This episode features an interview with Dr Laurence Baldwin, Assistant Professor of Mental Health Nursing at Coventry University, in which we discuss the effects of the pandemic on the nation’s mental health, and examine how it has potentially affected children and young people in particular. I also review “Atomic Habits” by James Clear, an article in New Scientist magazine exploring consciousness, and provide a link to a video series I made about my prostate cancer journey. Finally, at the end of the show you’ll find a short, guided meditation called “Relaxation on the Beach” for beginners in particular (downloadable separately further down this page).
Some of the major topics that I discuss with Dr Laurence Baldwin in the show include:
- The pandemic has threatened so many aspects of our lives and undermined what many would see as being the key aspects of our psychological well-being: the need to feel safe; the need for social, emotional and physical comfort; the need to be close to others; and the need for things to make sense, be predictable and be familiar. How well have we coped with these aspects of mental health over the last couple of years with what we hope will be a once-in-a-lifetime event?
- It has been hard enough for adults, but especially so for children and young people whose education has been severely disrupted. How well have we safeguarded the futures of our children and young people. Have we set a good example for them in the way we, as adults, have coped? Have we kept them safe? Have platforms like the TV and social media helped? Have we succeeded of failed in supporting them?
- Many of us have had to turn to the private sector for counselling and therapy of various kinds. Is there a healthy balance between the resources available via the NHS and private practice? I had personal experience of the NHS not being able to offer ongoing therapy during the pandemic. How well has the NHS has coped with mental health care provision during Covid?
- We all saw that the NHS was faced with a staffing crisis due to Covid, with nurses and doctors suffering severe exhaustion, depression and anxiety. What has the journey been like for them, and are enough coming through into the profession to deal with any delayed effects?
- Now that restrictions are being lifted – for the time being, at least – will the mental health of the nation return to ‘normal’, or have issues arisen that will require continuing treatment for months, even years to come?
Resources and bonus material for this show
A deeper look at why our experience of the pandemic is so hard for us by Susannah Cowland and Dr Ava Horowitz (PDF, March 2020)
Maslow’s hierarchy of needs (Wikipedia)
Atomic Habits by James Clear
New Scientist magazine
Henry’s Prostate Cancer Journey videos on YouTube
The Relaxation on the Beach segment from this episode.
Transcript of Introduction and Main Interview from this Episode (created using Descript)
Paragraph timestamps are used to help reference the recording
Henry: [00:00:00] Welcome to episode one, the very first episode of Inside Your Head, the podcast and blog that explores psychology, mental health, neuroscience, self-help and related subjects. Here’s a short clip from today’s main interview.
[00:00:54] Laurence: I think on a human level, it’s more about where you were to begin with and how the pandemic has affected you individually. And people will have reacted differently, or, you know, if you’re living with someone who’s particularly anxious, then that kind of translates across to you as well. If you’ve got to reassure your partner, that it’s okay to go to the supermarket or you end up doing all of the going out the house stuff, that it just changes everything really.
[00:01:25] Henry: That short clip featured Dr. Laurence Baldwin, who I interview in the main part of the show. He’s Assistant Professor of Mental Health Nursing at Coventry University. And he very kindly came on the show to talk to me about the effects of the pandemic on the mental health of the nation, the effects it’s had on people who’ve been working in frontline services, a particular focus on the effect it’s had or potentially has had on our young people, our children and young people.
[00:01:57] And also we talked a little bit about what we can expect in the weeks and months ahead as the restrictions are eased, even in the face of the arrival of the Delta Variant, that’s very much in the headlines at the moment. So I hope that you’ll enjoy the main part of the show which will be coming along shortly.
[00:02:21] Now I’m going to be opening each show with a short section, dealing with stuff that I’ve noticed out there in the world, in the preceding couple of weeks between each show that might be stuff that I’ve seen on the television, things I’ve heard on other podcasts, things I’ve read in magazines or books and stuff that might’ve come up in conversation with people that I’ve met, all things that are focused on the subject matter that we’re covering in the show that I think might be of interest to you.
[00:02:54] Some of it might be newsy. Some of it might have been around for a while, but by goodness it’s news to me, and it might therefore still be news to you. So I hope that you enjoy this little introductory part of the show.
[00:03:07]Before I go any further, I also want to add that there’s another bit of the show, right at the other end, after the main interview called Relaxation on the Beach, which is me giving a short – 10 or 15 minutes – guided meditation, aimed at people who might not have done any meditation before or people who might have done some meditation in the past, but haven’t been doing it for a while or people who still do do some meditation, perhaps using one of the many apps that’s available nowadays, such as the Calm app but don’t mind having a go with someone else, doing the guiding for you. So that’s at the end of the show. So don’t forget to carry on listening beyond the main interview. If you want to listen to that, I’ll also be making those available separately as little short, 10 or 15 minute meditations that you can listen to on their own if you’d like after or in between the podcasts coming out, which I imagine will be on a fortnightly basis for the time being.
[00:04:13] Obviously, if things go bonkers and this goes large and gets popular, who knows, if I can afford it we might even be able to make it a weekly thing, if we can get enough guests to come on the show. Anyway, so let me kick off with something, that’s actually a book recommendation. Some of you may already have seen, or even read this book before.
[00:04:34]The author is quite prominent on social media and he runs a very, very popular newsletter with many hundreds of thousands, maybe even millions of people signed up to, and the author’s name is James Clear. And in 2018 he had a book published called Atomic Habits, Tiny Changes, Remarkable Results, and that was published by Random House in 2018.
[00:04:58] And that’s when I first bought it sometime around the end of 2018 and gave it a read through and thought, gosh, that’s jolly interesting, all about how to create good habits and how to break bad habits. At the time. I thought, yeah, that’s interesting. That will come in useful at some point in the future.
[00:05:17] Little did I know what was around the corner for me when, towards the end of 2019, something like September, 2019, I was diagnosed with prostate cancer, a diagnosis that came completely out of the blue. And then I was faced with, you know, coping with the prostate cancer itself, and the treatment.
[00:05:41] Treatment came in a number of forms. There were some tablets I was put on straight away, which then became three monthly injections of some pretty gruesome stuff. And also then beginning – actually started kind of June 2020, it was supposed to start in February, 2020, but the COVID pandemic put the kibosh on the NHS being able to deliver all sorts of treatment for serious illnesses because of you know, the, the workload – so started radiotherapy – 37 sessions of radiotherapy – kicked off in June and went on through till August, early August of last year and the combined effects of medication and the radiotherapy left me extremely debilitated, totally lacking in energy. I was also really rather obese at that point, overweight.
[00:06:34]And in fact, one of the weird things was because of the nature of the treatment I was told I mustn’t lose any weight until the treatment was finished because of the precision of the laser guided machinery, the zapping machinery I had to try and keep my body weight absolutely level if I possibly could.
[00:06:51] So I was, strange thing, strange experience being ordered, not to lose weight for the space of, you know, a couple of months for 37 sessions, Monday to Friday every week. And by the end of it, I was in a bit of a state. There’s no way of getting round that. I was very overweight and suffering from this terrible, terrible lethargy, lack of energy.
[00:07:16] And so I spoke to my oncologist and said is there anything could be done about that. And he said, well, to be honest, the only thing he’s heard anecdotally is that from some patients, not all, doing a bit of exercise can help restore energy levels. Well, me being me, I kind of threw myself at it. And at that time, you know, I was thinking, gosh, you know, well, what should I do?
[00:07:38] What, what are my goals here? What are my goals? What am I aiming to achieve? And I couldn’t come up with anything more specific than, well, I want to lose weight and get some more energy back. And so at that point I remembered this remarkable book by James Clear, Atomic Habits. And what he points out is that actually goals aren’t necessarily what you want.
