Steve’s Mental Health Blog

When Does Grief Become Depression?

Loss of any kind brings with it a lot of feelings. Loss of the pet rabbit for a child is still grief (and a useful experience for later life) as is the death of a close relative. But loss comes in many forms, such as the loss of a job or the sudden end of a relationship.

Our reaction to a loss of any kind is significantly relative to the value each individual attaches to the thing or person that has been lost. So when we experience a loss ourselves or witness the loss someones else has suffered, we should not be quick to judge.

I’ve experienced a heart-rending loss myself, with the death of my mother and also the suicide of a work colleague. I’ve also watched numerous friends and relatives who have also lost close family and friends. Perhaps the most pertinent experience I’ve had with loss and grieving is as a therapist.

Working for many years taking referrals from G.P.’s (Family Doctors) has brought me many people who are struggling with grief. The referral I usually got went something like:

“Mrs Suchabody is depressed after the death of her husband “X” years ago”

While in my early career I took the referrals at face value, experience and some extra studies have taught me, that grief is a process all unto itself and should be treated as such, rather than presuming some sort of mental “disorder”.

What is Grief?

Grief is a whole set of emotions that comes with the loss of a loved one (I will assume this for the purpose of this article). Those feelings are going to be huge and the effects catastrophic.

But we need to know that grief is the emotional aspect of bereavement, which is a process. As I’m sure you are aware, a process is a development of events, one after the other, usually in a specific order, which culminates in a finished “product”.

It’s a little like a novel, with a beginning, middle and an end, except that the chapters of the bereavement process can be in a different order for different people.

The bereavement process is always a long one. The length of which is different for everyone, dependant upon personality and circumstances. It can change us, at least temporarily, and always takes a few years to come to terms with.

The Bereavement Process – in Brief

The purpose of this article is not to discuss the bereavement process per se, but rather about trying to identify when something is happening that is beyond the natural process. To do that we need to at least acknowledge something of the process itself.

There’s been some excellent work done in this field over the last 50 years. One pioneer in this area was psychotherapist Elisabeth Kübler-Ross with her book “On Death and Dying” (1969). Her work provided a much more clear understanding of the bereavement process, which she identified as:

  • Denial & Isolation
  • Anger
  • Bargaining
  • Depression
  • Acceptance

….which obviously became known as “The 5 Stages of Bereavement”. If you would like to learn more about the process itself, then I would point you to David Kessler’s website.

There have been other ideas about this process, some adding more stages, such as the 7 Stage Process discussed by Jennie Wright (2011) which you can see on her website HERE.

For our purposes, it’s important to note that “depression” features prominently in the process (as you might expect). It’s this part of bereavement that is often the point where someone is more likely to present to their doctor for help. Let’s take a look at how this can happen.

Depression….or Not Depression?

Rather than try to re-invent the wheel, let me quote from Jennie Wright’s website about what you might expect from the depression stage of bereavement…

“Just when your friends may think you should be getting on with your life, a long period of sad reflection will likely overtake you. This is a normal stage of grief, so do not be “talked out of it” by well-meaning outsiders. Encouragement from others is not helpful to you during this stage of grieving.

During this time, you finally realize the true magnitude of your loss, and it depresses you. You may isolate yourself on purpose, reflect on things you did with your lost one, and focus on memories of the past. You may sense feelings of emptiness or despair.”

As you read the above quote, you should be able to recognise that Jennie implies a natural shifting or movement through the “depression”. The idea being that as time progresses, natural thought processes occur that gradually bring the bereaved person to a point where they can almost step out of the loss and into a muted acceptance.

But what if they can’t? What if this stage just drags on and on, a year? Two years or even more? When does this so-called depression end? Is there some kind of yard-stick with which to measure this horrible stage?

Unfortunately, there’s no template for this other than a vague understanding that natural grief should take us through to the final stages of acceptance. This is the hard part. Simply because there is no “one size fits all” then it’s often during this stage that the bereaved will visit their doctor and ask for help.

If you’ve done some reading on this subject (or just related back to your own experiences) then you will know that feeling flat and down, crying and a variety of other feelings are all part of the loss you feel. But strangely, even in the early stages of these feelings, some people will head straight for the doctor for some help. Maybe they expect taking some tranquillizers or anti-depressants will make it go away? Yes, I’m sure it will help…. help to prolong (or even freeze) the natural process of emotional healing.

There’s a time for drugs, but it’s certainly not yet!

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The bereaved may have been feeling the depressive stage for (let’s say) 6 months. Then he goes to the doctor because “It’s unbearable” he says. Is now the time for those drugs? Are 6 months long enough? How can the doctor know, especially if she only allocates 10 minutes per patient? In all likelihood, the bereaved will come away with a prescription for an anti-depressant. Oops. We’ve just added chemicals into the mix of a natural process.

I’ve worked with a lot of doctors over the years. As a result, there’s a couple of things I have become acutely aware of, the first of which is that family doctors are not mental health specialists. In fact usually, they aren’t specialists in any field of study. Typically you might say, they follow the adage of being “jack of all trades, but master of none”.

Then there are the issues of experience and attitude. I will let you fill in the blanks there. I will just say that I have had the displeasure of having had a family doctor in the past who was “less than wonderful”.

The picture I’m painting may sound rather negative, but the fact is, few people know anything about the grieving process and that includes doctors.

So is the “depression” stage of grief actually a clinically diagnosable condition? Well, no it isn’t. Until it is! Sorry I know I’m talking in riddles. I will explain.

The naturally occurring stage is most definitely not depression as understood by psychiatrists etc. Often times, the bereaved will gradually notice they have less unpleasant thoughts. Some days are better than others. Gradually. Then one day he notices that he feels different somehow. Basically, that’s how it goes with the natural process of bereavement. If after an extended period of time, these things don’t happen at all, there are no better days or in fact, there is a shift toward becoming entrenched in typical depressive symptoms, then it’s likely that something has gone wrong.

