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DIY therapy

Distraction therapy, or ‘shut up and deal’

Last week, a reader called Tom wrote in with this story:

I am finally coming out the other side of a pretty deep existential crisis (possibly a result of drug use) and I am seeing the colour flood back into my life. I have just turned 29. The last 5 years have been pretty bleak and filled with crippling anxiety. Everything I once believed and valued seemed to be lies and the world felt hollow. I then began looking for the truth.

The deeper I looked into philosophy, Buddhism, meditation, health and fitness etc the more questions and uncertainty I created for myself. This ramped up my motivation to find the answers.  The more I looked, the more uncertainty I created, and the more I needed to look. During this period my anxiety became crippling.

how_the_frisbee_took_flightFortunately I was able to realize what was going on and pull myself out of this cycle. I decided for a period that I would cut everything out of my life that caused uncertainty. This included reading or listening to any self help, philosophical, health and fitness etc article or podcast. I focused on filling my days with play, eg frisbee, non-fiction books, comedy, eventually friends. Within two weeks to a month, I felt like a completely different person.

I think there is a tendency for thinkers/sensitive types, whatever you want to call us, to over-think and intellectualise depression. I think in hindsight, if I had just ridden out the depression, I would have fallen back into life fairly quickly. However, my need to find answers lead me down a rabbit hole of depression and anxiety.

I will still have questions because that is my nature. However, I now understand the importance of diverting my attention and hope I am now better able to ask whether a particular line of intrigue is helpful or unhelpful to my quality of life.

I like Tom’s advice. Sometimes, in the darkness, we need to give our minds a rest, and find a distraction. Games are good for that. It reminds me of Billy Wilder’s film, The Apartment. Shirley Maclaine’s character has tried to kill herself with an overdose. Jack Lemmon’s character finds her, resuscitates her, and then tries to keep her awake and busy by playing cards with her. When she asks him what’s the point in life, he replies: ‘shut up and deal’ – a line she repeats to him at the end of the film, when she has recovered and they’re in love.

ApartmentMac58598257

One of the few philosophers who understood our need for distractions amid the existential confusion was Blaise Pascal, the 17th century French philosopher and mathematician. He’s a fascinating figure – he was one of the leading mathematicians of his age, he almost died in a riding accident, and then had a sort of near-death experience (known as his ‘nuit de feu’ or ‘night of fire’), after which he became a religious philosopher. But he’s fascinating even if you’re not theist –  he’s really the first existentialist philosopher, in that he has an acute sense of the mystery of existence and the absurdity of human endeavour.

His Pensees, or ‘thoughts’, are a collection of brief meditations on existence. Here’s one of them:

449407The only good thing for men is to be diverted from thinking of what they are, either by some occupation which takes their mind off it, or by some novel and agreeable passion which keeps them busy, like gambling, hunting, some absorbing show, in short what is called diversion.

That is why gaming and feminine society, war and high office are so popular. It is not that they really bring happiness…What people want is not the easy peaceful life that allows us to think about our condition, but the agitation that takes our mind off it and diverts us.

That is why this man, who lost his only son a few months ago and was so troubled and oppressed this morning by lawsuits and quarrels, is not thinking about it any more. Do not be surprised: he is concengrating all his attention on which way the boar will go that his dogs have been so hotly pursuing for the past six hours. That is all he needs. However sad a man may be, if you can persuade him to take up some diversion he will be happy while it lasts….Without diversion there is no joy, with diversion there is no sadness.

Now, Pascal is being somewhat hyperbolic here. His ultimate hope is that we will make a leap of faith beyond boredom and diversion and put our trust in the Christian God. Personally, I believe in the Socratic approach – I think we can learn to discover and challenge the core negative beliefs underlying our suffering. But we can’t do that all the time. Sometimes we just need a break from our ruminations.

There is even a type of therapy built around just this insight, called ‘Distraction Therapy’. Therapists have experimented with using different forms of distraction to take patients’ mind off their physical pain, such as games, videos and music. One experiment projected nature sounds and images into hospital rooms when patients were receiving a painful bronchoscopy. The ‘significantly reduced pain’ in the patients, apparently.

Schirn_Presse_Glam_Karl_Stoecker_Brian_Eno
You won’t feel a thing

Many hospitals now use distraction therapy, like Chelsea and Westminster, which is teaming up with the musician Brian Eno to design ambient light and sound installations to take patients’ minds off the pain. Imagine Brian Eno jumping into the operating theatre, in full glam regalia. That would be distracting.

So the next time you have the blues, you could go to a psychodynamic therapist, lie down, and really pick that scab. Or you could try the Billy Wilder approach: shut up and deal.

Five years of IAPT (Improving Access for Psychological Therapies)

It’s been five years since the launch of the government’s flagship mental health programme, Improving Access for Psychological Therapies (IAPT).

IAPT is the biggest expansion of mental health services anywhere in the world, ever. It has already trained 4,000 new therapists in Cognitive Behavioural Therapy, and 2,000 more therapists are being trained. It’s doubled the NHS spend on mental health services (from 0.3% to 0.6% of the NHS annual budget), and is on course to treat 900,000 people for depression and anxiety in England every year, many of whom would never have had access to therapy in the private sector. The recovery rate for people requiring two or more sessions of treatment is approaching 45%, with others making improvements even if they remain depressed by clinical standards. That is a lot of human suffering healed, though still only 10-15% of those afflicted by depression and anxiety.

It is also, by the by, been five years since I started blogging.  Five years ago, I became fascinated by the direct link between Cognitive Behavioural Therapy and ancient Greek philosophy, and also by how governments were beginning to ‘roll out’ CBT on a mass scale, in the NHS, in schools, in the US Army and elsewhere. It seemed to me an interesting moment in the history of politics, philosophy and psychology. I started the blog, which back then was called The Politics of Well-Being, in February 2008, and I’ve really enjoyed it. For a prickly Stoic like me, it’s allowed me to be the master of my own fate, not dependent on the whims of commissioning editors, able to explore what interests me at the length I want.

