How to support grieving college students – Part 1

Between 35% and 48% of college students have lost a family member or close friend within the last two years. Grieving college students and young adults can often feel isolated and vulnerable, and may feel that no one else ‘gets’ what they are going through. In the first part of this two-part post, co-author of We Get It, David Fajgenbaum says in his own words how he aims to provide guidance and support for bereaved students and young adults.

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Losing a loved one at any age is difficult. But there are certain things about college and young adulthood that can make it a particularly difficult time to grieve. We’re often away from home for the first time and/or at college. We’re going through an intense period of personal and professional development. We’re swamped with assignments or work tasks. We’re often geographically far from our ill or grieving loved ones. We’re supposed to have the “best four years of our lives” and be worry free. Despite having other grieving young adults all around us (one out of three college students reports grieving in the last year), we can and often do feel completely alone and believe that there is no one around us who “gets” what we are going through.

We get it. These are some of the reasons that Heather and I have dedicated much of our lives to helping grieving college students and young adults. Heather has published bereavement research, advocated for young adult grievers as the President of the Association for Death Education & Counseling, and helped to establish one of the only student bereavement leave policies in the nation on her campus at Purdue University. I established a peer-led grief support group at Georgetown University after my mom died, grew the organization into a national movement (AMF) that has reached 3,000+ grieving students on 200+ campuses, and helped to propel college student grief to become a priority issue in higher education in the United States.

But four years ago, Heather and I connected over our mutual concern for all of the students not being reached by my nonprofit and not benefiting from Heather’s research and outreach. We had seen the impact that can be made on a griever’s life when they receive the support they desperately need, and we knew there were many more around the world in need of support and of connection with others who “get it.” Some individuals are able to find and connect with those with similar experiences of loss, whereas others are never able.

We assembled a book of autobiographical narratives written by 33 grieving college students and young adults for grieving college students and young adults. We believe these narratives can give readers a voice and the courage to share their grief experiences with others. We have discovered that one of the most powerful experiences for grieving individuals is to hear even a small element of their own experience being expressed by another. We wanted to make this experience possible for all, regardless of their access to others with similar experiences.

This book provides a window into the many grief reactions and mourning approaches of 33 grieving students and young adults. These young adults contributed their stories to this book to make a difference in the lives of future grieving students through sharing their stories–through showing that they “get it.” Rather than providing a prescription for how grief should be done, they genuinely describe the thoughts, feelings, and behaviors they experienced throughout their grief journeys. The power of this book is in the candid, engaging, and heartfelt sharing contained in these stories. We have offered the whole narratives, organized them based on themes, and provided commentary and reflection questions at the end of each chapter to help grievers to keep actively moving forward. We are so grateful for their beautifully-written stories.

If you are a grieving college student or young adult, we hope our book will be helpful for you and that you will find multiple points of connection as you read. This book was also written to offer guidance to those who want to support grieving college students and young adults, including family members, friends, counselors, professors, or university staff members. If you fall into this group, we hope that this book will provide helpful insights into the unique and dynamic nature of grief.

I’d like to close by sharing some of the lessons I’ve learned through my own grieving process and work:

First, helping others through support and community service has been very therapeutic for me , and I’ve heard this from many of our AMF members. The community service component is a particularly helpful way to get guys, like myself, to confront some of their emotions – through actively doing something. Along the same lines, I also get tremendous therapeutic benefit from dedicating my life to fighting cancer. Second, the power of peer support and being able to speak with others who “get it” cannot be underestimated; my support group at Georgetown was my lifeline. Third, we all express our emotions differently, so it is essential that we encourage people struggling with grief to express their emotions in whatever way is most helpful for them. Fourth, even though it has been over 10 years, I still miss my mom and wish that she were still here. But the sadness and intensity has certainly decreased over the years, so that I’m able to integrate my memories and the lessons she taught me to be able to actively move forward.

