Showing posts with label depression. Show all posts
Showing posts with label depression. Show all posts

Tuesday, 6 September 2016

Cold Comfort Terms

More views of - or before - Cambridge Film Festival 2016 (20 to 27 October)
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6 September












The above strand of Tweets relates to what is set out in A new formulation of the moral superiority inherent in what 'a good reason' is to be depressed




 Unless stated otherwise, all films reviewed were screened at Festival Central (Arts Picturehouse, Cambridge)
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Thursday, 23 January 2014

Skinner and Sanity

More views of - or before - Cambridge Film Festival 2013
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11 January


For Lucy Johnstone (@ClinpsychLucy) - written on a train into King's Cross

Some will be familiar with the idea of what is called (after the experimental psychologist of this name) a Skinner box, essentially a maze for rats, designed to test them (the rats) under different regimes and so make inferences about their psychological state, based on how they navigate the box.

Imagine such a box (or, rather, a series of them, say ten), on a relatively small scale, but designed to be resistant to the ingress of water. The experimental subject sees water (or a coloured liquid might be more effective) enter the system, and it is his or her job, each time, to direct it to a specified goal, either to the centre, or to one of a number of dead-ends, where there is a sink : the flow is such that, if the subject does not act reasonably quickly, the liquid will start to flow over the channels of the maze, which counts against him or her.

The subject directs the water by using baffles, i.e. insertable barriers that block the water from following any given route, and they represent means for closing off options that, once taken, cannot be undone. He or she is marked on criteria such as how quickly and effectively he or she directed the flow, whether the flow (and, if so, how much) ended up exiting from other sinks, and whether the flow ran over the channels. Say five times with each of ten target sinks, and this over ten boxes of different layout – no opportunity to run any one box successively, but in randomized order in which the five chances to tackle any given sink in any given box is allocated over the total runs, n = 500.

Analyse these data as one likes, say giving a weighting on which out of the five runs on this target in this box the results are for. Some statistically significant comparisons will result. Then imagine doing another 500 runs, and this just as training, but with the subject now told that he or she can operate freestyle, i.e. choosing the target sink, but, perhaps with penalty sinks (which might or might not be specified (beyond their existence and their number), which, if any liquid reaches first, stops the run and imposes a penalty, based on various criteria such as time elapsed, sinks blocked at that point, and a qualititative analysis of strategy. The subject would then be penalized, sometimes, for directing the water to a given sink, because it is an unstated penalty sink.

Now extrapolate all this to, say, human behaviour. X has been tested, for example, on the autistic spectrum, and been given a diagnosis. Does that mean, if the liquid is the flood of stimuli, inputs and other people’s behaviour, that we have done any more than establish that, over a thousand runs in life, X has adjusted to trying to deal with it in a number of symptomatic ways ? Maybe life has baffled X, and X has tried to understand or adjust to it, coming to find some strategies that are, if not better, than at least less bad than others for being effective, given the task specified – because of the flow, and the need to direct it, X was forced to block off some choices, and become more habituated to others.


Subject A has an experimental profile, over the two regimes of 500 runs apiece, which corresponds to what we might think of symptoms, and the tendency to exhibit or experience them, so does a similar Subject B. Otherwise, A and B may actually be more dissimilar than similar, seen in the round (outside these tests), but their test results bring them together into the same place on the spectrum – their humanity, interests, values, become valued less than what they happen to have in common :
A may resemble B, but also, otherwise, resemble C, but compare B and C and the match may not be statistically significant on a chi-squared analysis that compares their data. We could have an alphabet of subjects and more cases where the statistically significant comparisons do not predict the match with another who also matches one of the matching pair.

We could consider a tendency to depression, bi-polar disorder, schizophrenia as other test-results, other matches or mismatches. Do they tend to persuade us that diagnosis is perhaps no more than picking and choosing between bundles of what we call symptoms, and inferring the existence of a diagnosable condition, when a rigid experimental testing such as imagined might throw us back on our common humanity, battling the flow of money, relationships, stress, etc., against time and other objectives ?




