Mental health in Northern Ireland; thinking about the context of our lives.

My aim in counselling is to understand my client as fully as I can. Understanding goes hand in hand with empathy. The better I can understand a clients life, experience and perspectives, the better I can imagine what life might be like for them.

For me, part of that work is understanding the context in which a client lives their life. So on one hand, tuning in to and responding to the client as they sit in front of me, while at the same time zooming out to get the macro view of their life.

We all live within in structures, societies, histories, communities, social rules and constraints. Some of the effects of these on our lives are obvious, and others are harder to spot. Some of how the society or context we live in can effect our lives can have everything to do with other parts of our identity. Two people can live in the same geographical location but be having very different experiences in life depending on their ethnicity, gender expression, social class..and so on.

All of that is to say, I have been thinking alot recently about the context in which we lives our lives in Northern Ireland in an effort to understand what effects our mental health. Although I do work with clients in other parts of UK & Ireland, the majority of client are based in Northern Ireland.

I came across two studies of interest on the subject; Mental Health Foundation: Mental Health in Northern Ireland: Fundamental Facts 2016 and Review of Mental Health Policies in Northern Ireland by Professor Siobhan O’Neill, Professor Deidre Heenan and Dr Jennifer Betts in conjunction with Ulster University.

There is ALOT of information in both documents, pointing to a complex issue with lots of different areas for consideration and I’m not even going to try to summarise it here. However there were a few things that jumped out at me.

The first, and probably most obvious one, that is mentioned alot in correlation to poor mental health here, and that the effect of living though conflict, and/or living in a post-conflict society (depending on how old you are now).

Transgenerational trauma. Living through events that are disruptive and traumatic has an impact on mental health. But also living in a society that has been though a traumatic event in it’s recent history, even if you were too young to really understand what was happening, or weren’t born yet, can also have an impact on mental health.

Best illustrated in The Body Keeps The Score by Bessel Van Der Kolk, the idea is that trauma can be stored in the body and stays there until the person can find a way to release or discharge it. And that trauma can also be passed down on a genetic level, to the next generation of people. So even if they didn’t experience it directly, or weren’t even alive at the time, they can still feel the effects.

This is widely accepted as a huge contributing factor to the overall picture of mental health in Northern Ireland.

Other factors highlighted in the reports as contributing factors to poor mental health are lack of funding and investment in NHS mental health services and community based services which leads to difficulties in accessing help, higher levels of deprivation and social need, austerity, chronic stress, living in a polarised and divided society and the fear of difference.

On a personal note, I could add into that our frustrating and depressing political landscape, the lagging behind on womens, LGBTQ and BAME rights. And actually I would maybe also count the weather, I always feel the mood and spirit of the place lift on a sunny day.

One of the things I found really interesting about reading the documents is just how much we don’t know, and are still to find out about the experiences of older people, younger people, women, peri natal experiences, the LGBTQ population and the Black and Ethnic minority population. There are gaps in the knowledge of the mental health experiences of large sections of the people that make up our population.

So I guess my point is that it feels helpful to understand all of this when working with clients. And maybe it’s helpful, reassuring even, to place mental health in a societal context rather than to any lack or failing on the part of an individual. And here in Northern Ireland, there definitely some things that are specific reasons for where we are with our mental health, and so many gaps in the experiences of a diverse range of people that are still to be understood.

Languishing…maybe one of the most relatable moods of this last year?

“The absence of wellbeing..languishing is the vast, meh-coloured desert between flourishing and depression, a general condition of non-thriving”

You know you are languishing if you experience burnout, you feel numb, it’s hard to focus and your mojo has disappeared. And most important, it is a rational reaction to a very irrational year.

What to do about it? Small, but achievable challenges to relight your fire (according to the article).

Guardian article links to a NYT article hidden behind a paywall (if, like me, you’ve already used all your free views) which links to Corey Keyes original 2002 article on languishing “The Mental Health Continuum; From Languishing to Flourishing in Life”.

https://www.theguardian.com/society/2021/apr/20/not-depressed-or-flourishing-how-languishing-defines-modern-life

On Connection

“We are empathic beings who feel for each other. Our very success as a species is rooted in our ability to be aware of each other’s needs, to notice each other’s pain and to experience deeply felt physiological and emotional empathy.”
― Kae Tempest
, On Connection

I recently read the beautiful book “On Connection” by poet, performer, writer and playwright Kae Tempest. The book had a big effect on me, and as soon as I had made it to the last page, I immediately went back to the start and read it all over again.

I think for the first time in my life I really understood what a poet is. There was something in the way that Kae was able to put words and imagery to the experiences that we as a collective group of people have been going through, that connected to some deep place in me.

The book is about lots of things. What I took to be the overall message is that we have found our way into a state of disconnection, both from ourselves and from other people (and also from nature) and this is what defines the time we are currently living in. And the way out of this place is re-connection.

I think this is something that many people can relate to and has been highlighted even more with the year that’s been in it.

Shortly after reading the book for a 2nd time. I was out for a walk by the sea listening to some of Kae Tempest’s performance poetry through my headphones. I experienced a profound feeling of being able to put the weight of the world down, just for a second. Their words made me feel seen and somehow in that seeing made the tension in my shoulders release and relax for a moment.  

As I progress along in my counselling career and move further away from the time spent doing my formal counselling training, the more I am crafting myself into the kind of counsellor that makes the most sense for me to be. I find at the minute that what influences my practice the most are authors, artists, other counsellors and friends expressing their humanness.

