On continued thinking about psychotherapeutic treatment and Investment in Therapy, we could be invited to recognise that the human body has a Doctor, a Physiotherapist, a physician or even a dietitian. A car has a mechanic. A house an architect, electrician, carpenter, plumber, builder or gas engineer.
What do we prescribe for our minds? A psychiatrist, a pill and drugs, Sleep, a book, a counsellor or psychotherapist?
Waiting for Help Yet it can take a long time to get the help from a mental health professional waiting on the NHS for IAPT support.
What if you were to see mental health support as a worthy investment in to yourself? A significant £200 – £350 – £1200 per month investment for a period of 6 – 9 months? And then no more suppressed pain or payment to recover from years of denial. That you have placed a high premium yield on resolving past issues and concerns. The investment would result in more head space, energy, resilience and healing for you.
Value What are the outcomes of paying good hard earned investment money into a stock or bond or even a bank? You get a return on your investment generally. The warning usually is, that your capital is at risk, which it is. Things in the financial world can sometimes yield less, potentially.
Guarantees What assurances are there for counselling and psychotherapy to be a good investment that could go well for you?
Well the honest truth is a therapist will work hard to ensure that what happens in those 50 – 100 minutes goes well. A therapist will diligently work in a way that is largely supportive. They will also challenge you and help to bring about change in either a micro or macro way.
The big question here is are you ready to invest in that type of change? Do you have the capacity, support, strength, resilience, time, resources to invest in therapy?
Patience The other question that needs to be asked is how much longer are you going to live with the inner buried emotional pain?
The bereavement, the divorce, the loved pet that had to be put down last year that you can’t bring yourself to buy another because, well you know…
The empty nest, the immigration to the other side of the world, the war you escaped from, the worries of parents as their child transforms into a teen and wants to go places without them, the new job, the work colleague that’s difficult to work with, beginning to identify as a different gender or becoming gender less, the student debt and wondering if ever you can pay back that loan, the mortgage and car payments, growing into an awareness of being attracted to others who are the same sex, Christmas, new year goals, holidays the list is near endless.
Swells The sense of overwhelm is gigantic. We do well to get up, get our game faces on and step out into the world and face it – it being the ugly low feeling.
Then there are those days when getting up is too much. Anxiety, fatigue, low mood and all the moods have said today you are not going anywhere!
This is not a bad cold or flu this is an annoying niggle that grew. It started on a Wednesday and by Sunday it had arrived. It sits on your chest slowly draining you, squeezing what life you had. Out.
Disguised Comfort It (the ugly low feeling) wants nothing but your undivided. It wants you to stay in with it. It wants comfort. It is like a small child that won’t leave your side. It seeks no comfort from anyone else. Only YOU can make it better. “Talking won’t help” It lies. Getting outside in sunlight it cries “We will surely die”. And so you stay in. Calling work saying you are too sick and unwell to come in – today.
That project that you were excited about last week – you hide from. Even this project can’t save you. That excitement that once was there can’t pull you out of this. It’s too late one can begin to fear. It’s close to all lost and very nearly is.
Turning the channel on the TV to more Friends, Frasier, Telly novellas, African Movies, Safari programmes, Bollywood, House Fixers, Netflix documentaries, podcasts, online magazines.
Everything can seem so pointless…
Maybe there are other ways to be with this feeling? Have the curiosity to try something’s differently. Our minds often don’t know what’s good and healthy for us.
Running the Black Men’s Therapy Group has gifted me and my co counsel Sheila Samuels with more evidence of how necessary the Introductory course/workshop is for Black Men.
A previous post Jitters, observed the negative side of what too often happens, when someone does not get the help so often not looked at as a support. Therapy is often a last resort and sometimes barely that. How can therapy be successful when there is so much at stake? There are a number of reasons for the reluctance to engage. Cost. Culture. Cures and Cons.
Cost Therapy is not generally a low cost investment. See Kwanda’s initiative to redress this. IAPT was seen as a possible panacea for the masses to engage with psychologically trained individuals to access C.B.T. (Cognitive Behavioural Therapy).
