Hey Noble people! After a long absence I’m pleased to announce my piece for TheMighty ‘We need to talk about ableism in academia’ has just been released!
Please take a look and comment if you relate to these experiences!
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Author: Joel Bates
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Guest post at CentralBylines
‘Britain’s ongoing relationship with racism’.
The UK is in the midst of a huge wave of denial by its people and its government. The racial disparities and abuse faced by BAME individuals is a topic all too many would like to avoid. Unfortunately, others do not have the privilege of ignoring this issue as it will not ignore them.
Go to CentralBylines to read the full article.
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Guide to living alone
‘6 tips for Home Alone 5 – pandemic boogaloo’
Living alone can be the best and the worst thing. You’ve got time and freedom like never before, but living alone in a pandemic? That’s a whole new ballgame.
I’ve lived alone before but living alone during the pandemic was a real challenge. It was during this time I picked up some tips and tricks, or rather, realisations that have helped me enjoy my time alone.
Talking to yourself – it’s normal! – Many people associate talking to yourself with mental illness or the infamous ‘hearing voices’. However, in many cases talking to oneself is actually a healthy habit to get into.
One benefit of talking with yourself is that it can slow down your thinking, engaging linguistic brain areas and forcing yourself to process your thoughts differently. Hearing them aloud offers new possibilities in interpreting them and can prove useful for problem solving.
Not to mention, it can be nice just to have a little running monologue as things happen. Learning to make a joke out of something and learning to laugh with yourself are two skills that can really help during times of solitude. Common Cognitive Psychological approaches view our cognitions (our thoughts) as integral to the development of mental health conditions. With negative cognitions and interpretations forcing the individual onto a dark path.
So, try chatting with yourself, learn to enjoy the conversation.
Nobody wants to hear it but – eat well. – I know if you’re anything like me you have been bombarded with healthy eating slogans and marketing from primary school all through to adulthood. It’s tiring and can make us feel guilty for eating anything other than raw salads and purified water!
Just try to provide your body with the right nutrients. Try and get some leafy greens, low fat sources of protein, Vitamin C rich foods such as peppers and vitamin D rich foods such as mushrooms into your diet. Add a touch of spice and once bland vegetables become all the more exciting. If mental health is a concern try looking up the Mediterranean Diet – studies suggest this diet can reduce symptoms of low mood, and depression. It’s well worth a try!
Most of us struggle with what to make, bored of the 5 meals you know how to cook, it’s dinner time again. If this sounds familiar, try looking up vegan or vegetarian recipes. By necessity, these recipes have to be inventive to add flavours and textures you lose when removing the meat, and as such they offer a new world of possibilities for you to try. And there’s no reason you can’t add meat to it if that’s what you fancy!
Even better, dark chocolate and red wine have been shown to reduce chances of blood clots, something we’re more and more at risk of the longer we sit at home unmoving. So, crack open a bottle and enjoy, knowing you’re treating your body to what it deserves.
The kitchen is the heart of the home and food is a universal comfort blanket, so don’t forget to take a moment to purposefully enjoy what you’re eating.
Stay connected! – Abuse of Zoom is peak lockdown one behaviour, with people joining group calls to speak to people they wouldn’t normally have seen either way, even without a lockdown.
That aside, it’s still important to keep in contact with others if you’re living alone. Social contact and support offer numerous mental and physical benefits. Even if there’s nothing left to say, a chat here and there can go a long way in the isolation.
Another option open to you is hotlines. Now you may have your reservations about contacting a hotline, but ones such as the ‘SHOUT’ text line I volunteer for is open to everyone.
Avoid doom scrolling. – It’s easily done, you go onto your platform of choice – Twitter, Facebook, TikTok etc. – you read one post, then another and another! The next thing you know it’s 3am and you’re sat in the dark in your room shaking with terror at the sh*t show that is the world currently.
Sitting for hours looking at all the bad things in the world does nothing for the world, does nothing for you and doesn’t help you get through this tough time we’re all facing.
Find your muse. – Hobbies, particularly creative ones, give us the chance to stretch our creative minds and exercise our skills. Finding what’s right for you is down to you. Regardless of what you choose, hobbies provide psychological benefits that shouldn’t be ignored.
