TV dramas give misleading view of mental illness

December 23rd, 2010

Television dramas too often portray characters with mental health problems as ‘dangerous’, according to a study of peak-time programmes. Almost half (45 per cent) of fictional characters with mental illness have storylines depicting them as violent or posing a threat to others, says a report by Shift, the campaign to tackle the stigma associated with mental health issues. In addition 63 per cent of references to mental health in TV soaps and drama were ‘pejorative, flippant or unsympathetic’.

The study, by the Glasgow Media Group, examined three months of drama programmes on British terrestrial channels from 1 January this year. ‘Some of this study suggests that mental illness is still used as an easy source of violent tragedy or as something to poke fun at,’ said the report, called Making a Drama out of a Crisis. Even soaps commended for raising awareness of mental ill health, such as EastEnders’ character Stacey Branning’s struggle with bipolar disorder, end in violence.

The study noted increased use of telephone helplines or websites after episodes that featured mental health. One example was the peak in hits to the Manic Depression Fellowship website which matched the story twists in EastEnders’ high profile bipolar disorder story.

The Guardian

posted by Counselling Madrid. The referral service for counselling in spain.

Chocolate lovers are more depressive

November 21st, 2010

People who regularly eat chocolate are more depressive, experts have found. Research published in the Archives of Internal Medicine shows those who eat at least a bar every week are more glum than those who only eat chocolate now and again. Many believe chocolate has the power to lift mood and the US team say this may be true, although scientific proof is lacking. But they say they cannot rule out that chocolate may be a cause rather than a cure for being depressed.

In the study, which included nearly 1,000 adults, the more chocolate the men and women consumed, the lower their mood. Those who ate the most – more than six regular 28g size bars a month – scored the highest on depression. None of the men and women were on antidepressants or had been diagnosed as clinically depressed by a doctor.

Dr Natalie Rose and her colleagues from the University of California, San Diego, say there are many possible explanations for their findings, and that these need to be explored. It may simply be that people who are depressed crave chocolate as a ‘self-treatment’ to lift mood, or depression may drive the craving without any beneficial effect.

Mid-life crisis arriving earlier

November 21st, 2010

Increasing work hassles, money worries and loneliness mean people aged 35 to 44 are the unhappiest in society, a study by Relate says. The age group came out worst in a series of measures, with 40 per cent saying they had been cheated on by a partner and 21 per cent complaining of loneliness a lot of the time. Relate CEO Claire Tyler said her counsellors see more 35 to 44 year olds than any other agre group. “Traditionally we associate the mid-life crisis with people in their late 40s to 50s, but the report reveals that this period could be reaching people earlier. It’s when life gets really hard – you’re starting a family, pressure at work can be immense, and increasinly money worries can be crippling. We cannot afford to sit back and watch this happen.”

The Independant

The Downside of Positivity

October 18th, 2010

Americans are a ‘positive’ people. This is our reputation as well as our self-image. We smile a lot and are often baffled when people from other cultures do not return the favour. In the well-worn stereotype, we are upbeat, cheerful, optimistic and shallow, while foreigners are likely to be subtle, world-weary and possibly decadent. American expatriate writers like Henry James and James Baldwin wrestled with and occasionally reinforced this stereotype, which I encountered in the 1980s in the form of a remark by Soviet émigré poet Joseph Brodsky to the effect that the problem with Americans is that they have ‘never known suffering’. (Apparently he didn’t know who had invented the blues.) Whether we Americans see it as an embarrassment or a point of pride, being positive – in affect, in mood, in outlook – seems to be engrained in our national character.

Who would be churlish or disaffected enough to challenge these happy features of the American personality? Take the business of positive ‘affect’, which refers to the mood we display to others through our smiles, our greetings, our professions of confidence and optimism. Scientists have found that the mere act of smiling can generate positive feelings within us, at least if the smile is not forced. In addition, good feelings, as expressed through our words and smiles, seem to be contagious. ‘Smile and the world smiles with you.’ Surely the world would be a better, happier place if we all greeted one another warmly and stopped to coax smiles from babies – if only through the well-known social psychological mechanism of ‘mood contagion’. Recent studies show that happy feelings flit easily through social networks, so that one person’s good fortune can brighten the day even for only distantly connected others.1

Furthermore, psychologists today agree that positive feelings like gratitude, contentment and self-confidence can actually lengthen our lives and improve our health. Some of these claims turn out to be exaggerated… though positive feelings hardly need to be justified, like exercise or vitamin supplements, as part of a healthy lifestyle. People who report having positive feelings are more likely to participate in a rich social life, and vice versa, and social connectedness turns out to be an important defence against depression, which is a known risk factor for many physical illnesses. At the risk of redundancy or even tautology, we can say that on many levels, individual and social, it is good to be ‘positive’, certainly better than being withdrawn, aggrieved, or chronically sad.

