Open Up - South East
Open Up South East monthly round-up November 2007
- South Eastern service users join together to hit the headlines!
- Guardian article on discrimination against high flyers
- Mental Health Act Code of Practice consultation needs you!
- Training for trainers into research course
- National Service User Network management committee recruitment
- Vacancies for Mental Health Act Commissioners
To promote your future mental health related activity please submit your info to [email protected] before 16 December for the Xmas edition of this newsletter.
· South Eastern service users join together to hit the headlines!
Open Up was unable to meet the huge demand for places on its recent media skills training courses. But help is at hand if you are interested in developing your media and communications skills in a supportive environment. There will be a meeting beginning of January 2008 in Maidstone to discuss the setting up of a regional service user media action and communications skills group. Please contact Raza Griffiths, Open Ups Co-ordinator for the South Eastern region, on [email protected] or phone 07737 647 445 Mondays/Tuesdays for more info.
Who is the media action group for?
All people who identify as service users, regardless of whether they participated in any of the Open Up media skills courses. The meeting will be facilitated by Raza Griffiths, who has trained service users to appear in the national and regional media. All travel expenses for service users in the south east will be paid for and snacks will also be provided.
What will the media action group do?
At this stage the plan is for the group to have regular meetings with input from local journalists and representatives of service user initiatives in other parts of the country which have been successful in raising the media profile of mental health. The idea is to eventually build up a network of trained service user peer support and mentors so that service users across the south east will have someone to turn to (as well as offer support in return) in order to help them with any aspect of their media work.
What is the value of the media action group?
To feel more supported in effectively using the media to promote the anti stigma message, advertise your group effectively and raise awareness of local and national mental health issues.
Agenda for the media action groups first meeting
Some of the issues we will be looking at will include capacity building the network as well as discussing some of the core skills that people would like help with, such as how to contact a local journalist, writing a press/media release, getting your key messages right, answering difficult questions, negotiating levels of confidentiality with journalists and also learning communications tools such as powerpoint. This will be YOUR chance to get your voice heard in the future direction of the group.
· Guardian article on discrimination against high flyers
Talking of getting our stories heard in the media, The Guardian ran a special feature in its G2 magazine on 12 November on the discriminatory attitudes faced by professional high flyers in the workplace, with a special feature by Jonathan Naess of Stand to Reason, an organisation for professional people which challenges stigma around mental distress
Underneath this are several other recent mental health links in The Guardian.
· Mental Health Act Code of Practice consultation begins
With the passing of the Mental Health Act in the teeth of united opposition from service users, carers, services and legal and human rights bodies the focus has now shifted to the Code of Practice for the Act. The purpose of the Code is to give clear guidance to practitioners on how to apply the Act in practice. The Department of Health and other bodies are organising consultation events to hear the views of service users and other stakeholders on the content of the Code in terms of its style, tone, content, ease of use and omissions.
Details of the Code and consultation can be found here http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_079842
This link includes:
- Index of the Mental Health Act itself
- details of the Consultation process for the Code including specific questions asked under 4.44
- the draft Code itself to be commented on
- an easy read version of the above (recommended as an introduction to this complex subject for beginners!)
The Consultation will finish on 24 January 2008. As much of the time will cover the Christmas holidays there is not really much time, so get stuck in soon! The Department of Health (DH) is organising a series of workshop consultations around the country including the following events
Be warned that the DHs previous record of listening to results of past consultations (e.g. The Race Equality Impact Assessment for the Act itself) has been quite lacklustre, so you might have to push a lot to get heard! You can also write in direct to the DH, either as a single individual or as part of a group response. The results of the consultation will be published in early April 2008 and the Code itself will come into force with the Act in October 2008. A series of mental health organisations including Together will be holding consultation events of their own on the Code.
Why is the Code important?
Whilst the Code cannot challenge the Act itself, it does cover major aspects of service users contact with services, and professionals have to keep the Code in mind as any deviation from it could make them liable to end up in Court in extreme cases. It is therefore a tool that service users can use to defend their rights and get proper treatment.
What does the Code cover?
Every aspect of service users contact with services, including general principles (which were regrettably excluded form the face of the Act itself), patient safeguards and supports, admissions criteria, inpatient care and community treatment and aftercare
What parts of the Code should we focus on?