Unless stated otherwise, all films reviewed were screened at Festival Central (Arts Picturehouse, Cambridge)
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Saturday, 21 December 2013

Supporting the garlic-eaters - or declining a Faustian pact

This is a Christmas review of It's a Wonderful Life (1946)

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21 December (updated 22 December ; Tweets added, Christmas Day 2015)

This is a Christmas review of It's a Wonderful Life (1946)



When George Bailey (James Stewart) kisses his wife Mary (Donna Reed) on their wedding night, he murmurs (more to himself than to her) ‘Wonderful, wonderful’. He has something then that he loses – or, rather, loses sight of.

Their location at that moment is bizarre in its real sense, and almost, also in its real sense, surreal¹, for they had planned a honeymoon without much thought for the future. But it symbolizes some things, such as courage in adversity and less love in a garret maybe than riches in heaven.

As has been said, George loses sight of the self who found all this, which initially seemed so ramshackle, made whole and complete by Mary’s love and care for him. He faces what seems an impossible position, and his enemy Potter (who started as if to remedy George’s uncle’s mistake, before seeing the capital for him in it (the palpable miserly wickedness embodied by Lionel Barrymore)) threatens him with penalties from a position of power : George ends up abusing the forgetful / easily distracted Uncle Billy (Thomas Mitchell), and, not believing that anyone can help, gets frustrated with Mary and the children, showing only tenderness for Zuzu [one is reminded of Louis Malle’s Zazie], in bed with a temperature

He has lost hope. What happens, when he seeks to drown his sorrows makes matters worse, and causes him despairingly to recall Potter’s words of derisory rejection, thinking that his value is in being dead, not alive. In one version of the Gospel story, distraught at what he has done, Judas throws the thirty pieces of silver down when they will not be accepted back from him and they are used to buy The Potter’s Field (which is the name of where George builds his homes, but which is where the graveyard is in what Clarence shows him, a Bedford Falls without George, where the place is then called Pottersville ?); in another, Judas hangs himself, so suicide, choosing death over continued life (which some try to harmonize as his doing one and then the other).

Clarence Ardbody (that seems to be his name, and he is charmingly brought to us by Henry Travers) is George’s guardian angel, and he leaves George, after what he has shown him – but only when George chooses to embrace life again, after seeing a world where he is the nobody that he has allowed himself to believe that he is. There he is someone whom no one, not even Mary, knows and is even frightened of, and who is the witness of how differently things could have been.

The conception of this film, starting with prayers for George, Clarence’s appointment, and seeing how George became who and where he is, avoids the easy solution that Clarence should simply tell George how Potter kept back the crucial money that he decided not to return. The film has George choose life, after Clarence’s ruse (used again by Luc Besson in Angel-A (2005)) diverts him from his own plight to – where his heart is as a man – someone else’s, but only after he comes to value himself and the life that he has.

Meanwhile, aside from those prayers, Mary has been addressing the problem that gave rise to his disaffection and, although she did not know it, led him to the brink. He was going to choose water : water had been where, saving his brother from drowning, he lost hearing in his left ear, and into which, in a sort of sacramental baptism, envious hands contrive for Mary and George to fall. Water was falling from the sky and into the new home that Mary had contrived for George and her, and, of course, in the snow of Christmas Eve, it is there in frozen form. That is just an observation, but, those who believe that the other three classical elements will be there when water is found can, of course, excavate…

A criticism that could be levelled at the pacing of the film, which is why do we spend so much time with George in the world where he does not exist before he understands. Actually, because it builds up to him being rejected by the woman whom he still thinks of as his wife (and whose status Clarence has been a little unwilling to give), it takes that for the message that his mother only runs Ma Bailey’s Boarding-House because he is not around to sink in – George has both drunk a lot, before meeting Clarence, and had a double after, and the film symbolically represents how difficult, with a person in deep depression, it is for the truth of his or her worth to permeate and unfreeze that numbness of being dislocated from the world.

As the lyrics of Talking Heads’ song² Once in a Lifetime go, seeming to see a dislocation, from the opposite pole of psychosis :

You may tell yourself, this is not my beautiful house
You may tell yourself, this is not my beautiful wife


In the world that he sought to leave, George had lost contact with the things and people who mattered to him, burdened by not knowing what to do; in the world that Clarence shows him, he is able to seek out what should be familiar, and keeps trying, ending with Mary. It is only when, under danger of gunfire, that he has gone back to where he started that he can value what he had before and ask for it to be restored – before, it might as well have been in a vault as behind a veil, for he could break through neither to it.

