stressed-student80% of Sheffield students self report disturbances in mental health.  This was the shocking statistic presented by Anna Mullaney, welfare officer for the students union, speaking at a debate, organised by Sheffield’s University Counselling Service.  More objective studies have shown that  1 in 4 students have a mental health problem.  Around  50% of people attending doctors surgeries or specialist clinics have illness that defies medical explanation, such as eating disorders, Irritable Bowel Syndrome or Chronic Fatigue Syndrome, all of which often start during a period of adolescent dependency extending into the mid twenties or beyond.

Why might this be so?  Is it because children are so overprotected they are ill equipped to cope with the stresses and pressures of independent life at university?  Or is it that modern Universities are particularly toxic for students?  Or are we just over-medicalising everyday experience?

 

Are Universities dangerous?

When I went to University in the nineteen sixties, I was among a privileged 30%.  I knew I had a job waiting for me as soon as I left.  The government funded my tuition fees and I had local authority support for my accommodation and sustenance.  As the Prime Minister of the day proclaimed, ‘we had never had it so good!’   It was true.  We were very fortunate.  We were also eager to make our way in a world that seemed more secure than it does now.

Nowadays, most young people expect to go to University.  It is a rite of passage into adulthood but there is not a guarantee of a job at the end of it. Many university leavers start life on benefits.  The bar has been raised.  Employers are often looking for students with Masters degrees or Doctorates and these are only awarded to the most competitive students.

The pressure to succeed, claimed Ms Mullaney, often means extra courses, assignments and ‘character-developing’ involvement in student politics, administration and sport.  Universities were always a preparation for life, but that life has become much harder. Most students have to take casual employment in bars or restaurants just to earn enough for the necessities of food, shelter and entertainment.  Many find it more economic  to live in a house together with other students, but this gives them no privacy and little time for thought and study.  They may fall out with their housemates or feel coerced into drinking too much, taking drugs or casual  sex.  The stereotype is that students work all day, finish their shift in the restaurant late a night, then hang out with their friends until the early hours and then get up for lectures again the following morning, but that may not be the norm.  Nevertheless, loneliness, poverty, the stress of assignments and exams, alcohol, drugs and sex make for such a toxic mix, it is amazing that so many students get through it.  But many don’t and what happens during what should be  ‘the time of their lives’  may leave them increasingly susceptible to illness and stress.   So is university that dangerous or does it just seem so?  Is this why more students are living at home these days?

 

The Pathologising of Everyday Life

The other speakers in the debate went to University in ‘the golden age’.  Sir Simon Wessley, now President of the Royal College of Psychiatrists, acknowledged the results of mental health surveys of young people and the stresses of university life, but questioned whether such stress should be considered abnormal or just part of growing up.  Change is always stressful and leaving home and going to university has always been a challenging transition.  It is way we deal with stress and the experience and resolution of anxiety that helps people learn and grow in confidence and enjoy life.  Enjoyment and self confidence always comes with overcoming risk.

Wessley questioned whether we were not in danger of pathologising everyday experience?’   Might, for example, everyday sadness and disappointment now be regarded as depression; life stress, anxiety disorder; a robust exchange of views, bullying;  focus and hard work, autism or obsessive/compulsive disorder; or the boredom of an intelligent child,  attention/deficit hyperactivity disorder?  There is obviously something in that but such assumptions may condemn many to accusations of malingering, rejection and stigmatisation.

Quoting from a study of those soldiers deemed at risk from battle trauma, Wessley noted that the greater proportion of those at risk showed resilience under fire and grew from the experience.  The same applies to assessments of vulnerable students.  Fitness to study assessments could rule people, who otherwise might do brilliantly, out of university.

 

Does Awareness make people ill?

Ken  McLaughlin, Professor of Social Care & Social Work at Manchester Metropolitan University questioned the benefits of awareness campaigns for mental illness. He wondered whether this might focus too much attention on vulnerability instead of celebrating the risk and the excitement of life.  Awareness creates labels, which makes people more conscious of being sick and justifies illness behaviour?  Have we become so Health and Safety conscious that we worry ourselves sick about the risks of everyday life than just accepting them and enjoying the challenge?   Moreover, he added, by labelling people as mentally ill, are we producing a stigma, that isolates the individual, causing rejection and more tension and illness.