Be warned the Code is a long document of over 200 pages! You can send questions via email to Open Up South East regional co-ordinator Raza Griffiths on [email protected] and he will get back to you a.s.a.p. The Code is helpfully divided up into chapter headings so perhaps you should concentrate on those headings that you are most interested in. We are being advised by the Mental Health Alliance to concentrate on ambiguous parts of the Code rather than directly challenging the Act through the Code. So things to focus on could include Supervised Community Treatment, Advance Decisions and the relationship of the Mental Health Act to the Mental Capacity Act which has important implications for advocacy and which the Code for the Mental Health Act is by no means clear on. Anything focusing on the new Approved Mental Health Professional needs to be scrutinised closely, as this is a new and untested role which will have a key part to play in tribunals and assessments. Whereas previously Approved Social Workers filled the role of non clinician at these key stages and had the power to challenge clinicians decisions, the fear is that as the new role will be open to clinicians there will be less of a challenge to clinical opinion.
How can I make a difference?
Attend the meetings listed above and write to the DH as an individual or as a group to the address given in the links. To be more effective remember to illustrate your points with real life examples if you can! If you are planning your own meeting to discuss the Code and there is enough interest and numbers, then please write to Raza Griffiths and he will try and get a specialist from the Mental Health Alliance (which organised opposition to the Act itself and succeeded in getting through some changes) to participate and help with their specialist knowledge of the Act and the Code
• Training for trainers into research course
The Service User Research Group for England (SURGE) is delivering training for trainers courses in London on 6 and 13 December. The training is for people with some experience of training and research to deliver a course on research and evaluation to other users and carers. The material to be delivered is the REACT training package which helps service users and carers to participate or lead in research and evaluation projects. That course is a 15 day course accredited with the Open College Network. To get a free place on the Trainers course you need to get the support of your local Mental Health Research Network regional lead which for the south east is Elizabeth Hutt on 020 7848 0691 [email protected] But hurry as places are limited!
• NSUN management committee recruitment
The National Service User Network (NSUN) is a national organisation across England which aims to develop networking and build capacity to support existing service user groups. They are currently recruiting for management committee volunteers. Please email Raza Griffiths if youd like further information, person specification and an application pack
• Vacancies for Mental Health Act Commissioners
The Mental Health Act Commission acts as an important watchdog to the operation of the Mental Health Act as it relates to detained patients. These posts are being advertised as wanting applicants with experience of mental health services who are currently under represented in the workforce. The posts are 26 days per year and include some positions in London and Essex but not in the south east region itself. Local commissioners get £225 per day and cut off date for applications is 7 December http://www.mhac.org.uk/?q=node/496
Can watching a film like The Departed help you cope with your own betrayals? Does The Queen make you think about your place in class and society? And can a movie like Letters From Iwo Jima teach you anything about war and conflict?
Proponents of cinema therapy say that, in addition to getting award nods, these and other movies can and will change the way we think, feel, and ultimately deal with life's ups and downs.
An increasing number of therapists prescribe movies to help their patients explore their psyches. And while few therapists have actually gone so far as to package their practices around cinema therapy, movies -- like art, books, and music -- are becoming one more tool to help those in therapy achieve their goals and overcome their hurdles. And books with such titles as Rent Two Films and Let's Talk in the Morning and Cinematherapy for Lovers: The Girl's Guide to Finding True Love One Movie at a Time are finding their own niche in the self-help sections of many bookstores.
"Cinema therapy is the process of using movies made for the big screen or television for therapeutic purposes," says Gary Solomon, PhD, MPH, MSW, author of The Motion Picture Prescription and Reel Therapy.
"It can have a positive effect on most people except those suffering from psychotic disorders," says Solomon, a professor of psychology at the Community College of Southern Nevada.
In fact, Solomon often lectures at prisons to help inmates learn to use movies as therapy to see what they have done to get them into their current predicament and, hopefully, to learn from it.
Cue up your DVD player because "cinema therapy is something that is self-administered," he says. "That's not to say therapy on a one-to-one basis is bad, but this is an opportunity to do interventional work by yourself."