But to be able to recognise the difference, we must not only have an understanding of typical depressive symptoms but also of the process of grief too.

When Bereavement Goes Wrong

So why does bereavement go wrong? Is it that a person just has too much love for their lost loved one? Well in some instances that may be true. I’m sure we’ve all heard of very elderly couples dying within short periods of each other. My own great-grandparents died within 6 months of each other. I knew they had been together since the late 1910’s, being married just after he returned from the trenches of WW1.

This kind of event is hard to explain in any scientific way. It’s easier to simply say that the surviving spouse just gives up their life, not feeling the strength to carry on.

This isn’t the kind of problem I’m referring to though. So what is it that causes a person to get stuck in one place in the process of grief? I guess the exact answer to that is as numerous as there are humans on the planet. So to try to answer the question, I’m going to have to generalise.

Something “abnormal” has happened.

Abnormal? Yes. As in “something out of the ordinary for a natural grieving process”.

Let’s not get carried away and start talking about mental illness.

Let me give you a hypothetical example. The wife of a couple has a serious road traffic accident and is killed. The husband is mortified and after 18 months finds himself heading deeper into depression. He keeps his wife’s clothes around and has pictures of her all over the house. He sits for hours just watching their videos or sitting in silence as he thinks about their life together.

This is typical behaviour for a person who absolutely refuses (through a conscious act of will) to let his dead wife go. The longer this goes on, the more likely he is to become clinically depressed (a diagnosable depressive condition).

The problem with the man in my hypothetical example is something to do with his own deep need to hold on to not only the memory of his wife but her physical existence. To the rest of us, that seems quite unrealistic, but to this grieving man, it seems to make perfect sense. He holds on to her and so he feels some comfort in that. To let her go would mean more pain than he could bear. So this is his method of survival.

Once or twice as a therapist, I have worked with clients who manifest the appearance of the physical form of their dead spouse as a “ghost”. However, working through the issues, the “ghost” stops appearing as they gradually come to accept their loss. In essence, what they experienced were hallucinations as part of a psychotic episode, brought on by the extreme stress induced by their feelings of loss.

As any psychiatrist will tell you, psychosis (slipping into an alternate reality and interacting as if it were real) occurs for only some people, whose ability to cope with extreme mental stress is such that they are more prone to enter the condition. It doesn’t happen to everyone.

Usually, depression during bereavement is the result of the bereaved person being unwilling or unable to deal with some aspect of their situation. It may be an unwillingness to accept the circumstances of the death, such as a murder where the perpetrator is still at large. It could be any unresolved issue surrounding the death.

It is also just as likely that the bereaved person has had little or no experience in the past, of dealing with emotions in any significant way. This could be as a result of personality problems, or simply never having had to deal with the strong emotions that naturally come as a result of the trauma associated with the loss of a close relative or friend.

In my experience in working with bereaved clients, I have never had a client who was not able to move on from the stuckness they feel in their grief. That’s not me “blowing my own trumpet”. Rather it speaks to the fact that people can get stuck in grief and to move on, sometimes they need to be able to examine themselves and their situation in order to find that sequence of thinking or put things into better perspective, so they can get back on track, that being the natural process of grieving.

So to round this article off, yes clinical depression can become an element of bereavement. It usually starts as a result of some kind of “stuckness” in the process and if that happens, then it morphs from the bereavement form of feeling down (which I realise is an understatement) into full-blown depression.

I suppose as an ex-therapist I am bound to say this, but I really mean it when I say that the best way to become un-stuck, is to find a really good bereavement counsellor and be prepared to cry…a lot.

Further Reading:

David Kessler – The 5 Stages of Grief (website)

Jennie Wright – The 7 Stages of Grief (website)

If you like what you have seen here then please take a look at my book “The Whole Family“.

Click the photo to go to the page to learn more:

Buy paperback or eBook on Amazon
A book to make your home life a happy one – by Steve Chriscole

 

What is Depression?

Understanding Depression Series – No.1: What is Depression?

Introduction

This is the first in a series of articles that will attempt to break down the condition known as “Depression” into sizable chunks so that it will hopefully be easier to digest.

By no means is it an easy subject to explore. There is no “one size fits all” with this condition and it varies in intensity and severity across a wide range. It must also be said at the outset of this series, that everyone’s experience will be different in some way. There is, however enough of an overlap in terms of the experience of depression across individuals, to at least describe some of the common experiences that people have within their depression.

You might wonder just who these articles are aimed at? My answer to that question is “Pretty much everyone”. I appreciate that someone who is in the depths of depression might find it hard to concentrate and read articles, but that does not apply to all.

So if you want to get an understanding of this subject which comes from both first-hand sources (namely me) and also from the hundreds of clients I have worked with as a therapist over many years, then I hope you will find that these articles are for you.

Let’s Get Started

To try to understand what depression is, let’s get a few of the misconceptions out of the way first:

  1. Depression is not the same as feeling miserable. I often hear people say, “I feel depressed today” which is simply a way of saying “I’m not in a good mood” or “I feel unhappy” for whatever reason.
  2. Ever heard someone say “Snap out of it!” I know I know I have. Well if you are truly depressed, then snapping out of it (sic) is impossible. If it were that simple, then we wouldn’t have depression on near epidemic proportions in our society today.
  3. Depression sufferers are not “weak-willed”, “pathetic” or “lazy”.
  4. Most depression sufferers have little or no control over the condition.

So now we’ve got those out of the way, what exactly is it? Well, that’s where the problems start because no two people are alike. The experience of depression will be different for everyone in either large or small and subtle ways.