[00:08:01] It’s actually focusing on the process, focusing on the system is what’s going to help you to achieve stuff. I mean, I can quote directly from the book here. He says, yeah, “…prevailing wisdom claims the best way to achieve what we want in life is to set specific, actionable goals.” And certainly those of you who may work in business of one form or another have heard of, you know, actionable goals, measurable , actionable goals.
[00:08:31]But what James says is “…goals are about the results you want to achieve. Systems are about the processes that lead to those results. If you want better results, then forget about setting goals, focus on your system instead. Goals are good for setting a direction, but systems are best for making progress” and in my experience, I couldn’t agree more. And so what I did was I started out with a spreadsheet, an Excel spreadsheet. How boring is that? Starting an exercise regime with a spreadsheet! My partner Ann and I also, to help shift the weight, took up Dr Michael Mosley’s Fast 800 Diet, which is a way of rapidly losing weight, but safely.
[00:09:22] And it seemed to me that if I wanted to shift the weight and regain energy shedding the pounds as quickly as I could, would also be a good idea. So I literally started out with a spreadsheet and on day one, I seem to remember that the goal was to be able to do about a minute’s worth of exercise as little as that it was literally okay, roll out of bed. And before you do anything else, try doing five press-ups, five sit-ups, 30 seconds jogging on the spot. Okay. Total around one minute. And I can tell you the first few days that was enough! That level of exertion was enough and I’d be out of breath and okay, that will do. But , every day or every other day, I would add, say, another press-up another, sit-up, an extra 10 seconds of jogging on the spot. And then once I got up to around two or three minutes, I started thinking, well, all right. Okay. I can add in another exercise here to add a bit of variety. So maybe do a couple of star jumps, maybe do a few bodyweight squats, that kind of thing.
[00:10:41] And over time, day by day, week by week, I made progress. And I was actually quite surprised at how rapid my progress was to the point where in April, by the end of April, this year 2021, after just starting around about September, October last year– so in the space of about six months, I had managed to shed around 27, 28 kilos in body weight.
[00:11:13] That’s like 58, 60 pounds, something like that. Someone do the maths! And I had dropped two sizes in trousers and shirt size. So I’d gone from XXXL to XL in shirt and jacket size. And I had gone from a 38 inch waist down to a 34 inch waist in trousers. Kind of almost one of those classic pictures of the guy who’s got the pair of trousers where you could fit two of them into it. Right. Not quite that dramatic, but very dramatic, you know, as far as I was concerned and I had regained control of my body to a very high degree, you know, I’d, I’d – muscles were appearing! Body weight had vanished. It was an extraordinary transformation and the transformation continues cause kind of end of April, beginning of May, I have to admit, I started to get a bit bored, exercising on my own at home, by which time I was doing something like 45, 50, sometimes even 60 minutes in a session of all kinds of you know, bodyweight exercises, HIIT training using weights up here in my attic studio. And I’d reached the, certainly reached the limit with what I could do with the weights up here in a safe manner.
[00:12:37] So I took on the services of a personal trainer and I now go and visit personal trainer twice a week and we do a proper regime with much heavier weights in a much safer environment. And she’s absolutely brilliant and has reinvigorated my love of exercise. Eh, you know, I was very, very fit as a youngster and my brain for many years had been trying to get me to do things that I was able to do when I was like 18, 19, 20 years old, but the body was refusing.
[00:13:05] Well, a few of those things have become possible again. And I’m over the moon about that. It’s been fantastic for my mental health as well as my physical health. And I can’t recommend exercise enough as a way of digging yourself out of a psychological hole. But the main thing, main point I want to make is that this book, Atomic Habits by James Clear was pivotal in my ability to do that . And if you are someone who’s looking to either create good habits or get rid of bad habits like smoking, overeating, whatever it might be, staying up too late… I can’t recommend it highly enough. You know, I don’t want to sound too evangelistic about it, but it is a brilliant book. And just to give you a little insight: the way he’s created four laws about how to create good habits and then inverted them to help you to get rid of bad habits.
[00:14:02] And the way he talks about the way he explains that habits are formed, the way that they are built is that we respond to a cue and then craving and then have a response and kind of demand or need a reward at the end of it. So the way he applies this, as it says to create a good habit is make it obvious, make the new good habit obvious, make it attractive, make it easy.
[00:14:33] Hence the, for example, only starting with a couple of minutes a day, rather than saying, oh, I’m going to run a mile today on day one. No, don’t do that. And make it satisfying. And breaking a bad habit, you kind of turn things on, on their head. And so what you want to do is make it invisible, make it unattractive, make it difficult to do and make it unsatisfying. And that may sound all terribly simplistic, but trust me, the book explains everything in great detail. It goes through every stage in great detail about how to achieve either creating good habits or getting rid of bad ones. And as I say the main thing is to think small, think about small incremental changes, rather than focusing on big goals. Like New Year’s Eve resolutions that you’re likely to have given in the space of a week. You know, it’s no good saying, oh, I’m going to do the London marathon. And then putting on your training shoes and trying to bang out 26 miles round the streets on day one, you’re going to half kill yourself, it’s dangerous and you’ll give up.
[00:15:47] Far better to say on day one: do you know what? I’m just going to jog to the end of the street and then day two, okay, I’m going to add literally just like 10 paces to that. And before you know, it, you’re running a mile or you’re running five miles. Add to things incrementally and over time, the transformation will be remarkable.
[00:16:11] It’s only time. And I look back at ‘before’ photos, how I looked six months ago: I can’t believe it. I mean, it’s absolutely amazing to me and utterly amazing to me that, you know, good friends of mine say, you know, “oh, hi skinny, how you doing?” I’m not quite that skinny yet. I have to point out I’ve still got a way to go.
[00:16:32] But compared to where I was, I’m visually a different person. So Atomic Habits by James Clear, thoroughly recommended.
[00:16:40] Now I’m going to turn briefly to talk about the latest issue of New Scientist magazine. This one I’ve got here came out on the 10th of July and the thing I want to draw your attention to is there’s a section in there all about consciousness.
[00:16:58] “The 10 Biggest Questions About the Greatest Mystery in the Universe” is like , gosh! What is consciousness? How many states of consciousness do we have? Can physics explain consciousness? What is consciousness like in other animals? When did consciousness evolve? What are the models of consciousness? How would we know if a machine were conscious? What’s consciousness for? Is consciousness detectable in the brain? Is the universe conscious? This is moving out to really mind-bending territory, but it’s fascinating stuff. And does consciousness make reality? Now I’m not going to go into any detail about this other than to say, it’s one of those things you read once in a while, that just makes you go, whoa, this is amazing. This is fantastic stuff. This is the kind of stuff I really love. You know, the kind of stuff that you’ll see occasionally like a Horizondocumentary, where they look into subjects just like this, what is consciousness? How, how do we know we’re aware? What is awareness? Do other creatures have awareness?
[00:18:09] How do we know? If they have awareness, what kind of awareness is it? I mean, one of the things they talk about in the article is that they think that octopuses, for example, each of their legs may have independent awareness. I mean, how alien is that? Right. And physicists are getting involved – quantum physics now is, is consciousness to do with quantum physics inside the neurons of the brain?
[00:18:36] This is extraordinary stuff. Very, very exciting. And I have to tell you, I hope at some point to be able to get someone on the show who’s involved in this kind of research. Funnily enough, there’s at least one person at the University of Sussex, just down the road from where I live, in fact, whose name is mentioned, I’m going to be emailing them to say, please come on the show to talk about this stuff, because I think it’s something that you will all find fascinating and is mind-bending in that wonderful way that the science of the brain and our psychological life can be.
[00:19:15] So a thorough recommendation for the latest issue of New Scientist magazine, which is available in paper, digitally and all that kind of thing. Like everything else is these days.