David C. Fajgenbaum, M.D., MSc, is a Research Assistant Professor of Medicine in the Division of Hematology/Oncology at the University of Pennsylvania and the co-founder of the National Students of AMF Support Network, a non-profit organisation dedicated to supporting college students grieving the illness or death of a loved one. Dr. Fajgenbaum co-founded the organization in 2006 in memory of his mother, Anne Marie Fajgenbaum (AMF). The organization is now a national movement that has supported 3,000+ students on 200+ campuses and raised national awareness about college student grief. AMF now stands for “Actively Moving Forward.” David has been profiled on Forbes Magazine’s 30 Under 30 list, the Today Show, Reader’s Digest, and 40 million bags of Doritos.  David received his BS from Georgetown University, his MSc in Public Health from Oxford University, his MD from the University of Pennsylvania, and his MBA from The Wharton School of Business. Dr. Fajgenbaum lives in Philadelphia, PA.

Learn more about We Get It.

Read part two of this blog post.

Can children be depressed?

It may be hard to believe that children can experience depression at a very young age, but as the NHS explains, “10% of children in Great Britain aged between 5 and 16 have a mental health problem, with 4% of children suffering from an emotional disorder such as anxiety or depression.” Lloyd Jones, author of The Princess and the Fog, shares his personal experience with depression as a child and adult, and explains how he learned to cope through his art.

This content was originally posted on Lloyd’s blog.

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‘Depression has been something of a running theme in my illustration work for a long time and The Princess and the Fog is obviously no exception. It is a subject that is very  near and dear to my heart as I’ve personally suffered from depression for most of my life.

I first felt as though I had a tendency towards depression when I was a child. I had only a cursory understanding of what it was – namely that it made you feel tired and sad and disinterested in things much of the time – which I felt described me, but I didn’t really know what it MEANT to be depressed or what one was supposed to do about it. I remember I confided in an adult – a family member, I won’t say whom – for some advice. “I think I’m depressed,” I admitted. “What have you got to be depressed about?” they replied, fairly astounded. And that was the end of the discussion. I suddenly felt as though I hadn’t earned the right to be depressed. I was just a kid. I didn’t have anything to be depressed about. I suddenly felt so embarrassed and so intensely alone. I don’t really remember what happened after that but I know that for a long time I wasn’t able to talk to anybody about it again.

It wasn’t until I was 21, in the second year of my BA, that I was first officially diagnosed with depression and put on fluoxetine. Suddenly I was allowed to be depressed. It was okay to talk about it and there were pamphlets and medicines and all sorts of things I was allowed to know about. I had had some experiences in college with herbal remedies and counselling that only seemed to be taken semi-seriously and didn’t really do much for me but this was the real deal. Depression as a theme started seeping into my illustration work as something I finally understood enough to be able to communicate. Projects like the Short Term Diaries of the first year of my MA gained some popularity as an alternative therapeutic tool, and I seemed to reach a lot of people with my short graphic memoir zine There’s A Hole In My Chest and its follow-up There’s a Hole In Your Chest. I was meeting and communicating to increasingly more people who felt the way I did.

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Excerpt from ‘There’s A Hole In My Chest’

For the second year of my MA I wanted to do something different, having felt a bit stifled by the Short Term Diaries towards the end of the project. I liked the responses I got to my Hole in Chest books so I thought it might be a good idea to keep the same theme rolling. Writing and illustrating a picture book had been on my bucket list for a while so I thought I’d give it a try.

When I began writing the story I had to do a lot of research into childhood depression to make sure I tackled the subject responsibly and respectfully, and to make sure I got my facts straight. I discovered after struggling to find much that childhood depression was still a relatively new concept and that up until recently it was believed that children could not become depressed. Suddenly I had a bit more context for the loneliness I had felt as a child. There were hardly any books for children with depression out there. There were dozens of books and pamphlets and cartoons and other media for children living with just about any other mental illness you could think of, but not depression. I realised that if I made one, it could actually be really important to someone. A year and a half of working on it later, and here we are.

If I had had a book like The Princess and the Fog when I was a child, I wonder how different things would have been. If I’d known that I wasn’t the only person out there feeling this way, I can’t help but think I might have felt a lot less isolated and desperate, and  perhaps because of that I would have had a better understanding of how to deal with it. That was the book I tried to create. If The Princess and the Fog helps even one kid out there feel like they don’t need an excuse to be depressed, that there’s somebody else out there who’s been through the same thing and survived, and that they can do the same, then I’ll have done my job and I’ll be happy.