The idea, says Solomon, is to choose movies with themes that mirror your current problem or situation. For example, if you or a loved has a substance abuse problem, he suggests Clean and Sober or When a Man Loves a Woman, or if you are coping with the loss -- or serious illness -- of a loved one, he may suggest Steel Magnolias or Beaches.
When watching such movies as a form of therapy, he says to look for the therapeutic context such as addiction, death/dying, abandonment or abuse, the ability to reach out and touch the viewer, and the overall content or subject matter.
Many Faces and Forms of Cinema Therapy
But "there's not one definition of cinema therapy," says Oakland, Calif.-based cinema therapist Birgit Wolz, PhD, author of The Cinema Therapy Workbook: A Self-Help Guide to Using Movies for Healing and Growth.
There's "popcorn cinema therapy," which can include watching a movie for a needed emotional release. According to Wolz, popcorn cinema therapy is rather heavy on cinema and rather light on therapy.
In what she dubs as "evocative cinema therapy," Wolz prefers to uses movies as therapy to help others learn about themselves in more profound ways based on how they respond to different characters and scenes.
It works like this, she says: "First, I ask about their personal situation and get a sense of where they are at in their lives, and then I will recommend movies that may speak to them on certain levels."
There's also cathartic cinema therapy involving laughing or crying, Wolz says. "This is also effective if it's done right as a precursor or a first stage of psychotherapy," she says. Say a person is in the midst of a depression; a movie that helps them to cry can open up different levels of their psyche, she explains to WebMD.
When watching movies, Wolz recommends sitting comfortably and among other things, noticing what you liked and didn't like about the movie and which characters or actions seemed especially attractive or unattractive.
She also suggests asking yourself whether there were any characters in the movie who modeled behavior that you would like to emulate.
It helps to write down your answers, she says.
Make-Your-Own Movie Therapy
In what may be the Sundance festival of the cinema therapy world, the Chicago Institute for the Moving Image (CIMI) helps people seeking therapy for depression or other serious psychiatric illnesses, including schizophrenia or amnesia, to write, produce, and direct their own movies.
"We work with patients who tend to have personal interests in making a movie or a screenplay and are already working with a therapist," says Joshua Flanders, CIMI's executive director.
"We will be brought in as a consultant to work with the patient and therapist to edit screenplays, rehearse scenes, and try out people," he says.
"The process of filmmaking provides a certain amount of therapy, organization, and order that people with psychological diseases need, and it helps the therapist see what the conflicts are within their patients lives," Flanders explains.
In a sense, making a movie or creating a screenplay enables the therapist or loved ones to see the world through this person's eyes.
In the past, Flanders has seen people make "enormous breakthroughs" with this form of cinema therapy.
A Word of Caution
But patients should not cancel their next therapy session to catch a matinee, cautions Bruce Skalarew, MD, a Chevy Chase, Md.-based psychiatrist and psychoanalyst and the co-chairman for the Forum for Psychoanalytic Study of Film.
Movies are often used in therapy or analysis, Skalarew tells WebMD.
"People will bring up a movie or a book, and the selection process of what they hone in on can be a clue to some obvious -- or not so obvious -- conflict that they are working with," he says.
If the therapist is familiar with the movie, he or she can see distortions or anything the viewer may have emphasized, de-emphasized, or left out for deeper insights into their personal issues and struggles.
That said, Skalarew cautions that he is not advocating cinema therapy or movies as a prime means of therapy. "Like art therapy, dance therapy, and music, you can bring it into a traditional form of therapy, and as an accessory it can be very useful."
If you've decided to dress as a scary, creepy character this Halloween, you're likely to have plenty of company. Witches, zombies, ghouls, vampires, and werewolves are perennial favorites of young and old alike.
You should also know, however, that most of these characters have medical and psychological "baggage," say the handful of experts who study them.
So don't just take along a vial of blood or some magic potion to make your character more believable. Find out the possible medical and psychological reasons that may have made them so frightening in the first place. But beware: Even the experts disagree on the truth surrounding some of the creepiest Halloween characters.
