Space and time

Recently I took on a new challenge. Neil Usher requested speakers for “Workstock” – nothing unusual in that except the format. It was to be a pecha kucha segment so 20 slides on a timed release every 20 seconds. This limitation intrigued me so I volunteered.

I enjoyed the rigour of developing such a short presentation. I decided early on to use my own images throughout the talk which made sourcing much easier. Next came the series of decisions about what content I wanted to share. As the brief was around health and wellbeing it made sense for me to talk about emotional and mental health. With such a small amount of time available I wanted something impactful and I realised that actually less is more in such a situation. Accordingly I wrote a talk which had plenty of room for reflection rather than bombarding people with content. In the end the running order also played in to my hands as I was the last speaker so it was appropriate for the audience to slow down and consider my presentation thoughtfully.

Luckily (or perhaps not) the session was recorded for posterity. I’ve turned my segment in to a YouTube clip. The audio and video sync is a little shaky but I hope it gives you a good idea of what I delivered.



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When all is said and done

The Community Psychiatric Nurse was very friendly. We chatted backwards and forwards about how I was and what help they could offer right now. We talked about the level and type of medication I am on and whether it is working. We had a brief discussion on various options for sleep medication and how I might best use them.

She was kind, compassionate and didn’t assume anything about me. She didn’t need my life story or diagnosis history in order to listen and care.

We talked about how I’m in a period of far reaching change right now (both personally and professionally) and the potential impact that could be having. We spoke about the seasonal effect and if that might be contributing. We even spoke about how my health seems to run in three year cycles and maybe I’m just due a change of mood.

We talk about self care and my plans to get out in nature more. I admit that my lack of concentration has meant I’m fearful of being on the bike. We chat more easily about a couple of great walks I’ve done recently, the photos I’ve taken and the mental space created by being in good company, accepted for who I am.

Just as she is accepting me right now.

How ironic then to get a letter the very same afternoon from the psychiatrist I saw most recently. In it I’m described as being “abrupt” and showing my “displeasure”. Obviously whatever my GP wrote last week has stung the psychiatrist in to some sort of action as I’m told that my case will be put to the “referral meeting for a discussion” – whatever that actually means.

Image by permission of Jo Burt and Rouleur magazine.

Image by permission of Jo Burt and Rouleur magazine.

The CPN could do nothing practical in the call though we agreed that a medical review with a consultant was worthwhile and that she would make enquiries about the best way to do that. It will hopefully mean that my notes leave this trust in good (and something approaching accurate) order as I seek better care in the future.

You see that’s the point. I understand that when all is said and done sometimes the NHS staff can’t do much in the moment to help. It’s down to self care and doing what you can (or accepting what you can’t). The difference in this moment was that the person cared. I didn’t need to try to hold the mask on, to appear like I’m coping when I’m hanging on.


A quick note about the image in this blog. It is used by kind permission of the artist Jo Burt and was originally used to illustrate an article about eating disorders in the November  2015 edition of Rouleur magazine.

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It creeps insidiously about me,

Like a fog, real but somehow distant, intangible. 

I reach out, trying to grab on to the dreamworld,

Desperate for the warm embrace. 

Instead I’m left in the dark,

Alone with the rush of thoughts and emotions. 

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From humble beginnings….

They say a week is a long time in showbusiness and I’m inclined to agree as we near a year since myself and Keely launched The Mental Blocks. Even being able to name Keely is a huge step forward from when we started out. The very real threat of discrimination for her hung over our initial attempts to create an interesting way to view mental health stigmatisation.

As we approach our anniversary I think it’s a good time to reflect not just on what we have done but also how it has evolved and how it has changed and supported us.

B5ebA4zCIAA81W8.jpg-largeWhilst our work is a webcomic, each issue isn’t a strip of images but rather one single image with which to drive our narrative forward. There are exceptions to that (the Christmas party for example) but generally we try to get everything in one picture. This obviously leads to a certain amount of tension around available space and also the amount of dialogue.



It’s fair to say that certain images have had too much exposition but in others (such as Amy’s nightmares about entering a psychiatric hospital) we have managed to use no words beyond a title. The intellectual rigour required for that has been both a source of joy and frustration for the two of us. I think the most rewarding images are the ones where the picture says everything.




We don’t tend to plan too far ahead in the story. Whilst we have a broad idea of direction we tend to shoot the images weekly so that they stay fresh. The exception to that is when we are working with other organisations.




Our partnerships with Time to Change and Mental Health First Aid England both required the storyline to build towards them  and final pieces were shot in advance so we could plot backwards. To their credit both organisations trusted us to involve them and didn’t try to change our way of working.


So how do we do it? It’s pretty simple yet also quite challenging. At the start of a week we will speak on the phone (we rarely meet) and discuss the images. As Keely talks through our ideas I will adjust our standard sets (the office, Amy or Nick’s home for example) and begin to put the characters in. I will take pictures on my iPad and send them to Keely by photo stream. She will suggest any changes and I will reshoot as needed. Then I will import the images in to a cartoon app and begin work. If we have a tweet going out that day then we will do the words over the phone but often we will exchange ideas on the photo stream and I will send Keely amended images as we go. We rarely talk after the photoshoot with all communication happening via text.

The beauty of this system is that we can drop in to it when needed, there is no time pressure as such and we also get space to reflect. It allows for our own self care and also for us to support each other if one of us isn’t so well that week. When we started we thought we would do 2/3 images a week. Sometimes we manage that, other times we don’t manage anything for a fortnight but our supporters have been very understanding. We don’t constantly retweet or trail our images. We publish them and they take on a life of their own. Images we think are great disappear without trace, others we weren’t sure about are endlessly shared.

We’ve often been asked if we use photoshop but the reality is that each image is as seen. A picture of a model set. We use and reuse standard Lego sets and build some areas ourselves (Keely’s husband is a master builder and designed our office and training room).  The only exception is the Time to Change and MHFA England storylines when we got bespoke items such as manuals and promotional materials printed by our good friends at

We are aware that our timeline is read by everyone from people with lived experience through to psychologists with plenty of variety in-between so our aim is to make the images honest without triggering the viewers, interesting without spelling out everything. We deliberately leave the images open to interpretation. Our audience will take what they need to and we don’t try to enforce one particular world view on anyone. Our work has been described as a “good medium for gently getting strong messages across” and certainly the Lego allows us to lighten a serious subject without being inappropriate.

Recently we were shortlisted for the Mind Media Awards – which is incredibly humbling, honouring and exciting for us both. Please bear in mind that we didn’t start out with any specific outcome or plan so to get national recognition is amazing to us. Thank you to those who nominated us. It has helped us reflect and actually realise just how much creative effort goes in to making the images each week. Both Keely and I have worked throughout the last year and The Mental Blocks is a side project we do in addition to our jobs. No one pays us but we feel that the content is valuable and useful. We hope you do too.

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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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