How I recovered from the Body Dysmorphic Disorder which took over my life

Tags

appearance, avoidance, body dysmorphic disorder, compulsions, Depression, distortion, perceived flaws, preoccupation, Therapy

How I recovered from the Body Dysmorphic Disorder which took over my life

While the poorly understood condition is often believed to be a simple case of people thinking they are larger or more unattractive than they are, it is actually a distorted view of how they look so much so they become preoccupied with it. It often involves focusing on one perceived flaw and the majority of people with the condition are preoccupied with an aspect of their face, but it can be about any body part. The illness involves avoidance and compulsions and it can have a significant impact on their daily life, becoming very debilitating. Affecting both men and women, the Body Dysmorphic Disorder foundation says the impact of the condition on a person’s life can be so severe they effectively become housebound. Many people who have the condition are also single or divorced, suggesting it is difficult to form or maintain relationships.

Dr Rob Willson from the foundation says around two per cent of the population are believed to have the condition, which usually starts in adolescence.

Omari, 29, told The Independent he can trace the origins of his BDD, which he was finally diagnosed with in 2012, to his 16th birthday. An aspiring model, he took part in a photoshoot  yet immediately before became increasingly “tormented” over the appearance of his eyes – so much so that he even resorted to using his mother’s make-up to try and camouflage them. Things worsened when he went back to look at the photos and the photographer retouched an area around his eyes.

“I was waiting to see the first action he did and he went to the eyes. That was immediately it there, my evidence […] looking back he touched up other things I’m sure but I don’t have that in my memory. All I have is a really vivid, burnt image of him blending the area of my eyes.”

A year after first experiencing BDD symptoms, it was when Omari began studying at Oxford University that they reappeared and took over his life. Studying a humanities subject where he was largely outnumbered by girls and therefore admittedly “in his element” after attending a same sex school, Omari put pressure on himself for everybody to like him.

“I wanted to be the guy all the guys wanted to be and all the girls wanted to be with,” he says. The BDD obsession around his eyes continued and deteriorated to the point he feared not wearing glasses as his eyes would be exposed. One perfectly innocent comment from a girl he liked is something that stands out in his memory: “She said something like: ‘I like you in your glasses’ But what I heard was: ‘Thank god you put your glasses on’ and thought it was code for ‘Jesus, about time, it was horrible to look at you before now.’”

Part of the issue with BDD, Omari explains, is that you actually feel that you are a burden on people because of your appearance. “Part of it is: ‘If I go outside, I will make little children run away from me’.

Wearing his glasses became what is known as a ‘safety behaviour’ which are mental or physical acts aimed at reducing the threat of the perceived flaw, according to Dr Willson. “Examples of this might be checking or examining ones appearance in the mirror, avoiding bright light, avoiding being seen up close, concealing perceived flaws using make-up or seeking cosmetic or dermatological procedures.”

“My main issue was the bags under the eyes but then also the issues of them generally being a weird shape and being evil or looking dead and glassy, so many things really, but the day-to-day issue was worried about the bags and looking tired,” he explains. “There were mornings when I would get ‘dry eyes’ … I wouldn’t leave the room I shared with my best friend and would wait for him to leave. I would sit there getting more and more tense and feeling resentful towards him about not leaving. Then I would hear the door close and I would freak out, begin throwing stuff around, punching walls – everything short of properly screaming basically.

“My glasses became a permanent feature… it really limited my life as I was always active and sporty and couldn’t wear them for football or rugby. There would be days where I would put my contacts in and then put my glasses on top and I couldn’t see any more…. I had to look below the level of the glasses so I wouldn’t fall over. I would bump into someone and have these conversation where I had to pretend I was making eye contact with them, meanwhile they’re a complete blur and I would be getting headaches because my vision was really messed up.”

Further safety behaviours would extend from the accessories he wore to the words he spoke. “I would avoid phrases with the word ‘eye’ in it,” he explains. “I would never say ‘I’ve got my eye on you’ as I was worried that would trigger people to look at my eyes.”

Additionally, he avoided mirrors: “I would go weeks without looking in a mirror or I would only look in one if I had sunglasses on or I found a way to squint so I could never properly focus on my eyes.”

Omari dealt with the thoughts in his head alone for a very long time, scared that if he repeated them aloud they would be met with confirmation from others.

“At that time, I didn’t see any way I could talk to anybody about it because in my head if I told them then they would confirm it. There was a small part of me that thought ‘If I don’t talk about it maybe it’s not real or I’m getting away with it. I’m definitely not going to draw their attention to it’.”

This led him to withdraw from people leading him to sink into a “very deep depression” which he believes was made worse by feeling like he was pretending to everybody. In addition to struggling with the thoughts on his own, Omari felt like a “fake” and would beat himself up about the fact he was presenting a confident external persona yet suffering on the inside.