Halloween Character Case File No. 1: Witches
Witches got a mostly bad rap as sinister types who cast spells in the Middle Ages, says Stanley Krippner, PhD, professor of psychology at the Saybrook Graduate School in San Francisco. And it's typically undeserved, he insists. They may be the most psychologically healthy of all the creepy Halloween characters. "In the Middle Ages, some of the witches were probably emotionally disturbed," he tells WebMD. "But in my opinion, most of them were not. They were very good herbalists and midwives. Some of them were surgeons.
"Remember, this was an era where women didn't have much power," Krippner says of the witches' heyday in the Middle Ages. "This was one way they could get some respect."
Some witches, he suspects, were better doctors than the men doing the healing back in those days. But as the witches got more powerful, buying up land wanted by the men, he says the anti-witch crusades occurred, including the witch hunts of the 14th century.
Not all the witches back in the Middle Ages were on that level, of course, Krippner says. "As with any profession, there probably were a few kooks."
Likewise, Krippner says, modern-day witches, by and large, are "a very positive, respectful, peaceful religious group."
Halloween Character Case File No. 2: Zombies
Zombies could be considered innocent bystanders, just the guy or gal next door -- until someone in the villages of yore decided they had done something wrong. "They then would go to a trial by ordeal," says James D. Adams, PhD, associate professor of pharmacology and pharmaceutical sciences at the University of Southern California School of Pharmacy, Los Angeles, and an expert in zombie history.
Townspeople would rub a preparation of Datura stramonium on their bellies, Adams says. "The Datura stramonium contains scopolamine, the motion sickness drug," Adams says. The belief was that if people were innocent they wouldn't have any symptoms from the preparation being rubbed into them.
But people absorb it at different rates, he says. "The people who react quickly absorb scopolamine within a couple of hours," Adams says. "In some, scopolamine can take 13 hours to be absorbed."
Those who absorb the preparation quickly can begin to hallucinate, with visual and auditory changes, and their breathing becomes depressed, he says. Those are the ones who turn into "zombies" -- someone who can barely walk, barley see, and walks very clumsily. They walk around with arms outstretched, stiff arms and legs, as if they are bumping into things, he says.
Those who absorbed it slowly, he says, went home and slept it off. And they were presumed innocent.
Another expert, Daniel Lapin, PhD, a clinical psychologist with a private practice in San Francisco, sees the medical mystery of zombies differently. In Haiti in the 1700 and 1800s, the bokor, or priest, selected a victim and laced his drink with curare, a preparation of plant poisons that knocks out the motor nerves but keeps the sensory system untouched.
"As total paralysis sets in, the bokor pretends to be magically inducing the paralysis," Lapin says. "The bokor next officiates at the victim's burial. The victim thinks he or she is being buried alive." And the victim is right.
Two or three days later, the bokor digs up the victim. "The victim bonds subserviently and forever with the person who digs them up, usually the person who drugged them," Lapin says.
Sometimes, however, Lapin says the victim would "go crazy during the ordeal," and the bokor then has no use for them and drives them away. The victim would then be likely to wander from village to village, Lapin tells WebMD, earning the reputation as the village idiot.
Halloween Character Case File No. 3: Ghouls
Ghouls, traced back to ancient Arabic folklore, have a complicated, troubling psychological profile. They like to hang around burial grounds. And they have an obsessive-compulsive desire to consume corpses, says Lapin. "Unlike a psychotic, they know what they are doing, know the consequences, know it is wrong, and could turn themselves in," he says.
"Some just obsess about this in their head," he says, but some actually do the dastardly deed. In 19th-century India, for instance, Lapin says there are reports of women with this condition, sitting around a grave and "chowing down."
Halloween Character Case File No. 4: Vampires
Probably the best-known vampire is Dracula, the centuries-old vampire who stars in the 1897 Gothic horror novel by Bram Stoker.
While some say vampires have no heart, that's not true, says Lapin, who self-published a book, The Vampire, Dracula, and Incest. "A vampire has a heart, but it is imploded [psychologically]," he says. That's the origin, he says, of a vampire's need to suck blood.
Developmentally, he says, the vampire has a "glitch" in the oral sucking stage of development. "It's not accurate to say they are fixated," he says, "because if they are really fixated that would be the roots of narcissism."
"Dracula was a narcissist, but not all [vampires] are," says Lapin.
