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Why we’ll never change our minds....

I’m back after a few days in sunny Spain visiting relatives (here, have a pic), but there was no outrunning Brexit there... and it’s understandably coming up in client sessions too.  Mostly this is a conversational thing, akin to talking about the weather while settling into a session, but people certainly feel very strongly about the topic and for some clients it’s a problem. A client was describing the difficulty they faced in stopping their family from arguing over Brexit - something that keeps happening with every new ‘meaningful vote’ that takes place.  It’s raw and painful and the arguments are pretty serious.  Nobody, my client says, is prepared to give ground.  Nobody will change their mind in any way.

It reminded me of an article in the Independent (here) that I’d saved to my browser and then forgotten about.  It suggests some reasons why it’s difficult to change our minds about decisions we make.   As I began writing about in a post in the autumn, our brains have certain evolved motivational systems, including a ‘threat maintenance’ system and a motivation to create attachments with others and form bonds of allegiance. This comes with consequences when we need to make decisions.  When we make a decision we also become attached to our choice, and important choices form a part of our self-identity.  In other words, psychologically our choice becomes part of who we are.  

“Who we are” becomes part of the group we are in, and then the group we are in is set against the other groups.  It’s tribal.  Take a look at football fans for further info.  And if you disagree?  Well, my threat maintenance system kicks in...   In fact, Social Identity Theory suggests we derive an identity from the social groups of which we are a part, and individuals will tend to conform to the characteristics that are acceptable to the group.  This means opinions and views we hold that cannot easily be integrated to this social identity are more likely to be hidden (Tajifel, 1981).  So our positions begin to become more and more entrenched.

To change your mind involves overcoming all this, having inevitable conflict with people in your group and, psychologically, giving up a part of yourself for good. Of course there are certain situations where the consequences of this are much more serious than that sounds - you can get ostracised, punished or even killed for going against ‘your group’.  Not easy.  

Becoming more and more entrenched in a viewpoint is something comes up a lot for financial traders (my old stomping ground), as our tendency to identify with our choices and then to build a self-identity around them leads to something called “escalation of commitment”.  This is where we stick with bad choices and ‘double down’. The psychological motivation for this is to justify initial decisions, but this can lead to ignoring evidence to the contrary, and once identified with a decision there is an aversion to accepting we are wrong and so we delay crystallizing a loss. Then there is impression management to consider - facing up to the consequences and scrutiny of bad choices (Kelly & Milkman, 2013).  I’ve seen so many people get more attached to their decisions the more erroneous they’ve proved to be.  I know I’ve done it myself a thousand times.  Of course this doesn’t just happen when trading.  We all experience ‘escalation of commitment’ plenty of times and in many ways.

Have a read of the article if interested.  I don’t agree with all points made, but I do agree that highly complex topics are hard to distil down to accurate and relevant information from which decisions can be made.  Technology alone and the plethora of information on the web probably make that an impossibility now.  This is before politicians show up to make matters even worse.  

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Working through it... (29.11.17)

The most recent Office for National Statistics figures on employment show that 32.06 million people in the UK are in employment, which is 74% of people aged between 16 and 64 years. 

Did you know that 1 in every 6 of these people, at any point in time, is likely to have a mental health condition?  A recent Deloitte study estimates the cost to employers at close to £26 billion p/a, and the overall cost of mental health issues to the UK economy at somewhere around a whopping £70 billion per year (or about two Brexits, which is a handy unit of measurement for very large numbers...). 

This is a really serious problem as the figures illustrate, but the personal cost is even greater.  The same study suggests that 300,000 people will leave work each year because of mental ill-health.

Clients who are struggling with anxiety, depression or other mental health issues can experience lots of inner turmoil when thinking about how to handle their work situation.  This can feel an even more pressing crisis than difficulties at home as it’s sometimes easier to share how you are feeling with close family and friends.  Being open about mental health at work can be hard, and in some industries talking openly about it is absolutely taboo.

For those suffering and wondering what to do about their job, there are all sorts of questions that come up.  Is it wise to say something to my manager?  To what extent will my situation be understood?  To what extent will I be limiting my career?  Will people gossip? Will I be overlooked for promotion?  Will I be fired? Do I really trust my manager or H.R. department to be discreet? Will I always have a stigma attached to me?  To what extent does the severity of what I’m feeling leave me with little choice but to resign?  “I need the money, but I don’t see how I can make it through...”.  “I am letting everyone down by being sick!”

Mixed in these are very legitimate fears, and talking to H.R. or managers can seem risky, so fears are often hidden altogether or saved for the therapy room. The opportunity for employers to help their staff may never materialize because the trust is not there.

This is also one of the reasons I believe that the type of coaching offered to executives in stressful industries is not sufficient at the moment.  Staff may experience extreme stress at work (and work may exacerbate stress in other areas of life), and what is offered often doesn’t allow for deeper psychological work with employees who may hold great responsibility. 

Employees for their part often don’t trust their employers to handle 'real’ issues in a way that is both confidential and sensitive.  We’re left with a situation where mental ill-health can go unchecked and can, in extreme circumstances, put both individuals and entire institutions in jeopardy. 

It’s obvious a better solution is needed - the ability to work at psychological depth with executives (or indeed anyone) is vital to fix the ‘foundations’ before more traditional coaching can help to ‘build the house’ on top of them.  If this were offered in a confidential and sensitive way, then the number of 300,000 who leave work each year due to mental illness would probably come down, and productivity would probably go up.

The impact on employers is considerable. The cost of ‘presenteeism’ (working while in ill-health)  attributable to those working with a mental health condition stands at £15.1 billion p/a.  This reflects the lowered productivity of people working while suffering with debilitating conditions.  On top of this we can add the cost of actual absence from work, which Deloitte sets at approximately £8bn.

But the cost to individuals interests me more.  The average person spends 90,000 hours of their life working, and their job (including how they feel at work) impacts a great deal on longer term health outcomes.

Figures for 2015-16 indicate that work-related stress accounted for 45% of all working days lost to ill-health, but - and this is important - data from Mind indicates that 95% of employees who have taken time off due to stress named another reason for absence (such as upset stomach, headaches etc).

This is a worrying statistic even if we allow a large margin of error.  This truly is one of the hidden issues of our time. Companies who are actively looking to address this issue in innovative ways deserve all the support we can give them. 

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Mistakes... (4.11.17)

I grew up on a diet of 1980’s films and two of my very favourites were Wall Street (1987, Sheen & Douglas) and Trading Places (1983, Aykroyd & Murphy).  Both are very different, but both of them captivated me.  The glamour of Gordon Gecko in Wall Street and the casual way the characters in Trading Places took risks and made vast fortunes stuck with me into my teens, and I began to hope for a career as a trader. Eventually the dream came true, and for a while in my early twenties I had a job trading fixed-income derivatives for a firm in the City.  Looking back, I can see how this type of work must have seemed a good bet for someone like me who’d never been an academic high-flyer.  This was an exciting career where decent instincts and raw nerve might just be enough of a substitute for, say, being truly gifted at maths or the sciences.

When I eventually got the job I loved it, but the reality was a bit different to the dream.  For a start I had to haul myself out of bed at 4.30am every day for years to get to my desk in time for the opening bell (I didn’t see Southern Rail in any 80’s movie…).  I remember feeling tired and quite stressed.  In the films every trading decision tended to be the right one and making money was easy, but it was far harder in reality to sit on positions that were sometimes many thousands of pounds offside (usually money I could not afford to lose), hoping that the markets would magically turn around and wondering if I should cut my losses.  The money wasn’t good and was mostly commission-based, the work was competitive, everyone was under pressure to make revenues and cover costs and the firm was crammed with ambitious people. 

In this environment there were plenty of personal conflicts, but our manager was good at resolving them.  In meetings he would take our chorus of complaints in his stride and he could get to the heart of the matter quickly – he always acknowledged things like frustration, fear, upset or wounded pride in ways that did not leave anyone feeling put on the spot.  His collaborative way of dealing with people never felt overplayed, and his readiness to deal with everyone in a genuine way was an equalizer that made us all the more determined to do a good job for ourselves and for him.  

He wasn’t perfect, and actually made mistakes quite often, but here’s the thing: he almost always worked quickly to repair the situation by openly admitting his mistake and then trying to put things right. I’d like to say he got promoted and was well rewarded but he eventually got fired while he was on holiday… welcome to the City...

An important idea in therapy is that it may be better for clients if the therapist is not a ‘perfect fit’ all the time, but is instead ‘good enough’.  An echo-chamber of perfection, where therapist and client are always perfectly in harmony is actually less useful than occasional troublesome exchanges.  The idea isn’t for a therapist to make loads of mistakes or be disagreeable, but that there is a window of opportunity in  which differences, some tension or difficulty followed by repair,  actually deepens the relationship between client and therapist and helps therapeutic change. 

This is handy… because mistakes are inevitable in the spontaneity of therapy, which involves two people meeting in a very emotional way and without a script. A therapist might make a poor interpretation, miss the point, says the wrong thing, give offence in some way.