[00:19:26] The final thing I’m just going to mention is I put a link on the website for the podcast to some videos I made about my journey through the process of being diagnosed with, and then treated for prostate cancer , some videos I made that are on YouTube, they’ve been up there ever since September, 2019, and I’ve added to them. And I’m gonna put a link to those because a good friend reminded me that some people found them extremely useful.
[00:19:58]They’re pretty hard hitting. I don’t pull any punches. I tell it like it is what it’s like to be a man going through this process. Sometimes I get quite emotional not just because of the drugs that I’m on, that you see explained at the time, but also because it’s an emotional thing, being a man who’s got prostate cancer and the effect that that can have on a number of aspects of your life.
[00:20:25] So I’m going to put a link to those videos because they’re dealing at least as much with the psychology of being a prostate cancer patient as with the physical effects of which there were numerous effects, many of which were pretty unpleasant. So be warned, they don’t pull any punches, but I know for a fact, because a few guys have got in touch with me and said effectively, they saved their life, because they saw the video went and got themselves checked, got a simple blood test that their doctor had discovered that in fact all was not well. And then fortunately they were in the system, treatment was able to begin and I’m delighted to say, they’re still with us here today. So that link is going to be on the blog.
[00:21:15]If you’re interested, if you are a white guy aged 55 plus or thereabouts, or a black guy, age 45 plus or thereabouts, because for whatever strange genetic reason, it seems to affect black men sooner than white guys. Watch the videos, get yourself checked, a simple check a simple blood test called a PSA blood test could save your life. And if you are a family member or a friend of someone of that age, a male of that age, by all means you go ahead and watch as well, because you might learn enough to persuade someone to go and get themselves checked.
[00:21:59] All right. So we’re going to take a brief pause now, and then we’ll return with the main part of the show where I’m interviewing Dr. Laurence Baldwin who’s Assistant Professor of Mental Health Nursing at Coventry University. See you in a minute.
[00:22:39] Welcome to this part of Inside Your Head, where I get to interview people who know stuff about the subject matter that the podcast is dealing with and today I’m absolutely delighted to have on the show someone I’ve known for many years, actually through a different sphere of life completely, but I found out what he does for a living and gosh, I thought, now there’s a man who I’d like to have on the show and the person I’ve got sitting with me in a virtual sense today is Assistant Professor Laurence Baldwin. Hello there Laurence.
[00:23:15] Laurence: Morning, Henry. Thank you for having me on, it’s an honor to be the first guest on your new podcast.
[00:23:21] Henry: Thanks so much for coming on the show. Onerous responsibility, of course, being on episode one representing your profession, but I’m sure that you’ll do absolutely fine. And I think it’s really going to be fascinating for the listeners to hear your journey into the mental health profession, because there you are now an assistant professor at the university of Coventry, but in fact, you started out your career as a mental health nurse. So please tell the listeners a bit about your journey.
[00:23:52] Laurence: So a long, long time ago, before I came into nursing, I actually studied theology. But I worked out, I was never going to make a good vicar. So I looked around for something else that might be about people.
[00:24:05] And theology is arguably about people as well. But mental health nursing is definitely about people and particularly about sort of interactions and therapeutic relationships and stuff like that. So that’s where I ended up training in an asylum in Nottinghamshire many years ago. And at that time, it was an asylum.
[00:24:25] Things have moved on a lot since then. I spent a lot of time early on in my training. I worked out that I wanted to work with children and young people really. So after an initial stint on the normal adult wards, I ended up spending a lot of time as a, initially a clinical nurse specialist in children and young people’s mental health.
[00:24:45] And then later on, I was a nurse consultant doing some, you know, a lot of hands-on stuff, but also doing training research and some national stuff that I did with the Royal College of Nursing as well. And then about five years ago, I moved across to Coventry University. I picked up a PhD along the way. So I’m a nurse and a doctor. So two reasons to trust me – PhD, not a medical doctor. And now I teach mental health nursing. We’re just starting an MSc as well as the undergraduate course. And I’ve taught research methods and stuff like that at postgraduate level. So one thing has led to another really; I’m still a nurse, I’m just an assistant professor of mental health nursing.
[00:25:32] Henry: Right. You sent through your very, very impressive CV, Laurence. It’s one of the most comprehensive CVs I’ve seen in a long time.
[00:25:39]Laurence: It’s just very long because I’ve been around a long time.
[00:25:41] Henry: You’ve been around a long time sure, but I think it reveals rather more than that, that obviously you’re, you’re passionate about your subject matter.
[00:25:49] You’ve written quite a lot of papers about mental health nursing, particularly about the, the mental health of children, the care of children and young people. What is it in particular that’s drawn you to that aspect of the profession, Laurence?
[00:26:06] Laurence: I think with children and young people, you see the potential for things to get fixed, in a way that maybe is harder to do with older people. The key with children, young people is to just be aware that they’re not fully formed yet. They – adolescents and teenagers particularly hate it when you’re pointing that out to them, but – in many ways their personality is still growing , and a lot of child mental health and young people’s mental health stuff is about helping them to learn better ways of coping with situations.
[00:26:39] So for example, a lot of the self-harm stuff that we see is about coping with the first period of sustained stress or difficulty. And, and self-harm is a bad way of coping. But for often, for the young people, it’s the only way they’ve got. So you’ve got the potential there to help them find better ways of coping.
[00:26:59] And those ways of coping hopefully will follow them through the rest of their lives. So I think it always feels like there’s no really good research evidence to suggest that if you get in early, it will fix things long-term but intuitively it feels like that ought to be happening.
[00:27:17] Henry: Sure. Absolutely.
[00:27:18] Yeah. And in this series of podcasts as it grows I’m sure that we’ll be covering a lot of the coping mechanisms that you’ve mentioned there, both for adults and children. It’s one of the kind of primary reasons for me starting this show because of my own journey over the last couple of years and the things that I’ve learned along the way that have literally saved my life.
[00:27:41] And , as you mentioned there, one of the most distressing things in connection with young people is that self-harm is often one of the things that they feel they, that is one of their only options at a very young age. Because they’re not old enough to have learned the resilience that as adults, hopefully we’ve built up over time.
[00:28:04]And obviously this is, you know, very serious subject matter, not to be dealt with lightly. But of course we’re seeing a lot of, you know, because of social media these days as well, and things like gender politics, it’s kind of risen to the forefront of many news broadcasts. I think that’s fair to say, isn’t it?
[00:28:22] Laurence: Yeah, absolutely. I think the problem at the moment is that there is the epidemic that we’ve talked about is mostly about the physical stuff, but certainly my colleagues who are still in practice are telling me that their epidemic is starting now.
[00:28:38] Henry: Yeah, yeah, absolutely. And we’re going to kind of move on and talk about that in, in some depth, I think.
[00:28:44]So, so yes, let’s, let’s in fact plunge in here as is clear, you know, the pandemic, COVID-19 pandemic, threatens so many different aspects of our lives and has undermined many of the key aspects of our psychological wellbeing that, you know, the entire population and by that, and I’m referring to some notes provided by a really good friend of mine, actually, who is a social worker and has firsthand experience of dealing with the effects of many of these things.
[00:29:19]Basically what we tend to crave as human beings, isn’t it: we need, we need to feel safe. We need to feel that we’ve got social, emotional and physical comfort. We feel the need to be close to others and the need for things to make sense, be predictable and be familiar. And obviously the last couple of years has really thrown all that up in the air for all of us, hasn’t it? So, okay, in your view, you know, speaking as someone who’s, you know, a senior professional in the mental health industry now, how do you feel that – I mean, obviously we can only speak for the UK, really, we get, you know, other different countries have coped in different ways, they have different cultures – but certainly in the UK, how do you feel that we’ve coped as a nation with this degree of mental health upset in the last couple of years Laurence?
[00:30:12] Laurence: I think the difficulty, and you’ll see this played out on the media, is the difference between the health imperatives and the political imperatives. So the science suggests that closing down is the most important thing to prevent the physical transmission of COVID-19 for example. The politics is always going to say, well, that’s dangerous for the economy and bad for people’s health and all the rest of it.