So I take it as a sign of progress that, in just the last decade or so, economists have begun to show an interest in using happiness rather than just the gross national product as a measure of an economy’s success. Happiness is, of course, a slippery thing to measure or define. Philosophers have debated what it is for centuries, and even if we were to define it simply as a greater frequency of positive feelings than negative ones, when we ask people if they are happy we are asking them to arrive at some sort of average over many moods and moments…

In addition to the problems of measurement, there are cultural differences in how happiness is regarded and whether it is even seen as a virtue. Some cultures, like our own, value the positive affect that seems to signal internal happiness; others are more impressed by seriousness, self-sacrifice, or a quiet willingness to co-operate. However hard to pin down, though, happiness is somehow a more pertinent metric for wellbeing, from a humanistic perspective, than the buzz of transactions that constitute the GDP.

Surprisingly, when psychologists undertake to measure the relative happiness of nations, they routinely find that Americans are not, even in prosperous times and despite our vaunted positivity, very happy at all. A recent meta-analysis of over 100 studies of self-reported happiness worldwide found Americans ranking only 23rd, surpassed by the Dutch, the Danes, the Malaysians, the Bahamians, the Austrians, and even the supposedly dour Finns.2 In another potential sign of relative distress, Americans account for two-thirds of the global market for antidepressants, which happen to be the most commonly prescribed drugs in the United States. To my knowledge, no one knows how antidepressant use affects people’s responses to happiness surveys: do respondents report being happy because the drugs make them feel happy or do they report being unhappy because they know they are dependent on drugs to make them feel better? Without our heavy use of antidepressants, Americans would likely rank far lower in the happiness ratings than we currently do…

How can we be so surpassingly ‘positive’ in self-image and stereotype without being the world’s happiest and best-off people? The answer, I think, is that positivity is not so much our condition or our mood as it is part of our ideology – the way we explain the world and think we ought to function within it. That ideology is ‘positive thinking’, by which we usually mean two things. One is the generic content of positive thinking – that is, the positive thought itself – which can be summarised as: Things are pretty good right now, at least if you are willing to see silver linings, make lemonade out of lemons, etc, and things are going to get a whole lot better. This is optimism, and it is not the same as hope. Hope is an emotion, a yearning, the experience of which is not entirely within our control. Optimism is a cognitive stance, a conscious expectation, which presumably anyone can develop through practice.

The second thing we mean by ‘positive thinking’ is this practice, or discipline, of trying to think in a positive way. There is, we are told, a practical reason for undertaking this effort: positive thinking supposedly not only makes us feel optimistic but actually makes happy outcomes more likely. If you expect things to get better, they will. How can the mere process of thinking do this? In the rational explanation that many psychologists would offer today, optimism improves health, personal efficacy, confidence, and resilience, making it easier for us to accomplish our goals. A far less rational theory also runs rampant in American ideology – the idea that our thoughts can, in some mysterious way, directly affect the physical world. Negative thoughts somehow produce negative outcomes, while positive thoughts realise themselves in the form of health, prosperity and success. For both rational and mystical reasons, then, the effort of positive thinking is said to be well worth our time and attention, whether this means reading the relevant books, attending seminars and speeches that offer the appropriate mental training, or just doing the solitary work of concentration on desired outcomes – a better job, an attractive mate, world peace.

There is an anxiety, as you can see, right here in the heart of American positive thinking. If the generic ‘positive thought’ is correct and things really are getting better, if the arc of the universe tends towards happiness and abundance, then why bother with the mental effort of positive thinking? Obviously, because we do not fully believe that things will get better on their own. The practice of positive thinking is an effort to pump up this belief in the face of much contradictory evidence. Those who set themselves up as instructors in the discipline of positive thinking – coaches, preachers, and gurus of various sorts – have described this effort with terms like ‘self-hypnosis’, ‘mind-control’, and ‘thought control’. In other words, it requires deliberate self-deception, including a constant effort to repress or block out unpleasant possibilities and ‘negative’ thoughts. The truly self-confident, or those who have in some way made peace with the world and their destiny within it, do not need to expend effort censoring or otherwise controlling their thoughts. Positive thinking may be a quintessentially American activity, associated in our minds with both individual and national success, but it is driven by a terrible insecurity…

While positive thinking has reinforced and found reinforcement in American national pride, it has also entered into a kind of symbiotic relationship with American capitalism. There is no natural, innate affinity between capitalism and positive thinking. In fact, one of the classics of sociology, Max Weber’s Protestant Ethic and the Spirit of Capitalism, makes a still impressive case for capitalism’s roots in the grim and punitive outlook of Calvinist Protestantism, which required people to defer gratification and resist all pleasurable temptations in favour of hard work and the accumulation of wealth.

