Rethink for PD

I don't remember quite why I agreed to go to deliver a free three hour seminar to several people at Rethink HQ on why PD matters and how it is different from most of the rest of mental health, but the view from their seminar room alone was worth it. We even had to take our own sandwiches.

Unfortunately, because it was completely unscripted and unprepared, I can't remember anything that was said - although I have a vague recollection of getting quite excited, being rude about the government's mental health policy and using a couple of swear words. 

But by the end, everybody seemed happy and appreciative.

An odd afternoon, but I hope they end up doing something sensible about PD - they certainly seemed to get the point. But they are one of those big corporate NGO-type organisations - so you never can quite tell.

The London WASP

A rather disappointing event deep in the windowless and airless bowels of a London hotel, improved considerably - at least in wackiness - by Peter Tyrer's family and friends rendition of 'Browning- An Operetta'.
Peter claims it was in the service of giving the new and rather sterile Royal College of Psychiatrists HQ a soul.

The Peter Tyrer show

Graham Thornicroft did his set piece on Global Mental Health, which I saw him repeat a couple of weeks later at the parliamentary launch of  "Mental Health for Sustainable Development" for which Adrian Worrall and I submitted evidence to the committee, and yet it emerged with no mention whatsoever of groups...
www.appg-globalhealth.org

The Graham Thornicroft show

Robin Johnson and I followed, with our 75 minutes truncated to 60, giving the WASP the benefits of EEs, PIPES and PIEs. Here's the prezi:

http://tinyurl.com/wasptalk 

Founders group - London number two

...and as I added - it's not surprising that it's depressed when it has been so badly emotionally abused for such a long time. It's showing typical signs of long-term abuse - learned helplessness, always in fear of yet more persecutory demands, and anhedonia.


But what a fabulous building is the professional home to the nation's 600,000 nurses!

The grand staircase at the RCN

And what a good meeting we had - it ran like clockwork: some of the organising team thought it was too gloomy and pessimistic, but I reckon that's exactly what we need at this stage.
For more info, go to the group website - which is going to be a major resource for the campaign.
But while that's being built, here's an HSJ article about it all: http://tinyurl.com/fginhsj

The grand collection of volunteer group analysts

We won!

Which is very ironic, to win a sustainability award for a project that is financially unsustainable...

But here's all the info from the press release:

‘Greencare for Personality Disorder’, run by Growing Better Lives Community Interest Company, has been named Outstanding Contribution to Sustainability Psychiatric Team of the Year 2014 by the Royal College of Psychiatrists. The annual RCPsych Awards mark the highest level of achievement within psychiatry, and are designed to recognise and reward excellent practice in the field of mental health. Three members of the team were presented with their award by Dr Daniel Maughan, Royal College of Psychiatrist’s Lead for Sustainability, at a prestigious ceremony held at the College’s London headquarters on 6 November.

Rex Haigh, Fiona Lomas and David Hare

‘Growing Better Lives’ is a social enterprise based in a yurt at Iver Environment centre near Uxbridge.  The team work with Slough NHS patients to provide an intensive ‘bio-psychosocial’ programme for patients with personality disorder, who have often suffered severe childhood abuse. There are weekly therapy groups based on principles of modified therapeutic communities, ecological sustainability and ‘greencare’ (therapeutic horticulture, animal assisted interventions, care farming and other nature-based approaches).  The team includes ex-service users, horticultural therapists and a medical psychotherapist. Iver Environment Centre is run by Groundwork South, who are partners in the project’s delivery.

Competition for the RCPsych Awards is extremely tough, and the judging panels were impressed by the quality of this year’s entries. The judges said: “The Greencare for Personality Disorder programme demonstrated really excellent environmental awareness across all aspects of the service from care delivery, reducing energy usage through to local food sourcing and using green spaces therapeutically. They also engaged both staff and patients in the service with improving sustainability and gave a high priority to improving environmental awareness”.

Professor Norman Sartorius, probably the most distinguished psychiatrist in the world, who also received an award at the same ceremony, endorsed the idea of therapy in a yurt when he recounted his experience in one in Mongolia, commenting that “it’s a circular space which is very non-threatening, very non-violent”.

When receiving the award, Dr Rex Haigh, the psychiatrist in the team, said:

“NHS services for personality disorders are often very poor, and greencare is a holistic and economically viable alternative to treatment with medication and hospitalisation.

Sustainability is about connecting people to each other and to nature, helping people to see that there is a life worth living, and on a planet that is worth living on.”