Eventually, his mother caught him in the midst of a near-breakdown and he told her about his BDD thoughts. However, for a while this strained relations between them as Omari pushed her away for fear she would confirm the thoughts.

“My thinking was that she was my mum and loves me unconditionally and thinks I’m beautiful but if she doesn’t then that must mean I really am hideous… I pushed her away and couldn’t talk to her about it at the time, I have since.”

Omari found out he had BDD when he was 21 after reading an article about the condition. He says most others he knows with the illness also “stumbled upon it” and the symptoms were not identified by a health professional.

After discovering he had the condition, he signed up for a trial of intense therapy dedicated to the illness where he learned to overcome the thoughts and tackle the safety behaviours and compulsions.

Therapy helped and he began to take up hobbies like dancing which he says has also helped with his recovery. Writing a book and tutoring students foreign languages, he now says he is in a good place and his life is “hugely on track now”.

He is currently in the midst of a social media campaign called “In the face of BDD” where he is taking a photo of himself – in any situation and with no filter, edits or retakes – every single day for a year and sharing it on Instagram to raise awareness of the condition and money for the BDD foundation.

“It’s sad because I look back on the years and at family photos and I’m not in any of them. I either made excuses and got away or, more likely, I wasn’t at the event,” he says solemnly.

But now, with his life back on track, he wants to help others overcome the condition.

“Recovery from BDD really is possible. It is a journey. The first step is talking about it and the second is realising that when you do you’re fine.

Advertisements

Misjudged counselling and therapy can be harmful, study reveals

Tags

psychotherapy, therapists, Therapy

Misjudged counselling and therapy can be harmful, study reveals

Counselling and other psychological therapies can do more harm than good if they are of poor quality or the wrong type, according to a major new analysis of their outcomes.

Talking therapies are usually helpful to people who are distressed, but in a minority of cases where it goes wrong it can leave vulnerable people more depressed than when they first sought help, the authors say.

Prof Glenys Parry, chief investigator of the government-funded AdEPT (Adverse Effects of Psychological Therapies) study, said that there needs to be greater recognition of the potential for counselling to make people worse.

“Most people are helped by therapy, but … anything that has real effectiveness, that has transformative power to change your life, has also got the ability to make things worse if it is misapplied or it’s the wrong treatment or it’s not done correctly,” she said.

Very little research has been done on the negative impact of psychological therapies, even though they are increasingly prescribed in the NHS as well as being very widely available privately. Cognitive behaviour therapy is recommended in preference to pills for mild to moderate depression and anxiety.

Parry and her colleagues at Sheffield University’s School of Health and Related Research (ScHARR) and the Department of Psychologyanalysed data routinely collected by therapists as well as the results of clinical trials. They included point scores of the levels of depression before and after courses of treatment and self-reported levels of wellbeing. They also interviewed therapists and clients to find out what goes wrong and when and how. The study was funded by the government’s National Institute for Health Research.

Although they say in general the results, which they have not yet published in detail, are positive, they found that they were variable across every type of psychological therapy. Some therapists had a lot more clients whose state of mind deteriorated than others although, Parry pointed out, that could be because they had more difficult cases. And some may have got worse whether they had therapy or not.

“Somebody could deteriorate during therapy but if they hadn’t had the therapy, they could have been dead,” she explained.

But, said Parry, both therapists and clients need to be more aware of the potential dangers and those who feel they are getting worse need more help. Her team have used the findings from the research project to set up a website to help people going through any form of psychological counselling called supporting safe therapy, which offers guidance on what to expect and advice if things go wrong.

“We have just got to be grownup about it – counselling treatments are effective but we need to understand more about the circumstances in which they can go wrong.”

There have been widespread reports of “transgressive behaviour” by therapists who abuse the trust of their clients, but less so about poor quality support. “There has always been the risk of a therapist misbehaving,” she said, “but we are talking about something much broader than that – not just a very, very small minority of people who fall into the hands of somebody who’s not practising properly.”

“I’m very keen that we grow up as a profession and start to look at these issues. If airline pilots said we get some people who crash, we’d all be worried about it. We have got to learn from when things go wrong and get much more scientific about it and much more careful about it, but not making out that it is a big drama,” she said.

Therapy does not work for everyone, says the website, which quotes the words of clients themselves. “I was coming out of therapy with no skills to deal with the emotions that it brought out,” said one. “I was starting to feel like I was at fault for not making it work,” said another. “The therapist verbally attacked my character and told me I was being over the top. The next week she said she was sorry for what she had said while also blaming me for provoking the outburst!” said a third. The website also advises people on how to make a complaint.

New hope to treat schizophrenia with therapist-controlled avatars

Tags

avatars, hallucinations, hearing voices, schizophrenia, Therapy

New hope to treat schizophrenia with therapist-controlled avatars

Scientists are examining whether computer-generated avatars can help patients with schizophrenia.