Additionally, the act of carrying out a hobby or interest alone like this teaches us how to be alone in a way unlike anything else. There’s no deadline, there’s no specific rules or demands that must be met. Many people, myself included, find cooking to be very therapeutic. Try not to see it as a chore but as an opportunity, a challenge, or a moment just for yourself to enjoy. Switch off your laptop and turn on some music, pour a glass of wine and get cooking. See it as a moment for creativity and experimentation, learning to appreciate the process can set you up to enjoying food more and feeling the sense of accomplishment when you create a culinary masterpiece.
Whatever you choose to do, enjoy your moment alone with your paintbrush, pencils, spatula, or saxophone!
Mindfulness. – You’ve probably heard a lot about mindfulness lately. Along with certain meditation and sleep apps there has been a real uptake in interest in such approaches to finding your zen space. There’s plenty to choose from and I’m not going to recommend any specific ones here, that is up to you! However, I do recommend looking into incorporating mindfulness principles into your daily life. Even better add meditation into your daily routine.
It’s worth a try and can really give you some peace of mind if you struggle with anxiety or low mood/depression.
So there you go, my tips and tricks for living alone. None alone are ground-breaking and none of them will suddenly alter your life, but each represent an opportunity to focus your time and energy on the positives in what can be a very drab and dull existence.
Good luck out there,
Joel x
‘Emotional support animals – the Uk’s outdated discriminatory legislation’
The UK is plagued with inequalities, one important area overlooked by our current legislation is that of Emotional Support Animals (ESA). Before we get into this, let’s answer the question, what’s the different between a support animal and a service animal?
Support animals Vs. service animals
In the UK there is a legislative disparity between ‘support’ and ‘service’ animals, but why?
The most well-known service animal is likely, the ‘guide dog’. These animals provide invaluable support for people with visual impairments in the form of a 24/7, non-judgemental, four-legged companion that allows them to reclaim their independence.
Because of the training guide dogs undergo for their role they are viewed under the category of ‘service animals’, and are permitted to enter shops, restaurants, rented accommodation etc. Yet animals, including guide dogs, also offer tangible psychological benefits.
The Psychological benefits guide dogs can elicit can be explained in terms of the confidence and freedom that they provide to their owners. Yet, there is also an inherent ability to for animals to soothe and comfort individuals in distress, making them the ideal companions for those struggling with mental or emotional difficulties.
These animals come under many names but are generally known as Emotional Support Animals (ESA). Countless research investigations have shown the positive effect of ESAs in depression, anxiety, and other mental health conditions. Yet, if you were to request permission to take an emotional support animal into your workplace or even your own rented accommodation you would almost certainly be refused entry.
Requesting an ESA at my university accommodation started off well with my landlord claiming they were ‘invested in the well-being of all tenants’ and recognised the tangible support ESAs offer. Yet within the same email my request was denied because legally they had no obligation to permit an ESA. Naturally, I questioned this decision. If they were so concerned with our well-being, why wait until they are legally obligated to allow an ESA when they could decide to allow them…
To this I was merely told ‘our position has not changed’.
This made me wonder, why is there such a distinction between animals that ultimately provide an improvement in people’s well-being? The answer, the UKs dodgy legislation…
Legislation
In the USA ESAs are recognised on similar, if not the same, level as service animals. Yet in the UK companies, landlords, and workplaces are more than free to turn disabled people with ESAs away if they wish to. The reason for this is…confusing.
The distinction between service animal and support animal is generally made on the basis of training. A guide dog is trained to provide support for people with visual impairments whereas emotional support animals – largely – undergo very little training.
The issue with this distinction is that it discriminates on the basis of needs. A guide dog acts as the eyes of an individual, which requires a great deal of training. The need of a person with emotional or mental health related difficulties arguably come much more naturally to these animals. A dog elicits a positive feeling in most people just by their very nature, they are of course known as ‘man/woman’s best friend’.
Yet because they are not trained for their role they are seen more as pets than as service animals in the UK. I take issue with this as the contribution of an ESA is not measurable in terms of training received and not comparable to those offered by a guide dog. These are distinctly different animal roles for distinctly different problems. The UKs inaction on this matter highlights its laissez-faire attitude to supporting those with mental illness and hidden disabilities.