I’m now researching a long article on the first five years of IAPT, which hopefully a magazine will publish. This week I interviewed David Clark, the CBT psychologist who masterminded IAPT, as well as several other therapists and service-users, and next week hopefully I’ll interview Richard Layard, the economist who made the economic case for IAPT to the Labour government in 2006. IAPT only arose, by the by, because Clark and Layard happened to meet when they were both made fellows of the British Academy in 2003. They met during the tea break, and Layard said he was writing a book on happiness and was interested in mental health. Clark told him a bit about CBT, and the rest, as they say, is history.

David Clark, left, having some more tea

Here are five interesting things I’ve learnt so far about IAPT:

1) IAPT is the prime example of psychotherapy in the age of big data

Back in the early 20th century, the evidence for psychotherapy consisted of therapists’ personal case histories, anecdotal evidence like Freud’s Anna O or Wolfman cases. These were interesting to read (who doesn’t love a good story) but they also turned out to be misleading and not very scientific (some of Freud’s patients didn’t recover, like he said they did). Today, psychotherapy is embracing the era of big data, and IAPT is the prime example of that. Service-users fill out feedback forms before each session, which are used to assess how well the treatment is working. These forms are then collated to assess how well the programme is working at the national level too.

So far, the data from IAPT has been fairly rudimentary, only really looking at recovery rates. But as of next month, the data sent through will be much richer, taking account of what conditions patients have, what treatment they received, what ethnicity and demographic they are, which region they’re in, and so on. All of this will be available to the public through the NHS’ information centre, which will which therapies have worked well for which conditions, and where the service is failing to reach people, in particular regions, demographics or ethnicities. There are already signs, for example, that IAPT is not sufficiently reaching the millions of people who suffer from social anxiety – so this group may need to be encouraged to self-refer for services.

2) IAPT needs improving

There is a risk that IAPT will suffer from ‘mission creep’ and end up being allocated serious cases it was not designed to treat. It’s designed for the treatment of common mental disorders like depression and anxiety. Unfortunately, in some local authorities, commissioning boards have cut funding for other types of psychotherapy which are used for more serious conditions, so IAPT services are now treating patients with, say, bipolar disorder or personality disorders. David Clark says that’s not happening at a national level, but may be happening in some regions (it is).

IAPT also remains controversial in so far as many psychotherapists in non-CBT traditions say it only really provides CBT. This is because the National Institute for Health and Clinical Excellence (NICE) mainly recommended CBT when it reviewed the evidence for psychotherapies for depression and anxiety (it also recommends Interpersonal Therapy, Couples Therapy, Counseling and Behaviour Activation Therapy). But psychodynamic and psychoanalytic therapists say NICE is wrong, and that in fact the evidence suggests all talking therapies work roughly as well as each other. They also suggest studies comparing CBT to other treatments are often biased because the researchers have an allegiance to CBT. And, finally, they insist randomised controlled trials aren’t necessarily the best assessment of how therapies work in practice.

These issues remain very contested within psychotherapy. This is unsurprising – IAPT must have arrived like a bomb into the world of private psychotherapeutic practice. Suddenly, there were 4000 new therapists providing therapy for free, many of them with only a year’s training. That was bound to annoy older therapists in the private sector.

Peter Fonagy

There are signs that other forms of therapy are beginning to embrace the IAPT methodology. Several prominent psychoanalysts from the Maudsley Clinic, including Peter Fonagy, are trialling Dynamic Interpersonal Therapy, which is a form of brief psychoanalytic therapy for depression. If the trial is approved by NICE, it might mark an interesting moment of mass Freudian therapy.

3) The NHS’ mental health services are about to become a free market

Just a few years after IAPT created a free national mental health service, the Coalition government’s NHS reforms are about to open it up to competition. Starting this year, Health and Well-Being Boards will be able to commission ‘any qualified provider’ to provide mental health services in their area. That might be the existing IAPT service, or it might be some new organisation competing for tenders.

Well-Being Boards will have to decide how to choose between competing organisations. They could decide to give money to the organisation with the best recovery rates. But that might create what David Clark calls “a skewed incentive” for organisations to only take on easy cases where recovery is much more likely, while turning away any harder cases. It also creates the risk of unscrupulous organisations simply faking their results in order to win NHS contracts. The Department of Health is considering how best to evaluate organisations at the moment – perhaps ‘progress made’ is better than recovery rates, in that it takes account of difficult cases who have made a lot of improvement even if they’re still clinically depressed. Some therapists think outcome measures should also assess actual changes people have made in their lives, rather than simply how they’re feeling.

4) IAPT is being expanded into new areas, and new countries

IAPT is now being rolled out for children and young people, though it appears to be happening on a smaller scale than the adult roll out. It’s also being expanded to treat patients with chronic physical health problems that may be co-morbid with emotional problems, like say cardiovascular disease or chronic pain; or for physical conditions that may be partly psychosomatic, like Irritable Bowel Syndrome. There are also trials underway of IAPT-style services for psychotic illnesses like Bipolar Disorder, Manic Depression and Personality Disorders, often using CBT but also Dialectical Behaviour Therapy. I would be interested to see if CBT might become one tool the NHS uses as it tries to reduce national obesity levels: there is some evidence it’s useful as part of a diet plan.

In terms of other countries, Scotland and Northern Ireland have still yet to put serious investment into mental health services, although their national mental health strategies have suggested they should. Canada’s new national mental health strategy also calls for greater provision of talking therapies. Norway has recently launched an IAPT-style pilot programme, with around 12 IAPT-style centres around the country.

Sweden already has a CBT programme to help people back to work, which hasn’t alas proved very successful. IAPT in the UK has more modest targets for helping people back to work, which so far it’s met – but a new article in the British Journal of Psychiatry suggests that Richard Layard’s original estimate of IAPT’s contribution to QALYs (Quality-adjusted Life Years) was “highly inflated” – so it may not be quite as good economic value as Layard originally argued.