 

Blaming the individual for society’s ills.

McLaughlin was was concerned that societal and political problems were so often reconfigured as psychological issues for the individual.  People who are unemployed may not so much need counselling or CBT; they just need help to find a job. Trades Unions seem more concerned with helping people cope with inequalities than fighting them.  The same might apply to student union initiatives. It’s often when people feel entrapped in a situation where they feel ignored or unfairly treated that they get ill.  Expressions of frustration and anger can be quite rational responses to the injustices of life.  CBT may help the individual deal stay with their troublesome feelings, but positive action may be more effective.

Situations that induce feelings of entrapment, impingement, rejection, isolation, loneliness, inequality, poverty and hopelessness often underpin distress and illness and should not just be seen as a failure on the part of the individual. We need to address what it is about society that makes people feel bad.

 

Are interventions exacerbating the problem? 

Professor Kathryn Ecclestone, from The University of Sheffield’s School of Education said that the university has trebled its expenditure on psychological support of students, but questioned the evidence base of such interventions.  Mindfulness courses, resilience training, trigger warnings on upsetting lecture material and provision of ‘safe spaces’ for vulnerable students have become commonplace. She questioned how helpful these were.   ‘Are we offering much needed support and recovery facilities or are we in danger of fostering dependency?  Do self help groups keep people in illness?

Simon Wessley quoted from research showing that psychological debriefing after trauma  doubled the rate of breakdown.  It was better to talk about normal things with family and friends, he claimed.

 

At the age of 19 to 21, young people are still trying to find who they are.  Students are very suggestible; they take on many worries about the way they feel they should be. Experience gains at University lasts throughout life.  Instead of creating a space to talk about a perceived problem or seeking escape through sex and drugs and loud music,  universities might help students to work together, face life and experience that frisson of risk and resolution that will them grow into responsible and confident adults.

 

 

archersSo it’s all over.  Or is it?  Helen is out of prison.  The jury decided that there was not enough certainty to convict her of attempted murder or even wounding with intent.  Instead, the balance of evidence favoured the interpretation that she acted in defence of Henry, her son. Rob’s reputation is in tatters.  He has been branded as a rapist and bully, using manipulation and mind games to systematically undermine his wife’s self confidence. It now looks as if Helen will get custody of her children, though Rob will almost certainly be granted access.

This must be the most disturbing storyline to come out of The Archers; it’s a long way from cake making to domestic abuse.   It could be written as a play or a film though I suspect radio best  facilitates projections from our own experience.  As Sunday’s extended episode demonstrated, the members of the jury had each identified with the protagonists according to their own experience.  One had a friend in the same situation as Helen, another prided herself in surviving a coercive relationship, a third had lost access to his own children.  This story touches us all.  Irrespective of our gender, there can be few of us who have not felt manipulated by our spouse or who, at times of stress, have not sought to coerce or control our partners.  We know the territory. This story shows how risky marriage can be.  We could end up losing everything.

Helen stabbed her husband; her defence was that she was so systematically goaded and undermined by Rob that this was an accident waiting to happen.  Did he not actually put the knife into Helen’s hand?  But how often do things go the other way?  How many women have so provoked a man with threats of abandonment and removing the children that he has lashed out or found solace elsewhere, provoking what they may both most fear?

It is too simplistic to dismiss Rob as a villain.  We need to ask ourselves: what is it that makes someone like Rob behave the way he does?   Why does he need to be so controlling?   Is it insecurity?  Does he have a deep seated fear of abandonment?  Rob, an only child, was sent away to boarding school at a very early age by two ambitious and selfish parents.  We don’t know much about their relationship, but Bruce seems a somewhat tyrannical husband and Ursula the long suffering wife who learnt how to appease her husband while satisfying her attachment needs through Rob.

