Get involved in a worthwhile project of some kind;
  • Keep mentally active;
  • Write goals, even little ones to keep motivated;
  • Resolve to make the best of every situation;
  • Adopt happy physiology – stand straight, move quickly, smile;

Become an ‘inverse paranoid’. Expect good things to happen every day. This doesn’t necessarily mean the world will treat anyone better – but it does mean that people notice good things when they do happen and won’t waste time ruminating about or getting paranoid over the little inconveniences that happen to us all.

The simple truth is that if depressed people wait around for someone else to make things better for them it just won’t happen. However since one of the symptoms of depression is lack of motivation the big danger is that they will do just that. Your job as support worker is to motivate service users to take responsibility for their mood and circumstances while still giving assistance as needed.

This can be a difficult balance to strike. The general rule of thumb is to intervene less and less over time as the service user is encouraged to do more and more for themselves. But be careful. This isn’t an excuse to abandon people who really need our help – simply an awareness that they need to work toward greater independence as time goes on.

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Understanding and working with anxiety in health and social care

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In this video I discuss the evolutionary roots of anxiety, its purpose as a call to action and the way to manage it in the modern world. Beginning with broad principles of freeze, flight and fight we consider the role of the brain’s primitive limbic system (reprile brain) in anxiety, the Freudian concept of appropriate and inappropriate anxiety and ways to help people to overcome it. We consider the basics of relaxation, of anxiety management and the ‘3 stage test’ to help people regain perspective.

We consider reassurance and the folly of offering reassurances we can’t back up with facts – that just demonstrates us to be untrustworthy or ill-informed, causing the anxious person to reject our attempts to help them altogether.

Finally we consider the role of gradual desensitisation (exposure therapy) as opposed to ‘flooding’ in a quest to help people to build up positive memories of facing the thing they fear.

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