Saturday, 20 October 2012

Wheeling, Dealing and Scheming

Sadly the psychodynamics session was mediocre at best, but bumping into Bulent over coffee, I suggested what a good member of the Edcuation Section committee Yousuf would be, and he warmly agreed. Soon after this, I found Yousuf, and he invited me to a grand pow-wow of the heads of all the 67 sections of WPA, to which he had already been invited to be a gatecrasher. Enthusiastic at the smell of new blood (maybe) we were actively included in the discussions to promote cross-sectional working. So Yousuf agreed to be on the Education Section, and apply to be on Developing Countries Section – for which I fully expect him to be chair or secretary within a year.

For my part, I made contact with the Psychotherapy Section chair, and want to explore their interest in collaborating with the Education Section in promoting the importance of experiential learning and our KUF-style ‘quality of relationships’ training - which of course was the subject of our symposium on Thursday. I also recognised the potential that might come of joining the Social Psychiatry Section, to perhaps promote the new breed of TCs we are developing in the UK, and hope to do in culturally congruent ways in Afghanistan (and maybe elsewhere).

So, much as an autocthanous delusion crystallises out of thin air, here’s the game plan that Yousuf and I have cooked up:
  1. Following our symposium, we do what we can to promote experiential learning through the psychotherapy and education sections. Use our presentation as a springboard for the idea.
  2. Join that with developing countries section (hopefully under Yousuf’s leadership!) to develop training programmes such as we were planning for Kabul last year (see previous blog entries)
  3. See if this could be done as an activity of Putting People First, maybe in collaboration with IMH.
  4. See if IMH would be interested in developing cross-cultural KUF-type online material as part of the training effort.
  5. Suss out whether the psychotherapy section is interested in TCs.
  6. If so, plan a congress symposium in the next year or two as part of the section’s work. To include the Thames Valley TC model, Steve Pearce’s RCT, the cultural and economic benefit of adding greencare, and plans for Afghanistan. Maybe also including the Social Psychiatry section.
  7. If not, take that symposium to next June’s separate Social Psychiatry congress in Lisbon.  Maybe do this anyway.
  8. See if there is any other interest in such a symposium from people at the TCTC Windsor Conference this coming week.
Maybe they should keep us two apart!
Footprints on the pavement

In some need of an antidote to wheeling, dealing and scheming, I followed the antipsychiatry footprints on the pavement to the travelling film exhibition put on by the American ‘Citizens Commission on Human Rights’. Slick but extremely shrill,  I presume it is something they put on all over the world for events like major psychiatric congresses, to ‘put the other side of the story’. Although I was sympathetic with much of what they were saying, the message was drowned out for me by the high intensity invective and ‘hard sell’ – populist maybe necessary to transmit messages like this, but dumbing-down to this level patronises everybody and just insults most people’s intelligence.
Dumbed down
 The other footprints – much more numerous and continuous – led to a sinister black lorry identifiable by only a pharmaceutical logo. Inside, we were promised an frightening experience of what schizophrenia was like. As close as a theme park ride is to something really frightening, tabloid tales are to truth, or Hollywood is to real life. Lavish and clever – but that’s all most people expect nowadays isn’t it? Like the antipsychiatry roadshow, I suspect it treks round the globe to follow international congresses and events – although with very different purposes, intentions and values, with equal shallowness and lack of integrity.
A sinister lorry

Then I just caught Paul Moran presenting the rather counter-intuitive results of a feasibility RCT for crisis plans in BPD: the trend, without statistical significance, was to increased self-harm when engaged with a well-shared crisis plan. The economics data, and qualitative ‘successful engagement’  result, pointed the other way, but nothing was conclusive. Rather disappointing. Let’s hope Steve Pearce’s RCT of TCs isn’t as damp a squib…

More importantly personally, and in a whole-system way of thinking, was a few minutes conversation I had with Paul. Our unsubstantiated conclusion widened out the one that Yousuf and I reached yesterday morning: many psychiatrists in the NHS are being systematically devalued, disempowered and demoralised. In other countries, in other and kinder times, this would be a public mental health problem.

The day finished with a dinner cruise on the Vlatva River, which cheered us all up and was an almost perfect combination of music, food, fun and utterly beautiful scenery. With the added bonus of one of our team getting engaged in a deep and meaningful conversation with an e-psychiatrist , who presented papers on the power of cyber relationships, proposing a serious reversal of his professional practice – and requesting uncharacteristic hyper-proximity. She told him to buzz off, and the rest of us formed a human shield around her for the rest of the evening.

In wandering back to our hotel through the streets of the ancient quarters of the city, we chanced upon the dear old astronomical clock.  The midnight performance was a few minutes away, so we regained our favourite spot in the street cafĂ©, and tried a few adventurous cocktails, all wrapped in bright red blankets against the chill of the night. Only to be sorely disappointed at the witching hour: no apostles, no Jesus, no lust, sloth, greed or even rattling death. Our waiter told us that silent night lasted from the last performance at 11pm until the first at 7am. 

And so to bed.

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