Hidden disabilities
This oversight by UK legislation is a shining example of how hidden disabilities are not taken anywhere near as seriously as they should be. Change is long overdue yet when the issue is brought up it becomes a discussion of ‘whose disability is worse’.
Both experiences of people with physical and mental disabilities are deserving of respect and worthy of support. To compare them serves no purpose other than to juxtaposition one as lesser than the other. To denounce treatment options for one group because its method does not require training or tangible or physical benefits just as guide dogs do is absurd.
In the UK, if a person has a mental health condition for over a year it is classified as a disability. For anxiety you can be provided a Disabled Students Allowance (DSA). Yet, when it comes to support animals our legislation has absolutely no concern with the well-being missed out on by our out-of-date laws. Yet, it appears we are stuck in endless debate with the ill-informed, unwashed masses.
The ‘devil’s advocate’ people – what disability looks like
Many things we take for granted were once outlawed by outdated legislation. We look back and say ‘well that’s just how it was’. Yet when new changes are proposed they are almost always met with derision and criticism, regurgitating the line that if something is written into law then it must be morally and ethically correct.
With any proposed amendment of change to legislation there are always people happily playing devil’s advocate. The apparent need compare two different things on an axis that makes one appear absurd is tactic often used by traditionalists, ‘if we allow this, what will be next?’.
These people argue that ESAs are more like pets than service animals, and that the legal recognition for service animals should remain only for animals that support ‘truly’ disabled people. These are the same people that harass blue badge users for not ‘looking disabled enough’. These people feign concern for ‘truly’ disabled people to excuse their ill-informed policing of disabled people’s rights.
Despite only 8% of disabled people in the UK requiring a wheelchair, in the eyes of the devil’s advocate people, if you’re not in a wheelchair you’re not disabled. Through their outdated view of what disability looks like they see support options for non-wheelchair using disabled people not as levelling the playing field but as an unfair advantage. Such people have always been around, this does not mean we need to listen.
Closing thoughts
It’s time to listen to people who would benefit from this change in policy and work out a way for ESAs to be given the same rights as service animals and help defeat this mental health epidemic we face in the UK.
Have your say here: Make ESAs Legal UK.
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Guest post at CentralBylines
Got the exciting news that another article has been published over at CentralBylines.
The article takes a hard look at the UK governments excuses and dodgy dealings in the past twelve months.
CentralBylines is part of the UK Bylines network and are actively seeking stories on local events. Please contact me if you’d like to get involved. Suggestions, ideas, and stories welcome!
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Guest post at CentralBylines – pt 2
Over the moon with the response to part 1 over on CentralBylines social media!
By all means, go and enjoy part 2!
We’ve discussed the treatment options available to us through your GP or therapy, but what else is there to choose from?
There are some options remaining that you can look into from the comfort of your own home, though, I will state for the record. It is important to discuss any treatments you want to try with your GP. There are less regulations around these treatments so it’s important to look into their legitimacy, reviews and any potential risks.
Without further ado lets get into it
Herbal home remedies
Anxiety and depression can trigger dissociation, so it may be worth looking into some herbal or home remedies if pharmaceuticals aren’t your thing.
St Johns Wart, lavender roll-ons, aroma therapy are all options to help you destress and reduce the chances of being overwhelmed. Be sure to check in with a doctor if you are on any other medications and you should first discuss it with them before you start self medicating.
Another topical treatment is CBD. I won’t get into the details but CBD is being viewed as a very helpful drug with little to no risk. CBD is made from marijuana extract but without the chemical THC. This chemical THC is what makes you feel high, its psychedelic properties are what you often associated with weed. CBD however, will not get you high and is totally legal. What’s more, research from King’s College LDN has even shown it have preventative properties when it comes to psychosis and has been shown to aid depression, anxiety and insomnia. All of which can help reduce dissociation.