Lloyd Jones lives in the south of England. Lloyd has a first class honours degree in Illustration from the University of Portsmouth, an MA in Sequential Design and Illustration from the University of Brighton and he is currently working on a PGCE FE from the University of Southampton. He has learned to live with his fog, rather than suffer from it. Learn more about The Princess and the Fog

Find out more about depression and anxiety in children here.

 

Goodreads Book Giveaway

The Princess and the Fog by Lloyd Jones

The Princess and the Fog

by Lloyd Jones

Giveaway ends August 19, 2015.

See the giveaway details
at Goodreads.

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Six steps to finding balance in busy lives

It is important to know that life imbalance is one of the biggest causes of stress in the western world; consequently understanding why we experience imbalance in our modern lives, and finding strategies to help you overcome it, is very useful! Teena Clouston shares 6 steps to finding balance in busy lives from her new book Challenging Stress, Burnout and Rust-out.

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So what is burnout and rust-out?

Burnout and rust-out are caused by long-term stress; burnout is marked by exhaustion and rust-out by apathy and disengagement. Which of these we experience and when, is variable, dependent on the unique individual and his or her circumstances. Stress and imbalance can be linked to some specific personality traits and thinking patterns that we can unconsciously adopt to manage the daily grind but which, unwittingly, can maintain our state of imbalance and levels of stress.  For example, people who rush around like busy bees, or those that put up with or make excuses for their busyness and overwork are all using different strategies to deal with life conflicts, pressures and time scarcity, but sadly, are failing to diminish stress. Alternatively those that fight back and overcome these pressures seem to be able to live a far more balanced and healthy life because they dare to challenge the status quo and take time to do things they find meaningful or enjoy doing, irrespective of the pressures of work or general over-busyness.

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Resistance is not futile

 

6 steps to achieve a healthy work-life balance

There are several different ideas shared in the book but if I had to choose 6 they would be:

  • Gain some autonomy over your workload
  • Review and adapt your views and attitudes about work so they become congruent with what you really want in life
  • Share your daily responsibilities with others
  • Do something meaningful everyday
  • Live in the moment
  • Walk in nature

These techniques are not a cure-all in terms of work-life or indeed, more general life balance. That’s because, in reality, they all need you to put in a lot of effort in terms of making changes in how you live your life everyday, and that is not easy. For example, if you are going to use mindfulness techniques to try to focus on the moment or cognitive behavioural strategies to change your thinking or attitudes about life balance, then you have to practice that regularly and put some work in every day. That said, you do need to start somewhere and from small moves big things can grow and consequently, with practice, you can really change your sense of balance, your quality of life and ultimately, your well-being; thus practice may not make perfect, as the saying goes,  but it can make life just a little richer and more satisfying.

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Illustrations by Peter Cronin, ARSMA.

Teena J. Clouston is a Reader in Occupational Therapy and Life Balance at the School of Healthcare Sciences at Cardiff University, UK. Over the last ten years, her research interests have become focused on the meaning and experience of lifestyle balance, and her PhD specifically studied the influences of paid work on finding balance in everyday life. Learn more about Challenging Stress, Burnout and Rust-out here.

Teach your Child How to Fight Anxiety

Natasha Daniels is a child therapist  and has worked with young children and their families for over 15 years. Her book, How to Parent Your Anxious Toddler, covers everything parents of an anxious toddler need to know, to help them tackle everyday difficulties and build up their child’s resilience, independence, and coping mechanisms. In this post she shares some advice on helping your child to fight anxious feelings.  

Teach your Child How to Fight Anxiety….and be a Super Hero!
Teaching your child how to fight anxiety can start at a very young age. I have worked with children as young as two and three that were able to learn skills on how to face their fears. So, roll up your sleeves and start arming your child with skills to overcome their anxiety. It is never too early to turn your little one into a superhero!

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EPISODE 1: DEVELOP YOUR LITTLE SUPERHERO

Set the Battle Ground
Have your child name their worries. Sometimes this will just be Mr. Worry, but you can pick something more specific based on your child’s fears (Mr. Bossy, Mr. Bugs, Mr. Scared, Mr. Sick etc.). Tell them that Mr. Scared likes to boss kids around and make them fearful. Have them create a worthy superhero to fight off Mr. Scared. I like to use the child’s name with Super in front of it (Super John, Super Amber, etc.). Have them draw a picture of Mr. Scared and of their superhero. Prompt them to make the superhero look like them in some way.