The avatars are designed by patients to give a form to voices they may be hearing, then controlled by therapists who encourage patients to oppose the voices and gradually teach them to take control of any hallucination.

A new study has been launched to assess the effectiveness of using the technology. Researchers, who have been given a £1.3m grant from the Wellcome Trust, hope that the system could provide “quick and effective therapy” to help patients reduce the frequency and severity of episodes.

Almost all of the 16 patients who underwent up to seven 30-minute sessions in a pilot study conducted by researchers at University College London (UCL) reported a reduction in the frequency and severity of the voices that they heard.

Three of the patients stopped hearing voices completely.

Julian Leff, emeritus professor of mental health sciences at UCL, who developed the therapy and is leading the project, said: “Patients interact with the avatar as though it was a real person, because they have created it they know that it cannot harm them – as opposed to the voices, which often threaten to kill or harm them and their family. As a result, the therapy helps patients gain the confidence and courage to confront the avatar, and their persecutor.

“We record every therapy session on MP3, so that the patient essentially has a therapist in their pocket which they can listen to at any time when harassed by the voices. We’ve found that this helps them to recognise that the voices originate within their own mind and reinforces their control over the hallucinations.”

The larger study, which will be conducted at the King’s College London Institute of Psychiatry, will begin enrolling patients in early July. The first results are expected towards the end of 2015.

“Auditory hallucinations are a very distressing experience that can be extremely difficult to treat successfully, blighting patients’ lives for many years,” said Professor Thomas Craig of the King’s College London Institute of Psychiatry, who will lead the larger trial.

“I am delighted to be leading the group that will carry out a rigorous randomised study of this intriguing new therapy with 142 people who have experienced distressing voices for many years.

“The beauty of the therapy is its simplicity and brevity. Most other psychological therapies for these conditions are costly and take many months to deliver. If we show that this treatment is effective, we expect it could be widely available in the UK within just a couple of years as the basic technology is well developed and many mental health professionals already have the basic therapy skills that are needed to deliver it.”

Paul Jenkins, chief executive of the charity Rethink Mental Illness, added: “We welcome any research which could improve the lives of people living with psychosis. As our Schizophrenia Commission reported last year, people with the illness are currently being let down by the limited treatments available. While anti-psychotic medication is crucial for many people, it comes with some very severe side effects. Our members would be extremely interested in the development of any alternative treatments.”

Schizophrenia is estimated to affect around 400,000 people in England.

The most common symptoms are delusions and auditory hallucinations. Experts estimate that as many as one in four patients do not benefit from drugs which help people with the condition.

Is it ever right for a therapist to cry?

Tags

crying, therapists, Therapy

Is it ever right for a therapist to cry?

Ask most people about their idea of a therapy session and it will probably be a dispassionate professional sitting quietly taking notes as a patient pours out their darkest secrets – possibly on the analyst’s couch. The patient may even break down in tears.

Suggest that it was the therapist who cried during a session and many might dismiss the notion. But recent research has discovered that as many as three-quarters of therapists may have wiped away a tear when listening to their patients.

The study was carried out by Amy Blume-Marcovici, a clinical psychologist at Alliant University in San Diego in the United States.

She found herself with tears in her eyes during a therapy session with a female patient.

“I worried mostly that I had harmed her, or that she would feel ‘can this person handle what I’m talking about?’ And then I also worried that I’d been unprofessional.”

In her study Blume-Marcovici says it’s not a case of therapists sobbing: “Most often this was people describing themselves as ‘tearing up’… for the large majority the tears were beyond their control. Most of the time they did not regret their tears and they said that their client was not aware of their tears.”

The therapists who took part in the survey encompassed beginners through to the most experienced.

Among those who admitted to crying, 30% had done so in the last four weeks. So crying is not a rare occurrence.

Even though women cry more in daily life, it wasn’t reflected in the therapists’ reporting of their own tears. Men cried just as often as women. Blume-Marcovici suggests that women might “hold back tears” more than men, to control how they behave in the sessions.

Susie (not her real name), who herself underwent therapy is horrified at the thought of therapists crying.

She saw a therapist in her 30s because an abusive childhood made her into “an angry control freak” that needed careful handling.

“If my therapist had cried I’d have never returned. I needed a therapist who was in control of their emotions… at the start I needed to feel that my therapist was a superhuman who could fix me, so seeing any wavering would have demolished my confidence in them. I was terrified of my own emotions and I think I would have felt enormous guilt that I had made them sad.”

Simon Wessely, a professor of psychological medicine at the Institute of Psychiatry at King’s College London agrees.

“You’re supposed to be a professional,” he says. “It’s perfectly okay to empathise with people when they’re in distress. But there’s a big difference between that and then bursting into tears.

“You could also say for example, what you just told me made me feel angry and to prove that I’m now going to slap you. That wouldn’t be very good, would it? I don’t like the idea that at some point the patient might push the box of tissues back to you.”