As a portrayal of depression, it demonstrates the truth that one cannot ‘snap out of it, ‘count one’s blessings’ or ‘pull oneself together’, and also, with Clarence’s inscription in Tom Sawyer (some significance in that choice of book, one would warrant), of the value of true friends. But the film works without entering into those considerations, just better if one sees what is slow to change in George.

And perhaps one has to consider the force, in Potter, that George has been fighting, whose Pottersville is debauched and gaudy when (in Clarence’s other world) there had been no one to stop him making it that way : on his desk, seen most clearly when the offer is being made that is too good to be true, is a skull, a bell in a triangular arch, but also an apparatus for heating something over a flame in a spoon that would not be out of place in the drug-laden realm of shooting-up in Trainspotting (1996)³.

In different ways, Potter, desiring domination in a no more rational way than Iago wishes Othello’s destruction, is stood up to by George’s courage and self-sacrifice : by riding the effects of the run on the bank, opposing Potter (and getting the vote) when he moves that the Building & Loan be wound up, and by rejecting a cushy offer for himself. Probably far-fetched that they are parallels to the temptations in the wilderness, but George does give up, respectively, (along with Mary) their honeymoon, his cherished plans of travel⁴, and a life of benefit for himself by going over to Potter…

James Stewart has humour (some of it at the inquisitiveness of Annie, the servant), warmth, and frustration at what he has to give up for what he believes in, even if he does put his foot in it by calling it ‘a crummy little office’ (or some such) to his father : that characteristic quality to Stewart’s voice fits hand in glove with the sort of astonished pleading with people to know who he is. Barrymore, even when he is slow to see his final winning hand against George, brings a smouldering, disgusted malevolence to the role of Potter.

And, when soaked from the swimming-pool trick played on them, George has walked Mary back home in borrowed clothes, Donna Reed and Stewart have a delightful awkwardness to them, so that he does not quite dare kiss her properly when she dares to offer her hand, and then both are spooked by him being urged to kiss her (one almost feels that, by not doing what is suggested, he is trying to avoid his own destiny, and cheat history...). And he has to be snatched away, without that kiss (or, acting against form, trying to exploit her being robeless in the hydrangea bush) on this very night, because of his father’s health. Pain prolonged, and hope deferred, but bringing a life together that they want to lead – though threatened by the opportunistic Potter and George’s despair.


Happy Christmas !



Post-script

One can also find, given that the film was made in 1946, a Hitler figure in Potter : George's father appeased him by putting him on the Board of the Building & Loan ; George fought his offer to Building & Loan customers with Mary's and his honeymoon fund ; Potter offered an alliance to George ; and rejected Potter takes the opportunity to turn the weapons of law and order on him.


End-notes

¹ The ruins where Edward Scissorhands is found spring to mind.

² By David Byrne, Christopher Frantz, Tina Weymouth, Jerry Harrison, and Brian Eno.

³ Seen more obviously, though fleetingly, is a bronze bust of Napoleon Bonaparte near the window in Potter's office.






⁴ He is a sort of Marius (in Daniel Auteuil's film this year of the same name), with a sense of Wanderlust.




Unless stated otherwise, all films reviewed were screened at Festival Central (Arts Picturehouse, Cambridge)
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Tuesday, 22 October 2013

Mental-health in-fighting

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22 October

There is a well-worn claim that a person with an experience of schizophrenia is called a schizophrenic, whereas a person who has cancer is not called a cancerist.

But we do call people diabetics, haemophiliacs, coeliacs, hypochondriacs, hysterics, alcoholics, etc., and half of those nouns relate to physical conditions.

Yes, it is nicer not 'to define someone' by reference to their health, but the cancer argument employed is a bogus one, not least since I believe that people do sometimes relate to hearing that someone has cancer on an irrational level, of its being karma / punishment, or as if the cancer is infectious, or the person can no longer be related to as a person, but as only a substrate for a deadly disease : dehumanizing the person, by only seeing him or her in terms of the spread - or remission - of the cancer(s). (In another posting, I suggested how mental ill-health is not different from, but exactly like, a broken leg.)