Dress the Superhero
Children love dress up and there is something transforming when one is dressed as a superhero. Have your child pick out a superhero costume that they can wear when they are a fighting Mr. Scared. A cape and a mask are always good places to start. If they have a particular superhero that they love – have them dress up as that instead.

Give them the back story
Set the stage for your child by giving them their superhero story. Incorporate your child’s fears into the story. Their story might go something like:

There once was a mean, bossy guy named Mr. Scared. Mr. Scared liked to go around bullying kids and making them feel scared. Every time Mr. Scared was able to make a kid feel scared, he would grow bigger. Super John wasn’t going to let Mr. Scared grow any bigger! When Mr. Scared started telling him to be scared of the dark, Super John didn’t listen to him! He knew he could turn on the lights.

Put on Your Game Face
In my house we have a “Brave Face” pose. Whenever anyone is scared to do something – we say, “Brave face!” and we all put our heads up high and proud. Sometimes duck lips are included. Sometimes it is a full superhero pose – arms on hips, chest pushed out. It is a nice way to empower each other and it encourages us to fight through our fears. At the very least, it lightens the mood and makes us all laugh.

EPISODE 2: SEND YOUR SUPERHERO OUT TO BATTLE

Verbally encourage your superhero
Having your child dressed and feeling empowered is only half the battle. Now they will need actual experiences to challenge and fight Mr. Scared. You want to encourage your child’s independence by giving them the least amount of assistance they need during these challenges. First start by giving them verbal support. You can say things like, “Don’t let Mr. Scared win this battle! Where is Super John? Do you need to get your cape on? Show me the Brave face!!”

Give suggestions to your superhero
Give your superhero some suggestions. You can say, “I know it seems dark upstairs, but there is a light switch right there you can turn on.” Or another suggestion might be something like, “We can sing together as you go upstairs so you know I am still right here.”

Offer limited support to your superhero
When your superhero is lacking some any superpowers – it may be time to call in for back up. The main goal is for your child to feel success, so if you have come to the conclusion that Mr. Scared is definitely going to win the battle, get your kiddo’s back! Offer the least amount of intervention as possible. This might be turning the light on for them or walking half way up the stairs with them. Always premise your assistance with something like, “Okay Super John I will make you a deal. I will turn on the light for you if you do the rest” or “I will go up the first flight of stairs, if you go up the rest.” Getting your child to agree on a plan makes it more likely that they will stick with it…sometimes. If that doesn’t work – pleading helps – “Don’t let Mr. Scared win! I know you can beat him!”

Okay, if all else fails, bribe your superhero!
I know that if someone told me to jump off a high dive there would very little that anyone could say to get me to do it. However, if the price was right – I might be encouraged to face my fears and try to do it. When all else fails offer a “challenge prize.” I will often have families set up a “challenge treasure box” that is filled with dollar store toys and prizes. When your child is faced with a particularly hard challenge, you can offer a challenge prize if they try to do it. You want your child to push themselves just slightly out of their comfort zone. If they are able to do this, but don’t fully complete the challenge you can say, “You were amazing! I know that was scary for you, but you went ahead anyway and tried to do it! You get a challenge prize for being so brave!”

Children don’t turn into superheroes overnight, but if you don’t give your child the skills to fight their fears, they have lost the battle before it has even begun.

This post was originally published on Natasha’s blog: http://www.anxioustoddlers.com/ 

Find out about Natasha’s book How to Parent Your Anxious Toddler, read reviews or order your copy here 

 

Designing The Princess and the Fog

What better way to explain depression to children than with a relatable and enjoyable storybook full of vibrant illustrations? The author of The Princess and the Fog, Lloyd Jones, reveals the motivation behind designing this book and its characters in his distinctive and colourful style. This content was originally posted on Lloyd’s blog.