Before we get into specifics, let’s take a quick look at the different categories of depression that doctors, psychiatrists and psychologists like to use. I think it’s a useful thing to do to recognise the language used when they diagnose depression, along with getting a very basic “feel” of what might be called the symptoms:

  • Bipolar (Manic) Depression – This is regarded as being a deficiency in the organic nature of the brain (lack of lithium in the neurons) which causes extremes of emotions, thrusting the sufferer into ecstatic “highs” and literally moments later into the depths of despair. This condition is usually treated with drugs.
  • Clinical Depression or Persistent Depressive Disorder – thoughts on the nature of this condition vary. Some sources regard it as being a brain chemical disorder. Others think of it as a psychological condition (we will discuss the merits vs demerits of this in a later article). Either way, it is long-term (lasting years or even a lifetime) condition and requires significant medical input. Often treated with drugs and/or therapy.
  • Mild to Moderate Depression – probably the most common form, affecting the majority of people diagnosed (or not) with depression. The symptoms vary considerably, but generally speaking, they will include extreme lethargy, isolation, irritability, inability to concentrate, persistent worrying and anxiety.
  • Psychotic Depression – this form is unusual in that sufferers may be experiencing a more serious depression and then they can begin to experience feelings of paranoia, delusions or even hallucinations.
  • Seasonal Affective Disorder – as the name implies, this is a depression which is related to the time of year. It will usually be associated with dark, cold and wet seasons.
  • Peripartium / Postpartium Depression – these are depressive episodes that occur in women either during pregnancy or after the birth. The latter is also known as Post Natal depression.

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  • Pre-menstrual depression – with a shift in female hormones this can trigger depression just prior to monthly menstruation.
  • Situational Depression – this type of depression is also quite common as it is a form which can occur after a traumatic incident or significant life change. It could be seen to be the same as Mild to Moderate Depression above. It is also known as an Adjustment Disorder. Don’t confuse this with bereavement (see below).

Some Basic Facts About Depression

We will be going into more specific detail in subsequent articles. For now, I just want to talk about a few points which are most pertinent for everyone to know about depression:

  • Depression always has a start point (cause) even if that cause is not known. That start point could be absolutely anything, either in your current life, recent or distant past. Part of the problem with depression is actually finding out what is the initial cause.
  • Depression is usually a reaction to and is linked with some internalised method of thinking (cognitive process) and/or belief system (with associated emotions). This means depression is an emotional state that is generated as a result of some kind of internal confusion/frustration/stress/guilt/regret etc. which in turn is deemed unresolvable, thus causing a circular all consuming mixture of revolving thought and strong negative emotions, usually aimed at themselves.
  • Depression is a psychological RESULT of some external event or influence. No matter how we see things, we develop our own internal valuing systems over time (which can be fluid). The possibilities for conflict with our valuing systems are endless. Often we don’t have sufficiently developed thinking processes to cope (such as a child who is abused). It’s mostly about how we cope (internally and behaviourally) with all manner of events and experiences that will determine whether we become depressed or not.
  • Some forms of depression are linked to trauma, either recent or long in the past, which may have been either one single event or a series of events over a long period of time. This could play out as Post Traumatic Stress Disorder or depression, or indeed a combination of both.
  • Depression can be BEATEN with the right help and with determination.

(Please Note: the above list does not include depression which stems from organic brain disorders).

That’s all for this time. I will be back soon with the next article in this series. I hope to see you then.

If you like what you have seen here then please take a look at my book “The Whole Family“.

Click the photo to go to the page to learn more:

Buy paperback or eBook on Amazon
A book to make your home life a happy one – by Steve Chriscole

Do YOU Have a Personality Disorder?

I imagine you will immediately say, “No, of course I haven’t!” and you will probably be right.  What about the people in your life? Do you find yourself bearing the brunt of weird, unusual, controlling, obsessional behaviour from people close to you? Only you will know if the people around you behave in ways that cause you a problem.

The purpose of this article is not to get you to start examining all your family, friends or work colleagues, looking for the tell-tale signs. Its purpose is to help you to firstly examine your own behaviour and secondly to learn more about this greatly misunderstood concept. Thirdly, if you have someone in your life whose behaviour is a cause for concern, then hopefully this article will help you to understand them better.

What’s in a Name?

I want to preface this article by saying that this is a huge subject and I couldn’t possibly cover all aspects of it here. During this “mission impossible” I have chosen to undertake, I will bring you the benefit of my experience as a Counselling Therapist in UK Mental Health Services and private practice and point you in directions to allow you to learn more. (This computer will not self-destruct in five seconds…..!).

A number of other words have been used to describe this “condition”, such as psychopath and sociopath. There’s no difference at all in the meaning of these words. It’s simply that someone objects to a name for some politically correct reason, and so it changes. The condition, however, remains the same. Personally, I don’t care what you call it. I will use “PD” in the rest of this article because it’s easier to type!

What is a Personality Disorder?

I guess the first place to look to get an idea about this means we should look at the medical establishments’ definition of PD. Below is a quote from the current “official” definition from the “Diagnostic and Statistical Manual for Mental Health Disorders – Fifth Edition” (or DSM-V) for the consideration of the diagnosis of PD:

“The essential features of a personality disorder are impairments in
personality (self and interpersonal) functioning and the presence of
pathological personality traits. To diagnose a personality disorder,
the following criteria must be met:

A. Significant impairments in self (identity or self-direction) and
interpersonal (empathy or intimacy) functioning.

B. One or more pathological personality trait domains or trait facets.

C. The impairments in personality functioning and the individual‟s
personality trait expression are relatively stable across time and
consistent across situations.

D. The impairments in personality functioning and the individual‟s
personality trait expression are not better understood as
normative for the individual‟s developmental stage or sociocultural
environment.