If a mistake is made, then the process of trying to fix the situation is important.  In openly noting the mistake and looking to fix it a therapist lessens any sense he or she is a sage who is never wrong, and it becomes easier for some clients to attribute their progress in therapy to their own efforts and work – rather than attribute it to the therapist in front of them.  It might foster confidence that disagreements or misunderstandings can be tolerated and resolved, inside and outside the therapy room, and might encourage some clients to hold more trust in their own evaluation of a situation.  In trying to fix the relationship following a rupture, both therapist and client may learn new and useful ways of resolving other difficult situations.  Moreover it could become a useful part of exploring things like the need for self-definition versus the need for relatedness.   It can turn out that a mistake made by the therapist does wind up helping the client in some important ways that become clearer over time. 

Where there are just enough differences between the therapist and client for there to be occasional turbulence in sessions, then both may experience a deepening understanding of themselves, others, and the world.  It is a tension in which growth is possible.  This also reinforces a view that client and therapist are both equal subjects working together in a shared endeavour, and both are human.   

I’ve been thinking about all this because I recently made a mistake that I could not fix.  I had an assessment late one evening after an emotionally charged session in which a client and I had shared a strong connection resulting in a feeling of deep presence and calm.  Our session had ended in such a state, and instead of resetting myself for a new meeting (perhaps a splash of cold water to the face) this sense of serenity stayed with me.  Within just a few minutes and in a matter of one sentence, I said precisely the wrong thing at precisely the wrong time, having failed to attune myself properly.  That I meant well with what I said is true, that this very rarely happens is also true, but this is poor consolation for someone who had reached out for help and did not find it with me, and I am sorry about it.

In this case I had no chance to try to repair this disruption to our relationship, as the relationship itself did not yet exist.  It’s not a great feeling, but is an important reminder to prepare myself as well as I can for new meetings.  I suppose it is also a reminder that mistakes are inevitable, however unwelcome they are to me.  Where I get it wrong I’ll try to recognise it as soon as possible, and work hard to fix it.

Happy bonfire night all.

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Back to School...2 (1.10.17)

The next couple of months are going to be busier than normal for me with some large projects that I’m responsible for all happening at the same time.   This is not a complaint at all, because I prefer being busy to the alternative and a lot of my work through WhiteStone is deeply interesting and rewarding.  It does mean the weeks are flying by, and as I’d already started to outline Boarding School Syndrome (BSS) in my previous blog I wanted to complete the outline before more time passes.

Let’s get right to it and talk about some common things that are encountered in a clinical setting.  I mentioned emotional encapsulation in my previous post as a central feature of BSS.  This refers to a form of psychological splitting, where emotional vulnerability is eventually disowned by the young boarder as a defence against finding herself in a situation where this vulnerability might single her out from the pack.  This is the child’s adaptive attempt to survive in her changed environment, and can be either a gradual process or marked by a specific moment that might be recalled within therapy.  Being sent away from home is an event where many of the conditions that are associated with healthy psychological and physical development are suddenly disrupted – this includes the total and sudden loss of the family unit, familiarity (a home, a bedroom etc), pets, places, people and things – these are replaced instead by strange staff at a strange school with confusing customs and traditions, surrounded by other strangers.  This requires urgent adaptation, and the child has to abandon her biologically programmed need for attachment.

The web of relationships, into which we are born and on which we rely for healthy development, is traumatically disrupted by this experience in a number of ways.  Instead of secure attachment, which is fostered in children through attuned care-giving from parents (summarised mightily), the sudden loss of family increases the chances of the child developing an adaptive attachment style to deal with the traumatic event she has undergone.  This may involve emotional encapsulation, a dismissing style, where she learns that it is safer and much less painful to dismiss or minimize her own emotional experiences than to feel them, as she learns her needs will not be met and perhaps do not deserve to be met.  Alternatively the child may instead form an adaptive strategy that involves amplification of her need for caregivers and comfort - a kind of hyper-activation of the need to be close to others.  Instead of developing a secure attachment style marked by flexibility, a growing ability to experience herself as ‘good enough’ and a capacity to understand the emotional experience and intentionality of others, the child may instead develop strategies that shut her off from her emotions (dismissing) or lead her to become overwhelmed  by them (amplification).  In some cases she might switch between both of these adaptive strategies in what psychologists call a ‘disorganized’ way.

These adaptive patterns of being can remain with us throughout life and can run very deep.  What starts out as a survival strategy can quickly become a representational filter that limits the extent and nature of access to our own thoughts, feelings and desires.  And so adaptive patterns begin to influence and shape how we see the world, the predictions we make, how we see ourselves and others.  Much work in psychotherapy is to provide the type of reparative relationship where the flexibility I mention above is encouraged and adaptive strategies can be spotted and some of these ‘filters’ perhaps even changed. 

You’ve probably already guessed that a dismissing style is particularly common for ex-boarders.  Joy Schaverein has outlined various clinical markers for this.  Here are some examples:  problems with intimacy and difficulties being fully open and honest about feelings even with a loving spouse or family;  difficulties identifying such emotions in the first place, which may register as anger and yet mask other emotions which are hard to accurately name; difficulty talking about these things even in the safety of therapy; a tendency to make very dependent relationships but then to ‘cut off’ emotionally (either as part of a repeating pattern within relationships or permanently); difficulty creating or sustaining intimate friendships, or sustaining situations such as employment or education etc;  a tendency to be more comfortable time-tabling family life, and perhaps holding fixed views of what ‘should’ happen; a tendency to struggle dealing with vulnerability in others, (if your own vulnerability has been dissociated, it is tougher to acknowledge it in others).  Interestingly, as Duffell points out, ex-boarders in therapy may not at first recognise these things of themselves, even though their spouse or family may see these issues very clearly and indeed have encouraged their loved one to seek help.  Often these issues manifest as a depressive episode for ex-boarders, and this is a common trigger for entering therapy and eventually seeking help.

What is the psychological process that such people have gone through to get here?  What happened to them at school?  Duffell talks of a ‘privileged abandonment’ and Schaverein talks of the moment of abandonment itself.  The moment of being taken to boarding school and parents departing is a moment for which no young child can be prepared or give consent.  Many ex-boarders can remember this moment clearly, as for example I can.  Others report a sense of amnesia, a dissociation of feelings and a sense of numb shock.  As Schaverein says, this is the moment “the child becomes lost for words”.  Remember that young children need adults to give words to their experiences – particularly emotional ones -  as this is what allows children to metabolize their powerful emotional experiences and make sense of them.   This cannot now easily happen as reliance falls on a house-master who is looking after many children, and has limited experience or training in these respects.  In later years children may develop a sibling bond and take on some of these parental tasks and ‘parent’ each other, but this will not be possible for young children arriving at a boarding school. 

It can be common from this point for children to feel homesick, which is really a proxy for feelings of bereavement.  This is often a gradual process of realisation, from initial alarm, to searching behaviour (anger and guilt), then hope of rescue, then mourning, grief and feelings of internal loss.  As well as grieving, children may experience their new school as a form of captivity.  They are taken to a place they cannot leave and where all activities are regulated and time-tabled - food, clothes, work, play, censored letters, lessons, and so on.  As Schaverein says, ‘private reverie‘ is discouraged, and unsanctioned spontaneity may be frowned on.  Whether this is just an enduring extension of the Victorian idea that boarding schools are a place to ‘unmake the child and make the man’, I cannot say, but I think it’s a fair bet.  Here is a quote from a Mr Woodard, founder of my own public school, who in 1858 said the aim of the place was to, “remove the child from the noxious influence of home and home comforts”.  Hmm.

Younger children often experience a powerful and troubling internal incongruence too.  Perhaps they have been told school will be fun, possibly (these days) a little like Harry Potter, and that they will be enjoying lots of activities, and that the whole experience will be good for them – as Duffell says “the making of them”.  So the child is placed in an internal double bind.  She ‘knows’ that this is ‘good for her’, but it does not feel good.  She may also have a sense that financial sacrifices have been made so she can go to boarding school and that she is expected to be grateful… yet it does not feel good at all.  The child’s experience inwardly is at odds with what her caregivers have told her it should be… and thus she may come to experience herself as unworthy or a failure, and to doubt her own perceptions.  She may have a sense that to share these things will be deeply upsetting and that caregivers will be angry, and so she may come to feel responsible for maintaining the emotional equilibrium of her parents at a very young age .  These are things for which small children have no words and only a limited understanding, and so cannot verbalise.  The child increasingly becomes separated from a coherent narrative of her own life. 

As an adult a further double-bind is that such an upbringing is considered a ‘privilege’ and so discussion of any of these serious things can feel like a dangerous flirtation with being considered an ingrate,  fair game for ridicule rather than compassion from a society that considers them to have been born lucky.  This is common. The same process works internally too; ex-boarders may hide from themselves (and their therapist) the traumatic nature of their boarding school experience, such is their sense of shame at admitting such a ‘lucky start’ might actually have caused some problems – there can be a feeling it would be deeply ungracious, a bout of navel-gazing and quite unmanly to ‘whine’ about such things.  So as adults, ex-boarders may trivialise the tough experiences they had as young children, especially if they came to associate closely with (and attach closely to) the school in which they spent many formative years, and where some good friendships and good times were also had.  It can be hard to consider the cost at which these things have come, even when facing troubling issues later in later life.