Helping those who wanted psychological support to begin resolving and managing their experiences of depression and anxiety well. The NHS support was provided through GP services for those who either expressed need or were found to be able to access C.B.T. support. The cost for a person wanting C.B.T. is nothing but time. Current waiting lists are between 6 – 18 months in some areas.
Culture For many people there is a sense of unknowing and unconscious/conscious fear when thinking to access talking therapy (a stigma). TV shows like In Treatment, Queer Eye, In Conversation with John Bishop and Couples Therapy allow viewers to see the process outside of themselves. Sort of like a fly on the wall. Viewers don’t get the first hand raw experience of what therapy does. Therapy can often be a truly eye opening experience. It can be scary too. Don’t let fear prevent you doing great things, again!
Uncoupling However living with the pain of what potentially is lying hidden could be seen as worse. On a number of levels the person living with the pain knows this too.
Many cultures across the globe have differing ways of managing internal scars. Some attend to these scars in community settings, some go to see a Doctor or psychotherapist, some a faith healer, shaman or spiritual leader a wise elder in the community. The aim is similar – to unbuckle the experience of (emotional, physical, psychological, historic) pain from the present.
Not for Me Therapy supports a person or group to achieve this aim of unbuckling. In a Western technology filled world. Some cultures have developed a socially accepted space in the minds of their people for therapy to be an acceptable form of treatment. For some cultures including the African Diaspora, Asian Diaspora and South East Asian Diaspora, therapy is often seen as something that is not to be touched. Therapy is for other peoples. “We don’t speak our family matters to outsiders.” “It makes us weaker as a community that has already suffered and is going through our own ongoing struggles with it’s identity purpose, history and future.”
Cures Therapy is not a cure. It has helpful elements that have curative affects for individuals and for groups but it by no means can wipe out past traumas and pains in a single shot. The process can take time – sometimes for a few years.The accumulative effects are like a river cutting through rock or an overnight heavy snowfall. Therapy cannot undo centuries of pain. What therapy can do is support a better understanding to support groups and communities resolve current and past experiences.
It is Written Books like The Body Keeps The Score and It’s Not Always Depression support an individual and groups to begin reviewing their current lived experience and review them critically. The two books highlighted above and therapeutic encounters generally encourage people to take out the parts that are not working for them anymore. Observe the learning from an array of differing experiences. Begin implementing another way to live and live well. I can think about a number of clients I have worked with for 1 – 5 seasons who have all gained somethings from therapy and found a way to let their past demons die and accept their now to live as best as they can making improved choices.
Cons Therapy has it’s good, bad, and indifferent encounters between therapists and clients. The right mix often happens when skilled therapists meet willing clients to address their difficulties. At times an incompatible mix can happen of cultures, sexes, compassion fatigue of therapists, unconscious biases, identities and egos are amiss and both the client and therapist cannot make the therapeutic encounter work. The fatigued battle weary therapist and enthusiastic risk aware client would be an interesting dynamic to supervise.
Cons? The thinking behind IAPT’s 6 appointment model is that a short focused piece of work can be effective when a single problem is looked at solely. This is equal to 300minutes of considered time and can be effective to resolve an issue. The difficulty arises when more than one primary concern is activated or pulled through. Which can happen as a result of discussing the other factors around the initial reason a person engages in therapy.
Time is a valuable commodity as is a successful outcome for the work for client and therapist.
Cons?? Six appointments at times does not touch the sides of heavily affected people’s challenges like complex post-traumatic stress disorder (CPTSD). Another difficulty that the Global Majority has with encountering therapy are the historic experiences of colonisation, criminalisation, cultural appropriation and theft, villainizing communities and splitting groups of people along tribal, ethnic and gender lines. An implicit encouragement of groups to fight politically or physically inside of these constructed divisions, and then them to be offered a westernized approach to heal communities seems like an insult to a historic injury.
Cons! Where would trust exist within these paradigms to complete a piece of effective work? Western approaches to therapeutic outcomes were developed originally for a small group of people in Europe!
