Opacity

Seven days notice, a garbled voicemail on the phone says that a therapist has had a cancellation and could I attend on Tuesday week to meet them.

I can’t. I also can’t make the following two appointments and I know that will be an issue for the therapist to have so much dead time in their calendar. The time they first meet you is the time they will offer you going forward and I’d told the service that Monday and Friday are the best days to allow me to continue to run some sort of business.

The voicemail doesn’t state the duration of therapy being offered and when I call the office no one there can tell me either. They also can’t say whether this impacts my place on the waiting list. Whether declining two offers (due to them being made for days where I’ve long stated my non-availability) automatically excludes me going forward.

I try booking on to the “Service User Workshop” I’ve been invited to but apparently it’s probably cancelled due to oversubscription. They will get back to me but they can’t say when that will happen.
On the bright side the medication seems to be holding me in place. Colleagues say I seem a little more measured, my speech slowing to a more normal rate. I certainly seem to have a little more capacity and insight. I’m quite reflective which is not normally a feature of being this high up on my personal mood scale.

GlydersOne of the things I’m reflecting on is that if I ran my business with such opacity and contempt for the customer then I wouldn’t last in business terribly long. I understand the arguments that the NHS can’t allow every customer to be “right” but in my work I’m open with clients about the capacity in my system, when and how I can work for them. They accept I have limitations and are grateful that I keep them informed.

What I face is a bureaucracy which appears to have little interest in the care it provides to me and to others in a more acute situation. I appreciate that dwindling budgets mean cuts to services. I know that I’m not an urgent case. However, being told more about the decisions and compromises being made by the service would really help me to manage my expectations and reduce frustration. It’s the hope which kills you.

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Once more with feeling

We made our way down the corridor, placing entry fobs to each door as we moved farther and farther away from natural light. On entering the room I was offered a seat by the table. She sat opposite and began to rummage in her voluminous handbag. Carefully she withdrew a laptop before disappearing back into the darker recesses of the bag to find the power cable. I waited as she plugged it in and connected to the network. Finally she introduced herself.

“I’ve been looking over your file and I just need to clarify a few things.”

I sat motionless waiting for the questions, the clarifications, the small details being checked again. Sure enough they came thick and fast. It was quickly apparent that actually my file hadn’t been read. At least not thoroughly. Her statements seemed a product of suggestion and skim reading. Events were conflated and confused. I was beginning to wonder where it would end. I regretted commenting about the system in earlier meetings, should I have described it as a faceless bureaucracy? Probably not.

Finally through a mixture of effrontery and cajoling I draw her out from behind the screen. She starts to write in a notebook and this is better. Long ago I developed the ability to read upside down so I begin to get a sense of what is important to her and what she records from my answers.

Then I start to push back….

“When will I next be called to a meeting?”

“Will it be of a longer duration”

“Do I need a representative”

My enquiries obviously fluster her. It’s apparent she isn’t expecting me to question her. The balance starts to shift. We start to become more equal.

“These questions you are asking me, I’ve been asked them before, many times. The answers should be in my case file.”

Guardedly she says that she needs to understand my file for herself. It’s the opening I’ve been waiting for.

“Will it be you I see next time?”

Her eyes can’t meet mine. We both know the game is up. I ask her why I need to repeat these answers to her. I count carefully on my hands to work out how many people I’ve been passed between. I work out she is the thirteenth in three years.

I’ve had enough. It doesn’t matter to me what they put on my file. I guess they will say that maybe the medication isn’t making me calmer, perhaps that I am “resistant”. I know I’m far gone when it merely amuses me that she disagrees with me having been given therapy. The very thing I’ve stated was a real help, which kept me off medication. The very thing I can’t get any more of – perhaps because my complaint to the trust is closed and I’m not a potentially embarrassing problem for them any more.

I get up to leave. The doctor says that someone will see me in three months.

It’s not even worth asking about the apparent discrepancies in my notes. Perhaps that’s how they do it. Try to get people confused about what they said at earlier meetings, misrepresent what was said. Or maybe it’s just another doctor who hasn’t got time to read the file, who hasn’t prepared properly.

I can’t tell any more.