But if early capitalism was inhospitable to positive thinking, ‘late’ capitalism, or consumer capitalism, is far more congenial, depending as it does on the individual’s hunger for more and the firm’s imperative of growth. The consumer culture encourages individuals to want more – cars, larger homes, television sets, cell phones, gadgets of all kinds – and positive thinking is ready at hand to tell them they deserve more and can have it if they really want it and are willing to make the effort to get it. Meanwhile, in a competitive business world, the companies that manufacture these goods and provide the paycheques that purchase them have no alternative but to grow. If you don’t steadily increase market share and profits, you risk being driven out of business or swallowed by a larger enterprise. Perpetual growth, whether of a particular company or an entire economy, is of course an absurdity, but positive thinking makes it seem possible, if not ordained.

In addition, positive thinking has made itself useful as an apology for the crueler aspects of the market economy. If optimism is the key to material success, and if you achieve an optimistic outlook through the discipline of positive thinking, then there is no excuse for failure. The flip side of positivity is thus a harsh insistence on personal responsibility: if your business fails or your job is eliminated, it must be because you didn’t try hard enough, didn’t believe firmly enough in the inevitability of your success. As the economy has brought more layoffs and financial turbulence to the middle class, the promoters of positive thinking have increasingly emphasised this negative judgement: to be disappointed, resentful, or downcast is to be a ‘victim’ and a ‘whiner’…

At the turn of the 21st century American optimism seemed to reach a manic crescendo. In his final State of Union address in 2000, Bill Clinton struck a triumphal note, proclaiming that ‘never before has our nation enjoyed, at once, so much prosperity and social progress with so little internal crisis and so few external threats’. But compared with his successor, Clinton seemed almost morose. George W Bush had been a cheerleader in prep school, and cheerleading – a distinctly American innovation – could be considered the athletically inclined ancestor of so much of the coaching and ‘motivating’ that has gone into the propagation of positive thinking. He took the presidency as an opportunity to continue in that line of work, defining his job as that of inspiring confidence, dispelling doubts, and pumping up the national spirit of self-congratulation. If he repeatedly laid claim to a single adjective, it was ‘optimistic’. On the occasion of his 60th birthday, he told reporters he was ‘optimistic’ about a variety of foreign policy challenges, offering as an overview, ‘I’m optimistic that all problems will be solved.’ Nor did he brook any doubts or hesitations among his close advisors. According to Bob Woodward, Condoleezza Rice failed to express some of her worries because, she said, ‘the president demanded optimism. He didn’t like pessimism, hand-wringing or doubt.’3

Then things began to go wrong, which is not in itself unusual but was a possibility excluded by America’s official belief that things are good and getting better. There was the dot-com bust that began a few months after Clinton’s declaration of unprecedented prosperity in his final State of the Union address, then the terrorist attack of September 11, 2001. Furthermore, things began to go wrong in a way that suggested that positive thinking might not guarantee success after all, that it might in fact dim our ability to fend off real threats. In her remarkable book, Never Saw It Coming: Cultural Challenges to Envisioning the Worst, sociologist Karen Cerulo recounts a number of ways that the habit of positive thinking, or what she calls optimistic bias, undermined preparedness and invited disaster. She quotes Newsweek reporters Michael Hirsch and Michael Isikoff, for example, in their conclusion that ‘a whole summer of missed clues, taken together, seemed to presage the terrible summer of 2001’.4 There had already been a terrorist attack on the World Trade Centre in 1993; there were ample warnings, in the summer of 2001, about a possible attack by airplane, and flight schools reported suspicious students like the one who wanted to learn how to ‘fly a plane but didn’t care about landing and take-off’. The fact that no one – the FBI, the INS, Bush, or Rice – heeded these disturbing cues was later attributed to a ‘failure of imagination’. But actually there was plenty of imagination at work – imagining an invulnerable nation and an ever-booming economy – there was simply no ability or inclination to imagine the worst…

Positive equals good
What can we be if not positive? ‘I do believe in the power of positive thinking,’ veteran newspaper editor Ben Bradlee wrote recently. ‘I don’t know any other way to live.’ 5 We’ve gone so far down this yellow brick road that positive seems to us not only normal but normative – the way you should be. A restaurant not far from where I live calls itself the Positive Pizza and Pasta Place, apparently distinguishing itself from the many sullen and negative Italian dining options. A veteran human resources executive, baffled by my questions about positive thinking in the workplace, ventured hesitantly, ‘But isn’t positive… ​good?’ He was right: we have come to use the words ‘positive’ and ‘good’ almost interchangeably. In this moral system, either you look on the bright side, constantly adjusting your attitude and revising your perceptions – or you go over to the dark side.