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The Princess

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I chose a princess as the protagonist of my book because it is an archetypical character in children’s fiction. If you know that a picture book is about a princess, you can infer a lot about what the story, setting and characters are likely to be based on the countless princess stories you’re already familiar with. I was then able to turn that on its head by introducing new elements to surprise the reader and make the main character of the story much more relatable.

Additionally, princesses are typically revered and looked up to by the children who read their stories. They are something that a lot of young girls in particular strive to be. If a princess can get depression, anyone can. I think it’s important that the children who read my story can relate to its protagonist in quite a personal way so that they know that they aren’t alone and that this thing that they’re struggling with that they can’t explain can happen to just about anyone else. Depression can make you feel very alone, so just knowing that there is someone out there – even a fictional princess – who is going through something similar can be a huge comfort.

 

The Setting

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The setting of The Princess and the Fog is a strange mix of traditional old-fashioned fairy tale and modern day. A huge purple castle sits at the heart of a bustling modern metropolis. The Princess rides horses, everyone else drives cars. Television and print media apparently exist but so do knights and adventurers with swords and shields. This, again, is designed to make the story relatable on a number of different levels. Children will find the fairy tale elements of the situations as familiar as the real life ones.

In my research into writing for children I learned of the importance of metaphor. Children do not tend to like stories with aggressive morals. While the book deals with real-life problems, I have managed to avoid “outing” the children who read it by disguising the issues that young readers may be facing behind metaphors. Readers may understand that the book is describing a situation similar to their own without feeling like it’s singling them out or trying to teach them a lesson. The story is designed to be enjoyed in its own right but with a hidden depth to it that should communicate with any young readers who are feeling the same way as The Princess.

 

The Fog

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In my early design ideas for the book I was toying with various ideas for how to represent depression visually. I had previously used the idea of a hole in one’s chest and an obscured, scribbled out face in an earlier independent project called There’s A Hole In My Chest and didn’t want to use it again as I thought it would be too grim for children. Early ideas included some kind of slow, lazy slime monster not unlike The Doldrums in The Phantom Tollbooth, a hat or helmet of some kind that couldn’t be taken off once it was put on, and a ball and chain, but none of these quite described the feeling adequately. I decided that whatever it was it needed to be opaquely black, thick, impossible to remove and in some way at least partially obscure the protagonist’s head and face to create a sense of loneliness and isolation from the outside world.

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The title The Princess and the Fog popped into my head one day and it just fit perfectly. It ticked all the boxes, I could illustrate it in a similar frustrated scribbly way as the obscured faces in There’s A Hole In My Chest, and I just couldn’t resist the pun. The exact depiction of The Fog developed considerably  over the course of making the book before I settled on how it looks in the final product, particularly after notes that it obscured too much of The Princess’s face and could be seen as scary for some readers.

 

The King and Queen

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It was important to me to have the King and Queen both appear very physically strong, in their own ways. The Queen is extremely tall with very large legs but she’s very thin and a little unbalanced, while The King is short and squat with diddy little legs but with a very large upper body. In this way, it shows that they each have their own strengths that make them a very well-balanced team, both as parents, supporters and as the co-rulers of the unnamed kingdom in which the story takes place. Most children will look to their parents as their first port of call in times of crisis and The Princess is no different. The King and Queen are the first two characters to offer help to The Princess in dealing with her affliction. Although they get it a bit wrong at first, they are an essential part of the large support network The Princess is eventually able to put together. I hope any parental figures reading this book will be inspired to be as strong and determined as The King and Queen.

 

The Supporting Cast

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The other characters in the story that The Princess eventually enlists for her support network all play important parts in aiding her gradual recovery. Most of them straddle that same weird line between fairy tale and reality by representing both a trustworthy adversary one might find in the battle against depressive illness and a friendly fantasy character. The Druid, for example, brews up some potions for The Princess to try to help her fight away the fog.

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With his lab coat and diplomas, The Druid is clearly a metaphor for a doctor offering to help medicate the problem. But not everybody responds to medication. Everybody experiences depression differently and no one cure exists that will work for everyone, so I felt it important that the story never explicitly states which of the many solutions The Princess uses to try to rid herself of The Fog actually ultimately works.