For the young child at boarding school there follows, in time, a choice point.  Either the boarder must adapt and find a way to navigate her new environment and begin to dissociate from her need for her (now unavailable) family and home, or continue to suffer and take the chance of being singled out as a target onto which other students can project their own fears.  Eventually the child dissociates from the pain and protects a nucleated self from experiencing further trauma.   In short, she must adapt or find herself alone and singled out.  Here is emotional encapsulation. “He wears a mask and his face grows to fit it” (Orwell).  I will link to a documentary at the end of this post, where this process is shown in some detail.

Finally, the sense of loss young boarders experience is repeated many times with return trips to school over many years, and so loss is re-experienced routinely in a way that reinforces adaptive strategies.  This further crystallizes a split between the ‘survival personality’ of the boarding school self and the ‘home self’ which is fundamentally changed too.  Those suffering with BSS often report a sense of ‘no longer being known’ at home when they returned for school holidays, and so having a sense of not belonging anywhere, they had changed in ways not recognised by their parents and so were now alone here too.  Many ex-boarders remain with a sense of exile throughout their lives, a sense of non-belonging as if they are not really participating in their own life.

Nick Duffell spends a lot of time at the moment lobbying for the abolishment of boarding schools for the under-16’s.  I am not sure I would go that far.  I can think of plenty of examples where home-life may be far more troublesome than an upbringing in a good institution.  For children in their teens it is important to also begin to individuate and this seems a more natural and much less damaging time to consider this type of education.  I also think that technology such as mobile phones, and much greater emphasis on pastoral services in schools should not be ignored – it is obviously much easier to maintain a meaningful contact with children at school in recent years with phones and email, and schools have become much more sophisticated in terms of considering the wellbeing of children in their care.  That said, I want to be careful not to diminish the suffering that many will be experiencing right now who are at boarding school – an institution is absolutely no replacement for a good family - but general trends in a better direction must also be recognised. 

I’ll be coming back to this topic, no doubt, and I hope this blog is at least a useful general overview and a start point for readers who are interested to know more. 

As promised, here is the Cutting Edge documentary “Leaving Home at 8”.  It tells the story of four boarders who we meet just a few days before their departure to boarding school.

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“Circadian what?!“ (16.10.17)

A few weeks ago I was talking to a friend about how he was finding it hard to get out of bed in the morning.  Over the months it was becoming a physical struggle to throw back the covers and swing an arm to stop his alarm, then to haul himself out of bed and into the shower.  He couldn’t attribute this to any particular thing in his life, but he felt there could be a psychological cause (stress).

Another person in this conversation then mentioned something called ‘circadian rhythm’, and I admit I hadn’t ever heard of this.  I’ve heard of sleep cycles and know a little bit about optimum length of time to rest, but never specifically this term.   I should have known all about it, but it joins the long list of things I feel I should have known about but have somehow managed to miss over all the years.  I find it hard to believe there was never one lecture, book, newspaper, chat or TV programme where circadian rhythm came up… but there it is… people must have saved the topic for when I left the room. 

In the last weeks I’ve mentioned circadian rhythm to a few people, trying to find a partner-in-ignorance, but based on the looks of amused surprise and/or concerned sympathy I think I am totally alone.  On the small chance you, like me, have totally missed out on this one then the below might be of interest.

Put simply, all animals and plants have a circadian rhythm.  This is the natural ‘biological clock’ that repeats over the course of a 24-hour period (approximately).  It governs endogenous ‘built in’ things like bodily functions; body temperature, hormone production, when we feel tired and must sleep, when we feel hungry and must eat.  These things fluctuate in a natural cycle over each 24-hour period.  The command centre for this is located in the suprachiasmatic nucleus, a pair of groups of cells in the hypothalamus in the brain.

If your circadian rhythm is healthy, you may still be either a ‘lark’ (morning person – likes to wake early), or an ‘owl’ (night person – prefers to wake late), but the rhythm is itself stable over time and responds to external cues in the environment.

This response to external cues is important.  Your natural rhythms are affected and reset by signals such as daylight and the length of the day and the night. You experience this every time your body adjusts to a new timezone.  It’s also handy because the average circadian rhythm doesn’t clock in precisely at 24 hours. 

A client has been kind enough to send me some information on studies carried out by Rutger Wever, a German scientist who made significant contributions to the field of Chronobiology.   Between 1964 and 1989, Wever conducted 418 studies involving 447 human volunteers placed in an isolation-suite for several weeks without clocks or other time cues. It was found that the volunteers tended to go to bed an hour later and to get up about an hour later each day. The key finding was that the natural circadian rhythm in humans is actually somewhere close to a 25-hour cycle, although some later studies have involved individuals with a cycle up to 30 hours.  So external environmetal cues such as daylight and nightfall really do keep us in check and are very important.

If you’re struggling to get out bed yourself and tempted to blame yourself in some way or put it all down to psychological factors, it’s worth considering your circadian rhythm.  Your body has its own tempo and neuro-biological imperatives, and the factors making it hard to throw back the covers may well be every bit as physical and environmental as they are psychological. 

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Leadership wobbles... (12.10.17)

In May I wrote about Theresa May’s use of the ‘strong and stable’ slogan, and expressed some doubts about making stability a central part of the pitch.  The election was not a good one for the Prime Minister and I’m not sure things have really picked up since.  I’ve read a lot in the last week about her party conference speech, which most pundits seemed to agree was painful to watch but some felt showed the quiet tenacity of the PM – soldiering on despite the place literally falling down around her and hardly being able to talk.  Others felt that there is nothing worse than having a PM who people ‘feel sorry for’, and that the staging mishaps and her illness are just symptomatic of her collapsing authority and her raw personal luck. 

I haven’t actually watched the speech, but I have heard Theresa May’s interview on LBC radio with Ian Dale (10th Oct).  I thought the most telling question was when Dale asked the PM if she would vote for Brexit if the referendum were to be held again today.  The implied line of questioning is clear:  “Are you a convert to Brexit?  Do you now believe in it?  Are you doing something you believe in?”.  She could not say yes.  What she actually said doesn’t matter much, but it was general white-noise about ‘evaluating again based on the evidence’ etc.  The point is she is the PM and could not answer this with a truthful affirmative.

Leadership comes in many forms and there are lots of different styles that leaders can adopt to inspire people and maximise the chances of reaching goals.  To name a few of these leadership styles:  autocratic, democratic, task-orientated, relationship-orientated, bureaucratic, laissez faire, transactional, transformational.   These can be grouped together into polarities, such as Autocratic v Democratic, where autocratic leadership is highly instructional (“I say, you do”) and democratic is fully inclusive of a range of opinion (“let’s all decide together”).  A good leader will (and must) embody many of these styles, to various degrees, in different situations.  But of course lots of people in authority gravitate to their favourite style and stay there for most of the time, and many will find it hard to make changes even if the situation demands it. 

The pairing I think is most interesting for Mrs May’s current predicament is Transactional v Transformational.  I think the PM’s preferred mode of leading is transactional.  She said herself when launching her bid to become the PM that she is not a ‘showy’ politician, and that her strength is knuckling down and ‘getting on with the job’.   Based on what I’ve seen I’m happy to take her at her word.  This ‘getting on with the job’ slogan is truly in season, and is now the low-energy replacement for the rejected ‘strong and stable government in the national interest’. 

Transactional leadership involves a managerial style focused on organization and operations and the decision-making processes – it can certainly help you ‘get on with the job’.  You don’t need a cause or a vision, but you do need a solid grasp of what makes your department tick and what will motivate your staff.  It’s the sort of style we might say is associated with getting the best out of everyone in relatively benign conditions.

Transformational leadership on the other hand emphasizes things like a vision, embracing change, and innovating.  Leaders using this style are often very charismatic and can draw great loyalty from their followers, and this can be very necessary in times of crisis to galvanize large numbers of people (think Roosevelt and Churchill).  Warren Bennis and Burt Nannus outlined some qualities for a transformational leader:  1) Having a clear vision for the future.  2)  Being a ‘social architect’ for their organization.  3)  Creating trust through consistency and clarity.  4)  Having positive self-regard.  I’ll leave it to you to consider how well these apply to our current leadership, and also any alternatives.

If good leadership involves switching between different leadership styles when the situation changes, then surely this is needed more than ever in the middle of a Brexit process that has a momentous number of moving parts.  However you voted and whatever feelings you have, if we assume leaving the EU is now inevitable then we move closer to a ‘no deal’ scenario and the City is getting nervous. 

The question Ian Dale asked Teresa May was about Brexit, but did it also show an inability to switch styles of leadership?  Did it show a difficulty in channelling any kind of transformational energy that might help generate a vision and some momentum?  Did her response show anything other than that she is committed, head-down and without personal belief, to manage us towards Brexit as best she can?