E. The impairments in personality functioning and the individual‟s
personality trait expression are not solely due to the direct
physiological effects of a substance (e.g., a drug of abuse,
medication) or a general medical condition (e.g., severe head
trauma).” (Note 1. DSM V)

The above quote merely scratches the surface of PD, and includes some words and ideas whose meaning might not be clear to the uninitiated, so let’s take a look at some of them in language that we can better understand:

  1. Pathological Personality Traits – It’s probably the word “pathological” that might cause some difficulty. It’s a word used as an all-embracing term for absolutely any diagnosable mental health disorder. Exactly what is regarded as “diagnosable” is described in detail throughout the entirety of the DSM-V document.
  2. Significant impairments in self (identity or self-direction) and
    interpersonal (empathy or intimacy) functioning – The patient has significant problems with how they see themselves, either who they are or how they progress through their life. There is the addition of having problems with understanding the feelings of others and the ability to have close personal relationships.
  3. One or more pathological personality trait domains or trait facetsif we translate this into English rather than medical-speak, this criterion for diagnosis explains that a patient must exhibit behaviour from at least one of any of the broad groups of PD, or one of the particular recognised behaviour patterns from one of those groups.
  4. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations – This is fairly self-explanatory. This initial definition doesn’t go into details about the timescales involved but is explained in more detail in the specific categories of PD within DSM V.
  5. The impairments in personality functioning and the individual’s personality trait expression are not better understood as normative for the individual’s developmental stage or sociocultural environmentIn other words, this is directed to child development and significantly different cultural environments. As regards children, and adolescents in particular, they can exhibit behaviour that, to adults, could seem unusual, challenging or even violent. Care needs to be taken in assuming there is evidence for a PD in such circumstances. As regards cultural environment, diagnosis of PD should take into consideration practices which are within the context of the patient’s culture or environment.
  6. The impairments in personality functioning and the individual’s
    personality trait expression are not solely due to the direct
    physiological effects of a substance (e.g., a drug of abuse,
    medication) or a general medical condition (e.g., severe head
    trauma)This is simply saying that the unusual behaviour has nothing to do with the effects of alcohol, drugs or any other medical condition.

So all of the above explains the basics of what psychiatrists are looking for when they are considering a diagnosis. I want to point out that the process of diagnosis is not the same as going to see a doctor for a medical complaint. It will involve several consultations with a psychiatrist over several months, as well as ongoing regular assessments by Mental Health Nurses (in the UK at least).

Personality Disorder Types (According to DSM-V)

The list below is taken from DSM-V and is the latest label for each diagnosable PD. There isn’t space in this article to look at them individually. If you want to read more about the specifics of each category, then follow the link at Note 1 at the end of this article.

  1. Antisocial Personality Disorder.
  2. Avoidant Personality Disorder.
  3. Borderline Personality Disorder.
  4. Narcissistic Personality Disorder.
  5. Obsessive-Compulsive Personality Disorder.
  6. Schizotypal Personality Disorder.
  7. Personality Disorder Trait Specified.

I assume you’ve had a scan through the online document I recommended and no doubt you were bemused and bedazzled by the vast array of criteria for each of the categories.

As you look through each category (and you really should to be able to get a grasp of each category) you will notice some common features, despite the fact that each category describes markedly different overall behaviour.

Here are some of those common features:

  • Anxiety
  • Low self-esteem
  • Very self-centred
  • Inability to empathise with others
  • Emotional instability
  • Problems with intimacy
  • Depression

But these common features don’t paint the whole picture. Looking at PD from the academic perspective only allows for a more objective and remote picture. It doesn’t provide us with what it’s actually like to have a PD, nor do we get any sense of how the real-life effects of their behaviour manifest itself in the lives of others.

The Real World of Personality Disorders

So let us change our approach now and start to look at PD from a more subjective perspective, such as one who observes the behaviour and recognises it for what it really is.

I’ve had the privilege of working with a great number of clients over the years as a Counselling Therapist. When I began all those years ago, I had no intention of singling out any one type of issue for greater interest or scrutiny. It just happened.

Over time, I started to notice a pattern. Working with many clients in any given week, I noticed that there were one or two clients who were experiencing anxiety or depressive reactions which were directly connected to how a significant other was treating them. During my work with those clients, it became clear that the perpetrator was usually someone close to them (e.g. husband or wife) and they were behaving in a way that was strange or cruel.

After maybe a couple of years of working I began to realise that there were some common features in the people my clients described. But what was more troubling for me was that all this started to have meaning for me on a more personal level, but I just couldn’t place it at first.

My training as a Person-centred Therapist baulked at the idea of categories and labels. It was the antithesis of my training. However, I was working within a “medical model” setting, so I had to get used to the conditions and disorders as I played along so I could keep my job!

Little did I realise when I began, that I would now turn to the medical model’s journals and “bible” (DSM-IV, an older version) in order to try to piece together what I was seeing and feeling. What I discovered was quite an eye-opener.

I began to scan read the criteria for PD of the various “types” and as I did, something else came to mind which I will explain because it has a bearing on that sense that all this had some meaning for me that I just couldn’t place.

One day it suddenly dawned on me that for many years I had been struggling to understand the strange and cruel behaviour of my father. I was gradually learning more and more about various so-called “mental illnesses” but I just couldn’t place him in any particular category, that is until I discovered information about PD.

I could see the pervasive traits he demonstrated throughout my lifetime and it became abundantly clear to me that he was to all intents and purposes an undiagnosed sociopath.

Ok, so things started to become clearer for me as I worked with my clients. I was beginning to recognise certain tell-tale traits that indicated PD. I kept these things to myself. You could call it a kind of private study. Until one day, when I finally took the risk.