5) There is a role for community arts organisations to work with IAPT services

IAPT services sometimes try to help patients beyond their course of therapy, so that they carry on their recovery and also meet other people working to get better. Sometimes, IAPT services will run post-treatment groups  – for example, some services run mindfulness-CBT groups for people with histories of depression. And sometimes they will connect with local community groups, such as MIND or Re-Think. That includes connecting with community arts groups – Lambeth’s IAPT service, for example, works with local sports organisations, a theatre group called Kindred Minds, an African culture group called Tree of Life, a debating club, even a circus-trapeze training group, as well as with several peer-led recovery groups. These groups have their own funding sources, by the way, they’re not funded by IAPT.

Some local authorities are also developing Recovery Colleges, which take a more educative approach to mental health recovery, treating people as students learning how to take care of themselves. I’m teaching a workshop in ancient philosophy at one such Recovery College next month, and I think there’s a lot of room for arts and humanities academics to connect with IAPT services or Recovery Colleges for their own expertise, whether that’s in art history, drama, history, literature, philosophy or other disciplines.

One therapist I interviewed, Nick McNulty from Lambeth’s IAPT centre, said he’d just met a client who was interested in Stoic philosophy, and wanted more of a values-based approach to mental health recovery. IAPT’s job is not to tell people what the good life is, it’s to help them through crises and to get them to a position where they can begin to seek the good life for themselves, according to their own definition of it. I think at that stage, after IAPT, there is potentially a role for practical philosophy, if it offered a broader ethical context for some of the CBT skills that people have recently learned. However, it would obviously need to avoid being dogmatic or preachy, helping people explore various different models of the good life without imposing one onto them.

In general, IAPT strikes me as an educational project as much as it is a health programme. A lot of what it provides is ‘psycho-education’, or ‘guided self-help’, trying to teach people to learn how to take care of themselves, as Socrates tried to do, and become ‘doctors to themselves’ as Cicero put it. NICE clearly sees the benefits of self-help, which is a big validation for people like me who believe that self-help isn’t a load of junk, although clearly the relationship with a therapist is very important for some people too. By providing a ‘stepped care’ approach, IAPT tries to help both people like me, who are interested in learning how to take care of ourselves, and other people who are really seeking a relationship of care.

We, as users of the service, need to learn how to ask for what we want – how to self-refer for talking therapy even if our GP wants us to take Prozac, how to ask to step up to a higher level of care if guided self-help isn’t enough, how to ask for specific types of therapy, and also how to ask how to change therapist if we don’t have a rapport with the one allocated to us. We need to learn how to take care of ourselves and each other, not entirely relying on the NHS to do the work for us. And, finally, we need to learn how to support the young service politically, if it’s something we think is worth keeping.

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In other news:

The Atlantic magazine considers the ‘touch-screen generation’ – what impact will their immersion in digital technology have on children’s development?

The New Yorker reports on a new text-analysis study of the history of hip-hop, charting such nuggets as the first appearance of the word ‘bling’ and the number of uses of ‘Nike’ versus ‘Adidas’.

Are the French ‘taught to be gloomy’?

In the US, President Obama has launched an ambitious new project to make pre-school childcare universal, at the cost of $10 billion a year. This blog post looks at James Heckman, the psychologist whose work on childcare and early interventions has been an inspiration for Obama’s policy.

Polly Toynbee penned this excellent crie de couer over a new round of benefit cuts set to be introduced on Easter Monday, including slashing the budget for financial advice from the Citizens Advice Bureau from £22 million to £3 million.

Also in the Guardian, a report on the Care Quality Commission, which has found a fifth of hospitals fail to treat the elderly with the dignity they deserve.

In the London Review of Books, John Lanchester gets excited about fantasy fiction, and the new series of Game of Thrones (spoiler alert – he gives away some of the plot).

The BBC has a new 30-part series on the History of Noise, presented by David Hendy of the University of Sussex. The TLS, meanwhile, reviews a new book on the history of silence in Christianity.

Finally, I recently finished Alex Ross’s excellent history of 20th century classical music, The Rest is Noise. There was also a BBC TV series to accompany it, called The Sound and the Fury, which is available on BBC Four’s wonderful archive of TV on modern classical music. Here is a clip from it, of Messiaen’s Quartet for the End of Time, which he composed when a POW in Stalag VIII concentration camp. He and three other prisoners performed it in the camp, in the rain, on January 15, 1941.

See you next week,

Jules

The re-birth of Stoicism

We’re coming to the end of Stoic Week. People all over the world have been practicing Stoic exercises and reflecting on Stoic ideas this week, thanks to this wonderful initiative, launched by a young post-grad at Exeter University called Patrick Ussher. Some of Patrick’s students have been sharing their thoughts on the exercises via YouTube. This is what studying philosophy at university should be like – experimenting, practicing, reflecting, sharing.

Of course, hardcore Stoics might say we shouldn’t share the fruits of our practice – we should ‘tell no one’, as Epictetus puts it. But I actually think it’s good to share your practice with other Stoics, as long as you’re not showing off. My own rather humble practice this week has been to knock off the booze for a week. Small steps, I know – but I’ve stuck to it out of the thought that it’s not just me practicing – there are lots of us out there, committing to this week. We’re stronger when bounded together.

It’s also been a good opportunity for people to say how they’ve been helped by Stoic writings in their life. People like Dorothea from Vancouver, who this week tweeted:

I went through an extremely difficult time a few years ago and one of the things that helped was Stoicism. Reading Epictetus was like having a wise friend sit with me in a situation that no one, not my friends or family, could understand.

Right on Dorothea! As I discovered when I was writing my book, there are loads of people out there who have been really helped by Stoic writings through difficult times, for whom Stoicism means a great deal to them. Everyone from Wen Jiabao, the prime minister of China, who says he has read Marcus Aurelius’ Meditations over 100 times, to Elle MacPherson, who named her son Aurelius, to Tom Wolfe, who got into Stoicism a decade ago and is still very into it today (he said he’d write a quote for my book – Tom, if you’re reading this, get in touch…I need your help!)

So here’s my question: is Stoicism really enjoying a revival or a rebirth now? Or is that a gross exaggeration? And if there is a revival happening, where could it go?

