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A few weeks ago I went to an international conference on BPD in Berlin. It's taken me this long to recover sufficiently to be able to blog it. Where to start?? Well, to contextualise my grievance which follows, I recently spoke at a conference run by Broadmoor, on social inclusion and recovery. 4 of the 5 speakers were service users, and there were plenty of service users in the audience.

In Berlin, however, there were dozens and dozens of plenaries, workshops, seminars, poster sessions etc - not one of them run by a service user. The whole event was framed in terms of us as patients, research fodder, medical curiosities. I did write in very good time to the conference organisers offering to run a session - and didn't even get a reply!! (Perhaps my mentioning, for the first time in a conference context, that I've got an OBE backfired. They probably thought it stands for Obviously Bloody Empty-headed.)

The irony is that Germany has an outstanding, dynamic, warm, creative, constructive organisation of people with BPD - Grentzposten. They had a stand at the conference which generated huge interest, not least because of the excellence of their regular magazines. The very very best part of the 3 days for me was meeting and becoming instant pals with the women who run the organisation. It is a real honour to be able to publish the video of the interview with Tina and Franzi below.

(The one concession to service users was that there was one session where German service users met with professionals to discuss their views, priorities etc. My almost fully evaporated O level German didn't stretch to managing the session.)

I went to the conference because I wanted to hear and bow down in gratitude to Marsha Linehan, the creator of dialectical behavioural therapy. It's not really appropriate to go into details here, but I was 'surprised' by the tone of her presentation and it triggered a bizarre meltdown. At one stage, when I was finding it almost impossible to contain the suicidality the presentation had evoked, I did think that it would be ironic if a presentation all about how many lives Linehan and DBT have saved resulted in one being lost. I am soooo lucky to have a genius, super-skilled, continuously accessible crisis therapist, Patrick Doyle. It only took a few hundred (or at least 2) calls to Patrick for me to be sane and stable enough to be able to return to the conference the next day.

In contrast, the presentations by Anthony Bateman and Peter Fonagy were phenomenal. Accessible yet highly specialist, humorous yet palpably empathetic, self-depracating yet conveying powerful credibility. I'm very grateful to Prof Bateman for letting us include the videos of his demonstration of mentalisation based therapy on the website. Click here to watch these.

Right. I'm off to email my new big pal Tina from Grentzposten. Please do watch the video below as Tina and Franzi are exceptional advocates for those of us with BPD.



 
 
I've read and heard some great quotes and stories this week:

Lance Armstrong (Olympic cyclist who overcame cancer):
"Pain is temporary. Quitting lasts forever."

The following is a pretty weak joke, but it really resonates for me in terms of my wrestling with the decision to die:
A man falls off a cliff. As he plunges to the ground, he's heard to mutter: "So far so good."

I've started doing stand-up gigs. Not an obvious choice for someone with severe depression, suicidality etc - and perhaps that's why my routines aren't very good. But I get to hear great gags! These are my favourites from the fabulous open mic night run by The Dead Comedian's Socks:

"My mother suffers from Parkinsons. She can't stop going around interviewing people."

This gag was delivered by a bloke who exaggeratedly staggered on stage looking all dishevelled and holding a pint: "I'm a recovering alcoholic. I had flu last week but I'm feeling better now."




 
 
Thanks to my lovely niece Esther for showing me this quote, from a book by the drama educationalist Gavin Bolton:

“the notion of ‘protection’ is not necessarily concerned with protecting participants from emotion...but rather to protect them into emotion”.

I like the idea of protecting us from feelings, but can't deny the attraction of protecting us from very painful feelings.
 


 
 
 
Was a sunny day, not a cloud was in the sky, not a negative word was heard….

 

Thanks Paul. This is indeed how it was in downtown Muswell Hill, as Friday grew to a close and the inevitably rainy weekend drew nearer. I couldn’t be out in the back garden because I was waiting for an Asda delivery. The bill was very cheap and the van was very late.

 

I retrieved my thoughts from the flowerbeds, and imagined how it would be when the guy arrived. (Women may have broken through the glass barriers of politics, religion and being a gang member, but Asda delivery remains a prime feminist target. Mainly because women need punctual deliveries in order to juggle 3 full-time jobs.)

 

Anyway, I reminded myself that the driver is the conveying hero, and it’s the system that’s faulty. I thought about how much earache they must be given from justifiably irate customers and probably unjustly snappy bosses. And then it struck me. Perhaps the ultimate mentalising achievement is considering and empathising with Asda delivery men, traffic wardens, dentists, telesales people and disgraced politicians.

Was a sunny day, not a cloud was in the sky, not a negative word was heard….

 

Thanks Bob. This is indeed how it was in downtown Muswell Hill, as Friday grew to a close and the inevitably rainy weekend drew nearer. I couldn’t be out in the back garden because I was waiting for an Asda delivery. The bill was very cheap and the van was very late.

 

I retrieved my thoughts from the flowerbeds, and imagined how it would be when the guy arrived. (Women may have broken through the glass barriers of politics, religion and being a gang member, but Asda delivery remains a prime feminist target. Mainly because women need punctual deliveries in order to juggle 3 full-time jobs.)

