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Autumn 2012 / ISSUE 46

>> Hooked into Consmption >> Urban Harvest >> Confined Spaces >> Claralympics!! >> The Most Savage Insult


Equilibrium Patron Dr Liz Miller Mind Champion 2008

Front cover image of

the team
Facilitator: Kate Chase. Editorial team: Dev Chatterjea, Angela, Pumla Kisosonkole, Ian Stewart, Meg Kelly. Graphic designer: Anthony Park.

Equilibrium is produced by service users. Reproduction in whole or in part is strictly forbidden without the prior permission of the Equilibrium team. Products, articles and services advertised in this publication do not necessarily carry the endorsement of Equilibrium or any of our partners. Equilibrium is published and circulated electronically four times a year to a database of subscribers; if you do not wish to receive Equilibrium or have received it by mistake, please email unsubscribe to

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After 7 years as facilitator of Equilibrium I am moving on in a few weeks. As a team we have managed to move Equilibrium from a 4 page newssheet to a longer paper based version and then (as now) eggless confection with fruit and flakes thanks Gavin!) , picnics in the park and the Claralympics (qv), Marco Lanzarote, Nigel Prestatyn and Olive, Ants super skills in all things designy and his absolute faith in organic management, the indoor sparkler event, sitting on important chairs in the training room, chats about everything from vitamin D to the Ugandan royal family, Gavins total faith in our abilities, and the collective effort to try and make a difference. I slope off now down the road in N8 and hand over to Kate who Im sure will bring Equi out of the to a limitless electronic space corralled into online magazine format as well as being on our blog: www.equilriummag. We have embraced Twitter too and tried to broaden our readership. What will I miss? Countless things the chat, the winter sing-alongs (Mamma Mia Mamma Mia) with Marcias fab harmonies uh huh, the mice in St Anns, countless cakes (latest being a fab digital shadows. I will continue to try and keep wellbeing on the map and keep up my obsession with trying to improve the lives of those with some form of distress. As recovery is more prevalent in the developing world than in the UK, and in lots of ways the treatments on offer vary little from how they were 60 years ago (ECT, strong drugs etc), theres so much room for change. I will still contribute and really look forward to each fresh issue of Equilibrium.

Clarification: Article on Stuart Low Trust Philosophy Group in issue 44 of Equilibrium was written by Rachel Paine and Harry Adamson.


Meg Kelly

Hooked into Consumption

regularly uses the internet are ensnared in powerful patterns of addiction which can come to govern our daily lives. He convincingly argues, for example, that it is no coincidence that iphone users are forced into OCD-type behaviour in order to keep their mobiles charged and updated with the latest software, nor that sugary cupcakes trigger similar biochemical responses to heroin. Unfortunately, Thompsons writing style is at The Fix: How Addiction is Invading Our Lives and Taking Over Your World, Damian Thompson (Collins, 2012, 18.99 hardback) The idea that products from cakes to internet sites are increasingly designed to be as addictive as possible is both chilling and entirely unsurprising. After all, there seems to be no limit to how low multinationals will stoop to mould us into ideal consumers, cut off from anything (social bonds, knowledge of the conditions in which these items are produced, a capacity both to fully inhabit the present moment and to see beyond it) which might hinder an unbridled gobbling of so-called goods and services. Any effort to make the inhabitants of economically rich countries more aware of this is to be applauded, even if, as in this case, the attempt borders on the slapdash. Thompson has some interesting points to make. His principal concern seems to be to highlight how many more people than we might imagine in fact, almost anyone who times irritatingly repetitive, as is his occasional tendency to make assertions rather than fully develop arguments backed up with evidence. To give one example, the statement that through our addictions to technology we are increasingly replacing people with things is repeatedly made, but not developed. This is a pity. Nevertheless, anyone reading this book may find themselves more aware and wary - of the ways in which we risk losing ourselves in a torrent of short-term desires, each demanding its own fix as soon as possible, or sooner. And this awareness might just result in our having more of a chance to pause before we reach for just one more piece of chocolate, or look at just one more website before we return to the non-virtual world. So its interesting how the insubstantial, slightly tantalising writing style of this book had me drawn hurriedly from one chapter to the next, barely leaving time for the arguments to be digested. After alll, publishers want us to consume, too.