[00:30:40] So we’ve, we’ve coped with that to a degree. I think in terms of children’s stuff, the imperative to keep the schools open has been a tricky balance that they’ve had to try and achieve really. Because the difference with children is that it’s harder for them to understand that this is a temporary thing.
[00:31:01] It’s an important stage wherever they’re at in their, in their development. A year, a year and a half, two years is a long chunk out of any young person’s development or… so being isolated, particularly difficult for, for teenagers and stuff. It’s, you know, they’ve got all their social media and other ways of doing things, but it’s not the same as interacting face to face with people.
[00:31:24] So that sort of normal developmental stage is really difficult. For the really young ones, it’s not being able to interact at all. The sort of preschoolers and nurseries haven’t been open or have been operating in a very limited basis. So all those normal social elements are, are the reason that has driven keeping the schools open.
[00:31:46] In terms of broader mental health. Obviously there will actually be a very small number of people who’ve quite enjoyed not having to socially interact with other people. So, you know, that that’s been okay for them. But that’s quite a small number of us. And the rest of us will have struggled with all manner of things, not being able to do the normal stuff.
[00:32:10]And then, you know, we have all of us have a routine. What you do at Christmas was disrupted last year. Levels of health anxiety, for example, will have gone through the roof. In terms of just, you know, depending on how you are individually, if you were already a bit anxious about other people and, and stuff, then you’re probably a lot more anxious about them now. And you’ll be on the side of the argument that says we should carry on wearing masks for a long time, yet look over your nose at people who get too close to you in the supermarket as they do.
[00:32:44]So you know, I think all those normal anxieties have all been heightened for, for lots of us, you know, I found myself in the early days, particularly getting quite anxious, which I’m not normally a particularly anxious person, but just the uncertainty of where it was going. Particularly the early days, it wasn’t clear how things were going to run or how things were going to work out.
[00:33:06] And I guess now it’s a little more predictable, but still we get mixed messages from politicians about what’s the best way to say, stay safe or what things should open, or where we should wear masks and stuff like that. So that, that kind of uncertainty is very, very current, at least in the UK at the moment.
[00:33:26] Elsewhere has been a little more decisive, I think. But internationally, the American experience has been very different from ours. You know, what’s happened in Australia and New Zealand. They handled it very differently, for example. So yeah, you can get political about how the government has handled it.
[00:33:46]I think on a human level it’s more about where you were to begin with and how the pandemic has affected you individually. And people will have reacted differently, or, you know, if you’re living with someone who’s particularly anxious, then that kind of translates across to you as well. If you’ve got to reassure your partner, that it’s okay to go to the supermarket or you end up doing all of the going out of the house stuff, that it just changes everything, really.
[00:34:14] Henry: Yeah. One of the things that struck me, I’ve got a friend who’s got elderly parents who are quite frail. And I think it’s fair to say that many people in a similar situation, because of the news that was coming out of care homes early in the pandemic where the mortality rates were shocking, I think there’s no other way of putting it, isn’t it?
[00:34:39]Henry: And that, I think for a lot of people created a great deal of anxiety about the chance factor, you know, the, the, the, what are the probabilities of possibilities of just randomly walking down the street, picking up the COVID and then going to see someone you love who may be elderly and frail. And then before you know it, you’ve accidentally transmitted the virus to an elderly parent or relative who might die. And that the, the NHS was clearly under a huge amount of strain. I mean, my experience was I, I, you know, and I’ve talked openly about this and I’m going to be introducing the listeners to a series of videos I made about my experience because in September, 2019, just before the kind of outbreak was announced, I was diagnosed with prostate cancer and my cancer treatment was delayed for several months, you know, it was supposed to have started in February, 2020. It didn’t end up starting till kind of late June 2020.
[00:35:43] I’m not someone who’s normally prone to anxiety, but I have to say that for the first time in my life, I, you know, it was bad enough having a cancer diagnosis then being told, yeah, well, we’re not going to be able to treat you when we would like to treat you because the hospitals were totally overwhelmed with, with the COVID stuff, you know, and I know I’m not alone.
[00:36:04] There were tens of thousands of cancer patients and people with other serious illnesses in identical situations. And I think that what we have to recognize don’t we Laurence is that for many people, even though we might not have recognized it at the time what, what we were suffering from was kind of trauma and that therefore, you know, in a totally different sphere, I’ve been very interested in post-traumatic stress disorder and that kind of stuff, that it’s entirely possible that a large swathe of the population is going to be suffering in one form or another to some extent or another, that kind of experience where it’s this realization that you’ve been through a traumatic experience and it needs to be processed to use the language of psychology.
[00:36:53] How, I mean, how well prepared do you think the mental health profession is in this country for dealing with the aftermath of what we’ve all been through, Laurence?
[00:37:07] Laurence: It’s a difficult one, because I think if you talk about trauma in general, a shared traumatic experience is generally easier to get through than an individual traumatic experience.
[00:37:18] So there’s there’s elements. So it’s why veterans stick together, for example, because they they’ve got a shared experience. In many ways we have all been through a very similar thing, but our experience of this trauma is going to be very different, very individualized. So you know, what level of trauma? You’ve used the word “resilience” before and people will react very differently.
[00:37:41] Resilience is all about, you know, why do some people go through the same experience, do better than, than others? You know, what is it about their character or their personality or their support network that makes it easier for them to cope with a bad experience compared to the person who is next to them.
[00:37:57] So I think it is going to be interesting to see how people cope. Generally. I think the way that mental health services are set up in the UK is that the NHS mental health services are set up to deal with a level of mental health distress that’s quite high. And then there are sort of lower levels of different sorts of provision including the sort of third sector charity areas that deal with different sorts of things. So sort of going through from acute mental illness down through what we call IAP, so Increased Access to Psychological therapies then into counseling services and support services. So there are various different levels of support available.
[00:38:44]Like I said earlier, I think from a mental health perspective, my colleagues who are still practicing are saying, you know, a lot of this has been suppressed. People haven’t been out as we start to open up, then people will have all manner of experiences that they need to process. And some will be more severe than others.
[00:39:02] You know, some people have been very, very isolated The elderly particularly. But other people have been more anxious and less willing to go out. Some people will have been traumatized by the fact that they had to go out. So, you know, frontline services, for example, nursing colleagues who worked throughout this pandemic are all exhausted and possibly quite traumatized. Certainly there’s a lot of stuff coming through about the people who’ve had to work in intensive care units throughout . Other people transferred into those ICUs because the capacity was expanded, who weren’t necessarily ready for that, that where there’s a level of trauma for those staff, how they’ll cope.
[00:39:45] From a nursing perspective, lots of nurses are saying when this is over – because we’re the kind of people that stick around and do things when we have to – when this is over, there might be a bit of a, you know, I’ll go and find something that’s less traumatic for me to be doing. So I think it’s going to be interesting, I think, particular groups and when I say frontline staff, you know, paramedics, police services, those kinds of people who’ve had to work throughout as well and to some extent, the other key worker groups as well who coped in different ways. But the good thing, I think if there is a good thing, is that it is a shared experience. So we’ve all been through this together, albeit in sort of variations of difficulty.
[00:40:27] We all have different experiences. You had your experience of cancer and you talked openly about that and that’s great. You know, other people have their own story. Yeah, my, my brother, for example, passed away last year with a respiratory disease and wasn’t diagnosed with COVID, but yeah. Pretty sure it was.
[00:40:46]So, you know, we all had different traumas and that’s individual to each of us, even though the sort of shared experience is broadly, similar.