Continue reading the main story

Bedside manner

There is little known about therapists crying, however doctors have been the subject of considerable scrutiny in this area.

Empathy “is something student doctors think about”, according to Dr Graham Easton, who trains medical students at Imperial College, London.

He said: “They worry about being unprofessional, that it’s a sign of weakness or emotional instability rearing its head.

“But a lot of us feel it can be an expression of compassion and of empathy, which is increasingly promoted in medical training and in fact required by professional bodies.”

Conducting a consultation in a professional, yet caring manner requires a blend of skills – everything from a doctor’s body language to a comforting hand can communicate a range of signals to the patient that can help put them at their ease.

Medical professionals are human too. In some areas of medicine, where sharing bad news with patients on a regular basis is part of the job, it can have an effect on individuals.

What makes a therapist cry?

In the therapy sessions patients are at their lowest ebb, often recounting tales which are distressing to listen to.

Consultant clinical psychologist Gillian Colville knows this only too well. She helps to support the families of very sick children in paediatric intensive care at St George’s Hospital in London.

Some of her patients are in deep distress after a child has died.

“I glisten,” she admits. “Certain things that people say – you can’t fail to be moved by.”

It’s happened a couple of times recently and the clients noticed. “One caught their breath and changed the subject… the other continued what they were saying. But I don’t do it on purpose, I wouldn’t know how to.”

In the American survey just over half of those who cried believed it didn’t have an effect on their client and close to a half thought it had changed their relationship for the better. Less than one per cent felt it had harmed their client.

Amy Blume-Marcovici noted that older, more experienced therapists were more likely to cry. She suggests that this could be because they are more comfortable with expressing their emotions.

Gillian Colville uses professional support at work to cope with the pressures. She says she sometimes cries during sessions with her supervisor. “I do weep… a child dying is unutterably sad. I would be worried if I wasn’t moved, but I have to take note and look after myself too.”

Susie said she would have been distressed if her therapist had cried during her sessions but confesses: “Now, as a relatively sane person, I can see that there’s actually nothing wrong with a therapist crying, because they are human.”

Stigma of mental ill health is ‘worse than the illness’

Tags

anxiety, barriers, Depression, discrimination, economy, employment, mental health issues, psychotherapy, recession, relationships, stigma, Therapy, treatment

Stigma of mental ill health is ‘worse than the illness’

It is the single biggest cause of disability in the Western world but many sufferers say the stigma attached to it is worse than the illness itself, according to researchers.

While celebrity sufferers who speak out about their depression are hailed as heroes, ordinary citizens are shunned, taunted and abused.

An international study of more than 1,000 sufferers in 35 countries has found that three quarters said they had been ostracised by other people leading them to avoid relationships, applying for jobs and contacting friends.

Discrimination is leading many to put off seeking treatment with a subsequent worsening of their condition.

Drugs and psychotherapy can help 60-80 per cent of people with depression but only half get treatment and only 10 per cent receive treatment that is effective – at the right dose, for long enough and with the right kind of therapy.

The international study published in The Lancet found that levels of discrimination were similar to those for schizophrenia revealed in a similar study three years ago.

Professor Graham Thornicroft, head of health service and population research at the Institute of Psychiatry said: “We have a major problem here. Non-disclosure is an extra barrier – it means people don’t seek treatment and don’t get help.”

While public confessions of depression by well known people including the tennis champion Serena Williams, the US actress Kirsten Dunst and chat-show host Stephen Fry were increasing, abuse of sufferers was also widespread.

The Norwegian Prime Minister, Kjell Bondevik, attracted worldwide approval when he relinquished power for three weeks to his deputy in 1998 while he recovered from an episode of depression. He was subsequently re-elected.

In contrast, Professor Thornicroft described the case of a woman who had dog faeces posted through her door because neighbours wanted her out and another in which police halted an interview with a man whose flat had been burgled when they learnt that he had been in psychiatric hospital.

“Our findings show discrimination is widespread and almost certainly acts as a barrier to an active social life and having a fair chance to get and keep a job,” he said.

The Government’s Time to Change campaign launched in 2008 aimed at reducing discrimination against people with mental illness had proved to have had a “modest but significant” impact, he added.

In a separate study, researchers have found that the 2008 economic crash led to a deterioration in the mental health of men – but not women.

Anxiety and depression increased markedly among men in the three years following the crash, but women escaped largely unscathed.

Rising unemployment and falling income are not to blame, the researchers say. Instead, job insecurity is thought to be the cause.

Mental ill health among men rose from 13.7 per cent in 2008 to 16.4 per cent in 2009 before falling back to 15.5 per cent in 2010, according to the study published in the journal BMJ Open.

Men derive much of their social status from their occupation and are still the main wage earners in most families. They are becoming more mentally unstable because of the fear of losing their jobs in the recession.