It is likely that the early experience of abandonment punctuated by spells of over indulgence left Rob him with a deep distrust of relationships, especially with women. The prediction was that they would always let him down, just like his mother. This would particularly apply to romantic or sexual relationships, and more so with marriage and children, where the consequences of failure are so much greater.  So Rob would have an exaggerated sense of ownership. Helen had to belong to him. If she wasn’t part of him, she would have to be rejected.  He was the man; like his father he had entitlement.  He could not tolerate her having a life of her own; it made him feel insecure.

People like Rob just have to get their own way.  They are often very charming.  They know how to make others believe that are special.  This is the entrapment.   They have such a fragile sense of themselves, they need somebody else and are more likely to attract and choose a partner who also has a fragile sense of identity and can be manipulated.   Rob found this first in Jess; she was 16 and had just taken GCSEs when he met her.  He was older and had just left university.  He swept her off her feet, married her quickly and whisked her off to Canada.  It was all very romantic, but Jess never conceived and the relationship cooled.  When they came back, he met Helen and soon seduced her with his charm.  Helen was a willing victim and that made him feel secure, for a while.

Insecure, frightened people like Rob are highly manipulative; they play mind games, set tests, issue veiled threats, make it clear what would please them or displease them and all the while increase the level of coercion and strip away any sense of individuality.   It is a form of mind control; a thought crime.   

Rob fenced Helen in; he distrusted her friends, her family, he disliked her going to work, he didn’t like her wearing anything too revealing and more sinister, he was so desperate to create a copy of himself that he forced her to become pregnant.  And when she was pregnant and they knew it was a boy, the control increased.  He smothered her in cotton wool, got his mother in to make sure she didn’t do anything herself and when she resisted, he persuaded her she was ill and needed antidepressants.  Her only way out was to leave him, but he would never allow that. The possibility that she might leave would feel like death to Robert and lead to desperate measures, like putting the knife in her hands. Such people are dangerous.

Our culture glorifies the romance of falling in love and getting married, but it is probably the most risky thing any of us ever do.   Falling in love is about finding someone who makes us feel good about ourselves.  People write about that ‘oceanic’ feeling of well being.  Everything, even the most mundane situations, is touched with charm.  Every love song that has ever been written is about us.  But do we fall in love with the other person or do we experience the illusion of falling in love with an idealised version of ourselves, as viewed through the eyes of our lover?    Our love object brings out the best in us just our regard brings out the best in them.  It is a heady and for many, once in a lifetime experience.  For a brief moment, we are one mind and one body. In successful and stable couples, it transforms into a kind of mutual interdependence that allows each partner to be themselves and grow independently, secure in the knowledge that they are loved. Trust replaces the need for control.

With couples that are less secure, falling in love possesses a quality of desperation.  Those who have a fragile sense of their own identity crave somebody who will make them whole; their other half.  Such couples cleave together and for a time everything is wonderful.  Rob and Helen were besotted with each other.  Rob was looking for somebody who would help him secure his purpose in live, a true partner, while Helen thought Rob was so wonderful, she was more than willing to be that person to the extent of giving over parental responsibility for her son and letting him take over her business.  Such love is not so much blind as drugged.  It is a wonderful illusion until the mist clears and they realise that their beloved has different set of needs, values and even morals and ethics, and understand that they are a mere mortal and not at all like the image one had created of them.  Then the only way they can hold on to the illusion is through coercion and control.

It can only end in tears.

 

 

musselmannThe old ones of Auschwitz Birkenau, the survivors, called them the ‘Muselmann’ (german for Muslims); the weak, the inept, the ones who distanced themselves from suffering by giving up.  Deprived of any expectation or hope, they no  longer suffered, they just existed, shuffling along like zombies to the inevitable conclusion;  already dead in spirit.  Any hope had been destroyed together with their humanity and dignity.  . 

Jenny fell passionately in love with a man, who abandoned her.  So she declared War on Want by refusing to submit to her own emotions and with that her need for  sustenance?   This is Jenny’s way. Others use drugs to fill the void left by the loss of hope, others eat or drink too much, others seek sex and others find refuge in illness or madness. In a moment of clarity after the storm, Lear expresses that it is better to lose his mind than to be preoccupied by devastating grief.  