[00:40:55] Henry: [00:40:55] Both you and I are interested in history. So of course what’s immediately kind of bells ringing in my head it’s, there’s a kind of similarity to what a previous generation would have called the ‘Blitz’ mentality where, you know, there’s an entire generation, that’s gone through that particular bit of World War Two and there’s been veterans returning home from the front line who then felt like, well, I can’t really talk about my experiences because the people on the home front have had an equally bad experience in their own way. It’s, it’s complex stuff, isn’t it? I think that’s it.
[00:41:30] Laurence: Yeah. That’s interesting. I mean, particularly with the veterans, you, you hear so many stories of First World War and Second World War veterans who just didn’t want to talk about it because they’d had such an extreme trauma. Our trauma through the pandemic has been difficult, but no one’s been dropping bombs on us. So it’s been different. You know, the, the trauma that, like I said, a shared trauma is, is easier to deal with. But you know, people deal with it in different ways because of their own particular setups and their own individual experiences.
[00:42:02] Henry: One of the things that I noticed was as soon as the vaccine became available and of course we have to, you know, send praise to the scientists who so astonishingly rapidly, in fact, came upon an effective vaccine, Oxford AstraZeneca vaccine, and I think then it was quite an interesting process, the way that the mood of the nation changed and then became this kind of race.
[00:42:30] How quickly can we get the vaccine out ? You know? But also then, this strange polarization that, that happened in the country between the, the people who had the vaccine and the people who were anti-vaxxers that kind of thing are all these kinds of conspiracy theories and things that started floating around was quite extraordinary and at times another kind of disturbing element wasn’t it, that kind of was introduced to this, what was already a complicated soup. And that must have been, you know, for, thinking of the medical profession, that must’ve been so exasperating.
[00:43:14]And obviously, you’re a man who was kind of close to, you know, the, the medical profession and you must have kind of had some kind of insight to the frustrations around that Laurence.
[00:43:26] Laurence: Yeah, it is. I mean, it is frustrating. The, the Oxford scientists who worked on, on the vaccine, obviously we’re building on stuff that they’d already prepared.
[00:43:35] So COVID, isn’t that different from MERS and SARS. So they were able to build them. That’s what, that’s why the speed of development and gives them credit, they’ve been very altruistic about not making a huge profit out of this, you know, keeping the price down. I think the, the adaption to how people have reacted to the vaccine is interesting.
[00:43:54] It is very, very frustrating for those of us who come from a evidence-based practice background, where we follow the science, this obviously works and therefore you should take it. And that’s, that’s true of other treatments as well. You know, why do people not take their diabetes medication for example, when then they ought to? Why do people like myself who probably should want to lose a bit of weight, not lose weight, when it would do us good?
[00:44:20] I think the general, again, the general politics is following a bit of sort of this sort of antiestablishment conspiracy theory thing. And there was an always an element of that around the sort of anti-vaxxers, but they were largely in America and relatively few in the UK, it seems to have tapped into this sort of mistrust of authority that is more of a broad societal problem, certainly around, you know, I live in Nottingham and we have quite close to me there’s a so-called Christian bookshop, which has been opening regularly through the pandemic and has been fined, and has been very divisive in the community. So people have sort of adopted that in a, you know, it’s almost like they’ve gone beyond the vaccine thing into into the more anti-authority thing. It sort of fits their narrative to use the jargon.
[00:45:13] Henry: Yeah, a kind of anarchic narrative. I mean, let’s, let’s come back to the subject that’s closest to your heart, you know, children and young people and the effect that this has had on them in the last couple of years, because obviously as we say, you know, it’s been hard enough for adults, but the kids, their education has been so disrupted there’s there was already stuff every year it seemed about exam results.
[00:45:38] And then the whole thing about where your kids, they’ve not had the lessons, so we just kind of guesstimate what kind of grades they’re going to get. And this is their future we’re talking about here. Obviously. Do you feel that as adults, we’ve set a good example to our young people about how to cope with a major crisis?
[00:46:00] Do we think that we’ve met their needs in the last couple of years in general? Do you, is there anything that you’ve noticed that you’ve either been particularly kind of horrified by or impressed by, in terms of the response that we’ve been able to provide for our young people in the last couple years?
[00:46:25] Laurence: Oh, I’ll start with the impressed bit then. I think we have to give credit to all the teaching staff in schools who’ve sort of carried on throughout and they’ve been put on the front line very much potentially at the expense of their own health. And there is, you know, all the stats say, actually teachers are not getting sick at a greater rate than anyone else, but it doesn’t stop you getting anxious when, particularly at the moment, there’s lots of stuff about school closures and bubbles and stuff, and lots of people going off. I think it’s been very hard for, for all the staff in schools to, to manage that, manage their own anxieties, manage doing, you know, we’ve had to do this at university level as well, but putting everything online is not as simple as it sounds.
[00:47:09]Doing things differently, delivering teaching in a very different way. You do have to adapt what you’re telling, you can’t just sort of take your lesson notes and, and talk into a Zoom camera or Teams meeting or whatever. It doesn’t work like that. So, you know, I think for the staff dealing with that, that’s been really difficult.
[00:47:31] I think for the young people. I think it’s more about the social stuff. Initially, it sounds great, doesn’t it? You don’t have to go to school for a while. But that, that novelty soon wears off, you know, kids naturally have more energy and they want to be up and doing stuff. So being cooped up in a house is hard enough for an adult. It’s harder for, for young people by and large. So, you know, again, they have some advantages: being digital natives, they can get on the social media a lot more, but it’s, it’s simply not the same as seeing people face to face, kicking a ball around outside, that kind of stuff. So I think they have suffered.
[00:48:09] I think what’s happened with a lot of stuff during this pandemic, is that a process that was already happening gets naturally accelerated. Prior to the pandemic, simple example, I’d made maybe four or five Skype calls in my life. Now I’m often doing that many in a day. So that, you know, what would have happened anyway has been accelerated. For young people it’s the same thing really. The things have just happened much faster, things had to go online and that, you know, people haven’t coped with that as well as they would. It’s just been really tough for them. And for those that had worries or concerns already, those have become exaggerated. Things have built up, they don’t have access to their normal support networks, certainly things like child protection.
[00:48:59]Your kids have been stuck in houses with potentially parents or other adults who are not good for them. So the level of reporting on child abuse has gone down because the opportunities to report it has gone. Domestic abuse will be the same. It’s the same thing. People get stuck, little things become big things very quickly.
[00:49:21] So levels of domestic abuse have gone through the roof as well. And yeah, to give, give people credit, people are trying to do stuff about that. Yeah. The train companies are offering free travel for people needing to get to refuges, those kinds of things so it’s brought out the best of, of some people in terms of, you know initiatives like that.
[00:49:41] But it’s also magnified existing conditions and just made those go a lot faster. So if you were hovering on the edge of a mental health problem before this, you know, this pressure cooker that we’ve all been through will have made it come on much faster. And that’s why it’s feeding through now into formalized services.
[00:50:01] You know, it’s talking to frontline colleagues in Coventry last week and they were saying half the pediatric beds, general pediatric beds in their local hospital are full of young people with mental health problems.
[00:50:17]Henry: Goodness me!
[00:50:18]Laurence: Now that’s, you know, we we’ve had that before, when I was working in Derby, we didn’t ever got to half, but we would, you know, there is a, an established procedure if young people self-harm or overdose, they have to be admitted. They have to get a mental health assessment, but the numbers have never been this high. So yeah, it’s, it’s tough times at the moment.
[00:50:38] Henry: Looking at an aspect of what you’ve just been talking about there, I think one of the things that’s been highlighted for many adults, particularly because of enforced isolation or paranoia about, you know, going outside or anything.
[00:50:54] I look at the proliferation of online delivery services now, you know, gosh, Amazon’s profits have leaped enormously. And now there’s people who deliver anything to you in the space of five minutes, you know, ingredients for your dinner, or, you know, booze for the week, whatever it is. It’s just the number of delivery services, extraordinary, which has alleviated some of the problems for people who got worried about literally going to the corner shop, you know, or standing in a queue and you’re standing in a queue and you’re wearing your mask, but the person in front isn’t wearing a mask and all that kind of stuff that we’ve all been through.