I think there is something of a revival taking place, in large part thanks to Albert Ellis and Cognitive Behavioural Therapy, but also thanks to the revival of the idea of philosophy as a therapy or way of life. And, finally, I think Stoicism fits quite well with our increasingly crisis-prone era. I’ll go through these three factors, quickly.

Stoicism and CBT

The biggest driver for the revival of Stoicism is its direct connection to Cognitive Behavioural Therapy. When I discovered this link, back in 2007, I couldn’t understand why it wasn’t more written about. I found it amazing that ideas and techniques from ancient Greek philosophy should be at the heart of western psychotherapy (2007 was the year the British government started putting hundreds of millions of pounds into CBT and also the year CBT started to be taught in British schools via the Penn Resilience Programme). And no one was writing about it. So I started to write about it. In 2009 I came across Donald Robertson, a cognitive therapist and scholar, who was also writing about it. I interviewed him for my first ever YouTube video.  Check it out and enjoy the trippy special effect at the end illustrating the Stoic idea of the ‘view from above’.

In 2010, Donald published the first ever book properly exploring the relationship between CBT and ancient philosophy. It’s a great book and helped me a lot.

Sam Sullivan, the Stoic mayor of Vancouver, accepting the Olympic flag in Turin

Then, this year, I brought out my book about ancient philosophies and CBT (not just Stoicism, also Epicureanism, Cynicism, Platonism, Scepticism etc),which featured interviews with lots of modern Stoics – Major Thomas Jarrett, who teaches Stoic warrior resilience in the US Army; Chris Brennan, who teaches Stoic resilience in the US Fire Service; Jesse Caban, who is a Stoic in the Chicago police force; Michael Perry, a Stoic Green Beret; Sam Sullivan, the Stoic former mayor of Vancouver, and others. I was helped a lot by the NewStoa community set up by Erik Wiegardt, which helped me get in touch with all these modern Stoics.

Since the book has come out, I’ve done a lot of talks about the connection between Stoicism and CBT, like this one on Radio 4. The book got a nice review in The Psychologist this week (behind a pay-wall alas), and I hope it has encouraged more of a dialogue between psychology and philosophy. The same month my book came out, Oliver Burkeman of the Guardian brought out his book, The Antidote, which also interviewed Albert Ellis and made the connection with Stoicism. We were both interviewed in this Guardian Books podcast talking about Stoicism and CBT.

Then, at the end of this year, Christopher Gill in Exeter’s classics department organised a seminar on Stoicism and CBT, which brought together Donald, me, Tim LeBon, a cognitive therapist and philosophical counsellor;  classicist John Sellars; Patrick Ussher, occupational therapist Gill Garratt and others. The Exeter Project has been a great help in making the connection between Stoicism and CBT a bit more explicit and academically credible.

The revival of philosophy as a practical way of life

Secondly, Stoicism has revived in the last few years thanks to a broader revival of ancient philosophy and the idea of philosophy as a way of life. When Alain de Botton brought out the Consolations of Philosophy in 2000, he was widely reviled by academics for dumbing down philosophy. A decade on, however, more and more academic philosophers have come round to the idea that philosophy can and should be an everyday practice, and even a form of self-help. That’s partly through the influence of de Botton and the School of Life network, but also through the work of academic philosophers like Pierre Hadot and Martha Nussbaum, who have pushed forward a more personal and emotional form of philosophy (by emotional, I don’t mean gushing and sentimental, I mean it works on the emotions, it tries to help people flourish). So academia has played its part in the revival, but I’d suggest self-help writers like De Botton, Eckhart Tolle and Tim Ferriss have been key in bringing Stoic ideas to a wider public.

Stoicism is popular in times of crisis

Exeter during Stoic Week

Finally, I think Stoicism is enjoying something of a revival because it fits with our crisis-prone era. It’s a good philosophy for coping with volatile and chaotic times. You wouldn’t expect it to be that popular during an age of affluence, for example  like we were in from 1955 to 1975, although it was popular then among some officers in Vietnam like James Stockdale. But you would expect it to be popular in times like now, an age of austerity and emergency, when our economies are crashing and our cities are being constantly buffeted by floods and hurricanes. It is appropriate that, in the very week Exeter University hosts ‘Stoic Week’, floods are coursing through the town. Our imagination has become more apocalyptic – whether that be in films like Deep Impact, books like The Road, or TV shows like Derren Brown’s Stoic-inspired Apocalypse. We’ve started to wonder how we’d fare if some of our affluent accoutrements were stripped from us. How would we, poor bare forked animals, cope upon the heath without our lendings?

There has been a growth in nostalgia for the Stoicism of our grandparents – the generation before the baby-boomers, who went through the war with a calm Stoic spirit (or so it seems to us). Hence the popularity of the old war poster, Keep Calm and Carry On. Hence the interest in the history of the ‘stiff upper lip’. Hence the call this week by a Tory MP and GP for a return to the values of ‘post-war Stoic Britain’, when people took care of themselves and didn’t burden the NHS with all their self-indulgent lifestyle illnesses. We are in the midst of an austere reaction to the consumer excesses of the baby-boomers, and Stoicism goes quite well with that reaction. Though of course, the baby-boomers are a part of the Stoic revival too – not least in the increased interest in assisted suicide. The baby-boomers want the freedom to choose their own death, as Seneca put it. If death became the ultimate lifestyle choice, that would be a huge cultural shift, away from Christianity, and back towards Stoicism (the word suicide, by the by, was invented by a 12-century theologian in a tract written against Seneca).

Where could the revival go?

So, there is something of a revival happening. But where could it go?  Well, I think we’re all learning how to take care of ourselves better, learning how to be the ‘doctors to ourselves’ as Cicero put it. I don’t think that necessarily means we’re all going to become card-carrying Stoics, but I do think and hope we’re becoming more intelligent about our emotions and how to heal them, and more DIY about our health in general and how to take care of ourselves.  I suspect and hope that this will involve a continued growth of interest in ancient philosophies – Greek, Buddhist, Taoist, Confucian, Sufi and so on. One of the most encouraging phenomena in this difficult era is the synthesis of ancient wisdom and modern empiricism – the Shamatha project in California is one of the great examples of it. I hope that my psychology colleagues in the Exeter project, Donald Robertson and Tim LeBon, can do more empirical work on Stoic ideas.