The alternative to positive thinking is not, however, despair. In fact, negative thinking can be just as delusional as the positive kind. Depressed people project their misery onto the world, imagining worst outcomes from every endeavour and then feeding their misery on these distorted expectations. In both cases, there is an inability to separate emotion from perception, a willingness to accept illusion for reality, either because it feels good or, in the depressive’s case, because it reinforces familiar, downwardly spiralling neural pathways. The alternative to both is to try to get outside of ourselves and see things as they are, or as uncoloured as possible by our own feelings and fantasies, to understand that the world is full of both danger and opportunity – the chance of great happiness as well as the certainty of death.

This is not easy. Our moods affect our perceptions, as do the moods of others around us, and there will always be questions about the reliability of the evidence. Generally it helps to recruit the observations of others, since our individual perceptions could be erroneous, and whether the issue has to do with the approach of a marauding leopard or the possibility of a financial downturn, the more information we can gather the better off we are. This is the project of science: to pool the rigorous observations of many people into a tentative accounting of the world, 
which will of course always be subject to revisions arising from fresh observations.

But the group – whether it’s a prehistoric band of 40 people, the president’s National Security Council, or the American Psychological Association – is not entirely trustworthy either. No matter how intelligent and well informed its members are, the group may fall into the grip of collective delusions, frenzies, intellectual fads, or what has been identified in recent decades as group think. There seems to be an evolutionary paradox at work here: human survival in the face of multiple threats depended on our ability to live in groups, but the imperative of maintaining group cohesion can sometimes override realism and common sense, making us hesitate to challenge the consensus or be the bearer of bad news. So, after checking with others, it remains the responsibility of each individual to sift through the received wisdom, insofar as possible, and decide what’s worth holding on to. This can require the courage of a Galileo, the iconoclasm of a Darwin or Freud, the diligence of a homicide detective.

At issue is not only knowledge of the world but our survival as individuals and as a species. All the basic technologies ever invented by humans to feed and protect themselves depend on a relentless commitment to hard-nosed empiricism: you cannot assume that your arrowheads will pierce the hide of a bison or that your raft will float just because the omens are propitious and you have been given supernatural reassurance that they will. You have to be sure. Prehistoric humans had to make a careful study of the natural world and the materials it offered them – for example, rocks, clay, plant fibres, animal sinews. Then they had to experiment until, through trial and error, they found what actually works. Without a doubt, throughout our several hundred thousand years of existence on earth, humans have also been guided by superstition, mystical visions, and collective delusions of all sorts. But we got where we are, fanning out over the huge continent of Africa and from there all over the earth, through the strength of the knots we could tie, the sturdiness of shelters and boats, the sharpness of spearheads.

Human intellectual progress, such as it has been, results from our long struggle to see things as they are, or in the most universally comprehensible way, and not as projections of our own emotions. Thunder is not a tantrum in the sky, disease is not a divine punishment, and not every death or accident results from witchcraft. What we call the Enlightenment and hold on to only tenuously, by our fingernails, is the slow-dawning understanding that the world is unfolding according to its own inner algorithms of cause and effect, probability and chance, without any regard for human feelings.

Seeing things as they are
I realise that after decades of positive thinking the notion of realism, of things as they are, may seem a little quaint. But even in America, the heartland of positive thinking, some stubborn strain of realism has persisted throughout these years of delusion. When the stakes are high enough and the risks obvious, we still turn to people who can be counted on to understand those risks and prepare for worst-case scenarios. A chief of state does not want to hear a general in the field say that he hopes to win tomorrow’s battle or that he’s visualising victory; he or she wants one whose plans include the possibility that things may go very badly, and fall-back positions in case they do…

In our daily lives, too, all of us, no matter how determinedly upbeat, rely on what psychologist Julie Norem calls defensive pessimism to get through the day.6 Not only pilots need to envision the worst; so does the driver of a car. Should you assume, positively, that no one is going to cut in front of you or, more negatively, be prepared to brake? Most of us would choose a physician who is willing to investigate the most dire possibilities rather than one who is known to settle quickly on an optimistic diagnosis. In matters of the heart as well, a certain level of negativity and suspicion is universally recommended. You may try to project a thoroughly positive outlook in order to attract a potential boyfriend, but you are also advised to Google him. When people write to advice columnists about their suspicions as to a spouse’s infidelity, they are told not to ignore the warnings and think positively but to confront the problem openly…