When shopping around be sure to check reviews and ensure you know what dosage you’re getting. Start small and build up. Also, ensure you check for any side effects with any medications you’re on. I’m currently of an antidepressant that interacts with CBD so that it becomes metabolized by the body in excess, resulting in an increase in my medication dosage. Which could risk overdose. So be sure to look into this if you’re on any meds!
Third wave therapies
Meditations, hypnosis and mindfulness can all help with anxiety symptoms and reduce your levels of stress. In particular, mindfulness has been touted as a particularly effective treatment for dissociation.
I’ve been told, dissociation is characterised by a disconnection with everything around you, while mindfulness is characterized by a deliberate awareness of everything around you. This cognitive opposition may explain why mindfulness is seen as an effective treatment for dissociation.
However, it is suggested to be most effective when added to your daily routine. The emphasis is on learning mindfulness and integrating this mindset into your everyday life. It is not a magic solution and cannot stop dissociation when it occurs but generally can limit the severity and length of dissociative episodes if adopted into your routine.
Hypnosis sessions can be useful if you suffer with insomnia. From personal experience I find myself more anxious and more likely to dissociate if I’m tired. So hypnosis for sleep can help reduce this!
Grounding ideas – for when it’s too late
Once you’re feeling dissociated, many of these techniques may not be much use to you. That is, other than mindfulness. Techniques such as mindfulness ground you in the present, in the environment and pull you out of the dissociative blur.
The best way to do this is to incorporate your senses. What can you see? Touch? Smell? Can you name 5 things you see?
Some particularly useful methods may include heat. A cold shower, splashing cold water over your face, or holding ice in your palms have been praised for their effectiveness.
Additionally, familiar smells may help. This may be sad to admit but I had a particular room spray in a period of my life I look back on fondly. The smell itself relaxes me. The same may be true for you!
Anything that gets you invested in the present can help you in your fight against dissociation.
Resources
There are an abundance of online resources for you to choose from. So please, take a look. These resources have helped me in my understanding and appreciation for my dissociative experiences.
Carolyn Spring’s blog: https://www.carolynspring.com/blog/
Grounding tools: https://www.psychologytools.com/resource/trauma-dissociation-and-grounding/
Youtube: Multiplicity&Me, DissociaDID
Mind resources: https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/self-care/
As we’ve seen, dissociation is highly complex and variable phenomenon. With it’s roots in our past experiences, influencing our present this hard to define disruption to our perception can be tricky to live with. But what treatment options are available to us?
Let’s take a look at the main treatments available, note treatments will vary depending on your location. This summary is based on those available in the UK.
Pharmaceutical treatments
Unfortunately there are no medications that can fix or reduce dissociation directly. Dissociation exists in a relative blind spot for pharmaceutical companies. However, it is not all bad news, there are medications out there that can indirectly help with dissociation.
If you came to a doctor or mental health professional with depressive or anxious symptomology you’re more than likely going to be put onto anti-depressants. The most commonly prescribed and most-side-effect-free being SSRIs. These Serotonin Specific Reuptake Inhibitors provide individuals with a much needed relief from their most intense symptoms.
SSRIs won’t influence your mood instantly, as they take a number of weeks to take effect, but for many they provide a much needed lifeline. For those that experience dissociation as a result of environmental or personal stress such as PTSD, BD, BPD, or anxiety disorders such as OCD, these medications can significantly reduce negative symptoms. As we’ve discussed, dissociation can occur when an individual becomes overwhelmed so these SSRIs can help prevent this from occurring and by extension reduce instances of dissociation or by the very least reduce the severity of episodes.
Therapies
NHS options
There are multiple therapies available to individuals with mental health concerns. Though, the focus is generally on dealing with anxiety and depression. Dissociation is something less familiar to most in the industry so it’s important to find someone that knows what they’re talking about.
In order to find a therapist that knows their stuff it’s worth consulting with your GP or health care provider to see if you can work out the best option available to you. A good rule of thumb to remember is that – generally – trauma centres will have more knowledge and expertise on dissociation than the average therapist. So it may be worth looking there for options and even worth contacting them to discuss it with them before you request a referral.
Through the NHS you can fairly easily be assigned a therapist, but you may have to wait a while due to unfortunately long waiting lists. However, it’s important to find the right therapist, try not to settle if you feel your therapist isn’t the best fit for the job. You’re allowed to not get on with a therapist, you can request a change.