However, I personally think Stoicism itself is lacking some things. As Martha Nussbaum told me in this interview, it’s part of an ‘anti-compassion’ tradition. It lacks compassion, is too cold, too uncaring. I remember, on Stoic email lists, when someone has said that something terrible has happened to them, no one would say anything consolatory to them. They would just stiffly quote Epictetus – the philosophical equivalent of a punch on the shoulder. And I would feel like giving that person a hug and saying ‘yes, that’s pretty shit, but you’ll get through it’. The Stoic position of ‘nothing is fucked here, Dude’ seems to me too cold. We’re not Gods, we’re humans. I think we should be careful that the revival of Stoicism does not become too libertarian, part of a backlash against the welfare state. We also need to make clear that Stoicism does not mean repressing your emotions. Far from it. Nor should it mean coping entirely on your own with difficulties. Stoicism today should mean taking care of each other, not just of yourself.

A key contemporary challenge is that Stoicism lacks a proper sense of community, and if you look at modern attempts at building a Stoic community – the NewStoa group, or the Stoic Yahoo list, I don’t think either of them have been that successful, because they are too logical and not caring enough, so they end up with men bickering over terminology, rather than humans caring for each other.

Nonetheless, let me end on a positive note: the Stoics taught us some amazing stuff about how to transform the emotions, and how to take care of ourselves.  It’s just that, in my opinion, those lessons are best taught alongside other philosophies of the good life. Again, I come back to the same point I often ask myself: can we build philosophical communities that are genuinely caring, compassionate, nurturing?

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Tobias Jones

Next week, hopefully, I am off to meet a hero of mine, Tobias Jones, who runs a community like that in Dorset, for recovering addicts. Tobias wrote a fantastic book called Utopian Dreams, asking the same sort of communitarian questions that we are discussing. Do read it, it’s brilliant. I’ll hopefully be interviewing Tobias for a new podcast I’m putting together for Aeon magazine. Should be a really fun, exciting venture. Here’s a piece Tobias wrote for Aeon on his commune.

Next Tuesday, come to hear Angie Hobbs talking about the future of philosophy at the London Philosophy Club, at the Bethnal Green Working Men’s Club. She’s a fascinating speaker, and it’s a brilliant venue.

This week, my friend Sara Northey arranged a brilliant LPC evening, with a talk by clinical psychologist Peter Kinderman. Peter put forward a radical and (in my opinion) quite persuasive argument about why most psychiatric diagnoses and unscientific and deeply unhelpful, and we should instead switch to a problem-based analysis of emotional problems. Here’s an interesting write-up of the event by Natalie Banner, a philosopher at KCL’s Centre for Humanities and Health.

The accuracy of social psychology studies is under the microscope, after Dutch psychologist Diederik Stapel was found to have faked some of his studies, without being found out by the social psychology journals in which he published his results. A new report condemns not just him but the whole field of social psychology for its ‘sloppy’ research culture.

This New York Times article (forwarded to me by Matt Bishop) has been widely discussed in among therapists – it says business is declining for therapists, as people increasingly want problem-fixing rather than long-term counseling (Peter Kinderman would approve!). So therapists are having to hustle to get more business, which means putting more effort into branding. I’ve often thought that therapists should, at the least, put a video of themselves on their website explaining who they are and what sort of problems they can help with (in fact I considered setting up a business to help therapists do this).

Talking of therapists making videos, here is a video of Windy Dryden, a leading cognitive therapist in the UK, doing a song-and-dance version of CBT to the tune of ‘Moves Like Jagger’. Bizarre! Though it did make me think – perhaps I could put together some CBT songs..

Tomorrow, I’m speaking at this conference in Amsterdam along with Alain de Botton, Philippa Perry, Roman Krznaric, Stine Jensen and others. Still a few tickets left I think, if you’re in Holland and fancy coming along. My Dutch publisher, Regine, has been really amazing in promoting my book in Holland, and it’s got into the top 100. She is a force of nature.

The book is now out in Germany. One of my readers, Julia Kalmund, has arranged for me to come and speak at Munich University.  Nice one Julia! She wins this week’s awesomeness prize. It’s also just come out in Turkey….any Turkish readers of the newsletter??

A guy called Ahmad from Pakistan got in touch with the London Philosophy Club this week. He wrote:

Philosophy should be promoted in every community because it is usually above any caste and creed…Unfortunately there are not favorable conditions in Pakistan for such activity, London has a certain attitude for this,as it provided shelter to Volatire and Marx when Europe wasn’t ready to tolerate them…I want to become an active member of London Philosophy Club and to try to go to London for studies,it would be a pleasure for me to remain in the company of such creative social minds.

I find that great and inspiring – that’s why I love philosophy, because it connects us beyond any caste or creed. Good luck to you, Ahmad. Meanwhile the British government has succeeded in lowering immigration…by putting off foreign students from studying here. Doh!

See you next week,

Jules

PS, if you fancy some weekend reading, download my report on Grassroots Philosophy

The Philosophy Hub is go!

Photo of London Philosophy Club by Greg Funnell

Big day today. I’ve finally finished my report on grassroots philosophy groups, which you can download here: Connected Communities- Philosophical Communities.

It’s taken me eight months to research and write, and has made me realise quite how vibrant and diverse the world of grassroots philosophy is. There are 850 philosophy groups just on meetup.com alone, with a combined membership of 125,000. I’ve found philosophy groups all over the world, from Fukushima to Rio de Janeiro. And I’ve learnt how grassroots philosophy often connects academia to society, with many academics happy to give their time for free to encourage the love of wisdom.