When our children are old enough, and if we can afford to, we send them to college, where despite the recent proliferation of courses on happiness and positive psychology, the point is to acquire the skills not of positive thinking but of critical thinking, and critical thinking is inherently sceptical. The best students – and in good colleges, also the most successful – are the ones who raise sharp questions, even at the risk of making a professor momentarily uncomfortable. Whether the subject is literature or engineering, graduates should be capable of challenging authority figures, going against the views of their classmates, and defending novel points of view. This is not because academics value contrarianism for its own sake but because they recognise that a society needs people who will do exactly what the gurus of positive thinking warn us to avoid – ‘overintellectualise’ and ask hard questions. Physicians are among the highly educated professionals who dare not risk the comforts of positive thinking in their daily work, and as one of them, author and surgeon Atul Gawande, has written: ‘Whether one is fighting a cancer, an insurgency or just an unyielding problem at work, the prevailing wisdom is that thinking positive is the key… to success. But the key, it seems to me, is actually negative thinking: looking for, and sometimes expecting, failure.’7

Realism – to the point of defensive pessimism – is a prerequisite not only for human survival but for all animal species. Watch almost any wild creature for a few moments and you will be impressed, above all, by its vigilance. The cormorant restlessly scans the water for unexpected splashes; the deer cocks its head to pick up stray sounds and raises a foot in preparation for flight. Many animals – from monkeys to birds – augment their individual watchfulness by living in groups so that many eyes can be on the lookout for intruders, many voices raised in an alarm call, should one approach. In its insistence that we concentrate on happy outcomes rather than on lurking hazards, positive thinking contradicts one of our most fundamental instincts, one that we share not only with other primates and mammals but with reptiles, insects, and fish.

The rationale of the positive thinkers has been that the world is not, or at least no longer is, the dangerous place we imagined it to be. This is how Mary Baker Eddy saw it: the universe was ‘Supply’ and ‘Abundance’ made available to everyone by a benevolent deity. Sin, crime, disease, poverty – all these were ‘errors’ wrought by minds that had fallen out of resonance with the cosmic vibrations of generosity and love. A hundred years later, Martin Seligman, the founder of positive psychology, was describing anxiety and pessimism as unhelpful vestiges of our Paleolithic past, when our ancestors scrambled to avoid predators, ‘flood, and famine’. Today, however, ‘goods and services are plentiful’, as he put it; there is enough to go around, and we can finally let our guard down. Any lingering dissatisfaction is, as Eddy would have said, a kind of error – correctible through the right self-help techniques and optimism exercises.

Real threats to happiness
But has the human outlook really been improving over time? For affluent individuals in peaceful settings, decidedly yes, but our overall situation is as perilous as it has ever been. Even some of the most positive-thinking evangelical pastors have recently acknowledged the threat of global warming. The notion that the world’s supply of oil may have peaked is no longer the province of a few environmentally minded kooks; doomsters are gaining respectability. Everywhere we look, the forests are falling, the deserts are advancing, the supply of animal species is declining. The seas are rising, and there are fewer and fewer fish in them to eat.

Over the last couple of decades, as icebergs sank and levels of debt mounted, dissidents from the prevailing positive-thinking consensus were isolated, mocked, or urged to overcome their perverse attachment to negative thoughts. Within the United States, any talk of intractable problems like poverty could be dismissed as a denial of America’s greatness. Any complaints of economic violence could be derided as the whining of self-selected victims.

It’s easy to see positive thinking as a uniquely American form of naïveté, but it is neither uniquely American nor endearingly naïve. In vastly different settings, positive thinking has been a tool of political repression worldwide. We tend to think that tyrants rule through fear – fear of the secret police, of torture, detention, the gulag – but some of the world’s most mercilessly authoritarian regimes have also demanded constant optimism and cheer from their subjects. In his book Shah of Shahs, about life under the shah of Iran, who ruled until the revolution of 1979, Ryszard Kapuscinski tells the story of a translator who managed to get a poem published despite the fact that it included the seditious line ‘Now is the time of sorrow, of darkest night.’ The translator was elated at being able to get the poem past the censors, in this country where everything is supposed to inspire optimism, blossoming, smiles – suddenly ‘the time of sorrow’! Can you imagine?8