Lloyd Jones lives in the south of England. Lloyd has a first class honours degree in Illustration from the University of Portsmouth, an MA in Sequential Design and Illustration from the University of Brighton and he is currently working on a PGCE FE from the University of Southampton. He has learned to live with his fog, rather than suffer from it. Learn more about The Princess and the Fog

 

Exclusive look at The Princess and the Fog

Enjoy this sneak peek at The Princess and the Fog, JKP’s latest children’s book. Vibrantly illustrated, this book was designed to be read with children aged 5-7 who are suffering from depression. 

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Once upon a time there was a Princess. She had everything a little girl could ever want, and she was happy. That is, until the fog came…

 

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Lloyd Jones lives in the south of England. Lloyd has a first class honours degree in Illustration from the University of Portsmouth, an MA in Sequential Design and Illustration from the University of Brighton and he is currently working on a PGCE FE from the University of Southampton. He has learned to live with his fog, rather than suffer from it. Learn more about The Princess and the Fog

 

What about parents who aren’t able to emotionally connect with their child?

Jane Evans, trauma parenting specialist and author of Kit Kitten and the Topsy-Turvy Feelings and How Are You Feeling Today Baby Bear?, writes about the importance of giving children the best chance to catch up on their emotional awareness and build their emotional vocabulary.

Evans-KitKitten-C2WThere are many reasons why a parent or carer might not be able to be emotionally connected and available to a child. It might be that they did not have that kind of childhood so they aren’t aware of the benefits of talking with a child about their own and others’ feelings. Or, it could be that they are preoccupied with their own unmet emotional needs, living with domestic abuse, addiction, an eating disorder, high levels of stress and anxiety or other physical or mental illness, any of which could create a distance between them and the child they are raising.

What it doesn’t mean is that they don’t love their child as that’s a different matter altogether, it’s often more that they are not able to tune into and regulate their child’s emotional needs and state. This can have a lasting impact on all areas of a child’s development as they may struggle to express and cope with their daily emotions and this can then get in the way of their learning, being able to make friends, have fun and enjoy a carefree childhood.

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The story of Kit Kitten shows how Kit becomes withdrawn, watchful and is often overwhelmed by not being able to put feelings into words and from not having a close adult to help unpack all of them in a safe and manageable way. This is something I have repeatedly seen in the parents, children and young people I have been working with for over two decades now. It causes such emotional distress and anxiety, and often leads to mental and physical illness from the stress of feeling emotionally invisible, stuck, overwhelmed and isolated.

Kit Kitten and the Topsy-Turvy Feelings aims to address this missing emotional connection early on to offer children the best chance to catch up on their emotional awareness and build their emotional vocabulary by encouraging adults to begin this vital work with them in a gentle way. Emotional intelligence is the key to good mental health, to being free to access learning and to building healthy long-term relationships for life.

 

‘If your emotional abilities aren’t in hand, if you don’t have self-awareness, if you are not able to manage your distressing emotions, if you can’t have empathy and have effective relationships, then no matter how smart you are, you are not going to get very far.’

– Daniel Goleman

 

You can find out more about Jane’s work, upcoming events and read more of her blog posts on her website: http://www.parentingposttrauma.co.uk/ You can also follow her on twitter: @janeparenting2

Mental health support made simple

Following the second edition release of Introducing Mental Health, authors Connor and Caroline Kinsella provide insight into taking a more global and simplified approach to mental health support in the fully revised and updated second edition.

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We wrote the original Introducing Mental Health: A Practical Guide to make the very complicated seem a little bit simpler and to help front-line workers do what often seems like the impossible. It’s not an easy role at the best of times, but much has happened in the nine years between editions to make the job of mental health care even more difficult than it was in 2006.

As thoroughly well behaved and professional writers (ahem) we chose not to fill the book with a long list of all that is wrong with UK mental health services. After all, most of our British readers need no reminders of the savage cuts, dwindling resources and disappearing in-patient beds that are now a feature of UK mental health.