Brexit is an existential crisis, and the EU political class don’t currently look inclined to be flexible.  I suppose this can change quickly, but right now the conditions are not benign and ‘getting on with the job’ is starting to feel a little like trying to fly a kite in a hurricane.  If the PM can’t begin to find a way of leading in a transformational way then I think there may be further unpredictability ahead…

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Back to School... (12.9.17)

I took my dog for a walk early this morning, leaving the house at just before 7am.  It is now the 10th of September so the middle part of the day can still feel a lot like summer, but autumn is already starting to cut into the fringes.  I left the house feeling cold and wearing a coat but return with it tied around my waist and wondering what madness possessed me to take it.  Soon autumn will be here, but for now no item of clothing you wear is quite right…

This morning we walked through the woods and our route took us to the Bolnore Village sports field.  My dog has a take-or-leave attitude to long walks, but she is very passionate about chasing a ball or fetching a stick.  She also loves playing fetch with empty plastic drinks bottles which we find along the way, so we get to perform the small public service of picking up litter, having a game, then dropping the bottles off in a bin.  Another thing she loves is charging through piles of grass cuttings and using her nose to fling the cuttings into the air. She then jumps about trying to catch the falling grass.  The results are mixed and half of it usually lands on her head, but it’s always fun to see her try.  This morning she played this game for a minute.  The grass has been cut on the playing field, and four new football pitches have sprung up since I last visited.

In the cold morning air, the sight and the scent of the grass suddenly evoked powerful and familiar feelings in me.  The smell of fermenting grass, the newly painted white lines of football pitches, the first leaves falling, a starker sunlight…  This is a scene I saw many times throughout my childhood and I associate it strongly with my return to boarding school after summer holidays.  This sudden reaction/feeling was complicated and contradictory, containing within it both a sense of heart-sinking doom but also a sense of familiarity and of ‘coming home’.  This was a jarring feeling, like two separate reactions occurring at once - negative and positive. 

This scene came on the heels of me attending a conference on ‘Boarding School Syndrome’ of which the keynote speakers were Nick Duffell, Joy Schaverien and investigative journalist Alex Renton.  Leading lights in bringing Boarding School Syndrome to wider attention.  In particular, Nick’s work was pioneering.  The 1994 TV documentary “The Making of Them” was a powerful examination of the habit of sending children away to be educated.  This documentary, and a book of the same name, resonated with many ex-boarders who had experienced problems after boarding and so entered therapy.  Joy Schaverein, a Jungian psychotherapist, has worked to outline the common features of this syndrome.  It was a pleasure to meet and have a chance to talk to both of them.

I hope to write in more detail on Boarding School Syndrome as I haven’t done so here yet.  I just want to make one observation about my contradictory feelings this morning.  Schaverien has defined certain common traits that therapists frequently encounter when working with ex-boarders.  One trait includes something she calls emotional encapsulation, (or as Duffel puts it the building of a ‘survival personality’), a splitting off of dangerous emotions as a protective mechanism, often a tendency to be secretive with emotions and not to express needs clearly or transparently, even with self.  This is a process by which a child eventually insulates herself from the pain of loss – a split is created – a ‘boarding school me’ that is built for survival and a separate ‘home me’ that is fundamentally changed and hidden in the shadows.  

I think that for a second I actually saw that split in myself this morning and that these two parts of me, caught by surprise, competed to react to the same view.  It happens from time to time.

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Walking... (1.9.17)

I’ve just arrived back in the UK after a trip to New York.  There are a lot of reasons to love NYC, but if I had to pick two reasons the first would be that it looks like nowhere else on earth.  The scale and dimensions are so striking to the eye of a tourist and this still surprises me years after my first visit. The largest skyscrapers we have in London - the Shard and One Canada Square in Canary Wharf - would be middling in size in Manhattan, and be just two amongst the 265 scrapers on offer.  The second thing I like a great deal is that I often end up walking a lot, and this is the best way of really getting to know a beautiful and diverting city. 

There are other ways of getting about, of course. Taxis are everywhere and are pretty cheap compared to London, but progress by car will be slow for a lot of the day.  The grid structure which is responsible for giving everything a very connected feel also leads to traffic chaos if vital routes are blocked for any reason, which they often are.  Getting into or out of Manhattan by road is tough, just ask anyone stuck in traffic trying to get through the Lincoln tunnel or headed to JFK airport.  The Subway system seems to work well on the north-south axis, but not so well on east-west axis, so it may not deliver you to the heart of your intended destination without a good walk at one end or the other.  Subway entrances are not illuminated and obvious to spot as they are in London, they are easy to miss, and once inside the ticket machines are ponderous to use, and also not inexpensive for a one-way trip at $3.00. 

The awkward ticketing systems touch on something that surprises me about New York generally, namely the slow uptake of new technologies which make commercial or travel transactions increasingly quick and easy.  In London, all I need to do is walk to a tube turnstile, wave my debit card in front of a reader - and boom - I am through and on a tube.  No queue, no hassle, no need of a paper ticket which you have to hold the right way before swiping through a temperamental gate.  In the UK if I want to buy something from a shop or pay for a meal, the vendor will invariably bring a terminal over to me, I will insert my card, enter my PIN and the job is done in a few seconds - or I will use contactless technology to do the whole thing instantly.  Not so in Manhattan where the majority of establishments still take your card, disappear off, come back with a receipt minutes later requiring your signature (including working out and adding a tip).  I know this was also the norm in the UK up until ten years ago or so, but that is quite a long time, and it does feel arcane doing this in Manhattan where everything else around you looks like a scene from the future.  For the same reasons, queuing and paying for things takes quite a long time compared to the low-touch experience that is already the case in other major world cities. 

Walking is as low-tech as it gets, and we did lots of it.  I suffer from generalised tendinopathy, which means there are periods where walking is quite uncomfortable and walking a long way not possible (if you spot me around the town I sometimes walk with a stick).  Luckily the trip coincided with a ‘good patch’ and apart from one evening where I could have happily jumped in an ice-bath, there was no pain that Ibuprofen couldn’t sort out. 

My family (some of whom live in NYC) are all in various ways into fitness - my nephews and niece are 9,7 and 5 respectively and are super-active. All three, including the five-year-old, could easily beat me in a race and, it pains me to admit it, at most other physical things. Everyone has a Fitbit, and kids and adults like to beat their own ‘personal bests’ at things like steps taken, or distance walked.  Not wanting to feel left out, the week before travelling I downloaded a step counting app on my phone.  So I know that in the UK I walk around 12,000 steps a day - about 8km - including walking from London Bridge station to my office and back.  When in New York this amount jumped up significantly.  An extract of some of the step counts per day: 18k, 26k, 32k, 22k, 28k, 22k  - on average somewhere around 16km a day. 

It is amazing the effect that measuring and monitoring performance can have.  For a start there is an awareness, based on empirical evidence, of your own normal baseline of activity.  I actually thought I walked more each day in the UK than it turns out I do.  But I now know accurately what I do, and can begin to correlate my activity and the type of activity I am doing with the level of pain I feel in my tendons, which might be helpful. I also feel pretty motivated to keep my step count higher and to stay as active as I can, and this is greatly helped by being able to see patterns, trends and progress - maybe even hitting a new record.  I also see my young relatives actually using their own statistics to motivate themselves to push themselves even further physically - this is both with and without adult encouragement.  It is a reminder to me of the power and importance of having a goal and trying as best as possible to measure progress towards it. 

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Anxiety... (18.8.17)

I’m writing a few short articles on some of the most common issues people face.  These will also appear on my website on the Issues page.  If interested, plenty more will soon be there.  This one is about Anxiety.

———-

“Worrying is carrying tomorrow’s load with today’s strength- carrying two days at once. It is moving into tomorrow ahead of time. Worrying doesn’t empty tomorrow of its sorrow, it empties today of its strength.”  Corrie ten Boom 

While there is wisdom in this quote, anxiety is not quite the same as worry (although worry may be an expression of anxiety).  Nor is anxiety the same as ‘stress’ or ‘strain’ (although anxiety may heighten your stress, and stress may heighten your anxiety).  Anxiety is not the same as ‘fear’ either, as anxiety is usually a generalized feeling rather than something with a clear focus.

The purpose of anxiety

Most emotional states have an evolutionary purpose which has served us, as ‘thinking’ but physically vulnerable beings in a  dangerous world over millennia.   The ability to experience anxiety helps us evaluate and react to the environment around us.  It helps us to perceive danger and increase the chances of getting 'a good outcome for me’.  A sense of understanding, both in-your-bones and in-your-mind that you feel unease, that there is a risk of something unwelcome occurring, can help us increase our vigilance, be prepared to take action, reduce reaction times and trigger decisive choice-making.   Our problems start when this helpful facility begins to work in ways that are no longer helpful to us, but instead cause us to suffer. So, what is anxiety? Why do I 'have it’?

Several factors may be in play:   physical factors (e.g. thyroid problems), childhood environment,   genetic predispositions, biochemical imbalances (changes in the levels of chemical messengers in the brain), and stress and strain in your life currently. From a psychological perspective, one way of considering anxiety is our emotional expression towards uncertainty.  As we develop in childhood we create our own ‘mental landscape’ - psychological inner-structures that help us make sense of our experience and, importantly, begin to make predictions about the future.  At times in life, we might find that the things we have 'taken to be certain’ are challenged by situations that are difficult to predict or control, and so the integrity of our inner-structure is challenged.  Anxiety can arise in this space. This anxious feeling may not be limited to just ourselves and our immediate situation but can be felt for others and also cover anxiety about things we would like to happen in future situations, for ourselves and others.

Anxiety can be understood as a response to a fear of uncertainty.  It is an attempt to ward off unwelcome uncertainty, and also acts as a warning that uncertainty is near.   We can also begin to fear the fear of uncertainty.  This is when anxiety really takes us into its grip.