Soviet-style communism, which we do not usually think of as a cheerful sort of arrangement, exemplified the use of positive thinking as a means of social control. Writing of the former Yugoslavia at the beginning of the 21st century, Dubravka Ugresic observed that ‘former communists, modern capitalists, nationalists, religious fanatics’ were all picking up on the fresh breeze of positivity from the West. ‘They have all become optimists.’ But this was hardly something new, she went on, because ‘optimism has a stain on its ideological record… If anything has survived Stalinism itself, it is the Stalinist demand for optimism.’9 In the Soviet Union, as in the Eastern European states and North Korea, the censors required upbeat art, books, and films, meaning upbeat heroes, plots about fulfilling production quotas, and endings promising a glorious revolutionary future. Czechoslovakian literature was suffused with blind optimism; North Korean short stories still beam with relentless optimism. In the Soviet Union itself, being charged with a lack of historical optimism meant being charged with distortion of the truth or transmission of false truths. Pessimism and ideological wavering meant the same thing… ​In various disputes, the possibility of an alienated and lonely hero in socialism was forbidden in the name of the demands for historical optimism and a positive hero.10

The penalties for negative thinking were real. Not to be positive and optimistic was to be ‘defeatist’, and, as Ugresic writes of the Soviet Union, defeatists paid for the sin of defeatism. Accusing someone of spreading defeatism condemned him to several years in Stalinist camps.9 In his 1968 novel, The Joke, the Czech writer Milan Kundera has a character send a postcard bearing the line ‘Optimism is the opium of the people’, for which the character is accused of being an enemy of the people and sentenced to hard labour in the coal mines. Kundera himself was punished for daring to write The Joke. He was expelled from the Communist Party, saw his works removed from libraries and bookstores, and was banned from travelling to the West.

American preachers of positive thinking would no doubt be appalled to find themselves mentioned in the same breath or even the same book as Stalinist censors and propagandists. After all, Americans exalt individual success, which was not a communist ideal, and no one gets hauled off to labour camps for ignoring their teachings. But even among American proponents of positive thinking, you can find a faint uneasiness about its role as a mental discipline, a form of self-hypnosis involving affirmations, visualisations, and tightly focused thoughts. ‘Don’t think of “thought control” as a repressive tool out of George Orwell’s 1984,’ John Templeton advised the readers of one of his self-help books. ‘Rather, think of it as a positive force that will leave your mind clearer, more directed, and more effective.’11

The big advantage of the American approach to positive thinking has been that people can be counted on to impose it on themselves. Stalinist regimes used the state apparatus – schools, secret police, and so on – to enforce optimism; capitalist democracies leave this job to the market. In the West, as we have seen, the leading proponents of positive thinking are entrepreneurs in their own right, marketing their speeches, books, and DVDs to anyone willing to buy them. Large companies may make their employees listen to the speeches and may advise them to read the books; they may fire people who persist in a negative attitude. But it’s ultimately up to the individual to embrace positive thinking and do the hard work of attitude adjustment and maintenance on him- or herself. And judging from the sales of motivational products and the popularity of figures like Oprah and Osteen, this is a task that large numbers of Americans have eagerly undertaken on their own.

Yet, as the cover story of the January 2009 issue of Psychology Today acknowledges, the American infatuation with positive thinking has not made us happier. Lumping academic positive psychology and the ever-growing host of ‘self-appointed experts’ together into what he calls the ‘happiness movement’, the writer notes that, ‘according to some measures, as a nation we’ve grown sadder and more anxious during the same years that the happiness movement has flourished; perhaps that’s why we’ve eagerly bought up its offerings. 12 This finding should hardly come as a surprise: positive thinking did not abolish the need for constant vigilance; it only turned that vigilance inward. Instead of worrying that one’s roof might collapse or one’s job be terminated, positive thinking encourages us to worry about the negative expectations themselves and subject them to continual revision. It ends up imposing a mental discipline as exacting as that of the Calvinism it replaced – the endless work of self-examination and self-control or, in the case of positive thinking, self-hypnosis. It requires, as historian Donald Meyer puts it, constant repetition of its spirit lifters, constant alertness against impossibility perspectives, constant monitoring of rebellions of body and mind against control. 13

Positive thought control
This is a burden that we can finally, in good conscience, put down. The effort of positive ‘thought control’, which is always presented as such a life preserver, has become a potentially deadly weight – obscuring judgement and shielding us from vital information. Sometimes we need to heed our fears and negative thoughts, and at all times we need to be alert to the world outside ourselves, even when that includes absorbing bad news and entertaining the views of negative people. As we should have learned by now, it is dangerous not to.