Private options
If you can afford it, and not all of us can, it may be worth seeking a private counsellor or therapist that specializes in dissociative disorders. While it can be pricey, you get the benefit of freedom of choice. You can identify therapists near you using the counselling directory, which allows you to include specific areas of expertise. What’s more, many therapists are happy to discuss their skills and knowledge before you start treatment so it’s worth emailing a brief summary of your situation, symptoms and goals, and asking them if they think they could help.
The downsides of this of course, are the costs. Dissociative disorders can be hard to shake, so fees can stack up over time. What’s more you may have to relay some information to your GP or health care provider from your therapist if you require medication or specific referrals. They can communicate but when it is NHS-NHS inhouse it can be easier for the client as they are not stuck in the the go-between role.
Specialist dissociation clinics
If you have severe dissociative symptoms you do have the option of going to see a specialist. In the UK there are currently three clinics set up that specialize in dissociation. These are, The Pottergate Centre, The Clinic for Dissociative Studies, and The CTAD Clinic. Each other these specialise in dissociation and offer the best and most informed treatment options.
Of course, the downsides of these are that they’re incredibly hard to get referred to. The Pottergate Centre is open to private treatment but if you’re looking for an assessment this will cost you at a minimum £500 and more likely over £1000. If you’re trying to get a referral through the NHS you will be required to jump through a lot of hoops.
It is likely you will be told that, because these clinics exist outside of your clinical group (your local NHS trust) you will need to be referred by secondary care and display tangible reasons for why the care provided locally is not sufficient.
This will require you getting an assessment from a psychiatrist, the waiting lists for which are…lengthy. For context, I told my GP I wanted to be referred to one of these clinics in August 2020 and so far I have spoken to a psychiatrist for 15 minutes and given another appointment in three months time. During this whole time I have been fighting to get this referral but without any luck.
I’m not saying it’s impossible, but it won’t be a walk in the park.
For the next instalment of support, take a look at our self-help resources.
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Dissociation – causes and mechanisms
Disclaimer: this is not meant as a substitute for expert advice, and help from a professional is the safest way to find answers for your concerns.
Trigger warning: reference to trauma and abuse.
Causes of dissociation
It is the widely held belief that dissociation is caused by significant trauma. Now, what is significant can vary from person to person. Contrary to common held belief there is no universal yard stick for what is and is not a traumatic experience.
A lot of research has gone into understanding trauma, but efforts on defining what constitutes a traumatic event has been ultimately abandoned. Commonalities of traumatic events such as hostility and threat are accepted but a more nuanced understanding recognises that what constitutes a trauma is an individual matter.
Many like to view trauma as an external matter, what has happened to you. It is more accurate to view trauma as internal, what you felt as events took place. This understanding far better explains the apparent variation in trauma responses from person to person.
What traumatizes one person may not traumatize another, even if the event or events they experienced were the same or similar. A multitude of personal and situational factors influence an individual’s relationship to a potentially traumatic event.
With such variation it stands to reason why there are so many disorders associated with dissociation and trauma. For many individuals, dissociation is the brains attempt and protecting you. But how does this occur?
Mechanisms of dissociation
It is commonly understood that dissociation occurs more frequently in people that have a pre-existing inclination to imagine. Yes, to imagine or day dream allows us to exist in alternate realities. Linking back to the first article in this series, many of us dissociate when we watch TV or a movie. We become emotionally engaged and moved by what we are viewing even though we know it to be fictional or staged.
This ability for dissociative states to elicit emotion is also seen in reverse. Individuals with the ability to imagine that find themselves in hostile or unsafe environments can subconsciously or consciously escape from this unpleasant environment by way of their imagination.
Escaping an environment by way of dissociation is frequently seen in children from abusive homes. Like we can escape to a dissociative state of joy or sadness when we watch TV we can also escape negative emotions in our real environment and ‘switch’ to a safer imagined or dissociated environment to protect ourselves when we become overwhelmed. This explanation is used to justify why dissociation occur in adults.