When acute, the anxiety we experience in our lives is no longer in proportion and certainly not helpful. This can take form in our lives in a number of ways, including phobias, obsessive-compulsive disorders, situational or separation anxiety, generalised anxiety disorder (GAD) and other such conditions.  Why do more people seem to be suffering from anxiety issues?

The world today is unrecognisable from the world only a few generations ago.  An explosion of information and connectedness means we need increasingly complex world-views and nuanced inner-structures to help us navigate what can be an extremely contradictory environment. 

Such a lot can be expected of us, and sometimes this can feel pre-ordained and 'mapped out’ for us, in ways that go against our own inner wisdom. This opens the door to many more internal conflicts, leading to insecurity and anxieties.  A more congruent, simplified world-view may be an explicit target (or, more often I suspect, a non-planned but helpful consequence) of a positive therapeutic process - and reduced internal conflicts is one reason those with a simpler world view seem more secure.

Symptoms

Anxiety is often experienced as a collective of certain symptoms.  Here are a few typical ones, but this is not exhaustive:

Excess ‘worry’

General feelings of upset & unease

Feeling shaky/dizzy

Feeling like you might faint/pass out

Thinking unpleasant thoughts

Thinking that you might “go crazy” or sense of impending doom

Physical symptoms, including: increased heat rate, heart palpitations, shallow/fast/difficult breathing, muscular tension, dizziness, tightness across the chest, headaches, hot flush, sweating, dry mouth, panic attacks (a combination of two or more of the above symptoms).  

The effects of these can be frightening and contribute to further feelings of uncertainty, leading to a vicious circle. Anxiety is very commonly experienced.  It is estimated that 1 in 10 adults may suffer from a disabling anxiety disorder in their life, but it is a very treatable and therapy can really help.  Check out the link in detail, some useful information is there.

I suffer from anxiety, what steps can I take today?

Therapy can help, and the work may be deep (addressing psychological foundations) and also solution-focused to alleviate symptoms (building on top of the foundations), but would probably cover some personal history and exploration of patterns and triggers that cause a sense of anxiety, and the thought processes that keep the feeling full of such unhelpful momentum.  There are various techniques that will help reduce the level of anxiety you feel. I also encourage you also to take steps to help yourself today.  Anxiety in the right dose is intended to help, and it is important to bring this back into a helpful balance.  To deal with physiological reactions, you can try deliberately inducing the opposite states.  For example, should you find your breathing becoming rapid and shallow, consciously relax the body and bring attention to your hands and feet. Making sure to exhale fully (and leaving a one second pause before beginning the next breath), take three slow, deep breaths into your lungs.  Your focus stays split between feet, hands, and the breath.  Repeat for a minute or two.  Count just to three then start again.Note after a minute your symptoms will most likely have begun to subside.  You have brought them under control.

Anything else?

Returning to the quote at the top of the page.  It reminds us that nearly all worry is in the future, and this is why I like it.  But, while quotes are interesting, I also think that unless you can really access the wisdom that they point towards and take steps to make it real in your life, then they remain nothing more than a shiny bauble - something we can all agree looks nice, but ultimately no more use than a chocolate teapot - and not something that can help me… (ha!) If that is you, I would ask you to consider this quote instead:

“Yesterday is today’s dream…. and today is tomorrow’s dream”.

Have a think about that for a minute – actually think about yesterday, with its concerns and challenges and good bits and bad bits, the mundane, the interesting, the commute, the supermarket, the argument, the grief, the painful and the pleasurable, the concerns, the relief - consider it.  Think how real it all was (and how real every day is while we travel through it).  But… how real is it today…?

I wonder if on some level you find a bit of liberation when considering this quote, as I do…

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Who am I...?  (5.8.17)

Did you know that the average person in the UK watches 24 hours of television a week, with a significant minority watching around 40 hours?  That equates to over 9 years, or 16 years for the more committed, of watching television if you live to the average life-expectancy.  That is some very serious TV watching, and the expectation is that this has risen further since UKTV ran their study of viewing habits 18 months back....  Lots of us now favour ‘on demand’ TV services (SKY+, catchup TV etc)  so you never need to go without, and increasingly we consume TV while on the go - through tablets and phones and so on.  Anytime and wherever you are you can watch TV.  What a time to be alive.

If you think this is a bad thing then we’ll get on ok, because my household is definitely playing a part in bringing down that average. In the last week I calculate I’ve watched three hours of TV.  That is fairly typical for me, and if I do sit down it is usually as much to sit with my partner and my dog on the sofa as it is for anything that may be on the screen.  I think that there is a ‘muscle’ involved in concentrating on the TV and, like everything, if you don’t exercise that muscle you find yourself tiring quite quickly.  After 30 minutes I usually am thinking about doing something else.

This means the TV is really my partner’s domain... and what she has on is what I will watch for as long as I watch.  That suits me just fine. One of the shows she watches is called “Hoarders”.  This is a reality show filmed in the States, and the format involves a cleanup crew and psychologist called by concerned relatives (or referred by a state agency) to visit a person with a serious hoarding problem, and the show is recorded over the duration of a three-day cleanup.  Three days is clearly not long enough to tackle the underlying psychological issues at play, and nor is a short TV show able to show more than a small fraction of that effort, but it is long enough to make a start. Having seen a good number of these shows I’ve formed the view that the level of care and professionalism shown towards the Hoarder is high, both from a therapeutic and practical organization standpoint.  It’s also clear there are after-care funds and provisions made for ongoing support. I like the show.

Hoarding is a complex issue, but what I’m interested in here is one particular aspect of experience that all of us share, but which is quite pronounced for hoarders.  Often close friends and family members of hoarders will have no idea of the atrocious and unsafe living conditions that their relative/friend is living in.  “I had no idea he/she was living like this!” is a very common phrase heard on the show.  Equally the person with the hoard can often compartmentalize their life very well - it is almost as if there is more than one person - the ‘person with the hoard’, and, say, the ‘professional woman at work’.  Those at her place of work have actually never really met the “person with the hoard”.

This show is packed with such examples of hoarders playing different ‘roles’, and others (friends, family, co-workers) perceiving the hoarder in that way only.

This is the bit we can all probably relate to, helped by considering the extreme example some hoarders give us.  Most of us find that we play certain roles too.  This is understandable. It would be tough to be a policeman on duty and act as you might do at home.  Equally, in many other jobs, you need to be professional and show a level of competence that you do not when talking with a friend on the phone. Suffice it to say, stepping into different roles is very common and often necessary.

However, there is a strong gravitational pull to some of these roles that doesn’t always allow for us to altogether choose what role we slip into and when.  My partner often says to me when we visit my family who live in another part of the country (imagine an exasperated tone): “But you turn into a child when you are with your family, like a big teenager!”  While I personally feel this is very unfair to teenagers across the land, it is said in a spirit of fun and, frankly, I also have to admit it is true.  I don’t see my family a great deal, and so it is noticeable to me that I do find myself thinking and acting in a different way - I might catch myself becoming a bit sulky or intolerant, perhaps a bit more lazy than normal, generally acting in a way I don’t associate with the ‘home version of me’ and different again in lots of ways to the ‘work version of me’.  This isn’t limited just to what I say and do, but it also covers what I think and feel and what my internal reactions are likely to be to any events that may occur.  My entire representational framework is somewhat different, and this is the case, however subtly, whenever I am in different roles, in different situations, & doing different things. 

Maybe you can relate to this as you consider your own life. All of us have multiple roles we step into and, to an extent, each role has its own set of feelings, retrievable memories, attitudes, and impulses, all of which support the particular role.  At the same time - and this is key - most of us are also capable of sustaining a relatively stable sense of a ‘self’ that sits in the middle of all this at the very centre of the web, switching hats and uniforms, maybe, but still me.  All other things being equal, this is ‘normal’.

With this analogy in mind I invite you to take a step further and to consider something else.  What if, in order to be accepted - to be acceptable - at some point in your life, you had to ‘switch hats’ in a different way?  Picking one example ...what if you grew up in an environment where any sign of sadness was met with a violent reaction?  Where a sign of emotion such as crying was met with intolerance or ridicule, being ignored totally or something unpredictably worse? What if this unmet need was so dangerous or problematic that you had to disavow it in order to survive, to be acceptable in some critical way?  A psychologist may well tell you this aspect of yourself (this need) would be dissociated and not integrated into that sense of “me” that sits in the middle of the web.

Dissociation refers to a splitting off of experience that is incompatible with the “me” that sits at the centre of the web. The more things that are dissociated, the more likely we are to find our own experiences to be confused, frightening, disorganized and generally unstable. The less we will be able to maintain a coherent sense of ourselves at both the centre of the web and within the roles-we-play.

At the extreme end of this are disorders such as Dissociative Identity Disorder, and then we move back down the continuum on our way back to ‘normal’, and on the way back there we may well meet a hoarder or two.  People hoard for many reasons, and no two people are the same, but to make some general points I’ll generalise a bit.  Some of those featured on the “Hoarders” show have some key things in common.  Often traumatic episodes have led to dissociated, unintegrated experiences and lots of emotional pain, of which the hoard can be understood as both an externalisation of, and, crucially, a distraction from.  The central “me” at the heart of their web is thus fragmented, at least partially. The daily roles that the hoarders inhabit can be surprising disparate and adaptive (the unworthy hoarder, the effective worker, the good mother, the horrible wife, the organized friend etc), sometimes with very little cross-connections between roles (”I had no idea!”).  All this means the “me” at the centre has an increasingly hard time constructing a coherent internal narrative that keeps the roles-we-play in orbit of the centre.  Usually, by the time the Hoarders film crew has arrived, this last part has collapsed completely.  There is a lot of work ahead for people in this situation to move forward, and I always cheer when people really engage with the process, take advantage of the psychologist and after-care therapy that is made available. It doesn’t always happen.