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Fruit for free:

n a sunny Saturday afternoon in September, I biked down to Ally Pally to join Urban Harvests annual Red Berry Walk. With blackberry season almost over, you might have thought there would be little to pick unless (unlike me) you knew about hawthorns (native and exotic), sloe, crab apples, rosehips and quince! Before this walk, I would have been hard pressed to identify all of these, let alone know what to do with them. But during the hour or so I spent strolling round the park with a large and friendly group of foragers, I learnt enough to feel confident about foraging on my own afterwards. I learnt that whilst native hawthorn berries are small and mostly seed, their exotic cousins can be the size of small cherries and many grow as ornamental street trees. Sloe (which, confusingly, is the fruit of the blackthorn) turned out to resemble tiny purple

Urban Harvest Foraging Walk

Meg Kelly

plums though eating them raw is not recommended. They can be used to flavour vodka, or possibly salted like olives. My favourite find was the crab apples. It was a triumphant moment when, a few weeks later, I found myself at the bottom of Muswell Hill and peckish. Should I pop into the newsagents and buy a chocolate bar? But hadnt we found a crab apple tree round here during the foraging walk? I found the tree again, and its small sweet and sharp red fruit on their long stalks free, and healthy - kept me going until I arrived home for lunch. And I never even knew that crab apples were edible Urban Harvest is an informal group based in North London, holding regular foraging walks and foraging-themed meetings. For information about foraging, details of future events or to join the email list, visit


Green Minds

at Mind

in Haringey


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ind in Haringey have been running a gardening group at Station House on Stapleton Hall Road for

The group have transformed the land to the rear of Mind in Haringey to include a seating area where people can meet for coffee, have lunch and meet friends, creating a very sociable and welcoming environment. They have also created a sensory garden which is full of herbs and lavender which are regularly used by some of our therapy groups. Beyond this is a large area of working allotments which involved landscaping, planting of a variety of seasonal fruits and vegetables, herbs and flowers. The fruit and vegetables are dug up and used to provide a meal to the participants of the gardening group. The group is currently preparing the allotments for winter and have been planning on further developments to the garden. These include creating a natural meadow on the third tier of land which will include bird and bat boxes, bee hives and a pond. The group feels that this will maintain a natural balance with nature and attract wildlife into the area. The real success has come from providing the participants with a sense of achievement and ownership of something that they have helped to create. Our participants regularly express how much they enjoy attending the gardening group and how much better they have felt since being a part of it. To see a persons confidence grow through a sense of achievement really clarifies the importance of the project.

the past two years. The purpose of the group is to improve the well-being of people living with mental ill-health by being out in the garden growing fruit and vegetables. It has proven to be a very successful group and many of the members feel that it has had a positive impact on their mental health through the social interaction, feeling of ownership and sense of belonging. Mind in Haringey has created an educational, socia-

ble and fun environment which has reduced the feeling of isolation that many of the service users experience. One of the regular participants joined the group following severe bouts of depression and has stated that the gardening group has helped him cope with his mental illness. More recently, he has graduated from being a service user to becoming a volunteer and now assists with running the group and has been leading the planning process for the coming years project. The gardening group has given me grounding and a reason to be. I have regained my confidence and self-esteem with Mind in Haringeys help and could not hold them in higher regard.

If you would like further information about Mind in Haringey and the other activities we provide or would like to support the work we do, you can visit our website at, or our blog at


Considering performance, madness and psychiatry
Cambridge Sept 2012
This was a day of contrasts from the old fashioned retro medical model keynote speech from Kay Redfield Jamison (USA) to a one person installation come play come medical note that was Dylan Tighe (Antic imposition: Acting Mad(ness). Madness and theatre are high on my list of preoccupations and I was chuffed to see a whole two day conference jointly organized by lecturers from Cambridge and Exeter Unis First up the famous KRJamison who wrote The Unquiet Mind and grabbed a slice of public attention. As time has passed I have realized how faulty her thoughts on mental distress are she has had severe bipolar disorder for a long time and ascribes to the lithium/ECT school of treatment . Admittedly the fact that she has been suicidal and has been a counselor to the suicidal too may inform her affection for pharms, but her presentation stuck very closely to a very neuroscientific and non holistic script. Image of Dylan Tighe


