Tag: mental health

Review – The CBT Toolbox

Posted October 28, 2020 by Nicky in Reviews / 0 Comments

Cover of The CBT ToolboxThe CBT Toolbox, Jeremy Crown

A friend who knows I studied a little bit of the science around mental health, and am also currently seeing a therapist for CBT, asked whether I thought this book would work as a self-guided treatment. It’s available cheap on Kindle, and free on Kindle Unlimited, so it’d be kind of nice to think it’s an easy answer.

Well, I’m not discounting the power of a good book, ever, but I don’t think it’s likely to ever be a very good idea to try to do CBT on yourself. A therapist can slice through a whole crowd of issues to pick out the one which sounds important right now; you’re the one stuck in your head with the dizzing number of possibilities. If you know yourself really, really well, then maybe you can pick out the right thing… but even then, it can be hard to take things seriously, and give things a proper try, without someone to report back to. It can be hard to see your progress without having someone to help you see it, even if you self-administer the GAD7 or the PHQ9 or whatever other diagnostic.

And this particular book… no, it’s not a replacement for CBT. It can help introduce you to some of the ideas, but mostly it explains what a therapist will focus on, and a really high-level version of what they might choose to work on. My “deferred worry” system isn’t mentioned, for instance, even though it’s what my therapist identified as the most likely thing to help me. (Not sure. Maybe it is helping.) It has a worksheet for each type of problem that it mentions, but I don’t think it is (or could be) a replacement for the expertise of someone who has treated all kinds of people in their practice, and who can hone things down to what you need.

It would be a good one to read if you’re feeling a little sceptical about CBT and what it might offer; I still wouldn’t turn down CBT based on how you feel about it after reading this book, but it gives you a bit of a frame of reference for what CBT can be used for, and how broadly efficacious it is considered to be. So, it’s of use, but not a treatment plan unto itself.

Rating: 3/5

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Review – Come Tumbling Down

Posted January 23, 2020 by Nicky in Reviews / 5 Comments

Cover of Come Tumbling Down by Seanan McGuireCome Tumbling Down, Seanan McGuire

Received to review via Netgalley

Come Tumbling Down is the latest installment in the Wayward Children series, and really does not make sense as a starting point. Weā€™re thrown into it as a girl nobody knows comes through Jack and Jillā€™s door, carrying the unconscious body ofā€¦ Jill? And naturally thereā€™s a whole new quest, despite all the rules.

Iā€™ll admit to racing through this and definitely not lingering on anything. Jack is too close to home, with her serious OCD; I remember exactly what itā€™s like to worry that every inch of the skin of the body youā€™re in could be making you die any minute now. I also donā€™t enjoy the bits where sheā€™s actually losing her entire mind as a result of the intensity of her OCD. I think Iā€™m too close to it to fairly judge whether Jackā€™s behaviour seems right, but it didnā€™t feel right to me, at least not towards the end.

(Yes, I’m aware that Seanan McGuire is #ownvoices when it comes to OCD.)

I also wondered if it was intentional that everything the characters do actually enables Jackā€™s OCD, because I get the feeling it is intended to be read as supportive. And maybe it is, for someone with a very different view of OCD than I have, I’ll acknowledge that: I know that coming back from those compulsive behaviours is really hard, and some people don’t want to (and/or do not believe it is possible). But knowing how I came back from it, I can’t stand the way everyone enables it in this book, because I know that when I was in that position, people kindly caving to my compulsions made them worse.

For me, it really isnā€™t the epitome of love to create a map of someoneā€™s freckles to show them that none of them are cancerous and help them monitor it obsessively ā€” I can see that itā€™s actively making that person sicker. Itā€™s not a matter of ā€œwear gloves and youā€™ll be fineā€; the gloves do not help, there’ll just be another step after the gloves (refusing to touch anything at all, perhaps). I remember my loved ones being torn between reassuring me and knowing they shouldnā€™t; itā€™s not an easy thing to do. But in my experience, OCD isnā€™t some kind of lifelong thing you just have to live with. There is treatment, you can stop being afraid. Itā€™s rough, but it can be done, and the longer you delay doing it and engage in the reassurance behaviour, the harder it is. So it was pretty fraught reading all these things the characters do for Jack which seem kind and (for a real person) would probably just push her further into paranoia. Maybe Seanan McGuire experiences it a different way, but from my own perspective and a clinical understanding of OCD, I just cannot enjoy this the way I suspect it is meant to be enjoyed.

Also, I just really want to see Kade get a story for himself. Not somebody elseā€™s quest, not somebody elseā€™s happy ending. Heā€™s enabled almost every other characterā€™s story so far, without being given the chance to grow and find his own place for himself.