Clinging on

Clinging on

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Straight to the heart of the periphery

When I’m delivering Mental Health First Aid (MHFA) training we spend a lot of time talking about “non-judgmental listening”. About how important it is to listen to what people say. That often they will talk openly about the distress they feel, about how their mood is and even open declarations of intent to harm themselves. We teach people to act appropriately and refer onwards to professional help as a matter of urgency. However not all situations are so acute and sometimes that non-judgmental listening may have to go on for quite a while. Certainly those in HR teams find themselves helping staff over a long period of time, running the risk of compassion fatigue.

The importance of ongoing listening was on my mind when talking to a colleague recently on social media. Now I’ll admit that having a “conversation” about listening via direct message on Twitter has a certain irony about it but the debate went back and forth and we also discussed whether one can “listen” when it’s a purely electronic text exchange. We discussed what made either of us “good listeners” and thought about the space and time for reflection that a text exchange has. Also the ability to read back through the message stream and recap patterns / themes.

Often in organisations we pay lip service to listening. We are listening for a reason, to finish a yearly appraisal, to project manage an event, to represent a department at a meeting. We listen whilst waiting for the chance to jump in with what we need for closure, for our outcome.
IMG_2708On the flip side, working as a coach I spend a lot of my life listening with no agenda for myself. Hearing people, acknowledging them and letting them speak their truth is what it’s all about. I find that that in many sessions I discount some of what is being said and start wondering about what isn’t being said, what other space I can make for the coachee to be themselves more fully. Rather than getting stuck in to the “presenting issue” allowing this peripheral space and opportunity for reflection is what gets the coachee to the root cause of what is going for them.
How does that link back to MHFA and ongoing listening? Well I think that often we are looking to fix people. Get them back to work / functioning again. Sometimes people just need to be heard. One of the ways of recognising those having difficulty with their mental health is the notion of uncharacteristic behaviour, the voluble member of staff becoming withdrawn, changes in eating patterns or sleep perhaps. Precisely the kind of things we might miss if we only have a “performance management” conversation with them or focus on their attitude in meetings.

Sometimes the periphery is exactly where the heart of the matter is.

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The spaces between

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We sat on the balcony chatting. The view wasn’t majestic or awe inspiring as such, just looking over a courtyard, towards a high rise block of flats. The conversation ebbed and flowed, the wine went down and bit by bit we made sense of some work, some writing, a few small conundrums and challenges that we were variously facing. The space to our front opening up our minds and allowing room for the thoughts to emerge, some of them dropping and falling to the cobbles below, others taking flight as fully formed ideas.

 

Another day, another place. Training in a museum. A historic building, all sash windows and shutters. Dark and cool inside, a quiet, calm place to work with emotive content. At lunch we all emerged blinking in to the sun. The gardens of the museum providing a spacious oasis of green, inches from a bustling street. Allowing us to free our thinking and set out what we have learned and our hopes for our organisations.

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A hot, airless room. Forty five minutes in to a hard work out of yoga. Sweating heavily and praying for the last few movements when the teacher suggests a headstand – something I’ve never even attempted. Patiently she talks us through it. A few grimaces around the room, a sheepish laugh from me but the encouragement is there. I move my mat to the wall for safety and slowly set up. I move first one leg and then the other. I can’t quite trust it and I swing back down.

The teacher adjusts my stance slightly and I try again. This time it holds. My legs go up and stay up. I’m fully inverted. For the first time ever in yoga my head fully clears. I lose any thoughts of being correct in my posture or where my breathing should be. Suddenly my head, heart and gut align and my conscious mind lets go.

I’m there, in the space between…..

 

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The truth beneath your feet

I’m sure it’s just a suggestion in my mind but I’ve always sworn that I can feel when I’m home. The soft chalky soil of Dorset with the sharp hardness of flint woven through it seems to connect with me. The energy and history of my homeland rising up through the soil. I mean how many counties have their border designated a world heritage site?

This is the second blog inspired by a single podcast episode. The podcast concerned is “The one you feed” and focusses on personal development. In this episode I heard the quote “Fools seek from afar, the wise find truth beneath their feet”, now this makes sense for me in respect of my upbringing and the values instilled in me by my parents. Which is not to say my childhood was insular but more that it was rooted in age old truths and the rhythm of the seasons.

Last week I was reading various business and mental health articles, best practice, holocracy and patient care amongst them. Almost all of them seemed to be reaching out for an external solution, finding an answer in how another organisation had cracked a problem and trying to graft that solution on to their own situation. Now obviously working as a freelancer I guess I shouldn’t bite the hand that feeds me but I was concerned by this solely outward focus.  