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he is literary and artistic and speckled her talk with quotes from Robert Lowell Where youre going, Professor you wont need your Dante. (ie the nearest asylum). She also speckled it with words such as disease, biological, genetic, clinical, etc setting out her stall as a pretty medical one. She talked of heredity (the gene has never been found, and intergenerational heredity apart from new work on epigenetics is unproven. She brushed over the fact that a lot of her literary and artistic subjects may have been syphilitic (van Gogh etc) and was very keen to prove their bloodlines were full of inherited madness. She claimed that each psychotic episode would take a chink of the brain hmmm what about the harm done by drugs to the brain? She glossed over any evidence that suicidal ideation may be increased by some drug treatments and was hugely keen on the illness of the brain model. Other presentations included a look at drama within old asylums, annual shows, etc all seen by the presenter in a slightly distant and anthropological way. And a dramaturg from the Young Vic production of the Changeling spoke of how they rendered Middleton/Rowley for the 21st c. A woman from the US spoke of working within the Clubhouse system and running movement classes. They subverted (in a way) their drug regime by putting on a pageant wearing sashes marked Thorazine and Lithium Dylan Tighe a theatre practitioner in his 30s from Dublin presented a one man medley

of his medical notes, his theatre reviews, a Youtube vid of his play and his next album. Brave and very affecting. The best bits of any conference are the 0-60 conversations had in lobbies and on the way to meals. I bonded in seconds with a historian of the emotions (speciality: PTSD, flinching and mimicry) and a Professor of Medical Ethics with a love of theatre. The afternoon brought smaller group sessions great work being done in York with performers with distress and those without and audience assumptions. Two speech therapists working with children with a diagnosis of AHDD spoke of a drama intervention improving the kids lives, and a bunch of anthropologists explained how they had become healthcare assistants on a ward with Alzheimer patients and created a drama. I was not so sure of the ethics of this if the patients had not had Alzheimers and been able to express themselves more lucidly how would they feel? Felt knackered at the end and slipped back home but it had been a fabulous mix of angles, thoughts, emphases and ideas for the future. I now hope to be part of a special interest group on healthcare and theatre. As the conference organisers said: As the old asylums are being demolished, left derelict, or transformed into flats, and the survivors of the system pass away, it is vital that we document this vanishing theatrical past and chart its development in the contemporary psychiatric landscape. Polly Mortimer


Love in the asylum

Poem of the Issue: Dylan Thomas

A stranger has come To share my room in the house not right in the head, A girl as mad as birds Bolting the night of the door with her arm the plume. Strait in the mazed bed She deludes the heaven-proof house with entering clouds Yet she deludes with walking the nightmarish room, At large as the dead, Or rides the imagined oceans of the male wards. She has come possessed Who admits the delusive light through the bouncing wall, Possessed by the skies She sleeps in the narrow trough yet she walks in the dust Yet raves at her will On the madhouse boards worn thin by my walking tears. And taken by light in her arms at long and dear last I may without fail Suffer the first vision that set fire to the stars.


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2 Notes from
Marco Lanzarote
1) If you have ever been a smoker and wondered after you stopped how, or if, your lungs could return to normal function then the answer could be eat plenty of broccoli. Researchers at John Hopkins University in Baltimore, Maryland have found that apart from helping to prevent cancer, broccoli may also have beneficial effects on the lungs. The article in New Scientist (23.04.11) states that white blood cells called macrophages help clean the lungs and guard against infection. The chemical pathway that performs this task is wiped out by smoking. Sulphoraphane, a plant chemical that is made by broccoli and other cruciferous vegetables- can restore this pathway. So, give up smoking and eat plenty of broccoli. Mental ill health costs society 105 billion per yearI have always been clear that it should be treated as seriously as physical health problems. (Asylun News p11) The coalition, whose Care Services Minister Paul Burstow is advising that 400 ,million is being invested to make sure that talking therapies are available to all people of all ages who need them The article estimates that of the 6.1 million people with treatable anxiety or depression in England, only 131000(or 2.1%) received talking therapy. 2) A news article in Asylum magazine (autumn 2012) reports briefly on research published by the LSE on the millions of pounds wasted in the NHS due to the lack of proper mental health treatment, and suggests the appointment of a special cabinet minister to deal with the issue.