"Vampires may have a psychological need to control others," says Barbara Almond, MD, a Palo Alto, Calif., psychiatrist and psychoanalyst at the San Francisco Center for Psychoanalysis. She has published on the topic of Bram Stoker's Dracula and its psychoanalytic explanation.
Vampirism, she says, could represent a fantasy. "The fantasy would be taking over and controlling others by bleeding them."
The victim and vampire, she tells WebMD, can become pathologically dependent on each other. The victim may also become a vampire, and then they will never leave each other.
Krippner sees yet another possibility for a vampire's behavior. "Vampires may be anemic," he says. Going after another's blood, he says, "might be a form of self-medication."
If he had to pick a psychiatric diagnosis for vampires, he says, "I would say they were suffering from delusional schizophrenia." Vampires might have believed they could live a long time if they drank human blood, Krippner says.
Halloween Character Case File No. 5: Werewolves
Werewolves, talked about and reported on since ancient Greek times, may have a rare psychiatric disorder called lycanthropy, in which one has the delusion he or she is being transformed into a wolf.
The lycanthropy can be due to a psychosis or hysteria, what most of us call madness, Lapin says. It's not linked with depression, he says.
Werewolves, Lapin says, also "get a sexual thrill, conscious or unconscious, from murdering. They want to dominate and control through terror that evokes submission, and they want to humiliate and degrade."
Believing he is turning into a wolf by imagining the hair growth is the werewolf's way to disassociate, Lapin says. "It's simply a way to stay unconscious of what they are doing."
The Joy of Being Creeped Out on Halloween
If your motto is the scarier the costume, the better, chances are you like the creepiness of it all.
And some say that's just fine -- at least for while. "Halloween," Krippner says, "is one of the few occasions where it is OK to flirt with the dark side of life."
Horror films are more graphic than ever. Why do we watch, and what do scary movies do to us?
By Richard Sine
Reviewed by Louise Chang, MD
Halloween is nigh, and along with the parade of adorable elves and fairies knocking on your door come some more disturbing phenomena: scary haunted houses, wild parties and, perhaps most jarringly, a new onslaught of ghastly horror films. This year the biggest new release will be Saw IV, the fourth installment of a tale of a psycho who delights in putting his victims through ever more elaborate and deadly traps.
Scary movies are nothing new, but films like those in the Saw and Hostel series have offered something different: They focus less on the suspense of the chase and more on the suffering of the victim, leading some to dub them "torture porn." They feature levels of gore and violence once reserved for cult films. And despite the extreme gore, they're attracting big crowds at your local megaplex -- and may already be loaded into your teenager's DVD player.
If you're not a horror movie fan, you may be puzzled about why people put themselves through the ordeal of watching such movies. Many behavioral researchers share your puzzlement, giving rise to a term: the "horror paradox."
"No doubt, there's something really powerful that brings people to watch these things, because it's not logical," Joanne Cantor, PhD, director of the Center for Communication Research at University of Wisconsin, Madison, tells WebMD. "Most people like to experience pleasant emotions."
Defenders of these movies may say they're just harmless entertainment. But if their attraction is powerful, Cantor says, so is their impact. These impacts are felt by adults as well as children, by the well-adjusted as well as the disturbed. They may linger well after the house lights go up -- sometimes for years. And they may be anything but pleasurable.
(Do you like scary movies? What are your favorites? Join the talk on the Health Café message board.)
Scary Movies: The Fear Is Real
So is the fear you feel when you watch someone being chased by an axe-wielding murderer any different from the fear you might feel if you were actually being chased by an axe-wielding murderer?
The answer is no, at least not from where Glenn Sparks sits. Sparks, a professor of communication at Purdue University, studies the effects of horror films on viewers' physiology. When people watch horrific images, their heartbeat increases as much as 15 beats per minute, Sparks tells WebMD. Their palms sweat, their skin temperature drops several degrees, their muscles tense, and their blood pressure spikes.
"The brain hasn't really adapted to the new technology [of movies]," Sparks explains. "We can tell ourselves the images on the screen are not real, but emotionally our brain reacts as if they are our 'old brain' still governs our reactions."