David has been my client for twenty years.  He first came to see me because of persistent abdominal pain and constipation, which he was convinced was caused by a cancer of the bowel that his doctor had failed to diagnose.  No medical tests could convince him that he did not have a disease that would kill him unless promptly and properly treated.  He was very suspicious of any notion of any psychological cause but never stopped coming to see me.  David has never   given up, but he has been a hostage to fortune and he suffers for it.  He clings on to the idea a notion that life has to be fair.  He believes in trust and in spite of everything, retains expectation and hope.  If he were religious, this might give him peace of mind, but he’s not and it doesn’t.  Instead his expectations condemn him to torment of frustration and disappointment as life lets him down yet again.  For David, the pain and mental anguish represents his life force, a continuous grudge against the ineptitude of doctors, the neglect of society and the unfairness of life. . 

It was only recently that he came to the realisation that he doesn’t have to be a victim; the passive recipient of what life delivers. People rarely do what we want. They are much more concerned with their own needs. In that respect, life can never be fair.  It’s a world in which those who shout loudest often get all the prizes.  So if David wants to get what he needs out of life, he has to create the conditions that provide what he needs. 

Those who survived the dreadful conditions in the Nazi concentration camps were the ones who were able to retain a sense of their own identity and adapt to the environment without giving up.  They had no expectation of kindness from the prison guards, but they could gain sufficient life force from a brief glimpse of the mountains, the sound of birdsong, the memory of a melody or composing a poem.  Life is what each of us can make of it.  David’s wife was recently seriously ill with cancer, but this gave him a sense of purpose and worth as he negotiated with the doctors, looked after himself and the house and kept up a email commentary to friend.  .  

Life is never easy,  but we don’t have to submit to its cruelties and injustices. Neither do we have to make ourselves ill by railing against the world and suffering the torment and the illness.  There is a third way.  That is to adapt and take responsibility for our own destiny.

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Don Juan, the ambivalent one, the wild man women love to hate or hate to love, the one they want to tame or not, the libertine who liberates sexuality from the everyday shackles of marriage, the maverick who rejects the mores of society to please himself, the nomad who promises freedom but delivers loneliness.  Don Juan epitomises the essential conflict of masculinity, excitement or commitment; constantly on the move, he comes in through the window late at night but does not stay for breakfast. 

But who is Don Juan?  Is he a melancholic, searching for something he can never find and does not wish to?   Inasmuch as we all model future relationships on our first love with our mother, do we imagine little Juan’s mother as a tease, unavailable, the joy of possession snatched away from him leaving the unremitting quest but no trust.  So is the Don predestined to a perpetual  struggle between life and death; does he yearn for the love that will kill him, yet fear it?  His promiscuity embraces death but flees the pain.  Is he Peter Pan, forever in search the Wendy he must reject in place of Lilith, la femme fatale, who will seduce and kill him?  Or can we imagine him unfulfilled, getting old;  a wine soaked depressive regaling all who will listen with of tales of conquest,  sans teeth, his flirtations rendered impotent by repetition?    

Don Juan is complicated; he disturbs us.  On the one hand he represents excitement, power, liberty, joy, orgasm.  On the other he is a coward; fearful that relationships weaken him.  He will never  commit or belong.  He does not wish to possess.  He needs to explore, seek out, live the adventure, continue the quest. 

So what of Don Juan in the 21st century?   In an age when technology has uncoupled sexual urge from reproduction and given women control of their own sexuality, has he been rendered redundant by a tipping of the scales of sexual power?  Is there less risk in seduction and less meaning?  Disconnected from social responsibility, coupling is ruled by the thrill of the moment, the sensation.  So is everybody Don Juan?  Is it a case of every man and every woman for themselves?   We read that community and family are being eroded, less people are entering the commitment of marriage,  more children are raised by single parents who are less available as role models or guides,  young people are exposed to sex and pornography at a precocious age and are more likely to experiment with variations in sexuality.  There’s no mystery any more.   So has the Don not so much disappeared as become normalised, familiar and tamed and well, boring?  Is he just as likely to be gay these days?   Has our sexualised society become lost in adolescent fantasy?   Psychiatrists tell us that more males are phobic of commitment.  Sociologists report that career women cannot find partners to father their children.  At a time when loneliness and depression are the common ailments among the young, has romantic love lost some of its passion?