It can be a common thing for people who operate very well in life and are successful by lots of measures to feel a lot (or a little) like I describe above... as though the roles they inhabit are just too disparate.  That each one is a remote island from the next and all are too hard to maintain - that there isn’t enough crossover between them and ‘who I really am’.  Ultimately, there is a sense that something may have to give, and indeed it might... This is something I have heard quite a lot, phrased in different ways, as the reason people come into therapy. The work here, as with an extreme hoarder too, may involve looking at all aspects of your life that have become spread out, then seeing what sits at the centre, exploring what works for you and does not, and then (if you wish it) to try and integrate and connect all of these roles more fully.  Drawing back to a stronger more central ‘you’, and telling your story from this place and less from the periphery.

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Mindfulness...2 (25.7.17)

From time to time I might add exercises or interventions to this blog that you can also try if interested - I’d like this place to also be a bit of a repository of things a reader might find useful, & maybe a prompt to do some more digging.  Today I’m revisiting Mindfulness.

I’ve been keeping up (mostly...) with my resolve to introduce a little mindfulness into each day.  I really see this as two things;  firstly the cultivation of attention, and then secondly trying to take that present-moment awareness and carry it over into all the other things I get up to each day.  Here’s a couple of simple exercises I’ve tried that are working well for me at the moment.

Direct your attention inwards towards your heart

Helps cultivate a consistent inward attentiveness.  People who practice this technique often report feeling more present than when all their attention is outwards on stuff, sound, movement etc:

1.     Find something outside and in front of you to use as a point of focus. A door-handle, light-switch etc.

2.     While maintaining some attention outwards on that point of reference, pretend that you have double-sided eyes and look back, in and downwards towards your heart.

3.     As you do this, notice what happens to the thoughts in your mind.  Do they quieten?  Do you become aware of how still it is within you now?

Take your attention to your senses for serenity

By filling your attention with your senses you leave less attention for the thinking mind. You become more fulfilled with your surroundings:

1.     Notice what you can see… just look without labelling, the shapes, textures, distances between objects, the light, focus in on objects, swoop to larger field of unfocused view.  See the centre, the periphery.

2.     Notice what you feel… the seat you are sitting on, your clothes on your skin, the air dancing around you, the temperature… your breath… feel your breath. 

3.     Notice what you hear… tune in.  no labelling or judging, just hear what is…. Ticking clock, a bird, some traffic.  Listen as though someone has turned the volume all the way up.

4.     Notice what you smell…. Take your attention to your nose, be fully aware of the sensation of air going in and out… the passage of air. Are there any smells? Are they sharp or dull, high or low, sweet or sour?

5.     Notice what you taste… What tastes are already present on your mouth?  You can practice further with foods and drink..

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Mindfulness...

The topic of mindfulness has come up in a couple of sessions recently...  Paraphrasing: do I think it is useful and something that should be done, or not? 

I try and answer questions as openly as I can (if I can), but usually after an exploration of why my client thought to ask me. This can be useful and also this helps to ensure my clients’ views remain the central focus, rather than an opinion of mine.

After some talk along these lines, I wanted to give an answer to these questions, but both times I had to think hard about it.  

On the one hand, I think mindfulness is very useful, even crucial, and has value when looked at from a number of ways... but on the other hand, I often let my own practice of mindfulness lapse.

Claiming it is wonderful then admitting to practising infrequently seems a strange position, no?

Jon Kabat-Zinn is a leading author on Mindfulness having pioneered a number of mindfulness-based stress reduction programmes in the States.  He defines mindfulness as “paying attention to the present moment with intention, while letting go of judgement, as if your life depended on it” and I write this definition mostly because it is one I happen to have remembered - but there are different definitions depending on whether you see mindfulness as a spiritual, psychological, or physiological phenomenon.

Mindfulness/meditation plays a part in many organised religions, and the focused intentionality (similar to present-moment awareness described by Kabat-Zinn) can be seen in the process of ‘prayer’.  It may be most visible in Buddhism, where mindful meditation is the central vehicle of spiritual development.  Here we see purposeful meditations which focus on bodily experience, desired states of mind, and on the nature and causes of suffering, and much else. 

These meditations form a roadmap to Nirvana and Enlightenment - a state of bliss - where insights are made into the nature of reality. This is done through exercising the ‘muscle’ of sustained present-moment awareness and concentration on an object of meditation.

So meditation can be a gateway to the divine.  This usually comes with attendant religious rituals; some kind of ‘code’ and belief structure, religious ceremonies, rites-of-passage to mark spiritual transitions, even a ‘total way of life’ including legal structure etc.  Mindful meditation/prayer is an important tool through which we can symbolise events in awareness in the present moment, and is part of the bedrock of a spiritual way of life.

In recent years there has been so much written about the psychological benefits of being mindful.  The spiritual dimension is still there, but the emphasis is on the benefits of practice in reducing stress and improving general health.  There’s so much out there to read, but Kabat-Zinn, Eckhart Tolle, the Dalai Lama & Mark Williams are on my bookshelf somewhere and I’ve found them all interesting starting points.

There is one aspect which seems crucial at the heart of mindfulness.  To live ‘mindfully’ implies an ability for a person to be in a situation, but to develop a capacity that allows them not to equate themselves with the situation they are in.  It strengthens a reflective capacity that allows us to break free from psychological-equivalence with difficult circumstances in our lives (either in our inner world or real-life events) that feel rigidly permanent.  It allows room for new narratives and interpretations, and so we avoid being completely swallowed by a problem situation.

All of us at some time may feel totally embedded in difficult situations in our lives, and it’s tricky to see a bigger picture.  Sometimes this is helpful (for example, I don’t want to think of the ‘bigger picture’ at a time where I need to take urgent action), but a lot of the time we’re stuck and embedded in problems in ways that leave us exhausted, unhappy.  Perhaps in damaging relationships, or difficult jobs, overthinking, dealing with trauma and so on.  We might feel absolutely swallowed up with difficult emotions and unable to get any distance from them, or any objectivity.  Instead, our world becomes one of psychological-equivalence with the events that are ‘happening to us’.  This is usually not a good place to be.

This is why I think mindfulness is very helpful indeed.  It is the psychological practice through which we can cultivate and encourage flexibility.  We can draw ourselves up and out of this embedded state, allowing ourselves to become aware even for a few seconds that we are a subject capable of overseeing our own experience, and not an object being buffeted from one event to another.

This is where psychotherapy can play a big part too in helping people strengthen their ability to hold different perspectives when looking at the problems they are experiencing in life.  It encourages the kind of mental flexibility that allows people to become ‘untrapped’- able to move away from repeated painful patterns and recognise there may be other ways of seeing the world that might be more helpful.    I think psychotherapy and mindfulness are similar in this respect, both help to develop the same mentalizing function.

From a physiological standpoint a mindfulness practice may well help you train-your-brain along the lines I covered in my last blog post (see It’s not brain surgery....is it?).  Kabat-Zinn cites studies carried out by his research unit at the University of Massachusetts - these show interesting results, including shifting activation in particular areas of the pre-frontal cortex from the right-hemisphere to the left-side, and associated strengthening of this region of the brain.  This may help operate as a brake on powerful emotions that upset equilibrium and lead to better emotional balance. 

In addition, studies show greater activation of areas of the cerebral cortex involved with present moment awareness (as compared to a sample of people who had not completed his mindfulness programme). This suggests mindfulness helps people develop a more sophisticated way of experiencing oneself, others and the world.

This is good stuff then.

So why do I often find my own mindfulness/meditation practice stalling?

Well, frankly, there’s not a great excuse but the real answer is because it’s HARD.   But writing this has motivated me to start afresh.  I tell myself I am usually too busy, and I am quite busy but I have a few minutes a day.   I tend to jump a little too far into the future when considering things I want to start, which is nicely ironic for mindful meditation. For example,  a part of me is also considering how I will sit, where, for how long, what I will wear to be comfortable etc.  This can sometimes squash gentle first steps.  Knowing this, I think I will start small this time and work up. 

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Experience... (14.7.17)

From time to time I meet candidates who have applied for various positions at the place I work. I’ve given up keeping a tally, but I’d estimate over the years I’ve been involved with well over a hundred interviews and twice that number again of ‘internal conversations’ with existing staff that are similar, about career progression and so on.

The way I conduct interviews has changed a lot over time and the more I’ve done of them the happier I am if they take on the quality of a conversation rather than a high-stakes Q&A session.  This is now invariably what I try for, and I’m lucky that the hard work of checking expertise has mostly already been done, which leaves me free to try to encourage an open dialogue.

