Holistic Minds
On Friday I am giving a talk about the ‘coming off’ medication process, I thought I’d write a sneak preview of the talk here. We (we being Evolving Minds) have just finished running a year long ‘coming off medication’ support group in Hebden Bridge. The group successfully supported a number of people to reduce their medication, the medications that were reduced were the full range of psychotropic drugs, prescribed for mental health problems. We were inspired to run the group by the Mind ‘Coming Off’ research, which we saw presented in Cambridge a year ago. The group may well be re-launched in the Autumn as a ‘Holistic Minds’ mental health support group which will not focus solely of reducing medication but have that resource available.
Why are such initiatives needed? Prescriptions for psychiatric drugs increased by 243% in the ten years up to 2002 - this also meant a 700% increase in cost. There appears to be a lack of knowledge at GP level and a reluctance of doctors in general to inform people on the best ways to reduce their dependence on psychiatric medication. Mind’s Coming Off medication research found that many people did not feel supported by their doctors when they decided they wanted to reduce their medication. For example where doctors were involved, they were the least likely to be found helpful of any group of professionals/helpers. Partly this is to do with risk. If an serious incident occurs relating to a patient if that person is on medication the doctor is ‘covered’ whereas if they are not on medication, doctors feel they are more likely to be blamed for not having intervened with medication. Another problem is training, most doctors are trained almost entirely to see mental health problems as brain problems, rather than psychological experiences that are ways of responding to social events in the present and past. The pharmaceutical industry spend millions on direct advertising and representations to doctors and millions more on indirect product promotion through sponsoring events and flooding the NHS with ‘free’ drug promoting products. Perhaps we can start to undermine their influence by changing the training of mental health professionals so that it is genuinely more holistic.
A holistic model of health argues that illness is a way of releasing toxins from the body and that we have to work with the illness (to help it on its way out of the body) rather than try to suppress it. Drugs often seem to have the effect of merely temporarily suppressing the mental health problem. A holistic model argues if you suppress illness rather than deal with it you can create chronic illness. I see emotional distress and confusion as meaningful responses to social injustice and tragedy. By suppressing the symptoms we only bury the problem and nature has a way of bringing those problems back sooner or later. We recognise this with the use of street drugs and alcohol, that relying on them to push away pain is problematic, but when we are legally pushing drugs to people the costs of this approach are not looked at.
Encouraging the use of drugs is encouraging the use of quite a passive approach to dealing with your distress. You are expected to lie back and wait for the drugs to do their work. People are more likely to give up on their own resources to deal with their problems. We need to offer people a broad range of ways of dealing with their thoughts and moods, that includes more active coping strategies and initiatives.
I think every mental health professional should know at least ten different relaxation and grounding techniques that they are confident to teach people they are working with (in a future blog I will outline my current top ten!). We also need to increase the level of group activities available to service users as well as linking people into stuff already going on in the community. It is great we have Tai Chi in Lynfield Mount (every Tuesday at 10.30 am in the Rec’ hall). I would like more such classes every day. Boxaerobics for example would be a great way to help people express frustration. I understand there is a punch bag available to in-patients at Airedale hospital, this is good news. When we introduced dance classes last year briefly to Lynfield Mount they were also popular. Drama is also an excellent way to learn new skills in expressing and dealing with emotions. Shoestring Theatre offer a good class for service users at the Cellar project on a Wednesday afternoon. It would be great to get Drama classes into Lynfield too. Such activities can be valuable stepping-stones to community-based activities.
If we can express the emotion that is drivng our distress we are often than able to get some peace of mind and focus on getting on with life. So giving people a range of different ways to connect with themselves and express themselves will then allow people to approach reducing their reliance on psychotropic medication in a pragmatic way.
May 15th, 2008 at 6:22 pm
Very interesting article - and I look forward to your top ten list.
So much here that echoes with my own experience. I have just started reducing one of my antidepressants (with the agreement and support of my psychiatrist) but still lack confidence in my own resources to deal with my problems, as you highlight. Expressing emotions (heck,e ven recognising them!) is a big barrier for me. I like the idea of different classes being used to do that, and, I have to say, have found that my symptoms are more manageable when I am attending yoga and body balance classes at the gym. I’m experimenting with adding in some aerobics type sessions too. Creativity is another huge factor which I believe is often overlooked; making something (anything!) is, in my experience, a very positive process and another way in which people can express themselves. Interesting. I think I will look at ways I can step up my self-expressive activities in conjunction with reducing medications.
May 19th, 2008 at 9:40 am
Hi Rufus. Interesting comments about retraining/improving the training of mental health professionals. In primary care, how much scope do you think there is for educating GPs about their prescribing habits?
May 19th, 2008 at 10:06 pm
Hi Rollercoaster,
different ways of connecting with emotions work for different people. Some people like having a punch bag to let out any tension. I have found different mindfulness practices useful: For example mindful breathing and mindful walking which I will write about in more detail in a few days. I met someone the other day who spontaneously draws a picture each day and uses the content as another way to gage what she is feeling. Other people use diaries or journals. The book ‘The way of the Artist’ suggests ‘Morning pages’ encouraging people (who want to unblock their creativity) to write for twenty minutes first thing in the morning whatever comes to mind even if it is: ‘I don’t know what to write, I feel really silly doing this…’ The book Non-violent communication has some good ideas on ways to express feelings and needs. Drama and roleplay can also help with this and writing letters to someone we are struggling with - that we do not have to send - can be a good starting point to expressing difficult feelings.
Hi Tom,
in regard to retraining GP’s I think we have to see it as a priority. In Cambridge a group inspired by Mind’s coming off research has started training local GP’s I am supporting them to gain funding for a project that will try and promote this more nationally. I know that a Bradford GP training scheme plans to use the ‘Doctor who hears voices’ film as a training resource as do the York Medical school. We have set up a website that also gives good information about reducing medication at http://www.comingoff.com hopefully G.P’s will become aware of this resource over time.
May 23rd, 2008 at 9:45 pm
Hi Rufus,
I first read about you in Oliver James’ book They F*** You Up and just saw you on The Doctor Who Hears Voices. I fully support your approach to helping people recover from the symptoms that can lead to them being labelled as mentally ill. I went through some very difficult stuff which led to psychotic episodes and almost diagnosis for bipolar disorder recently (my symptoms were enough to qualify for “mania” but I refused to believe it was a chemical balance and came up with more plausible environmental factors). After deciding psychiatry and medication was misguided, and I was merely reacting normally to abnormal situations, I improved immediately and have not had any problems since and my life has got so much better. I use NVC and mindfulness too, by the way. I’ve found Eckhart Tolle’s Power of Now useful as well. I’ve been doing a lot of reading about spirituality and what-not and have recently got heavily into Taoism, which is very inline with the holistic approach. Looking back on all the troubles I’ve had, I now see them as a blessing as they steered me onto a much better life path. If only more people got the chance to work through the situation and find the good, rather than having it all cancelled out by drugs.
Keep up the good work
Jack (not my real name)
May 28th, 2008 at 2:04 pm
Thank you Rufus - these are interesting ideas. I like the idea from “The Way of the Artist” and might try it. Am still gradually reducing one of my medications, held back alittle by advice from my psychiatrist to take it even more slowly than I would have!
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