When Sparks studied the physical effects of violent movies on young men, he noticed a strange pattern: The more fear they felt, the more they claimed to enjoy the movie. Why? Sparks believes scary movies may be one of the last vestiges of the tribal rite of passage.
"There's a motivation males have in our culture to master threatening situations," Sparks says. "It goes back to the initiation rites of our tribal ancestors, where the entrance to manhood was associated with hardship. We've lost that in modern society, and we may have found ways to replace it in our entertainment preferences."
In this context, Sparks says, the gorier the movie, the more justified the young man feels in boasting that he endured it. Other examples of modern tribal rites include roller coasters and even frat-house hazing.
There are other theories to explain the appeal of scary movies. James B. Weaver III, PhD, says many young people may be attracted to them merely because adults frown on them. For adults, morbid curiosity may be at play -- the same kind that causes us to stare at crashes on the highway, suggests Cantor. Humans may have an innate need to stay aware of dangers in our environment, especially the kind that could do us bodily harm, she says.
Yet another theory suggests that people may seek out violent entertainment as a way of coping with actual fears or violence. Sparks points to a study that showed that shortly after the murder of a college student in a community, interest in a movie showing a cold-blooded murder increased, both among women in the student's dormitory and in the community at large.
One popular explanation for the appeal of scary movies, expressed by the likes of horror novelist Stephen King, is that they act as a sort of safety valve for our cruel or aggressive impulses. The implication of this idea, which academics dub "symbolic catharsis," is that watching violence forestalls the need to act it out.
Unfortunately, media researchers say the effect may be closer to the opposite. Consuming violent media is more likely to make people feel more hostile, to view the world that way, and to be haunted by violent ideas and images.
In an experiment, Weaver showed gratuitously violent films (with stars like Chuck Norris and Steven Seagal) to college students for several nights in a row. The next day, while they were performing a simple test, a research assistant treated them rudely. The students who had watched the violent films suggested a harsher punishment for the rude assistant than students who had watched nonviolent films. "Watching these films actually made people more callous and more punitive," says Weaver, a researcher at Emory University's department of behavioral sciences and health education. "You can actually prime the idea that aggression or violence is the way to resolve conflict."
Just because people seek out scary movies doesn't mean their effects are benign, researchers say. In fact, Cantor suggests keeping children away from these films, and adds that adults have plenty of reasons to say away, as well.
In surveys of her students, Cantor found that nearly 60% reported that something they had watched before age 14 had caused disturbances in their sleep or waking life. Cantor has collected hundreds of essays by students who became afraid of water or clowns, who had obsessive thoughts of horrible images, or who became disturbed even at the mention of movies such as E.T. or Nightmare on Elm Street. More than a quarter of the students said they were still fearful.
Cantor suspects that the brain may store memories of these films in the amygdala, which plays an important role in generating emotions. She says these film memories may produce similar reactions to those produced by actual trauma -- and may be just as hard to erase.
Cantor views horror films as unhealthy because of the physical stress they create in viewers and the "negative trace" they can leave, even on adults. But the effects are especially strong on children. In her book, "Mommy , I'm Scared": How TV and Movies Frighten Children and What We Can Do to Protect Them, Cantor describes what frightens children at different ages and how to help them cope if they happen to see something disturbing.
The Torture Trap
Why has "torture porn" caught on in recent years? Experts who spoke to WebMD offered a number of possible explanations. With the controversy over torture that has followed in the wake of the Abu Ghraib prison scandal, viewers may wonder "what [torture] would be like," Sparks says.
Or the reason may lie with the filmmakers, who are entranced by the ability of digital special effects to make gore look more realistic, suggests Weaver. Alternately, they may be seeking to up the ante set by graphic television shows such as CSI.
As people become more desensitized to violence in the media, Sparks and other experts worry that we may also be becoming more desensitized to violence in real life. And Cantor worries that films with explicit gore may be more likely to be traumatizing.
With some hard-core horror movies having performed poorly in the box office this year, Sparks hopes that the torture porn trend is on its way out. In surveys he has done, Sparks has found that most people -- even adolescent males -- don't actively seek out violence in films.
"The further films go today, the more likely it will be that people will decide that the costs outweigh the benefits. Then they'll say, 'I don't want to see that anymore.'"