The authors from the Social and Public Health Sciences Unit in Glasgow, say that while women’s mental health appeared to change little in the period it may have deteriorated since due to job cuts in the public sector.

 

Not enough adoption placements are being found for children

Tags

abuse, adopters, adoption, adoptive placements, Children, family, foster care, neglect, placement orders, support, Therapy

Not enough adoption placements are being found for children

The government’s overhaul of the adoption system is designed to speed up the approval process and make it easier for people to adopt. But the latest Department for Education statistics for England reveal that the number of children waiting to be adopted has increased by around 15% since last year.

In March 2011, there were 6,240 children with placement orders, a year later there were 7,160. A placement order is granted when a local authority plans for a child to be adopted. At the same time, the number of children placed with adopters has decreased by 1% since 2011 – and 6% since 2008. This suggests that while more placement orders are being made, not enough adoption placements are being found.

John Simmonds, policy director for the British Association for Adoption and Fostering (Baaf), says the number of children with placement orders is a concern: “I don’t think we have a sufficient number of adopters being recruited at the moment. For some children there’s a prospect that they won’t get placed at all.”

If progress is to be made, he believes it is crucial that adopters know they’ll get the necessary support once their child is with them, particularly in the case of harder-to-place children such as sibling groups, older children and those with disabilities. “There needs to be a recognition that, for any adopter, this is a challenging thing that people are taking on.”

The support provided to adopters by local authorities and voluntary adoption agencies varies. Julie and Mark had a six-year-old boy placed with them for adoption last year. Julie says that, despite their local authority’s promise of support, appropriate help and information ceased when it looked as though the adoption could go ahead and they began asking questions and requesting support. The placement broke down and their child returned to foster care.

Julie says: “I did not want to lose our boy. He was my son whom I had begun to bond with, loved and had envisaged being part of our lives for ever.” She believes their son could still be with them had they been supported adequately.

By contrast, Rose adopted her son through Adoptionplus, an agency that provides specialist therapeutic support for all of its adoptive families. She says: “We felt very well prepared for our little boy to be with us.” Rose says support is available whenever they need it. “Although we’ve got set therapy sessions, we know that if we don’t need to access them we don’t have to. The great thing is that we could not see them for months and months, or years, and then ring them up in six years’ time and say this is starting to be an issue, and then they can help us out with that. That’s just great to know.”

Currently, 72% of adopted children were neglected, abused or both by their birth families. Alan Burnell, director of adoption agency Family Futures, says many children they see are scared and need help to adjust. “Even though they’re in safe, new environments, they need help to rewire their brain so that they can accept the love and the care that they’re getting in adoptive families,” he says.

Local authorities are obliged to assess adopters’ support needs, if requested, but not to provide any specific services identified by those assessments. “The key to adoption success is in the post placement support and therapeutic input,” says Burnell. Family Futures has been placing children for adoption since 2009 and offers support from a team of therapists, paediatricians, teachers, psychologists and social workers. “All the families that come to us have access to that whole multidisciplinary team, who can provide whatever help they need over a long period of time,” he adds.

Joanne Alper, director of Adoptionplus, used to manage a local authority adoption team. “It used to break my heart to see the same children coming back into care again and again, following breakdown after breakdown of fostering and adoptive placements,” she says. “The local authority used to respond to these children from very much a crisis intervention perspective.”

Alper is part of the team that set up Adoptionplus to support children’s long-term needs. The agency started placing children for adoption in 2011, and employs a support team of specialists.

Diane Cecil manages a team at Essex county council whose job is to find families for children who are hard to place. “We have placed many children outside of Essex,” she says. “There have been some voluntary adoption agencies and local authorities that have provided good post-adoption services, and there have been some that haven’t provided anything at all.”

Cecil’s team recently placed a child with an Adoptionplus family after his first adoption broke down and it was clear he would need ongoing support. “I feel confident … this little boy and these adoptive parents are being provided with a very good support service,” she says. Although the cost of this type of placement is high (Adoptionplus charges local authorities £65,000 for placement and support), she adds that the alternative for the child would have been long-term foster care, costing the council around £27,000 per year. “For us, I felt that was a really good investment.”

• Some names have been changed

Government tackles abuse of children accused of witchcraft

Tags

abuse, neglect, ritual abuse, Therapy, Torture, violence, witchcraft

Government tackles abuse of children accused of witchcraft

The government has announced plans to tackle the “wall of silence” around the abuse and neglect of children accused of witchcraft, following the brutal murder of Kristy Bamu, who was tortured to death in London in 2010 by his sister and her partner after they said he was a witch.

Key charities say many cases of “ritual abuse” are under the radar and that the belief in witchcraft is on the increase in the UK.

Under the new plans, the government aims to identify and prosecute more offenders by raising awareness of faith-based abuse and its links to trafficking, missing children and sexual exploitation or grooming. The goal is also to help the victims give evidence.