Some people object to the term service-user, saying that they did not choose to have mental-health services (they were cajoled, coerced, sectioned, medicated against their will, mistreated (when they were supposed, ironically, to be treated in the system's own terms)), others simply do not care, even if they have had the same experiences, and are not worried about a need to challenge use of the word.

In similar ways, some have a diagnosis thrust upon them, and struggle to feel content with someone else defining their experience in that way, whereas others, refused a service unless they have a diagnosis, embrace one, and feel that it validates.

Of course, that sense of validation, of finally being believed, could relate just as much to the situation of someone with what turns out to be a brain tumour, who succeeds in persuading someone to carry out a scan and whose findings account for their bizarre or troubling symptoms, previously discounted on supposed medical grounds.

Or there could be a person who is happy with his or her body-shape at 22 stone, and who rejects the notion of being obese - and, if it is not interpreted as a mental-health issue (with implications for a forced admission), but, say, as a lifestyle choice, he or she is free (subject to these irritating medical promptings) to do as he or she pleases with his or her body.

So, returning to the question of diagnosis, one person might be able to get help, because of a diagnosis, whereas a person, supported with a diagnosis of bi-polar disorder, might then be denied support, if it is claimed that it was a misdiagnosis and that he or she has borderline personality disorder (and vice versa, the latter likely to be a case where he or she is pleased with the new diagnosis, which he or she has probably been fighting to have recognized as 'a better fit').

And then there is so-called depression (because I believe that the word has outlived its usefulness - unless it can be 'reclaimed' - when too many people think that it just means being a bit sad, that the person described as being depressed is lazy, shamming, not trying as they would, and that they know what it means, when they do not). I took issue with @StephenFry likening depression to a meteorological cold front, which, like the wind, rain or snow, just is until it is over :

I honestly thought that having that debate might make people question whether low mood and negativity really just are, or whether some people might be helped - some of the time - by psychological intervention, as practitioners and writers such as Paul Gilbert want to say (e.g. Gilbert's self-help book, Overcoming Depression). Fry's message of waiting for the good days to come may work at one level, where crashing for two or three days may allow one to regroup and feel restored / revived, but what if that crashing could be avoided, or, at least, postponed to a less critical time ?

It is this polarity of the discussions in mental-health circles that frustrates me : Fry was no doubt wishing to be helpful, but seemed didactic in his statement, as if to the exclusion of the possibility that sessions with a psychologist might make an improvement such as described. Likewise, those 'saddled with' a diagnosis (and, maybe, poor or no treatment) seem to be at odds with those who, as suggested, might have had their beliefs about themselves confirmed by one.

When one person, wanting to feel safe from impulses to commit suicide (which I maintain is an acceptable expression), might benefit from feeling safe on an acute psychiatric ward, someone who is at a level of depression not just to be numbed to what is happening might equally experience it as too lively, too fuelled by the activity of those whose mood is at the opposite extreme to be a therapeutic environment - and they, too, might find each other's psychotic assertions frightening and disturbing, which is hardly likely to lead to peace and a lowering of anxiety.

Is a ward such as that, then, a microcosm of the flare-ups that the mental-health element of Twitter seems to accommodate, perhaps even invite or spark ? Or is it no different from any topic where feelings are running high on both sides ?




Unless stated otherwise, all films reviewed were screened at Festival Central (Arts Picturehouse, Cambridge)
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Friday, 9 August 2013

Article in The Guardian as popular as Crocodile Dundee's snake in a lucky dip ?

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10 August

To my mind, such of the mental-health community as has been lashing out at Giles Fraser's article Taking pills for unhappiness reinforces the idea that being sad is not human has missed the point :


Typical comment on Twitter says that Fraser does not know what depression is, whereas I believe that those readers have not troubled themselves to understand what he is saying, and, therefore, he is just as misconstrued as those who experience / have experienced depression often are.