If we were to widen the lens and take in the planet through a global and pan view, communities from Central and South America, the indigenous populations of Australasia, Inuit communities, Sub Saharan Africans and Northern African communities may not access therapy marginally or fully because of their own senses of culture, their community understandings, religions, beliefs, sense of collectivism and historical legacy experiences with the West. A Eurocentric approach with therapy would need to be de-colonised and become incorporated within the cultures therapy hopes to support.
Cons!! There are also the experiences of what White psychiatrists, and White therapists have perpetrated against Global Majority communities which adds to the sense of historic mistrust against westernised approaches to healing.
I have been asked over the past few months how the Black Men’s Therapy course has gone. Wonderfully would be how I would answer the question. The initial jitters and experience of serendipity became a rounded experience of therapy.
Wary Topics covered included included Low Mood and Depression, Anxiety, Mood Management, Addictions, Loss and Self Care. The initial group of men that came were initially in the first few minutes wary. There was good enough reason. None of the course attendees had previously met. They were also new to me and my co-counsellor Sheila.
1st Block For the first block of 6 appointments, in order to assist the conversation and support holding the group, the frame was to offer a check in, review the week just passed through and towards the end of the meeting provide a check out.
The first day of the course gave opportunity for the 5 men that joined to meet and greet each other. Get to know who was in the room and know their reasons for being a part of the course. The first day went very well and gave a sense of what the rest of the course would look and feel like.
January 2020 The 2nd block of 6 appointments were looser in their formation. 3 previous attendees joined the follow up course with 1 new attendee. Check ins became a way to engage with the subject material of that night’s discussion. Topics included Intergenerational/Trans-genertional Traumas (PTSS), Micro-Aggressions and Stereotypes.
Congruency One of the outcomes that I was pleased to notice was the willingness of the group to engage with challenging and difficult material in an open and honest way.
Showing who they are amongst other men without the need to hold up a mask pretending bravado or being a braggart. The vulnerability I had hoped would be a consistent and precious part of the meetings was consistently realised.
One of the reasons a level of congruence was achieved was the sense that we had all come together for a specific purpose. To talk on a level with others that look like us about experiences that intimately impact on our lives, the lives of our families and those we consider friends allies and our community.
Membership The next block of 15 appointments is to start on the 18th of March 2020. The course will be an open group – and will accept new and previous attendees to attend as often or as infrequently as they would like.
The idea of a closed group became muted within the 1st block of 6 appointments. The idea of not admitting new members after the 3rd meeting was tested after 2 new men joined the course in week 4.
The group successfully negotiated how to accept and work with new members. From January going forward the group were settled in themselves and were willing to engage with difficult personal histories. The men were able to discuss concerns related to identity and being in hostile work spaces.
Sign Up If interested in joining the next group send an email to either myself or to Sheila Samuels via our websites. Click on the links above.
Reconozco un gran La tragedia sucedió cuando Lo ultimo que comimos Juntos
Compartiendo suavemente el Daño en la cena Mesas escuchando a otros Ríete y habla Silenciosos colores sobre el último Noches eventos como si nada Importante sucedía entre nosotros.
La lágrima significativa y Pensé que podría ser Valiente y fuerte y Permanecer resistente y Afable. Esta cosa Comenzó con un paseo Por agua amurallada.
La caminata tanto larga Y chistoso. Los dos Riendo y hablando Camden atado. Enrollando lentamente hacia Un lago y cervezas.
Siempre con cervezas. Cuatro años de necesitar Que te quedes y Continúa con tu No tan gentil insistente Fuerza empujando mi Mente a nuevos awareni Y luego te fuiste.
Perdido. Tambaleándose como un Pescado sacado del agua, Sin el equilibrio de la Azul profundo para continuar el Sosteniendo, guiando el cuidado Afirmando
Tu ciudad no esta tan lejos Pero ya parece Demasiado gran tramo para. Un amigo sin hogar A menudo dice ‘Hasta que Nos vemos de nuevo y lo sé Eso no puede pasar
Hasta que un velo es Levantado Imperceptible Una madeja, tan delicada como un encaje de telarañas Hilado dorado, Sin embargo, rara vez se usa.