Tim Loughton, the children’s minister, said: “Child abuse is appalling and unacceptable wherever it occurs and in whatever form it takes. Abuse linked to faith or belief in spirits, witchcraft or possession is a horrific crime, condemned by people of all cultures, communities and faiths – but there has been a wall of silence around its scale and extent.

“It is not our job to challenge people’s beliefs but it is our job to protect children. There can never be a blind eye turned to violence or emotional abuse or even the smallest risk that religious beliefs will lead to young people being harmed.”

Kristy Bamu was 15 when he arrived in London from his home in Paris to visit his sister and her boyfriend for Christmas. Eric Bikubi, the man he referred to as his uncle, became fixated with the idea that he was practising kindoki or witchcraft. With increasing violence, Bikubi, 28 when he came to trial, tried to “exorcise demons” from the child.

During the torture, described during the trial this year as a “staggering act of depravity and cruelty”, the 15-year-old was deprived of water and sleep, and punched and kicked repeatedly. Floor tiles were smashed over his head and his teeth were hit out with a hammer.

The trial followed the case of child B – an eight-year-old Angolan girl who was beaten and cut, and had chilli rubbed into her eyes after being accused of being a witch in 2003 – and that of eight-year-old Victoria Climbié murdered by her guardians 12 years ago.

Despite low reported figures of ritualised abuse, police have warned that the crime is “hidden and under-reported”.

Under plans drawn up in the national action plan to tackle child abuse linked to faith or belief, police, social workers and others who come into contact with potentially abused children will get more training. It recommends that children should have better access to therapy and emotional support after abuse.

Drawn up with faith leaders, charities and the Metropolitan police, the plan urges local communities and churches to work more closely together to prevent abuse.

Loughton said: “There has been only very gradual progress in understanding the issues over the last few years – either because community leaders have been reluctant to challenge beliefs which risk leading to real abuse in their midst; or because authorities misunderstand the causes or are cowed by political correctness.

“This plan will help people recognise and know how to act on evidence, concerns and signs that a child’s health and safety is being threatened.”

The research is limited and there are few official statistics concerning the abuse of children accused of witchcraft. In the past 10 years there have been 81 recorded police investigations in London of faith-based child abuse, while research commissioned by the Department for Education and Skills in 2006 analysed 38 cases involving 47 children, from Africa, south Asia and Europe, all of whom had been abused in the name of possession or witchcraft.

Research for the education department on child abuse linked to faith, based on previous findings, is expected by the end of the year.

Mor Dioum, director of the Victoria Climbié Foundation UK, welcomed the move to recognise faith-based child abuse. “By bringing the issue into the open … we can better protect and support members of our communities when they seek to highlight their concerns. However, we need to work more effectively with families to achieve better outcomes for children and young people affected by this type of abuse,” he said.

Simon Bass, the chief executive of the Churches’ Child Protection Advisory Service, said a multi-layered approach was necessary to address the issue.

Pastor Jean Bosco Kanyemesha, representing the London Fire Church International, Peace International and Congolese Pastorship in the UK, said the government’s move “was an adequate response to resolve issues troubling our local communities”.

Debbie Ariyo, the director of Africans Unite Against Child Abuse, described the action plan as the first step taken by any government to seriously tackle ritualised child abuse, but said it was not going far enough. She called on the government to make it illegal to brand a child a witch.

“We would have liked to see the government go further but we believe this action plan will go a long way to encouraging voluntary agencies to take concrete steps to fight this type of abuse,” she said.

Scandal of mental illness: only 25% of people in need get help

Tags

anxiety, cbt, Children, Depression, mental health issues, physical health, stress, Therapy

Scandal of mental illness: only 25% of people in need get help

The “scandalous” scale of the NHS‘s neglect of mental illness has been described in a report which suggests only a quarter of those who need treatment are getting it.

The report claims that millions of pounds are being wasted by not addressing the real cause of many people’s health problems. Nearly half of all the ill-health suffered by people of working age has a psychological root and is profoundly disabling, says the report from a team of economists, psychologists, doctors and NHS managers, published by the London School of Economics.

Talking therapies such as cognitive behaviour therapy relieves anxiety and depression in 40% of those treated, says the Mental Heath Policy Group led by Lord Layard. But despite government funding to train more therapists, availability is patchy with some NHS commissioners not spending the money as intended, and services for children being cut in some areas. “It is a real scandal that we have 6 million people with depression or crippling anxiety conditions and 700,000 children with problem behaviours, anxiety or depression,” says the report. “Yet three quarters of each group get no treatment.”

Layard added: “Mental health is so central to the health of individuals and of society that it needs its own cabinet minister … The under-treatment of people suffering from mental illnesses is the most glaring case of health inequality in the NHS … Despite the existence of cost-effective treatments it receives only 13% of NHS expenditure. If local NHS commissioners want to improve their budgets, they should all be expanding their provision of psychological therapy.”