Far be it from me to defend Thatcher, whose beliefs and policies I despise, but I no more believe that her There is no such thing as society speech was given a fair press* than this article :


1. Fraser's first two paragraphs, i.e. setting the context for the rest of what he talks of, are about his behaviour at school, how children who behave like that now may be diagnosed with ADHD, and may even be prescribed ritalin.

2. Anyone who has watched the documentary Bombay Beach (2011) will have seen Benny prescribed with anti-psychotics, which I find even more horrifying.

3. The third paragraph I come back to, though the effective point is that, just as diagnoses of ADHD and prescriptions have risen sharply (there are nearly four times as many in just eleven years), so have prescriptions for anti-depressants.

I do not read what Fraser says here as saying that his experience amounts to depression, but the opposite, i.e. that it does not.

4. The fourth paragraph talks about how chlorpromazine (thorazine in the States) and other medications came to be used for the purpose of altering mood in psychiatry, and were originally used for treating infections.

I see nothing much wrong in inferring that, if a medication can be licensed, manufactured and prescribed for some other purpose, then the pharmaceutical industries have a motive for promoting them.

5. Fraser does not report them, but some recent studies have been quoted where it has been shown that the effect of anti-depressants is no better than a placebo. If true, that not only casts doubt on why the NHS spends money on them (or we take them), but also strengthens what Fraser is actually saying.

6. In his final two paragraphs, he brings together the industries' desire to make and market products with that of GPs to do something for patients (either because the patients are distressed and ask, or because, in any practice, there will be GPs who are 'more interested in' the physical side of health, and who maybe do not know better than prescribing when others would not).

7. Fraser has been demonized as if he does not know what depression is, whereas I follow him as saying that maybe things that are not depression are treated as if they are.

No one who knows how little training GPs (primary health, as it is called) are required to have in mental health would :

(a) Go to his or her surgery without establishing which doctors lean towards it, or

(b) Believe that the fact a doctor has prescribed means that it was appropriate, or that a referral to secondary mental health services, pressed as they are, would even be accepted.


To suggest that Fraser's article is really of a Pull yourself together kind is, I think, a hasty and ill-judged reading, stemming from anger and disappointment at believing depression to have been written off.

However, he would have done well to make clear that he is not disputing that depression exists, only that treating people as if they have clinical depression (i.e. without their having symptoms such as anxiety, waking too early or sleeping too much, not feeling much - or anything - emotionally, etc.) is not really doing them a favour.


End-notes

* Since I gather that she meant just the opposite of what people claimed - still, it all helped remove her.




Unless stated otherwise, all films reviewed were screened at Festival Central (Arts Picturehouse, Cambridge)
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Sunday, 12 May 2013

The Agent Apsley on depression

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12 May

To open* :



Since I Tweeted this, I shall say more (to @stephenfry, or - as he may not - anyone who cares to listen) :



What did this refer to ? :

Depression isn't a straightforward response to a bad situation, depression just is, like the weather.


Where I saw it, it wasn't properly punctuated (unlike here), and no source was given (true elsewhere) :




Excuse the poor quality of another's reproduction of his letter, but it seems that he wrote something similar, just at more length, to someone called Crystal seven years ago (10 April 2006**), shown at http://missbeautifullydepressed.wordpress.com/2012/01/13/depression-is-like-the-weather/


But is Fry right, or do such analogies hamper us 'getting to grips with' the negative thinking, patterns of self-depreciation, and modes of cataclysmic reaction, which might make life better, in time ?


If I'm wrong - and Fry's right - then people like Wilhelm Reich with his cloud-busting*** just has no place in a world where a crap day is a crap day, but it will pass... Forget Reich, but, as some will also know, clouds can be seeded - and so, in this respect, we can manipulate when (and so where) rain will fall.

That doesn't destroy Fry's analogy : it's the message, though, of sheer helplessness that he seems to convey in :

In the same way that one has to accept the weather, so one has to accept how one feels about life sometimes.


You'd think that no one (who can afford to) spends the winter in (what they hope will be) warmer climes - or even just (with a car) drives out of the rain (or into it, for that matter).