The therapy yurt at Iver Environment Centre

The interior of the yurt - an ideal setting for group psychotherapy

Website: www.growingbetterlives.org
Video: http://tinyurl.com/greencaretalk
Contact: fionalomasnpd@gmail.com

Growing Better Lives CIC is a social enterprise committed to providing, training, and researching critical approaches to mental health. 

A truly radical and critical conference

... held in the medieval grandeur of Dartington, with its Bohemian and Arts and Crafts roots, and Transition Town Totnes - an inspiration for anybody with a sustainable thought in their head.

This was the inaugural Limbus Critical Psychotherapy Conference, title 'Challenging the Cognitive Behavioural Psychotherapies: The Overselling of CBT's Evidence Base'. Official site here. There were six talks, with lots of large group plenary discussion time, good spaces for small group reflection around our tables - and a bar with decent beer in the evening!

Farhad Dalal opened the proceedings with a short impassioned plea for the values of being authentic and human.

The first session was Jonathan Shedler: What is the Evidence for Evidence-Based Therapies?

Jonathan Shedler

A lovely critique of the over-egging of the academic mountain of papers 'proving' the effectiveness of CBT.

Quotes:

• "the master narrative"
• "Evidence Based Therapy has become a brand and its apparel is all marketing, with a vast chasm between the buzz and the research "
• "the inverted pyramid of shame"

The next session was Goran Ahlin: Waiting for the tide to turn: Aspects of the rise and expected fall of CBT in Sweden.

Goran Ahlin

A decade-by-decade trip through fifty years of Scandinavian psychopolitics - though I'm not sure I'd be as optimistic as he was about the tide turning any time soon.

Quotes: 

• "New Public Management" (a rather chilling concept which ran through much of the weekend)
• Sweden was saved from the worst excesses of the post-1979 economic system
• "Fascistic state of mind" (from the discussion)
• 'Intolerance of any uncertainty" (ditto)

After lunch was Patrick Pietroni: Improving Access to Psychological Therapies: Where we were, where we are, and where we are going.

Patrick Pietroni

Turning IAPT into something meaningful - a vision of how an integrated primary-care based therapy system could deliver real therapy with much more benefit to everybody - rather than the superficial, transient, overcontrolled and often inaccessible system of Lord L and David C. And it has already started in Shropshire!

Quotes:

• "A different kind of space"
• "healthy human relationship systems"
• "social determinants of health"
• "Every MBA in DH should do an MBWA: management by walking about"

First up on Sunday was Oliver James of TV and book fame: Happiness, CBT and Apple Pie. Not to be confused with Jamie Oliver of course! 

Oliver James 

A gripping tale of intrigue and skulduggery as an elderly lord of the realm meets a sinister man-in-black psychologist - and try to make everybody happy. With solid genetic and social commentary.

Quotes:

• "Drivel"
• "La-la land"
• "Weasel words"
• "Happiness rubbish"
• 'Thrive' as a 'completely irritating' book

Next was Del Loewenthal: NICE Work if You Can Get It; Evidence and research cultural politically influences practices.

Del Loewenthal

This was a dense intellectual argument from deep in the academic world of non-positivism, and a scrupulous picking apart of the NICE machine

Quotes:

• "post exisitentialist"
• "relational psychoanalysis"
• "How dreadful it would be if psychotherapy became an agent of social control" (in discussion)

The formal presentations finished with Farhad Delal: Statistical Spin, Linguistic Obfuscation; The Art of Overselling the CBT Evidence Base.

Farhad Dalal

This was based on a close examination of a prominent CBT 'evidence' paper, and showing just how slippery both the numbers and words are - and how the impact it therefore has is a long way from the science in it.

Quotes:

• "3rd wave CBT" (about acceptance rather than control)
• Mischievously incudes words like 'Compassion-based'; 'Mindfulness-based'; 'Attachment-based' and 'Resilience-based'. 
• Parallels with Ben Goldacre and Bad Pharma
• "reduction" of risk of relapse does not equal prevention
• "CBT did iatrogenic harm" to those who had <3 depressive="" episodes="" li="" previous="">
• "MCBT (mindfulness-based CBT) is a perversion of an Eastern philosophical tradition." 

So, together with conversations setting up a SW event for the NHS campaign - and lunch with one of the key players in Transition Town Totnes - and scheming other cunning plans: a very stimulating and exciting weekend. I hope the 'Totnes / Limbus / Dartington Conference' becomes a regular fixture on the psychotherapy calendar.