But while it’s all very well to moan incessantly about our own back yard, we looked to the developing world for inspiration to update the simple, straightforward approach to mental health care embodied in the first edition. We’re lucky enough to have as a close friend one Vikram Patel, the Foreword writer of both editions, who is also the director of the Centre for Global Mental health, London. Vikram has spearheaded the global mental health movement which has helped make mental health a priority issue in those parts of the planet where malnutrition, malaria and HIV have traditionally demanded resources that truly put our own budget cuts and resource slashing into perspective. He is now on Time Magazine’s ‘World’s 100 Most Influential People’ list and we met up with him just as he had been interviewed for BBC Radio Four’s excellent The Life Scientific series.

It was a little strange sitting in a London pub with an old friend who is now the psychiatric equivalent of Kim Kardashian, albeit with a rather more worthwhile contribution to the world. While western psychiatry remains bound by an ever increasing list of obscure diagnoses, pharmacological treatments and reliance on highly trained professionals, the global mental health approach is a means of delivering care and support to communities without the need for complex resources, vast infrastructures or highly qualified personnel. Under this guise, mental health support is largely delivered by local people who, to put it quite simply, work with people not symptoms. In a word, it’s a very, very simple model of mental health care. And it works.

Psychiatry is, after all, a relatively straightforward science. It doesn’t take a master’s degree to recognise  when someone is severely depressed or saying bizarre things or taking an hour to leave their house because all the windows and doors need checking several dozen times. But supporting people through mental ill health can be anything but straightforward, and with qualified professionals and NHS facilities becoming ever more scarce, we now rely on police and prison officers, accident and emergency staff, housing support workers and (increasingly) friends and relatives to deal with our most needy and distressed people.

And while the poorest parts of the world begin to develop simple low-tech support systems that make optimal use of professional expertise combined with common-sense and the local knowledge of communities, the global mental health approach starts to look a lot like the sort of system that in many ways we in the UK are adopting by default.

We’ve written Introducing Mental Health twice, in both editions reflecting the many different scenarios and types of worker with whom we have worked in both clinical practice and training. We haven’t ignored the huge advances in the science of genetic and biological origins of mental illness, and have tried to make the science accessible to all. After all, there aren’t many people who would guess how much their Chinese takeaway has in common with the latest explanation of psychotic illness*. But above all we’ve strived to learn from Professor Patel and global mental health how this is above all a social issue, and how all of us have a part to play in helping our community’s most distressed and vulnerable people. It’s really surprisingly simple.

* Sorry. You’ll have to read the book to find the answer.

 

Caroline Kinsella has been a registered nurse since 1980 and has specialised in working with offenders and individuals with severe mental health problems. She has a Master’s degree in Forensic Mental Health from St Georges Hospital Medical School and is currently working with the Dorset Inreach Team as a mental health nurse assessing and care co-ordinating the needs of offenders in several Dorset prisons. Both Connor and Caroline live in Dorset, UK.
Connor Kinsella trained as a mental health nurse and has considerable experience of working with mentally ill people in both in-patient and community environments. Since 1998 he has designed and facilitated training for a wide range of services in health and social care. He writes a well-regarded blog called The Stuff of Social Care and has contributed to The Guardian’s Social Care Network.

To learn more about Introducing Mental Health click here.

 

Who takes care of the caregiver?

Shake up your view of your demanding and relentless work so that you can start to put yourself at the centre of your caregiving work. Cheryl Rezek, author of Mindfulness for Carers, has written an incredibly honest blog on why it’s important to say ‘no’, putting yourself first, and being mindful of your emotions as a carer.

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Taking care of someone else = neglecting to take care of yourself.  Does this ring true for you?  A carer or caregiver is often prone to using all their time, energy and resources giving the person or persons the attention and support that is needed.  However, the danger that can arise is that the caring is only working in one direction.

This blog isn’t about patting you on the back, telling you that you really ought to get some rest or saying what a great job you are doing.  You know all these things already.  You should be patting yourself on the back for all that you do as well as making sure that you get enough sleep and keep your stress levels down.  The chances are you don’t do any of those things or the rest of the long list that could be tagged onto that one.  This blog is about shaking up your view of your demanding and relentless work so that you can start to put yourself at the centre of your caregiving work.