In my experience most organisations have vast pools of untapped energy and innovation within them. Yes, sometimes they need an injection of fresh thinking but in the main those people would shine and deliver if they were trusted, resourced and encouraged. I wonder what would happen if we looked for the truth where we stand, inside our own organisation, inside ourselves……….

  

…… and yes this is a picture of where I’m from, I’m stood on an Iron Age fort, grounded.
  

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Bouncing off the world

I open the box and withdraw the contents. I slowly and carefully read the guidance leaflet, turning the small packet over and over in my hands as I do so.  I take a deep breath and push the tablet out of the little plastic blister, popping the foil. I neaten the tear, tidying the edges up as a delaying tactic. I can’t put it off any longer. I pop the tablet in my mouth and swallow it down. It’s such a small tablet I don’t have any trouble with it but I still pour a glass of water down after it to be sure.

I shouldn’t complain: I’ve had some sort of working diagnosis for over 20 years and this is the first time I’ve had to take the mood stabilising medication so common to others. Actually I say it is the first, I’m sure I’ve needed it other times but over the years a combination of alcohol, other poor coping strategies and occasional bouts of counselling have seen off the worst of it until my body somehow resets.

In recent years I’ve started to properly track my mood and also to reflect back over the past. I’ve noticed about a three-year cycle where I reach crisis point. This time I’d not recovered from the late 2011/ early 2012 crisis (a long term depressive episode) before I could feel a huge upswing. Normally I become relatively stable for a while but this time I’ve felt like a pinball, flung forward and bouncing off the world.

I was aware of this in late 2014 and I asked for more help with the racing in my mind. The clinicians agreed that help would be forthcoming, indeed I was offered a therapist in February. However he had no flexibility on available days and it would have left me unable to deliver a two day course, something which is a key part of how I earn my money so it was back to the waiting list. When that offer of therapy came about only two months after requesting help I was optimistic that I would be close to the top of the list for the next therapist. I was wrong.

Which left me at the Community Mental Health Team last week talking to a kindly locum psychiatrist who was willing to enact something I had discussed at the start of the year – starting mood stabilising medication.

In all honesty I’m ok about starting the medication. Yes it feels like a big step but also it is an essential step. As the psychiatrist put it, “you can pin your hopes on therapy but what will the wait do to you? We have something which may help you in the interim and we can start today.” I talked to him about the yoga, the cycling and the self care I do. He nodded and said, “well with all that effort and your symptoms still aren’t shifting then maybe you need some extra help”.

He’s right. I know he is right so this is where you find me, accepting the help.

 

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Here, now.

When I was riding regularly a couple of years ago I had a favoured training route. I knew roughly where I was / needed to be in both distance and time terms for any given point. I also knew how to cut the route short or extend it depending on my fatigue. Since knee surgery and then a freak accident where I sliced my leg open on the chainring (don’t ask) I’ve struggled to ride consistently and comfortably. I’ve had the bike refitted for me and that’s helped but in many ways I’ve lost the ease and comfort I used to find from a ride. Which is an issue when you’re not allowed to run and you’re not a great swimmer.

On the last couple of rides I’ve had errands to run that have meant changing my route at the start. Rather than swing back on to my old tried and trusted (and pleasingly quiet) lanes I’ve struck out in new directions. With nothing other than a rough idea how the busy villages and towns to the south of me are laid out I’ve just turned the front wheel left and right as the mood takes me. This has led to a few errors and U-turns but also to many surprises – who knew there were so many llamas in the local area?

This weekend I was listening to a podcast and there was a quote which grabbed me, “If you’re not here now, you won’t be there then”. This quote was in my mind as I rode steadily along. I had a sense of remaining very connected to the present – not always the easiest thing for me with my mental health. The roads were full and I needed all my concentration at times but I found capacity to remain focussed and alert to what my body was telling me in terms of fatigue.

I’ve been wondering whether hearing the quote made my ride more “mindful” – a real buzzword / hot topic in both the mental health and business worlds that I inhabit. I guess the answer is probably – but more than that I was also conscious of the surrender of having no map and wearing no watch. If anyone had asked me where I was or what time it was I could only have answered “Here and now” which is such a rarity in this always on, constantly connected world. And you know what? I enjoyed it so much I’ll do it again and again.

As I write this blog I’m reminded that this is actually a lesson I had forgotten, one I remembered from a cartoon so I’ll reproduce that here courtesy of the excellent webcomic xkcd.com  

  

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