Reading this, I did enjoy it a lot, but the more I think about it, the less I do. Thereā€™s all kinds of interesting stuff going on with the balance of Jackā€™s world and meta-fictional stuff about stories, butā€¦ for me, this one was overshadowed by Jackā€™s OCD. And yeah, thatā€™s probably a very personal thing, but thatā€™s allowed.

Edit: Some sections of this review have been changed to make it clearer that I understand that Seanan McGuire is #ownvoices and has a different outlook on it than me.

Rating: 2/5

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Turn around: Ursula Le Guin’s words of wisdom

Posted January 24, 2018 by Nicky in General / 2 Comments

I first readĀ A Wizard of Earthsea when I was eleven, I think, or around that age. I loved it from the start. I didn’t love the later books as much then as I do now, because I had to grow up a little to understand them — sometimes I wonder if I’ll ever be grown up enough to understand everything Ursula Le Guin had to say to me.

It’s one AM, and I heard two hours ago that she’s gone, and though I’m sad, all I can think about is the enormous gifts she gave the world, and one gift she gave me in particular. Not that she ever knew I existed, not that she was writing with me in mind… But nonetheless, it was a gift, and it saved my life.

I don’t mean that it pulled me out of the way of an oncoming lorry or cured me from some terrible cancer or persuaded me to turn back from a clifftop. And it wasn’t given for free: it was hard, and I had to work at it, and still do. But she showed me how to get my life back, with the power and wisdom of her fiction.

IĀ was pretty sick. I was afraid of everything. I was afraid of dying, and I was afraid of living, and I was afraid of everything in between. I tried to run away from anything that scared me: I was scared of cancer, so I wouldn’t read anything where a character had cancer. I was scared of bugs, so I wouldn’t read anything with bugs in it, even sometimes quite throwaway references. I was scared to tears one winter hearing a line from Simon & Garfunkel: “Silence like a cancer grows…” And I didn’t want it to be me — I didn’t want to be afraid, I didn’t want to deal with it, I saw myself as something helpless, something being pursued. It was from outside me and nothing could keep it out.

And I happened to pick up a book I loved, for comfort, and found a character who was scared just like me. A character who was running away from what scared him — running away from the fear itself, letting the fear drive him… until he came to his friend, his teacher, a man who knew how hard the lesson was but told him what he had to do.

ā€œIf you go ahead, if you keep running, wherever you run you will meet danger and evil, for it drives you, it chooses the way you go. You must choose. You must seek what seeks you. You must hunt the hunter.ā€

I haven’t always been able to follow Ogion’s advice. Sometimes I hesitate and draw back. But it’s entirely true: if you run from anxiety, it comes after you. If you won’t acknowledge that fear is a part of you that deserves to be recognised, it swallows you whole. If you turn and face it… Ged triumphs because he turns to the Shadow and names it with his own name, tells it that they are one and the same.

My fear and I, we’re one and the same. It’s a part of me, and the more I deny it — the more I run from it — the stronger it grows. But like Ged, in turning to face it, I’ve found my strength.

I don’t imagine that Le Guin wasĀ unafraid of death, but she acknowledged her fears and saw them clearly, and they had no dominion.

For a word to be spoken, there must be silence. Before, and after.

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What Should Diversity Mean?

Posted September 14, 2015 by Nicky in General / 37 Comments

Last weekend, I was following posts and tweets about Maggie Stiefvater (a white writer) being on a panel called “Writing the Other”. You can get some background here, but it’s not necessary for my post. The gist of many of the posts was that Stiefvater, a white writer, had no place on such a panel. There is a certain argument for that — that whatever else she is, Stiefvater still has a certain amount of privilege that means her voice doesn’t need promoting as much. And her definition of “Other” was fairly loose and included “writing about places you haven’t visited” and examples like that, which is not usually what we mean when we’re talking about “the Other”.

To pause and briefly define terms, when we’re talking about “Otherness”, it’s usually (in my understanding) about other identities, rather than other experiences. So gay people, people of colour, people with disabilities, Jewish people —Ā groups of people who are “Othered”, who are treated as a distinct group with common traits.

But I did like something Stiefvater said in her original post, which I’ll quote here:

I assumed I was asked to be on the panel because Iā€™m write [sic] about magic and mental illness, and magic that sometimes is a metaphor for mental illness. As someone who is tired of seeing OCD and suicide treated flippantly in novels, Iā€™m looking forward to talking about how Iā€™d like to see writers who donā€™t have personal experience with those things tackle them respectfully without making the story an Issues story.