What we notice in the city 1

Polly Mortimer

Hats Off
Polly Mortimer

Hats off to the late Princess Alice, mother of Prince Philip. She managed to recover from harrowing war work in World War 1 on the front line, a diagnosis of paranoid schizophrenia, 2.5 yrs in an isolated German clinic, separation from her children and bravely she harboured an escaping Greek Jewish family in WW2 . On a routine journey back from the south Bank one night I found myself comparing

myself to Mayhew the great documenter and interviewer of 19 c Londoners. I sat mute, but with my eyes and ears the Friday night became more and more psychedelic. From girls spewing into binliners on the Embankment, I found myself next to a pinktrousered neer-do-well trying to interest mild Italian tourists in going to Camden to score some weed he was far from his missus and baby. Then when I reunited with my bike I passed some stranger sights too a man on a quad bike leering at schoolgirls at a busstop, a small woman scuttling into the bushes of a dark park and finally out of a side turning came a young woman wearing nothing but a hoodie, bra and thong nonchalantly and undistressed crossing the road to her flats.

And more hats off to Patrick Stewart the actor who fronted an extraordinary episode of Who do you think you are? He had suffered extremely as a child and adult from witnessing extreme domestic violence meted out on his mother by his father, returned from WW2. He pieced together his fathers war, spent at places where extreme events happened such as Arnhem. He then visited Combat Stress, the brilliant charity for those who declare with war trauma ( PTSD ) - thousands more never reach CS. Finally he could start to understand, but never condone, the rage and intolerable behavior of his father as rooted in his horrific experiences.


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Tree Fall

3 images of left-hand column: courtesy of Lucy Fisher


Paralympics - A Personal Experience

By Dev Chatterjea

s everyone knows, the Paralympics was an major success, and the high achievement of the athletes and

these athletes are the best in their fields. It would not be logical to assume that all people with various disabilities should be able to do such feats, and so should be judged by their own capabilities. As a lead up to the games we had a series of training events. Some of the training would last 9 hours or more. This is especially for the ceremony where we had to train for eight or nine hours straight for four days in a row. As a Games Maker an average day there would be two shifts in the morning, 6 am to 3.30pm and the evening shift would be from

people involved in the event i.e. all staff and volunteers (games makers and ceremony volunteers) is well known. To stage an event in such epic proportions was a major task. As you probably have guessed I participated as a volunteer in the opening ceremony and as a Games Maker. To participate in such an event was a major and enjoyable moment. Before I start talking about my experience there is one point that should mention. All


4pm to 12pm each day. I used to do the morning shift which meant leaving home at 4.45 am and reaching there by 6am, followed by a group meeting next to the Aquatics Centre at 6.30. During one of these meetings we would get to know whats going on for the day and end with doing the hoke cokey and the Mexican wave including an annual wave to the CCTV cameras. This may seem a strange thing to do but it was a way of getting us in the mood for the day. There was one occasion where I was asked to work at the world square. This area was known as the rush hour zone and aptly named the congestion zone. This is where all outdoor entertainment would occur. A standard morning would start with us in our allocated areas ready to start, some lively music. At this point we would have to direct large crowds, well over 30 people, to their destinations. This mad rush as one staff member put it would occur many times a day. During this time you would get some strange questions such as: Can my daughter throw fairy dust on the athletes? Which way is the main stadium? When they were looking straight at it. On a sobering note a young family came up to me and said they dreamed they would one day see something like this and they liked what we were doing. One day on the Main entrance at Stratford Gate which was where the mad