A defence mechanism out of control
Dissociation offers us an escape from negative emotions we cannot do anything about. As children have little autonomy or power in our society it is theorized dissociation is frequently used as an escape because they have no tangible control to remove themselves from the environment.
This route of escape can become a learned behaviour. Meaning that adults can experience dissociation when they become overwhelmed. This can explain why people often experience dissociation as part of an anxiety or depressive disorder. The extreme emotions are too much to handle and the brain switches to a dissociative state as a form of protection.
Issues occur as dissociation is in essence avoidance of the consciousness, making it very hard to function while dissociated. Deficits in memory, knowledge, attention and perception are all altered during dissociative states, making it hard to meet any of the demands of every day life. Not to mention, the experience of dissociation can be unnerving.
For many people, their trauma or previous dissociative experiences may be alien to them, pushed to the back of their mind in a dissociative haze. Meaning that each and every time can feel as unfamiliar and bizarre as the first. Unsurprisingly this can provoke anxiety in people, which can further drive them onto a path of dissociation as they question what is wrong and why their thoughts feel so alien to them.
For people experiencing dissociation there are tips and techniques to help manage the experience. These techniques may not 100% remove you from the dissociative state, but they can provide a sense of routine and control for those of us that struggle with the uncontrollable nature of dissociation.
Now we’ve discussed dissociations occurrence in every day life as well as it’s relative none-existence within my undergrad it’s time to look into how it is categorized.
Diagnosis or experience – the slight paradox of dissociation
Dissociation is understood in terms of diagnosis and dissociative type. Yet these types and diagnoses vary and overlap wildly. For instance, there are two types of dissociation known as depersonalization and derealization. The former involves a distinct feeling of being detached from ones self. Whereas derealization involves the distinct feeling of being dethatched from ones surroundings.
This detachment is described as a feeling of separation, distance, and the feeling that things or oneself are not real or fake. It is this detachment that makes dissociation so hard to pin-down. By their nature all dissociative states involve a detachment that make the perception and experience of the state hard to remember and describe. This is a unique occurrence as the individual is dissociated from the very senses they use to describe every other lived experience.
In the case of depersonalization/derealization disorder (DP/DR) these two states reoccur as the defining features of the disorder. As such it is known by this name, yet these states are also experienced within plenty of other disorders.
For example, Post Traumatic Stress Disorder (PTSD), Borderline Personality Disorder (BPD), Bipolar Disorder (BD), Dissociative Identity Disorder (DID) and psychosis are all closely linked with dissociation.
Yet all of these disorders have elements that make them distinctly different, despite sharing the same dissociative states.
What complicates things further is the matter of identity and dissociation. Common feelings for dissociation-plagued individuals is that of a disconnection from themselves and their identity. Yet, in more extreme cases, in what is considered the most extreme dissociative disorder a person’s identity is not only dissociated but altered.
Dissociative Identity Disorder (DID) is better but inaccurately known as Multiple Personality Disorder. This involves the fragmentation of a personality into distinct personality states separated by so-called dissociative barriers.
These barriers keep these distinct personalities – mostly – separate. For example, many of these personality states (known in the community as ‘alters’ for alternative personality states) cannot recall events experienced when another was ‘fronting’ (in control of the body). This ‘dissociative amnesia’ is integral to the memory problems reported by people that experience dissociative symptoms.
Yet, this amnesia can occur in varying forms. Either between alters, as seen in DID. Or for times during a dissociative episode. This is characterized by an ongoing and reoccurring loss of memory for these times, known as time-loss or black-outs.
On top of this, it is reported that some individuals do not knowingly experience dissociation until repressed memories emerge from an event that their brain had locked away and hidden from them.
This adds additional complexity to matters as you have an almost impossible to pin down mental state that can influence your memory of past and present events while also influencing your personality. As such, people that experience dissociation often have trouble finding the right diagnosis as dissociation exists on multiple planes. The type, severity, trigger and related disorder all impact an individuals understanding of their dissociative experience.
With all these variables, trying to find support for dissociation is all too difficult, with many health care providers ill-equipped for such matters. Making finding the right diagnosis next to impossible.
What we are yet to discuss is, why does dissociation occur? What self-help tips can you carry out daily?
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