[00:51:32] But I think for a lot of people that has accentuated, what is obviously one of the most dangerous problems really, which is loneliness. You know, it’s a pervasive problem and it can lead to severe, you know, mental health issues obviously. It’s one thing feeling, oh, I’m feeling a bit lonely today, but if you’ve got the option of popping out tomorrow, you’ll feel fine about popping out tomorrow.
[00:51:57] That’s not a problem: it’s when it becomes a persistent thing and you become locked within your own walls to a certain extent. And of course, this also applies to our young people who were used to, you know, playing with their mates in the park or in the playground at school or whatever, and suddenly found themselves as you say, trapped, you know, and I think that’s not too strong, a word trapped in, in the house.
[00:52:22]Even if they’ve got good parents caring parents, they, you know, young people they have this rebellious streak. They want to get out and play with their own age group be with their own, you know, their own kind. And of course, as you know, sadly is the case, you know, these reports of the level of domestic abuse that has gone through the roof and the harm of children, you know, the, the revelation that there are many abusive situations out there, it has been a real shock.
[00:52:54] So I think, you know, since this is your kind of specialization, tell us something about how, how does the system cope with that? Because you’ve got, you know an older generation suffering from loneliness, but also kids are feeling isolated and alone. How’s as a nation – how as a service – do you cope with, you know, that two-pronged attack as it were,
[00:53:18] Laurence: It’s important to see individual needs. So, you know, like you said, some, some children, young people, brought up in really nice houses and, you know, they’ve got the space and stuff, others cramped in really tiny flats on the 15th floor. You know, their experience is going to be very, very different. And it’s the same with older adults as well, or individual adults, you know, we’ve got you know, I’m lucky enough to have someone that comes and helps with our garden on Saturday mornings because I’m rubbish at gardening.
[00:53:44] So you know, his experience is he’s lived with his brother in a tiny flat, and apart from coming to see us on Saturdays, he just went out to the shops at six o’clock in the morning to avoid other people, you know, so I think it’s, it’s quite hard for most of us to imagine, or to fully understand other people’s experience because we’re kind of getting used to, you know, we all have friends who are a bit similar to us.
[00:54:11]And we kind of end up thinking everyone’s a bit like that, but actually the experience of different people across the country is going to be very, very different. How the services react is again, going to be very different when we have service provision, that’s quite siloed in its approach really. So the people dealing with young people are very different to the people dealing with elder people.
[00:54:34] They may all work for social services or the health service, but services are carved up differently, but they’re all under pressure at the moment. And some of the people are, you know, it’s natural, really, some people are good at telling you when they need help. And some people are very bad at telling you when they need help.
[00:54:54] And maybe the older generation is, is one of those that don’t like to trouble the doctors, or don’t like to make a fuss or, you know, feel like other people’s concerns and their worries are more important than theirs, so actually getting people to access services in the first place. And you know, we’re still probably completely unaware of exactly how big the problem is at this stage where we’re kind of coming out the far end but in other ways, we’re not. Maybe the physical element of this is, is getting to the point where it’s being suppressed. The vaccines are starting to work for most of us. But not everyone’s been vaccinated yet, again with children they haven’t made a decision when to vaccinate them or if to vaccinate them, even though they’ve been proven to be safer, at least sort of 12 plus.
[00:55:49] So there are still going to be concerns and it will take a long while to sort of work through the system I think. The health service has a massive backlog now because all the resources were thrown into dealing with the COVID situation. And then it opened up for a little while as with your experience, there were prioritized some services that needed to be done quickly, but the backlog for the routine stuff is still very, very long and will take a long time to, to work through.
[00:56:20] So, you know, I remember back when I was on frontline services myself, we did things like pandemic planning. You know, there are always plans around. But you can never quite anticipate exactly what the pandemic is going to be like. You know, if you think classic films like Contagion in many ways, it was quite a good film, but it did assume that, you know, when you caught something, it was pretty much deadly and you dropped dead.
[00:56:47] This one is very, very different. You know, the emergence of long COVID, for example, might have a really long impact on the health service and individuals. The fact that a lot of people were wandering around asymptomatic and therefore infecting other people without knowing it, you know, that wasn’t, I don’t think particularly anticipated even though, you know, SARS and MERS were similar in some ways, but much more contained, those were similar kinds of respiratory problems, but less contagious.
[00:57:21] So you know, every pandemic is going to be a bit different. Every planning is going to be a bit different. So you can plan for what if half our staff are off, we’re going to struggle. Yeah, pretty obvious. But actually having to do it for 18 months, two years is a bit different to, you know, the scenarios I worked through for example, as part of emergency planning where, we kind of anticipated, it would be a short term thing. So your services are having to learn on the hoof at the moment. And we don’t have the acute onset phase where we weren’t quite sure what we were dealing with. But we now have the, we’re not quite sure how this is going to pan out in terms of how long is the recovery phase. Do we get to a point where we go back to what used to be considered.
[00:58:06] Henry: Yeah, absolutely. And psychologically, as, you know, as a punter, it’s so strange because, you know, here’s the government announcing that effectively on the 19th of this month or whenever it’s, Hey, we’re back to free for all do what you like.
[00:58:20]And then you’ve got the scientific advisors saying, oh, hang on a minute. Not so sure about that. And also as individuals, we’re just looking at the news, well hang on a minute, this Delta variant has appeared out of nowhere and suddenly the number of infections is going through the roof again! Fortunately it’s not yet been reflected in the number of hospital beds being taken up or the number of deaths, but still it’s I think as an individual and most of us are probably feeling pretty strange about this.
[00:58:52] It’s like on the one hand we’re being told, oh it’s all fine, go and have your summer holidays and whatever. And on the other hand with, you know, I read the Guardian, they have a little graph every day and there’s that graph sort of creeping up and up and up and up again. And it’s almost like “is this over or isn’t it?”
[00:59:07] And so psychologically we’re back to that anxiety and uncertainty that we were experiencing a couple of years ago where suddenly the numbers seem to be going up again.
[00:59:18] Laurence: Yeah, I think that’s right. It certainly I’ve thought the last few days it does feel like the beginning again, where you’re not quite certain what to believe. When we’re looking at the numbers, I’m not an epidemiologist by any stretch of the imagination, but they are starting to go up, the number of deaths per day. Even though we’ve got vaccines it’s higher than it was this time last year during the summer, which is traditionally a quieter period. So I think that that does feed into people’s anxieties, you know, and it does feed into that. “You know, I’m not quite sure what to believe here.” You know, I come from a health background, so I much prefer to, to try and understand what the, the epidemiologists are saying and what my colleagues on the frontline are saying and going, “it’s still pretty tough out there”
[01:00:04] But the difficulty is you can’t see it can you, it’s not like, you know, it’s not like the war time scenario where you could see bombs flying through the air. This one is, you know, and I think that feeds into, to the conspiracy theorists, you know, because you can’t see it. It’s hard to fully understand it. And I guess now I mentioned my brother, you know, other people, lots of us know someone who’s suffered from this.
[01:00:31] And many of us know somebody who’s died, which is different from the beginning. But on the face of it, if you go out to the shops, it looks pretty normal.
[01:00:40] Henry: [01:00:40] Yeah, absolutely. It’s weird. I think this is, you know, this ties in neatly with, you know, that that kind of list of stuff that I mentioned earlier, that there’s certainly the situation now we’re back to the need to feel safe. Can I feel safe? Well, what’s happening out there? And secondly, the need for things to make sense, which is like, well, hang on a minute, I thought we dealt with this. I thought we’ve, you know, we’ve all got the vaccines. Surely everything should be back to normal now, this isn’t making any sense.