I have come to understand that one of the most beneficial things I can do for my client is to sit with them in their pain and discomfort. Not try to rescue. Not try to fix. Not offer interpretation. But just to notice their pain and sit with them in it. To help them feel seen. With the hope that if my client feels seen, then they can feel like they can put down the weight they carry, even for just a moment.

But it can feel tricky sometimes, unnatural even to just sit with someone’s pain. We are not always very good with other people emotions. Sometimes they can scare us or feel too close to home. Sometimes we can feel that something might happen to the person if we don’t take action, give advice or intervene in some way (which in some cases can be true). Like everything, it can be a balance and judgment call. But in that moment when we are thinking of solutions, it moves to being more about us and less about the other person.

This is part of the practice.

In another part of the book, Kae Tempest says that the harder you try to connect with someone or something, the further away from connection you get. That you cannot force connection, it either happens or it does not.

But what you can do is to create the right kind of conditions, in your life and in yourself, so you are open and available to connection if it does appear;

“I can’t summon connection down from the ether and expect it to land in my lap. But I can do everything in my power to create a welcoming environment for it when it does decide to turn up”

I have thought about this a lot, about how to create the right kind of conditions for connection, that “collaborative and communal feeling” to appear in my work with clients.

Sometimes I try to get my thinking brain to take a back seat and become more aware of my body and emotional experiences, I try to stay open, and notice where and when my tendencies to close down are. I chip away it, daily over long periods of time with experimentation, experience and efforts to get to know myself as well as I can. Always knowing that it might happen, and it might not, and both of those things are ok.

The New Hotness

I have just passed a 2nd birthday in Lockdown. Looking back at the first couple of posts written at the beginning of this whole thing last year, I certainly did not anticipate that we would still be in some variety of lockdown a year on. But here we are, with things hopefully due to change in the next few months with the majority of people receiving their vaccine.

On of the things that I am seeing coming up recently, both in my social circles and with clients, is that many people have experienced body shape changes after a year of of working form home/swimming pools being closed/yoga classes being cancelled/sports training cancelled/being encouraged to stay home.

These changes can mean we might feel a bit less confident, it can impact on our self esteem, and sometimes can come up in our relationships.

We can be very hard on ourselves when it comes to our bodies. We are encouraged to hold ourselves up to an (often unobtainable) ideal and can give ourselves a hard time if we do not meet it.

I encourage kindness and compassion to yourself and your body always. We have such a strange and at times difficult year that whatever your body’s current 1-year-in-lockdown vibe is, it is perfectly OK as it is.

In the words of the Feminist Survival Project, “You are the new hotness, even better than the old hotness”.

https://www.feministsurvivalproject.com/episodes/episode-18-new-hotness

A counsellor in lockdown.

We are now over two months into lockdown. Throughout this time I have continued working with clients (through the agency I work for as a co-cultural counsellor), moving my practice to video or phone sessions, which are working well.

My work with clients during this time has in many ways mirrored my own thinking and processing about the situation we find ourselves in. In the couple of weeks immediately after the beginning of lockdown, Coronavirus took up much of the focus of our sessions.

Some clients came to sessions with worries and fears about the health of parents or vulnerable people in their lives or their own health. Others had to quickly adapt to working from home, being on unpaid leave, or continuing to work in front line healthcare, or home schooling children. It took us all a bit of time to try and make sense of the lockdown rules. The general sense of anxiety and uncertainty of the situation exacerbated by the intense and fearsome media reporting made the virus feel all encompassing. So it was not surprising that Covid-19 took up much of our time in those early weeks.

Now, 9 weeks on, with time to normalize and get our heads around things, and with some light at the end of the tunnel as restrictions begin to slowly lift, coronavirus has mostly moved into the background.

With some clients, the work has circled back to the initial issues pre-covid. With other clients, some new issues have emerged as a result of lockdown,

Overall, clients have reported having more time and space to reflect on their lives. Being mindful that the usual distractions like hobbies, work, friends, exercise are not easily accessed at the minute. So I have been working with clients to help them develop strategies to manage new emerging thoughts and feelings without becoming overwhelmed.

Clients who had been feeling burned out, report feeling benefit from having the time to rest, work less, avoid the morning commute in to work, or spend more time with those closes to them in lockdown.

Of those clients who had been feeling very socially isolated in their lives before lockdown, some now report feeling that they feel equal or part of the community around them for the first time in a long time, because now everyone is isolating, not just them.

In some cases it seems lockdown has provided a chink of light, an insight into what changes the client would like to make and how life could be post lockdown. Some of the work then we have started to do is to start planting the seeds for a new way of living.

So this continues to be an unusual time indeed, but there is a shift happening at the same time for all of us. And I will, as always, continue to work with whatever clients bring to sessions and we will adapt and grow into a new way of being in a post-lockdown world.

“That discomfort you’re feel is grief” coronavirus, anxiety and a changing world .

The coronavirus (COVID-19) pandemic has brought up intense, confusing and uncomfortable feelings for all of us.

This calm and thoughtful article from the Harvard Business school features David Kessler who is a leading expert on grief. I have found it useful when working with clients through this time.

Kessler talks us through the stages of grief and says that much of what we are experiencing right now is a form of collective grief.

He also outlines the effects of distorted thinking and ‘anticipatory grief’ on those of us predisposed to anxiety or anxious thinking patterns, and says the key to managing our mental health during this time is by finding balance (among good news/bad news stories), acceptance and finding meaning.

You can read the article in full by clicking on the link below:

https://hbr.org/2020/03/that-discomfort-youre-feeling-is-grief