To me, thisĀ definitely has a place on a diversity panel. I can tell you that as someone with an anxiety disorder, I’veĀ definitely been Othered. Even just as a Welsh person, I’ve had experiences that sometimes echo those of people of colour — for instance, when I read Catrin Collier’s introduction to Margiad Evans’ book,Ā Country Dance:

I grew up in Wales in the 1950s and 60s, yet [Margiad Evans’] work was never mentioned at my school or local library. Whenever I asked the eternal question ‘What should I read next?’ I was directed towards Russian, English, American, German and French novelists. I discovered a few — a precious few — Welsh authors for myself, which only added weight to my teachers’s pronouncement that ‘people like you (translate as South Wales valley born) don’t write’.

Sound at all familiar? It did to me — both from the experiences of post-colonial people (which arguably, includes the Welsh) and from my own experiences. I didn’t know thereĀ was any Welsh literature. Raised in England, I was vaguely under the impression that writing was not a thing Welsh people did, that we didn’t have a written culture. Or not one worth exploring, at any rate.

Imagine my surprise at university, at the age of 21, when I signed up for a ‘Welsh Fiction in English’ class, and discovered a whole world of Welsh writing!

So what should diversity mean? The assumption seemed to be that Maggie Stiefvater could not be Other, could not represent diversity, because she’s visibly white.

Diversity should mean we remember to look for the invisible stuff, too. The very fact that people immediately assumed that Stiefvater couldn’t be Other is a little worrying — there are invisible illnesses and disabilities, there are people who aren’t out, there are people whose racial/cultural background isn’t obvious. Diversity panelsĀ obviously shouldn’t be made up solely of white people, but let’s make an effort to think about the non-obvious forms of diversity, too. Just because you can look at someone and see white skin, a majority culture and a boyfriend, that doesn’t mean they don’t know anything about diversity.

I haven’t read any of Stiefvater’s work yet, nor do I know anything about her mental health; the fact that she wanted to talk about it, though — and that the person who criticised her involvement in a panel didn’t even seem to consider that angle — struck a chord.Ā If Stiefvater has things to say about OCD and suicide from personal experience, then we need to make space for that. If not in a panel about ‘Writing the Other’, then where? What is more Other than a group of people who’ve beenĀ literally demonised throughout history?

Now, if there’s a panel made up entirely of white people, we should definitely criticise it. And we should criticise any sign of homogeneity in such panels, if we end up at a point where a panel is all white gay men, or all white women with mental illnesses. But perhaps not by targeting an individual and saying, essentially,Ā ‘you have no right to talk about being Other‘. Maybe, instead, we could ask, ‘Why do you feel you’re qualified to talk about being Other? What do you bring to the table?’ Let’s make a space for people to say, “I have an anxiety disorder, and I wanted to talk about how ‘crazy’ people are represented in fiction.” Or, “Well, I’m a woman dating a guy, but I’m actually bisexual and I’d like to talk about bi-erasure and problems specific to bisexual people.”

And if the answer is, “Well, actually, I’m not from a minority group at all, but I have thoughts about how they should be portrayed in fiction,”Ā then we can say, “Maybe you should step down from the panel in favour of people who’ve lived those experiences.”

Mind you, I don’t know if that’ll work, because some people will always think they have something worthwhile to say, whether they do or not. Some people will always privilege their voices above others. But I’d like it if people would just stop to think about what diversityĀ really looks like — whether itĀ looks like anything at all, or whether we need to hold back on some of our assumptions.

Maybe it does need to look diverse. I just read Justina Ireland‘s post about diversity panels, and the fact that her experiences show that having a person of colour on the panel — just one! — already means a lot to other people of colour. Maybe we need to make sure that the people we have to speak on diversity panels are not just diverse, but intersectionally so. Black and mentally ill. Gay and Jewish. Genderqueer and Islamic.

For damn sure, diversity panels right now are sending a message, and it’s not the right one.

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Review – Rewire Your Anxious Brain

Posted September 23, 2014 by in Reviews / 0 Comments

Cover of Rewire Your Anxious BrainRewire Your Anxious Brain,Ā Catherine M. Pittman, Elizabeth M. Karle

Received to review via Netgalley.

I didn’t read this from cover to cover, as I’ve read other books like it before. My main interest was in seeing how solid the scientific basis of this is — one of the authors has a PhD, but I could have a PhD in literature, which would by no means qualify me to speak on neuroscience — and how helpful I thought it might be for other people who end up in the same position I’ve been in. The good news is, from my knowledge of science and my intimate knowledge of anxiety disorders, there’s a lot here that’s useful. It doesn’t just focus on targeting the conscious part of anxiety generated by the cortex — which people often try to target on its own, with CBT — but also acknowledges the contribution of the amygdala.