 

Anyway, I reminded myself that the driver is the conveying hero, and it’s the system that’s faulty. I thought about how much earache they must be given from justifiably irate customers and probably unjustly snappy bosses. And then it struck me. Perhaps the ultimate mentalising achievement is considering and empathising with Asda delivery men, traffic wardens, dentists and disgraced politicians.

 
 
 
Mentalisation: a key skill for psychiatrists and their patients

Jeremy Holmes

Mentalisation: ‘mind-mindedness’, the ability to see ourselves as others see us, and others as they see themselves; to appreciate that all human experience is filtered through the mind and therefore that all perceptions, desires and theories are necessarily provisional.

Psychotherapy, whether cognitive or psychoanalytic, aims to enhance mentalisation skills and to identify situations in which mentalisation is impaired. Mentalisation and arousal are inimical – stress interferes with the ability to mentalise effectively. Stressed non-mentalising psychiatrists and their patients, especially those with borderline personality disorder, are less likely to make good decisions than their mentalising counterparts. Training helps overcome this.

The British Journal of Psychiatry (2008)
193, 125. doi: 10.1192/bjp.193.2.125
 
 
 
My Ausie pal Andrew Mowat is on a trip to the UK, to promote his new book The Success Zone and I’m delighted that he’s staying over at my place tonight. At the moment Andrew, global guru in neuro-scientifically informed inspirational leadership is downstairs making his bed. Not with bed linen, which would itself suggest a hospitality lapse on my part. With 23 zillion nuts and bolts and an Ikea manual written in a loose mash-up of Swedish and twaddle. And when I say ‘bed’, when Andrew finishes constructing it, the product will have more in common with a foam jigsaw puzzle than a piece of furniture conducive to rest let alone sleep.

 

So the least I can do while Andrew creates his bed is to promote his book. Admittedly, it would be easier and certainly more convincing had I read all of it. But I’ve read a few chapters and they’re seriously great. Andrew translates complex and crucial scientific stuff about the brain into accessible information. And it’s actively engaging reading, through the use of stories about real people’s brains in action. Including mine, on page 10.

 

Arguably this is an account of my brain frozen rather than in action, and Andrew’s description of how my brain goes into the ‘Red Zone’ when I’m stressed out was a complete break-through for me. It gave me a way of understanding, explaining and remembering when in this state what’s going on up top. Precisely because the Red Zone is when my brain is hijacked by its lump of dull, highly limited amygdala, I can only think in the most basic way. What I have to do is calm down enough to be able to revert to my brain’s Blue Zone, broadly the pre-frontal cortex. Not anything Einstein would be proud to own and operate, but certainly more help in problem-solving and recovering my equilibrium than the pre-historic remnant that is the amygdala.

 

The Success Zone is much more than just a description of the companion zones. It contains a brilliant set of ideas and examples for effective leadership, which Andrew describes as leadership of both ourselves and others. A personal development, leadership, coaching and stress-reduction book all in one.

 

Buddy has done a grand job in standing guard so that Andrew doesn’t slack, but I should now stop enthusing about his book, and make sure that his practical skills are as good as his professional ones.

 
 
 
My quality of life has been transformed since I got cable TV. So many amazing programmes ranging from the classically magnificent (the David Attenborough oeuvre) to the serendipitous joys of Pimp Your Ride and Ace of Cakes.


But in addition to these TV channels, I’ve got another one which I didn’t sign up for, have no control over and pay for emotionally rather than by standing order. It’s my very own inbuilt SBC. Suicide Broadcast Channel. It drives me completely nuts, switching itself on without warning and at the most inconvenient times. Blasting out its very limited and insistent message that I’ve got to kill myself. I actually don’t need any additional encouragement in that direction, because despite the quality of my ‘real life’ being very high, I can’t climb out of the suicidal canyon I’m stuck in. What helps when I’m trying to cope with the canyon is a beautiful, soothing soundtrack (eg uplifting choral music) or something fun and mobilising (the livelier Queen tracks.)

 What doesn’t help is bloody SBC frequently switching itself on and demanding I kill myself.
 
 
I've just got a set of talking scales. Actually, because I bought them for 50p from ebay and they come direct from Uzbekistan, they're more like shouting scales. If you're within a 400 mile radius of Muswell Hill you'll know that I now weigh an improbable 55.5kg. Improbably symmetrical but mainly improbably few compared to a month ago.

A month ago I quit a(n also improbable) £50 a day skunk habit and the weight is cascading off me. I'm still much fatter than I was pre-depression, the real culprit being Olanzapine. Obviously I'm just an innocent victim and my eating behaviour is irrelevant. It was the Olanzapine that made me put on 2 stone (several thousand kilos? I've no idea how much a kilo weighs, whether whispered or shouted.) Amazing that a product that manifests itself in a pellet smaller than a tic-tac contains within it several pounds of instant flab.

BTW, do any of you know how much 55.5kg is in the old fat currency?