A vigilant realism does not foreclose the pursuit of happiness; in fact, it makes it possible. How can we expect to improve our situation without addressing the actual circumstances we find ourselves in? Positive thinking seeks to convince us that such external factors are incidental compared with one’s internal state or attitude or mood. We have seen how the coaches and gurus dismiss real-world problems as ‘excuses’ for failure and how positive psychologists have tended to minimise the ‘C’, for circumstances, in their happiness equation. It’s true that subjective factors like determination are critical to survival and that individuals sometimes triumph over nightmarish levels of adversity. But mind does not automatically prevail over matter, and to ignore the role of difficult circumstances – or worse, attribute them to our own thoughts – is to slide toward the kind of depraved smugness Rhonda Byrne expressed when confronted with the tsunami of 2006. Citing the law of attraction, she stated that disasters like tsunamis can happen only to people who are on the same frequency as the event. 14

Worldwide, the most routine obstacle to human happiness is poverty. To the extent that happiness surveys can be believed, they consistently show that the world’s happiest countries tend also to be among the richest. While the United States ranks 23rd and the United Kingdom 41st, for example, India comes in a gloomy 125th out of 178 nations.2 Some recent studies find furthermore that, within countries, richer people tend to be happier, with about 90 per cent of Americans in households earning at least $250,000 a year reporting being very happy, compared with only 42 per cent of people in households earning less than $30,000.15 When the New York Times surveyed New York neighbourhoods in 2009, it found that the happiest areas were also the most affluent and, not coincidentally, the most thickly supplied with cafés, civic associations, theatres, and opportunities for social interaction. The least happy neighbourhood was a part of the Bronx characterised by abandoned buildings, mounds of uncollected garbage, and the highest unemployment rate in the city.16

For centuries, or at least since the Protestant Reformation, Western economic elites have flattered themselves with the idea that poverty is a voluntary condition. The Calvinist saw it as a result of sloth and other bad habits; the positive thinker blamed it on a wilful failure to embrace abundance. This victim-blaming approach meshed neatly with the prevailing economic conservatism of the last two decades. Welfare recipients were pushed out into low-wage jobs, supposedly, in part, to boost their self-esteem; laid-off and soon-to-be-laid-off workers were subjected to motivational speakers and exercises. But the economic meltdown should have undone, once and for all, the idea of poverty as a personal shortcoming or dysfunctional state of mind. The lines at unemployment offices and churches offering free food include strivers as well as slackers, habitual optimists as well as the chronically depressed. When and if the economy recovers we can never allow ourselves to forget how widespread our vulnerability is, how easy it is to spiral down toward destitution.

Happiness is not, of course, guaranteed even to those who are affluent, successful, and well loved. But that happiness is not the inevitable outcome of happy circumstances does not mean we can find it by journeying inward to revise our thoughts and feelings. The threats we face are real and can be vanquished only by shaking off self-absorption and taking action in the world. Build up the levees, get food to the hungry, find the cure, strengthen the first responders! We will not succeed at all these things, certainly not all at once, but – if I may end with my own personal secret of happiness – we can have a good time trying.

Barbara Ehrenreich exposes the psychological effects of a world which tells us to put on a happy face and the blindness of nations that refuse to imagine the worst.
Extract from “Smile Or Die – How Positive Thinking Fooled America And The World” by Barbara Ehrenreich, published by Granta.

Women’s Mental Health

September 10th, 2010

Good mental health is important to everyone. And because it is so important, we need to talk about it more. This booklet (please see link below to complete booklet) is about women’s mental health. It is based on the best science available. Researchers have a growing understanding about women’s unique mental health needs. This booklet does not take the place of your doctor. And it does not diagnose mental illness. But it offers tips to help you protect your mental health. It also suggests who to turn to and where to go when you need help. And it could make it easier for you to talk about mental health. Promoting better mental wellness for women is important to everyone.

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Depressed men are often not diagnosed

August 27th, 2010

British men suffering from depression are missing out on treatment, owing to the skewed criteria used by GPs to diagnose the illness, warns Paul Farmer, chief executive of Mind. Men are just as likely to suffer from mental distress as women, and are far more likely to kill themselves. Due to the emphasis on typically female issues and the symptoms of depression, the extend of the problem among men is largely hidden. Farmer said Mind is working on how to encourage GPs to look out for more male symptoms of depression, such as aggression or anger, and is calling for “the increased provision of mental health services tailored for men”.
The Guardian
re-published by Counselling Madrid, Counselling in Spain