rush would happen. Working at the gates would mean standing for long periods of time. One morning at the Stratford Gate we were as usual scanning tickets, a group of ecstatic people all wearing clothes with the Union Jack flags, including wigs came through. As normal we scanned their tickets. Towards the end a couple came in wearing the flag clothes but the other way round. The man who was wearing the dress danced in screaming I am Miss UK. You could imagine our reaction to seeing this! A month before the Games Makers started work, we started the rehearsals for the opening ceremony. This was some feat because most of us had not performed on stage for years let alone on a global stage of more than a 2.5 billion people. The first two rehearsals started at a studio in west London were we got our accreditation, our roles in the ceremony and numbers. In my case I was a marshal. A marshal is one of a group of people who dance, guide and keep the athletes happy. On the face of it it seems very easy, but everything is done to the second and highly timed as well as lot of rehearsals. I would find this out when the rehearsals moved to a large warehouse in Daganham, on the outskirts of London. The day would start at 11pm with several bendy busses taking over 900 performers to a rather remote warehouse. This is where the hole rehearsals was done to scale and timing. We were put to our paces cont...


above images: Dev Chatterjea

such as entering the stadium in order, dancing on the spot and creating the shaad (the Paralympics flag). This was repeated over several times and each time faster. The day would end at 7pm and we would be sent to the stations by busses. This type of rehearsal would continue through the weekend and on to Monday in rather warm summer weather. Around five days before the start of the opening ceremony our rehearsal moved to the stadium. It wasnt until then that it occurred to myself and other performers how immense was the scale of what we were going to do. I remember walking on to the center of the stadium seeing all the props, the globe and the lighting men working on the set, and thinking to myself I am really doing this!

On the Sunday, which we called the test day, we had our dress rehearsals. This is where everyone involved in the show, from the performers, camera men, elections, flag bearers and us the marshals, came together to see how it would pan-out in full show mode. This is when we got our uniforms, those blue, yellow, orange coloured uniforms which was the same colour as the stage floor. Doing the full dress rehearsals made it more real. On the day of the of the Opening Ceremony (or aptly named Show day) everyone came in a good six hours before the start. As we were getting ready and doing a quick rehearsal I could sense the excitement of what was going to happen. There was also a mad rush to get our uniforms ready. Unfortunately the costume department had got all


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the marshals uniforms, but some were missing. Also, some were incredibly small and tight, and some were too big.

called out one by one, and each time we all got even more excited. Finally our turn came. One of the staff called

Around about 7pm the audience started to enter the stadium area. From our vantage point we could see a gigantic heard of people coming in from Stratford Gate. Rather than panic, which is a commonly known reaction, there was a rather overwhelming feeling of excitement and electricity in our ready area. As the show time got closer each group were

our groups name and the whole room burst into deafening scream with everyone including me screaming with excitement. Within seconds a staff member took us outside to the noisy thumping music coming from the stadium. As we waited marshals at the front started shouting this is it guys. And we walked on stage. The rest is history.

Owing to many factors one being that none of us are champion sportspeople and to the various reasons why that is age, ability, being hampered by various conditions and/or the drugs given for them, etc etc we decided to have our own Olympics in the park this summer. The Claralympics took place on an afternoon of mixed weather - in Priory Park, N8. Sadly Clare Balding was otherwise engaged but we managed to have a smashing picnic of artichoke tartlets, pistachios and fruit and started our games in earnest with no commentator but ourselves. For those who

were happier seated on the ground we had Throw the ball into the bag and How many pistachios can you peel in 1 minute. This last game was judged by our own personal Games Maker Lizzy (in uniform) who happened to be passing at the time and joined us. Then we segued onto the more challenging part of the games The Richard 3 Banana Race followed by Anarchist Rounders. Dev won the R3 race, and Anarchist Rounders is designed to have no winners. Based loosely on Monty Pythons Philosophers Football Match, there are no rules and everyone wins and loses. Posts are marked by apple juice cartons. There were no prizes but everyone had a laurel branch to put in their hair (like in Ancient Greece) and went home happy.
Pictured: official adjudicator of the global event that is the Claraympics.