A third of families have a member suffering a mental illness, the authors found. The report says mental health problems account for nearly half of absenteeism at work and a similar proportion of people on incapacity benefits.

In 2008, Layard and others won the argument that treating anxiety and depression saved the NHS money. A programme called Improving Access to Psychological Therapy (IAPT) was set up to train thousands more therapists.

Official figures, however, show that too few people are getting treatment across the country. There were 6.1 million with treatable anxiety or depression in England but only 131,000, or 2.1%, entered talking therapy in the last quarter of 2011.

There are stark differences between primary care trusts. Walsall did best, with 6.4% of depressed and anxious people in talking therapy, followed by Swindon with 5.8% and Northumberland with 5.5%.

But Hillingdon, west London had only 0.1% in treatment – 17 out of 29,000. Barnet and Enfield, both in north London, had 0.3% and 0.4% respectively.

Layard said commissioners were wrong “if they think ‘why don’t we cut a bit of that [talking therapies]’ when they are spending money on infinitely lower priority conditions. Depression is 50% more disabling than conditions like angina, arthritis, asthma or diabetes.” Even including those on medication, treatment only reaches a quarter of those in need.

Commissioners needed to understand that treating people with mental illness saves money, the report says. Layard pointed to a survey at two London hospitals which found that half the patients sent for an appointment with a consultant had physically inexplicable symptoms, such as chest and head pains for which there was no organic explanation. “These are people with somatic symptoms as a result of mental stress,” he said.

In the long term he said he would like to see psychologists and therapists working alongside physical medicine doctors in the acute sector, to help determine the real cause of people’s apparently inexplicable symptoms.

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, said the report showed mental health remained a poor relation to physical health for the NHS. “The government has rightly committed to a parity of esteem between physical health and mental health in the health and social care bill, and surely they must now deliver on what they have promised.”

Dr Clare Gerada, the chair of the Royal College of GPs, applauded the efforts of Layard and his colleagues to increase the availability of talking therapies.

“We live in a stressful society and the number of patients with mental health problems presenting to GPs is on an upward spiral,” she said. “GPs face tremendous challenges in caring for patients with mental health problems in primary care and we welcome any development which will help us improve their care.”

The care services minister, Paul Burstow, said: “Mental ill-health costs £105bn per year and I have always been clear that it should be treated as seriously as physical health problems … the coalition government is investing £400m to make sure talking therapies are available to people of all ages who need them. This investment is already delivering remarkable results.”

More:

NHS is’failing’ mental health patients

Relationships After Sexual Assault

Tags

rape, sexual assault, Therapy, trauma

Relationships After Sexual Assault

Or should I say the “lack of relationships” after sexual assault… Trust is a difficult thing, especially when you’ve fallen victim to a rape. After becoming a victim myself and eventually seeking therapy, I couldn’t trust anyone, not even myself. Can you imagine the feeling of not being able to trust yourself? I am still very mistrustful and fearful. To understand why, I would have to revert back to the crime itself along with some common misconceptions.

Since writing about this publicly, many people, mainly men, have argued with me that rape is an act that men cannot help executing because of their “natural” sexual drives and desires. This misconception is also the reason why victim-blaming excuses often fly without much questioning from others. “She was dressed like a slut,” “She is very promiscuous,” and many many more excuses for rape crimes take the blame off the perpetrator and place it on the victim. At one point, I too thought that rape was a sexually-motivated crime. When it happened to me I was young, cute and totally disinterested in the “friends” who raped me. I thought that maybe they had wanted me bad and knew they couldn’t have me so they resorted to rape as it was the only way to “get” me. It made sense in my head, at the time.

This is, of course, wrong. Rape is not about sex. It is about control. It is a crime like any other where something is taken without consent. If a man walks into a bank with a gun, he uses the gun as a weapon to procure money from the bank. Rape is similar. A rapist overpowers the victim by using sex as a weapon, much like a gunman scares bank tellers into submission by waving around a firearm.

A rapist is similar to a bully in the schoolyard picking on smaller kids so he can feel “bigger.” It is possible that the friends who raped me did it because they knew I would never sleep with them in a million years willingly. This still doesn’t make it about sex. Maybe they wanted to have sex with me but they knew that I wouldn’t, and out of anger and resentment decided that they were going to have sex with me with or without my permission. That night, they put something in my drink so they could do it without fear of me remembering or finding out (or so they thought…). In the end, they got what they wanted, despite what I wanted. Yes, what they originally wanted might’ve been sex, but without my consent what they wanted from me surpassed the sexual and entered into the realm of control: They wanted me to do what they wanted.