Ban on gay conversion therapy

August 19th, 2010

More than two-thirds of doctors at the British Medical Association’s annual meeting in Brighton have approved a motion backing a call for the Royal College of Psychiatrists and other mental health standards bodies to reject so-called “gay conversion therapies” and ban their use in their codes of practice. They also agreed that health departments should investigate alleged cases of conversion therapy being funded by the NHS. The vote follows a year-long undercover investigation published in The Independent in February. Patrick Strudwick, a journalist and campaigner, posed as a “patient” to reveal how evangelical therapists – some operating within the NHS – tried to “reorient” homosexual men and women using techniques developed in the US. One of the people Mr Strudwick interviewed described his treatment as “psychological torture”. Mr Strudwick desribed the vote as a “watershed moment in the struggle for gay equality”. He said that his undercover investigation for The Independent, which prompted this motion, highlighted the fact that not only are (JM: some) psychiatrists and psychotherapists still peddling these “abhorrent techniques”, but that in some cases the NHS is paying for it.
Tom Dolphin, vice-chair of the BMA’s junior doctors committee who proposed the motion, said: “sexuality is such a fundamental part of who a person is, that attempts to change it just result in significant confusion, depression and even suicide. You can’t just wish away same-sex attraction no matter how inconvenient it might be.”
But Cardiff consultant neurophysiologist Gareth Payne said there was no “gold standard” evidence that conversion therapy did not work and was harmfull. He said it was important to respect the wishes of patients who asked for the therapy.

The Independent

Antidepressant use rises as recession feeds wave of worry

August 12th, 2010

The number of antidepressants prescribed by the NHS has almost doubled in the last decade, and rose sharply last year as the recession bit, figures reveal. The health service issued 39.1m prescriptions for drugs to tackle depression in England in 2009, compared with 20.1m in 1999 – a 95 per cent jump.

Doctors handed out 3.18m more prescriptions last year than in 2008, almost twice the annual rise seen in preceding years, according to previously unpublished statistics released by the NHS’s Business Services Authority. The increase is thought to be due in part to improved diagnosis, reduced stigma around mental ill-health and rising worries about jobs and finances triggered by the economic downturn.

But doctors warn that some people are being put on the drugs unnecessarily , especially those wth milder symptoms of depression, partly because there is too little access to talking therapies. “I’m concerned that too many people are being prescribed antidepressants and not being given counseling and cognitive behaviour therapy (CBT), because access to those therapies, while it is improving, is still patchy”, said Professor Steve Field, the chairman of the Royal College of General Practitiones.

Source: The Guardian

Choice of treatments helps anxious

July 9th, 2010

A US study in the Journal of the American Medical Association has pioneerd a more flexible approach to treating anxiety, offering a choice of treatments, and giving health professionals a computer-based tool to track patients. The study included over 1,000 patients. About half were given a choice of talking therapy, drug treatment, or both; the other half carried on with the treatment suggested by their doctor. After a year, 64 per cent of those offered a choice of treatment saw an improvement, compared with 45 per cent who´d received their usual treatment. Talking therapy was the most popular choice, 34 per cent choosing just this treatment, and 57 per cent opting to combine it with drugs. Just nine per cent chose drugs as their only treatment.

Therapy Today – June 2010
BMJ Publishing Group LTD

‘All the triggers to make me not work well happened’

June 3rd, 2010

Andy Berry, 33, moved from the United States to Britain in 1996 and works in marketing and communications. He has worked for household names such as Shell, the BBC and Microsoft as a project manager. Following a number of mis-diagnoses, he was eventually diagnosed with bipolar disorder.

“When I went back to work after I was off, after the diagnosis, I was in a team of seven people and of the seven people four had been off for extended periods with stress. In that regard I had support. However my direct line manager – you could just tell it was like you were stigmatised. You were just kind of looked upon as lower down in their esteem. To me that’s a failure of the company because they should have actually gone ‘okay, what’s wrong with the company that this many people are off?’. I don’t think they took it seriously or if they did I don’t think there was the will to actually address it. I think it was pretty much set in stone that it was a barrier to my career. You know, saying ‘well hopefully he can stick at this job’, those type of comments. ‘Do you think you can handle it?’

What drove me to the diagnosis was the way my role was manged. It was just when the government introduced the flexible working hours. I suddenly saw my hours jump from just over 40 hours to about 55-60 hours a week and finding myself in a situation where I was over-burdened . And then speaking to my boss about it and my boss saying ‘well just get it done, I don’t care’. And there was no end in sight. I just had a situation that was untenable and that created the frustration, the depression. Actually it created a scenario where all the triggers to make me not work well happened.
I think a lot of that is because lots of people who work who are managers are probably not suitable to be managers. They don’t understand how a happy workforce makes for better efficiency and better output. Somebody breaks a leg, you’ll understand that. Somebody has a mental health problem you’ll think oh, he’s crackers. But in fact there’s things we can do to bring people back in to wider society again and into the workplace. And de-stigmatise mental health. Its something that should be tackled. The work environment in the UK has changed in the last 10 years and if it continues to change in the same manner it will become a bigger issue. Longer working hours. Higher demand on staff. Its gotten more Americanised.”

Interview by Mary O’Hara
Source: The Guardian – UK
Counselling Madrid