Interviews can be an extremely lop-sided psychological encounter where one party has all the power and the ‘reward’ to bestow, and the applicant tries to say the right things (in the right way, at the right time) while containing any nerves or panic.  Years ago and in a junior role I was part of a small interview panel and saw this power abused, with candidates pushed unnecessarily by senior managers to a point where nerves got the better of them.  This was sold as being something of a test of their resilience under fire, but I’m not sure it was that at all.  As a junior I was mostly there to learn, and I think I did learn - but not much about the candidates. Being involved with that is something I regret, but  I also learned that some people with excellent abilities are just deeply uncomfortable in interviews, and I try to consider this when talking to someone.  I’ve also had to come through some tough interviews and I know how hard it can be to feel you have done yourself justice. 

Jobs in the finance sector are relatively few in number at senior institutional levels and the financial rewards are quite high.  The pressure is on.  For those that find themselves really needing a job to service a hefty mortgage and some school fees this can sometimes lead to a retreat in interviews to safe, stock answers - nobody wants to stuff these things up.  Often I hear very well rehearsed messages, and I don’t doubt the candidate is strong, but nonetheless I sometimes leave interviews that take on this character feeling that nothing is learned.  That psychologically we have not really met each other.

I certainly don’t blame the interviewees.  The challenge here is for the interviewer, if he or she wishes it, to help create the space in which it is clear that authenticity is as (or more) important than professional-sounding fluff and polish.  This is a difficult balance to get right for all sorts of reasons... and even if you do get it right there is no guarantee the person you meet will take up the invitation.  But if you give up trying to get it right, in my view you should also give up interviewing.  This is a skill that undeniably gets easier with some experience of running interviews.

‘Experience’ is a funny thing that I increasingly feel is both under-estimated and over-estimated at the same time (in my experience, of course). A candidate I met recently told me at great length of his relevant professional experience, and I realised after 30 minutes that nothing I could say would divert him from stock, slick (and very good) professional answers.  We saw the interview out and went our separate ways, not having really met.  In this case I could not say I had any direct felt sense of the candidate’s experience, despite his emphasis on it, and what was written on paper.  

There is an inter-subjective quality to Experience.  It isn’t just something you ‘have’ and then ‘do’ to others, despite what is on a CV.  Of course you acquire experience through personal practical contact with (and observation of) facts or events... but part of the advantage of having people in your company (or in your life) with experience involves them having a capactiy to transmit their experience in a way others can then receive - can get a feeling of - and which provides a generalised sense of depth and assurance from which others might learn things and be inspired. 

Many people seek help to interview better, and preparation and practice is key for sure  (therapy can also help in lots of ways with this), but I usually also encourage a focus on authenticity too - the vehicle through which your strengths and experiences are transmitted such that they can be felt and known by another.

“How is experience over-rated”, I hear you cry?  Well, as an example, twice in the last month I have talked with a member of staff who I value to encourage her to apply for an new job opening.  This involves an expanded role and, down the road, benefits that come with career progression into management.  Paraphrasing, she at first told me she feels too young and without the experience needed to make a success of the opportunity.  She thinks this, and yet this person actually fills me with confidence and I get a clear and felt sense of her varied (and entirely sufficient) professional experience.  The point is this:  I feel that I am in the presence of someone with experience.

Perhaps it is not that experience itself is over-rated, but that our view of it has become too narrow.  Such importance is assigned to acquiring experience that too little emphasis is placed on being able to wrap it up into an auto-biographical narrative that can be shared with and felt clearly by another.  This might suit people who happen to have been at work for more years, but can come at the expense of dynamism as some younger people, like the colleague I describe above, are often chasing ‘the right’ level of experience, which is always somewhere over the next hill.

The same is true in reverse, of course, experience can be under-rated and I have seen this professionally at times too.  If budgets are tight, say, it can be tempting to economise by sacrificing experience, and so expertise, and bring in  outsourced consultants brought in in bulk at the right price.  And we’ve all seen younger professional people who have all the answers and who are sometimes bit too quick to disregard experience too.  I was like that once, but now I'm all experienced I know better.  Ha!

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It’s not brain surgery..... is it? (6.6.17)

When driving in France recently our route took us by a huge engineering plant in the rust-belt that borders the beautiful city of Rouen. I have no idea what is produced there, but the structure is massive, a maze of piping, funnels and furnaces.  There are conveyor belts and walkways extending for what seems like acres in all directions.

I’m fascinated by the complex design and coordination that must have been required to construct a monster like this. Someone had to design it all and actually understand what each bit of the maze must do... then translate that understanding to paper in schematic plans. It’s easy to imagine there were lots of changes - disagreements on what pipe goes where and what walkway points this or that way.  All of this had to be settled and agreed, so presumably there was lots of paper.  Then the work would have begun, all built to a final set of specifications, all of them meeting industry regulations.  It must have involved thousands of people and maybe tens of thousands in the supply chain. The whole plant would have been built from the now-hidden foundations upwards, connecting all the different layers from bottom to top and side to side.  All the materials assembled at just the right points, all cut exactly to size and bound together by many teams working to the over-arching plan, all to the nearest millimetre.  Wow.

Now I’ve got no idea if this plant is, or ever has been, operational.  It looks old and defunct to me, but as I’ve never built a factory my opinion definitely doesn’t count for much. I find it enough to know that there are people out there who can make sense of things on such a scale, and that ultimately something will be produced that is useful - maybe electricity, medicines, or tyres, or…well…you get the point. 

For whatever reason, this plant always makes me think of a huge, rusty human brain whenever I see it.  It does look a bit like one in outline. I like to imagine someone may one day press the ‘on’ button and the whole thing will crank up and start thinking rusty thoughts. Ok, I admit a production plant is probably not the best analogy for a brain - it is far, far too ordered and simple - but there is something about the process of building such a plant, and connecting all bits of it to run properly, that is reasonably analogous to healthy neural and psychological development. 

As a practitioner I think it’s helpful to have at least a basic understanding of neural development throughout the lifespan. Work in this area increasingly allows therapists to ground their clinical work in ways that are measurably effective, and, I think vitally, if we work in an integrative way (as I do) it may help us choose the right therapeutic approaches to help our clients. This is pretty exciting stuff.

A few things have recently reminded me of the importance of this topic.  One was reading a good article in an industry mag Therapy Today by Sally Brown titled “The neuroscience of depression”. The other was someone telling me they had a relative that used to shout, it’s not brain surgery! as an admonishment when, as a child, this person could not make difficult decisions. Hmm. The third was someone else telling me how ineffective they happened to have found the short course of CBT favoured by the NHS (and this is something of a repeat theme).  

We know that experience shapes circuitry within the brain.  We know that what we call 'experience’ is, from a neural perspective, patterns of activating / firing brain cells. And we know that this pattern establishes synaptic connections within the brain that impact upon structure and functioning. 

A stimulus, let’s say a smile on the face of a mother, sets off neural activity in a baby’s brain.  Synaptic connections are created and the stimulus is associated with feelings of wellbeing in a neural network.  It is in this way that experience shapes the circuitry of the brain, especially so with repeated experience. This is the idea that ‘neurons that fire together wire together’ (Hebb).

So, the physical and psychological experience of our imaginary baby begins to manifest as newly established neural connections that in turn play a role in determining how this baby will react to future experiences.  Let’s say the mother in this story did not smile and turned away repeatedly (or worse), this would impede the development of those neural connections thus limiting the potential of the baby to feel emotions associated with wellbeing.  Over time, as the brain develops, these neural pathways form the basis of the young child making predictions about themselves and their environment.

Sticking with my slightly dodgy power plant analogy, let’s look at the brain itself.

Brainstem

Like the Rouen plant, the brain has a few levels that need to work together. Physiologically, the Brainstem is the ‘basement’ of the mind and the oldest part of the brain from an evolutionary perspective.  

A key structure within it is the Vagus nerve that regulates critical organs (heart and lungs etc) and the muscles in the face and head that allow social interactions. This nerve plays a key role in shaping our physiological responses to situations of all kinds, whether threatening or pleasurable.  It also plays a role in down-regulating the sympathetic nervous system too, without which we would spend much more time in fight/flight/freeze modes.  The regulating capacity can be knocked offline due to trauma or extreme stress, as sometimes seen in those with PTSD.

In short, the brainstem governs critical physiological functioning, and helps control over/under-arousal.  David J Wallin in his book Attachment in Psychotherapy suggests those suffering the effects of trauma may need help to ‘effectively modulate’ their levels of physiological arousal.  The work here would focus on body, nonverbal experience and the nuances found in the therapeutic relationship.  Note how this differs from the approach of short-term time-limited cognitive therapies offered, sometimes remotely, by the NHS (more on this below).

Limbic System

Next up we arrive at the limbic system - the ground floor of the power plant. This is the ‘emotional brain’ where we process feelings. There are two key structures:

Firstly, the Amygdala which acts as a sensory gateway and is well developed at birth.  Within fractions of a second the amygdala can appraise sensory input (a snarl, a gunshot, a shout etc) and signal to the brainstem to activate fight/flight physiological responses. The appraisal the amygdala makes depends on personal history, as the amygdala registers experience and holds ‘emotional memories’.

Secondly, the Hippocampus which provides the capacity to sequence and contextualise our experiences.  The amygdala cannot do this, and makes no distinction between, say, a Lion on the TV and Lion in your sitting room.  The Hippocampus therefore acts as an important brake that engages the parasympathetic nervous system ‘downstairs’ in the basement and allows physiological calming depending on whether the Lion is real.