Until now, the broader grassroots philosophy movement has not had a dedicated website, so today I’m also launching a website called The Philosophy Hub, dedicated to ‘building a global thinking culture’. It has a map where people will be able to find their local philosophy group or upload their own group – do please add your own group. Group organisers can then log in whenever they want and add details of upcoming events to their page. There’s also a history of philosophy groups on the site, going back to ancient Greece, which comes from my report (it focuses mainly on the history of western philosophy groups, and I want now to learn more about grassroots philosophy in other cultures). The site also has lots of other resources for people interested in researching grassroots philosophy, or who want to set up and run a club. Finally, there’s a blog which will focus on grassroots philosophy. It launches with an interview with John Mitchinson, one of the founders of the quiz show QI, who talks about the QI Club – the progenitor of the Idler Academy and the School of Life. He’s a fascinating, likeable person.

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The rise of grassroots philosophy is an encouraging phenomenon in a period of sudden and brutal change for higher education in the UK. This year, the coalition government slashed its block grant to universities by £3 billion, asking universities to finance themselves through higher tuition fees, which have risen from an average of £3,000 a year to roughly £8,000 a year.  Undergraduates are expected to pay these higher fees through loans from the Student Loan Company. The government’s hope is that this will increase consumer choice and competition among universities – this week, the government began granting university status to private education providers. Slashing the block grant and asking students to pay more was also, of course, intended to help reduce the budget deficit.

The anti-tuition student protest in London this week

No one knows quite what higher education will look like once the dust has settled. The reforms are rapid and bewildering, and often one part of the government seems to be acting against another part: the Home Office, for example, tried to crack down on the number of foreign students at English universities, just when universities desperately need their money. And already there are unintended consequences of the reforms. Andrew McGettigan, one of the organisers of the Big Ideas philosophy club in London, showed in an excellent report for the Intergenerational Foundation that the government had effectively tried to pull an accounting trick by switching funding from a block grant to state-provided student loans.

As Andrew shows, the trick may have reduced the deficit, but unfortunately (and apparently unexpectedly for the Business, Innovation and Skills department) all those new loans have also pushed up the Consumer Price Index (CPI) by about 0.6%. The CPI is used to calculate state pensions and other benefits, so a rise in the CPI of 0.6% means a loss to the public purse of around £2.2 billion annually. Vince Cable was asked about this unexpected consequence at a recent BIS parliamentary committee. He replied: ‘I don’t follow the logic’. This despite repeated warnings from the Office of National Statistics and the Higher Education Policy Institute of the effect of the loan-boom on inflation.

There could be more problems for the tax-payer further down the river. The Student Loan Company is set to lend around £10 billion annually, via income-dependent loans which will be paid back once graduates earn over £21K a year. But the government may have underestimated how much students borrow, while overestimating how much earnings will rise in the next decade, or how much interest rates could rise. If graduates take longer than expected to pay back the loans, or can’t pay them back, it could end up costing the tax-payer more rather than less. As McGettigan notes, students today may end up paying for their university education twice, once today and again as tax-payers in 20 years.

There are attempts to slow or oppose the reforms. This week, 10,000 students marched against tuition fees, but their demands were somewhat broad (from saving the NHS to freeing Gaza) and their alternative to student loan-financing was simply ‘tax the rich’. That may be some of the answer but it’s not all of it. Meanwhile, some senior academics have created the Council for the Defence of British Universities, which aims at resisting the commercialisation of higher education. But the CDBU risks looking like grumpy old academics trying to protect the status quo. They follow Stefan Collini’s argument that students don’t know what’s good for them, therefore putting them in control of the money is like letting children run a candy store. The CDBU worries that students will all choose subjects that give good salaries, like business and management studies, while neglecting more liberal subjects like history or philosophy (both of which have declined in popularity in the last few years, unlike almost every other subject). And the CDBU dislikes the government’s emphasis on quantifying the quality and ‘impact’ of research. Academics should, Collini argues, be free to pursue research for its own sake, without any regard to social or economic benefit.

To which I’d reply, yes, to an extent. But I think academics of my generation (if I can call myself an academic, despite my lack of a PhD) are far more comfortable with the importance of ‘impact’. We’re impatient with older academics who seem to see any attempt at community engagement as a distraction, who congratulate themselves on their ignorance of social media. We see the decline of the tradition of university extension as a great tragedy, an abandonment of the public role of the intelligentsia in society. In other words, I agree much more with the Stefan Collini who wrote Absent Minds, Collini’s 2006 book in which he bewailed the disappearance of public intellectuals in British culture. Nowadays we only seem to hear from academics when they’re complaining about the loss of their own privileges. Sixty years ago, Beveridge, who as a young man worked at Toynbee Hall, designed the welfare state while serving as Master of University College, Oxford. Bring back the Beveridge model of academics!

My generation also think universities should listen to the needs and desires of their undergraduates, and should do a lot more to provide well-being and counseling services on campus.  And I think we’re prepared to be creative and innovative in how subjects are taught at university. At Queen Mary, University of London, for example, we alas don’t have a philosophy department, so next year we’re launching a free practical philosophy course which any undergraduate can take, whatever their subject.  I’d also like to make the course available to the local community. And I think we can improve the university experience, so that one doesn’t simply study ‘management studies’ or ‘computer sciences’, but instead can learn from both the humanities, and the sciences, and learn vocational and life skills, to get a genuinely rounded education – closer to the American model, in other words, where students can study several subjects and get a broader education.

There is a lot to dislike about the government’s higher education reforms. They seem to be the sort of omnishambles we have come to expect. But resistance to austerity measures can’t simply be about protecting the status quo of the past. It needs to be a progressive vision, a positive vision, a vision of making things better.

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Jesus, I sound like Tony Blair. Cue Brian Cox on the synth. In the meantime, here are some young academics with vision.

First, meet Patrick Ussher at Exeter University’s classics department (that’s him on the right with the laptop open, at a recent Exeter seminar on Stoicism and CBT). Patrick wrote his dissertation on Stoicism and Buddhism, and is now doing a PhD on Marcus Aurelius. I met him at the seminar shown on the right. Next week, he’s launching an initiative called Live Like A Stoic For A Week. He’s produced a booklet where people can find practical Stoic exercises for life. Pick one, try it out for a week, and record the results through one of the well-being questionnaires provided by the psychologists working on the project (Tim LeBon and Donald Robertson). Me, I’m going to give up booze for a week. How about you? The week is being covered by the Guardian and has attracted lots of interest. Go Patrick!

