This Week in Mentalists (102)

In this week’s TWIM, we have posts on body dysmorphia, CBT, the placebo effect and more.

Fighting Monsters reports from the receiving end of the political debate over disability benefits.

Yesterday I visited G, a woman with anxiety and depression. . She had been very well for a good few months but of late, I’ve stepped up my visits a little as I can sense a downturn in her mental state. She is beginning to feel very low in mood.

We talked about benefits together. She receives Attendance Allowance. I see lots of people who claim Attendance Allowance and she falls right into the ‘absolutely eligible’ category, but she is concerned that before her health fluctuates, she is not entitled to receive the payments when she is ‘well’.

This has been a cause of great anxiety to her and in the context of politicking through the conference season targeting those who claim benefits for disabilities, she is feeling not only anxious but guilty. She is worried and concerned that she will be checked and discovered ‘on a good day’ and that her entitlement to these benefits will be rescinded.

There is no way that that would happen in my opinion because I have seen so clearly the effects that her illness has on her over a long term period.

A part of me though can’t fail to feel angry that both the government and the opposition are targetting those with the lowest income levels and with the highest level of needs in their ‘benefit fraud’ campaign. In my experience, those who do not claim that which they are entitled to, WAY outnumber those who fiddle the system but the scare tactics and villifications have led to a real fear among some people who have every right to claim from the ‘system.’

Lake Cocytus has discovered that Big Brother is watching his patients.

The patient felt that a secret military experiment with satellites was affecting her. She wrote to civil servants, her Member of Parliament and the Prime Minister. She was convinced that her experiences were through technological processes the military were developing and she wanted the experiment on her to stop.

We had a letter from FTAC.

Have you heard of them? I hadn’t. The Fixated Threat Assessment Centre (FTAC) was apparently set up in October 2006, according to The Times, and consists of police and mental health workers who “identify suspects.” Our patient came to light from their 2 or 3 letters to politicians.

Did you know police screened mail to “identify suspects” and then direct mental health services to intervene? Parliamentary questions have been posed, apparently Mr McNulty had “security, counter terrorism and police” within his portfolio, yet he was the chap explaining FTAC to parliament.

Hmmm. It seems that Big Brother is indeed watching us. And Big Brother’s mate is a mental health worker . . .

Mentally Interesting: The Secret Life of a Manic Depressive is struggling with body dysmorphia.

I am on the verge of ripping my arm open and pulling the contraceptive implant right out. I don’t know what else I’d use since I have some complicated limitations in this field. I wasn’t sure how common weight gain was but reading around, I’m not alone. Since I’ve had it put in, I have gained nearly two stone for no apparent reason, it’s all gone to my stomach. I look like a frog hanging from a hook in a biology lab. I have NEVER hated my body more than I do right now. And for me, with BDD, that’s saying something. The weight gain has been so rapid- I’m not overeating and I am struggling with eating-disorderedness because of it. I have a Dr Strangelove arm that flees to my mouth every time I eat and I have to shout the voice down because I can’t go so far back again.

My body feels completely alien because I can’t control it. And because I do have BDD, it keeps getting dismissed as paranoia. I’m not paranoid. I shouldn’t hate my body because of something so meaningless as weight gain but to me it’s very frightening and depressing to gain weight. I try to remember the misery of scuffed knuckles and leaving people outside public toilets while the contents of my stomach were spat out from one end or the other, all the miseries that now feel distant against the every-minute misery of feeling out of control. I struggle incredibly to lose it, and my calorie intake is small enough as it is. I don’t know if I have fucked up my body or not. It doesn’t feel like my own right now.

Neuroskeptic has a thoughtful and informative post on the placebo effect.

The strongest meaning of the “placebo effect” is a direct effect of belief upon symptoms. You give someone a sugar pill or injection, and they immediately feel less pain, or whatever. But even this effect encompasses two kinds of things. It’s one thing if the original symptoms have a “real” medical cause, like a broken leg. But it’s another thing if the original symptoms are themselves partially or wholly driven by psychological factors, i.e. if they are “psychosomatic”.

If a placebo treats a “psychosomatic” disease, then that’s not because the placebo has some mysterious, mind-over-matter “placebo effect”. All the mystery, rather, lies with the psychosomatic disease. But this is a crucial distinction.

People seem more willing to accept the mind-over-matter powers of “the placebo” than they are to accept the existence of psychosomatic illness. As if only doctors with sugar pills possess the power of suggestion. If a simple pill can convince someone that they are cured, surely the modern world in all its complexity could convince people that they’re ill.

Serotonin66 is undergoing CBT.

CBT and I feel I am going around in circles. Jan the therapist has said that the anxieties/depressions/intrusive thoughts are ‘normal’. She talks a lot about her seeming ‘normal’ experiences, but admits that as a therapist she sees things differently compared to how I do with my experiences. When I say I think I am going around in circles, I mean that we discuss the same things week in and week out. I agree I have made some progress – I do the thought charts, rate them and go through the alternative thought then rate that, and then see what the outcome is of my fear/thought and rate that. Yes the levels go down – that is progress. I also have to say whether I am catastrophising/prediciting initially when I have the thought/fear – yep can do that. Current task is to include a cost/benefit analysis of each anxiety/thought. Truth be known I haven’t done any writing regarding this cost / benefit thing. It is something I am not too sure about and I am feeling very lazy. There’s a part of me that wants to finish up with the CBT – maybe that’s me being impatient, I don’t know.

Obsessively Compulsively Yours discusses suicidal thoughts.

I have come to the decision that there is more to life than this. I know that doesn’t sound earth shattering, I know that most of you are probably sitting back and wondering how it took me twenty years to realize it, but to me it signals something pretty big.
I want to live. I want to get better. I want to have a career, a family; I actually wouldn’t mind a social life. Okay, so maybe that’s going a bit far, but I certainly want the first two. I do not want to wallow in this toxically inebriating self pity for the rest of my life.

So where has this come from? I was very low last week and I felt that I had no future, that I was
drifting along in a worthless body, empty of spirit and full of worry, too heavy to carry on and yet to light to sink in to the real stuff. I remembered what another mental health blogger, Seaneen had always said – when you feel like ending it all, give it a month. In my case a week sufficed. I don’t want to die anymore.

Suicidal thoughts still hold such stigma – it wasn’t that long ago that suicide was still illegal. Why is it that we can talk openly about sexuality, about our views on everything from politics to the mind numbingly boring, about religion and beliefs, and yet when it comes to a matter of life or death, when we feel like we are not made for this world and wouldn’t mind taking our chances in the next, people clam up and turn away?