Possibly one of the most difficult issues with being a caregiver is setting boundaries.  To do this can set in motion a whole range of emotions and fears – I’m being selfish; I don’t need help; what if something happens when I’m resting or out?; how will the person manage without me?  These responses are common and, at times, come about for good reason.  To say No to someone, in any form, may seem like a mean, uncaring or unrealistic thing to do but this is not always the case.  On occasions, the caregiver’s anxieties and fears are greater than those coming from the person being cared for.  We often don’t want to admit, or even acknowledge, that our anxiety may be what is driving us to be overstretched rather than only the needs or demands of the situation.  Perhaps there are occasions when you could go out or ask someone else to take your place for a short time but you may be reluctant to do this.  Why?  What is the concern behind this?  Do you think you’ll be criticised?  Have you lost touch with so many of your friends that you don’t actually have anyone to go out with?  Is it easier being the round-the-clock caregiver than having to deal with some other issue in your life?  Does your position give you power in the family or at work that isn’t allowed to be questioned?  Does your role give you a strong sense of identity that you may not otherwise feel?  As a professional, are you needing to present in a certain way to your colleagues or do you perhaps enjoy the energy and status that may accompany the demands of the job?  These are important questions to ask yourself as without some answers you will struggle to find a place for yourself.  With all the good that is done by being the generous and attentive caregiver, it can also work against you.

Most carers don’t set out to be in that role, unless by choosing a career in it.  The vast majority of family carers are doing it because of circumstance, often thrust upon them in some harsh way.  The choices here are dramatically reduced but, in spite of that, you still have a choice about how you take care of yourself as well as the other person.

There are evident differences between being a family caregiver and a professional person who is in a helping profession.  Family carers or foster carers feel an enormous responsibility for the wellbeing, comfort and survival of their relative or foster child.  Needless to say, professional caregivers such as nurses, doctors, social workers, therapists and health assistant also feel such a sense of responsibility but there is an inevitable difference as the family ties, bonds and history aren’t there, and while loss may be felt, sometimes deeply, it is not felt in the same way or with the same level of intensity.  Professional carers go home at the end of the day, or shift, and if they don’t they ought to.

It is important to also raise the issue of being a family carer for someone with whom one does not have a good or loving relationship.  This situation is more common than most people would like to admit but the other person’s vulnerability makes it very difficult to say no or to set limits.  Caring out of a sense of duty or obligation can lead to resentment and distress.

Caregivers come in many shapes and forms and people are in those roles for as many different reasons – a parent to a sick or disabled child, a special education teacher, a hospice worker, an adult child of elderly or ill parents, a partner of chronically ill or terminal husband or wife, a young child of an ill parent, a foster carer, a medical doctor, a community nurse, a health assistant in a mental health unit, a social worker, a carer of younger siblings.  The list is endless but the demands and stress frequently similar.

The big question is how you take care of yourself and if you don’t, why not?  Burnout and fatigue can lead to physical and mental health issues.  These are damaging and you then run the risk of making mistakes, becoming unwell and, at worst, needing to be taken care of yourself.

Mindfulness is a gentle, accessible and nourishing way of reducing caregiver’s stress and increasing their wellbeing and attention.  Research has also shown how those being cared for by people using mindfulness benefit from their carers being more present and open to them.

We are human and no matter how resilient we believe we are, how physically strong we show ourselves to be or how psychologically grounded we say we are, we are still human and being human implies that we have thresholds of tolerance.  It’s not about breaking or collapsing in a heap but far more about recognising that as a caregiver you need to take care of yourself as well as the other person.

Dr Cheryl Rezek is a consultant clinical psychologist and mindfulness teacher who brings a fresh and novel approach to how mindfulness and psychological concepts can be integrated into everyone’s life as a way of managing it in the most helpful way.  She has a longstanding clinical and academic career as well as runs workshops and authors books.  You can find out more about Mindfulness for Carers, read reviews or order your copy here.

 

Helping traumatised children let go of control

9781849057608 (1)In this extract from Helping Children Affected by Parental Substance Abuse, author Tonia Caselman talks about the importance of giving children and young adults a safe space where they can let go of control and shed their feelings of responsibility. Following an in-depth exploration of how victims of parental substance abuse feel about control and responsibility, you’ll find two activities that will help you carry out direct work on an individual and group level.

Read the extract now

 

You can find out more about the book, read reviews and order your copy here.