[01:01:09] And of course, then that affects again, well, does this mean that we’re going to have to start isolating again, distancing ourselves so that again, that need to be close to other people’s potentially being undermined, creating anxiety where that’s going to happen and the need for comfort. Well, I’m not sure how comforted I feel by what’s coming out from the official statistics.
[01:01:31] So those four factors, again, sort of coming back into play, like they were at the beginning of the pandemic, which is unsettling. I think it would be fair to say.
[01:01:42] Laurence: There’s a theory, which is well-known in sort of health circles called Maslow’s hierarchy of needs. It’s been critiqued, so it’s not perfect, but it does have this sort of triangle of basic needs at the bottom of food, shelter, comfort.
[01:01:56] And it sort of works its way up through, through things. And it does feel like we’re getting again to the point where things that we used to take for granted are not able to rely on anymore. So, you know, that, that pushes you down down the triangle of, of what’s what’s important. And, and as soon as you start undermining the bits at the bottom, the things that you take for granted, then that leads to all sorts of difficulties in terms of anxiety.
[01:02:23] And like you say, not knowing quite sure who to, who to trust on this . And then you start getting all those difficult things where you start looking at people in the supermarket and going, why are you not wearing a mask? And those divisions come up or those sort of culture war things that people talk about start to become more difficult because people sort of retrench and seek to protect themselves.
[01:02:47] So you know, that that can get very difficult. I’m sure that’s part of what’s been going on as well and learning to trust each other. It’s gonna be a hard thing over the next few months and years.
[01:02:59] Henry: Yeah. And undermining faith in the authorities when there are, and just recently that it’s been in the news kind of aspects of hypocrisy being blatantly visible, for example, where many tens of thousands of football supporters are allowed to get together in a stadium or then to go almost unchallenged wrecking the streets of London.
[01:03:26] Whereas people gathered, trying to gather together for peaceful protest about something hauled away by the police. I think this is something that’s going to be getting column inches for quite a long time to come. But that’s kind of straying outside our remit here is you say, you know, this is one of those areas where mental health, psychology and politics, they’re kind of interlinked in interesting ways actually aren’t they?
[01:03:51] Laurence: Even service delivery is, is political in many ways, you know, I’ve, since I’ve been at the university, I’ve taught a lot, a lot of international students. And, you know, again, we take for granted our socialized method of healthcare delivery in this country. But yeah, it’s not like that in most of the world, you know, how you deliver healthcare is a political issue.
[01:04:12] I think that the thing about people letting off steam a bit at the end that, that is an issue as well. That is about people having been confined and, you know, the euphoria about the football team doing really well. People have been very constrained and now they’re, they’re hoping that it’s over and they’re hoping they can get back to normal as soon as they can.
[01:04:34] And they have their idea of normal may not be as socially acceptable as you or I might think, but it is, it is about a natural desire to let off steam. And that’s hard to resent people too much, except that obviously impacts on other people. So it does bring out the worst in some.
[01:04:53]Henry: Yeah, it does.
[01:04:54] Let’s move on for a bit because I think we’ve got a little bit of time left. And one of the things I wanted to ask is because obviously if people realize, and this, you know, this is step one, realize you’ve got a problem, right? The same as if, oh, I think I’ve accidentally chopped my leg off you’d realize you’ve got a problem.
[01:05:12] At some point, you know, those of us who’ve been facing you know, what I fully acknowledged, mental health issues, depression, anxiety, that kind of thing over the years. One of the things certainly during COVID that became really obvious to me when I approached my GP and said, “I think I’m suffering from depression. You know, this diagnosis of cancer has taken me by surprise. And and I don’t know how well I’m coping and blah, blah, blah, blah. What can you do for me?” Well, option one was well I’ll give you some tablets, right? Now that’s obviously not all GPS. That was my GP. Or should I say ex-GP? I wasn’t satisfied with that as an answer.
[01:05:54] And I felt like surely there must be some other kind of option. Rather than just sticking me on more tablets , ’cause I was already on tablets for other stuff. And so I was referred at the time to an organization called BetterHelp in our local area and had to wait some time before I then had a conversation with a wonderful guy, I have to say. We had a long chat and he said, oh yes, what you clearly need is actually long-term ongoing talk therapy of one kind or another. Unfortunately, because of COVID we can’t offer that to you. Well the most I could offer you would be a series of six consultations, six half hour consultations. And it’s quite clear to me, you need a great deal more than that. So I’m just going to have to refer you back to your GP. So it’s like “What? Catch 22”. And in the end I ended up going and getting private counseling, private therapy sessions, which aren’t cheap, they are effective, but you know, and I’m feeling much better now, thanks everyone. But it’s that, that was kinda my experience. And so I imagine I, I’ve not been alone in that situation either.
[01:07:00] And so one of the questions I wanted to ask you Laurence, is in any case, what are the kind of dividing lines lines as you see, however rough a guide this is, between when someone has a serious condition that you would feel they need hospitalizing for in some way, taken into an institution, which I think used to go by the name of sectioning, something of that kind, compared to someone who’s got a, you know, it’s not a negligible problem, but it can be dealt with, and it can be dealt with, by the NHS in some way, some sort of service offering and other things where do you know what, that’s the kind of thing where you probably better off going to, you know, finding a private counselor therapist in your local area.
[01:07:48] Laurence: Okay. So you know, I guess the, the main issue you’ve highlighted the need for people to identify for themselves, that there is an issue. And that’s harder for men than for women.
[01:07:59] I think because of the way we’re brought up and, you know, not talking about stuff and being big and strong and all that stuff. I think in terms of service provision, it’s, when is a problem, a problem? If you’ve got low level anxiety and you can cope with it and you can think, well, that’s a bit silly, but I don’t feel great, but I can cope and it’s not a problem in some ways. And you can use your own resources. When it starts to impact on your life then it starts to become a problem. If you can’t go to school or you can’t go to work, then obviously it has become a serious issue. And when you start experiencing more severe symptoms, then – people hallucinate and all sorts of things – and you know, obviously that’s getting very serious.
[01:08:45] You mentioned sectioning. I think that’s, you know, that still happens. You know, sectioning is about people being detained under a section of the Mental Health Act. That generally only happens when people have lost all insight into what’s going on to them. So you know, their impact, that the impact is not just on them, but on other people as well or their condition is life-threatening. So generally we try and treat people before it gets to that point. And we, you know, most patients in mental health hospitals for example, are voluntary patients.
[01:09:19] They’re not on sanctions but they have enough insight to go. I have a problem and I need help. I think where you get the help from is difficult. And again, that goes back to the politics. In some ways, you know, mental health gets 12% of the NHS budget currently. And you can argue that it needs more than that.
[01:09:40] Children’s mental health gets a small fraction of that. We get less than 1% of the NHS budget. You know, and you could argue again that that’s, you could be more preventative if you do those things, but, you know, it’s difficult because services are set up the way you are. IAP services that I refer to tend to be called different things in different places.
[01:10:01] So I suspect that from your description, your local BetterHealth is an IAP service, and they are often set up with this CBT pattern of successions and then review. And that’s a financial constraint, you know, that’s how services set up. It’s a better option than nothing. It’s probably better than just going on the tablets.
[01:10:22] Best medical advice is take the tablets, if that helps you, but also get talking help as well. You know, the two often work together. Yeah. Sometimes you’re so poorly that you can’t do the talking stuff. The meds will get you to a point where you can do the talking stuff. And yes, obviously there are different sorts.
[01:10:43] Talking therapies. So the I app services tend to use something called cognitive behavioral therapy, which is well-researched and works really well for some things. But for other things, you do need longer term intervention and that’s by and large is not available on the NHS. So if you’re able and in a position to pay for it, that’s great.