I had been working with a man who was being psychologically tormented by a woman (an unusual occurrence in itself). He described her behaviour extensively to me, and I saw his immense struggle to just try to put some logic or sense into the way she was treating him. It was after a number of such sessions that I finally said to him, with great trepidation, “Have you considered that she might be a psychopath?”

“What’s that?” he asked. So I just laid out a basic run-down of some of the real-world behaviour of a psychopath. It went like something like this:

“Usually someone with a psychopathic personality will have or be:

  • Totally self-oriented. That means that they put their own agenda before anyone else’s, even to the point of causing others emotional or physical harm.
  • They will have an agenda (or agendas) which play out in such a way that does not relate to any idea of logic or common sense that the rest of us follow. In other words, their ways do not follow accepted societal norms.
  • Usually very intelligent people.
  • Extremely adept at deception. Excellent and well-practised liars.
  • Feel little if any remorse for their actions.
  • Often have pleasant or outgoing personalities in the world, but change completely behind closed doors.
  • Will go to extreme lengths to maintain the “cover” of their double life.
  • Usually, any signs of emotion are fake unless it comes about as a result of harm to themselves or discovery of their own misdeeds.
  • Highly manipulative. 
  • Create for themselves their own “reality” within which they see themselves as master. The reality of the world as seen by everyone else is something to be tolerated and dealt with. They have their own set of rules.
  • They deal with the real world by stealth, knowing that their own urges and beliefs violate societal laws or norms, and do not want to get caught. Yet their own higher “morality” provides the impetus for their behaviour.”

I’ve added a few extra things to the list above that I have seen over the years since, but you get the idea.

I realise that offering such information might seem quite judgemental within the context of therapy, but quite honestly, I felt that I would be a fraud (incongruent) and totally disrespectful to watch my client run around in circles, while I knew full well that he would never come to this conclusion on his own. After all, I reasoned that it had taken me a whole lot of years as a therapist to come to understand even the rudiments of this problem.

Needless to say, that client was stunned by what I said to him. Not because I had the audacity to say it, but that I had described his protagonist female to a tee! I am bound to say that this knowledge allowed him to examine his relationship and also more about his own choices and attitudes.

The Sliding Scale

The psychiatrists have their diagnostic methods, rules and treatments, but the fact

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remains that personality disorders are far more common than most people realise. The vast majority of them are never diagnosed. In fact, the UK National Health Service only started to recognise Personality Disorder as a treatable “illness” in around 2004.

 

I don’t particularly hold with the diagnostic methods of the medical model, although I can see how they can be of use. What I hold in greater stead is the recognition that PD not only comes in all shapes and sizes, but also in a huge range of intensity.

If you are like me and hate the idea of being labelled as “mentally unstable”, then the stigma of being diagnosed with a PD will be a very heavy burden to carry. So let’s just ditch the “I have a PD/I don’t have a PD” notion or diagnosis and think differently. So let me say this:

Most, if not all of us, have a personality disorder of one form or another.

It’s all just down to scale. For example, you might be someone who is a non-conformist. Maybe you don’t agree with the politics that surround you, and so you have your own ideas. Does that mean you have a PD? I doubt it, but there may be a hint of abnormality in your personality depending on what lengths you go to defend your beliefs.

What about internal anger? Perhaps you are someone who has a reasonable disposition normally, but when you have a couple of drinks, another side of you materialises. Does that count as a PD? If this is a consistent factor that you exhibit throughout your life, then yes, once again, there may be a hint of personality abnormality.

I could go on with many other examples of varying degrees of behavioural intensity, but what it all comes down to is that there is no such thing as a “normal” personality. It just doesn’t exist, which is why we are all unique.

We all have quirks and even eccentricities that are part of our natures. We accept these differences to a degree. We may assess a person to be “emotional” or “angry” or maybe “awkward” or even “obnoxious”. Much of our own assessment of others comes down to our own set of core beliefs, which are purely subjective in themselves, and highly variable from person to person.

Sometimes, those differences we see in others can often be some aspect of their personality that has been formed from indoctrination, abuse, trauma etc. from an early age. We rarely give them a second thought as we grow up into adulthood and forge our way through life.

Also, it is very important to realise that we all try to cover up our behaviour so as not to be seen as “abnormal” to some degree or other. All this (and more) makes it incredibly difficult to recognise a PD in another person when you remember that some of the highly developed skills of the person with a PD are to deceive, lie and manipulate others.

Make no mistake though. The sliding scale of abnormality will move into a danger zone quite markedly once attitudes of control, manipulation, lies and especially violence emerge. People don’t have to be “axe-wielding maniacs” to have a PD. They are like the chameleon lizard that changes its colour with each new environment. They can be quiet and unassuming, yet have hidden motives and agendas. Their violence can take many forms and may remain dormant.

I Have a Personality Disorder

To finish this incredibly interesting and difficult topic I will tell you that I myself have had to come to terms with my own personality “quirks”. I most certainly don’t think I come anywhere near the criteria for PD as set down in the medical model diagnoses. But I have had my problems.

I’ve had to work very hard indeed to first accept that when I was younger, I had incorporated into my personality, behaviour that was inappropriate. I’ve worked hard to determine which parts of me I want to accept, and those that I want to change.

I’ve been lucky. I have worked with a lot of people who have helped me to overcome the bad parts (mostly). What I have become is still so different from most people, but those differences are things that I have chosen to accept and even develop.

So finally, how can we tell if we have hints of PD in ourselves? Well as I have discovered for myself, there is only truly one way and that comes through self-examination. Self-awareness is key. Gradually coming to terms with who you are will help you to start the weeding process, and as we know, removing the weeds allow the plants to grow and bloom.

Weeding involves getting down on your knees. It requires effort, dedication and humility. Even more, it takes time and patience to be able to see the bigger picture of the beautiful garden that you want to create. It’s worth it in the end.