Vitamin D
be too low. The surgery gave me a prescription to take and said that I had to get a vitamin D supplement over the counter. I bought a supplement which was 1000 iu which is 500% RDA ( Recommended Daily Allowance ). I was taking it every morning after breakfast. Then I noticed that I kept feeling hungry, so I cut it down to 2 times a week. I did not feel hungry anymore but I started to feel


recently had a general health check done in my GP surgery. A blood test was done and the result showed my vitamin D level to

It was the Vitamin D tablets. I spoke to my GP about it and she said it shouldnt do that and told me not to take it for the next 3 to 4 weeks. I was feeling very bad so I had to book an appointment with the Consultant Psychiatrist. He said that the vitamin D tablet has reacted with one of the medications prescribed for mental health problems. So he gave me an increased dose of antidepressant to take if I feel I need it. While unwell I felt hungry and paranoid. For example I was crossing a high road and I got into my head that a car was


depressed with a capital D in the mornings. The mornings was like a nightmare . My radio clock alarm would go off at 7 oclock ands then I would keep pressing the snooze button until 11 clock. This happened every morning for 4 weeks.

going to crash into on purpose. I freaked out, ran straight into a young man coming towards me and grabbed his hands which were on his chest. I even feel scared when I hear my washing machine going into spin. This is a very unusual state of affairs. The GPs

I spoke to a nurse at St Anns Hospital and a centre officer at the Clarendon Day Centre and they both said what happened 4 weeks ago ? There was nothing I could think of, and then one day I spoke to somebody in the church about it and then the penny dropped.

said it shouldnt have happened to me so I have stopped taking them so dont worry ! This has happened to me personally. It does not mean you must stop taking vitamin D.


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Edward & the Day Care Centre

Nigel Prestatyn

s the brother of Edward who is too severely ill to be productive or constructive, particularly so in

date such individuals. Where they could listen to music, have lunch, tea and coffee, watch films, have entertainment put on, etc. In fact be offered some semblance of broader interaction, connection, and quality of life. But then would this laying on of special resources, (to use council lingo), be cost effective? Thats a question for the number crunchers.

a mental health day care centre setting, Ive often wondered if he might still benefit on some level from being in a more lively setting with other similar individuals - a setting beyond the dour confines his care home, and the same few familiar faces that frequent it. Mental health centres of yesteryear throw up images of individuals lounging around in smoke-thick rooms doing little to simulate image is outdated. Todays day care centres are places where individuals are expected to be productive and constructive; where theyre taught skills, provided with various types of training, helped to recover and move on, etc. And if they dont meet this criteria? well theyre unlikely be allowed to attend. From this transition from the old to new ways of running a mental health day care centre, individuals like Edward have been left out of the loop. a productive, worthwhile existence. But this

Likely, for the time being at least, Edwards daily life will be a little narrower in quality than I would like. Im also acutely aware of the great care and attention he receives at his present home. Those who run it do a tremendous job with extremely limited resources. Perhaps Edwards care home is a scaled-

Clearly most day care centres do not have the necessary resources to accommodate the severely ill like Edward. But Ive often wondered whether for one day of the week, at least special resources could be provided by day care centres which could accommo-

down version of a larger day care centre, with five members instead of fifty. Perhaps it does contain all of Edward needs. Perhaps Im in no position to judge And perhaps only Edward can know for sure what his needs are... and what they arent. But will he tell us...?



CoolTan Arts: Largactyl Shuffle

CoolTan Arts Celebrates World Mental Health Day and raises more than 5,000 on a Sponsored Walk for its workshops for people with Mental distress

n Saturday 13th October, a beautiful sunny autumn day, over 60 CoolTan Arts

CoolTan Arts is a Southwark based charity run by and for people with mental distress and exists to inspire the wellbeing and creative participation of a diverse range of people through the production of quality art. On the 4.8 mile journey walkers were led on a route through the pretty back streets of Southwark, with stops on the way for talks and art-making, entirely planned by CoolTan Arts volunteers. The walk included a stop to unveil

participants, volunteers, supporters and patrons gathered outside Maudsley Hospital to begin a sponsored walk to the Tate Modern. Our Largactyl Shuffle walk was organised to celebrate World Mental Health Day and explored the idea of BRANDED how labels and branding create stigma against those with mental distress. Cllr Abdul Mohamed Deputy Mayor of Southwark, Councillor Peter John, Leader of Southwark Council, and Cllr Veronica Ward joined us to open proceedings.