Ben Irvine of the Cambridge Well-Being Institute

On Wednesday, meanwhile, I traveled to Cambridge University to talk at a seminar on the politics of well-being organised by Tom Barker, an inspiring young PhD who is researching meaningful work. I spoke at the seminar alongside Ben Irvine, who is coordinator of the Well-Being Institute at Cambridge (where Felicia Huppert works), the founder of the Journal of Modern Wisdom, and the author of a new book, Einstein and the Art of Mindful Cycling. Ben, like me, passionately believes that intellectuals have a social responsibility to engage with society and communicate their ideas to as wide an audience as possible. I was very impressed with the range and calibre of people working on well-being in Cambridge, and how well the Institute brought people together fromdifferent disciplines (architecture, psychology, philosophy, geography etc).

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This week, the Office of National Statistics published a big report presenting and reflecting on the data on national well-being it has been collecting for a year. The head of the civil service, Sir Jeremy Heywood, called for ministers and civil servants to start using the data to make actual policy decisions, while the previous head of the civil service, Sir Gus O’Donnell (who is now running a well-being programme at the Legatum Institute) said one clear policy recommendation was for the NHS to spend less on physical illnesses and more on mental illnesses.

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The new CEO of Barclays Bank, Antony Jenkins, has (according to the Daily Mail) has “corralled his 125 most senior managers, including former close Diamond associate Rich Ricci, into attending a series of seminars and bonding exercises aimed at instilling ethical values. The executives will then be expected to act as evangelists for the new culture throughout the organisation. During the two days they will be immersed in sessions including history lessons on the bank’s heritage as a Quaker institution. They will also be subjected to ‘360 degree feedback’ on their performance, with people both above and below them in the hierarchy contributing to their bonus assessments. The process is designed to penalise self-serving or unethical behaviour.”

Sounds like the Cultural Revolution. I like the idea of lessons in Quaker values though. What I think would be great would be to combine ethics training courses with stress management / well-being courses – the essence of both resilience and ethics is good character.  I was at a fantastic conference on compassion and empathy today at the Quaker meeting house in London, by the way. The highlight for me was a workshop on Deep Listening by Rosamund Oliver. Good stuff, although she works for Sogyal Rinpoche. I loved his books when I was a teenager, and was gutted to find out he was a sex pest. Anyway, the Deep Listening workshop was brilliant.

Well, I think that’s enough information for one week. My book’s doing good in Holland, by the way, thanks to my amazing publishers, who lined up a lot of interviews and also launched a poster campaign (check it out on the right). They tell me it’s already going for a second printing. It also came out in Germany this week.

See you next week, and hope you like the report and The Philosophy Hub.

Jules

Top ten tips for recovering from mental illness

Here are my top ten tips for recovering from mental illness. Tell me any really good tips I’ve missed out in the comments. They’re not commandments, just what worked for me in recovering from social anxiety and minor depression – feel free to disagree. And although I don’t mention medication, because I personally didn’t use it, I know lots of people find that a helpful part of the recovery process – and an essential one if you suffer from a serious psychotic condition.

1) Know your enemy

If you have a particular condition or group of conditions, research them and know them. Know your enemy: know the kind of negative thoughts and behaviour patterns you might fall into, and watch out for them. Don’t let your condition lie to you or control you. Instead, learn how to manage it, and minimise its control over your life. Go on to support sites and see how the condition affects different people. Go on to reputable health and psychology websites and research what sorts of therapy seem to work well with it, and where you might find those therapies. Learn to be your own doctor. Recognise the thoughts and attitudes that are messing you up and causing you suffering. You’re probably all familiar with the CBT bingo list of cognitive distortions. Get to know your own particular biases, and watch out for them, guard against them.

2) Your thoughts are not ‘you’

If you have a mental illness, the thoughts in your head will sometimes cause you pain. And then some of us will freak out at having those thoughts and being a rotten or weak person. Thoughts are just thoughts. We don’t have to let them bully us or cause us pain. We can choose not to listen to them. We can say to ourselves: ‘I refuse to let those old negative thoughts cause me suffering any more’. When we stop believing in negative thoughts, we take away their power over us. We can raise our negative thoughts and beliefs over us like a God, and hand them a whip to beat us. Or we can choose not to believe them, not to give them power over us. We can free ourselves from the prisons we have constructed for ourselves.

3) We are habitual creatures. Changing habits takes long-term effort

Human personalities are bundles of automatic habits, lit up by a small ray of conscious thought. We can shine that ray onto our habits, think if they’re working for us, and if not, we can change our habits. Our personalities are always changing, all the way through our life. That’s the good news. Neuroscientists call it ‘plasticity’ – our ability to re-wire ourselves. The habits we grew up with are not written in stone for eternity. We can change them. But you have to work hard,  challenging the bad old habits of thought,  challenging the bad old habits of behaviour, facing your fears, and going through some painful moments. It takes energy and effort to change yourself but we can, in fact, change ourselves much more than we typically think. Change is slow – it happens over month and years. But then you look back and see how far you’ve come.

Part of Tip 3 is keeping track of our progress. Our intuitions about whether we’re getting better or not are often wrong. So we need to keep track of our progress more objectively and accurately. Don’t focus on the day-to-day fluctuations, focus on the long-term trend. You win some battles, you lose some battles, but are you winning the war? Keep track of your progress in a journal or on smartphone apps, keep track of your depression levels, for example, or your binge-eating, or how often you get panic attacks, or how often you are getting out to see your friends. Be scientific in your approach to mental health recovery. Keep track of your success in reinforcing good habits while weakening bad ones.

4) Focus on what you can control, while accepting for the time being what you can’t

Be efficient in your energy. Focus your energy on what you can control and change. With the things you can’t immediately change, learn to shrug and say ‘fuck it’. Lots of things will happen to us in life, and we don’t always have a choice over the people we meet or the situations we find ourselves in. But we do have a choice how we respond to them. Likewise, our childhoods are not our ‘fault’. But our adult lives are now our responsibility.