Note 1: (DSM V – General Criteria for Personality Disorder)

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When Suicide Is the Answer

Hey! Stop! You probably think this article is not for you. Such a “depressing” subject and “we don’t talk about that”.

Well, it’s precisely the fact that people don’t talk about it that so many people actually do it.

So please read on.

It’s either total despair or absolute clarity, but the result is the same. Suicide.

So many people around the world take their own lives, especially in Western cultures. Did you ever wonder why? How is it that a friend is here one day and gone the next. It comes as a huge shock and you rack your brains to try and remember if you saw any warning signs. Guilt creeps in along with the grief and the self-recrimination.

The grief is all about you, not the dead friend. So what about him? How come he suddenly ended his life? I can’t give all the answers, because every person has a different life and different troubles.

I had a friend, well more of a work colleague really. He killed himself and that day has never left me.

You see, it is sometimes possible to see the signs, recognise that something is wrong. In the case of my friend, it seems I was the only one who noticed. I did my duty and brought it to the attention of someone who I knew would talk to him. Three weeks later, he was dead by his own hand.

This is not his story.

How Does It Begin?

As I said, everyone has their own life and experience, so to try to provide an answer that is a panacea for all would be unrealistic and futile. But we can peek into the depths and find something that will help us understand this problem better.

Let’s start by defining a couple of things so we are clear about that which we will discuss. First of all, I am not talking about people who self-harm. Neither am I referring those who attempt suicide as a means of getting attention as a cry for help. It won’t be surprising to know that many of those attempts go wrong and actually end in suicide, which was not their real intent.

The “real” suicide will occur when a person has come to, what seems to them at least, a rational decision (one way or another) that the only true solution to their problems is death. Their death.

You might wonder how it’s possible to come to, what seems to them at least, a rational decision to commit suicide? Well if that’s your thinking right now, then this article is for you. I’m writing this to try and help you to understand this process. To those of us who have no thoughts of suicide, the idea just seems bizarre, selfish, and just fantastical that anyone could think that killing themselves is in any way the right choice to deal with any set of problems. But that’s just it. Their state of mind is not the same as yours. You are the one who’s out of step with this process.

If you think that engaging in suicide in such a calm and practical manner is not normal, then you would be right, of course, under normal circumstances. But these aren’t normal circumstances.

Each of us has our breaking point and once that point is reached, then it’s like breaking through the sound barrier. To begin there are buffeting and turbulence and things are really scary. Then you reach that specific speed and, providing the wings didn’t tear off in the process, there is a loud “BANG” and then calmness and serenity, like entering into another world.

My analogy can only take us so far. That smoothness and calm are akin to the altered state of mind that often comes to a person who has endured as much as they can. They reach critical mass (sorry for yet another metaphor) and something clicks in their mind, like a switch. There is a sense of relief and clarity of purpose. It’s like having a eureka moment when you see the answer to some puzzle that you’ve been struggling with for ages.

The difference is that this new state of mind leads to just one end. All the answers are clear. We, on the outside, would ask, “But what about the wife and kids?” and we are appalled at the selfishness. But we are not in the same state of mind as this person. They calmly justify their decision with “They’ll be better off without me to fuck up their lives”.

The outsider would say with shock and horror “But you are wasting your life. You have so much. Why throw it all away?” Our potential suicide has the easy answer “I’ve looked at all the options from every angle thousands of times and I thought there were no solutions for me, until today, when I realised that if I wasn’t here, then the problem would just disappear!”

It’s that seemingly rational decision that can simply just click into the mind.

So where does this all begin? The answer to that might seem somewhat trite, but it’s none-the-less true. The answer is anytime and anywhere with almost anyone.

You see, living in this high-pressure world is not what we were designed for. Just the act of living today is filled with rules, laws, regulations, political ideologies, conformity, work, study, relationships, technology, buying and selling and a whole lot more.

Where the problems start with the stresses of life are with how the well individual is able to cope with all of the above. This will vary enormously depending on a whole host of factors that go to determine personality. If for example, you’ve had a troubled childhood, then you are less likely to be able to cope with the traumas that life can bring.

By the same token, a person with a “healthy” personality who experiences some extreme horror may be pushed beyond their ability to cope. I’m just trying to define some peripherals to this problem. Within the confines, there is a myriad of ways that have the potential to lead to the final destination.

It often begins with the onset of depression, but it could just as likely be the enormous pressures of work or some other stressor. Depression is often a factor because one of the most common features that lead to suicide is the deep sense of being trapped. Not just the feeling, but actually being trapped in circumstances that have no escape (or so it seems).

The Heart of the Matter

Let’s look at another analogy. Imagine you’ve created a product that you just know everyone will want. People need to see your innovative thingymajig so they can see just how wonderful it is.

You’ve spent months or even years coming up with the idea and the design. Then finally you go into the production of your first workable product. But wait. How many other people were involved in that process? Five? Ten? More? You bounced your ideas off your family and friends. Then there’s the bank for a business loan. Maybe you want to rent a building etc. On and on to build your idea. At each step you find yourself talking about your fledgeling business to other people. Like any small business, you need to get known. So you find ways to contact many people.

Imagine how far you would have got if you didn’t talk to anyone at all about your idea? You’ve kept your idea in your head or on paper. You’ve thought of everything and tried to look at all the configurations of design, using all your expertise and experience to create that perfect thingymajig.

So, still not involving anyone else, you produce a prototype and it doesn’t work. So you go back to the drawing board and re-examine it. How much time and effort have you wasted doing that? How much frustration has come as a result of the constant failure?

Doesn’t this sound like a circular process? Something like we see in depression? Well of course it is. Depression is so often the platform from which suicide is launched and is an important step on the ladder down to suicide.