Generally, it seems a sympathetic and credible book that someone with curiosity and determination could work through to help cope with anxiety, whether it’s a full blown disorder or just something that crops up more often than you’d like. It’s not an exhaustive reference book of information mentioning every single disorder, every single type of medication, but it is somewhere to start. And it quite rightly encourages the reader to get the help of medical professionals, and it doesn’t dismiss the uses of medication.

Rating:Ā 4/5

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Review – Brain on Fire

Posted August 4, 2014 by Nicky in Reviews / 0 Comments

Cover of Brain on Fire by Susannah CahalanBrain on Fire, Susannah Cahalan

I didn’t expect to connect so personally with this. On the surface, there’s not much to compare between me and Susannah Cahalan. There are a few correspondences: the start of her illness was marked with an intense fear, almost a belief, that she’d been infested by bedbugs; so was mine. On the other hand, I “just” had GAD: Susannah Cahalan had an autoimmune disorder in which her own immune system was attacking her brain. (She does mention some speculation that obsessive-compulsive behaviours and other psychiatric issues may actually be attributable to inflammation of the brain similar to what she experienced. The more I think about that, the more I want to become a doctor, maybe work in psychiatry, or maybe neurology, and push that research further. And research into epigenetic aspects of mental illness. Or at least get to the point where I can understand all of the existing research.)

(And sotto voce, I can almost hear my mother’s comment: “Well, you should be a doctor.”)

Anyway, despite the vast differences in the actual content of our diseases, I shared some of Cahalan’s feelings about it. I felt like I lost part of myself, the steady logical voice that refutes the brain’s wilder ideas about what’s going on, and though Susannah lost a lot more than that, I know something about the struggle to regain your own mind. I think people often believe that my anxiety was just an emotion like all my others. It wasn’t, though. It felt stronger than anything else, stronger than me. It felt like something from outside of me, subjugating the real me. It was like having another person physically holding me back, sometimes. The sheer courage it took me to step outside the front door, sometimes — it felt impossible, alien.

So I shared with Cahalan some of the feelings of getting my old self back. Self-hate at the things that still aren’t going right. Worry about what people will think of you. Celebration of tiny steps at the same time as feeling they’re not enough, you’re not there yet. Wonder at how far you’ve come. Worry that you’ll relapse. I very directly share that fear Cahalan feels when she thinks she sees a bug or something. My brain conjured ’em where there weren’t any, too.

I was expecting to find this interesting because of the medical content. That is interesting, though because it’s from Cahalan’s point of view, it’s more of a layman’s understanding of the disease, a memoir of dealing with it. I found it unexpectedly much more compelling than that, because Susannah Cahalan lost and regained her identity, and therefore has a lot to say about the whole idea of identity, and maybe some things to teach neuroscience, maybe even psychiatry.

The financial cost of treating a patient with Cahalan’s disease is staggering, eye-watering, jaw-dropping — there aren’t enough adjectives. But to bring someone back from that state, that’s beyond price.

Rating: 5/5

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Review – Panic Attacks

Posted July 27, 2014 by Nicky in Reviews / 1 Comment

Cover of Panic Attacks, by Christine InghamPanic Attacks, Christine Ingham

I never actually finished reading this, because by the time I was halfway through, I was actually getting better. I’m returning it to the library now because I think it may be useful for other people, and right now, I don’t need it.

That said, I did find a lot of comfort from reading Ingham’s assurances that you can get better, and will gladly add my voice to that. The prognosis for someone with panic attacks improves if you know from the start that you can get better, and I’m here to assure you that you can. As my counsellor pointed out, I may always be an anxious person, and that means I have to work a little harder, but it’s possible. See also my Mental Health Awareness Month post for more about my personal journey.

The book itself is easy to read and encouraging, without minimising the fear you may feel if you have panic attacks. I had quite a few pages bookmarked in the half that I read. But really, like I already said, I think the most important thing was that it told me I could get better, when I wasn’t hearing that from a lot of people. And it told me I wasn’t alone.

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Mental Health Awareness Month: Generalised Anxiety Disorder and Me

Posted June 30, 2014 by Nicky in General / 10 Comments

There have been some great posts over at Uncorked Thoughts on Mental Health Awareness Month. Reading Leah’s post about her anxiety made me want to put together something about mine, because it’s important, and because people like me so often feel alone. It takes over and makes everything ten times harder.