a dedicated plaque at the site of the CoolTan Arts sculptural bench, installed in the north east corner of Camberwell Green, SE5. Designed and made by Rossen Daskalov and

Photo credits: Jez C Self, Hannah Maule-finch, Eva Megias and Emma Thatcher


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CoolTan Arts participants, it is dedicated to the local community. Finishing with a reception at Tate Modern, walkers had the opportunity to see CoolTans first pop up exhibition for A Postcard to the World a mail-art project exploring feelings about the Olympics and Paralympics. The event culminated with poetry, music, homemade cakes and socialising.

Michelle Baharier, CEO of CoolTan Arts, said: Im delighted at the huge support weve had from CoolTan participants, volunteers and all who joined us on this important walk, in celebration of World Mental Health Day and to destigmatise mental health we hope the final amount raised will surpass the total raised in 2011! A total (so far) of 5,130.00 was

Present at the reception were Simon Hughes MP, Liberal Democrat MP for Bermondsey and Old Southwark and Cllr Althea Smith, Mayor of Southwark, alongside local residents, walkers and other guests and visitors.

raised by charity staff, volunteers, participants and supporters which will allow creative arts workshops, walks and self-advocacy training to continue.

You can still donate to the CoolTan walkers by visiting:


What we notice in the city 2: Slugs

Meg Kelly

Slugs are not this colour. Slugs are not silver but this one is, slithering over the paving stones by the sage, as if it had just slipped in under the gate not just silver, but with black leopard-like markings I am horrified, captivated, repulsed. Theres a blackbird flitting between branches in the apple tree. I will him to come here, come here and eat this slug I put my bike away, go into the house, begin to doubt what my own eyes have seen. Go out again no sign of the slug. Are those silvery trails, left on the stones?
Photo right: Polly, Royal London Photo: Anthony

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The Most Savage Insult

Language within mental health is more than just semantics, and this is most significant in the case of diagnostic categories like borderline personality disorder and its effect on those diagnosed. By Clare Shaw and Debra Shulkes. Copyright: Open MInd

here is a huge body of clinical literature on the description, diagnosis and treatment of borderline personality disorder

(BPD). Yet this literature pays scant attention to its lived impact. Beyond rightful concerns about the labels immense stigma, few examine the effect of branding someones personality the core of their being as disordered. It is now 22 years since the current National Director for Health and Criminal Justice, Louis Appleby, denounced personality disorder (PD) as an enduring pejorative judgement.(1) Others have highlighted the vulnerability of people with the label to severe mistreatment and the smearing of their characters across medical and legal settings. (2) Still, service user and survivor reports of ongoing discrimination and degrading treatment go unheeded.(3) Calls to expand the description and diagnostic criteria have resulted in increases in diagnosis rates, with one recent survey claiming that 72% of the British population had personality disturbances(4) [] Clearly, there is a desperate need to pay attention to the voices of people who are stuck with this label.
l intense

BPD the official explanation: The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) aligns personality disorders with enduring, inflexible, socially deviant styles of thought and behaviour. For a diagnosis of BPD, five of the following symptoms must be cited: interpersonal relationships instability l mood reactivity l cont...

l affective


The Most Savage Insult cont...

impulsive behaviours l inappropriate intense anger l frantic efforts to avoid abandonment
l unstable

Diagnosed disordered: our story A diagnosis of BPD destroys lives. We should know. BPD is our primary diagnosis. When we listen to the voices of those who have been diagnosed with BPD, there is no debate it is hurting people. Badly.