As important as it is, depression is not the point I am making here. From my analogy above it should be clear to see that talking to others is of vital importance. It’s the gathering together of the ideas and the assistance of others that is so vitally important to get the job done. Success with a business adventure requires the co-operation of others.

So here we have a parallel with those who struggle with depression. Some become so demoralised and hopeless that suicide becomes their only option. They’ve run things around in their head for so long that the conclusion is that there is no solution to their problems, and for some, that final solution comes into their mind.

If only they had talked, I mean really talked with someone. If only they had had the opportunity to explore themselves with the assistance of someone who didn’t have an agenda. Someone who could help to provide another perspective, perhaps something that was not visible from the inside.

I’ve been through this process with other people many times. Seeing a person for the first time who believes strongly that speaking to other people about their problem is putting their burden on their shoulders. Then gradually encouraging them to open up and share their troubles.

Sometimes it takes a long time, but the effort is worth it. So I end by encouraging you to listen. Be that person who can share the pain of another, without judgement. You could save a life.

What to Do Before It’s Too Late

If you are contemplating suicide please talk to someone. Family or friend, it doesn’t matter. At the same time consider calling one of the following organisations:

In the UK: The SamaritansCampaign Against Living Miserably

In the USA: National Suicide Prevention Lifeline

In Australia: Lifeline ; Beyond Blue

In Canada: Kids Help Phone (For young people under 20 years old).

The above are some of the major charitable organisations that can be accessed by phone. See each site for more information.

See this article in Wikipedia for more:

https://en.wikipedia.org/wiki/List_of_suicide_crisis_lines

You can, of course, find a counselling therapist. In the UK go to this link to choose one near you (UK only): https://www.counselling-directory.org.uk

 

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In addition to trying to answer these questions, I also give you my own personal life as an example of a dysfunctional family.

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Mental Paralysis: Aftermath of Abuse

Did you ever feel so completely powerless when forced into a confrontation? I mean, it could be a situation as mundane as continuing to work for a company that you know is unethical, but you just shrug your shoulders and carry on, all the while hating what you are doing.

Or, it could be that person you know who just keeps on making jibes about you being overweight, or maybe the glasses you wear (“Hey four-eyes!”). You know the sort of things I mean.

Why do you put up with it? How come, despite the fact that deep inside it’s eating you up, you don’t speak up or make a choice?

Well if you’ve experienced bullying or abuse (especially as a child) then the reason is very likely to be that you have been conditioned into learned helplessness.

What Do We Mean by Learned Helplessness?

I’m going to refer to this as a “condition” rather than an illness. In some people, it could be so entrenched that it has become a rooted factor in their personality, and so it is part of who they are. In others, it is a reaction that has been learned and is reacted to more superficially and yet still has a significant effect on daily life. Hopefully, as you read on, the word “condition” will be revealed as being appropriately contextualised.

I think most people will know what “the rabbit caught in the headlights syndrome” means. It’s that sheer sense of fear that the little bunny feels when he’s confronted by the monster with the blinding eyes hurtling directly towards him in the dark. He freezes stiff and stares directly into the car headlights until he is bounced down the underside of your car. (Yes sorry, I’ve hit a rabbit doing just that!)

Is that learned helplessness? Well not exactly. For the rabbit, it’s more a case of freezing being an instinctive reaction to any form of danger. The rabbit “knows” that to move will make it more visible to a natural predator. Of course in the dead of night, the rabbit interprets the car headlights as the two massive glaring eyes of a huge predator.

It’s the rabbit’s reaction to a dangerous situation that gives us a clue to how we humans react in certain circumstances. We can also become frozen just like dear old Bugs, and while the reasons for the reactions is both are fear based, one is instinctive and the other is learned behaviour.

For us humans learned helplessness is a condition which does seem to reach deep into our psyche. Like it or not, it seems to be something within all of us that can easily be “switched on”, for want of a better phrase. All it takes is systematic exposure to some form of negative experience where there appears to be no escape or control.

If I try to explain the reaction in terms of a sensation, it’s like having a sense of being held down or fixed in place, unable to move (like the rabbit) but unlike the rabbit, the sense of fear is submerged beneath a host of “What ifs” and “I deserve this”, which leads to a debilitating sense of complete powerlessness, as though drained of all energy.

My own experience of this condition spilled over into dreams. I remember being in highly confrontational situations, and despite knowing what I should do, I just couldn’t move my arms. I wanted to protect myself or fight, but I just couldn’t move. It felt like mental paralysis.

There was always a kind of carry-over from night-time dreaming to daytime. Often times I didn’t remember the content of the dream, but I was left with that sapping and almost physical sensation of being drained. On days like that, I remember having to struggle through the day, forcing myself to engage in a meaningful way in my job. As I look back, I see the oppressive weight on my shoulders, which manifested as depression, although I never realised it as such at the time.

I lived with this condition (among others) for the first 40 years of my life and it was only through the study of psychology and training and practise as a therapist, that I could finally understand what I had been carrying all those years.

So How Did it Happen?

I think my case is such a common one and so anyone who has been in my situation would probably recognise themselves when I describe my experiences.

It started at home. My father was a violent abuser. He beat my mother first and then me. I’ve looked back at my life as a child many times and what I saw was that it didn’t matter if I had done something wrong or not, I was beaten. Of course, in my father’s eyes I expect he saw some misdemeanor, but to a small child who is still developing emotionally and cognitively, nothing I ever did seemed to warrant the level of anger and violence that was meted out.

My home-life seemed to ebb and flow between what I thought was normality and a deep sense of dread, fear and helplessness. It seemed that my mother was paralysed too. She had to endure this onslaught every day of our lives.