La próxima vez que lo veamos Será para decir con Un bocado de soy penas que el mundo Mi mundo estaba mas caliente Cuando eras Cerca. Ahora un refrigerador El amanecer me espera con Tu versión de tonto se fue.
Esta pérdida corta como el Otros como todas las salidas Finalmente hacer. Solo esto Uno causado por negligencia Fue por mi propia ruina.
De pie como la mitad Cabeza minoica enterrada, Meditando de color morado oscuro Gris. Es trueno Aplausos y lluvia. De nuevo
Having the jitters before the big day is normal, expected, an
indication of the importance of what is to be tried. 13th of
November was going to be gigantic because I was about to start providing a low
cost counselling group experience for Black Men in S.E. London.
*Solstice Shuffle With the days here in the northern hemisphere becoming shorter and shorter, and with that colder too, rather than retreat and hide. I want to fight back the dark with warmth and light. My colleague and I are to start something I feel will be big. Important. Game Changing. We have talked and laughed and listened and prepared.
It’s time. So the jitters, and jitter bugging are a nervous type of energy. Highlighting an excitement and a wondering of what is going to be. New. Novel. Nuanced. Black focused group therapy for men.
Why? Because why not! The reasons aren’t as important as the reasons that some are asking them. What reasons arise in your minds eye as to the reasons as to why, there could be need of an introductory course for therapy for Black Men?
Support Speaking with my supervisor a few months ago I asked, do you think this idea of mine is racist? He took his time and invited me to think about my reasoning, my question, the need. I did and said No, I do not feel that the group is a racist idea. The want is to support an under-served social and ethnic group access skilled support at a low cost. Some psycho-education will happen and the aim will be to support members grow towards a healthy sense of themselves and their position in the world.
Lack I recognise that men generally are less inclined to express themselves and be vulnerable with others. That takes time. It’s a strength that women largely are gifted with. Men tend to suppress their softer side for fear of being manipulated or hurt or worse humiliated. The concern is that under pressure, that hiding, turns those suppressed feelings into something toxic and harmful. We know of the term toxic masculinity.
Triplicate Being toxic as a Black Man is like a triple bind.
1. Not speaking about ones vulnerability and pain causes us (humans) to seek other ways to find release. Some of these ways can lead to long term health factors that affect Black Men in particular and those connected to them acutely.
2. Becoming toxic, distrustful, upset and angry causes others usually friends, partners and family to flee, reduce contact, disconnect from or just avoid and hide.
Professional dislike The trusted are often met with the same vitriol and disruptive rage as Drs, nurses, psychologists, probation officers, teachers, police personnel, employers and work colleagues. With the disruption some meet their needs through miss-telling of truths. Making the environment of the affected worse. Thus serving to – ratchet up their paranoia or distrust. Leading to more self isolation and projected anger at others.
Hitting Out The third and final bind is when the lid blows off!
These moments tips the scales violently over. The contents carefully balanced are shattered scattered and lost. The family, job, friends, savings, house, children, partner, colleagues, all ruined.
The man at the centre of the storm can then fall foul of pre existing stereotypes. He – unable to cope with the pressures of life. A Man Not really. A Man deemed crazy. Unable to climb and look after himself or anyone else for that matter. A drain on resources, draining energy, becoming to onlookers: menacing. Unworthy…
The Straw Mental health services are generally not accessed before the police are called in. Usually it is this point that help is found and quickly. Society seems ready to pounce as the risk level becomes uncontained by members of the general public.
Detention The implosion leads then to an enforced section and the man’s civil liberties of self-governance, self respect, self determination sanctioned and taken from him for between 48hours up to two weeks. Legally! Sometimes it can be for far longer. For this man it is a story he may have avoided. If there was a way to have found a space to discharge through speaking about his allostatic loads with (an)other(s).
Perhaps My jitters are about the chance to create a new story. For the one above. For that lonely man who shuffles along the street, sometimes talking or singing to himself. Looking unwell. Acting in a slightly bereft, unkempt way.