Anneka is only one year old, but she is bonding with me.  She stares hard at my face, makes eye contact, holds it, then reaches out, touches my nose, my eyes, my ears, scanning each of my features, fixing them in her memory.   Then later when she hears my voice she looks round until she finds the face and smiles.   It seems to me she is not just recognising, she is bonding. 

In the fusiform gyrus, deep in the inferior temporal lobe of the brain, there is a collection of neurones that respond to specific faces.  Damage to this area by a tumour or a stroke leads to the neurological condition, known as proposagnosia – absence of face recognition.  The same region also serves place recognition.  It responds to the features of particular cars in car enthusiasts like Rowan Atkinson, and to characteristics of birds in bird watchers like Simon Barnes.  Indeed Barnes writes about having a giss for a bird, a facility for identification from minimal cues.   If Anneka is played a recording of birdsong, she immediately looks out of the window to see the bird.  Is this the beginnings of giss? 

So is the fusiform gyrus, the site for pattern recognition?  And do people develop a facility for better recognition of patterns that are familiar and interest them, like cars, bird or traction engines?   That would make sense.  After all, Chinese people are better at recognising Chinese faces and find Europeans look very similar.  

But recognition is not the same as familiarity.  The latter is more a function of the amygdala and its emotional connections to the orbitofrontal cortex.   You don’t need recognition in order to form an emotional connection. People with proposagnosia are not autistic.  Some with proposagnosia greet everybody with great familiarity as if every face was a friend.   So do minor forms of proposagnosia lead to indiscriminate affection and intimacy, like the potion poured into Titania’s ear.  Almost anyone will do, even one with the head of a donkey.  Is promiscuity based on a neurological deficit of character recognition? 

Bonding is more enduring than emotional connection.  It requires a specificity, a recognition that is  consolidated by repetition.  Every time you see that person, go to that place, hear that song, a charge of emotion fixes the connection deeper into the memory, like paths through the forest.  It takes time to get to know a person, to trust the consistency of the interaction, to establish that  emotional railroad that makes relationships meaningful.   And once that bond has been produced, it is impossible to sever.  Reinforced by contact, it only declines by degrees when lack of contact and/or disillusion no longer sparks the memory.

 

Redpolls (Carduelis caberet), fidgeted high in the larch, picked clean Capability’s cones  

 and a few fragile fallow fawns shivered by the guard of red stags.

 Then  with a flash of blue’, the final whistle sounded on the plough, 

 the white swan took flight with a last wheezing of the pipes,

 and I stood in the grove while silent swallows swerved around my knees.

 

After thirty years, she could stand it no longer.

Her legs would no longer bear the weight

of it. There was no disease;  her numbness

didn’t follow neural logic.  She seemed relieved,

 

distressed more by  foreign news,

the Nazi’s were rounding up the Jews.

So was her spouse the tyrant, the brooding   

presence in the marriage bed?

 

Brooklyn Credit’s next in charge,   

the token Hebrew on the payroll, whose 

flaccid hatreds disavow his race 

and persecute his wife.   

 

Confined in their domestic fortress,

her legs refuse to do her duty,

to withold her infant man,

or bear his burden of suspicion

 

when that same dark hate forces  old women

to scrub the pavement with a toothbrush.

Lacking support, his despairing heart rages, then stops.  

She stands numb with pity and walks towards him.   

 

Broken Glass by Arthur Miller stars Anthony Cher and Tara Fitzgerald and is currently playing at the Tricycle Theatre, Kilburn before moving to the Vaudeville in  The Strand next week.