Although I never consciously thought it at the time, I kind of felt that this home life experience was what everyone went through at home. As a child, why would I think anything else? We lived next door to an incredibly poor family when I was small. I saw their sordid lives amid the dirt and the screams and shouting at all times of day and night. Now that, I thought at the time was bad. I had it easy compared to those three kids.

But my life was far from normal. Those people next door were blatantly poor; threadbare in every sense of the word. What I experienced was the “quiet” behind closed doors kind of abuse. All attempts were made to present a total sense of normality to the world. For me, this just served to cement my feelings of helplessness. I was lucky, wasn’t I?

So having been through a childhood like that (and I’ve only scratched the surface of that period) it should be plain to see that being trapped in this madhouse, day in and day out, it’s hardly surprising that I would learn that there was nothing I could do to change things. I just kept taking the punishment. I couldn’t hide (I know because I tried) and doing so just made the beatings worse. I couldn’t fight back because I was just so small. I just had to endure.

How Did I Overcome?

If you are able to place yourself in my shoes, then you will see quite clearly, how this kind of existence teaches certain lessons, the major one being “you must endure the pain and not fight back. Stay quiet and suffer”.

It took many years and a huge psychological effort on my part, but I did eventually learn to fight back and today I rarely feel helpless. I found a balance in my anger and developed an attitude which came out of the years of suffering. I have grown strong and resolute. I am able to make choices and strive for my goals, even when they are hard to achieve.

It isn’t possible for me to pinpoint one specific event or circumstance which was the definitive turning point. It has been my collection of such milestones that have enabled me to overcome my helplessness.

If I were to try to catalogue them, it would look something like this:

  • my first recognition that my family was different from others.
  • the first (and only) time I fought back against being beaten by my father.
  • the sense of relief when I left to join the military.
  • the gradual recognition that others saw me as being different (not in a good way).
  • the day I decided to begin learning martial arts.
  • engaging in personal development groups, where congruence was the key factor – I started to hear the truth about myself.
  • the first time I ever realised that learned helplessness was a “thing”.

If I spent a long time racking my memory, I’m sure I could come up with a lot more to add to the above list.

Some Other Things to Take Away From All This

There’s plenty of evidence for the theory (ies) of Learned Helplessness. You could start by reading about the research of Seligman (1974/5) [1] and his subsequent work with Hiroto (1975) [2]. Starting with rats and then looking at humans, Seligman showed how learned helplessness is a form of behavioural conditioning that works almost the same on humans as it does with laboratory rats.

If you were to study the psychological research before Seligman, you would learn about Pavlov and what came to be known as Classical Conditioning [3] and then Skinner with his research into stimulus/response conditioning, which became known as Operant Conditioning. [4]

Seligman discovered Learned Helplessness as a result of firstly engaging in the Classical Conditioning of dogs when he discovered that a dog who had been conditioned to receive a small electrical shock would not try to escape when the opportunity presented itself. Further studies showed that humans were just as susceptible to this type of conditioning (not with electric shocks obviously!).

If we take a much broader look at human society, we can see that learned helplessness can have as much effect on a population as it can on an individual, under the right circumstances.

Learned Helplessness & Depression

One final, but very important consideration is the very strong link between learned helplessness and depression. I have deliberately not delved into the technicalities of learned helplessness for the sake of space. You can, after all, do your own research. But I just want to add another effect of the condition which can link into depression, and that is the very personal effect it has on self-worth and self-esteem.

Part of the conditioning process is to make the victim feel like a victim. In other words, the pervading belief comes to be “It’s all my fault and I deserve this”. This might not be everyone’s experience (it wasn’t mine very much, consciously at least) but for those for whom it became a recognisable aspect, then it’s a very slippery slope from there to depression.

Hope for the Future

I want to end this article by stating what might seem obvious to most people, that being, “It’s different for everyone”. I can compare my life to someone else who experienced abuse as a child, and the circumstances surrounding our home life will be different in various ways. How a child processes his experiences will vary from child to child too. The net result will be that there will be similarities in outcome and behaviours such that we can broadly say that long-term abuse of children in a controlling environment will usually result in Learned Helplessness.

Admittedly, it is quite a journey to overcome this deeply ingrained conditioning. The start of the road to recovery is simply this: recognise the condition in yourself and be determined to overcome it. Then you will.

[1] – Learned Helplessness (Wikipedia)

[2] – Generality of Learned Helplessness in man

[3] – Classical Conditioning

[4] – Operant Conditioning

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If you enjoyed this article, please take a look at my book, “The Whole Family”.

(In paperback or eBook from Amazon)

It’s about relationships. How do you know who is right for you? You want a family right? But you’ve had some disastrous relationships and you don’t really understand why? Well I aim to answer those questions and much more.

How do families work? What are the dynamics in relationships? How can you learn more about yourself and why bother?

In addition to trying to answer these questions, I also give you my own personal life as an example of a dysfunctional family.

Click HERE to buy.

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New Book: “The Whole Family”

Just a quickie to introduce my new book, “The Whole Family” which is now available on Amazon Kindle, and in paperback version.

So what’s it about? It’s about relationships. How do you know who is right for you? You want a family right? But you’ve had some disastrous relationships and you don’t really understand why? Well I aim to answer those questions and much more.

How do families work? What are the dynamics in relationships? How can you learn more about yourself and why bother?

In addition to trying to answer these questions, I also give you my own personal life as an example of a dysfunctional family. Many years of personal development, therapy and practice as a Counselling Therapist have given me the opportunity to reflect on my own family and also on the similarities I found in the stories of so many of my ex-clients.

To try and balance my own experience with science, I also look at aspects of child development and learning from the perspective of psychological research.

The book is written in easy to read English and is available now on Amazon worldwide.

Buy “The Whole Family” (paperback version) HERE

Buy “The Whole Family” (Kindle version) HERE

Follow this link to see a preview of the book on Kindle.

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