If you’re not in a great place yourself right now, read this with caution. There’s a lot of health detail. If you’re just here for the books, feel free to skip this!

Read More

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If you can afford this, you can afford that

Posted April 2, 2014 by Nicky in General / 10 Comments

So today Chuck Wendig posted a thing about piracy and why he won’t put out a tip jar, which I’m not interested in arguing with. What I am interested in arguing with is this whole idea in the comments that if you’re reading ebooks, you must have an ereader, therefore you must be able to afford ebooks. Which is complete crap, guys, I can’t even tell you. Here’s some examples of what’s been said — it’s been said in public, so I think it’s fair to copy/paste:

My thoughts on the ā€œbut I canā€™t afford it!ā€ argument are thus –

1. You canā€™t afford a $5 e-book, but you can afford monthly internet? My internet bill (whether via my computer line or smart phone) is roughly thirty times my cost for an average e-book. Granted, thatā€™s an average. I buy a lot of low-cost author-pubbed items at 99c to level out the $6-10 fare. Still, internet costs a lot more than an e-book.
2. You canā€™t afford a $5 e-book, but you can afford something to read that it on? Whether itā€™s a computer, smart phone, tablet, or e-reader, these things out-cost the average e-book by at least 5 times if not more. Yes, the e-reader, etc, could be a gift, but seriously? If I was so broke I couldnā€™t afford a $5 e-book (or the internet service to download it), then getting an e-reader is pretty crappy and mean-spirited unless they were showering me with gift cards throughout the year. Itā€™s like buying someone a saddle when they canā€™t afford the pony.

And:

So waitā€¦. this guy ā€˜canā€™t affordā€™ to buy all the ebooks he wants (I know that feeling ā€“ I canā€™t afford to buy all the designer dresses I want eitherā€¦ so sadā€¦) but he CAN afford to have bought whatever ebook reader-thingy he reads his pirated books on? Strange, I thought compared to ebooks those things were WAY more expensiveā€¦ I had to save up for three years to get mineā€¦

So yeah, the first quote is roughly correct, even given my Ā£25 ereader: let’s say an average retail ebook is Ā£5, going by, say, Angry Robot (who publish, among many others, Chuck Wendig). That comes out about right: my reader cost five times the book. But it’s a window to many, many more books, including free books from a range of sources (Project Gutenberg, Smashwords, my local library, Baen, Netgalley, Edelweiss, publishers, authors) and cheap books. It’s easily worth it.

What really gets me is the sniffy judgement going on here. “You don’t spend your money the way I approve of, how dare you pay for internet and an ereader instead of books” — in fact, phrased like that, it’s downright snobbish. I get that it’s not fair authors aren’t getting paid, and some authors and series have suffered from it. But you don’t know what’s going on in someone’s life.

Like hey, let me paint you a picture: me, a year ago. I live with my grandmother; my mother pays her some rent for me. I had no job, and I didn’t go on benefits, so I lived entirely on the kindness of my family. Depressing enough to start with, right? And then there was my grandfather’s death, and my spiral into depression and anxiety that had been going on and getting worse since my second year of university. Guess what I clung onto when I was too depressed and scared to get out of bed?

Yup. Since you’re reading this blog, I’m gonna assume you’ve figured it out: books, and the internet.* I was too damn scared to leave the house some days. Going to the library where there were people, and germs, and possibly the need to communicate with people I don’t know — gah. Buying books in a store? Well, like I said, any money I had was my mother’s. So my ereader was a lifeline, and my grandmother paid for the internet, so it was easy enough to download books from Netgalley, the library, etc, etc.

Those are not the only reasons that scraping together Ā£25 for an ereader instead of five books (or rather, three, given UK pricing for dead tree books, or less than five trips to my nearest library last year) might be more cost effective for someone. You just don’t know. So please stop making these assumptions and trying to police how people spend their money, and go back to making the very fair argument that authors deserve to be paid.

(Not to mention the sensible point someone else is making that you don’t need a dedicated ereader to read ebooks. Your most basic smartphone can do it, your computer can do it, my five year old iPod can do it…)

ETA: Since I’ve been accused of piracy/theft in the comments, I will just point out that every method of obtaining books mentioned in this post is both legal and moral. It’s not an argument for piracy, it’s an argument for getting your nose the fuck out of other people’s financial decisions.

 

*Me: Here’s a thing. Imagine the prospect of me without an ereader, especially during the worst times in the last two years. Is there a quotable quote of your reaction to that idea?
Partner: A damn wreck? You’d have been a wreck going in circles, driving yourself insane.
(Pretty fair assessment.)

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