Crucially, the hippocampus is not developed at birth. Full functioning only becomes available in the second or third year of life. It’s easy to see how early experience and learning processed by the amygdala can result in context-free equivalence between safe and threatening situations, and be powerful and overgeneralised.  Again, ‘what fires together wires together’. 

From a physiological standpoint, these key structures within the brain can and do change in size, depending on the psychological state a person is in (over some time).  Sally Brown cites studies that show in a sample of people with depression the Hippocampus was 19% smaller on average.  Whether this is the cause or effect of depression remains unclear, but Brown quotes Schmaal: “We think that the association between a smaller hippocampus, especially in people with recurrent depression, is a result of prolonged and / or recurrent stress.”

Further studies show that psychotherapy does help.  There is good evidence that different modes of therapy treat  ‘different areas of the brain’ (more on this below).    This can help practitioners ask important questions: What therapeutic approach is the right one for this person?  Will cognitive approaches, for example, be as effective as deeper relational therapeutic work exploring sensations, feelings and impulses that are a reflection in the body and mind of these early pre-verbal experiences? But then cognitive or behavioural approaches might help develop strategies which reduce over/under arousal of the amygdala etc.

So maybe both are necessary as both do different things.  Alan Schore (a leading light in this field) suggests as much.  Sally Brown quotes him and I paraphrase: “For me there are two forms of psychotherapy. There is symptom reducing, short-term psychotherapy, then there is a second form of longer terms psychotherapy, which is growth-promoting.”

Austerity notwithstanding, what a shame the NHS doesn’t take notice of this and offer a much greater range of longer term talking therapies where it is indicated this may be a more useful approach. 

Neocortex

Back to the brain.  Now we are on the top floor of the power plant. The cerebral cortex is the higher and upper floor of the brain and is also the last to emerge from an evolutionary standpoint and in the individual.  This part of the brain helps us make sense of experience and our interactions with others and the world and its function continues to mature throughout life. The areas towards the back of the brain govern our perception of the world through the senses.  The front areas are responsible for thought, raising mental representations to awareness, planning, memory, language, reasoning and much else.

The most advanced area is the prefrontal cortex which has two distinct regions.  The first (dorsolateral) has strong connections with the hippocampus and the reason-oriented ‘left brain’ hemisphere.  The second region (middle prefrontal cortex) houses the orbitofrontal cortex, which sits behind the eyes and plays a vital role in emotional regulation.  It is a convergence channel through which bodily, emotional and cognitive channels pass. 

Behind the orbitofrontal cortex is the anterior cingulate which may be the seat of maternal behaviours and for conscious experience of emotion.  Finally, there is the insula, a small area vital for ‘interoception’ - how we know how we feel.  It is also suggested that this is the area responsible for the ability to impute the mental state of others, and involved in the observed phenomenon of firing ‘mirror neurons’.  A key area for the quality of empathy then.

The neocortex is essentially where we find memory and our predictive power.  Through experience (body, emotions, thoughts) neural patterns are laid down that help us make associative predictions about situations unfolding and future, potential situations.

Joining it up

So, we can see how the brain is built from the ground up in layers.  But as with the Rouen plant, one side has also to work with the other side with all the funnels and walkways linked up.  

The right-hemisphere (right-brain) is specialised to respond emotionally and nonverbally and has dense neural connectivity to the limbic system. The left houses conscious thought and represents experience in a linear way through language (the voice in your head as you read this).

There are some powerful arguments (Damasio, Siegel) that the higher cortex/left-brain structures are often dominated by sub-cortex/right-brain processes.  This suggests that neural traffic tends to be directional, coming from the ‘basement upwards’ rather than the ‘rooftop downwards’, with the sub-cortex ‘amplifying’ and the neocortex ‘moderating’.  This seems to call for a ‘basement upwards’ approach to psychotherapy.  Again, Wallin suggests should be grounded in body-work and including focus on non-verbal aspects of the therapeutic relationship and Alan Schore points also in this direction.

Brain Physio?

I hope that the mental health services offered by the NHS keep pace with discoveries in the field of neuroscience.  This should involve a much greater investment in longer-term relational therapies (as well as continuing investment in time-limited cognitive therapy, for which waiting times are far too long).  In my mind this is in no way a choice between approaches, but an acknowledgement that there is a clear need for the former, a current lack, and, I hope, a serious commitment to redressing the imbalance.

As mentioned earlier, psychotherapy of all modes can be helpful and Sally Brown cited several studies; one showed that over-activity in the amygdala was reduced to ‘normal’ after 8 months of psychodynamic therapy, and another study showed over 14 weeks of CBT a reduced over-activity in the amygdala and increased activity in the prefrontal cortex.  She quotes Siegle: “Cognitive Therapy teaches you to step in and use your prefrontal cortex rather than letting your emotions run away with you.”  This work perhaps helps the higher cortex/left-brain to regulate the arousal of the sub-cortex/right-brain processes. Maybe this is partly what Schore had in mind when talking about ‘symptom reducing’.

In the future as technology advances further, perhaps the idea of working directly with the brain might become even more explicit.  Maybe there will be such a thing as ‘brain physio’ where certain therapeutic approaches are known to have greatest neurological effect in certain areas of the brain.  For example selecting certain approaches that best strengthen, say, the anterior cingulate or insula regions, and another approach to develop strategies which regulate the over-arousal of the amygdala.  I am actually not sure at all how I would feel about such a development like this for various reasons, but I do suspect that this is what already 'happens’ through the course of effective psychotherapy.  Would it be such a giant leap to introduce an element of intentionality to proceedings?

Here is Schore again: “The right hemisphere is really the core of the problem.  It’s selectively involved in processing negative emotions in depression, pessimistic thoughts and feelings and outlook on life, as well as sensitivity to pain. And if you have connectivity that is poor within the hierarchical apex (bottom up) of the limbic system into the amygdala there is a poor ability by the ‘higher’ aspects of the brain to regulate the lower aspects of the right brain.”

For me these factors come together to make a strong case for an integrative approach to therapy, ensuring psychological foundations are solid from the ‘bottom up’, and a ‘top-down’ approach to our work to help alleviate symptoms and develop more helpful patterns. These things are not in competition but seem to complement each other and likely work on different parts of the brain.  

The Personal Consultancy framework may help with this (Popovic & Jinks, 2014) allowing, as it does, the integration of both the reparative and generative modes of therapy & coaching into a clearly demarcated framework of practice.  This is a reasonable proxy for the type of division of labour that Schore and others are talking about. More on this on my website if interested.

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(Happy) Endings... (17.6.17)

It’s been a month where a few situations, some professional and some  personal, have come to an end for me.  Two endings in particular have been quite hard, but both have also symbolised positive things for me too.

To my friends in East London, congratulations to you all and I’ll be raising a glass to you tonight.

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Risky Business... (22.5.17)

‘Risky Drinking’ is an HBO documentary following several people as they struggle with alcohol addiction.  It’s worth a watch if you’re interested in the issue, and the striking honesty of each of the people filmed had me gripped. 

There is no irritating narrator getting in the way of things, and no dodgy ‘reconstruction’ scenes.  Not much time is spent discussing the personal history of participants, save what people choose to say spontaneously.  As little time is spent exploring ‘pathology’ there are no leading questions that force subjects into having to defend or explain themselves.   

And so when something about their reasons for drinking is mentioned; losing a job, a bout of depression, challenging relationships and so on… it has the ring of powerful truth to it -  it has come up organically for that person, without a producer manipulating things in the background.  The result is more powerful because of it.  Each person is allowed time to talk without interruptions and it’s gripping. The focus is mostly on issues caused by excessive alcohol intake and the filming took place over a period of a few months.

A few things struck me. The immediate positive reinforcement of a drink ( the ‘high’) as well as immediate negative reinforcement (‘numbing the pain’). And although each person at times expressed the desire to stop drinking, it’s clear these reinforcements often outweigh other things; (such as family life, health, wellbeing, as well as other meaningful sources of gratification).  I was also struck that each person, at least at first, had no desire to achieve abstinence.  The target for all was for a greater degree of control of their drinking habits.

Beck, Liese & Najavits (Clinical textbook of addictive disorders, 3rd edition, 2005) make reference to key areas of psychological vulnerability that can be a contributing factors to the risk of misusing alcohol (or other substances), and each is an area in which therapeutic work can occur. These are:

Risky situations: external (people, places, things) and internal states (anxiety, depression etc).

Dysfunctional beliefs: anticipatory (’alcohol relaxes me’) and relief-oriented (”I’ll fail this unless I have a drink first”)

Automatic thoughts related to these beliefs: “Drink!” “Go Ahead!” “Relax!”

Physiological cravings.

Permission-giving beliefs : “I’ll quit soon.” “Just one won’t hurt”.

Behavioural strategies linked to the using of substances. “Go to the off license” “Call my dealer”

Adverse psychological reactions to a lapse or relapse that lead to a vicious cycle.

I feel sure that ‘greater control’ is a good choice for many people, and it is certainly a better strategy than ‘no control’.  But this documentary did make me wonder how out of control my life would have to be before I decided that abstinence might be the best choice for me…