Staying sane and mentally healthy in this world involves recognising the limits of our control. We’re in a big, complex world and we only have limited control over it – over the economy, the weather, the government, other people, our friends, even our own bodies. If we fixate on things beyond our control, we’ll make ourselves feel helpless, angry, paranoid, insecure and disempowered. Instead, we can focus on what we can control, even if it’s only small things. Here’s a nice quote from Albert Ellis, which my housemate just sent me:

The best years of your life are the ones in which you decide your problems are your own. You do not blame them on your mother, the ecology, or the president. You realize that you control your own destiny.

5) Get support

You can’t do it all on your own. You need help and support. This is the fight of your life, and you need a team in your corner. Tell your family what you’re going through. Tell some close friends. Be careful who you confide in though – not everyone you tell will be helpful. If they’re not helpful or sympathetic, go easy on them – they’re probably a bit frightened, or just ignorant. Find a local support group. Find a good therapist. Find a good support site and make contact with the more useful and positive voices on that site. Find stories of people who have come through the condition you are going through – then get in contact with them and ask for advice. And share your successes as well as your setbacks with other people. Celebrate your victories with your team.

6) Let go of the shame

Mental illness is as normal as physical illness. You wouldn’t feel ashamed or mortified if you had flu, for example, or cancer. So why feel ashamed if you have a period of mental illness? A common statistic suggests that 1 in 4 suffer from a mental illness at some point in their lives. but in fact, just about everyone will have at least one period of mental instability in their lives at some point, even if it’s not a diagnosable condition. There is nothing shameful about mental illness. In fact, facing mental illness with dignity and courage is morally laudable – it’s an achievement – particularly if you then use your experience to help other people going through tough times.

7) Think of others, fight for others

Getting over mental illness isn’t just about you – it’s about all the other people struggling with poor mental health. As sufferers from it, we’re in position to become experts, front-line correspondents from the trenches. So keep notes, get informed, share your experience, and if you get out of the labyrinth, go back and help other people get out. Remember how much it hurt, and don’t forget there are people still hurting. Here’s a quote from JD Salinger’s Catcher in the Rye I find inspiring:

Among other things, you’ll find that you’re not the first person who was ever confused and frightened and even sickened by human behavior. You’re by no means alone on that score, you’ll be excited and stimulated to know. Many, many men have been just as troubled morally and spiritually as you are right now. Happily, some of them kept records of their troubles. You’ll learn from them—if you want to. Just as someday, if you have something to offer, someone will learn something from you. It’s a beautiful reciprocal arrangement. And it isn’t education. It’s history. It’s poetry.

And here’s another, from Seneca, that I pinned up on my wall while I was writing Philosophy for Life:

There is no time for playing around. You have been retained as counsel for the unhappy. You have promised to bring help to the shipwrecked, the imprisoned the sick, the needy, to those whose heads are under the poised axe. Where are you deflecting your attention? What are you doing?

8) Take care of your body as well as your mind

We sometimes don’t realise the extent to which our mental health is connected to our physical health. An important part of recovery from mental illness is learning to take care of our bodies too: taking exercise can be crucial to getting better. If nothing else, going for a run or a swim gets rid of some of our nervous mental energy. Exorcise the demons through exercise! Also be careful of what you eat and drink – too much coffee might make you anxious. You might drink a lot in the evening to overcome your inhibitions, but end up making a fool of yourself, and then feeling extra-anxious and paranoid when you’re hungover in the morning. Take care of your body – you need as much energy as possible for the fight. Sleep is also hugely important – try to get to bed at a proper time and get at least seven hours. Try to live on a steady, even keel, however boring that sounds.

9) Don’t romanticise or over-intellectualise your condition

I don’t mean this in a harsh way, like ‘pull up your socks and stop making a fuss’. What I mean is, let go of the drama. Let go of the romantic myth of yourself as a unique eccentric suffering martyr. Let go of the myth of yourself as a unique snowflake, whose sufferings are deliciously interesting and complex. Let that shit go! It’s just another way to hold on suffering – to make love to your disease. I did that for years, then I realised the millions of people suffering from social anxiety had exactly the same thoughts and beliefs as me. Beneath all our drama and intellectual sophistication, our mental illness conditions are often pretty basic, even humiliatingly so (we long to be complex). This is why a lot of clever people would rather spend thousands of pounds on Freudian psychoanalysis – because, even if it doesn’t make them better, it flatters their unique complexity. Let that shit go. Try to define the beliefs or attitudes that cause you suffering as simply, clearly and undramatically as possible.

I also think it can be useful to see the ridiculousness in your situation. Having a mental illness is, often, ridiculous. It puts us in ridiculous situations. If we laugh at that, it means we’re not turning it into a big tragic drama. I like the Woody Allen scene at the end of Hannah and her Sisters about this. Woody’s been trying to find the meaning of life, then he finally finds it, in a cinema watching the Marx Brothers.

10) Enjoy the little moments

I have my reservations about the ‘happiness movement’ and its exclusive focus on happiness as the meaning of life. But they got something right: we can learn to cultivate moments of peace and happiness. That’s not the meaning of life, but it helps, because experiencing mental illness means we’re probably soaked in negative emotions. So we can try to cultivate little moments of positivity along the way. Learn what gives you pleasure – reading a particular author, maybe, or listening to music, or going for a walk, or seeing particular friends, or even tidying up your room. Drop by drop, we can get into the habit of happiness. We can choose not to beat ourselves up, but to let ourselves be happy, here in this moment. Eckhart Tolle may be a weirdo, but he got that right. All we have is this moment. We can take a breath, let go of our worries and regrets for just a second, and enjoy the moment, without putting any demands on it.

And finally, a last quote, from (I think) Winston Churchill: if you’re going through hell, keep going. Don’t give up. You’re in this fight for all of us. And we’re in it too, shoulder-to-shoulder with you.

More tips and stories in my book…