Rise The idea of creating something new as a psychological model is both powerful and exciting. People engaging in therapeutic communities and therapeutic work is a different outcome to the bleak one I have witnessed as a Londoner, as a person working in prison, as a consciously aware Black Man that wants to listen for a different ending. Sometimes a situation has to reach rock bottom before it gets better.
There are times when I am amazed by the generosity of spirit of the people I meet in prison. They may only be dimly aware. For this man I would like to share this piece of writing with him. An action of reciprocity. Effective Altruism? Maybe…
Bad Day I was having a shitty day. Walking with a walking stick in prison is a cumbersome and slow experience. The walking stick has me feeling vulnerable and very out there on my own. It’s a constant worry that at any moment something is going to go down and I’m going to be jumped beaten and my keys snatched off of my chain.
It has never happened to me.
(Yes, staff walk around with keys attached to a belt.) Uniformed Staff and civilian staff walk with aware that they carry a large responsibility along with those keys – a symbol of power.
Questioning The opposite is often what I encounter. I generally do not feel powerful. My visible vulnerability brings from many I meet, including officers and often young and mature black men, the nod, or the question of “Are you alright?” Or “You cool?” “What’s happened?” “You good?” “Take it easy, yeah?”
Fade Here I am seen and my daily struggle is met by others compassion, seeing myself as the injured and frail one. I find myself at times wanting to be invisible. But these calls are a gentle reminder that humanity lives here. These moments are of genuine sensitivity being shown from men who are doing hard time, some serving 18-30 years. I have accountability and a responsibility to uphold, mine and theirs.
Between On this day I passed from one wing to another. There are a number of wings/house blocks, housing between 100-150 men. Every house block has it’s own distinct vibe and concentration of prisoners: Vulnerable prisoners, lifers, remand and re-categorised prisoners. These men are due for parole or to be sent to other prisons for more open conditions. The prison has a total capacity servicing over 1000 men. Me negotiating the gates, doors and stairs takes longer as I manage the cane, the keys, assessment charts, writing paper to note take and my diary. An unholy slow moving ungainly mess.
Check-in I am to meet with a client who attends the bereavement group. (Thanks for the reminder I will offer a write up about this group soon.) I need to see him as he left the group early on this week and I want to make sure that he is okay.
Take We meet on his house block and I make my way into one of the offices that has a desk and 2 chairs on his wing.
I offer, “I wanted to come and see you as I wanted to find out how you are after Tuesdays meeting?” He says “Yeah, I just wasn’t feeling good you know? Sometimes this place takes the piss!”
I nod showing that I understand.
He continues “I asked for something that’s important to me for my religion and it’s not on the canteen sheet and I can’t get it! “It’s frustrating me. “I’m usually okay with it here. “But this thing. “I’ve been patiently waiting for 3 months and I couldn’t wait any longer. “I’ve done it their way for a long time and nothing ain’t happening for me. “I’m not just going for mine and leaving everybody else you know? “This is about me and for others like me.”
Release He shares his disappointments and numerous experiences of being let down and similar disagreements about the prison. Like, losing weight, standing forward and supporting others, confronting officers and attending to his overall fitness, wearing clothes he has had to keep care of for years because he can’t trust that things sent in will safely arrive.
Prism He says something like jail being more like a mental health institution in patois and we both laugh. Initially tentatively. Then gleefully. Recognising ourselves in a prison situation as Black men. One choosing to be there with the other, another doing his best to find peace within his situation in prison.
Re-set The laugh of this black man was like the baring of a soul with a comrade at arms, a fellow road weary traveller, a baller. His laugh invited me to view both his and my plight with compassion. This black mans laugh somehow seemed to restore me and also him. We sat and laughed in a prison, about prison and the folly of the circumstances we both found ourselves in. It was Capoeira meeting Jazz, Gum Boot Dance to Blues, Hip Hop bopping slow with Reggae, Salsa and Calypso rejoicing. It was natural and affirming that even here -prison – humanity could be found.
Re-Mix The wonderful ability to take something that is both internal and external put a spin on it and make it both his and mine. The experience of the infinite in a few short moments of laughter. How deliciously wonderful, amazing and so uniquely surprising. I left the prison a little lighter that day, usually a little guilt escapes with me.