self-image l suicidal and self-muti-

lating behaviours l chronic feelings of emptiness l transient stress-related paranoid ideas It is often said that such vague and subjective criteria could apply to almost anyone; who is to decide when anger is inappropriate or intense? So what is wrong with it? several studies have criticised BPD diagnosis for numerous reasons(5): its lack of scientific reliability and validity; its biased construction, which pathologises the coping strategies and options of particular populations such as women; its alarmingly unequitable patterns of diagnosis 75% of those diagnosed are women at least 70% of whom were sexually abused as children. Many draw parallels with notorious past diagnoses such as hysteria its overwhelming stigma BPD is arguably one of the labels most feared by staff and patients, being associated with phrases like manipulative, attention-seeking, untreatable and untrustworthy, and a list of assumptions so derogatory it has been described as little more than a sophisticated insult; its use as a punitive dust-bin diagnosis for those judged to be bad patients because they are troublemakers or have failed to respond to treatment []

In many ways it is a relief to be diagnosed... At last you have it irrefutably confirmed that you are wrong and have always been wrong.

And it makes such sense you have nothing else to blame but yourself. (Clare Shaw) It became clear to me that th diagnosis had caused women more distress that whatever validity had taken them to services in the first place No other diagnosis smears the womans character, trustworthiness and validity of her distress as much as BPD does. (Louise Pembroke) Having the diagnosis of BPD has never been a positive experience, its always hung over my head like a a dark cloud. (Jo)


Summer/ Issue 38


Since it was introduced to the DSM in 1980,

Copyright: Open MInd Language within mental health is more than just semantics. Words like personality disorder can deform thought and practice. They position the diagnosed as other in her distress. They tell her that her very being is disordered. They obstruct recognition of the role of context. And they push our voices, opinions and experiences to the margins of society. Whether we maintain that all diagnosis is Our diagnosis confirmed and deepened the most negative messages we had been given throughout our lives. It meant that it was our fault that services had not been able to help us. It meant that our experiences of childhood trauma and violence were overlooked as marginal details. It meant that we were not going to get better there would always be something wrong with who we are. We live with the legacy of that message to this day. [If ]Id never come into contact with it and Getting rid of the label The diagnosis of BPD is causing extensive damage to the people it is supposed to help. It is leading to bad practice in services rather than meaningful support. It is therefore imperative that professionals, practitioners, activists and academics stop promoting this regressive and traumatising label and all others like it. someone had validated and helped and cared and loved instead of immersing me in this... I wouldnt have tried to kill myself the second time. Because thats what it did. If I had died, this would have been the cause as it escalated my suicidality into a realm previously unknown to me. It caused me to feel sub-human. Its lethal.(6) flawed, or whether we feel that alternative diagnoses such as Complex Post-Traumatic Stress Disorder offer more helpful, less devastating alternatives to BPD, we must listen to the voices of those subjected to these labels. We must accept the simple, incontrovertible reality that the words we use to describe ourselves and each other really do matter. Language can help. Or it can hurt. It can kill. Led by service users and survivors we must: undertake urgent research and monitoring of the human rights situation of people with the label; look for alternative ways of framing and explaining the distress which often leads to a BPD diagnosis, as well as ways of assisting those who have been injured by the label.

1 Lewis , G and Appleby, L (1988) Personality disorder: the patients psychiatrists dislike, The British Journal of Psychiatry, 153:44-49. 2 Becker, D (1997) Through the Looking Glass: Women and Borderline Personality Disorder, Westview Press; Kirk, S and Kutchins, H (1992) The Selling of DSM: The Rhetoric of Science in Psychiatry, Aldine De Gruyter. 3 Castillo, H (2003) A dangerous diagnosis, Mental Health Today, February. 4 Yang, M, Coid, J and Tyrer, P (2010) Personality pathology recorded by severity: national survey, The British Journal of Psychiatry, 197: 193-199. 5 See for example: Herman, J.L (1997) Trauma and Recovery: The Aftermath of Violence- from Domestic Abuse to Political Terror, Basic Books; Pilgrim, D (2005) Key Concepts in Mental Health, Sage; Wirth-Cauchon, J (2001) Women and Borderline Personality Disorder: Symptoms and Stories, Rutgers University Press; Castillo, H (2003). 6 Personal correspondence with a survivor of psychiatry from Ireland.