Since starting counseling, my ability to trust has greatly decreased. For some reason, talking about what happened has opened whole new metaphorical can of worms. Not only do I have trouble trusting others, even family and friends I’ve known for years, but most of the time I feel like I cannot even trust myself. This is a problem many victims of sexual assault experience, and it often results in isolation from friends and family as well as a failure to forge new friendships and relationships.

A lot of people have difficulties in relationships, but a person who has survived rape will have extra issues. It takes a patient and special person to be their lover or even just their friend. Sometimes the additional trials and issues involved in relating to a sexual assault survivor are very, very sad. Last weekend I was invited to an awesome concert by a good friend. It was an all-day music fest, and it would be just the two of us and one of her good guy friends. I wanted to go but the idea of crashing at her place along with some guy I didn’t know terrified me. Even though he was a good friend of hers, someone she knew and trusted, I could not bring myself to trust. Because she is such an understanding and kind person, she wasn’t insulted when I told her why I was uncomfortable going. But not everybody is that understanding. Most people are not.

The friends and family I have both from my “real life” and those I’ve met online are the some of the most patient people in the world. I spazz. I am afraid. I do not and sometimes cannot trust. I overreact. I am overly emotional. With all those terrible traits, they are always there for me. They know I am trying but cannot help it. What has happened to me, to my emotions and my mind, is equivalent to a physical handicap. My perception of life and everyday occurrences will never be normal. They can never be put right again. Like a person who has lost a limb in an accident, the damage has been done and nothing will ever bring that limb back. Now that the limb is gone, they are presented with more challenges. They still have to live life as they did before they had a physical handicap, but now they must find new ways to do the things that used to come naturally to them. Now there are extra obstacles they must surpass to live normally; permanent obstacles that will be a new layer upon the structure of what they used to consider their normal daily life. Over time, things do become easier, but they will never again be the same, and only the strongest people can be friends with and participate in relationships with a person who has experienced this type of emotional trauma.

I sarcastically said that this article should be titled the “Lack of Relationships After Sexual Assault” because it takes an empathetic and patient person to be supportive and understanding to someone who has experienced that kind of trauma. Many survivors, including myself, have been dumped by a significant other after revealing that being a victim of sexual assault was part of our pasts. Though the term “survivor” sounds pretty tough, the truth is that survivors are often fragile, and find themselves being ditched by guys and friends alike who are often too callous or impatient to deal with the emotional rollar coaster a rape survivor experiences and deals with on a daily basis. It is easy for a survivor to become overly dependent on friends once they learn that they can open up and trust again because it feels so amazing to finally be able to trust a person.

Sometimes being honest about being a survivor or even just being yourself ends up pushing the friends who cannot handle it away. And though it always hurts, the heart knows in the long run that by being ditched, these “friends” were actually doing you a favor. I know that as a survivor of sexual assault, I do not need half-assed cold-hearted men or friends in my life, people who are scared of the mental scape that makes up my reality. Imagine living in my head? Imagine experiencing my fear and trauma firsthand? If a person cannot be there to hold my hand when something becomes difficult for me, if he or she does not feel that my good qualities outweigh my bad ones and cannot be forgiving of my emotional issues or the way I handle things, then maybe they do not deserve my friendship. Relationships after sexual assault are not always easy. In fact, sometimes the relationship with the self is as challenging as the relationships with the people around you. True friends will reveal themselves in time and it is those friends who must always be appreciated and never forgotten.

Sparx 3D Computer Game Beats Teen Depression

Tags

anxiety, CCBT, computer game, Depression, mental health issues, Teens, Therapy

More ccbt:

http://www.huffingtonpost.co.uk/2012/04/20/3d-computer-game-beats-depression_n_1439577.html?ref=uk

Playing a 3D computer game could be just as effective at treating young people with depression as face-to-face counselling, new research has suggested.

The study, published on British Medical Journal website bmj.com, found that many adolescents are reluctant to seek help for mental health issues.

To tackle that problem, researchers developed an interactive fantasy game called Sparx, which sees each player choose an avatar and then face challenges to restore balance in a virtual world overrun by ‘Gnats’ (Gloomy Negative Automatic Thoughts).

They found that the self-help game, which uses cognitive behavioural therapy techniques to help young users, had as much benefit as more traditional treatments, reducing symptoms of depression and anxiety by at least a third.

Of the 187 young people in New Zealand studied as part of the trial, significantly more recovered completely in the group playing the computer game. A total of 44% of those who completed at least four of the seven modules in Sparx recovered, compared to 26% of those who were receiving face-to-face treatment.

The authors of the study, who are based at the University of Auckland and the University of Otago, said Sparx was an “effective resource for help seeking adolescents with depression at primary healthcare sites”.

They added: “Use of the program resulted in a clinically significant reduction in depression, anxiety, and hopelessness and an improvement in quality of life.”

The game treatment could prove a cheaper, and more accessible, way for some teenagers with depression to get help. In the Sparx group, 95% of the adolescents said they believed the game would appeal to other teenagers.