[01:11:04] Lots of people aren’t obviously, or they find it really difficult or the kind of therapies that are around don’t suit them. For lots of kids for example talking therapies are not the greatest thing because they haven’t learned how to articulate how they’re feeling very well in a way that adults generally are, are better at so, you know, different approaches for working with kids are needed: art therapies, creative therapies, drama therapy, it’s those kind of things.
[01:11:33]So yeah, we’ve touched on politics throughout this because politics is part of healthcare. I think there is a responsibility and a difficulty for people to overcome the stigma and, and seek, like yourself, to recognize what the problems have been and being, I don’t like using the word “brave” because it’s not about being brave.
[01:11:54] It’s about finding a way of talking about it and understanding that that’s okay. Because we are still living it. It’s a lot better now. But we still live in an an age where mental health difficulties are stigmatized. People don’t understand them very well, so they’re frightened of them.
[01:12:12]And people even use the language wrong. So I’ve, I’ve been careful to use mental health issues or mental health difficulties. People will throw away phrases like, “oh, he’s got mental health, ‘an’t he?” So the whole phrase about mental health becomes stigmatizing and go around in cycles with that one.
[01:12:30]Henry: Because you know, mental health is, you know, the overall picture and we all want good mental health as opposed to bad mental health, you know, or, or impaired mental health. You’re absolutely right. I think that what, what I would say from my own perspective, as someone who acknowledges that in over the last couple of years, I’ve suffered from mental health issues is that, until you’ve lived through it yourself, it’s really hard to understand, let alone empathize with someone else who says they’ve got mental health issues. It’s because most of the time we tick along nicely, you know, we cope with stuff. We’re reasonably resilient to knocks and scrapes along the way, you know, or something bad happens, ooh, you know, give it a rub boy, you’ll be fine. And what I realized that I, because of my upbringing, which was that kind of “ooh, don’t make a fuss”, you know, ” boys don’t cry, give it a rub, you’ll be fine, it’ll be fine, don’t talk about it”.
[01:13:31] Man, it stores up up a nasty boiling brew that they can then bubble to the surface unexpectedly decades later in life. And that’s what happened to me, kind of related to my cancer treatment, not the cancer itself, interestingly, but to some of the medication I’ve been given to help suppress nasty things going on inside me. Totally unexpected, totally unexpected. And that’s why I started this podcast because it gave me an insight into, my goodness me, this is really important. Life-changing stuff.
[01:14:06] One of the things I wanted to kind of mention when we’re talking about different kinds of therapies there, something that I turned to because of the kind of person I am, my kind of background, I read a lot. So one of the first things I turned to actually was, I just went straight onto Amazon and kind of started downloading every self-help Kindle, buying every paperback on this, that, and the other that I could possibly find.
[01:14:31] And just kind of to a large extent, read my way out of trouble, you know, with help from caring friends who know stuff, you know about this kind of subject matter. And I think that it’s fair to say I would recommend that people start reading this stuff before they hit a major crisis rather than afterwards, but there are some, you know… I, for a long time, I think I poo-pooed the self-help section in the bookshop, you know, it was all a load of rubbish, self appointed gurus and that kind of stuff.
[01:15:03] Well, there are some of the people like that, but actually amongst that are some absolutely incredible books, some of which I’m going to be talking about on this show in the, in the series of programmes and kind of promoting on the website because you mentioned there Cognitive Behavioral Therapy, and one of the first books I read actually some time ago, it was a book about cognitive behavioral therapy, which became of interest of me because of the work I’ve done supporting a charity called Combat Stress. You know, a veterans charity where they deal with PTSD and stuff. And for certain aspects of that Cognitive Behavioral Therapy can be really good. And for many kind of, if you like everyday mental health issues, stuff like Cognitive Behavioral Therapy, as you mentioned can be really surprisingly good.
[01:15:51] So I think, you know, there’s, it’s worth saying that there was the option of a self -provision isn’t there of mental health care up to a point, you know, beyond which you need to talk to someone, you know, that that’s kind of my advice.
[01:16:10]Laurence: I think that works for lots of people. If you, if you’re the sort of person who loves books, then that’s great. For lots of people, they need to find other things and the talking stuff is important for that, but not just talking to a professional, talking to other people and being able to talk openly. I think, you know, men in particular struggle with that and you know, the, the shared emotional experience of sports for example, is one way that men let out their emotions in a socially acceptable way.
[01:16:36] But talking about how you feel a bit low, a bit fed up is not so socially acceptable. So now we need to sort of work our way through that. And you’ve got to find the thing that works for you, I think. You know, I worked with a lot of people, for example, who’ve looked at different things that would help.
[01:16:54] I worked, since we’re on the sort of veterans thing, I worked a couple of years ago with a woman who is looking at horticultural therapy, specifically for veterans Defence Gardens Project. And that’s great. I’ve, I’ve worked with other people, you know, I’ve got a friend who who’s worked with sort of animal therapies and you know horses and dogs and the help they can be great, but those are great for certain people.
[01:17:18] If you don’t like dogs, dogs therapy is not for you. If you’re not very fond of horses, don’t go on an equine therapy course. If you can’t stand being out in the garden, then horticultural therapy is not gonna work for you. All of these things, you’ve got to find the right thing for each person. And I think you’re right.
[01:17:37] It is difficult for the general population to fully understand how bad some of this stuff can be. We’re all a bit like that. I, when I was younger, I used to think people with allergies and stuff like that were a bit ‘wussy’. And then in my mid forties, I suddenly started getting hay fever. It’s like, whoa, this actually is really serious.
[01:17:59] Yeah, it’s the same thing. You know, everyone gets a bit of mild anxiety. But getting an acute panic attack, getting some severe onset of anxiety is very different and you never fully experienced it, then it’s hard to see how crippling it can be for people.
[01:18:14] Henry: Yeah, absolutely. Absolutely. Talking about different therapies, also, in subject matter, that I know you and I are both interested in, there’s Professor Tony Pollard, who runs the Waterloo project, digging up the battlefield of Waterloo with veterans. So archeology as a form of therapy as well. I think that there are many things – I’ll mention a word that will come up, I know, time and time again, in these, in these podcasts – flow, stuff that gets you into a flow state where your focus and attention is entirely kind of dedicated to something.
[01:18:48] It kind of blots out everything else. And it’s wonderful. You know, I think if, if you’re lucky like me, I work in a creative career. It’s one of the things that keeps me wanting to be in a creative career, but it can be very, very therapeutic as well. It just takes you away from everything else. And that for someone else it might be gardening for someone else it might be, you know, kicking a football against the wall, but it kind of comes down to the same sort of thing doesn’t it?
[01:19:12]Laurence, I think we’ve kind of started to run out of time here. So is there anything else you wanted to kind of say to the nation as it were about – how grandiose of me to imagine that the nation is listening to this! Maybe one day! – But is there anything else that you’d like to add as a kind of a takeaway for people about you know, coping with what is now please, touch wood, here, the kind of aftermath of the pandemic as, as we go forward over the coming months.
[01:19:43] Laurence: I think to not assume it’s going to return to normal, straight away for any of us, your life will not be normal. It may never be, as we knew it before. And that’s okay. In some ways, as long as we recognize that we’re in new times now, maybe for individuals, you mentioned that the thing about suppressing your feelings and trying to pretend they weren’t there.
[01:20:07] And you know, that that’s a way of coping that people have. It’s not necessarily the best way of coping. So recognizing your feelings, recognizing when you need to seek a bit of help and that it’s okay to seek help is really important. So if there’s a takeaway, I would leave you with that.
[01:20:26] Henry: Laurence, thank you so much for coming on the show. You’ve made episode one a memorable one for all the right reasons.
[01:20:34]Laurence: Thank you for inviting me.
[01:20:35] Henry: You’re welcome. Thanks everyone for listening. And I hope you’ve enjoyed this first episode of Inside Your Head.
[01:20:45]This podcast was produced by Henry Hyde copyright, Henry Hyde, 2021.