Staying with this powerlessness of just waiting for things to get better, or just feeling myself going low and allowing it to happen, is not what I spent a dozen or so sessions with a psychologist for, or why I read parts of Paul Gilbert's book Overcoming Depression, about compassion, self-hatred, and the like. 

No, I believe that @stephenfry's message is a negative and unhelpful one for anyone and everyone to hear - I have experienced being able to seed (or bust) those clouds, and I want to escape from this meteorological notion of the inevitably of depressions and cold fronts, which is, as far as I am concerned, not 'reality', as Fry claims, but barometric.


End-notes

* Quoting the spirit of Words and Music, one of Beckettt's plays for radio.

** He seems to favour the ever-encroaching US format for dates... He also writes (about the weather) It isn't under one's control as to when the some [sic] comes out, but come out it will. One day.

*** An experience that Kate Bush alludes to in 'Running up that hill' (from the album Hounds of Love), probably drawing on Peter Reich's (Reich's son') book.


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Thursday, 9 May 2013

Stephen Fry on depression

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10 May

It all started with this Tweet :




It sparked off :




And :





And - am I being quite reasonable ? - then :




Perhaps because I have lately disputed the common claim that mental ill-health isn't like a broken leg, which people can see - in my posting Mental ill-health is exactly like a broken leg !



Any thoughts, anyone ? Stephen Fry has (apparently)...


@theagentapsley Well I was speaking for/patronising myself actually.


Well, after Tony and Control, there's always that get-out, @stephenfry...




More here now...



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Wednesday, 28 September 2011

Daily diced parrot could help you slim

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28 September

Anything in common with 'Four cups a day can leave women less depressed, says study' (from AOL's sign-in page)?

Maybe just that claims can be made without someone knowing or giving the basis for the assertion, and sometimes that is the experimenter(s): some people will know of the biology paper, written by the editor of the journal in which it was published, that went through the mathematics / physics of flight in relation to the bumblebee.

I read the paper at the time, and its (albeit unhappy) conclusion was that it seemed to have proved that the bumblebee could not fly.

Of course, though, it can (in a fashion) - the biologist had to revisit his calculations, and, having found that a factor, effect, coefficient or variable had been overlooked. I did not see what was written then, but the bumblebee - a great relief to it, I'm sure - was authorized to fly again.


Turning to these 50,000 nurses, of whom, presumably, 25,000 did not drink coffee at all, unless there was a whole range of amounts of coffee drunk on average by the coffee-drinking nurses, plus the ones who stuck to tea (or smoothies).

What sort of coffee?

* Filter coffee?

* Instant?

* A skinny decaffeinated cappuccino bought in from a nearby Starbucks®**?

* Turkish coffee (with two sugars)?

* A double espresso from a filling-station with a self-service machine?


If the reports that I have seen mean anything, it must have been coffee with caffeine, because someone is suggesting (although there is actually caffeine in tea) that it might be what makes those nurses experience (or report) depression less: that person may only have skimmed through the report, and I have just seen and heard the headline, when I need to get to read the report...


In the meantime, isn't there something special about nurses and their life-style? - and I don't mean the Carry on Nurse or pornographic stereotype. It's not unusual for them to work double-shifts (e.g. morning and afternoon, night and morning), and could do two of those with very little time in-between, such as arriving for a shift at 7.00 a.m., not finishing till 10.00 p.m., and having to do the same the following day.

Not a typical working-life, unless that has been adjusted for that factor, so, unless something was done to compensate, not the best sample, even though the size is a good one. What would the effect on influences (social, emotional, economic, personality, predisposition, prior experience of depression, etc.) be of such a lifestyle? - of the working life of a nurse anyway, with all that they are exposed to socially, economically, etc., in their actual work?

And coffee? People who do not drink coffee drink something else for al sorts of reason, and those who do drink it, drink it for all sorts of reason, but often to give themselves a kick or a boost. Could wanting a kick or a boost say more about those who drink coffee than anything else? And what about nurses who smoke? Nurses who smoke and who drink coffee, nurses who don't smoke, but drink coffee, nurses who don't drink coffee, but who smoke?





** Which Garrison Keillor, in his novel Love Me, described that the narrator's partner and he did when they were 'slumming it' - and I tend to agree with that analysis.
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